12 JUL 2018

Eu: Future Relationship White Paper

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

I thank you for your comments, Mr Speaker. I welcome the Secretary of State to his post, but I do not think it possible for Members to question him about the White Paper without having had a chance to read it. He said that he will step up planning for a no-deal scenario. Will he commit to publishing the consequences of no deal for individuals, communities and the economy, so that we can all assess what its impact will be?

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

I respect my hon. Friend's views, and I know she takes a close interest in these matters. I seem to remember that under previous Administrations statements and hard-copy documents were received very late, but I have apologised for what happened today, and I will endeavour to ensure that it is not repeated. On her broader point, we have tough choices to make, and the White Paper seeks to reconcile the challenge of ensuring that we leave the customs union, with all the benefits of that and opportunities to be grasped, while also minimising any potential disruption to trade. I will release more details to the House about our no-deal planning in due course.

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11 JUL 2018

The Treasury

Thank you to Robert Jenrick,the Exchequer Secretary to the Treasury for meeting SW Conservative MPs to discuss budget priorities and the Spending Review. There was a long list of issues to discuss including transport infrastructure , funding pay rises for schools, water bill rebates and urgency to settle back pay for sleep-in shifts in social care

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10 JUL 2018

Grammar Schools: Transport

Written Answer

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

To ask the Secretary of State for Education, with reference to the Chancellor's announcement in the 2017 Budget , what the timetable is for the extension of free school transport for children in receipt of free school meals to those travelling to selective schools.

Nick Gibb Minister of State (Education)

The Department is committed to ensuring every child is able to access a good school place, regardless of background. The new Selective Schools Expansion Fund will create more good school places where there is local demand by supporting the expansion of existing good or outstanding selective schools. Those schools that are successful in their application will be expected to undertake activity to encourage more pupils from low-income families to attend and be committed to improving access for disadvantaged pupils.

Children will be eligible for free transport to a selective school if they meet the existing eligibility criteria.

The Department expects more children to become eligible for free home to school transport as a result of new rules on eligibility for free school meals, and will be providing local authorities with additional funding to help them provide this.

The Department is not, however, taking forward proposals to open new selective schools and, not taking forward plans for free transport specifically for children who are eligible for free school meals who attend their nearest selective school.

Where disadvantaged pupils are not eligible for free transport, schools may wish to consider whether it is appropriate to use pupil premium funding to support transport costs for these pupils.

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09 JUL 2018

Stalking Protection Bill

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

It is a pleasure to serve under your chairmanship, Mr Gray. I will start by thanking the many people who have come forward to talk openly about their own harrowing personal experiences at the hands of stalkers—including those who have been bereaved as a result of stalking—and the many organisations that have provided support and expertise: the Suzy Lamplugh Trust, the Gloucestershire stalking support service, Paladin, the Alice Ruggles Trust, Protection Against Stalking and, of course, many members of the police and the police and crime commissioner lead. I am very grateful to all of them for sharing their expertise. I am also grateful to the Minister's Bill team, who have been extraordinarily helpful in providing support.

Clause 1 creates a new civil protective order to protect victims of stalking, called a stalking protection order. I am delighted that the Bill has received such strong cross-party support. I really welcome this consensus, on behalf of those who have been victims of stalking in the past and, more importantly, those whom we can protect in the future. It is worth reiterating why we are here to create the new orders. Responses to a public consultation launched in December 2015 stressed the need for earlier intervention in stalking cases to protect victims and to address emerging patterns of behaviour in perpetrators before they become entrenched or escalate in severity, as well as for putting in place vital extra protections. They identified a clear gap in the existing protective order regime, particularly in cases of so-called stranger stalking, where the stalking occurs outside a domestic abuse context or where the perpetrator is not a current or former intimate partner of the victim.

The Bill is therefore intended to provide the police with an additional tool with which to protect victims and deter perpetrators at the earliest possible opportunity, and to fill the gap in the protective order regime. Stalking protection orders will be available on application to a magistrates court by the police, ensuring, importantly, that the onus to take action is not placed on the victim and that the police have end-to-end sight of the entire process, from application to enforcement of the orders, and if there is reasonable cause to believe that the proposed order is necessary to protect another person from the risk of stalking.

I should inform the Committee at this point that I am exploring the possibility of the British Transport police and the Ministry of Defence police also being able to apply for these orders. I hope to provide an update on Report.

Crucially, the orders will be available in cases of stranger stalking because, unlike with existing protective orders, clause 1 contains no requirement for stalking to have occurred in a domestic abuse context or for there to be a current or former intimate partner relationship between victim and perpetrator. The clause also contains no requirement for the orders to be made on conviction. Again, that is unlike what happens with existing protective orders.

Alex Chalk Conservative, Cheltenham

I congratulate my hon. Friend on her vision and stamina in promoting the Bill, which have been a lesson to us all. The fact that there is no requirement for a conviction is the strength of the provision. However, I am interested in the burden and standard of proof to be established before an order can be made. One can well imagine that they would be contested; and they should be imposed only where it is fair to do so, given that breach of such an order could result in a custodial penalty.

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

I thank my hon. Friend for the extraordinary work that he has undertaken on behalf of victims of stalking. He is right to draw attention to that matter. Orders could be made on the balance of probability, but breach of an order would be a criminal offence. That is the important distinction, and I know that he welcomes those arrangements.

As I mentioned, clause 1 includes no requirement for orders to be made on conviction—an important distinction —or for the behaviour giving grounds for the application to have met the criminal threshold. That is what my hon. Friend the Member for Cheltenham was pointing out, and it is because stalking protection orders are designed specifically to permit early intervention when the criminal threshold has not yet been met but where it is known that there is a serious risk of harm as a result of stalking. If the police are gathering evidence and preparing a criminal case for court—for example if they are pursuing a stalking conviction—that takes time. The orders are not intended to replace such prosecutions. They can protect victims at the earliest possible opportunity and also are a way of stepping in to address the perpetrator's behaviour before it progresses into an obsessive campaign. Breaking the cycle is much more difficult if the behaviour is allowed to continue for longer.

To address the behaviour in question effectively, orders would make it possible to impose prohibitions and positive requirements on the perpetrator. Clause 1 would allow the police to propose to the court a bespoke intervention to protect the victim from harm but also, crucially, address the perpetrator's behaviour. Requirements to be imposed on a perpetrator by orders include notification requirements similar to those for registered sex offenders. Those are provided for in clause 9 and would help ensure that the police had the right information at the right time to manage the risk posed by perpetrators effectively. A perpetrator who did not comply with the conditions of a stalking protection order would face a criminal penalty for breach under clause 8, with a maximum sentence of five years' imprisonment.

Finally, clause 12 makes provision for the Government to issue statutory guidance to the police on the use of the orders. That will be developed in collaboration with criminal justice partners and sector experts and will help ensure that the police have the knowledge, understanding and confidence to use stalking protection orders to their full potential. It is only right to acknowledge that a new stalking protection order will not in itself deliver a better response to stalking; that will require an improved awareness of stalking on the part of all professionals working in that space, and a continued focus on improving the criminal justice response through the provision of high-quality training, guidance and professional development.

Other measures, beyond the scope of the Bill, were suggested on Second Reading. One was a stalking register. I know that the Government are committed to looking at wider options to improve the response to stalking, and to linking those considerations to wider work on supporting vulnerable victims. However, it is important to note that the notification requirements that could be imposed on a perpetrator under clause 9 are similar to those that can be imposed on registered sex offenders. I look forward to hearing the Minister's thoughts on that point.

I am sure that Committee members will agree that any further changes with respect to stalking should be introduced following rigorous and comprehensive consultation. That brings me to the reason I tabled an amendment to change the long title of the Bill: to ensure that it better reflects its content, which is limited to stalking protection orders and related matters. It is a minor, technical amendment that I hope provides neatness and clarity and will smooth the Bill's passage through Parliament.

I hope that I have made clear how the Bill provides the police with a welcome additional tool, the purpose of which is to protect victims of stalking and deter perpetrators at the earliest possible opportunity, even before the stage is reached at which a prosecution could commence, or to put in place protection while evidence for a prosecution is being gathered. It is imperative that we are able to provide effective support for victims of this devastating crime.

Emma Reynolds Labour, Wolverhampton North East

I congratulate the hon. Lady on introducing the legislation. Will she explain in more detail the provision for interim stalking protection orders in the Bill?

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

I thank the hon. Lady for asking about that. It can take time to bring together all the evidence needed for a full stalking protection order, but we all recognise that time is of the essence—I am sure we have all heard compelling evidence of serious harm ensuing. The point is to bring forward an interim order at the earliest possible opportunity, not to replace either a full stalking protection order or the pursuit of a stalking conviction where possible, but to ensure that we recognise that time is of the essence. In the most serious cases we would expect the police to use their existing powers regarding pre-charge bail conditions. I hope that answers the hon. Lady's question.

I hope that Members will give their full support to the Bill and I welcome the cross-party support and constructive debate.

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

I thank everybody who has taken part in the debate. We had a contribution from the hon. Member for Huddersfield, who has been talking about this issue for a very long time, and I pay tribute to him for his long-standing commitment. We also had contributions from my hon. Friend the Member for Cheltenham, the hon. Members for Rotherham and for Enfield, Southgate, my hon. Friend the Member for Gloucester, the hon. Member for Birmingham, Yardley, my hon. Friend the Member for Taunton Deane, the hon. Member for Wolverhampton North East, and my hon. Friends the Members for Eddisbury and for Torbay. The right hon. Member for Exeter also provided vital support, as did the hon. Member for Liverpool, Wavertree and my hon. Friends the Members for Redditch and for Harborough.

Mr Gray, thank you for your excellent chairmanship. Finally, I warmly thank the Minister for her ongoing dedication to this cause. I also thank the Home Office team, Christian Papaleontiou and Emily Stewart.

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05 JUL 2018

NHS 70

It was such an honour to be in Westminster Abbey today for the wonderful and moving service to celebrate NHS70 and to thank Nurse Alison Cull for her years of service to the community in Totnes (and for making it today despite her broken leg)

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04 JUL 2018

Sustainable Fisheries

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

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

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

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

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02 JUL 2018

Health and Social Care Committee

 

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

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02 JUL 2018

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

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

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

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

Kevin Foster Conservative, Torbay

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

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

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

Chris Green Conservative, Bolton West

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

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

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

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

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

Diana R. Johnson Labour, Kingston upon Hull North

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

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

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

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

Philippa Whitford Shadow SNP Spokesperson (Health)

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

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

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

Luciana Berger Labour/Co-operative, Liverpool, Wavertree

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

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

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

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

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

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

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

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

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

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

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

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

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28 JUN 2018

Backbench Business - Improving Air Quality

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

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

 

Neil Parish Chair, Environment, Food and Rural Affairs Committee

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

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28 JUN 2018

Exiting the European Union

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

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

Hilary Benn Chair, Committee on Exiting the European Union

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

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

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28 JUN 2018

Housing, Communities and Local Government Committee

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

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

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

Clive Betts Chair, Housing, Communities and Local Government Committee

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

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

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19 JUN 2018

Health and Social Care: Life Sciences and Medical Research

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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18 JUN 2018

NHS Long-Term Plan

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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

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13 JUN 2018

European Union (Withdrawal) Bill:

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

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

Robert Buckland The Solicitor-General

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

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12 JUN 2018

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

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

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


Phillip Lee The Parliamentary Under-Secretary of State for Justice

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

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11 JUN 2018

G7

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

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

Theresa May The Prime Minister, Leader of the Conservative Party

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

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07 JUN 2018

Tuberculosis

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

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

 

Nick Herbert Conservative, Arundel and South Downs

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

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

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07 JUN 2018

Bill Presented: Privilege

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

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

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

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

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

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

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

 I thank my hon. Friend for that point.

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

 

 

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07 JUN 2018

Leaving the EU: Fishing Industry

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

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


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

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

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05 JUN 2018

Offences Against the Person Act 1861

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Yvette Cooper Chair, Home Affairs Committee

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

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

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

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

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04 JUN 2018

Home Department: Topical Questions

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

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

Sajid Javid The Secretary of State for the Home Department

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

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24 MAY 2018

Porton Down

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

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23 MAY 2018

Social Services: Minimum Wage

Written Answers

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

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

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

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

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

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

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

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

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

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

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

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22 MAY 2018

Transport Emissions: Urban Areas

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

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

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

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

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21 MAY 2018

Miles Briggs

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

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21 MAY 2018

NHS Clinical Commissioners

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

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21 MAY 2018

Care Quality Commissioner

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

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21 MAY 2018

Community Buses

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

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19 MAY 2018

Citizens' Assembly

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

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17 MAY 2018

Gaming Machines

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

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

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

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

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13 MAY 2018

Amsterdam

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

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09 MAY 2018

Education (Student Support)

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

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

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

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

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09 MAY 2018

Data Protection Bill [Lords]: Information Orders

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

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

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

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

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

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

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

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

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

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

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

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

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08 MAY 2018

Learning Disabilities Mortality Review

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

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

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

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

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08 MAY 2018

Health and Social Care: Topical Questions

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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08 MAY 2018

Health and Social Care: Access to Social Care

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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02 MAY 2018

Breast Cancer Screening

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

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

Jeremy Hunt Secretary of State for Health and Social Care

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

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01 MAY 2018

Health Select Committee

Today the Health Select Committee discussed childhood obesity.

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30 APR 2018

Windrush

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

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

Sajid Javid

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

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26 APR 2018

Customs and Borders

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

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

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

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

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

Ben Bradshaw Labour, Exeter

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

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

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

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

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

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

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25 APR 2018

School Funding: Social Care

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

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

Kelvin Hopkins Labour, Luton North

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

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24 APR 2018

Energy and Industrial Strategy: Fracking: Methane

Written Answers

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

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

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

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

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

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

Methane emissions from shale gas production minimised and monitored.

Gas consumption remains within carbon budget limits

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

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

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

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

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

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

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

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23 APR 2018

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

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

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

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

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

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

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19 APR 2018

Surgical Mesh

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

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

.....

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

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

......

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

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

.....

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

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

.....

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

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

......

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

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

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16 APR 2018

Syria

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

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

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

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

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

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

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16 APR 2018

Syria

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

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

Theresa May The Prime Minister, Leader of the Conservative Party

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

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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.

.....

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.

They Work For You

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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.

They Work For You

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21 FEB 2018

Women NHS Leaders

It was inspiring to meet so many talented and passionate women fighting for 50:50 representation on NHS boards by 2020.

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21 FEB 2018

Medicines and Medical Devices Safety Review

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I welcome the Secretary of State's statement and his ongoing focus on patient safety, which has added so much to the patient experience. I also welcome the fact that he is clearly representing the voice of patients when learning lessons. Many of those who, courageously, have come forward, including many of my own constituents, have been harmed in the private sector. Will he confirm that all patients, wherever they were treated, will be included within the review and that there will be a focus on clinical governance, not only in the NHS but in the private sector?

Jeremy Hunt Secretary of State for Health and Social Care

I can absolutely give that assurance. We are considering how to strengthen oversight, because a tragedy is a tragedy wherever it happens, and we should be demanding the highest standards of care throughout our healthcare system. We are particularly considering the issue of data sharing, because often clinicians operate in both the NHS and the private sector, and we want to make sure that we do not have two datasets but that we share data in a way that makes patients safer.

They Work For You

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20 FEB 2018

Larwood

Thank you to all the teams & volunteers at the Larwood Practice and NHS Public Health and Local Authority leads from across England for meeting with the Health Select Committee today to share views on improving health and care. Great to hear about achievements and tackling challenges

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08 FEB 2018

Acute and Community Health

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I pay tribute to my colleague on the Health Committee, Rosie Cooper. She is a remarkable parliamentarian and advocate for patient safety. All of us on the Committee look forward to working alongside her to examine in full the Kirkup report's recommendations, and I welcome the Minister's commitment to a review of the fit and proper person test.

On the wider issues that the report raises, it is clear that when staff and funding continue to be cut from community services, there are terrible consequences for patient care. Will the Minister assure the House that he will work closely alongside the Care Quality Commission to identify other trusts in which issues such as this are likely to arise because of the workforce and funding pressures that are now being faced?

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

I am very happy to work with my hon. Friend on this. As she will be aware from reading the report, it is explicit that the finances were there for the existing service. That is stated at the outset of the report. What drove the problems was a wholly unrealistic attempt to seek foundation trust status, with a cost improvement plan that was simply undeliverable. There was a massive reduction, without any attempt to reconcile that with serious issues on staff levels and vacancies. As the report explicitly sets out, when staff raised those concerns, they were bullied, harassed and on occasion suspended without due cause. The culture has changed significantly, and measures have been put in place for how the regime involving NHS Improvement would address such issues and look at cost improvement plans.

On the extent to which the culture was driving the problems, I refer to the remarks I made in my statement. According to the report, the interim chief executive went in and found a significant underspend—£3 million—in the district nursing budget, at the same time as there were significant vacancies and patient harm. That culture was driving the issue, and that culture is what we need to put an end to.

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07 FEB 2018

Foster Care

Written Answers

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

  • To ask the Secretary of State for Education, how many children have been fostered in England in each of the last five years.
  • To ask the Secretary of State for Education, how many special guardianship orders have been issued in each of the last five years.

Nadhim Zahawi The Parliamentary Under-Secretary of State for Education

The numbers of children looked after in foster placements at any time during the year ending 31 March in each of the last five years were published in Table B1, in the statistical release Children looked after in England including adoption: 2016 to 2017 at: https://www.gov.uk/government/statistics/children-looked-after-in-england-including-adoption-2016-to-2017.

The numbers of children, who ceased to be looked after because of a special guardianship order during the year ending 31 March 2013 to 2017 in England, are shown in the following table.

  2013 2014 2015 2016 2017
Children who have ceased to be looked after because of a special guardianship order 2,770 3,360 3,550 3,860 3,690
  1. Numbers have been recorded to the nearest 10
  2. Only the last occasion on which a child ceased to be looked after in the year has been counted.
  3. Figures exclude children looked after under an agreed series of short term placements.
  4. Historical date may differ from older publications. This is mainly due to the implentation of amendments and corrections sent by some local authorities after the publicationdate od previous materials

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07 FEB 2018

General Practitioners: Migrant Workers

Written Answers

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

To ask the Secretary of State for Health and Social Care, what estimate he has made of the number of non-EU GP registrars who are currently on GP training schemes in England who will not be eligible for indefinite leave to remain when they finish their three-year training.

Steve Brine The Parliamentary Under-Secretary for Health and Social Care

Currently there are 719 non-European Economic Area national general practitioner trainees working under a Tier 2 visa. On the completion of training, these trainees would be eligible to apply for indefinite leave to remain if they meet the requirements as set out by UK Visas and Immigration. Eligibility is based on individual circumstance and will be decided by UK Visas and Immigration.

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06 FEB 2018

Centenary of Voting Rights For Women

Truly wonderful to see all the Acts of Parliament that made it possible for women to vote and to take their seats.
It is thanks to the sacrifice, courage and determination of so many suffragettes and suffragists that there are now over 200 female MPs - our democracy is stronger as a result.

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06 FEB 2018

Sky Ocean Rescue



Today, I supported Sky Ocean Rescue and committed to #PassOnPlastic.

Launched in January 2017, Sky Ocean Rescue aims to shine a spotlight on the issues of ocean health, particularly single-use plastic, and inspire people to make small changes.

Sky Ocean Rescue's whale, Plasticus, which is made up of a quarter of a ton of plastic – the amount that enters our oceans every second, came to Parliament, to bring to life the scale of the problem.

Here are the top tips on how you can #PassOnPlastic

  • Drink out of a refillable water bottle
  • Use a bag for life
  • Avoid products that contain microbeads
  • Buy cotton buds with cardboard rather than plastic stems
  • Swop your wet wipe for a flannel
  • Use a metal or glass straw
  • Buy fruit and veg loose rather than in plastic packaging
  • Give up plastic cutlery
  • Bring your own travel mug to your favourite coffee shop

We all have a role to play in saving our oceans. Small changes = big difference!

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06 FEB 2018

Health and Social Care: Routes into Nursing

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

Following the recent inquiry by the Select Committee on Health into the nursing workforce, we absolutely welcome the new routes into nursing, including the new role of nursing associate. However, one of the issues highlighted strongly was the need to retain our existing nursing workforce as well as to recruit into it. Will the Secretary of State comment on that?

Jeremy Hunt Secretary of State for Health and Social Care

My hon. Friend speaks very wisely—we do need to be better at retaining our existing workforce. I think that is why the Treasury has given me extra latitude in negotiations on the pay rise—those discussions are currently happening—but we also need to be much better at flexible working and at recognising the challenges people have in their ordinary working lives.

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05 FEB 2018

NHS Winter Crisis

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

The Minister will know that pressures in the NHS cannot be viewed in isolation from pressures in the community. It is great to see that he is now part of a Department of Health and Social Care. Will he say what is being done about making beds available in the community, to free up pressures in the NHS?

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

My hon. Friend, the Chair of the Health Select Committee, makes a valid point about the need for much more integration in our approach to the NHS. That is reflected in the appointment of my hon. Friend Caroline Dinenage as the Minister for Care, to look at that exact point.

Part of it is also looking at how we address other areas to deliver better outcomes. For example, 43% of bed occupancy at present is from just 5% of patients—those staying over 21 days. One key issue is how we bring down the current average stay from 40 days to, say, 35 days. That alone would unlock around 5,000 beds. We are looking at a more integrated model to address the pathways that I know my hon. Friend has highlighted in the Health Committee as a key priority.

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01 FEB 2018

Proxy Voting for MPS

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

My right hon. Friend is making a very powerful speech and I absolutely support the motion. I agree with her in very much hoping that this is the thin end of the wedge, because on the centenary of the Representation of the People Act 1918, we must do more to fix the pipeline problem here so that we encourage more women at a younger age to think about putting themselves forward to become Members of Parliament.

Maria Miller Chair, Women and Equalities Committee

I thank my hon. Friend for that intervention because, 100 years since the first woman sat in this place, it still feels for many of us as though we are operating in an 18th-century model of work, and that really needs to change.

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29 JAN 2018

Mental Health

Thank you so much for coming to Parliament to share your views on mental health, education and CAMHS today

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19 JAN 2018

Stalking Protection Bill

Thank you to everyone for their support for the 2nd Reading of my Private Members Bill.

The Stalking Protection Bill can be found here

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15 JAN 2018

National Security Capability Review

Sarah WollastonChair, Health Committee, Chair, Liaison Committee (Commons)

The Liaison Committee was unanimous in supporting the request of the Chair of the Defence Committee, my right hon. Friend Dr Lewis, to have the National Security Adviser appear in front of the Committee. My right hon. Friend the Secretary of State will know that there are precedents for the National Security Adviser appearing in front of the Defence Committee, the Foreign Affairs Committee and elsewhere, and Parliament has never accepted the Osmotherly rules, so will he give permission for the National Security Adviser to appear?

Gavin Williamson The Secretary of State for Defence

I am afraid that my hon. Friend is asking me something I cannot deliver. I can offer the Chief of the Defence Staff if she would like him, but I cannot offer the National Security Adviser. However, I will certainly pass on her request to Mr Sedwill.

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08 JAN 2018

Office for Students: Appointment

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I am afraid that I feel Mr Young's comments do cross a line and are indicative of an underlying character. We are talking about the kind of person who would tweet comments to a woman about masturbating over images of refugees—this does just cross a line. I feel that he should withdraw. When we apply for jobs, we all say whether or not there is anything in our past that could cause embarrassment. If that question was asked and it was answered "no", there is clearly a case for the board revisiting this and asking him to step down.

Jo Johnson Minister of State (Department for Education) (Universities and Science) (Joint with the Department for Business, Energy and Industrial Strategy), Minister of State (Department for Business, Energy and Industrial Strategy) (Universities and Science) (Joint with the Department for Education)

I recognise that, as I have said, many of the tweets have been obnoxious and repellent in many ways—obviously, I have not seen all 40,000 of them—but it is also important to recognise that that tweet was probably eight or nine years old, since which time Mr Young has been on something of a developmental journey. It is possible that there is a capacity for reform, and we want to encourage Mr Young to develop the best sides of his personality—those that have led to him setting up good schools and to working with disadvantaged children in London so that they can make the most of their potential. It is for those reasons that he has been appointed to the board.

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08 JAN 2018

NHS Winter Crisis

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I join the Minister in thanking NHS staff and in commenting that there is nothing new about winter pressures in the NHS. What is different is that they are extending now into traditionally quieter months, and that the depth of those pressures is so much more profound over the current winter, because there has been a failure over successive Governments to plan sufficiently for the scale of the increased demand across both health and social care. Will the Minister think about the forthcoming Green Paper for social care and think about combining it with health, so that we can see this as a truly across-system approach? I would also like to reiterate the points made by Dr Whitford about the role of bed-occupancy levels. Can the Minister tell us what the current bed-occupancy levels are in the NHS in England?

Philip Dunne The Minister of State, Department of Health

On the last point, I can confirm to my hon. Friend that, at Christmas eve, the bed occupancy rate was 84.2%, below the target of 85% that we set going into this particular winter period. Of course the rate fluctuates daily and I do not have the figures for the most recent days. We did at least start this holiday period in that position, which is a great tribute to the work done in preparing for winter. I wish to reiterate to her, as I did to my right hon. and learned Friend, the importance of the integration work being done through the sustainability and transformation partnership process between NHS organisations and social care providers. It is part of the solution for the longer-term arrangements that we need to put in place to try to make sure that people who are living longer live better, more healthily and in a more independent way out of hospital.

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20 DEC 2017

Liaison Committee

The Liaison Committee takes Evidence from the Prime Minister

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18 DEC 2017

Harassment in Public Life

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

Sadly, abuse and intimidation are directed not just against those in public life, but against their families and those who work alongside them. I am sure the whole House will want to join me in paying tribute to our amazing teams in our constituency and parliamentary offices—in my case, Nina Smith, Lucy Mannion and Daragh Quinn—who deal with people with unfailing courtesy and respect. It is a great shame that, after I am targeted as a traitor by organisations such as the Daily Mail, the extent of the abusive calls is unfortunately so great that I have to ask them to work from home, and that when Members listen to this stuff—when we go in and work alongside them the next day—we find that it is truly shocking and unacceptable.

Amber Rudd The Secretary of State for the Home Department

I thank my hon. Friend for making such an important point. It is for us all to remember that our staff—they are the frontline—so often have to deal with these abusive phone calls, and they do such a fantastic job in usually protecting us from them, but they often have to deal with a torrent of abuse. Yes, I completely share her view, and I wholeheartedly endorse what she says about the people who work for her, as I do about everybody whose staff working for them put up with a level of abuse that we all have to endure.

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14 DEC 2017

Business of the House

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

On one of the busiest Saturdays in the run-up to Christmas in Totnes, local activists—including, sadly, the local Labour party—decided to parade with a real coffin and leave a large and carefully constructed model of a coffin at my constituency office. Does the Leader of the House feel, particularly in the light of the report on intimidation in public life that was published yesterday, that the line of decency was overstepped? There are real dangers in using the imagery of death and directing it against individuals to whip up hatred. Most importantly of all, this kind of thing deters really good candidates from applying for positions in public life.

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

I was disgusted, as I am sure all right hon. and hon. Members were, to hear about my hon. Friend's awful experience. I texted her at the time to say that I hoped she was okay. It must have been absolutely terrifying. It was truly horrible and we should all condemn this kind of behaviour and call it out wherever we see it. Lord Bew's report on the abuse and intimidation of candidates highlights that this is not a simple matter of holding politicians to account. It goes far beyond that and it will be a deterrent to diversity and the high calibre of candidates we want to see standing for Parliament. We all combine in condemning that action against my hon. Friend.

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14 DEC 2017

Topical Questions

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I recently booked an appointment in the Reading Room. I thought that it would be like an inner circle of hell, and that I would be trapped in there for days reading the sectoral analysis. Indeed, I was there with Mary Creagh. In fact, there were only nine pages on health and social care, and the documents relevant to my Select Committee took me less than an hour to read in their entirety. I believe that in the interests of transparency, these very straightforward documents should be in the public domain. Will the Secretary of State publish them?

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

The sectoral analysis has already been made available to the Select Committees, as per the motion of the House, and to all Members of this House through the Reading Room. The documents contain a range of information, including sector views, some of which would certainly be of great interest to the other side in these negotiations.

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13 DEC 2017

Implementing the withdrawal agreement

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I agree with many of the hon. Lady's points, but is it not vital that we send out the clear reassurance, which the Prime Minister gave at the Dispatch Box to all our NHS and care staff, that they and their families are welcome to stay, that we want them to stay and that their rights are now guaranteed?

Philippa Whitford Shadow SNP Spokesperson (Health)

I absolutely agree with the hon. Lady, but unfortunately it is not enough to come to the Dispatch Box every couple of months with warm words of welcome to EU staff, when in between women who are raising families here, with British partners or partners of EU origin, are being turned down for permanent residency because they have not taken out private comprehensive health insurance. We have had 100 EU nationals sent "prepare to leave" letters. Friends of ours tried to get citizenship for their three children, who were born and grew up in Scotland: the eldest and youngest were given passports; the middle child was refused. I am sorry but the experience of EU nationals on the ground over the past year and a half has been horrendous. If the phase 1 agreement last week is to mean anything, we must incorporate it into the immigration Bill to give them certainty now, instead of telling them they might have to wait another year before they find out what their future will be.

To exercise the right to live anywhere, access to healthcare and social security is crucial. It has made such a difference, not just to EU nationals here, but to our pensioners who have settled in the sunny uplands of the northern Mediterranean. What position will they be in if they cannot access healthcare? We must recognise that freedom of movement was not a one-way street; our young people and professionals have been able to take advantage of it for the past 40 years. We are taking that away from the next generation, which is something that I find terrible.

The Government say, and it is in the phase 1 agreement, that they accept keeping regulations 883 and 987, so let us bring that in. Let us get that down on paper and get it passed, because saying to EU nationals, "You're welcome to stay, but there might be no deal, which means you'll have no legal standing and you won't be able to use the NHS," is no use to anyone.

The other thing that the EU has brought us, as well as rights and opportunities, is co-operation. The agencies of which we are members are probably the prime example of that. Sadly, more than half of the EU agencies do not have a constitutional position for third countries. Twenty-one of them allow participation and 12 of those allow what is called co-operation, which does not involve payment in the way that participation would. It is therefore important that the Government utilise those and keep us in, or as close as possible to, the agencies that were bringing benefit to the UK. It is also important to recognise that this affects all constituent parts of the UK—all four nations. These decisions cannot be made by delegated legislation, down in an office, with no discussion with Parliament or the devolved nations, which will have to mitigate and face the ramifications.

With an airport and the northern air traffic control in my constituency, naturally I support amendments 245 and 246, on staying in the single European sky agreement, which is the reform of airspace, and the European common aviation agreement, which is what allowed the budget airlines to literally take off and people to travel cheaply. However, the European Aviation Safety Agency is also important, and that is a body of the EU and EFTA. It is important to recognise that there are things we can be in, there are things we cannot be in, and we lose these because we seem to have negotiated with ourselves to move to a hard Brexit instead of a soft Brexit. People here are saying , "Oh yes, this was all aired in the debate." I remember hearing leavers saying, "Of course we won't leave the single market. Don't be ridiculous." Yet that is the plan and that is where we are heading at the moment.

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13 DEC 2017

Prime Minister: Engagements

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

Will the Prime Minister join me in thanking all the wonderful staff from across the European Union who work in our NHS and social care? Will she give them her personal, unequivocal assurance that they and their families will have the right to remain after Britain leaves the European Union?

Theresa May The Prime Minister, Leader of the Conservative Party

I am very happy to join my hon. Friend in thanking all who work in our NHS and social care sector, including those from across the European Union. They do incredible work, and it is absolutely right that we recognise the contribution that EU nationals make in this sector but also across our economy and our society. That is why we want people to be able to stay and we want families to be able to stay together. I am very pleased that the arrangements that were published in the joint progress report between the United Kingdom and the European Union last Friday show very clearly, on citizens' rights, that where people have made the life choice to be here in the United Kingdom, we will support them and enable them to carry on living their lives as before.

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12 DEC 2017

European Union (Withdrawal) Bill

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I congratulate my hon. Friend and the Procedure Committee, and I really welcome its proposals. Does he think that this idea should be extended to all statutory instruments?

Charles Walker Chair, Procedure Committee

My hon. Friend tempts me so much. It is not my intention today to spook the Government, but I think the sifting committee will probably be so successful that the Government and the House will want to embrace it for all negative SIs going forward.

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07 DEC 2017

UK Fishing Industry

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I wish to start by paying tribute to Sean Hunter, a Brixham fisherman who sadly lost his life in the past week. He was deeply loved by his family and the whole community, and I know that the House will want to join me in sending our deepest condolences to his family.

I also pay tribute to the Fishermen's Mission, which does much to support fishermen, their families and our wider communities, and join other Members in paying tribute to the coastguard, the Royal National Lifeboat Institution, the National Coastwatch Institution and all the emergency services for their professionalism and courage. Most of all, however, I want to thank the fishers themselves, who do so much, in such challenging conditions, to put food on our plates and bring so much to our national and local economies. The value of the catch to the UK economy in 2016 was £936 million.

I am also delighted to say that Brixham has again been voted the No. 1 fishing port in the UK and lands the most valuable catch in England. In excess of £30 million has been sold through Brixham fish market in the last year, and that is providing jobs not just at sea but in the processing sector on land. We recognise the value of all those jobs.

I also pay tribute to the responsible actions of our fishers, who have done much in responding to scientific advice to improve the sustainability of many of our species. However, just as we expect our fishers to respond to that scientific advice and reduce the total allowable catch, in many cases, so I would ask the Minister to respond and recognise that we expect fairness when the scientific data shows we are fishing sustainably. In his negotiations, in which I wish him well, will he therefore look at the sole quotas in VIId and VIIe? There is a very strong case for their being increased further.

We need to look again at the value of the scientific evidence on which the quotas are based. In responding to the debate, will the Minister listen to the concerns of fishermen who are asking for greater access to fisheries science partnerships in co-operation with CEFAS? I am concerned to hear that too often these requests are turned down. For some years, the UK has agreed to adhere to the data collection framework, so it is of great concern to hear that the sprat stock, for example, is still described as "Data Deficient". In his response, will the Minister say what is going to happen about that in future?

Several colleagues have raised the issues of bass fisheries. As time is short, I will not dwell on them, except perhaps to thank the Devon and Severn inshore fisheries and conservation authority for meeting me to discuss the wrasse fisheries, and to hold that up as an example of where responsible but proportionate precautionary principles are being applied.

In my closing moments, I say to the Minister that as we now move to thinking about where we are with Brexit and beyond, fishing communities want to see fairness. We recognise that we need to avoid falling into an acrimonious Brexit, but to maintain good relations in order to trade with our neighbours in the future. I just hope that he will make sure that our fishing communities are not let down, as they were in 1973.

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07 DEC 2017

Social Care

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

The House of Lords Select Committee on the Long-term Sustainability of the NHS rapidly concluded that it would be impossible to carry out its task without investigating the interrelated nature of social care, and it changed its remit accordingly. The Committee changed the scope of its inquiry because it recognised that we will not see a long-term, sustainable solution unless we address both. I am afraid that a Green Paper that focuses entirely on social care will fail to rise to the challenge. Has the Minister read the Committee's findings, and as she listens to those she consults at an early stage, will she be prepared if the advice from them is to consider health and social care together—that has been the advice of all the commissions that have looked at this—to go back to the drawing board and start again by looking at both health and social care?

Jackie Doyle-Price The Parliamentary Under-Secretary of State for Health

To reassure my hon. Friend on the terms of reference for the Green Paper, let me say that part and parcel of getting a long-term, sustainable solution very much involves looking at care, and I pointed out in the statement that we need to look at holistic areas of policy to deliver it. Housing is one area, because if we get housing conditions right, we can obviously enable people to live for longer. The whole purpose of having a Green Paper and a debate is to make sure that we consider this issue not in a silo, but holistically, with a person-centred approach.

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28 NOV 2017

Nursing Workforce

The Health Committee heard from senior officials, including Minister of State for Health, Philip Dunne MP, about the challenges facing the nursing workforce in England and the actions Government and arms-length bodies are taking to address these problems.

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28 NOV 2017

Maternity Safety Strategy

Sarah Wollaston Chair, Health Committee, Chair, Liaison Committee (Commons)

I warmly welcome the Secretary of State's announcements today, including the move to allow coroners to investigate full-term stillbirths. Will he set out the current waiting time for post-mortems for infants because, as he will be aware, there is a shortage of the very highly specialised pathologists who carry out this vital work?

Jeremy Hunt The Secretary of State for Health

I do not have that information to hand, but I will find out for my hon. Friend and let her know.

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23 NOV 2017

Universal Credits

Sarah WollastonChair, Health Committee, Chair, Liaison Committee (Commons)

I thank the Secretary of State for listening to colleagues on both sides of the House in this welcome package of changes to universal credit, and particularly for scrapping the seven waiting days, for improving the loans and advances that are available and for the changes to housing benefit. Will he join me in thanking Citizens Advice? Citizens Advice does so much to support all our constituents, and it also welcomes the changes.

David Gauke The Secretary of State for Work and Pensions

My hon. Friend is right to draw attention to Citizens Advice, with which we have strongly engaged. Indeed, I spoke to its chief executive yesterday, and I have a meeting with her—the chief executive—later today. We will continue to work closely with Citizens Advice, and I am keen to ensure that, when it comes to universal support, we continue to work closely with Citizens Advice because it provides people with a huge amount of practical support and help.

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14 NOV 2017

Paignton Community College

I met with Justine Greening today along with Kevin Foster to discuss our serious concerns about the condition of parts of Paignton Community & Sports Academy.

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14 NOV 2017

Nursing Home Beds

Sarah Wollaston Chair, Health Committee

In its annual “State of Care” report, the Care Quality Commission has highlighted that there are 4,000 fewer nursing home beds in England than there were in April 2015. What plans does the Secretary of State have to address the workforce and funding issues that lie behind this? Will he meet me to discuss the situation in my constituency and nationally?

Jeremy Hunt The Secretary of State for Health

I congratulate my hon. Friend on becoming Chair of the Liaison Committee. Of course, I am always happy to meet her, and the issue that she has raised is very important. Our figures show that the number of nursing home beds, as distinct from the number of nursing homes, is broadly stable. There is real pressure in the market, however, and there are real issues about market failure in some parts of the country, so I am more than happy to talk to her about that.

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13 NOV 2017

Ministry of Defence; Military Aircraft

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Defence, if his Department will give consideration to retaining UK aerospace design and manufacturing capability by taking into account supply chains when purchasing new aircraft.

Harriett BaldwinThe Parliamentary Under-Secretary of State for Defence

We recognise the important contribution the UK's Defence Aerospace Industry makes to the UK's national security and prosperity.

Through the Future Combat Air Strategy Technology Initiative (FCAS TI), announced as part of the 2015 Strategic Defence and Security Review settlement, we are pursuing a national programme to ensure the UK retains the skills and capabilities necessary to maintain our place as a global leader in this area including in the wider supply chain.

We continue to review the defence industrial landscape, including in the UK aerospace sector to better understand our longer-term requirements and delivery options including the potential for international partnering, industry's appetite to invest, adjacent civil investment and overall affordability. Our review process considers the broader supply chain and will be taken into consideration in future procurement decisions. In addition, the refreshed Defence Industrial Policy will further explain how our investment choices take account of factors contributing to a more dynamic and productive UK economy, in which the UK defence supply chain plays a crucial part.

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08 NOV 2017

Aerospace Industry

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Business, Energy and Industrial Strategy, what steps he is taking to strengthen and promote the British aerospace industry.

 

Richard HarringtonParliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)

The UK has the second largest aerospace industry globally, with strengths in some of the most technologically advanced parts of aircraft: wings, engines and advanced systems. The industry has annual turnover of around £32 billion, and exports some £30 billion.

Through the Aerospace Growth Partnership, Government is supporting action by industry to make sure the UK remains competitive, including a joint Industry/Government commitment of £3.9 billion for Research and Development activities through to 2026.

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Hansard

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07 NOV 2017

Presenting the 67 Petition

Today I presented a petition of over 1000 signatures to the House of Commons from the users of the No.67 bus service in Torbay, to urge Torbay Council to commit to providing a similar service to the previous No. 67 service for the sake of the local residents as soon as possible. This petition was collated by constituent Madge Forrester and assisted by Brixham Councillor David Giles

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07 NOV 2017

Health Select Committee

Today there was an oral evidence session on the Nursing workforce

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01 NOV 2017

Exiting the Eu: Sectoral Impact Assessments

Sarah Wollaston Chair, Health Committee

In response to the right hon. and learned Gentleman's point, may I formally request that these documents be released not only to the Exiting the European Union Committee, but to all relevant Select Committees, as requested by the Select Committee on Health yesterday?

Keir Starmer Shadow Secretary of State for Exiting the European Union

I will come to that, because we gave some thought to the process, and if the principle of disclosure is agreed, we are open to a discussion about exactly how that works. The Brexit Select Committee seemed the obvious Committee, but there is clearly interest in other Select Committees in the subject matter, not least medical services and social care, which I know will be of great interest to the hon. Lady.

Sarah Wollaston Chair, Health Committee

The Health Committee will shortly begin an inquiry entitled "Brexit—medicines, medical devices and substances of human origin". We will be considering, among other issues, how we can guarantee safe, effective and timely access to medicines and substances of human origin; the future of medical research and development; how we will co-operate and collaborate across Europe after we leave the European Union; and access to the appropriate workforce. The stakes could not be higher. The Committee does not want to damage the national interest; we want to do our job on behalf of patients, this House and the public.

We know that there are sectoral analyses of life sciences, pharmaceuticals, medical devices, medical services and social care. I did discuss with the Committee, in advance of our hearing yesterday, whether we wished to call for these papers, and we discussed many of the issues that have been raised in the House today. The Committee was unanimous in giving me the authority formally to request those papers from the Secretary of State, and I did so. Therefore, although there has been much comment this afternoon about there being a discourtesy in not raising this with the Committee, the Committee has considered it and would like the papers, on behalf of our patients, in order to allow us to do our job better.

I believe in transparency. I understand the concerns that have been raised and so would be prepared to see the documents in a private setting, if it is believed that that is the right way forward. But I and my Committee believe that we can do a better job on behalf of this House if we have access to the information. I therefore call on the Secretary of State to release it to us.

Sarah Wollaston Chair, Health Committee

On a point of order, Mr Speaker. Would it be helpful for you to inform the House what you feel a reasonable timeframe would be for the Government to respond?

John Bercow Speaker of the House of Commons,

I do not think I am obliged to do that, and I am not sure how much difference it would make. The issues are important but I do not think—I may be contradicted by senior procedural experts, to whose wisdom I should defer—that the matters are particularly complicated. One can take a view about this, one can consult "Erskine May" and one should reflect in a sober and considered fashion, but if the hon. Lady is asking me whether I envisage this being something that needs to be deliberated on over a period of several days, the answer is no.

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31 OCT 2017

Health Select Committee

Today the Committee took evidence from the Secretary of State for Health

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26 OCT 2017

Leaving the EU

Sarah Wollaston Chair, Health Committee

No deal would be a very bad deal indeed for this country. What if the House votes on the final deal and rejects it? Is the Secretary of State implying that those who voted against it would be saying that they would like to leave with no deal at all?


David Davis The Secretary of State for Exiting the European Union

All I was doing was repeating exactly the statement that was made at this Dispatch Box by the Minister during the debate on the relevant Bill.

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25 OCT 2017

Social Care

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow Dr Whitford and I particularly commend her comments on the importance of prevention, which we must not forget. I join the Minister in paying tribute to the wider care and health workforce, and of course the many unpaid family carers for all that they do. I would like to touch on the forthcoming consultation and some of the current and future challenges. If hon. Members will forgive me, I will take very few interventions because I know that many are waiting to speak.

On the consultation, the Health Committee yesterday had the pleasure of hearing from members of the House of LordsCommittee on the Long-term Sustainability of the NHS on the subject of the long-term sustainability of the NHS and social care. They started out with the remit of talking about the NHS, but rapidly realised that the two systems are completely inseparable and that we have to stop considering health and social care in separate silos. The Minister will hear overwhelmingly from the people who contribute to the consultation that we cannot keep thinking of these systems in isolation, so right from the outset will she make it a consultation on the sustainable future funding of both health and social care?

One thing that we heard loud and clear from members of the Lords Committee yesterday was that we need to do more about future planning and that the system for this has been dismal for decades. Their recommendation was that we should set up an office for health and care sustainability that gives us all good-quality, reliable data about not only the demographic challenges but the future needs of both systems so that we can plan ahead for the costs we face in a realistic manner.

Too often in this House we have very divisive debates on this issue, and the challenges in funding future health and care costs are so enormous that I fear the only way we will meet them is by those on both Front Benches and all Members across the House agreeing that we need to work jointly to reach solutions, because no political party has a monopoly on good ideas. Particularly in a hung Parliament, where it is very difficult for us to pass primary legislation, the only way we will move forward on behalf of the people we all represent—we all want the best for them—is if the solutions are worked towards jointly across the House. I hope all Members will move forward in this debate in a spirit of co-operation, because we have to fund this properly. I am afraid that there is a funding gap, although I absolutely welcome the £2 billion that has been pledged. There is consensus that by the time we reach 2019-20, we will face an estimated funding gap, despite the uplift, of more than £2 billion. That will have a real impact on all those we represent.

We must fund this properly not just now, in the short term, but in the long term, and we must come forward with solutions, but it is not just about funding. It is about staffing, and planning properly for a wider workforce across health and social care, so I very much hope that that will also be included in the consultation. Unless we plan ahead for our future workforce, we will always be playing catch-up, as we do at the moment. Of course, we have seen many important changes. In the future, for example, healthcare assistants will be able to train to move forward through the apprenticeship route to become nursing associates and on into degree nursing. We know from Camilla Cavendish's review that it is not just about pay in the sector but the lack of continuing professional development and training opportunities and, in particular, the inability to rotate through the NHS and social care community settings. That gives an example of how the Government are making some positive moves, which I welcome.

I hope that from the start the consultation will cover both health and social care and that the Minister will go further in covering not just the sleep-in crisis but some of the many other issues that affect my constituents. For example, some are having their assessments re-examined, and disabled young adults facing a change in the support that will be available to them. I hope that the Minister will meet me to discuss some of the issues raised by my constituents in Kingsbridge who face significant changes to their care.

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23 OCT 2017

European Council

Sarah Wollaston Chair, Health Committee

I welcome the Prime Minister's positive approach, and the news that we are within touching distance of a deal, because that is in everyone's best interests. However, in preparing for all eventualities, would the Prime Minister be willing to reinstate the seasonal agricultural workers scheme? Businesses in my constituency are keen to plan ahead for all eventualities.

Theresa May The Prime Minister

I was Home Secretary when the scheme ended, and at that stage the Migration Advisory Committee made it clear that it felt it was not necessary to reintroduce it, at least for a period of time. However, the current Home Secretary has asked the committee to look into immigration needs throughout the UK economy. I am sure that that will include consideration of the sector that my hon. Friend has spoken about, and of whether or not a seasonal agricultural workers scheme is necessary.


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23 OCT 2017

Defence

Sarah Wollaston Chair, Health Committee

On a point of order, Mr Speaker. It is now more than four months since the general election, but still the Liaison Committee cannot meet formally to carry out its functions on behalf of the House. Will you assist us, Mr Speaker, because I am afraid that repeated representations from across the House by Select Committee Chairs are not yet making a difference in ensuring that all Select Committees are properly constituted?

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

I am grateful to the hon. Lady for her point of order. It is absurd and indefensible that more than four months after the state opening of Parliament, that Committee, which, of course, consists of the Chairs of the Select Committees, has yet to be constituted. I might add—almost in parentheses, because I am sure that the hon. Lady will feel empathy with other colleagues on this front—that the same situation, I think, applies to the European Scrutiny Committee, and also to another Committee which is not a Select Committee but which is a Committee of Parliament, and a very important Committee at that, namely the Intelligence and Security Committee. Those Committees are there to scrutinise the Executive branch.

I discussed this important matter in a most co-operative exchange with the Leader of the House at the start of the summer recess, and I know that she used her best endeavours, with others, to ensure the constitution of many of the Select Committees some little while ago. However, the fact that the remaining Committees are as yet unconstituted is simply not acceptable.

It would obviously be most unfortunate if it were necessary for Members to keep raising points of order day after day after day after day before those Committees were established, and, as I am sure the whole House would want to avoid such an embarrassing fate, I can only assume that proper action will now follow. However, the hon. Lady is always attentive to her responsibilities, and I am certain that, in the grisly event that it is necessary for her to raise a further point of order, she will not hesitate to do so.

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18 OCT 2017

Universal Credits

Sarah Wollaston Chair, Health Committee

I support the principles behind universal credit. My question is this: why are we undermining a policy with the potential to change lives for the better by not addressing a fundamental flaw at its heart?

We have heard many compelling cases today, and we cannot ignore them. Siobhain McDonagh set out one of the flaws, but we have seen that a policy of test, learn and rectify can work. Today there have been universal congratulations for the Government on the introduction of a free helpline, and the bringing forward of access to advances has also improved the policy, but that does not get us away from the fundamental problem of a minimum six-week wait. That means that our constituents who are living on the edge—we are talking about real people's lives here—are going to start this process in debt and in arrears, as we have heard.

It is possible to apply test, learn and rectify to this process. I want to hear from the Minister in the winding-up speech that Front Benchers recognise that and that they are going to address the six-week wait. The advance does not solve the issue; it does not cover the entire amount. Those of us who represent our constituents have a cushion and we would probably manage, but many of the people I used to look after when I was in clinical practice and the people I represent now who come to my constituency surgeries have no cushion whatever. This is devastating for them, and we cannot ignore the very real, compelling case histories that we have heard. We cannot allow those to continue.

There are things that we can do. Bringing forward the initial payment would mean that fewer people needed advances in the first place. That would save us a complicated bureaucracy, allowing people to say for themselves when they start universal credit, "Please would you pay my landlord direct, because I know I am going to find that complicated? Please would you give me payments every fortnight, because I don't currently receive monthly payments?" Once they are established on the system, give them, with their advisers, the option to transfer to taking over their own monthly payments for their rent.

Heidi Allen Conservative, South Cambridgeshire

Does my hon. Friend agree that that would be sensible not only from an administrative point of view, but because work coaches could be helping people get into work, rather than helping them to deal with debt, stress and mental health issues?

Sarah Wollaston Chair, Health Committee

I absolutely agree. I say to the Minister, please, can we hear an assurance at least that there is a recognition of this fundamental flaw and that it will be addressed?

I know that Members on this side of the House will be abstaining tonight. Personally, I do not agree with that. The House should have an opportunity to express its view, and there have been occasions on which these debates, even though they are advisory, have led to changes in policy. If there is no way for me to express my view, on behalf of my constituents, that I think this fundamental flaw must be addressed before the policy is rolled out to the Totnes constituency next year, I am afraid that I will have to vote against the Government. I do not wish to do that because I support the underlying policy of universal credit—we have heard about many of its benefits—but, I say again, we are undermining it by not addressing the fundamental flaw at its heart. I hope the Minister will give an assurance from the Dispatch Box so that I do not have to vote against the Government.

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18 OCT 2017

Surgical Mesh Implants

I attended a Westminster Hall Debate today on the risk of surgical mesh implants.

The following is a link to the reporting scheme for women wishing to notify the MHRA of mesh complications. Then click on the devices tab

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12 OCT 2017

Unauthorised Encampments

Sarah Wollaston Chair, Health Committee

I thank my hon. Friend for the measured tone that she has set for this debate. Does it surprise her that there are often examples of forced entry clearly having been used—for example, angle grinders on gates or huge boulders dragged to the side, sometimes in front of witnesses? Does she agree that the police need much greater powers to intervene and move people on where that is happening?

..........

Sarah Wollaston Chair, Health Committee

I am disappointed that Laura Pidcock dismisses the issue as a clash of cultural norms. That does a great disservice to the Gypsy and Traveller community. I do not believe that incidents of criminal damage, environmental degradation, intimidation, fly-tipping and, in some cases, violence are cultural norms for that community; we are talking about a very tiny minority. As we have heard repeatedly in the debate, this is about ensuring the same rights, responsibilities and respect for everybody.

In the short time available, I will not repeat the many points that have been made, but propose to the Minister a solution-focused approach. We need much greater clarity about the police's powers to deal with witnessed criminal damage, because they are sometimes unsure of their own powers when criminal damage is reported or even when it happens in their presence.

So much revolves around dialogue. As has been said, meeting people and talking to them is important, but it can sometimes be difficult to know who to liaise with. During the consultation, will the Minister consider introducing a responsibility for someone to be appointed to speak for groups of Travellers and to liaise with them directly? That would allow us not only to advance the dialogue more constructively, but to hold somebody genuinely accountable.

That is about holding people to account, just as we would expect members of the local community to be held to account vigorously for intimidation of, or disrespect towards, the Traveller community. We still expect someone to be responsible for a group of people involved in the kinds of incidents that we have heard about today, such as fly-tipping. At the moment, nobody can be held to account for such incidents, yet the local community has to pick up the bill. That is where we are heading: a vicious cycle of communities being so resentful about these encampments.

We are asking for the same laws to apply to everyone and to see something coming out of this consultation that results in genuine action to ensure that people are held to account, in the same way that I would expect all my other constituents to be held to account for the kinds of incidents that we have heard about today.

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10 OCT 2017

Health Select Committee

The Health Select Committe met today to discuss the Work of NHS England and NHS Improvement

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10 OCT 2017

Mental Health Workforce

Sarah Wollaston Chair, Health Committee

As someone who is married to an NHS psychiatrist, may I start by paying tribute to all those volunteers, carers and professionals working in mental health on World Mental Health Day? Has the Secretary of State seen today's briefing by the Children's Commissioner, highlighting the vital importance of prevention and early intervention? Will he set out what steps he is taking to support a growing workforce—volunteers and professionals—working in prevention and early intervention?

Jeremy Hunt The Secretary of State for Health

My hon. Friend is absolutely right. I am aware of the report that she talks about. We know that half of mental health conditions become established before the age of 14, which is why early intervention is so important. In July, I announced an expansion in the mental health workforce—another 21,000 posts. A number of those will be in children's mental health, to address the issues she raises.

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14 SEP 2017

Local Housing Need

Sarah Wollaston Chair, Health Committee

The South Hams has one of the highest house prices to earnings ratios in the country. I know that the Secretary of State wants to help young people to get on the housing ladder by introducing the earnings ratio, but that will be of no help to young people in my constituency if all the homes become second homes. Will he set out his plans to deal with areas of exceptionally high second home ownership?

Sajid Javid The Secretary of State for Communities and Local Government

My hon. Friend makes a good point. She will know that schemes are already in place to help people to get on the housing ladder, such as the Help to Buy scheme, which has helped more than 400,000 people. On her specific point about second homes, measures have already been introduced but, as she highlights, this issue needs to be considered carefully and kept under review to see what more we can do.

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13 SEP 2017

Higher Education (England) Regulations

Sarah Wollaston Chair, Health Committee

The Leader of the Opposition reneged on his clear pledge to deal with historic debt. Does the Secretary of State agree that that policy would have meant graduates repaying not only their own debt but the future debts of others?

 

Justine Greening Minister for Women and Equalities, The Secretary of State for Education

Indeed. The Labour party has a confused, muddled, counterproductive and anti-social mobility policy on student fees and student debt that would put at risk much of our higher education sector. It would be absolutely disastrous.

The bottom line is that, even now, across the border in Wales, the Labour colleagues of the hon. Member for Ashton-under-Lyne are implementing the very increases, in line with inflation, that she is opposing here today. That shows a level of hypocrisy that is becoming a hallmark of the current Labour Front Bench. The bottom line is that they are in—[Interruption.] I am taking no lectures from the hon. Lady about taking interventions when she was scared to take more than two. The bottom line is that Labour's student finance policy is a cold, calculating con trick on young people. It is shameless politics.

I have three serious questions for the Opposition on the policy of no fees, and they are questions that they need to answer. How many of the poorest children in this country are they going to prevent from going to university under that policy? How many world-class universities will shut down because they run out of money? If highly paid graduates do not have to pay to go to university to get their degrees, who is going to pay the bill? Those questions have never been answered. The Opposition have no answers, because having a sensible approach that has the best interests of students, universities and taxpayers at its heart is not their objective, is it? Driving social mobility is not Labour's objective. Enabling more disadvantaged young people to go to university is not their objective. Properly funded universities are not their objective. It is just a cynical con trick. That is Labour's objective. Far from Labour being the friend of students and universities, its policy would destroy opportunity and destroy our world-class universities. This House should see straight through it. Frankly, the motion is not even worth the paper it is written on.

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13 SEP 2017

NHS Pay

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow Dr Whitford. I pay tribute to her for her work on the Select Committee on Health in the previous Parliament. That work was inevitably full of expertise and always constructive; I thank her for that. I agree with her that the NHS is a team, but that team should also include the wider social care staff because we cannot continue to look at the two systems in isolation. I echo her point, thanking all our NHS and care staff for the contribution they make not just to our wider economy, but—most importantly—to patients. Those are the people we should keep at the heart of this debate.

I welcome this debate. I also welcome the relaxation of the cap because we need to give the NHS Pay Review Body greater flexibility to make recommendations about what we need to put in place for our NHS staff. I agree with the hon. Member for Central Ayrshire that we should look at the impact of pay on morale, recruitment and retention—this is an international workforce, as well as a national one—but we also need to look at pay across regions and within specialties because there is great variation. We should focus our efforts on ensuring that we are looking at the situation from the patients' perspective by, for example, looking at the greatest areas of deprivation, which very often have the lowest ratios of NHS and care staff and who are under the greater pressure.

Seven years of sustained pressure on NHS pay is taking a toll. Nobody anticipated that it would go on for this long, so it is time to relax the cap. We should look not just at the issue of pay, but at the wider pressures within the NHS. I am delighted to announce that the Health Committee, which held its first meeting just before Prime Minister's Question Time, has agreed that its first inquiry of the Parliament will be on the nursing workforce. We will look not just at pay, but at the wider workforce pressures, including the increased workload that comes from increasing demand across the system, morale and all the other non-pay issues that contribute to the pressures on nurses. We will also look at bursaries and the new routes into nursing, and at their impact on people entering the nursing workforce. We have heard about that already today. For example, we know that those who drop out of nursing courses are more likely to be in the younger age groups, whereas those who go into nursing as mature students are much more likely to stay. We need to look at all those wider impacts.

Maria Caulfield Conservative, Lewes

I really welcome the news that the Select Committee is going to do a review of nursing. Will the Committee look into pay structure? The current Agenda for Change structure is being used by some trusts, in hospitals and communities, as a way of downgrading nursing roles. For example, a senior sister in one place may be paid a band 7 salary, whereas someone in the same role somewhere not too far down the road may be paid a band 5 salary. There is inequity in the current system.

Sarah Wollaston Chair, Health Committee

That is an important point. I very much hope that my hon. Friend will contribute to the Committee's inquiry. As well as looking at the new routes into nursing, we will look at the skills mix, roles within health and social care more widely, the impact of Brexit and language testing, workload and morale. We will be seeking contributions from hon. Members across the House and from people outside.

As I said, we will miss something if we just look at the issue as one of pay. Pay restraint is estimated to contribute between £3.3 billion and £3.5 billion of the five year forward view efficiency savings up to 2019-20. If that goes, what will fill the gap? We have to be careful that there is no loss of services or losses in the workforce, because workforce pressures—probably more than any other issue—contribute to nursing staff leaving the profession. We have to look at the bigger picture.

Eleanor Smith Labour, Wolverhampton South West

I have been a nurse for 40 years, but this is not just about nursing. There are other groups as well, including occupational therapists and physiotherapists, who are also registered professionals. Along with everybody else, they are just as important as nurses.

Sarah Wollaston Chair, Health Committee

The hon. Lady is absolutely right. Look, for example, at the applications for nursing courses. Even though the number of applicants has gone down, it may not ultimately result in a loss of numbers entering nursing. Some of the applicants from that overall drop in numbers might have gone on to other courses, so we need to look at the bigger picture. In opting to look at the nursing workforce, the Health Committee is not saying in any way that other parts of the workforce are not important. The NHS is a team, but it would be difficult for us to report within a certain timeframe if we looked at the entire workforce. I have no doubt that we will look at other aspects of the workforce over the course of this Parliament. I assure the hon. Lady that we will not lose sight of the bigger picture and I hope that she will contribute to the inquiry.

We need to look at the big picture regarding the total budget for health and social care. Norman Lamb has long made this point, and we have both made it clear that it is time for us to take a cross-party approach to sustainable funding for health and social care in the long term. I look forward to working with him on that over the course of this Parliament.

Norman Lamb Liberal Democrat Spokesperson (Health), Chair, Science and Technology Committee (Commons)

I totally agree with the hon. Lady and I am keen to continue working with her. Did she see the Independent Age survey that showed that well over 80% of Members of Parliament on both sides of the House agree that there needs to be a cross-party settlement for the future of the NHS and the care system?

Sarah Wollaston Chair, Health Committee

I welcome that and I look forward to working with the right hon. Gentleman over the coming months to try to encourage colleagues on both sides of the House, including the Front Benches, to agree to the idea. Next year is the 70th anniversary of the NHS, and I cannot think of anything more constructive we could do than to work across political parties in order to deliver sustainable long-term funding for health and social care.

I will bring my remarks to a close because I know that many hon. Members wish to speak. I look forward to hearing suggestions from colleagues in the House and outside this place about the points they would like the Health Committee's inquiry into the nursing workforce to cover.

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13 SEP 2017

Education Finance

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what assessment she has made of the effect of maintaining current levels of core educational funding for 16 to 18 year olds on (a) educational outcomes and (b) further education provision; and what plans she has for (i) funding and (ii) resourcing further education in the next five years.

Anne Milton Minister of State (Department for Education)

The post-16 system is performing well and a record proportion of 16 to 18-year olds are now participating in education or apprenticeships. The results in the first of the reformed A levels were released last month, with students continuing to achieve effectively against the high standards of the qualification and demonstrating their readiness for the demands of higher education. Overall A level results this year were stable compared to last year.

A record number of 18-year olds applied for places in Higher Education this year and the entry rate for English 18-year olds from disadvantaged backgrounds is at a record high.

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13 SEP 2017

Medicine: Education

Written Questions

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, what steps he is taking to support the development and growth of smaller and non-London medical schools
  • To ask the Secretary of State for Health, when he plans to announce the criteria and timetable for allocating additional undergraduate medical student places.
  • To ask the Secretary of State for Health, when allocating the 1000 additional undergraduate medical student places, what steps he plans to take to ensure that medical schools outside London receive a fair allocation of those places.

Philip Dunne The Minister of State, Department of Health

The Government has announced a historic expansion of medical school places in England, with an increase of 1,500 medical school places in England. The first 500 places have already been allocated and will be available to students in September 2018.

The Government response to the recent consultation was published on 9 August 2017, confirming that 1,000 additional medical school places would be available to medical schools in England via a competitive bidding process to be managed jointly by the Higher Education Funding Council for England (HEFCE) and Health Education England (HEE).

It also set out the priority areas bidding criteria would need to focus that include aligning the expansion to local National Health Service workforce need with an emphasis on priority geographical areas, including rural and coastal areas.

HEFCE and HEE are currently finalising the design of the bidding process and will publish details in the autumn.

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11 SEP 2017

EU Withdrawal Bill

Sarah Wollaston Chair, Health Committee

Without the Bill we cannot respect the will of the British people, as expressed in the referendum, and repeal the European Communities Act 1972. Without the Bill, as many Members have pointed out, we will see legal chaos. Given the sheer volume and complexity of the EU law that will have to be converted into UK law, I accept that the Government will need relatively wide delegated powers to amend legislation, but there is a distinction between necessary amendments as a consequence of our leaving the EU, many of which will be technical and minor, and those that implement entirely new policies. The delegated powers in the Bill will touch every aspect of our lives, as many colleagues have said—their use could be unprecedented in scale, scope and constitutional significance—so I am glad to hear that Ministers are in listening mode.

I will support the Bill tonight in the expectation that it will be amended in Committee and that there will be support for reforming the way delegated legislation is handled, so that Parliament, rather than the Government, can decide the appropriate level of scrutiny. Without that, we simply will not be able to bring control back to Parliament. It may be useful to those who are following the debate from outside this place if I explain how delegated legislation works and why it is important that we amend it.

I was first introduced to Delegated Legislation Committees when I was appointed to one dealing with draft double taxation relief and international tax enforcement orders. I thought there must have been a horrible mistake, so I sent a note to the Whip to ask about my duties. I received the following three instructions: “Turn up on time, say nothing and vote with the Government.”

People might argue that no one died as a result of my ignorance of international law on double taxation relief in Oman and Singapore, but what makes the system so absurd is that the very next Committee due to sit was a Delegated Legislation Committee examining the draft Medical Profession (Responsible Officers) Regulations 2010. It might be argued that, as someone who had just come to the House having been teaching junior doctors and medical students and having been an examiner for the Royal College of General Practitioners with an interest in doctors who were failing, I was better placed to be on the second Committee. It seems to me that there is an expectation that Members should not have any expertise at all. I think the general public would find that absolutely extraordinary; they expect Members to be able genuinely to scrutinise legislation.

There are many other reasons why the procedures should change. It is a great concern to people outside this place that many statutory instruments are subject to the negative procedure rather than the affirmative procedure and do not get any scrutiny at all—not even the current defective scrutiny. The power to change that does not necessarily need to come from legislation; we could use the Standing Orders. I commend the Hansard Society for the excellent work it did in advance of the Bill to set out how the procedures could be amended. Even though it is in our power as a House to put in place Standing Orders, for example to set up a Delegated Legislation Committee with the powers of sift and scrutiny that we have discussed today, it would help if Ministers indicated that they are in listening mode about that, too, and that they would support it happening over time. I genuinely feel that the Government do not want to obstruct sensible debate. All Members from across the House should work with Ministers to put in place something that genuinely works. We know that delegated legislation needs reform even without this Bill, so let use this as an opportunity. As we have heard, up to a thousand statutory instruments will be coming before the House, and we need the House to decide whether the procedure will be negative or affirmative. We need reform so that we can genuinely develop expertise along the lines suggested by the Hansard Society and so that MPs with a genuine interest scrutinise the proposals. The point is that a delegated legislation Select Committee could have the power to send a statutory instrument to a Committee of the whole House—not just a small Delegated Legislation Committee in a Committee Room, but with all of us here, similar to what we are doing today. It could also have the power to suggest sensible amendments that the Government would have to take away and consider.

I have said that I will support the Government tonight, but I do so only in the expectation that they will support sensible amendments.

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11 SEP 2017

Medicine: Education

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what estimate he has made of the number of extra UK medical school places that will be made available to international medical students after the removal of the cap on the number of such places.

To ask the Secretary of State for Health, what steps he plans to take to ensure that additional medical student places are fairly allocated to students from (a) the UK and (b) other EU countries.

Philip Dunne The Minister of State, Department of Health

The Government has announced a historic expansion in domestic supply of the medical workforce by funding an additional 1,500 medical school places in England available to domestic students from 2018-19. In addition, from 2019-20 English universities will not be limited in the number of international students they can recruit on a full fee paying basis.

For medical school intake targets, the only distinction that is made is between home or European Union students and those from outside the EU. As such, the additional 1,500 medical school places the Government is funding will be available to students from across the United Kingdom and all European Economic Area countries subject to the usual residency requirements.

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Hansard

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, for what reasons the Service Increment for Teaching funding allocation process is subject to the market forces factor; and what steps he plans to take to ensure that there is not an excessive regional disparity in allocations of that funding between London and non-London medical schools.

Philip Dunne The Minister of State, Department of Health

The funding for training placements in secondary care is allocated to placement providers by Health Education England using a tariff payment mechanism. These tariffs are calculated on the basis of average costs and do not take into account some features of cost that are likely to vary across the country. The tariffs are therefore adjusted by the Market Forces Factor in order to compensate for the cost differences of providing training placements in different parts of the country.

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19 JUL 2017

Department for Education: Vocational Guidance

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, when her Department plans to publish the careers strategy.

Anne Milton Minister of State (Department for Education)

We will publish a careers strategy in the Autumn. The strategy will have a clear focus on improving social mobility.

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12 JUL 2017

The Ambulance Service in Devon

Today I managed to secure a Westminster Hall debate on the Ambulance Service in Devon

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11 JUL 2017

The Future of the NHS

I delivered a lecture today in the Speaker's House on the future of the NHS

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06 JUL 2017

Adult Social Care Funding

Sarah Wollaston Conservative, Totnes

It is concerning to note from the CQC's state of adult care report that staff turnover rates have risen from 22.7% to 27.3% in the three years to 2015-16. Will the Minister meet me to discuss the important role that supporting skills and opportunities for career progression can play in reducing turnover, improving morale and, most importantly, improving the quality of care that people receive? Will he visit my constituency to see the excellent joint working that has been done by the trust and South Devon College towards just that?

Steve Brine The Parliamentary Under-Secretary of State for Health

I thank my hon. Friend for that. I think she knows that I will be in the vicinity of her constituency at some point over the next few months, and I would like to take her up on her offer. I wish her well in her current campaign.

The workforce is critical. Adult social care is a rapidly growing sector, and there are about 165,000 more adult social care jobs than there were in 2010. It is imperative that we get the right people into the right jobs, to deliver the improved quality of care and services that we all want to see. We are working closely with our delivery partner Skills for Care to improve the level of skills in the adult social care workforce, and we are making the profession more attractive with the introduction of the national living wage, from which up to 1.5 million people in the social care sector are expected to benefit. I might point out that that policy has come in only as a result of this Prime Minister and this Government.

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06 JUL 2017

International Trade: Food and Drink Sector

Sarah Wollaston Conservative, Totnes

More than £30 million-worth of fish was sold through Brixham fish market last year, the most valuable catch in England. Will the Minister meet me and industry representatives to discuss opportunities for expanding markets after we leave the European Union, as well as frictionless trade and smooth transfer across the border?

Mark Garnier Parliamentary Under-Secretary (Department for International Trade)

The Secretary of State is a Member of Parliament for the south-west, and he is happy to come and have that meeting, as am I as the departmental lead on the food and drink sector. Between the two of us, my hon. Friend Dr Wollaston may get twice as many meetings as she anticipates. We look forward to coming to help.

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06 JUL 2017

Brexit Agriculture and Fisheries

Written Answer

Sarah Wollaston Totnes
To ask the Secretary of State for Exiting the European Union, what steps he is taking to (a) engage with and (b) protect the interests of the South West's agricultural and fishing industries during future trade negotiations with the EU. (900263)

Mr Robin Walker:Under Secretary of State at the Department for Exiting the European Union

As part of our committment to hear from every sector and region in the UK, DExEU Ministers continue to engage closely with organisations across the agriculture and fishing industries, to enable us to understand issues for the sectors and to identify potential post-exit opportunities.

We have spoken to a range of organisations including the National Federation of Fishermen's Organisations, and the National Farmers' Union and will continue to listen to workers in the industry, trade organisations, producers and the public as negotiations progress.

Leaving the EU presents a major opportunity for the UK agriculture and fishing industries. The Government will be able to design new policies which specifically benefit British agriculture, the countryside and the fisheries, and provide better value for money to the British taxpayer.

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04 JUL 2017

Parliament's Education Service

This afternoon I spoke to teachers from across the country about my work as an MP and my experiences as a Chair of the Health Select Committee. This event was arranged by Parliament's Education Service

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04 JUL 2017

Health

Sarah Wollaston Conservative, Totnes

As a result of the capped expenditure process, the wider Devon sustainability and transformation plan is being asked to make £78 million of savings at short notice—within the next nine months. Does the Secretary of State share my concern about the impact on patients, the short timeframe and the undermining of savings already agreed by the STP? Will he meet me to discuss this matter and the wider CEP?

Jeremy Hunt The Secretary of State for Health

I am more than happy to meet my hon. Friend. The principle behind the capped expenditure process is that we should have fairness between patients in different parts of the country. We should not see patients in one part of the country disadvantaged because the NHS has overspent in their neighbouring area, but the way in which we implement the process must be sensitive and fair. We must ensure that we get it right.

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28 JUN 2017

Debate Queen's Speech

Sarah Wollaston Conservative, Totnes

It is a pleasure to follow Sir Edward Davey. When the national health service was launched in July 1948, it was launched on the basis of three core principles: that it should meet the needs of everyone, that it should be free at the point of delivery, and that it should be based on clinical need and not the ability to pay. Those principles continue to serve us very well; they are supported across the House, and they have been reinforced by the NHS constitution. The extraordinary success of the NHS and public health provision lies in its delivery of increased life expectancy. Many people who now survive into adulthood would not have done so when I qualified as a doctor, some years ago. However, that extraordinary success hands us the key responsibility and challenge of ensuring that we can continue to provide and to meet the needs of everyone in the coming decades. Yvette Cooper spoke of the importance of joint working across the House. Given that we now have a different parliamentary arithmetic, I agree with her, and I would extend that to the way we talk about funding of health and social care.

Gloria De Piero Labour, Ashfield

Last week I was told by Pauline that her mum, 79-year-old Sheila, who has dementia and heart failure, suffers from seizures and is unable to eat, go to the toilet or dress on her own, has been denied a funded place in a care home. Does the hon. Lady agree that that is a scandal that needs to be resolved?

Sarah Wollaston Conservative, Totnes

The hon. Lady has made a very important point. We will all see similar cases in our surgeries. However, we will not resolve the problem by having constant arguments about how we are going to do so. What we must do is agree, across the House, on how we are to provide long-term sustainable funding. I commend the House of Lords Select Committee on the Long-term Sustainability of the NHS for its work on the provision of long-term sustainable funding for health and social care. I welcome the commitment from Ministers in the Gracious Speech to seek sustainable social care solutions, but I call on the Government to extend that to health, because if we continue to view the two systems in isolation, we will fail exactly the patients, and others, to whom the hon. Lady has just referred.

The parliamentary arithmetic is such that there is an additional responsibility on all of us to ask what we can achieve by the end of this Parliament and what we can achieve when the NHS reaches its 70th birthday next year. I would say that by working together we could achieve something really remarkable, and I call on all Members from all parties to work to make that happen.

I also very much welcome the proposals in the draft patient safety Bill, but I put it to the Secretary of State that we need to get to grips with the impact of the workforce challenge across health and social care on patient safety. I agree with others that it is time for us to think again about the impact of the public sector pay cap. There is no doubt in my mind that seven years of the cap are now having a significant impact on morale in the health service and across our wider public sector. Again, I think that the change in the parliamentary arithmetic following the message that we have had from the electorate is very clear. People value our public services and they want to see this matter addressed.

One way in which we can address the issues of recruitment, retention and morale is to deliver a fair pay settlement, and I hope that we can make further progress on that. Again, however, we will achieve the funding that is required for that through realistic cross-party working. During the election campaign, and in the manifesto, we tried to address the issues of intergenerational fairness in funding these services, and it might be that, as we look realistically at how we are going to fund our public services, we need to take ideas from all parties in order to achieve our aims, so that we can do something about public sector pay and improve the retention rates in our health and social care workforce.

Another area of the Queen’s Speech that I want to touch on is mental health, and I should declare a personal interest, in that I am married to an NHS consultant psychiatrist who is also the registrar of the Royal College of Psychiatrists. I very much welcome the fact that we are the party that legislated for parity of esteem, but we now need to translate that into practice. It needs to be translated into ensuring that the welcome extra funding for mental health actually reaches the frontline and delivers.

I am pleased to see the proposals in the Gracious Speech for a Green Paper on children and young people’s mental health, and I hope that the Secretary of State will look at the joint work of the Select Committees on Health and Education in that area and take note of our proposals and suggestions. I also hope that he will look again at the work done by the Health Committee on suicide prevention. Suicide remains the single biggest cause of death in men under the age of 50 and in young people of both sexes. This is a core challenge, and one of the issues that we identified is now in the Government’s proposals—namely, how we involve the families of those with serious mental health challenges in their care and treatment. That does not involve riding roughshod over the important principles of confidentiality. Often, it can involve simple things such as ensuring that mental health professionals are aware of the consensus statement on how to achieve consent.

I welcome the progress that we have made on reducing the use of cells as a place of safety for those with serious mental health problems. Their use is wholly inappropriate and I hope that we can make further progress on that. There is much more that we can do to improve mental health care, but we have some excellent proposals in the five-year forward view. This is all about implementation, and I urge the Secretary of State to do everything he can to ensure that the money reaches the frontline, that there is transparency about that and that we make further progress on improving the mental health of young people and adults alike.

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27 JUN 2017

Education and Local Services

Sarah Wollaston Conservative, Totnes

Although we all recognise the need to address deprivation, does my right hon. Friend also recognise the need to address the historical injustices for underfunded areas? Will she confirm that she will increase the age-weighted pupil unit block in the funding formula and help to reduce the costs that some schools are facing through the apprenticeship levy?


Justine GreeningMinister for Women and Equalities, The Secretary of State for Education

As I said, we are committed to introducing fair funding. It is right that we hold all schools to the same standards and the same accountability framework, and it makes sense that we should ensure that children with comparable needs are funded comparably wherever in the country they are. I will set out shortly the details of how we will do that following the consultation.

I will finish my speech. [Hon. Members: "Hooray!"] In many respects I was just getting started, but I am sure the rest can wait for future debates. The Government have done sterling work in narrowing the gender pay gap and advocating having more women on boards, but those efforts cannot slacken and need to be stepped up. We will bring forward new approaches to supporting women in the workplace. The 30-hour childcare offer will help families with the cost of childcare, and our returnship pilots will explore new ways of supporting mothers—it is overwhelmingly mothers—to get back into work. We know from some of the work that is already under way how powerful they can be. Of course, inequality is not confined to gender, and the Government will bring a renewed focus to the ethnicity gap in our workplaces.

The Government have an ambitious agenda for this Parliament: creating world-class technical education, ensuring that there is a good school place for every single child, wherever they are growing up, and tackling inequality in educational opportunity in all its forms. To achieve those goals, we will be resolute in our pursuit of high standards. We are building on a firm foundation, although there is more to do and more to deliver. Our young people deserve nothing less. This nation contains a wealth of talent just waiting to be unlocked, which will create opportunity and success for individuals and a strong and prosperous country that can take on, and succeed in, any challenge.

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27 JUN 2017

NHS Shared Business Services

Sarah Wollaston Conservative, Totnes

While Members from across the House will be relieved that so far no patients are identified as having been harmed by this appalling incident, will the Secretary of State set out what steps he is taking to ensure that this can never happen again?


Jeremy Hunt The Secretary of State for Health

Absolutely. There is a short-term and long-term lesson. The short-term point is that it is unlikely this would happen again because it was paper correspondence, and we are increasingly moving all the transfer of correspondence to electronic systems. The longer-term point is exactly that—[Interruption.] An Opposition Member mentions cyber-attacks; they are absolutely right to do so, because of course we have different risks. This clearly indicates that we need better checks in place, so that when we trust an independent contractor with very important work, we know that the job is actually being done, and that did not happen in this case.

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19 JUN 2017

Devon and Somerset Fire Service

Thank you to Chief Officer Lee Howell and his team from the Devon and Somerset Fire Service for visiting Parliament today.

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27 APR 2017

Immigrants: Detainees

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, how much her Department has paid in compensation for unlawful immigration detention since figures on such compensation payments were published in 2014-15.

Robert Goodwill The Minister for Immigration

I refer the honourable member to my response to PQ 47658, submitted to Parliament on 19 October 2016.

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26 APR 2017

Immigrants: Detainees

Written Answer

Sarah WollastonChair, Health Committee

To ask the Secretary of State for the Home Department, whether procedures have changed as a result of recent successful prosecutions for unlawful immigration detention.

Robert GoodwillThe Minister for Immigration

The cross-system Detention Gatekeeper has now been introduced to scrutinise all proposed detentions independently of an arresting team. Individuals can now only enter immigration detention with the authority of the Detention Gatekeeper, who will ensure that there is no evidence of vulnerability which would be exacerbated by detention, that return will occur within a reasonable timeframe and check that any proposed detention is lawful.

Separately, Case Progression Panels have been introduced to review all cases within immigration detention by a peer-led panel. These panels focus on ensuring that there is progression toward return for all individuals detained, and that detention remains lawful.

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25 APR 2017

Immigration Enforcement Directorate

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, when she plans for the Immigration Enforcement Business Plan for 2016-17 to be published.

Robert Goodwill The Minister for Immigration

The Department's plans for immigration enforcement will be communicated in due course.

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25 APR 2017

Junior Doctors: Conditions of Employment

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what assessment was made prior to the implementation of the junior doctors' contract in 2016 of the additional financial and administrative cost associated with (a) pay protection, (b) additional hours payments, (c) guardian fines, (d) guardian of safe working hours role and (e) exception reporting management.

Philip Dunne The Minister of State, Department of Health

The contract will be recurrently cost-neutral with the exception of additional employer pension contributions arising from the increase in basic pay that was agreed with the British Medical Association as a condition for them entering negotiations in 2013 and was honoured by the Government. This is expected to rise to around £25 million per annum recurrently at the end of transition (circa 0.6% of total contract value).

In addition, there are limited non-recurrent costs of pay protection during transition. Upfront assessments of these costs are uncertain.

Additional hours payments and any fines reflect additional work carried out and are therefore outside the cost neutral funding envelope and will depend on how trusts manage juniors locally. Exception reporting is managed through rota management software. The role of the Guardian of safe working typically takes up a portion of the time of one consultant in each trust. This is seen as an investment in improving safe working for trainees.

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25 APR 2017

Affordable Housing

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, whether the Community Housing Fund will continue to be distributed through local authorities from 2017-18.

Gavin BarwellMinister of State (Department for Communities and Local Government) (Housing, Planning and London)

The first year of the Community Housing Fund was distributed through local authorities and used to build capacity within local groups. Funding for 2017/18 will be used to deliver housing on the ground for local people.

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24 APR 2017

Department of Health: Social Services: Finance

Written Answers

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, whether the forthcoming Green Paper on adult social care funding will look at the needs of everyone who receives adult social care.
  • To ask the Secretary of State for Health, what assessment he has made of the needs of working-age users of disabled social care ahead of the publication of the forthcoming Green Paper on adult social care funding.
  • To ask the Secretary of State for Health, what consultation he has undertaken with organisations operating in the care sector ahead of the publication of the forthcoming Green Paper on adult social care funding.

David Mowat The Parliamentary Under-Secretary of State for Health

Following the announcement of the General Election on 8 June, decisions on the future reform and funding of adult social care will be taken by the new Government.

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24 APR 2017

Drugs: Misuse

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, when the Government's new Drug Strategy will be published.

Sarah NewtonThe Parliamentary Under-Secretary of State for the Home Department

We are currently developing the new Drug Strategy, working across government and with key partners. The new strategy will be published in due course.

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24 APR 2017

Air Quality Strategy

Sarah Wollaston Chair, Health Committee

The Secretary of State has clearly set out the reasons for the delay, but in the intervening time, may I encourage her to strengthen our policies to encourage people to get out of their cars altogether? May I also urge her to read an article in this week's edition of The BMJ that clearly sets out the growing evidence of the benefits of active commuting, particularly by bicycle? Will she encourage us to get Britain cycling?

Andrea LeadsomThe Secretary of State for Environment, Food and Rural Affairs

My hon. Friend is right to raise that issue. The Government are a huge supporter of sustainable transport projects. We have invested £224 million in cycling since 2013, and £600 million in the delivery of transport projects across 77 local authorities through the local sustainable transport fund. As my hon. Friend says, we must do everything that we can to protect the quality of the air in our cities, and that includes changing the way in which people travel.

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20 APR 2017

Environment, Food and Rural Affairs: Food and Drink Sector

Sarah Wollaston Chair, Health Committee

The fishing industry is vitally important to my constituency. Will the Minister update fishers there and around the UK about if, and when, the Government will trigger their intention to withdraw from the 1964 London fisheries convention?

 

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

My hon. Friend makes an important point: there is a 1964 London fisheries convention which has access arrangements for a number of countries. As we have made clear on numerous occasions, we are looking at this very closely, and, as the Prime Minister said just two weeks ago, we hope to be able to say something on this shortly.

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18 APR 2017

Syria and North Korea

Sarah Wollaston Chair, Health Committee

Given the vile propaganda role of Asma al-Assad in propping up a murderous and barbaric war criminal, will the Foreign Secretary update the House as to what discussions he has had with the Home Secretary so that we can send a very clear message that such a role is incompatible with British citizenship?

Boris JohnsonSecretary of State for Foreign and Commonwealth Affairs

We do not discuss individual citizenship cases, as I am sure my hon. Friend knows, although I understand the feelings she is expressing. What I can tell her is that Asma al-Assad, in common with her husband, is certainly on the sanctions list.

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29 MAR 2017

Article 50

Sarah Wollaston Chair, Health Committee

I welcome the Prime Minister's clear commitment to a positive, constructive and respectful approach to the negotiations that lie ahead. May I press her further on behalf of the fishing community in my constituency and around the United Kingdom? She will know that in the past these people have been badly let down during negotiations, so will she give an equally clear commitment that the fishing community will receive a sufficiently high priority during the negotiations ahead?

Theresa May The Prime Minister, Leader of the Conservative Party

I can confirm to my hon. Friend that we are very conscious of the needs of the fishing industry. The Department for Environment, Food and Rural Affairs has been talking to the fishing industry. The Secretary of State and others have been looking carefully at the arrangements that will need to be put in place in the interests of the fishing industry, and that will be an important part of our considerations in future.

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27 MAR 2017

NHS: Reorganisation

Written Answer

Sarah Wollaston MP for Totnes

To ask the Secretary of State for Health, which sustainability and transformation plans contain no mechanism for engaging schools and colleges as active stakeholders.

David Mowat Under Secretary of State at the Department of Health

This information is not held centrally. Local areas are responsible for engaging with the staff, patients and the public, as well as organisations which may include schools and colleges, to further develop their plans.

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24 MAR 2017

Soft Drinks Levy

Written Answer

Sarah Wollaston Chair of the Health Select Committee

To ask Mr Chancellor of the Exchequer, what assessment he has made of the potential merits of using money raised from the Soft Drinks Industry Levy to support (a) nursery schools and (b) private nurseries in accessing the Children's Food Trust accreditation scheme; and if he will make a statement.

This question was grouped with the following question for answer:

To ask Mr Chancellor of the Exchequer, whether he has assessed the potential merits of using money raised through the Soft Drinks Industry Levy to extend the free school meals scheme to (a) nursery schools and (b) private nurseries; and if he will make a statement.

Jane Ellison: Financial Secretary to the Treasury

The Government has already confirmed that, in England, we will invest the £1 billion revenue we originally forecast from the Soft Drinks Industry Levy during this parliament in giving school-aged children a better and healthier future, including through doubling the primary school PE and sport premium and expanding school breakfast clubs. The Secretary of State for Education recently set out further details on this, including £415m for a new healthy pupils capital programme. The Department for Education will set out more detail in due course.

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22 MAR 2017

NHS: Reorganisation

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how many of the groups responsible for each of the 44 sustainability and transformation plans are consulting with schools and colleges in the development of those plans.

David Mowat The Parliamentary Under-Secretary of State for Health

Local areas are responsible for engaging with the staff, patients and the public, as well as organisations which may include schools and colleges. This information is not held centrally.

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21 MAR 2017

Education: Schools: Transport

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, if she will publish a list of school transport plans with no mechanism for engaging schools and colleges as active stakeholders.

Caroline DinenageThe Parliamentary Under-Secretary of State for Education

The statutory responsibility for transport to education and training for children of compulsory school age and for 16 to 19 year olds rests with local authorities, enabling them to make decisions which best match local needs and circumstances.

Local authorities are required to consult a range of stakeholders including schools and colleges about their post-16 transport policies. When developing transport policies for children of compulsory school age statutory guidance strongly encourages local authorities to consult.

Local authorities publish transport policies for school age children and post-16 young people on their websites. The department does not assess these to determine the extent to which local authorities meet these expectations for consultation. Links to post-16 transport policies can be found at www.gov.uk/subsidised-college-transport-16-19.

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21 MAR 2017

DVLA and Private Parking Companies

Sarah Wollaston Chair, Health Committee

It is a pleasure to serve under your chairmanship, Ms Dorries, and it is a real pleasure to follow my hon. Friend Mr Rees-Mogg and the compelling points he made. I thank my neighbour, my hon. Friend Kevin Foster, for securing the debate. In the short time left, I will touch on unreasonable practices and appeals and make a few further points following on from my hon. Friend the Member for North East Somerset.

There are highly unreasonable practices going on. We have heard many Members give examples. In my area, Premier Parking Solutions, to which my hon. Friend the Member for Torbay referred, has a particular problem with its machines, which is affecting many individuals, particularly when number plate recognition is used in combination with a requirement to enter the vehicle's number plate manually. In many cases, the machines do not record the first number of that registration plate.

The issue is that, because number plate recognition is being used, individuals do not receive a notification until about 10 days to two weeks later, by which time most reasonable people, having parked legally and paid the correct amount, will have discarded the clutter from their windscreen—I do not take much joy in tidying my car, so that would not affect me. Even if individuals have retained their ticket and can clearly prove that there has been an honest error, they find their appeals are not being upheld.

The other problem we have is the disincentive to appeal, because those who appeal have to pay a higher charge if their appeal fails—and fail it will. I have a series of clear cases from individuals who can demonstrate—I suggest to the Minister it is beyond any reasonable doubt—that they have legally parked, fully paid the correct amount and left within the required time, but who are still being hit. If they carry through the appeal process, they find they get nowhere. If they then refuse to pay, they are hit with a series of harassing letters and ultimately receive letters from debt recovery agents, which has an impact on their credit rating. That practice is wholly unacceptable, and intervention from Members of Parliament does not make any difference, either.

I am afraid that our constituents are being caught, and that has consequences. I will read from part of a letter from one of my constituents, which sums up the problem:

"I am an honest lady in my late 60s and I have never had an experience like this before. I live in rented accommodation on a limited income—I am not financially secure. It will cause me hardship to pay this fine when I fully believed I was doing everything legally and correctly."

The letters go on. Another pensioner wrote to me:

"I am a pensioner and all this angst really upsets me...I will do as everyone else has done and pay the £60 within the allotted time and try to forget it—but I have to say the injustice really riles me."

That is the injustice to which my hon. Friend the Member for North East Somerset referred. He is right that the role of Government is to stand up to help those who are powerless against such practices.

It is not just pensioners—I hear this from across a spectrum of individuals—but we should ensure that particularly those who may have difficulty in entering details via these machines have their interests protected. I agree with hon. Members who have said that at the root of the problem lies the DVLA and its complicity in the process. Will the Minister use every power he has to ensure that it takes its role and responsibility seriously? It has a responsibility to ensure that such practices are not allowed to continue. I hope that in responding he will inform all Members here, and constituents following the debate closely, what the Government will do to ensure that justice is done for all our constituents.

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21 MAR 2017

Health: Topical Questions

Oral Answers to Questions

Sarah Wollaston Chair, Health Committee

The NHS mandate was published yesterday, just days before coming into force. Can the Secretary of State set out the reason for the delay, because it allows very little time for scrutiny of this important document by this House? Will he also set out how he is going to prevent money being leached from mental health services and primary care to prop up provider deficits, so that we can meet objective 6 on improving community services?

Jeremy Hunt The Secretary of State for Health

My hon. Friend makes very important points. The reason for the delay was because about a month ago we had wind that we might be successful in securing extra money for social care in the Budget, and we needed to wait until the Budget was completed before we concluded discussions on the mandate. Our confidence as a result of what is in the Budget has enabled us to make the commitments we have made in the mandate, including making sure that we continue to invest in the transformation of out-of-hospital care.

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16 MAR 2017

Suicide Prevention Report

The Health Select Committee, which I chair, released it's report in to suicide prevention today and you may be interested to read it here.

I also spoke about this on the Today programme on BBC Radio 4 this morning and you may like to listen to this here. I spoke approximately 50 minutes in to the programme.

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15 MAR 2017

MHRA

I met with Dr Ian Hudson and Michael Rawlins from the Medicines and Healthcare Products Regulatory Agency (MHRA) to discuss the implications of Brexit in advance of the next stage of the Health Committee's inquiry into the implications of Brexit and health.

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14 MAR 2017

Georgia Shortman

Congratulations to Georgia Shortman, from the South Hams on being selected to represent Oxford Brookes University in Parliament celebrating excellence in undergraduate research. At Posters in Parliament, Georgia presented her dissertation on women in the wine industry considering the opportunities and obstacles, as well as different cultural attitudes to women in the industry.

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14 MAR 2017

Health and Social Care Budgets

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow Meg Hillier. I pay tribute to all the Select Committees and their members for the work that they done and to all those outside this House who made the compelling case that led to the announcements in the Budget. I say to the Minister that I unequivocally welcome those announcements, and I thank the Government for listening to the case that was made, not only about social care but about capital.

However, I would nuance some of that, because the point about social care is that we must not consider it "job done". The £2 billion over the next three years is very welcome—it is also welcome that it has been profiled to address the back-loading of the previous settlement. However, I would like the Minister to say how we will ensure that it gets to the frontline and is distributed fairly according to need, and also that that reflects the different abilities of councils to raise their own money through the social care precept, because that is important for public confidence about how the money is spent.

I also welcome the announcements on capital—the £325 million for the sustainability and transformation plans that are ahead of time is very welcome. I look forward to the announcements in the autumn Budget about further money, although the Minister will know that £1.2 billion has been transferred to revenue from capital. That is an ongoing issue that is hampering the ability of areas to put effective plans in place. Will he touch on that and say how quickly he thinks we will get to a position where we do not see these capital-to-revenue transfers as being necessary?

Another welcome announcement was about the capital improvements available to accident and emergency departments, although I would caution that this is being linked to putting general practitioners alongside casualty departments through co-location. This is not only about funding; it is about having a general practice workforce that can fund these co-located departments alongside out-of-hours departments and providing routine surgeries on Sundays. I am afraid that we simply do not have the workforce to sustain that activity. I know that there is a commitment to increase the workforce in primary care, but that is alongside a significant retirement bulge in primary care. Something will have to give. As things stand, I simply do not feel that we have the workforce to do that work.

Finally on the Budget, there was a very welcome announcement of a review and a Green Paper in the autumn, which we all look forward to. However, I call on the Government to stop and take stock, because next year will be the 70th birthday of the NHS, and it will come at a time when it is under unprecedented financial pressure. Over the last Parliament we saw a 1.1% annual uplift, against the background of uplifts of around 3.8% traditionally since the late '70s. This is a sustained financial squeeze, at the same time as an extraordinary demographic change and an increase in demand across the whole service. As welcome as the announcements were last week, I am afraid that they do not go far enough to address the scale of the generational challenge that we face. It is of course very welcome that more people are living longer, but that is happening alongside a shrinking base of our working population who are able to fund that demand.

We simply cannot carry on as we are. If the review focuses simply on social care, we will miss an extraordinary opportunity to address the issue in time for the 70th anniversary of the NHS. I would therefore ask the Minister to go back to colleagues and say, "Can we widen this Green Paper to take in health and social care, and can we try to do that on a consensual, cross-party basis?", as has been said by many across the House. Notwithstanding the issues about that in the past, the scale of the challenge is so great that we owe it to all our constituents to put that aside and to take nothing off the table in considering the scale of the challenge and the solutions ahead.

We have an opportunity to explain that to the public, because whenever I address public meetings and I ask people whether they would be prepared to pay more to fund our health and social care adequately, I find that the response is almost unanimous. People are ready for this. They understand the pressures, and they value health and social care immensely. That would be my big ask of the Minister: think again, widen the review, make it consensual and explain it to the public. Let us get the consent and move forward.

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14 MAR 2017

Ministry of Justice: Coroners

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Justice, what proportion of bodies were released by coroners within the Chief Coroner's target of three days in the most recent period for which figures are available.


Phillip Lee The Parliamentary Under-Secretary of State for Justice

The information requested is not held centrally.

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14 MAR 2017

Health Select Committee

The Health Select Committee met today to discuss Children and young people's mental health - role of education

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14 MAR 2017

Sex and Relationship Education

Thank you very much for taking the time to email me about personal, social, health and economic education (PSHE), and relationships education and relationships and sex education being included in the Children and Social Work Bill.

I also think that sex education should be compulsory. I believe that sex education has to be about more than 'plumbing and prevention' and I think that, once it becomes age appropriate, topics such as relationships and consent should also be discussed.

I am concerned about the extent to which young people are gathering information about sex from pornography, which is often violent and distorts understanding of what constitutes as consent. In addition, it is clearly of paramount importance that future generations understand the danger of sexually transmitted diseases and how they spread. After decades of highlighting this information to combat such diseases we do not want all the progress we have made to go to waste. I quite understand that many parents wish to broach these subjects with their children themselves. However, we should make sure all children receive the information they need. On the matter of reducing unplanned pregnancy at all ages, progress is being made on this and I do think that making sex education mandatory could be of further help.

I signed a letter to this effect to the Secretary of State for Education which you may be interested to view via the following link: http://www.parliament.uk/documents/commons-committees/Education/Correspondence/Chairs-letter-to-Secretary-of-State-re-PSHE-status-29-11-2016.PDF

I hope the following information on this topic from the Department of Education is of interest:

Schools should be providing all young people with a curriculum that equips them for success in adult life, and that also addresses modern issues like cyber-bullying and internet safety. Part of that responsibility is to ensure every child has access to relevant, factually accurate and age-appropriate PSHE and RSE.
The Secretary of State is personally committed to ensuring that progress in improving the availability and quality of PSHE and RSE is made a priority. The Government has introduced new clauses to the Children and Social Work Bill at Committee Stage which would require regulations to be made to require all secondary schools in England to teach relationships and sex education (RSE) and would introduce a new subject, 'relationships education' to be taught in all primary schools. Renaming the secondary school subject 'relationships and sex education' places emphasis on the intrinsic importance of healthy relationships and would deliver sex education within this context. The focus of relationships education in primary schools will be on building healthy relationships and staying safe.
The Department for Education intends to engage with key groups to develop age-appropriate subject content that includes teaching on mental wellbeing, consent, resilience and keeping safe online. The clauses would continue to allow parents a right to withdraw their children from sex education and schools would be required to publish a clear statement of their policy and teaching content to ensure parents are engaged in the teaching throughout.
It is important to make sure that our young people have the right information and right advice, and that what we teach them is fit for the world that children live in today. Starting at an early age so that children can understand relationships with one another, is sensible. However, the Government is not proposing that sex education be compulsory in primary schools beyond what is already covered in the science curriculum. Teaching must remain age-appropriate. The clauses emphasise that relationships education content should remain appropriate and the Department for Education intends to work with key groups to develop age-appropriate subject content.

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13 MAR 2017

Dr Henrietta Hughes

Dr Henrietta Hughes is the NHS National Guardian for speaking up freely and safely. Her role is to support whistleblowing and work with Trusts to be more transparent and to respond earlier to concerns raised by staff. We were able to discuss her initial findings and the experience of whistleblowers in my constituency.

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13 MAR 2017

Nuala Campbell and Alistair Johnstone

It was a pleasure to meet Nuala Campbell and Alistair Johnstone, who are the Guardians of Safe Working Hours for Torbay and South Devon and Bristol Hospital Trusts. We discussed junior doctors' workload and the problems of fatigue, stress and disillusionment. We agree on the importance of EU staff to the wider NHS, including here in South Devon.

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13 MAR 2017

Health Services and Social Services: Apprentices

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how much the Government plans to spend on health and social care apprenticeships in each of the next five years.

 

Philip Dunne The Minister of State, Department of Health

The new Apprenticeship Levy comes into operation in April 2017 and is set at a rate of 0.5% of an employer's pay bill. Apprenticeship Levy contributions by National Health Service organisations are estimated as £200 million in 2017-18 and will change over the next five years as the NHS pay bill changes. Estimates are not available for social care.

Apprentices are employed and individual employers will decide which apprentices to employ to meet their workforce needs. The Department does not centrally collect the plans of how many apprentices each individual employer intends to recruit by the end of 2020.

The Department is working with a range of partner organisations, including Health Education England, NHS Improvement, Skills for Health and Skills for Care to ensure NHS and social care providers have access to the apprentice standards they need to develop their own workforce and to make full use of the apprentice levy.

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09 MAR 2017

Drugs: Misuse

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what assessment he has made of the effect of the abstinence based approach for the treatment of drug addiction on levels of deaths from drug misuse.



Nicola BlackwoodThe Parliamentary Under-Secretary of State for Health

The provision of both harm reduction and abstinence based interventions is essential to any drug treatment system. Each local authority is responsible for ensuring there is a full range of drug treatment services available in their area to meet the needs of their local population.

During the recent Public Health England led inquiry into the rise in drug-related deaths, analysis of the treatment population did not establish a direct relationship between a policy focus on abstinence and drug-related deaths.

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09 MAR 2017

Health Services and Social Services: Apprentices

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, whether the revenue raised by the Immigration Skills Charge applied to NHS and social care sponsors of Tier 2 visas will be hypothecated for investment in apprenticeships in health and social care; and if she will make a statement.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what estimate she has made of the cost of the Immigration Skills Charge to NHS and social care sponsors of Tier 2 visas in 2016-17; and if she will make a statement.

Robert HalfonThe Minister for Schools, Minister of State (Department of Education) (Apprenticeships and Skills)

The income raised from the Immigration Skills Charge will support the provision of skills for the resident population, to address the skills gaps that employers face. Further information will be set out in due course. We have not estimated the potential annual cost to NHS and social care sponsors. The cost will depend on employer use of the Tier 2 skilled worker route.

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08 MAR 2017

International Women's Day

March 8th marked International Women's Day, celebrating women worldwide and highlighting where more must be done in the fight for equality. It was the first IWD where the number of female MPs ever elected outnumbers the number of men currently sitting in Parliament. When I was sworn in after the 2010 General Election I became the 304th female MP ever elected. I was proud to join so many of my colleagues in Members' Lobby for a photo.

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07 MAR 2017

Gabriel Wikström

It was fascinating to meet with Gabriel Wikström, Minister for Public Health, Healthcare and Sports in the Swedish Government. We discussed our shared aims to reduce public health harm from smoking, obesity, excessive alcohol and improving air quality. For both Sweden and the UK Government, reducing health inequalities is a key goal. I shared the Health Committee's perspective on the Childhood Obesity Plan and learned of some of Sweden's forthcoming legislation designed to improve public health. We also discussed the funding and social care challenges facing all EU nations.

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06 MAR 2017

The Daily Mile

I  met Education Minister Ed Timpson and Elaine Wyllie, founder of the Daily Mile, to discuss physical activity and its importance to children and young people's wellbeing. Many schools around the UK now take time at the start of the day to run the daily mile and it was also promoted in the Childhood Obesity Plan last year. The Minister was very positive about this scheme and how we discussed how he could better enable schools to participate and take advantage. I have also discussed this locally and hope to see children across the constituency benefit in future. The results have been transformative and once implemented, schools are positive about the benefits. It's well worth a look at their website.

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06 MAR 2017

RNLI

The RNLI plays an important role in this constituency. I was pleased to meet with their Director of Operations George Rawlinson to discuss their priorities including the new National Drowning Prevention Strategy. Local authorities and coastguards continue to work closely to reduce risk and to provide education on the importance of enjoying the sea safely and responsibly. You can test your knowledge on what to do in an emergency on the Respect the Water website.

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28 FEB 2017

Baroness Tyler

It was a pleasure to catch up with Baroness Tyler, to discuss her recent report What Really Matters in Children and Young People's Mental Health. The report was produced with the Royal College of Psychiatrists and examines how we can best make the changes needed to improve children's mental wellbeing. The Health Committee is holding a joint inquiry with the Education Committee into the role of education in children and young people's access to mental health services, which you can read more about here.

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28 FEB 2017

Doctors of the World

I met with Doctors of the World, the National AIDs Trust and Liberty to discuss my concerns about the information sharing agreement between the Home Office and the Department of Health. We discussed the important principle that information shared between patients and their doctor is confidential except in exceptional circumstances. The extension through the agreement to share exact addresses for those who have overstayed visas or other immigration offences does erode that principle and could have unintended consequences for public health if people do not seek treatment for serious conditions as a result.

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28 FEB 2017

Health Select Committee

The Health Select Committee met today to discuss Brexit and health and social care

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27 FEB 2017

Health and Social Care

Sarah Wollaston Chair, Health Committee

Today's debate on the supplementary estimates and the financial position of health and social care matters, first and foremost, because of the impact of that financial position on patient care. I start by paying tribute to our health and care staff across the country and, at this particular time, by noting and thanking those who have come from across the European Union to work in this country.

The current financial position is of great concern. As a result of the wider economic downturn, we are now in the seventh year of the longest financial squeeze in the history of the NHS. Although the Department of Health's budget has been protected in relation to many others, we cannot escape the fact that over the previous Parliament the average annual increase in its budget was 1.1%, which is far lower than the increase in demand and, of course, far lower than the historical increase of 3.8% since the late 1970s. All that is in the context of an extremely challenging position for social care. Between 2009-10 and 2014-15, there was a 10% real-terms reduction in social care spending by local authorities.

All that has taken place in the face of an extraordinary increase in demand, because of not only a rising population but our changing demographics. To put that into context, over the decade to 2015 there was a 31% increase in the number of people living to 85 and beyond, and we estimate that over the next 20 years we will see a 60% increase in the number of individuals who rely on social care. Over the years there has been an abject failure of Governments to plan for that, although it was entirely predictable. We absolutely cannot just keep ducking the question. We need not only to address the immediate financial problems that face health and social care, but to come together as a House to address the problems for the future.

Bill Wiggin Chair, Committee of Selection

It occurs to me that this is not a uniquely British problem; it is in fact a global one. I have been trying to find out where in the world social care is best delivered and whether we can learn anything from those countries.

Sarah Wollaston Chair, Health Committee

My hon. Friend makes an important point. We are all looking forward to the publication of the House of Lords report on future sustainability, because of course we have much to learn from other systems. I pay tribute to the Public Accounts Committee, which today published its report on the financial sustainability of the NHS. We have also seen the final position of trusts at the end of the previous quarter, so we now know that 135 providers ended that quarter in deficit. We are on course for a financial deficit across trusts of between £750 million and £850 million at the end of the financial year.

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27 FEB 2017

NHS Shared Business Services

Sarah Wollaston Chair, Health Committee

This is undoubtedly a very serious incident, but I welcome the detailed and thorough steps that the Secretary of State has taken to protect patient safety. However, he will know that there are ongoing problems with the transfer of patient records. GPs and hospitals spend endless hours chasing up results, investigations and letters on a daily basis. Is it not time that patients were given direct control of their own records, and will the Secretary of State provide an update on that to the House?

Jeremy Hunt The Secretary of State for Health

I thank my hon. Friend for her sensible contribution. She is right that, although the process of sending on these particular documents has been taken in-house, other parts of the contract were taken on by a company called Capita—[Interruption.] Jonathan Ashworth cannot stop, can he? Let me repeat that the work in question has been taken in-house. The other work, which is being done by Capita, has had some teething problems, of which we are very aware. We know it has been causing problems for GPs. The Under-Secretary of State for Health, my hon. Friend Nicola Blackwood has been meeting Capita and people relating to that contract on a fortnightly basis to try to identify the problems.

My hon. Friend Dr Wollaston is right that the aim in the long run is to give people control of their records. I am proud that, under this Government, we have become the first country in the world to give every patient access to their own records online. From September, people will be able to do that without having to go to their GP's surgery.

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27 FEB 2017

Fisheries: Treaties

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Environment, Food and Rural Affairs, if the Government will consider invoking Articles 15 and 11 of the 1964 London Fisheries Convention after triggering Article 50 of the Lisbon Treaty.

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

The Government is considering this issue very carefully.

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22 FEB 2017

Royal College of Radiologists

I was grateful to Dr Nicola Strickland, President of the Royal College of Radiologists for coming to Parliament to discuss the shortage in radiologists and the impact this is having on diagnosis and treatment of cancer and other serious conditions in the UK. An average of 9% of consultant posts are unfilled in the UK, with over 40% of these vacant for over a year. We need a clearer strategy for training, recruiting and retaining radiologists and radiographers.

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22 FEB 2017

Britvic

Following up on the Childhood Obesity Plan, I met with Paul Graham and Victoria McKenzie-Gould from Britvic to discuss the company's work on reformulation. The new sugary drinks levy has encouraged soft drinks companies to reduce the sugar content in their products but the effect of the levy will be increased if there is a price difference at point of sale. It would be wrong for customers choosing a low or no sugar brand to be subsidising those choosing high sugar alternatives. There is strong evidence that the various nutritional information on packaging is confusing consumers – simplifying labelling is one of the opportunities from Brexit which will allow us to set our own standards for example allowing us to show how many teaspoons of sugar are in a surgery drink.

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22 FEB 2017

General Medical Council

I met the General Medical Council's new Chief Executive, Charlie Massey, along with its chair Terence Stephenson. We discussed upcoming reforms to professional regulation and some of the challenges facing doctors, particularly in terms of revalidation and the concerns about the impact on the NHS and care workforce over Brexit. This is the subject of a current Health Select Committee inquiry.

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22 FEB 2017

Police Grant

Sarah Wollaston Chair, Health Committee

Does my hon. Friend agree that the assumption is often made that rural areas are wealthy? In fact, rural deprivation is significant, but it often needs to be measured in different ways. Those in rural areas are often on below-average incomes, but they have higher costs. I think that that needs to be stressed.


Sarah Wollaston Chair, Health Committee

I join the hon. Gentleman in commending the police forces on the work they do, particularly for those suffering from mental health problems. Does he agree that the funding formula needs to include not only that, but wider issues of vulnerability, particularly among the elderly population, which is higher in rural areas, especially in areas such as Devon?

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22 FEB 2017

Local Government Finance

Sarah Wollaston Chair, Health Committee

I would like to put on record the fact that my constituency covers part of Torbay, which has both a national and an international reputation for integration of health and social care. Despite that, it is now under extraordinary pressure from a number of sources, and it is very important that Ministers are aware of the strain that social care is under.

Gareth ThomasParty Chair, Co-operative Party, Shadow Minister (Communities and Local Government)

I commend the hon. Lady, who has been a brave voice on the Government side in raising this issue.

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21 FEB 2017

Health Select Committee

The Committee met today to discuss Brexit and health and social care.

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21 FEB 2017

South West Water

It was good to catch up with Dr Stephen Bird, Chief Executive of South West Water. Household bills are higher here in the South West and I was pleased to learn that South West Water's prices for 2017-18 will be kept below inflation. Those needing further support with costs may be eligible for a social tariff, discounting energy to those most vulnerable to fuel poverty. Some customers may also benefit from a water meter. We also discussed South West Water's work with apprentices. SW Water is a Top 100 apprenticeship employer and you can find out more about their projects here.

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20 FEB 2017

The Chancellor

This evening I met with the Chancellor to raise concerns about the business rates revaluation and the potential impact on local businesses in our high streets like Salcombe, Dartmouth Totnes and Kingsbridge. I hope to see some mitigation for worst-hit areas in the Budget on 8 March.

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13 FEB 2017

Health Services: Directors

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, by what metrics the effectiveness of Regulation 5: Fit and proper persons: directors is measured; and if he will make a statement.

Philip Dunne The Minister of State, Department of Health

Regulation 5 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, The Fit and Proper Persons Requirement (FPPR) for Directors came into effect for National Health Service bodies on 27 November 2014 and was extended to cover all providers regulated by the Care Quality Commission (CQC) on 1 April 2015.

The regulations include a requirement that they must be reviewed every five years, beginning five years after 1 April 2015. As yet the Department has not undertaken a review of regulation 5. Any such review would be completed with input from the CQC.

The CQC has advised that it is the provider's responsibility to ensure that all directors appointed are fit and proper for their role. The CQC's responsibility is to check whether providers have the right systems and processes in place to assure themselves of fitness.

The CQC has not yet conducted a thorough assessment of the regulations' effectiveness. However, in the first years of implementation, the CQC has received feedback on how the regulation is applied, often driven by an assumption that it is CQC's role to assess fitness directly rather than to assess providers' systems and processes.

In response to this feedback, the CQC has considered whether its current approach is in line with what can be reasonably expected of the CQC within the current regulations. The CQC has therefore begun a programme of work to improve its internal systems and processes for handling referrals under FPPR. There are three areas of CQC's guidance and processes that it is strengthening:

- Passing on all details of FPPR concerns raised with the CQC to providers

Presently the CQC does not pass on all concerns raised with it to providers to ask for an explanation. Instead the CQC assesses whether there are concerns that a reasonable employer should be expected to investigate and if the CQC does not think there is a substantive concern it does not pass the material on. When the CQC does share concerns, it initially summarises the information and will later send on the full material if requested.

CQC's intention is to change both of these steps so providers are notified of all concerns and receive all of the information immediately. The CQC will set out more clearly the type of investigation it expects providers to undertake, following notification.

- Interpretation of "serious mismanagement"

CQC believes there would be benefit in developing a clearer understanding of what type of behaviour constitutes 'serious management'. The CQC has prepared some draft guidance that characterises serious mismanagement and will shortly be publishing this for consultation. The CQC will develop the finalised draft into internal and external guidance as to how it interprets and applies this element of the regulation.

- The way CQC manages and records information regarding FPPR

It is recognised internally that CQC needs to improve the data available to itself about CQC's application of FPPR. The CQC is developing an approach to better enable it to track the volume of FPPR concerns shared with CQC by sector and the actions that result from these.

The CQC aims that, by undertaking the programme of improvements described above, CQC will be better placed to monitor the effectiveness of Regulation 5: Fit and Proper Persons in future.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, in how many instances the Care Quality Commission has asked service providers to instigate fit and proper persons requirement (FPPR) investigations for each year since the FPPR came into force; and how many of those FPPR investigations resulted in a director being discharged from duty.

Philip Dunne The Minister of State, Department of Health

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England.

The CQC has provided the following information:

The following actions have been taken in relation to Regulation 5 Fit and Proper Persons Requirement:

- CQC management reviews enable the CQC to reach a decision about the next course of action to take in response to a trigger for review, for example when we identify concerns around non-compliance with the regulations during an inspection, at the point of registration, or when we receive a safeguarding alert or concern. As at 8 February 2017 there have been 38 Adult Social Care (ASC), 14 Hospital, 5 Primary Medical Services and 37 Registration management reviews held regarding regulation 5.

There have been 28 enforcement actions under this regulation:

- 21 have been triggered by an enquiry, 16 of which were during the registration process.

- Seven were triggered by an inspection, four at ASC locations and three at Hospital locations.

- In seven cases registration was refused. In five cases registration was cancelled and in a further eight cases the providers were registered with agreed actions. The remainder included recommended fixed penalty notices, urgent and non-urgent imposition of conditions and warning notices.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, for what reasons the Care Quality Commission closed its fit and proper persons requirement process on Paula Vasco-Knight, then Chief Executive of South Devon NHS Foundation Trust.

Philip Dunne The Minister of State, Department of Health

The Care Quality Commission (CQC) has advised that in October 2015 the CQC received information of concern regarding the appointment of Paula Vasco-Knight as Acting Chief Executive at St George's University Hospital NHS Foundation Trust. These concerns related to Paula Vasco-Knight's conduct whilst she was Chief Executive at South Devon Foundation Trust. The CQC followed this up directly with the trust to review whether they had followed appropriate recruitment processes and carried out robust checks to determine Paula Vasco-Knight's fitness prior to her employment.

Based on the extensive evidence supplied by the trust and information provided separately from the Nursing and Midwifery Council the CQC concluded that the trust had not breached the fit and proper persons regulation at that time in relation to that appointment. The CQC informed the trust of this decision in February 2016 but reserved the right to reopen the case in light of any further information received. At the time of this decision, neither CQC nor the trust was aware of the fraud charges.

In April 2016 CQC received new information that led it to re-open the case. In early May 2016 both CQC and St George's became aware for the first time of the criminal investigation and fraud charges being brought against Paula Vasco-Knight. The CQC were subsequently asked by NHS Protect to put the case on hold pending their criminal investigation. St George's University Hospital NHS Foundation Trust suspended Paula Vasco-Knight at this time. These are matters of public record.

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08 FEB 2017

EU Nationals

I raised the question about the rights of EU Nationals in the UK at today's Prime Minister's Question Time

I am not alone in hearing from families long-settled here in Britain who are deeply worried that they could be separated after we leave the European Union. I know the Prime Minister will not want that to happen. Will she reassure all our constituents today that those who were born elsewhere in the European Union but settled here in the UK, married or in partnerships with British citizens will have the right to remain?

Theresa May The Prime Minister, Leader of the Conservative Party

My hon. Friend obviously raises an issue that is of concern all across this House. As she says, it is of concern to many individuals outside the House who want reassurance about their future. As I have said, I want to be able to give, and I expect to be able to give, that reassurance, but I want to see the same reassurance for UK citizens living in the EU. What I can say to her is that when I trigger article 50, I intend to make it clear that I want this to be a priority for an early stage of the negotiations, so we can address this issue and give reassurance to the people concerned.

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07 FEB 2017

Foreign Nationals: NHS Treatment

Sarah Wollaston Chair, Health Committee

Given the Government's stated objective of reducing health inequalities, will the Secretary of State set out how he will guarantee that those who are, for example, homeless or who have severe enduring mental illness—the most disadvantaged in our society, who are unlikely to have the required documentation—will receive the treatment they need?


Jeremy Hunt The Secretary of State for Health

I can absolutely reassure my hon. Friend. What we are doing is based on good evidence from hospitals such as Peterborough hospital, which has introduced ID checks for elective care and has seen absolutely no evidence that anyone who needs care has been denied it. This is not about denying anyone the care they need in urgent or emergency situations; it is about ensuring that we abide by the fundamental principle of fairness so that people who do not pay for the NHS through their taxes should pay for the care we provide.

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07 FEB 2017

Health Select Committee

The Health Committee met to discuss Childhood Obesity and whether this was a 'plan for action' or a 'plan for inaction and missed opportunities'

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06 FEB 2017

Parliamentary oversight of negotiations

Sarah Wollaston Chair, Health Committee

My right hon. Friend is absolutely right to be concerned about the fate of British citizens living in the European Union, but I agree with others who have said that, surely, a goodwill gesture would be a really positive thing for this Government to make. Two of my constituents are a married couple who have been living together in this country for 30 years, and I consider the wife to be as British as anybody else. We should make it absolutely clear that it is inconceivable that this couple should be separated, and that their children should be left with separated parents.

.....

Sarah Wollaston Chair, Health Committee

I wish to start by reading something from a letter I have received from a constituent. He talks about his wife, who was born in the Netherlands. He writes:

"She has lived in this country for over 30 years, brought up three British children and is completely integrated into the life of her local town. She is not part of any 'immigrant community'. She just lives here and is fully at home here. Until now, she has never seen herself as an outsider and has been able to participate fully in local life, thanks to her rights as an EU citizen. In two years' time, she will lose those rights and be a foreigner, dependent on the good will of the Government of the day."

I have written back to and met my constituent, because I think it is inconceivable that our Prime Minister would separate this family. However, many people are not reassured, and he and his wife sought for her to have permanent residency. This involved dealing with an 85-page document, including an English language test and a test about life in Britain, which is insulting to someone who has lived here most of her life and brought up three children here. This process is also very expensive, but the final sting in the tail is that she finds she is not eligible, because she has been self-employed and has not taken out comprehensive sickness insurance. This situation is unacceptable. We need to keep our compassion and keep this simple. It is inconceivable that families such as this would be separated, so we should be absolutely clear in saying so, up front.

Julian Knight Conservative, Solihull

I understand what my hon. Friend is saying about her constituency surgeries. I have had a similar experience and it is deeply upsetting in many respects, but will she join me in reflecting that the EU and Chancellor Merkel could have come to a deal on this earlier? The reality is that they have point-blank refused to discuss it before we trigger article 50.

Sarah Wollaston Chair, Health Committee

I agree with that, and I have also heard from constituents of mine who are British citizens now living in the EU. But my point is that, come what may, it is inconceivable that we would seek to separate families such as this one. There is no doubt that many people are sleepless and sick with worry about this, and we have all seen them in our surgeries. [Interruption.] It is true. I am seeing these people in my surgery. We also need to consider the tsunami of paperwork that we will have to deal with in settling the rights of these citizens if we do not get on with this quickly. We need to keep this simple. There is no way that families such as this should be subjected to a vast bureaucracy and vast expense. We all know that this needs to be settled, so in negotiating, surely, making a bold, open offer as a gesture of good will can do nothing but good in this situation.

Richard Fuller Conservative, Bedford

I agree with my hon. Friend, but my question to her is: can she cast any thought on why the Chancellor of Germany refused the offer?

Sarah Wollaston Chair, Health Committee

I have no idea why this is happening, but I am saying, as an important point to the Chancellor of Germany, that making this clear unilateral offer is the right thing to do, and we should get on and do it. There is no reason not to do so. Even if other countries were to take an obstructive and unreasonable line, it would still be inconceivable that our Prime Minister would separate families such as my constituents. So let us get on with this.

Anna Soubry Conservative, Broxtowe

Does my hon. Friend not agree that the Prime Minister as given her word that this will be a priority and she clearly hears the compassion that my hon. Friend reflects for her constituent, as we all do for all our constituents? We must, as I certainly do, accept the word of the Prime Minister that this will be her priority and that she will sort it.

Sarah Wollaston Chair, Health Committee

I thank my hon. Friend for that. Like her, I do trust the Prime Minister, and that is why I have taken a very reassuring line with my constituents. However, there is no substitute for a clear statement from our Prime Minister that, come what may, families such as this will not be separated, because that is the reassurance they seek. I hear what my hon. Friend says, but I think we should get on and make that offer, because it can be nothing but good to do so.

I also hope the Prime Minister will take further action on the issue of those who work in our NHS and social care. One in 10 of the doctors who works in our NHS comes from elsewhere in the EU, and I would like to say thank you, on behalf of the whole House, to all those workers and to all those who are working in social care. It would also be very much a positive move if we could say, up front, that those who are working here will be welcome to stay and make it very clear that we will continue to make it easy to welcome people from across the EU to work in social care and in our NHS.

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01 FEB 2017

Developing Countries: Family Planning

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for International Development, what estimate her Department has made of the potential shortfall in funding to charities and non-governmental organisations as a result of the revocation in the US of the Presidential Memorandum of 23 January 2009 Mexico City Policy and Assistance for Voluntary Population Planning and the reinstatement of the Presidential Memorandum of 22 January 2001 Restoration of Mexico City Policy; and what plans her Department has to ensure continued access to (a) family planning advice and (b) safe termination and contraception through its programmes.

James Wharton The Parliamentary Under-Secretary of State for International Development

It is too early to put an exact figure on the financial impact of the restoration of the Mexico City Policy.

The UK firmly believes that supporting comprehensive sexual and reproductive health and rights of women and girls, through proven, evidence-based public health interventions, saves lives and supports prosperity. We will continue to work with all our partners, including governments, UNFPA and civil society partners, to deliver this.

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31 JAN 2017

Post Offices: Rural Areas

Written Answers

Dr Sarah Wollaston Totnes

To ask the Secretary of State for Business, Energy and Industrial Strategy, what the implications for his policies are of the call by the Association of Convenience Stores for the Government to review the costs, income and viability of rural post offices on its Rural Shop Report 2017, published in January 2017.


Margot James Under Secretary of State for Small Business, Consumers and Corporate Responsibility

The Government entrusts the Post Office's management to keep the health of the network under review in order to meet the commitment we have set to maintain the network at over 11,500 branches. The commercial agreements it has with subpostmasters, rural and urban, covering costs and revenue form a key part of ensuring the health of the network. While these arrangements are commercially sensitive between both parties the evidence of their success is in the fact that that the network is at its most stable in decades.

Dr Sarah Wollaston Totnes

To ask the Secretary of State for Business, Energy and Industrial Strategy, whether his Department plans for the increase in Post Office outreach services in rural communities over the last five years to continue; and if he will make a statement.

Margot James Under Secretary of State for Small Business, Consumers and Corporate Responsibility

The Department for Business, Energy and Industrial Strategy keeps the state of the network under review including the provision of rural services through outreaches. Outreaches are provided so Post Office can maintain access to communities, most often in rural areas, where the old post office has closed. These provide a regular part time service, with hours tailored to the levels of demand in the community. They provide a welcomed link to the network for many isolated communities.

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31 JAN 2017

Energy and Industrial Strategy: Topical Questions

Sarah Wollaston Chair, Health Committee

It is 100 years since the destruction of Hallsands village following an act of environmental destruction and vandalism that saw the removal of protective shingle from the shoreline. Communities around our entire coast, including in Start Bay, face an even greater threat from climate change. Will the Minister assure me that he will protect us from an act of environmental vandalism —withdrawal from the Paris agreement?

Nick Hurd The Minister of State, Department for Business, Energy and Industrial Strategy

As the Prime Minister said in Prime Minister's questions last week, this country is fully committed to the Paris climate change agreement—as are all the countries that endorsed the Marrakech proclamation—and we hope that all parties will continue to ensure that it is put into practice.

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31 JAN 2017

Science Funding

Sarah Wollaston Chair, Health Committee

There is great concern about the future of fusion research after Britain pulls out of the EU and Euratom. Will the Secretary of State reassure us that he will continue to support and fully fund the Joint European Torus project and other joint research projects such as ITER—the international thermonuclear experimental reactor—after Britain leaves the EU?

Greg Clark The Secretary of State for Business, Energy and Industrial Strategy

The collaboration between scientists and those in the nuclear sector is one of the important aspects of the continued co-operation that we want and intend to see continue.

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31 JAN 2017

National Assembly of Korea

It was a privilege to meet with Na Kyung-won, chair of the Special Committee on Low Birthrate and Aging Society in the National Assembly of Korea and some of her colleagues. Korea and the UK share many similar demographic challenges as our populations' age and we must find sustainable long term funding and systemic solutions which enable older people to live independently and with dignity for as long as they can.

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30 JAN 2017

Public Accounts Committee

I joined Meg Hillier, chair of the Public Accounts Committee, for a seminar on NHS and social care funding in England. Joined by Members of Parliament and Peers, representatives of hospitals, doctors, local government, health policy and the NHS offered a comprehensive and effective briefing of the pressures in the system, as well as reflecting on possible solutions. It is vital that the Government bring forward a long term, sustainable funding solution reflecting that health and social care are part of a single system. I will continue to work with colleagues across the House to call for such a debate.

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26 JAN 2017

Junior Doctors

It was a pleasure to meet the BMA Junior Doctors Committee interim co-chair Dr Jeeves Wijesuriya and Harry Carter and Charlie Bell from the Medical Students Committee. We spoke of the challenges faced by junior doctors. It is incredibly frustrating for junior doctors who decide to spend a year working abroad in Australia are not able to arrange a Skype interview at hospitals in the UK, or even obtain a confirmed date for an interview. We must make it easier for doctors to return to the NHS and ensure that they are properly supported when they are here.

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26 JAN 2017

Post Offices: Rural Areas

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Business, Energy and Industrial Strategy, what assessment his Department has made of progress in securing the future of rural post offices; and if he will make a statement.

Margot James Parliamentary Under-Secretary (Department for Business, Energy and Industrial Strategy)

The Government understands the important role post offices play in communities across the country, especially in the more remote, rural areas. This is why in our manifesto we committed to secure the future of 3,000 rural post offices.

Thanks to Government investment the UK's network of 11,600 branches is at its most stable in decades, with over 98% of the UK population in rural areas within 3 miles of a post office. The investment is offering real improvements to customers, including an extra 200,000 opening hours every week and over 4,200 post offices open on a Sunday.

The Government's recent consultation will help us understand what the public and businesses expect from the Post Office and to understand more fully what subsidy is needed and what it should be used for.

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25 JAN 2017

Cancer Research UK

I met with Sarah and Emma from Cancer Research UK to discuss cancer diagnosis and treatment in the UK. Tackling obesity, poor diet and lack of exercise is an important strand of reducing cancer rates in the UK and we spoke about how cuts to public health budgets are storing up problems for the future. We must also tackle the ongoing challenges in recruitment and retention of vital clinical staff in this part of the workforce.

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24 JAN 2017

Cancer: Health Services

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, with reference to the National Audit Office's report, Progress in improving cancer services and outcomes in England, published in January 2015, what the total spend on cancer care in the NHS per newly diagnosed patient was for the most recent period for which figures are available.

David Mowat The Parliamentary Under-Secretary of State for Health

The National Audit Office published an estimate of the total amount spent on cancer care in the National Health Service to show the relative scale of the cost of cancer services to the NHS. The NHS does not routinely publish estimates of the total amount spent on cancer patients as the large scale and highly complex range of services that cancer patients interact with makes this very difficult. Many of the services used by people with cancer, in particular diagnostic and rehabilitation services, but also some treatment services, are not specific to cancer patients.

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24 JAN 2017

Health Select Committee

Today the Health Select Committee took evidence from the Secretary of State for Health on the impact of Brexit on health and social care.

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23 JAN 2017

Local Government Finance Bill

Sarah Wollaston Chair, Health Committee

I thank the Minister for giving way. He will know that the better care fund is an important redistribution mechanism, given the variable amounts that councils will be able to raise through the precept, which the Institute for Fiscal Studies estimates will raise £700 million over the next three years. Can the Minister give any encouragement on whether the better care fund will reflect the serious concerns around the problems with social care?

Marcus Jones Parliamentary Under-Secretary of State (Department for Communities and Local Government) (Local Government)

I think my hon. Friend is referring to what we term the improved better care fund, which will go directly to local authorities. That funding has been brought forward as part of the spending review 2015. She will probably know that that funding effectively was obtained by changing the way in which the new homes bonus operates, and sharpening the incentive in relation to the way in which that system operates. As such, therefore, that additional money is not freed up quickly enough to do what she says. Although this year £105 million comes into the system, next year it will be £800 million and the year after that—the last year of the Parliament—it will be £1.5 billion. Alongside that, in this financial year we have also put an additional £240 million into the social care system as a dedicated social care grant, which again has been realised from additional savings made through the new homes bonus.

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23 JAN 2017

Life Expectancy

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Minister for the Cabinet Office, what assessment he has made of the change to the life expectancy of (a) men and (b) women at age (i) 75 and (ii) 85 in each of the last five years.


Chris Skidmore Parliamentary Under-Secretary (Cabinet Office)

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the Authority to reply.

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23 JAN 2017

Mortality Rates

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Minister for the Cabinet Office, what assessment he has made of trends in death rates for people aged 75 and over in each of the last five years; and what steps his Department has taken to investigate the reasons for any change in such death rates.


Chris Skidmore Parliamentary Under-Secretary (Cabinet Office)

The information requested falls within the responsibility of the UK Statistics Authority. I have asked the Authority to reply.

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20 JAN 2017

Doctors: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, with reference to his announcement of 4 October 2016, that up to 1,500 extra medical training places will be made available from September 2018, what increased Service Increment for Teaching funding will be provided to support the training of those additional medical students.

To ask the Secretary of State for Health, with reference to his announcement of 4 October 2016, that up to 1,500 extra medical training places will be made available from September 2018, whether those additional students will be supported by the same (a) undergraduate fee and (b) Higher Education Funding Council for England banding payments as existing medical students.

Philip Dunne The Minister of State, Department of Health

National Health Service providers will receive clinical placement funding for the minimum number of students that Health Education England forecast are required to meet the longer-term workforce needs of the NHS.

In early 2017, the Department plans to run a public consultation on its proposals to expand domestic undergraduate medical training places by up to 1,500 per year, from the academic year 2018-19.

For the 2017-18 academic year, undergraduate medical students undertaking the first four years of their courses will qualify for the same tuition fee loan and living costs support package from the Student Loans Company as other full-time undergraduate students. For years five and six of their courses, these students will continue to qualify for NHS bursaries and an additional reduced rate non-means tested loan for living costs from the Student Loans Company.

Teaching grants for medical students will also continue under the Office for Students (which is expected to assume Higher Education Funding Council for England's funding responsibility from April 2018) reflecting the high-cost of the subject.

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20 JAN 2017

Physician Associates

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, when the consultation on the role of Physician Associates announced in his keynote speech to the NHS Providers conference on 30 November 2016 will be launched.

 

Philip Dunne The Minister of State, Department of Health

The Department is currently considering options for a consultation on the regulation of Physician Associates, which will be published in due course.

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18 JAN 2017

Epilepsy Nurses

I was privileged to meet my constituent Helen Skinner, an epilepsy specialist nurse who spoke compellingly from both her own family's personal experience and her professional experience about the need to prevent avoidable deaths as a result of seizures. We discussed the need to improve the recording of epilepsy related deaths because clear and accurate data plays an important role in driving effective change. We also discussed the impact of discrimination in the workplace on those living with epilepsy.

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17 JAN 2017

Royal College of GPs

It was a pleasure to meet Professor Helen Stokes-Lampard, the new President of the Royal College of GPs, to discuss pressures on primary care and the important role GPs and primary care teams play in supporting patients and alleviating pressures on the health system, We also discussed the RCGP's recent report into multimorbidity, which is where a patient lives with two or more long term chronic conditions – an increasingly important aspect of a GP's role. The GP Forward View is the long term plan for improving funding of and wider support for primary care and we discussed how this can be supported to make sure that funding reaches the front line.

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17 JAN 2017

End Violence Against Women

I met with the End Violence Against Women coalition, who spoke compellingly of the importance of integrating awareness of and training for health professionals to work with victims and perpetrators of domestic violence. Domestic violence costs the health service £1.7bn a year but is still viewed largely as simply a criminal justice problem. With two women a week being killed by a current or former partner, visits to the GP or A&E are vital opportunities to make contact and prevent escalation or continued abuse.

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16 JAN 2017

BMA Council

I met with Mark Porter, Chair of the BMA Council. We discussed the impact of Brexit on recruitment and retention of our vital EU workforce across the NHS. The Health Committee has launched an inquiry into the effects of Brexit and will be considering its impact on people and the wider health and social care workforce – keep up with the progress of the inquiry and all of the Committee's ongoing work here. Mark and I also spoke about the challenges facing junior doctors, morale, NHS funding and the ongoing issues around seven day working.

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16 JAN 2017

Independent Midwives

I met with my constituent Elizabeth, an independent midwife, and representatives of Independent Midwives UK to discuss the work of independent midwives and in particular the threats to their ability to practice as a result of rulings on their professional indemnity from the Nursing and Midwifery Council. These issues were subsequently raised at the Health Select Committee hearing and are the subject of ongoing discussions.

 

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13 JAN 2017

Broadcasting (Radio Multiplex Services) Bill

Sarah Wollaston Chair, Health Committee

I congratulate my hon. Friend on bringing forward this excellent Bill to broaden choice for community providers. Will he join me in paying tribute to the volunteers who work in community radio stations throughout the country? I very much welcome the opportunity to expand the role that they play in our communities.

 

Kevin Foster Conservative, Torbay

I thank my hon. Friend and neighbour for that intervention. Hospital radio absolutely provides an opportunity for volunteers to be part of delivering something to patients, and it also develops skills and talents that may well sustain them in a future paid career. There will be stories of people who have started off presenting a hospital or community radio show as a volunteer, but displayed talent that they could take much further. My hon. Friend will know Torbay Hospital Radio, which regularly provides the outside broadcast system for community events and fairs. The image of hospital radio is just someone sat in a broom cupboard at the bottom of the hospital, playing requests, but they actually get out in the community and do interviews, and they look to be more than just a station that people listen to in their hospital beds; they really want to make a contribution.

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11 JAN 2017

NHS and Social Care Funding

Sarah Wollaston Chair, Health Committee

I will try to be mindful of those comments, Madam Deputy Speaker, as I follow Dr Whitford, my colleague on the Health Committee. As always, she made thoughtful and thought-provoking comments, and I would like to endorse her points and expand on some of them.

First, I thank NHS and care staff. We have heard that they are facing unprecedented demand over the winter, but it is not just winter pressures that they face now—the pressures extend into the summer. As we have heard, that is not just about numbers but about the complexity of conditions and the frailty of those presenting in our accident and emergency departments. The Health Committee heard in its recent inquiry that the trusts that are most successful in getting close to the four-hour target are those that see it as an entire-system issue, and in which both health and care staff contribute to the effort, not as a tick-box exercise but because they recognise that it is fundamentally about patient safety and the quality of patients' experiences. That is why the four-hour target matters, and the Secretary of State is right to endorse it.

The Secretary of State is also right that we sometimes need to be more nuanced about our targets, and that he needs to be open to listening to what clinicians are telling him about how we can improve the way in which targets are applied. It would be a great shame if we in this House prevented those sensible discussions from taking place because of political furore. I urge him to continue to have them, and to take advice and listen to clinicians about how we can improve the use of targets, but he is absolutely right in being clear that he will keep the four-hour target.

We must talk about this as a whole-system issue. Accident and emergency is a barometer of wider system pressures, as has been pointed out, and I want to focus my remarks on the integration of health and social care.

I agree with colleagues throughout the House who have called for a convention on reviewing funding as a whole-system issue. We have heard that next year is the 70th birthday of the NHS, and what could be a better present than politicians changing the debate and the way in which we talk about the funding of health and social care, so that we do so in a collaborative manner that works towards the right solution for our patients? The consequences of our not doing that would be profound for our constituents, who would not thank us for not being prepared to put aside party differences and work towards the right solution.

Ultimately, this issue is about a demographic change that we are simply not preparing for adequately. In the case of the pension age, we recognised that there had to be a different debate given the change in longevity. Over the decade to 2015, we saw a 31% increase in the number of people living to 85 and older. Of course, that is a cause for celebration, but there has not been a matching increase in disease-free life expectancy.

I welcome the Prime Minister's focus on tackling inequality, but unfortunately we are not making sufficient progress on that, either. In her very first speech in the job, she talked about tackling the "burning injustice" of health inequality. We in this House have a role in doing that together in a consensual manner.

Norman Lamb Liberal Democrat Spokesperson (Health)

I very much agree with the hon. Lady. Does she share my welcome for the Prime Minister's response today in which she stated that she was prepared to meet us and other Members of Parliament from across the House, and my hope that it might start a more constructive approach?

Sarah Wollaston Chair, Health Committee

Absolutely. It was extraordinarily encouraging to hear the Prime Minister say that she was prepared to consider that and to meet Members from across the House. I urge colleagues who feel that this is a better way forward to sign up to it, speak to their party Whips and make it clear that it has widespread support.

Barbara Keeley Shadow Minister (Mental Health and Social Care)

I wonder, on this vital issue, whether the hon. Lady wants to say something about what her own party did on the two previous times we tried to get important cross-party working on health and social care: it made it an election issue, producing posters about a "death tax"; and on the second occasion the Secretary of State just walked away from the talks.

Sarah Wollaston Chair, Health Committee

I am afraid that that intervention is exactly not the kind of debate we want to be having. Let us look to the future. We are in a different part of the electoral cycle. I accept the hon. Lady's comments—I was still an NHS clinician when that happened and, like many of those working in health or social care, I looked at the yah-boo debate in this place and thought that surely there had to be a better way—but I ask her to put them aside and to look to the future rather than backwards, otherwise we will not get anywhere. I think our constituents want us, as politicians, to recognise the scale of the challenge and to get to grips with it.

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10 JAN 2017

Soft Drinks Industry Levy: Funding for Sport in Schools

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow John Mc Nally and my fellow Health Committee member, my hon. Friend Maggie Throup. I am very grateful to my hon. Friend Justin Tomlinson for bringing this very important debate to the House.

I realise that this is not a debate about the sugar levy per se, but I would like to state at the outset that I fully support the levy. In fact, if anything, I would like it to be extended to include milk-based sugary drinks. It addresses a very important issue, and it is worth reminding ourselves of the data on health inequality from obesity. Now, in the most disadvantaged areas, 26% of the most deprived children are leaving year 6 not just overweight but obese, with extraordinary long-term consequences for both their mental and physical health, so we should remain focused on what the purpose of the measure is.

Let me also stress that we should not think about tackling obesity as just about sport; it is also about nutrition. We should not lose sight of that in the debate. Reducing calories has to be the mainstay of addressing childhood obesity. That said, we should also have a message that exercise and physical activity matters, whatever one's age and weight, and has extraordinary benefits. I fully support the words of my hon. Friend the Member for North Swindon about how we can incorporate sport as part of the anti-obesity strategy and about the importance of hypothecating the money raised by the sugary drinks levy so that it goes to these types of project and is focused on the most disadvantaged groups.

Julie Elliott Labour, Sunderland Central

Does the hon. Lady agree that the 26% in the most deprived areas are probably children from the families who are least able to afford some of the things that have been mentioned, such as the £12.50 a day for sports activities, and that the cost of things should not rule out children who probably need that activity more than others?

Sarah Wollaston Chair, Health Committee

I thank the hon. Lady for her intervention. I absolutely agree. It is essential, if we are to address some of the accusations that this is a regressive tax, that we ensure that it becomes progressive in the way the money and the resources are allocated. I think there has been a commitment to that. We can look at how the Government have stated they will spend the money—providing up to £285 million a year to give 25% of secondary schools in the most disadvantaged areas the opportunity to extend their school day, and £10 million of funding to expand breakfast clubs in the most disadvantaged areas. I absolutely agree with the hon. Members who have already commented that that could be extended into holiday periods. I am talking about how we look at nutrition, and expanding nutritional education and, in particular, targeting that on the most disadvantaged areas. We know that Mexico's experience is that those on the lowest incomes end up spending more of their income on products such as sugary drinks, so we must be absolutely clear that the benefit returns primarily to the most disadvantaged, and of course it is the most disadvantaged areas that have the highest levels of childhood obesity, so I absolutely agree with what Julie Elliott has said.

This is primarily about school sport and how we hypothecate the money for activities in the most disadvantaged areas, although not just in the most disadvantaged areas. We have already heard the hon. Member for Falkirk pay tribute to Elaine Wyllie, and I add my tribute to her extraordinary achievements. She told me when I met her recently that if directors of public health take this initiative on board, that gives it much a greater impetus. She has looked at where it has been most successfully rolled out, and it is where directors of public health work together with education to push for it and see the benefits. Of course, the benefits are not just for children. The initiative is now being rolled out to families and staff in schools, so there is a whole-community approach to changing attitudes to mobility.

I would also like to make a point about active travel. The all-party parliamentary group on cycling, of which I am a member, held an inquiry in the last Parliament, "Get Britain Cycling". One issue that was very clear from that was that active travel is one of the forms of activity that people are most likely to engage in over the long term. I therefore urge my hon. Friend the Minister to consider how schools can engage with the programme and get children cycling to school and college. My hon. Friend the Member for Erewash pointed out that the cost of a bike can sometimes be a deterrent, but there are many things we can do about rolling out Bikeability to all ages across schools and ensuring that we focus on active travel, because that is the form of activity that people are most likely to sustain throughout their life.

I would also like to pick out the importance of play. I pay tribute to Play Torbay, in my constituency, and the work it is doing. That has been pointed out by the all-party parliamentary group on a fit and healthy childhood. I do not know whether the Minister has had the chance to read its excellent report, which considered how we can use the money effectively. I agree with my hon. Friend the Member for Erewash that evaluation is critical. We need to see what delivers results in the long term, particularly because, if the tax is effective in the way we hope it will be, the revenues raised from it will decrease as a result of behavioural change. We need to ensure that the money available is targeted in the most effective ways.

We should also look at the difference in activity rates between girls and boys. Girls are not as physically active; particularly as they go through the school years, activity levels decline. I urge the Minister to continue to support Sport England's "This Girl Can" programme, which has already been referred to. We need to look across the piece and make sure we engage children at every level in a way that they are most likely to continue to keep active. I have a concern that if we just talk about sport, we risk taking our eye off the ball. Tackling obesity first and foremost has to involve calorie reduction. We must take empty, wasted calories out of children's diets. There are other harms; obesity is not just about sugar levels. The biggest single cause of admission to hospital for primary school children is to remove their rotten teeth. The benefits of reducing sugar in children's diets go beyond tackling obesity.

Will the Minister liaise with his colleagues on the rest of the money from the sugary drinks levy that we are raising? As it stands, the Government have indicated that a significant proportion will go towards the academisation programme, but now that there has been a change to the policy objective of forced academisation, I think the sugary drinks levy would command far greater public support if every penny of it was hypothecated to public health measures to support children, particularly at a time when public health grants are being cut and measures to support children who are already obese are being cut back in local authorities. I hope to see even more of the sugary drinks levy being hypothecated to progressive measures to target children who are already obese and to help prevent children from becoming obese in the first place. I support my hon. Friend the Member for North Swindon in saying that sport is a key part of that, and that matters whatever a child's weight and whatever a child's age.

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09 JAN 2017

Mental Health and NHS Performance

Sarah Wollaston Chair, Health Committee

I welcome the Secretary of State's statement and the Prime Minister's focus on mental health in her speech today. She spoke of holding the NHS leadership to account for the extra £1 billion that we will be investing in mental health. Will the Secretary of State set out in further detail how clinical commissioning groups will be held to account for ensuring that that money gets to the frontline so that we can deliver progress on parity of esteem?

Jeremy Hunt The Secretary of State for Health

Yes, I can do that. It is a very important point. We have had a patchy record in the NHS of ensuring that money promised for mental health actually reaches the frontline. The way that we intend to address this is by creating independently compiled Ofsted-style ratings for every CCG in the country that highlight where mental health provision is inadequate. Those ratings are decided by an independent committee chaired by Paul Farmer, who is responsible for the independent taskforce report, so he is able to check up on progress towards his recommendations. I am confident that, by doing that, we will be able to shine a light on those areas that are not delivering on the promises that this Government have made to the country.

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22 DEC 2016

Neuromuscular Disorders: Ambulance Services

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what discussions his Department has had with National Ambulance Service medical directors on ensuring that the best practice system of flagging people with muscle-wasting conditions to ambulance crews in London, North West and North East Ambulance Services is used across all ambulance services.

Philip Dunne The Minister of State, Department of Health

The Department has not had any recent discussions with National Ambulance Service Medical Directors on this subject.

NHS England has advised that it is working with all ambulance services in England to ensure the right resource is allocated to the right 999 call at the right time.

Currently the flagging of patients with long term conditions or longer term care needs is not used universally. However the development of technology to allow real-time searching of the National Health Service number as a unique patient identifier will significantly increase the value of placing 'flags' on patients with specific clinical needs. This will then reliably allow any attending healthcare professional to access care plans and special patient notes to help inform individual patient management. This is a component of the 2017/19 ambulance service national Commissioning Quality and Innovation framework.

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21 DEC 2016

Health Professions: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what assessment he has made of the effect of including the market forces factor as a criterion for allocation of Service Increment for Teaching (SIFT) funding on the amounts allocated for each Local Education and Training Board (LETB) in England; and what estimate he has made of the proportion of SIFT funding spent on salaries in (a) London and (b) each other LETB in England.

Philip Dunne The Minister of State, Department of Health

The market forces factor (MFF) index used in the allocation of funding for clinical placements (formerly known as service increment for training) is consistent with the approach taken by NHS Improvement in adjusting service tariffs to reflect unavoidable cost differences between health care providers, based on their geographical location. This is considered the most appropriate method to adjust resource allocations in the National Health Service in proportion to these cost differences.

The MFF is applied to all three education and training tariffs, however it is not applied to the contribution to salary for postgraduate doctors in training, which instead are based on national pay scales and amended for inner and outer London weighting.

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21 DEC 2016

Dentistry: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will publish the rates at which the NHS market forces factor is applied to the dental service increment for teaching.

Philip Dunne The Minister of State, Department of Health

Payments for dental undergraduate clinical placements (formerly known as dental service increment for teaching) are outside the scope of the medical undergraduate clinical placement tariff and subject to local arrangements between the placement provider and Health Education England.

There is no nationally mandated market forces factor rate applied to these locally agreed payments.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how much dental and medical service increment for teaching funding was allocated to each dental school by (a) student and (b) in total for each of the last three years.

Philip Dunne The Minister of State, Department of Health

The table below shows the total funding allocated by Health Education England (HEE) for dental placements in England in each of the last three years.

Year  Funding Allocated £ million
 2014/15  £98.5
 2015/16  £97.7
 2016/17  £99.7

Source: HEE

Information relating to the funding allocated to individual dental schools is not held centrally.

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20 DEC 2016

Health Topical Questions

Sarah Wollaston Chair, Health Committee

The Health Committee has just published its interim report on preventing suicide. I thank all those who gave evidence to our inquiry and all members of the Department of Health advisory group. We support the strategy, but the clear message that we heard was that implementation needs to be strengthened. Will the Secretary of State meet me to discuss our report's recommendations, and will he join me in thanking members of the Samaritans and other voluntary groups around the country who will be working tirelessly over Christmas, as they do every day, to support those in crisis?

Jeremy Hunt The Secretary of State for Health

My hon. Friend speaks wisely. Christmas can be a very lonely time for a number of people, so we all commend the work of voluntary organisations that do so well. I would be delighted to meet her.

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19 DEC 2016

Physician Associates: Training

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will publish the funding provided through Health Education England for the training in NHS providers of Physician Associate students for each programme supported per student (a) per year and (b) over the course of the training.

Philip Dunne The Minister of State, Department of Health

The total funding provided by Health Education England for the training of Physician Associate students for each programme supported is:

- £15,655 per student per year; and

- £31,310 per student over the duration of the two year course.

The cost per student consists of tuition, maintenance and clinical placement funding as outlined in the table below.

  Clinical Placement
Tuition
Maintenance
Cost per student  £2,156  £7,310  £6,189

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19 DEC 2016

Medicine: Education

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps his Department is taking to ensure that students of private medical schools receiving training in NHS settings do not pay less than the cost of providing that training.

Philip Dunne The Minister of State, Department of Health

The arrangements for students of private medical schools to receive training in National Health Service settings are a matter for agreement between the medical school and the NHS organisation. Funding for placements commissioned by Health Education England and its local offices should not be used to subsidise any element of the cost of placements for non-NHS funded students or trainees.

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Hansard

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16 DEC 2016

Department for Transport: Rolling Stock

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Transport, what assessment he has made of the economic effect on the (a) South West region and (b) UK of the lack of new rolling stock available to train companies; and if he will make a statement.


Paul Maynard Parliamentary Under-Secretary (Department for Transport)

The Government and the private sector has continued to invest in new rolling stock in the South West and in other regions to provide improved services for passengers.

The market for new rolling stock in the UK has become increasingly vibrant in recent years, with a number of manufacturers competing to provide new rolling stock to the UK's train operating companies.

Train operators are not seeing a shortage of train manufacturing companies or financiers offering new rolling stock for the UK's rail network.

Over 1,900 new vehicles were ordered in 2016 alone.

Great Western Railway are acquiring 29 brand new bi-mode trains to operate services to the South West of England.

Nationally passengers will see over 5,000 new vehicles delivered to operators between now and the end of 2020.

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15 DEC 2016

Local Government Finance Settlement

Sarah Wollaston Chair, Health Committee

It is good news that people are living longer—in the decade to 2015, there has been a 31% increase in the number of people living to 85 and over—but already, more than a million people have unmet care needs. Although I welcome the fact that some of this money will be brought forward, I do not feel as though we are going far enough in this House to address the scale of the increase in demand and allow people to be cared for with dignity in their old age. May I join the Chair of the Communities and Local Government Committee in asking the Government to start cross-party talks urgently to ensure that we have a long-term, fair, sustainable settlement for both health and social care?

Sajid Javid The Secretary of State for Communities and Local Government

My hon. Friend speaks with experience. I know that she has spent a great deal of time looking into this issue, especially in her work as Chair of the Select Committee on Health, and I take what she has to say very seriously. I think I am correct in saying that my hon. Friend used the words "bring forward spending". Today's announcement on adult social care does more than just bring it forward; it is a real, significant increase in spending of £900 million. To be clear, that is an additional £900 million over the next two years where there are some of the biggest short-term pressures. That would not have happened had these changes not been announced. It is, significantly, new money, not just bringing forward spending. I know that she will welcome that clarification.

My hon. Friend referred to the need to talk widely, including with members of the Opposition. I would include in that local leaders, health professionals and social care professionals, and that is certainly what I intend to do over the coming months, to make sure that we keep this always under review.

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14 DEC 2016

Prime Minister Question Time

Sarah Wollaston Chair, Health Committee

One of my constituents has just had to move to residential care because no carers could be found to support her in her own home. She is at the sharp end of a crisis in social care that is as much about inadequate funding as it is about a shortfall in our very valued social care workforce. I am looking forward to hearing what immediate further support will be provided for social care, but is it not time that rather than having confrontational dialogues about social care funding, all parties work together, across this House, to look for a sustainable long-term solution for the funding of both integrated health and social care?

Theresa May The Prime Minister, Leader of the Conservative Party

My hon. Friend is right to raise the issue of looking at a sustainable way in which we can support integrated health and social care, and a sustainable way for people to know that in the future they are going to be able to have the social care that they require. As I said earlier in response to the Leader of the Opposition, we recognise the short-term pressures that there are on the system, but it is important for us to look at those medium-term and longer-term solutions if we are going to be able to address this issue. I was very pleased to be able to have a meeting with my hon. Friend to discuss this last week, and I look forward to further such meetings

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13 DEC 2016

Department for Transport: Rolling Stock

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Transport, what steps his Department is taking to accelerate access for train-operating companies delivering services (a) to the South West and (b) nationally to new passenger rolling stock.


Paul MaynardParliamentary Under-Secretary (Department for Transport)

Improvements in rolling stock are part of the Government's investment in the railways that will deliver better journeys for passengers.

In relation to the South West of England specifically, in July 2015the Department announced that Great Western Railway would be acquiring 29 brand new Hitachi AT300 bi-mode trains for longer distance services between London and the South West of England.

Nationally, new train procurements including Thameslink, Crossrail and the Great Western/East Coast Intercity Express Programme will see over 5000 new carriages delivered to operators between now and the end of 2020.

In 2016 alone we have announced that over 1900 new carriages will be delivered by the franchising programme over the next five years, including over 500 into the Northern and TransPennine franchises, 211 for Great Western, 150 for Great Northern and 1043 for East Anglia.

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Hansard

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06 DEC 2016

Care Quality Commission

The Health Committee held an accountability hearing with the Care Quality Commission (CQC) today. The hearing follows the regular series of accountability hearings held by the Committee in the last Parliament, and the reports on the CQC by the National Audit Office in July 2015 and the Committee of Public Accounts in December 2015.

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29 NOV 2016

Cross Country Trains

The Managing Director of Cross Country trains, Andy Cooper, came to meet local MPs in response to our concerns about proposals to change the timetable which would involve axing important services. A number of trains which run directly from Newton Abbot, Paignton and Torbay to Birmingham, and on to Manchester, would be lost each weekday. A shortage of new train carriages for the network means Cross Country has chosen to reduce services for this region to relieve overcrowding elsewhere.
Cross Country apologised unreservedly for the lack of publicity given to the consultation, which will impose such drastic cuts to services for us in the South West. The proposed changes will hit our tourism sector and other businesses, as well as cause increased overcrowding and inconvenience for an area of the country already disadvantaged by low investment in rail services. I am totally opposed to the company trying to relieve overcrowding elsewhere in the system at our expense. I urge all constituents to sign the Herald's 'Save our trains' petition, and I will continue to work with colleagues to call on the Department for Transport and the train operator to find a fairer way of tackling overcrowding and improving rolling stock.

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29 NOV 2016

Health Select Committee

Today was the last evidence session on suicide prevention where we questioned Jeremy Hunt and others

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29 NOV 2016

Second Homes

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, with reference to paragraph 6.6 of the Autumn Statement 2015, if he will publish the application process for applying for extra funding for local authorities in areas affected by high levels of second home ownership.

 

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, with reference to paragraph 6.6 of the Autumn Statement 2015, when his Department plans to make available the proposed extra funding for communities affected by high levels of second home ownership.

Gavin Barwell Comptroller (HM Household) (Deputy Chief Whip, House of Commons), Minister of State (Department for Communities and Local Government) (Housing, Planning and London)

The Department for Communities and Local Government remains committed to providing the funding indicated at Budget 2016 to support community led housing in areas affected by high levels of second home ownership. We will announce the allocation process for this funding shortly.

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Hansard

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24 NOV 2016

Reducing Health Inequality

 

Back Bench Debate: Reducing Health Inequality

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23 NOV 2016

Nurses: Training

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if the Nursing and Midwifery Council will include mandatory bowel and bladder care training for pre- and post-registration nurses in the new revised curriculum.

 

Philip Dunne The Minister of State, Department of Health

The Nursing and Midwifery Council (NMC) is the independent body responsible for the regulation of nurses and midwives in the United Kingdom. It is responsible for the way it discharges its statutory duties including setting standards of education, training, conduct and performance, so that nurses and midwives can deliver high quality healthcare throughout their careers. Accordingly, it is for the NMC to decide what it will include in its standards of proficiency. Its role as a professional regulator does not include developing or revising a curriculum. That is the role of education institutions.

The Code for nurses and midwives requires that they must prioritise people, practise effectively, preserve safety and promote professionalism and trust. This includes practising in line with the best available evidence. The Code also states that nurses and midwives must treat people as individuals and uphold their dignity by delivering the fundamentals of care effectively. The fundamentals of care include nutrition, hydration, bladder and bowel care, physical handling and making sure that those receiving care are kept in clean and hygienic conditions.

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Hansard

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23 NOV 2016

Autumn Statement

Sarah Wollaston Chair, Health Committee

The Care Quality Commission has warned that social care is at a tipping point and vulnerable people across the country are being left without the care and support that they need, which is adding hugely to costs for the NHS. I am disappointed that the better care fund has not yet been brought forward, but encouraged to hear that that is actively under discussion. Will the Chancellor confirm that we should try to get away from this divisive debate in the House about how we are going to fund our health and social care, and that all parties should work together for a new, sustainable, long-term settlement?

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22 NOV 2016

Incontinence: Health Services

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, which Clinical Commissioning Groups have put into practice the NHS EnglandExcellence in continence care guidelines published in November 2015.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps NHS Englandhas taken to promote the Excellence in continence care guidelines to (a) clinical commissioning groups, (b) patient groups and (c) the general public.

David Mowat The Parliamentary Under-Secretary of State for Health

Excellence in Continence Care is best practice guidance and NHS England does not currently hold information on which clinical commissioning groups (CCGs) have put the guidance into practice. However it anticipates auditing CCGs in future in order to capture this information.

NHS England issued a press release and secured significant media coverage to launch the guidance in 2015 and has promoted it to a range of audiences including special interest groups, professional societies and provider organisations.

In addition to media work, NHS England has engaged with key stakeholders who form part of the Excellence in Continence Care Board. The Board membership has evolved over time and has included clinical experts working in National Health Serviceorganisations, patient advocates and representatives. Board members support NHS England to raise awareness of the guidance to special interest groups, patients groups, professionals within their extended networks which recently included the Association of Continence Advisors Conference.

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22 NOV 2016

National Health Service Funding

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow my hon. Friend Dr Whitford.

I want to touch briefly on the importance of clear data, the current financial position, and the need to agree on a settlement for the future in this House rather than continuing to have such confrontational debates.

I can see how the £10 billion figure has been arrived at: by adding an extra year, starting from 2014-15, and by transferring budgets to NHS England. When the Secretary of State refers to the NHS, he is actually referring to NHS England. He is not including public health. He is not, for example, including Health Education England. However, it is crucial that they are considered. As my hon. Friend the Member for Central Ayrshire said, when we talk about transferring money from public health to the NHS England budget, we are cutting off our ability to control the increase in future demand. We face significant challenges, which we will not address unless we invest in those future services.

We sometimes talk about public health as if it were not front-line care, but it is. We are talking about, for instance, services to help people with addictions and sexual health services—really important costs for the NHS. There is also the challenge of the reduction in Health Education England's £5 billion budget, £3.5 billion of which is spent directly on the wages of health service doctors who are undergoing training, but also delivering front-line services. Cuts to Health Education England cut us off from future sustainability, because that is the budget that trains, retains and sustains our existing workforce. This is all crucial to front-line services.

The other way in which the £10 billion figure has been arrived at is by changing the baseline from which we calculate real-terms increases. I would say that it has never been more important than it is now for the public to have confidence in the data that we use. Trying to return us to talking about total health spending is not trying to be awkward; it is trying to be honest with the public. It is difficult to argue that more funding for health and social care is necessary if a £10 billion increase has been claimed. It is important that we continue to use the same consistent baselines that have been used in the past, so that the public can see what has happened to total health spending.

I welcome the front-loading of the settlement, and I welcome the fact that the NHS has been relatively protected in comparison with other departments, but the scale of the increase in demand is extraordinary. When Simon Stevens talked about welcoming the increase that had been granted, he made it clear that it was dependent on a fair settlement for social care and a radical upgrade in public health, and those two aspects are lacking.

I think that both sides are correct. I can see how the Secretary of State has arrived at the £10 billion figure, but whenever that figure is used we should also present a figure that refers to total health spending in the way in which it has always been referred to in the past. I think that that would help to build the Secretary of State's case for an increase in funding as we go forward.

Like others, I hope that we shall see an uplift for social care in the autumn statement, because the impact of social care on the NHS is now profound. There cannot be a Member in the House to whom it has not been made clear by people who come to his or her surgery that the state of the care system is in collapse and providers are in retreat. Even those who can afford to pay are finding it difficult to gain access to care.

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

Sarah Wollaston Chair, Health Committee

We know it does, and the CQC report describes social care as being at a tipping-point; it is in a very fragile state and we owe it to all our constituents to try to come together to agree where we go from here. Many have proposed a royal commission to look at future sustainability, but we have had commissions: the Barker commission set out the options, and the House of Lords is looking at future sustainability and the range of options.

I urge colleagues across the House to try to agree, rather than having this continual confrontational debate. The best way forward would be for all parties in this House to agree that this is an enormous challenge. My personal belief is that we should stick with our current very equitable system of state funding of our NHS, look at the various options and agree between us that we need to address this. We cannot keep ducking it; we owe it to all our constituents to adopt a much more constructive tone to our debate.

We know that the current position is unsustainable, and that was reiterated in today's National Audit Office report. We can continue to shout across the Chamber about how much is spent, but we know this will be a challenge whoever is in power, and I urge all colleagues to focus instead on a different approach. Yes, more can be done within the NHS, but I am afraid that the elastic is stretched far too tight for social care to make any more efficiencies. We now need to work together to see how we can fund this going forward.

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

Sarah Wollaston Chair, Health Committee

All I clarified was that the way it had been arrived at is not a way that the public would understand health spending, so I think the Minister is perhaps taking my words out of context, if he will forgive me.

Philip Dunne The Minister of State, Department of Health

We never claimed that we were increasing the Department of Health's budget; we were talking about the increases to the NHS. For complete clarity, in 2014-15 the NHS budget was £98.1 billion; in 2020-21, it will be £119.9 billion. For Opposition Members who cannot do the maths, that is a £21.8 billion increase in cash terms to NHS England, or £10 billion in real terms. We promised £8 billion; we are delivering £10 billion.

We also listened to NHS leaders' requests for a front-loaded settlement and delivered on that—it was welcomed by hon. Members in today's debate—with £6 billion of the £10 billion increase coming by the end of this year, including a £3.8 billion real-terms increase in this year alone.

We have also created a £1.8 billion sustainability and transformation fund for the current year to help providers to move to a sustainable financial footing. This fund will mainly be allocated to emergency care provision, which faces some of the greatest demand growth and financial pressures within the system.

This brings me to the next important point I want to address. While more funding is obviously welcomed, hon. Members have drawn attention to rising deficits in the budgets of NHS providers. We recognise that stronger financial management is required to turn this situation around, and we have introduced robust governance arrangements to get things back on track. There are four main elements to this plan: extra investment in the spending review, as I have discussed, and freeing up local government to spend more on adult social care; restoring financial discipline in the short term, through the measures set out by NHS England and NHS Improvement in July, with a wide-ranging set of actions; reducing demand for acute care in the longer term; and driving efficiency and productivity across the provider sector, building on the work of Lord Carter, who has identified large variations in efficiency across non-specialist English acute hospitals, and controlling cost pressures. The need to reduce variations was raised by my hon. Friend Andrew Selous in his very constructive contribution, and by Jim Shannon. We agree that we need to reduce the variability in the poorly performing trusts and bring them up to at least the average standard, if not higher.

We are now beginning to see the first fruits of the plan, with the publication last Friday of the figures for the second quarter deficit, which has been reduced to £648 million, down from £1.6 billion in the same period last year, representing a £968 million improvement. Progress halfway through the financial year is therefore encouraging, but there is no room for complacency. That is why the system needs to stick to its strong financial plan, supported by our investment and by a series of measures set out to help hospitals to become more efficient and to reduce the use of expensive agency staff.

Several hon. Members talked about the sustainability and transformation plans, 28 of which have now been published. The remainder will be published by the end of next month. Half of the Labour Members who spoke in the debate talked specifically about the STP covering Cheshire and Merseyside. It was disappointing that only one of those three Members was able to attend the Westminster Hall debate earlier today in which we discussed conditions in Cheshire and Merseyside. I remind Labour Members that that STP was led by the chief executive of Alder Hey hospital in Liverpool, with whom I would strongly encourage hon. Members who are complaining about a lack of engagement to have a conversation.

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22 NOV 2016

Peninsula Task Force

I joined MPs from Devon, Cornwall and Somerset, as well as Councillors from across the South West, to the launch of the Peninsula Rail Taskforce's report 'Closing the Gap'. The report sets out a 20 year strategic blueprint for upgrading the South West's rail network and its connections towards London, Bristol and the North. We highlighted the report's key themes to Rail Minister Paul Maynard, underlining the importance of making the line more resilient, as well as improving the speed and quality of the journey. The Minister reaffirmed the Government's commitment to improving rail links to the South West, including the Transport Secretary's announcement last week of a further £10 million in funding to improve resilience at Dawlish.

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21 NOV 2016

The Health Gap

Today I chaired an event with Professor Sir Michael Marmot, Director of the Institute Of Health Equity and the author of the new book 'The Health Gap: The Challenge of an unequal world". It was an enlightening talk about the problems around health inequality.

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17 NOV 2016

English Wine Industry

Sarah Wollaston Chair, Health Committee

Further to that point, will my hon. Friend join me in congratulating Sharpham Wine and Cheese, which does just that? It is not only producing fantastic wines but fantastic cheeses and is providing a welcome tourist centre for tours, sharing expertise and creating valuable local employment.

Neil Parish Chair, Environment, Food and Rural Affairs Committee, Chair, Environment, Food and Rural Affairs Sub-Committee

I very much commend the Sharpham vineyard, because, once again, it is reaching out. It is producing a good wine, and then we can have good local food and bring more and more tourists down to the south-west, provided that we dual the A30 into Honiton while we are it and along the A358 to Taunton—that was not part of my speech.

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16 NOV 2016

Social Care

Sarah Wollaston Chair, Health Committee

I agree with Norman Lamb on the need for cross-party working to achieve sustainable funding for both health and social care. As the hon. Lady will know, I have set out my concerns about the underfunding of social care in a letter to the Chancellor. Does she agree that it is not just about funding, however, but also about how we support and train our social care staff? Would she like to see further progress made on the recommendations of Camilla Cavendish about how we train and support our care staff to help to retain them as well as recruit them?

Barbara Keeley Shadow Minister (Mental Health and Social Care)

I agree, and that is why I started my speech by saying we should value the job our care staff do and we should train them properly; it should be a proper job with a proper career path. The care staff I met today were reduced to worrying about what they were being paid, however, simply because they were paid less than the minimum wage.

This is what six years of funding cuts to social care actually mean for people who need care and their carers: unmet needs for care; patients stuck in hospital, increasingly because they have to wait for a care home or a nursing home place; poor quality care in care homes, with one quarter of "inadequate" services unable to improve; poor quality home care, with more complaints being upheld by the ombudsman; more unpaid family carers having to step in to care; more unpaid family carers having to provide increased levels of care; and, without the right support, those family carers becoming isolated, burnt-out and unable to look after their own health. That is a disturbing deterioration in the state of social care. I want the Secretary of State to tell us whether he recognises the scale and seriousness of the issues I have outlined.

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15 NOV 2016

All Party Parliamentary Cycling Group

Today I met with the All Party Parliamentary Cycling Group, which promotes all forms of cycling i to discuss priorities for our future programmes to get Britain cycling and to improve safety.

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15 NOV 2016

The Shelford Group

I met with The Shelford Group, which comprises ten leading NHS multi-specialty academic healthcare organisations, to discuss health funding and the importance of free movement of NHS and research staff.

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15 NOV 2016

Professor Sneyd

Great to catch up with Professor Sneyd from Plymouth University to talk about medical student training, primary care and the terrific opportunities at Plymouth University

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15 NOV 2016

Care England

I met with Care England today to discuss the challenges facing social care.

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14 NOV 2016

Health Select Committee Visit

Thank you to Everton Football Club charity EITC and State of Mind for meeting the House of Commons Health Committee and for your work supporting mental and physical health and fitness.

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11 NOV 2016

Nurses: Pay

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what estimate he has made of NHS England payroll expenditure excluding VAT on (a) permanent nursing staff and (b) agency nursing staff in 2016-17.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what the value was of NHS Englandpayroll expenditure excluding VAT on (a) permanent nursing staff and (b) agency nursing staff in (i) 2014-15 and (ii) 2015-16.

Philip Dunne The Minister of State, Department of Health

The Department is able to provide payroll expenditure for all Qualified Nursing, Midwifery and Health Visiting Staff on employment contracts with the National Health Service. This information for 2014-15 and 2015-16 is tabled below. VAT costs do not apply to staff on NHS Employment contracts.

The requested information for 2016-17 is not yet available.

Year               
 Payroll costs for Qualified Nursing, Midwifery and Health Visiting Staff in NHS Hospital
and Community Health Services in England. (£)
 2014-15   
 13.3 billion
 2015-16  13.5 billion

The Department does not hold national data on agency staff that is broken down by staff group.

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08 NOV 2016

Grammar and Faith Schools

Sarah Wollaston Chair, Health Committee

My hon. Friend is making a powerful speech. Does he agree that the third issue should also be about social cohesion? Does he share my concern about some of the proposals on faith schools? I recognise the contribution that they make, but can he think of a single reason why the child of an atheist parent like myself should be excluded from a school because of their parents' lack of faith? Does he also share my concern that 100% selection by faith risks driving communities into further segregation and does nothing to improve social cohesion?

Neil Carmichael Chair, Education Committee, Chair, Education, Skills and the Economy Sub-Committee

I thank my hon. Friend for that instructive intervention. It goes off the issue of grammar schools, which I was hoping to talk about, but she is right that the issue of faith schools should be addressed. I say two things. First, we must have an inclusive society; we cannot parcel people up in that sector and say, "That's you—off you go!" That is not acceptable. We must make sure that our faith schools do not do that and instead are all embracing. It is the outward-looking school, of whatever faith, that will do a good job.

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08 NOV 2016

Health Select Committee

The Health Select Committee today held an oral evidence session with a number of experts on suicide prevention.

Representatives from Network Rail, the RNLI, Devon Suicide Prevention Alliance, the 'If U Care Share' Foundation, The James Wentworth-Stanley Memorial Fund, the Matthew Elvidge Trust, the MindEd Trust, Young Minds, and Suicide Crisis discussed this important issue

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07 NOV 2016

UK Statistics Authority

Thanks to Ed Humpherson, the UK Statistics Authority's Director General for Regulation, for coming to Parliament today.

We had a good, wide ranging discussion about the importance of facts and evidence in politics and decision-making.

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07 NOV 2016

Royal College of Anaesthetists

Today I met with Liam Brennan, the President of the Royal College of Anaesthetists. We had the chance to discuss the workforce in the NHS, anaesthetics safety, and more.

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03 NOV 2016

Community Pharmacies

Sarah Wollaston Chair, Health Committee

Further to that point, the Minister knows that our pharmacists are a highly skilled and professional resource that has long been underused in the NHS. He has mentioned the ongoing Murray review, and a sustainability and transformation plan process is also going on around the country. My concern is that the closures will come about in a random way, rather than through a planned process based on identifying skills in particular areas. Will he consider delaying them until we have all the reports in place and we can consider the matter on an area-by-area basis?

David Mowat The Parliamentary Under-Secretary of State for Health

The access scheme is the device that will ensure that pharmacies are not closed in a random way. I want to address the point about closures head on. It is my belief that there will be a minimal amount of closures. The impact analysis talks about 100 and it models 100. The average pharmacy has a margin of 15%, and the amount of efficiency savings that we are asking pharmacies to make over two years is 7%. In addition, the average pharmacy is trading for £750,000 when it closes or merges, even after we announced these efficiency savings a year ago. That value is being retained.

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02 NOV 2016

Health Select Committee

You can read the Health Select Committee report on winter pressure in accident and emergency departments here

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02 NOV 2016

Sierra Leone's Health Committee

It was an honour to meet with Dr Sesay MP, chair and colleagues from Sierra Leone's Health Committee to discuss improving health and sanitation.

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01 NOV 2016

Health Select Committee Suicide Prevention

The Health Committee held the first evidence session as part of its inquiry into the action which is necessary to improve suicide prevention in England.

If you are in need of confidential emotional support, you can contact Samaritans 24 hours a day by calling free on 116123, or emailing jo@samaritans.org

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01 NOV 2016

Pharmacovigilance

I met this morning with Dr Brian Edwards, Ms. Nimisha Kotecha and Mr Colin Knight, to discuss pharmacovigilance and the impact of Brexit on the industry

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01 NOV 2016

Sense About Science

Thank you to Sense about Science for coming to Parliament to talk about why evidence matters in public policy.

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01 NOV 2016

Mental Health Policy Group

It was great to catch up with the Mental Health Policy Group in Parliament today. I met with experts in understanding mental health from the Royal College of Psychiatrists, the Centre for Mental Health, Rethink Mental Illness, MIND, and the Mental Health Foundation.

We talked at length about the work of the Mental Health taskforce and what the NHS can be doing to improve mental-wellbeing across the United Kingdom. You can read more about the task force's work here

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31 OCT 2016

Advertising Standards Authority

I met with Guy Parker, Chief Executive of Advertising Standards Authority to talk about the importance of challenging misleading claims on medicines and alternative treatments, which can be dangerous and risky to health if they encourage people not to use traditional, evidence-based treatments.
A recent example is the ASA ruling on a company promoting thermal mammography, a medically unproven process of diagnosis.
We also discussed concerns over the marketing of unhealthy foods to children. In its recent Childhood obesity: brave and bold action report, the Health Committee made a number of recommendations aimed at protecting children from unsuitable advertising and to promote healthier family choices.

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31 OCT 2016

NHS Funding

Sarah Wollaston Chair, Health Committee

I agree with the Secretary of State that prevention is better than cure, but he will know that achieving the aims of the five year forward view was dependent on a radical upgrade in public health and prevention. He will know that it was also dependent on adequate funding for adult social care. In addition, there are continuing raids on the NHS capital budget, and we need to put in place the kind of transformation that he and our sustainability and transformation partnerships wish to achieve.

Will the Secretary of State therefore confirm that he recognises the serious crisis in social care and the effect it is having on the NHS, and the effect that taking money from public health budgets is having? Although I accept that he does not agree with the Health Committee's appraisal of the £10 billion figure, I am afraid I stick by those figures.

Jeremy Hunt The Secretary of State for Health

I have enormous respect for my hon. Friend. I respect her passion for the NHS, her knowledge of it and her background in it, so I will always listen carefully to anything she says. I hope she will understand that just as she speaks plainly today, I need to speak plainly back and say that I do not agree with the letter she wrote today, and I am afraid I do think that her calculations are wrong.

The use of the £10 billion figure was not, as she said in her letter, incorrect. The Government have never claimed that there was an extra £10 billion increase in the Department of Health budget. Indeed, the basis of that number has not even come from the Government; it has come from NHS England and its calculations as to what it needs to implement the forward view. As I told the Select Committee, I have always accepted that painful and difficult economies in central budgets will be needed to fund that plan. What NHS England asked for was money to implement the forward view. It asked for £8 billion over five years; in fact, it got £10 billion over six years, or £9 billion over five years—whichever one we take, it is either £1 billion or £2 billion more than the minimum it said it needed.

I think my hon. Friend quoted Simon Stevens as saying that NHS England had not got what it asked for. He was talking not about the request in the forward view, but in terms of the negotiations over the profile of the funding we have with the Treasury. The reason that the funding increases are so small in the second and third year of the Parliament is precisely that we listened to him when he said that he wanted the amount to be front- loaded. That is why we put £6 billion of the £10 billion up front in the first two years of the programme.

I fully accept that what happens in the social care system and in public health have a big impact on the NHS, but on social care we have introduced a precept for local authorities combined with an increase in the better care fund—[Interruption.] This is a precept, which 144 of 152 local authorities are taking advantage of. That means that a great number of them are increasing spending on social care. It will come on top of the deeper, faster integration of the health and social care systems that we know needs to happen.

On public health, I accept that difficult economies need to be made, but it is not just about public spending. This Government have a proud record of banning the display sale of tobacco, introducing standardised packaging for tobacco, introducing a sugary drinks tax and putting more money into school sports. There are lots of things that we can do on public health that make a big difference.

On capital, I agree with my hon. Friend about the pressure on the capital budget, but hospitals have a big opportunity to make use of the land they sit on, which they often do not use to its fullest extent, as a way to bridge that difficult gap.

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26 OCT 2016

Letter to the Chancellor

Use the following link to read the letter in full of the key requests to the Chancellor on the funding of health & social care.

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26 OCT 2016

BBC 5 Live Daily

This morning I was on BBC 5 Live with Emma Barnett, Clive Lewis and Tasmina Ahmed-Sheikh to talk about the Heathrow runway, party politics, and the NHS. You can listen to me on BBC iPlayer here.

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25 OCT 2016

NHS Clinical Commissioners

I met with Julie Wood from NHS Clinical Commissioners. The Clinical Commissioners represent clinical commissioning groups (groups of GPs who manage health spending locally). We discussed some of the issues facing the health service, including funding pressures and the importance of different bodies in the NHS and the social care sector working well together in the interest of patients.

North, East & West Devon CCG is currently consulting its Success Regime. You can have your say on the CCG website here.

NEW Devon is also consulting on continuing to prescribe gluten free foods. If this is something which would affect you, you can complete the survey on the CCG website.

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25 OCT 2016

Unplanned Admissions

I attended a reception hosted by Henry Smith MP at the Palace of Westminster to show my support for reducing unplanned admissions to hospital as a result of urinary incontinence. The event coincided with the launching of an updated version of a Best Practice Guide on improving continence care published by the Unplanned Admissions Consensus Committee. Thank you to Tracey Cunningham, Matron of Totnes and Dartmouth Hospital for attending and Ward Sister Michelle Thomas.

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25 OCT 2016

Private Members' Bills

Sarah Wollaston Chair, Health Committee

I fully support my hon. Friend the Chair of the Procedure Committee. Will theLeader of the House respond to the question he has been asked as to whether he accepts that the existing arrangements bring this House into disrepute? I believe that they do.

 

David Lidington Lord President of the Council and Leader of the House of Commons

We will respond in full to the Committee's report. Over the years, many criticisms of the private Members' Bill procedure have been made from different quarters. I will take seriously the proposals the Committee has made. However, we also need to ensure that under our procedures, legislation does not reach the statute book, perhaps even creating criminal offences affecting our constituents, unless there is clear demonstrable support within Parliament among a majority of Members for it to be enacted.

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24 OCT 2016

Health Service Medical Supplies (Costs) Bill

Sarah Wollaston Chair, Health Committee

Further to that important point about biosimilars, and in welcoming this legislation and the opportunity to create savings for the NHS, will the Secretary of State also address the long-standing issues around Lucentis and Avastin?George Freeman updated the House about the barriers in both domestic and European legislation that prevent the use of Avastin—it is not licensed for wet age-related macular degeneration—but the scale of savings could be so vast that there is a case for introducing measures in the Bill to allow for such issues to be addressed.

Jeremy Hunt The Secretary of State for Health

I am happy to look into that—some of my own constituents have been affected by that issue. I am not aware that there is scope to consider that important point in the Bill, but we should reflect on what we can do to deal with some of the anomalies in the drug licensing regime that lead to the unintended consequences that my hon. Friend talks about.

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19 OCT 2016

Baroness Floella Benjamin

Baroness Floella Benjamin chaired a meeting today to discuss the role of Physical Education as part of a health, wellbeing and confidence-boosting matrix and how to ensure involvement of the family in a physical activity relationship alongside schools/early years' settings.

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19 OCT 2016

Agriculture and Fishing

Sarah Wollaston Chair, Health Committee

Time is short, so I will congratulate my hon. Friend Scott Mann on bringing forward this debate, and endorse the many comments he and others have made about the importance of our farming industry. I would like to touch on: issues for our fishing industry, particularly fairness, markets, support and sustainability; our coastal communities—the Minister, whom I welcome to her post, will understand that, as she represents a coastal community—marine science; and the importance of talking to fishermen and farmers as policies go forward.

First is the issue of fairness—that is what fishermen are looking for. When 73 million of the channel fishing quota goes to British fishermen and 211 million goes to French fishermen, clearly that is out of balance. Fishermen tell me that they are unable to access waters within France's 12-mile limit, but others are able to access waters within our 12-mile limit, so that again is an area in which we have an opportunity to make significant changes. Also, will the Minister also comment on the issue of quota hopping? That has long been a source of concern to our fishermen.

This is not just about our fishing communities and fishermen; it is about the onshore sector, markets and access to those markets. Will the Minister join me in congratulating Brixham market and Brixham Trawler Agents? Last week, Mike Shaw and his team topped the £1 million-mark for the value of the catch landed through Brixham market. That market was worth more than £23 million to our local economy in the past year. However, the majority of the produce that goes through that market is for export, principally to the European Union. Clearly, it is absolutely vital that we protect those markets, and that we do not drive the producer sector away from Brixham and other areas in the south-west to the European Union. I hope that the Minister will focus on that, as well as access for the important workers in that industry.

Many hon. Members have touched on support for our coastal communities, our fishermen and, indeed, for Brixham market and others. Although many grants have come from the European Union, we all accept that the money is recycled from our own resources. It will be terrific if we have more flexibility to use that money in a way that is right for our businesses and communities. Will the Minister comment on whether those processes will speed up, and become more transparent and less bureaucratic? We have a huge opportunity to do that.

There is also the important issue of sustainability. We will exit the common fisheries policy at a time when it finally seems to be getting its act together; the 2014 reforms have really started to make a difference. Continuing to look at this by sea basin area will be important. Clearly, under the United Nations arrangements, we will still rightly be bound to liaise with our neighbours when coming to these agreements; we cannot just unilaterally make changes. It is important that the Minister acknowledges the importance of having a commitment to a maximum sustainable yield and to protecting our marine environment.

We must also look at pollution controls and safety at sea. Those who put their lives on the line for us to put fish on our plate deserve an absolute assurance that safety will be foremost in the Government's mind going forward.

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18 OCT 2016

Health Select Committee

The Health Committee questioned the Secretary of State for Health and NHS Chief Executives as part of the inquiry on the current state of NHS finances.

http://www.parliament.uk/business/committees/committees-a-z/commons-select/health-committee/news-parliament-20151/healt-finances-evidence2-16-17/

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13 OCT 2016

South West Royal College of General Practitioners

I met with Richard Pratt of the South West Royal College of General Practitioners to discuss the GP Forward View. You can find out more about the GP Forward View here:

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13 OCT 2016

Barnardos

It was fantastic to meet  with Debbie and Alison from Barnardo's to talk about their new project, 'Believe In Me' which aims to show off the incredible things that children who may not have had the best start in life can do.

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13 OCT 2016

Hospital Consultants

I met with members of the Hospital Consultants and Specialists Association to talk about the pressures facing the NHS and how to deal with the challenges the NHS faces. It was a pleasure to meet with Claudia, John, Ross, and Eddie from the Association.

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13 OCT 2016

Tobacco Control Plan

Sarah Wollaston Chair, Health Committee

It is a pleasure to serve under your chairmanship, Mr Brady. I commend Alex Cunningham for his tireless campaign on tobacco control and for introducing the debate.

In 1974, 46% of adults smoked, but that figure has now fallen to 16.9%. That is not an accident; it has been because of the concerted action of campaigners, cross-party working and Government support over the years. It has all been about price, marketing, availability, smoke-free environments, education, targeted support to help people to cut down and quit, and the availability of less harmful alternatives.

I also commend the Government and the Conservative-led coalition Government for their action over the past six years. We have seen an end to point-of-sale displays—the last refuge of advertising and marketing—and, finally, the introduction of standardised or what we might call "truth" packaging, which allows people to see the product and what it does to them. We have also seen further protection for children, with bans on proxy sales and on smoking in cars with children present.

The evidence shows that intervention saves lives, and in the case of smoking it saves lives very quickly. It can have a real effect in the same year on foetal, maternal and child health and on reducing cardiovascular disease and complications in surgery. It is definitely worth doing, both in the short and the long term. It should set a template for other public health measures, because it shows that they really make a difference and are definitely worthwhile.

As the hon. Member for Stockton North so clearly stated, however, these improvements do not mean we should be complacent. There are still 76,000 preventable and premature deaths a year as a result of smoking. Not only does that have a devastating impact on individuals and their families, it has other implications, not just for mortality but for the disease burden and the lives lived in very poor health. In my 24 years on the frontline in the NHS I saw that at first hand. Living with COPD and end-stage COPD is a dreadful burden on individuals.

There is also the cost to the NHS and the issue of health inequality, which we have heard about already. The cost to the NHS is about £2 billion a year. If we are to look at the long-term sustainability of our NHS, we must tackle that. Things can be done. Almost a quarter of hospital admissions for lung disease are attributable to smoking; we can do better on that.

As the hon. Member for Stockton North pointed out, the Prime Minister spoke in her first speech on the steps of Downing Streetabout the "burning injustice" of the life expectancy gap between rich and poor. I absolutely support her determination to tackle that; we also need to tackle the gap between rich and poor in healthy lives lived, which is also very important. The stark reality is that those who earn less than £10,000 a year are twice as likely to smoke as those who earn more than £40,000 a year. If the Government are serious about tackling health inequality, they have to have an effective tobacco control plan.

Of course, health inequality is a multi-factor problem. It is not just about issues such as smoking and obesity—there are many other important issues, such as education, poverty and housing—but we can make a difference both quickly and in the long term by continuing to tackle smoking. I really hope the Minister will acknowledge that it is about preventing new smokers from coming on board, helping existing smokers to cut down and quit, and imposing greater responsibility and accountability on the industry. The five year forward view rightly calls for a radical upgrade in prevention and public health, which is essential for the long-term sustainability of the NHS. Now is not the time to cut back on the services that deliver prevention and help for people to cut down and quit, but sadly that is what is happening.

I am afraid a lot comes down to budgets. In 2015, we saw a £200 million in-year cut to public health budgets, and that is set to continue. The Health Committee's recent inquiry into public health, which has now reported, found that there will be a real-terms reduction in public health budgets from £3.47 billion in 2015 to £3 billion by 2021. That will hit front-line services. Around 4.1% of total health spending is currently in public health, and that percentage is definitely set to decline, which is absolutely a false economy. We should be investing now to make the savings we need for the future—not just for individuals, though of course they should be the priority, but for the long-term sustainability of the NHS. That would be cost-effective.

We are already seeing the impact on front-line services: local authority stop smoking services have been decommissioned in Manchester, for example, and in Worcestershire they are now available only to pregnant women. We also need to look at how CCGs are withdrawing their support for GPs to prescribe nicotine replacement therapy. That is worrying, because there is a very clear evidence base for such services, as we have heard—I will not repeat what the hon. Member for Stockton North set out so eloquently. Cutting them is the worst example of poor value for money and letting people down. I really hope that when devising an effective strategy the Minister will look at that and make sure that those services are available, both within local authorities and at the frontline of NHS services.

As a former GP, I know the role GPs can play in persuading those who are in the most danger, because they see people when they are suffering the complications of smoking and their intervention at that point is often the trigger for people to quit effectively. But GPs are now left in a position where they cannot prescribe the products that we know might help patients. We absolutely must not abandon one of the most cost-effective measures in healthcare, and we must not add extra cost to the future.

Members in the main Chamber of the House of Commons are discussing baby loss this afternoon, and I am sorry that none of us can be in two places at once. However, it is essential to remember that if the Government are to succeed in their aim to reduce neonatal stillbirths and maternal deaths by 50% by 2030, we have to consider maternal smoking. Sadly, around 300 perinatal deaths every year are attributable to smoking. There are very important reasons across the board for tackling this.

Finally, I will touch on the issue of e-cigarettes, because there is some controversy around them. Some people fear that the industry will take over and that e-cigarettes will become a gateway into smoking, but the evidence so far does not support that. Of course we need to be vigilant and make sure that these products are not being marketed to children to push nicotine addiction, which then steps on to smoking, but so far the evidence is not there. Nevertheless, we need to watch the marketing side of things.

There is no doubt that for many people e-cigarettes are a gateway out of smoking or a way to reduce the amount that they use. It is estimated that in 2015 around 18,000 long-term smokers were helped to cut down and quit by such products. We should be encouraging their use, because the evidence supports that. We are currently members of the European Union and so subject to the tobacco directive, which will mean further restrictions on the use of e-cigarettes. Will the Minister confirm that she will look carefully at the emerging evidence to see where we want to fit in with and adopt that directive and, perhaps, where we feel that it might not be appropriate for the UK? It is an emerging picture, but the overall message should be that we should encourage the use of e-cigarettes and make them available to people when they need to use them.

I know that other Members wish to speak, so I shall not detain the House any further, other than to say that, like the hon. Member for Stockton North, I hope the Minister will be able to confirm today the timetable for the introduction of the tobacco control plan. I know that she will be personally determined to ensure it is effective.

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12 OCT 2016

Devon and Cornwall Business Council

It was a pleasure meeting the CEO of Devon and Cornwall Business Council, Ben Rhodes again in Parliament last Wednesday. We talked about how Devon businesses are going to be affected by Brexit, about Local Enterprise Partnership schemes in my constituency, and more.

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12 OCT 2016

President of the Syrian British Medical Society

It was a delight to meet with Dr Ayman Juni, the President of the Syrian British Medical Society about support for Syrian Doctors. We also talked extensively about the great work of Syria Relief, Britain's largest Syria focussed charity.

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12 OCT 2016

Obesity Health Alliance

A big thank you to the Obesity Health Alliance (OBA) for taking time to meet with me today. The OBA is a coalition of 30+ organisations working together to tackle obesity in Britain. We talked extensively about why the government's obesity plan needs to go further and about what we need to do as a nation to fight obesity in the United Kingdom.

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12 OCT 2016

Elaine Wyllie

It was an absolute delight to meet Elaine Wyllie the founder of the Daily Mile.  Elaine wanted to tackle the obesity and poor levels of fitness of the children in her school. The scheme is now spreading across the UK. The aim of The Daily Mile is simple – to get children fit by running for 15 minutes a day. The daily exercise is not timetabled. Teachers take their classes out at a time of their choosing. The children walk, jog or run with their classmates in the safety of their own playground. You can read more about this inspiring change that is really making a difference via the following link.

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12 OCT 2016

European Medicines Agency

Sarah Wollaston Chair, Health Committee

The hon. Gentleman is making a powerful case. These points were raised with the Select Committee on Health in the run-up to the referendum. Will he join me in calling for people to submit further evidence to the Health Committee, now that we have launched our inquiry into what the Government's priorities should be during their negotiations on the terms of our withdrawal?

Daniel Zeichner Shadow Minister (Transport)

I thank the Chair of the Health Committee for her intervention. I certainly encourage those in my area and others to take up that offer. We will be doing so.

Let me come to the most tangible issue of all: the future physical location of the European Medicines Agency. Just last month, the Government said in a written answer to my hon. Friend Andrew Gwynne:

"The future arrangements which apply in relation to European Union institutions based in the United Kingdom should be determined once the United Kingdom has left the EU. It is too early to speculate on the future location of the European Medicines Agency."

Early or not, speculation is intense, and others are moving fast to gain advantage. The EMA stated in July that it

"welcomes the interest expressed by some Member States to host the Agency in future", while stressing that the decision will be taken

"by common agreement among the representatives of the Member States."

Various member states are already vying to host the EMA. The Danish Prime Minister has said he is looking at it. The Irish HealthMinister has said that attracting the EMA to Dublin is one of the "more interesting" opportunities afforded by Brexit. Italy, Sweden and Spain are also reportedly expressing an interest.

The EMA employs some 900 people. What will happen to their jobs? Will those people move with the agency? Inevitably, there is concern that, should the EMA relocate outside the UK, there will be a knock-on effect on the wider pharmaceuticals and life sciences industries. When they next decide where to locate and invest, does losing the EMA hinder or help? In my view, the answer is fairly clear, but I would welcome the Minister's view.

We risk losing jobs. We risk losing influence. On a practical level, any company that sells to the European economic area has to have a qualified person for pharmacovigilance—an experienced, senior person based in the European economic area. If we are outside that area, QPPVs would have to move out of the UK or lose their jobs. There are 1,299 QPPVs currently in the UK. That is another potential loss, and of course, every highly-skilled job lost has a multiplier effect.

Perhaps the Minister can give us an estimate of how much all this will cost us. When I asked the Secretary of State for Exiting the European Union that question in the House on Monday, he had no answer. I appreciate that the Minister, following the lead given by the Brexit Ministers, is unlikely to be able to provide detailed, concrete information at this stage. I have some sympathy; if you do not have a plan, it is probably best to say as little as possible. However, I hope that the Government understand just how important it is for the UK to retain the closest relationship possible with the European Medicines Agency. It is important for patients. It is important for businesses. It is important for innovation, and it is important for our economy as a whole.

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Sarah Wollaston Chair, Health Committee

Does the Minister agree that the reason why we have such world-class expertise is the workforce? We must be absolutely clear and send a message to the world that, within our science and research community, we will not be maintaining a list of who is here from the EU and who is a British scientist. We must unequivocally send a message that Britain is open to scientists, researchers and the medical and healthcare workforce from around the world and the EU, not just from Britain.

David Mowat The Parliamentary Under-Secretary of State for Health

That last intervention—I say "last" somewhat hopefully—unites us all. It would be ridiculous if the world-class science that we must continue to do compromised on matters like that. I completely agree with my hon. Friend's point, and there is agreement across Government about that. If we need to make that clearer, we should.

I will finish now, as nobody is springing to their feet. I thank all hon. Members, particularly the hon. Member for Cambridge, for putting the issue on the agenda. It is right and important that the topic is at the forefront of our negotiations, and that we get the right answer in the end.

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11 OCT 2016

Health and Social Care

Sarah Wollaston Chair, Health Committee

I welcome greater integration, but the Minister will be aware that there are grave concerns about the effect of cuts to social care on the NHS. More and more patients are spending greater time in more expensive settings in hospital when they could be better looked after in their own homes or in the community, but cuts to social care make that impossible. Will the Minister set out what appraisal the Government are making of the effect and the damage to the NHS of cuts to social care?

David Mowat The Parliamentary Under-Secretary of State for Health

My hon. Friend is right: social care funding is tight. It is also true to say that those parts of the country that do the best in this regard—there are some that do considerably better than others—have integrated social care and health most effectively. On the budget itself, there is some disparity among different local authorities. About a quarter of local authorities have increased their adult social care budget by 5% or more this year.

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10 OCT 2016

Broadband

I met today with the Minister for Digital and Culture, Matt Hancock MP to directly make representations about the way that rural Devon has been disadvantaged by relatively slow progress of broadband compared to some other areas.

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10 OCT 2016

Calais Jungle

Sarah Wollaston Chair, Health Committee

I welcome the Home Secretary’s statement and the sense of urgency that she brings to this important issue. These are deeply traumatised children. Can she update the House on not only what mental health provision will be available for them when they come to this country, but what is being done to identify families who will have the specialist skills to help and support those children coming here under the Dubs amendment?

Amber Rudd The Secretary of State for the Home Department

My hon. Friend raises a very important point: once we have them over here, how will we best look after children who have been traumatised, and families who are feeling vulnerable? We are working closely with the local authorities to ensure that they can provide the necessary support, and we can assist them.

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14 SEP 2016

British Farming Day

I met with the NFU at the Back British Farming event in Westminster to celebrate farming's contribution to Britain's economy and food security. British farming accounts for 3.9m agri-food jobs in the UK.
I discussed issues ranging from Brexit to tackling bovine TB with Matt Ware the NFU's head of government affairs and also met with Gemma Harvey, whose family runs a dairy farm in the South Hams, and who has recently joined the NFU as a graduate.

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13 SEP 2016

Hospitality and Tourism Day

I met today with  Graham Grose and Edward Bence as part of the Hospitality and Tourism Day in Parliament. We discussed a range of issues facing the industry, including tourism VAT, Brexit and seasonal workers, the National Living Wage and training and apprenticeships.

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12 SEP 2016

Department of Health: Migrant Workers

Written Answers
Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will discuss with theGeneral Dental Council steps to address the disparity in acceptable scores on the International English Language Testing System achieved by dentists and dental hygienists and the scores accepted in such tests by the General Medical Council for doctors from outside the UK who are able to practise in the UK.

Philip Dunne The Minister of State, Department of Health

Both the General Medical Council (GMC) and the General Dental Council (GDC) are able to apply a language test to international applicants wishing to practise in the United Kingdom. Proportionate language controls can also be applied by the GMC and GDC on all applicants from the European Economic Area wishing to practise in theUK to ensure that doctors and dentists have the necessary English language skills to practise safely in the UK.

It is for the GMC and GDC as independent regulatory bodies to decide what constitutes an acceptable knowledge of English to practise safely in the UK including an acceptable score in the International English Language Test.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether his Department plans to respond to the policy briefing from the Royal College of Surgeons on English language testing of EEA healthcare professionals, dated 17August 2016; and what plans he has to introduce clinical language tests for EEA healthcare professionals working in the UK.

Philip Dunne The Minister of State, Department of Health

Changes to United Kingdom law introduced in April 2014 and March 2015, allow the General Medical Council (GMC), Nursing Midwifery Council, General Dental Council (GDC), General Pharmaceutical Council and the Pharmaceutical Society of Northern Ireland to carry out language controls for European Economic Area (EEA) doctors, dentists, nurses, midwives, pharmacists and pharmacy technicians in Britain. The regulators are now able to apply proportionate language controls for EEA professionals before registration and admission onto the register ensuring that only those healthcare professionals who have the necessary knowledge of the English language to do their job in a safe and competent manner are able to practise in the UK.

Under the Mutual Recognition of Professional Qualifications Directive (MRPQ) regulatory healthcare bodies, including the GMC and GDC, are required to recognise primary and specialist medical qualifications gained in an EEA healthcare professional's home member state.

The people of the UK have voted to leave the European Union, however until exit negotiations are concluded the UK remains a full member of the EU and all the rights and obligations of EU membership remain in force. This includes implementation of the MRPQ Directive.

A number of concerns have been raised about the constraints that the Directive places on the ability of UK regulators of health professionals to carry out robust checks of both the clinical and language skills of medical professionals from the EEA seeking to practice in the UK. The Government shares these concerns and will review the checks that UK regulators are able to apply in light of the EU exit negotiations.

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12 SEP 2016

Asylum: Children

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, what steps she is taking to accelerate the process of family reunification for unaccompanied refugee children in Europe.


Robert Goodwill The Minister for Immigration

The Government began work to implement the 'Dubs amendment' immediately after the Immigration Bill gained Royal Assent. Over 30 children who meet the criteria in the Immigration Act have been accepted for transfer since it received Royal Assent in May, the majorityof these have already arrived in the UK.

We continue to work with the French, Greek and Italian authorities and others to speed up existing family reunification processes or implement new processes where necessary for unaccompanied children. We have seconded a UK official to Greece, we have a long-standing secondee working in Italy and will shortly be seconding another official to the French Interior Ministry to support these efforts.

We have established a dedicated team in the Home Office Dublin Unit to lead on family reunion cases for unaccompanied children. Transfer requests under the Dublin Regulation are now generally processed within 10 days and children transferred within weeks. Over 120 children have been accepted for transfer this year from Europe.

We also continue to consult local authorities about the transfer unaccompanied refugee children from Europe to the UK, where it is in their best interests.

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08 SEP 2016

Soft Drinks: Taxation

Written Answers

Sarah Wollaston Chair, Health Committee

To ask Mr Chancellor of the Exchequer, what the Government's plans are for the implementation of the soft drinks industry levy; and if he will publish a timetable for the implementation of that levy.

 

 

Jane Ellison The Financial Secretary to the Treasury

The Soft Drinks Industry Levy consultation was launched on 18th August 2016. At the Budget in March, the Government announced that it would consult on the Levy during the summer and legislate in Finance Bill 2017, for implementation from April 2018. This timetable remains in place.

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08 SEP 2016

Scamming: Vulnerable Individuals

Sarah Wollaston Chair, Health Committee

Has my hon. Friend also considered the risk and actual harm caused when scammers market fake medicines online? That is a particular problem. Operation Pangea has been seizing many such products as they come into the UK, but people need to be aware of the danger of buying from online pharmacies. They need to be sure that they are buying from a reputable agent of the pharmacy industry in the UK, and people can look at logos to check that they are doing so.


Sarah Wollaston Chair, Health Committee

I wonder whether the Minister in the legislation will also address the fines that are meted out when people breach the rules. She may be familiar with the case of Pharmacy2U, which, disgracefully, sold the details of more than 20,000 of its customers, many of them very vulnerable, to marketing companies. The fine of £130,000 is derisory and no meaningful deterrent.

Sarah Newton The Parliamentary Under-Secretary of State for the Home Department

As always, the Chairman of the Health Committee makes a powerful point, and I am sure those responsible for drafting these measures will take them into careful consideration, ensuring that the scope of the measures captures some of the very harmful behaviour of scammers and fraudsters and that there is sufficient deterrent to those considering undertaking these crimes from the regime of punishments put in place, including fines.

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07 SEP 2016

Badger Cull and Bovine TB

Sarah Wollaston Chair, Health Committee

I support further research into vaccination, but is the hon. Gentleman aware that there is a global shortage of bovine TB vaccine? It is the same vaccine as is used in humans, it needs 10 times the dose, and it needs to be repeated every five years. There is no possibility of an injectable vaccine roll-out at this time, and the programme has even been suspended in Wales.

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05 SEP 2016

Junior Doctors: Industrial Action

Sarah Wollaston Chair, Health Committee

I welcome the BMA's suspension of next week's damaging industrial action. It is clear from its statement that thousands of doctors had been in touch to say that they wanted to keep their patients safe. Doctors know that they cannot do so with full, rolling, five-day walkouts. Will the Secretary of Statetherefore join me in asking the BMA to ballot its members to hear their views before they proceed with the other proposed, damaging, five-day walkouts?

 

Jeremy Hunt The Secretary of State for Health

The BMA should talk to its members much more because, as far as I could tell, the consultation over the summer showed that only a minority actually wanted this extreme series of rolling one-week suspensions of labour that the BMA supported in the end. Most junior doctors are perplexed and worried about the situation and would love to find a solution. There was a bitter industrial dispute, but we actually started a process through which trust was being rebuilt on both sides. In a series of meetings, I met the junior doctors' leader to talk through the areas of her greatest concern and we made progress in addressing two of those four outstanding areas. Building that trust means actually sitting around the table and talking, not having confrontational strikes. I think that that is what most junior doctors want.

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05 SEP 2016

Exiting the European Union

Sarah Wollaston Chair, Health Committee

I warmly welcome my right hon. Friend and the whole Front Bench team to their important new roles in making a success of Brexit. Will the Secretary of State set out what discussions he has had with the EU Trade Commissioner, who has taken a much tougher line on article 50? We all agree it is in everyone's interest to get on and negotiate before we exit, but in a recent interview she indicated that that will not be the case.

David Davis The Secretary of State for Exiting the European Union

Yes, but the commissioner is not in a position, frankly, to tell the Secretary of State for International Trade what he can do, subject to meeting European law. European law in this case means not putting a free trade agreement into effect until we leave. That is the limit. In terms of other discussions and negotiations, commissioners have tried to say that we cannot speak to other members of the European Union, which is sort of silly. We are an ongoing member of the European Union and we take our responsibilities seriously. It is implausible that, in our conversations with member states, we will not talk about what is coming next.

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19 JUL 2016

Impact of the Spending Review on health and social care

The Health Select Committee report released today, covers the NHS funding challenge and calls for clarity, workforce and training, public health and inequality, social care and transformation.

To read the report click here

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13 JUL 2016

Health Professions: Training

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether legislative changes will be required to remove the NHS bursary for healthcare students by September 2017; and if he will make a statement.

 

Ben GummerThe Parliamentary Under-Secretary of State for Health

The proposed reforms to healthcare education funding for introduction on 1 August 2017 will not require amendments to the legislation under which the National Health Servicebursary is provided.

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13 JUL 2016

Health Services

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether his Department plans to publish and keep updated a public resource for identifying and assisting contact with (a) chairs of clinical commissioning groups, (b) chairs of health and wellbeing boards and (c) sustainability and transformation leads.

George FreemanThe Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

There are currently no plans to publish a central resource of contact details. Contact details for each clinical commissioning group are publicly available on their websites. The table below shows where this and other relevant information is publically available:

Chairs of clinical commissioning groups

https://www.england.nhs.uk/ccg-details/

Chairs of health and wellbeing boards

http://www.kingsfund.org.uk/projects/health-and-wellbeing-boards/hwb-map

Sustainability and transformation leads

https://www.england.nhs.uk/2016/03/leaders-confirmed/

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13 JUL 2016

Clinical Commissioning Groups

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, when clinical commissioning groups will be required to update their local transformation plans; and what plans he has for such plans to interact with sustainability and transformation plans.

George FreemanThe Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

Health economies have come together to develop Sustainability and Transformation Plans (STPs) for their footprints until 2020/21. As with the current arrangements for planning and delivery, there are layers of plans which can sit below STPs, with shared links and dependencies. STPs do not replace the existing system architecture. Rather STPs act as an umbrella, holding underneath them a number of different specific plans to address key local issues.

Clinical commissioning groups (CCGs) have operational plans for 2016/17 in place. Operational plans for 2017/18 will reflect the contribution of the CCG to the overall STP. The timelines for the development of the 2017/18 operational plans are being finalised.

The March guidance stressed the importance of responding to 10 key priority areas which included mental health. Footprints are at different starting points, and so the degree of detail that has been provided in the 30 June STP checkpoint varies. However, final STPs will be expected to set out how Mandate priorities will be delivered, including the oversight of locally led transformation plans for children and young people's mental health, before being agreed.

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12 JUL 2016

Neuromuscular Disorders

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what recent discussions his Department has had with NHS ambulance trusts to encourage them to work with Muscular Dystrophy UK to increase health professionals' knowledge of care for people with muscular dystrophy and neuromuscular conditions.

 

Jane EllisonThe Parliamentary Under-Secretary of State for Health

NHS England is responsible for commissioning specialised neurological services, including some services for patients with neuromuscular disorders. NHS England has published a service specification for neurological care that includes an exemplar service specification for neuromuscular conditions that sets out what providers must have in place to offer evidence-based, safe and effective services.

The specification can be found at the following link:

www.england.nhs.uk/wp-content/uploads/2013/06/d04-neurosci-spec-neuro.pdf

National Health Service providers, working with local area teams, may establish neuromuscular networks if they consider it would benefit service provision; such decisions are a local matter.

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11 JUL 2016

Great Western Railway's Bicycle Policy

Sarah Wollaston Chair, Health Committee

I thank the right hon. Gentleman for securing the debate and absolutely agree with everything he has said so far. Does he agree that it was clear from the Get Britain Cycling inquiry that he and I served on in the previous Parliament that active travel to work is a key aspect of encouraging people to get cycling, and that the health benefits that that brings are not in dispute?

Ben Bradshaw Labour, Exeter

Yes, I completely agree. I have described the system as Orwellian partly because of the confusion and the contradictory messages that are being given to the public, but the hon. Lady is exactly right that this is a moment in our history when we should be encouraging people to use sustainable transport and to take their bikes on trains. If there is space on trains, people should be allowed to put their bikes on to them.

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08 JUL 2016

Health Services

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether NHS England has met the key deliverable in the 2014-15 NHS England business plan to ensure that more than 70 per cent of all scientific and diagnostic services are part of accreditation programmes.

 

George Freeman The Parliamentary Under-Secretary of State for Health

The measurement of scientific and diagnostic services was more complex than originally envisaged which meant that the 70% target for these services to be part of an accreditation programme was difficult to quantify. NHS England continues to lead a programme of work to increase the number of scientific and diagnostic services that are part of accreditation programmes and demonstrate robust quality assurance measures.

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06 JUL 2016

Paediatrics: Audiology

Written Answers

 

 

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, how many paediatric audiology services have registered for the Improving Quality in Physiological Services accreditation scheme to date.
  • To ask the Secretary of State for Health, how many paediatric audiology services have (a) been allocated a date and are awaiting an assessment visit by UKAS inspectors under the Improving Quality in Physiological Services accreditation scheme and (b) failed to gain accreditation after their initial assessment visit, since the accreditation began in 2012.
  • To ask the Secretary of State for Health, how many paediatric audiology services have reached the level required, using theSelf-Assessment and Improvement Tool, to be eligible to apply for accreditation under the Improving Quality in Physiological Services scheme.

Alistair Burt The Minister of State, Department of Health

As of July 2016, 74 services are currently registered – covering all stages of gaining and holding Improving Quality in Physiological Services accreditation.

NHS England does not hold information on the number of services that have been allocated a date and are awaiting an assessment visit by United Kingdom Accreditation Serviceassessors, or the number of services that failed to gain accreditation after their initial assessment.

NHS England does not hold information on how many paediatric audiology services have reached the level required, using the Self-Assessment and Improvement Tool, to be eligible to apply for Improving Quality in Physiological Services accreditation.

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06 JUL 2016

Junior Doctors Contract

Sarah Wollaston Chair, Health Committee

I welcome today's statement and thank the Secretary of State for dealing with many of the extra-contractual issues that have blighted the lives of junior doctors. I join him in regretting the outcome of the ballot. Like my right hon. Friend, I welcome Doctor Ellen McCourt to her post. I know that my right hon. Friend will work constructively with the junior doctors committee to try to resolve the outstanding issues. In proceeding in a careful, measured way with the imposition of the contract, will he work to reassure the public that if patient safety issues arise during that process, he will deal with them?

Jeremy Hunt The Secretary of State for Health

I thank my hon. Friend for her measured tone and for being an independent voice throughout the dispute. I spoke to Dr Ellen McCourt earlier this afternoon. I appreciate that she is in a very difficult situation, but I wanted to stress to her that, as I told the House this afternoon, my door remains open for talks about absolutely anything and that I am keen to find a way forward through dialogue. I had lots of discussions with Dr McCourt when we were negotiating the agreement in May, and I know that she approached those negotiations in a positive spirit.

We have set in place processes, and that is one of the reasons why Professor Bailey recommended phased implementation—so that if there are any safety concerns, we can address them as we go along. The Minister with responsibility for care quality, my hon. Friend the Member for Ipswich, is leading a process that will keep looking at the issues to do with the quality of life of junior doctors. NHS Employers is leading a process that will look in detail at how the contract is implemented. Absolutely, the point of the changes is to make care safer for patients; we will continue to keep an eye on this to make sure that it does so.

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05 JUL 2016

Health Select Committee

Today the Health Select Committee met to discuss the Professional Standards Authority.

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05 JUL 2016

Department of Health Nurses

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps he plans to take to ensure that UK nursing is effectively represented at (a) the World Health Assembly and (b) other EU and international fora.

 

Ben GummerThe Parliamentary Under-Secretary of State for Health

The World Health Assembly (WHA) is usually attended by theChief Medical Officer and senior health officials. In the past the Chief Nursing Officer has attended the WHA, though in recent years has not been part of the Department's delegation. However, the World Health Organization (WHO) is largely focussed on public health and the Chief Nurse atPublic Health England works with and contributes to international nursing development with the WHO, including attendance at the WHO Nursing Forum, and also contributes to other global programmes.

There is a European Chief Nursing Officers forum which Government chief nurse advisors attend. It is for the Chief Nursing Officer for England to attend this meeting. In her absence one of the other United Kingdom Chief Nursing Officers should attend.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps he plans to take to ensure nurses are consulted on his Department's future policies after the proposed closure of the Nursing, Midwifery and Allied Health Professions policy unit in his Department.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether (a) staff and (b) external stakeholders were consulted on the proposal to close the Nursing, Midwifery and Allied Health Professions policy unit in his Department.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what mechanisms he plans to put in place to ensure ministers receive impartial nursing advice after the proposed closure of the Nursing, Midwifery and Allied Health Professions policy unit in his Department.

Ben Gummer The Parliamentary Under-Secretary of State for Health

The Department leads the health and care system in England, working closely with a range of organisations on whose expertise it draws, including the nursing and midwifery expertise in NHS England and Public Health England. The Department's approach to ensuring that nurses are consulted about future policies is to flexibly access professional advice from a wide range of sources, including arms-length bodies, regulators, stakeholders and professional bodies.

The Department's policy teams will establish new networks and relationships with stakeholders and partners and collaborate with the Chief Nursing Officer (CNO) to ensure systems are in place to secure advice when developing evidence based policy. These changes do not affect the role of the CNO, who as CNO of the Department already advises, and will continue to advise all Ministers and the Department on the range of nursing and midwifery issues.

The Department is changing the way it works to deliver its essential work for the Government while achieving efficiency savings. All of the changes we are making through the resulting DH2020 programme are being done transparently and communicated to staff.

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01 JUL 2016

Cervical Cancer: Screening

Written Answers

Sarah Wollaston Chair, Health Committee

  1. To ask the Secretary of State for Health, what steps he is taking to address the decline in cervical screening uptake in the 25 to 29 age group.
  2. To ask the Secretary of State for Health, what recent assessment his Department has made of the barriers that prevent women from attending cervical screening.
  3. To ask the Secretary of State for Health, what steps his Department is taking to increase cervical screening rates among (a) women with learning disabilities and (b) women in deprived communities.

Jane Ellison The Parliamentary Under-Secretary of State for Health

There is a range of work going on to understand the reasons for the decline in cervical screening uptake amongst women aged 25 to 29 and to try to address them. They include:

a) Data and information – access to data, cleansing, benchmarking for providers, timely and useful information for commissioners; b) Behavioural insight – communication with commissioners, providers, patients and public; c) Commissioning levers – commissioning contracts in public health (S7a) and primary care; d) Partnership work – relationships with commissioners and providers; and e) Sharing best practice – what works well, evaluation and how to embed quality improvement

Public Health England (PHE) is working with colleagues in NHS England and Health and Social Care Information Centre to implement the Accessible Information Standard which is intended to improve access to services for vulnerable and disadvantaged groups. Through the re-development of cervical Information Technology systems opportunities will arise to review how to help improve uptake.

PHE supports providers to help meet the Accessible Information Standard through the provision of high quality information for people with learning disabilities or sensory loss. A national group of experts and service users has been set up to oversee this work and will be updating the existing easy read leaflets and developing new materials over the next 18 months.

PHE is aware that there are a range of factors which may act as barriers in hindering women from attending cervical screening. It is hoped that through the STRATEGIC (Strategies to Increase Cervical screening uptake at first invitation) interventions will be identified to help minimise barriers and assist women to attend screening whilst increasing uptake across all quintiles. The STRATEGIC trial was completed in 2015 and researchers are expected to publish findings later this year.

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07 JUN 2016

Health Select Committee

Today the Health Select Committee met to discuss Public Health post-2013, structures, organisation, funding and delivery.

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01 JUN 2016

Breastfeeding: Obesity

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, if he will ensure that the benefits of breastfeeding will be included in the upcoming obesity strategy.

Jane EllisonThe Parliamentary Under-Secretary of State for Health

Our Childhood Obesity Strategy, which will be launched in the summer, will look at everything that contributes to a child becoming overweight and obese.

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27 MAY 2016

Breastfeeding

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what plans he has to continue monitoring breastfeeding rates following the abolition of the infant feeding survey; and if he will make a statement.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what the implications for his policies are of the findings in The Lancet Series on breastfeeding, published in January 2016; and what steps his Department is taking to increase breastfeeding rates.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how many full-time equivalent staff in his Department were working on breastfeeding in each year from 2010 to 2016.

Ben Gummer The Parliamentary Under-Secretary of State for Health

Following the discontinuation of the Infant Feeding Survey, the Department has been exploring with Public Health England (PHE) and other key stakeholders alternative methods and sources of information to monitor the impact of its policy on infant feeding.

In future, the Maternity and Children's Dataset will regularly capture data on breastfeeding initiation and prevalence from all women using NHS services rather than using a survey sample. This means that local service providers and commissioners can have up-to-date (e.g. quarterly) information about outcomes for their local populations, enabling service provision to be more agile, responsive and targeted.

The Government is committed to supporting breastfeeding through the Healthy Child Programme. Breastfeeding is also included in the Public Health Outcomes Framework so that the improvements can be tracked, and action taken as needed.

Since 2010, we have recruited more than 2,100 additional midwives who will provide women with the information, advice and support they need with breastfeeding. A further 6,000 midwives are in training. There are also 3,400 more health visitors than in 2010.

The Department is working with PHE, NHS England and UNICEF to try and encourage women to breastfeed for the first six months, although we recognise that not all mothers choose to or are able to breastfeed.

Support and information is currently available to health professionals and parents through NHS Choices, the National Breastfeeding Helpline, UNICEF UK Baby Friendly Initiative, the Start4Life Information Service for Parents and local peer support programmes.

The Department has not retained a record of how many full-time equivalent staff there were with a specific focus on breastfeeding between 2010 and 2016; breastfeeding policy has always formed part of the larger maternity policy for which the Department has the policy lead. Resources to cover this policy area would have fluctuated according the level of work required at any one time.

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26 MAY 2016

The Economy and Work

Sarah Wollaston Chair, Health Committee

I congratulate the Government on including in the Queen's Speech a measure to introduce a levy on sugary drinks manufacturers. I do so because it cannot be acceptable in our society that we continue to allow 25% of the most disadvantaged children to leave primary school not just overweight, but obese. I congratulate the Chancellor on looking at the evidence that the gap between the most advantaged and disadvantaged children with childhood obesity has been increasing, based on data from the child measurement programme.

It is important to tackle the problem and to look not just at obesity, but at the effect on children's teeth. We know that the commonest reason for primary school children to be admitted to hospital is to have their rotten teeth removed. The Chancellor is right to target sugary drinks manufacturers. AsAlison Thewliss pointed out, those are empty calories with no nutritional value whatsoever. When we see that a third of teenagers' calorie intake from sugars is from sugary drinks, it is right that we do everything we can.

The measure is progressive. I welcome the contribution that it will make as part of a wider strategy to tackle childhood obesity. It will encourage manufacturers to reformulate their products to bring in lower levels of sugar. I would like the Chancellor, perhaps when he responds to the debate, to set out what he is doing alongside manufacturers to encourage them to introduce a price differential associated with the levy bands so that we can guide people to make healthier choices.

I particularly welcome the fact that this money will be hypothecated. As a result, we will see a doubling of the school sport premium for primary schools. We will also see an expansion of the breakfast club programme in the most disadvantaged areas, and up to 1,600 schools will benefit. The accusation that is often made is that the levy is regressive, not progressive, but that is countered simply by the fact that it is the most disadvantaged communities that will benefit most from hypothecation.

Like the hon. Member for Glasgow Central, I urge the Chancellor to go further and to extend this measure to milky drinks with high levels of added sugar. Milk is good for children, and we should be sending a clear message that it is good, but milk with nine teaspoons of sugar in it is not good for children's health or their teeth. I also agree with the hon. Lady's point about alcoholic mixers. I therefore hope that the Chancellor will look again at extending this measure, because I think much more benefit could come from it if he did.

On the other proposals in the Queen's Speech, I thank the Chancellor for the measures he will introduce on broadband. As a Member representing a rural community where businesses and local residents alike are disadvantaged by not having access to high-speed broadband, I think these measures will be very welcome. Likewise, I welcome the commitment to bring forward a fair funding formula for schools such as those in the west country, which have been severely disadvantaged up until now.

I know that many other Members want to speak, so let me say in closing that I welcome the measures in the Queen's Speech. This is a bold and brave Chancellor—the Health Committee called for bold and brave measures to tackle childhood obesity, and that is what we have seen from the Chancellor in this Queen's Speech. I hope he will stiffen his sinews, resist the efforts of the drinks manufacturers to oppose this measure and encourage them to look at how they can improve the health of our nation and our children by supporting reformulation.

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20 MAY 2016

Junior Doctors Contract

Sarah Wollaston Chair, Health Committee

I congratulate both sides on returning to constructive negotiations and on reaching an agreement. I pay particular tribute to Professor Sue Bailey and the Academy of Medical Royal Colleges for their role in bringing both sides together. I welcome the particular focus, alongside the negotiations around weekend pay, on all the other aspects that are blighting the lives of junior doctors. I welcome the recognition that we need to focus on those specialties that it is hard to recruit to and on those junior doctors who are working the longest hours, as well as the focus on patient safety.

However, we are not out of the woods yet. We need junior doctors across the country to vote for this agreement in a referendum. May I add my voice to that of the Oppositionspokesman on health to say that what is needed now is a period of calm reflection? We need to build relationships with junior doctors into the future. Will the Secretary of Statecomment on his plans for building those relationships with our core workforce?

Jeremy Hunt The Secretary of State for Health

First, I very much agree with my hon. Friend in her thanks to Professor Dame Sue Bailey for the leadership that theAcademy of Medical Royal Colleges has shown in the initiative that, in the end, made these talks and this agreement possible. I know it has been a very difficult and challenging time for the royal colleges, but Professor Bailey has shown real leadership in her initiative.

I also very much agree with my hon. Friend about the need to sort out some of the issues that have been frustrations for junior doctors—not just in the last few years, but going back decades—in terms of the way their training works and the flexibility of the system of six-month rotations that they work in. This is an opportunity to look at those wider issues. We started to look at some of them yesterday. I think there is more that we can do.

It is important that this is seen not as one side winning and the other side losing, but as a win-win. What the last 10 days show is that if we sit round the table, we can make real progress, with a better deal for patients and a better deal for doctors. That is the spirit that we want to go forward in.

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11 MAY 2016

White Paper on the BBC Charter

Sarah Wollaston Chair, Health Committee

I welcome the Secretary of State's words of reassurance on editorial independence. Will he also provide reassurance on regional broadcasting and its continuing importance for the BBC?

 

 

John WhittingdaleThe Secretary of State for Culture, Media and Sport

I very much agree with my hon. Friend about the importance of BBC regional and local broadcasting. When it comes to BBC local radio in particular, it is difficult to imagine that the commercial sector would ever provide the sort of news broadcasting and local community information that the BBC provides. This is certainly one of the BBC's strengths, which I hope to see continue and strengthen even further in the future.

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10 MAY 2016

Health: Topical Questions

Sarah Wollaston Chair, Health Committee

Community hospitals are immensely valued by the communities they serve. Will the Secretary of State meet me to discuss the proposals for south Devon, which will particularly affect my constituents living in Dartmouth and in Paignton?

 

Jeremy Hunt The Secretary of State for Health

Yes, I am happy to do that. I have a number of community hospitals in my own area. It is really important that even as the functions and jobs that community hospitals do inevitably change, we recognise that they have a very important long-term future in the NHS.

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09 MAY 2016

Health Select Committee

Today the Health Select Committee met to discuss the impact of the Comprehensive Spending Review on health and social care

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05 MAY 2016

Department of Health: Out-patients

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps his Department is taking to collect data on (a) the number of patients who are required to return to hospital for a review or follow-up out-patient appointment or procedure and (b) the length of time between such patients' initial appointment and that review or follow-up appointment.

Jane EllisonThe Parliamentary Under-Secretary of State for Health

Such data are already collected in Hospital Episode Statistics, a data warehouse managed by the Health and Social Care Information Centre that includes details of all admissions and outpatient appointments at National Health Service and independent sector hospitals in England. A summary report of the data published for 2014-15 is at:

http://www.hscic.gov.uk/catalogue/PUB19608/hosp-outp-acti-2014-15-summ-repo-rep.pdf

Information on length of time between first and follow-up appointments has not been published because there are no national standards for the appropriate intervals, which will vary between different services or specialties, and between individual patients, depending on the severity of the condition and clinical decision making.

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04 MAY 2016

NHS Bursaries

Dr Sarah Wollaston (Totnes) (Con)

Let me start by congratulating the shadow Health Secretary on calling this important debate. First and foremost, it matters because of the impact on patients of a nursing workforce shortfall. When the Health Committee's recent primary care inquiry took evidence, Professor Ian Cumming estimated that shortfall to be between 15,000 and 20,000 nurses. This is not just about the overall shortfall; it is also about shortfalls geographically and in certain key areas, particularly primary care, community care and mental health. We therefore need to look at the big picture.

The workforce shortfall adds costs. We know that the agency staffing bill was about £3.3 billion in the last year and that three quarters of trusts are still breaching the agency price caps, although we are making some progress on that, with the relevant figures being £303 million in October last year and £287 million in February this year. These resources should be spent elsewhere, on patient care. There is an over-dependence on nurses who are trained overseas. They are a very valued part of our workforce but they are often being recruited from countries that can ill afford to lose them. We will need to train more nurses—that is the prime consideration of this debate, along with how we achieve that.

I congratulate the Minister on the proposals to open up many more places to nursing students, but we should consider some unintended consequences and I wish to touch on those further in this debate. We must do this without disadvantaging or cutting off our current core nursing workforce. It is absolutely right that we pay particular attention to the impact on mature students, because we have heard the data on that: 23% of all nursing applicants are over 30; more than half are over 21; and, as the hon. Member for Lewisham East (Heidi Alexander) said, the average age is 28. The question is whether this core mature nursing workforce are going to be deterred from applying.

We have already seen an example of innovation, with the University of Bolton partnering the Lancashire Teaching Hospitals NHS Foundation Trust to start offering places where students apply through the UCAS route. They introduced 25 places in the first pilot, with the first intake being in February last year, and there were 650 applicants for those places, even though they knew that they would have to access loans. There has been a very successful second round, with an increase to 75 places this year, and so the assumption that people will simply not apply for these courses just is not correct. We need to bear it in mind that we cannot necessarily extrapolate from there to a wider increase in numbers, but I ask the Minister whether there is any room, as we start to roll this out, to retain some bursaries for our very valued core mature nursing workforce for at least the first few years, until we know what the impact is. Will he address that in his summing up? Is there any role for a period of transition? It is important that we bear in mind the potential for unintended consequences.‚Äč

Two thirds of those who apply for nursing places are unsuccessful, and it is unreasonable not to increase the opportunity for those students. I very much welcome the Minister's plan to roll out other opportunities to enter the nursing workforce. We know from the Cavendish review that one reason we lose so many from our core healthcare assistant workforce is because there are no continuing professional development opportunities for them. Very many of those people, whom we know to be fantastic at their job, are not able to progress in the way that we should be allowing them to do. The key focus for us in this House should be: what is best for patients? What is best for patients is for us to train up a more diverse workforce, through many routes. There is a case for saying, "Let's not completely abolish bursaries in the first round. We could phase things in more slowly."

Another opportunity we could look at to try to attract people into nursing is through recognising that the clinical component is very high in the nursing course, at about 50%. Is there any way we could recognise that with a limited grants system for those who would otherwise be deterred? Perhaps at the end of a nursing course we could recognise mature students, particularly those who have taken on a second degree. Is there a way we could allow an extra payment to go to those nurses, particularly those who are going to go on to train in specialties where there is a shortage, linked with a period of NHS service. I know that we are using such an approach in general practice to try to attract people into shortage specialties. Would the Minister also consider that in responding to the legitimate concerns about the impact on the mature nursing workforce?

In summary, there are things we are doing where we are making progress, but there are things we can recognise as being unintended consequences. I hope the Minister will also look at some of the other recommendations from the recent Health Committee inquiry on primary care and say, "What can we do, as we increase the number of these courses, to increase the exposure to shortage specialties within the training period?" Too many of our healthcare workforce are staying within acute care and we know that if they have increased exposure to primary care during their training, they are more likely to want to go into those specialities.

Finally, as we increase these other opportunities for nursing and physician associates, may I ask the Minister please to touch on registration? We have heard evidence that, sometimes, not being registered can deter people from taking on physician associates. Allowing those associates to be registered is a recognition of their skills. These should be professional qualifications, and I hope that he will refer to that in his summing up.

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03 MAY 2016

Planning Obligations

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, whether regulations are in place to ensure that (a) town councils, (b) parish councils and (c) local communities can exercise a community right to bid for independent qualified contractors to deliver highways infrastructure works that are funded by Section 106 contributions from developments within their parish as part of any competitive bidding process carried out by the local highways authority.

Brandon Lewis Minister of State (Communities and Local Government)

Provisions are in place under the Community Right to Challenge to enable town and parish councils and voluntary and community organisations to challenge how council services are delivered by submitting a bid (Expression of Interest) to the relevant council.

Expressions of Interest need to be made in respect of an existing service and one that the local authority has responsibility for providing, which councils must consider and can only reject if specific circumstances set out in legislation apply. If a developer is undertaking work as part of an agreement underSection 106 of the Town and Country Planning Act 1990, then this would not fall under the scope of the Right to Challenge as it would not be a local authority service.

However, if a highways service was to be delivered by a local authority as a result of a Section 106 contribution then this would be within the scope of the Right, although it is important to note that local authorities are able to reject an Expression of Interest if a service is already the subject of a procurement process or pre-procurement negotiations. If this is the case, the town or parish council or community group would be able to participate in the procurement process.

The Community Right to Bid provides local people and parish councils with the opportunity to nominate a building or land for listing by a local council as anAsset of Community Value (ACV), which, if the owner decides to sell, a moratorium of up to six months is triggered. During the moratorium period, the asset cannot be sold except to a community bidder.

If a highways service was to be delivered by a local authority as a result of a Section 106 contribution then this should be within the scope of the Community Right to Challenge. It is important to note though that local authorities are able to reject an expression of interest if a service is already the subject of a procurement process or if the authority has entered into negotiations with a third party to deliver the service and these are at least in part conducted in writing. Where the services are currently being procured, the organisation in question would be able to participate in the procurement exercise.

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03 MAY 2016

Southern Health NHS Foundation Trust

Sarah Wollaston Chair, Health Committee

The report into Southern Health makes disturbing reading, but we will never tackle unacceptable levels of health inequality and early deaths among those who live with learning disability and mental health issues unless we address safety and risk. Will the Minister go further on the mortality review and set out how we can see where differences exist around the country? Will he reassure the House that duty of candour will in future be more than a tick in the box?

Alistair Burt The Minister of State, Department of Health

A tick in the box for duty of candour, which the report mentioned, was unacceptable—it must mean much more than that. The learning disability mortality review programme is important and will support local areas to review the deaths of people with learning disabilities, and use that information to help improve services. In time, it will also show at a national level whether things are improving for people with learning disabilities, and whether fewer people are dying from preventable causes. That review is already under way in a pilot in the north-east in Cumbria, which will help to inform us how the programme operates as it is rolled out. Plans are in place to roll out that review across all regions of England between now and 2018, with pilots commencing in other parts of the country between 2016 and 2017. That work has never been done before, and it is right that we are doing it now.

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27 APR 2016

Out-patients: Attendance

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what safeguards are in place to ensure that patients who require review hospital appointments are seen within a clinically recommended or safe time.

 

Ben Gummer The Parliamentary Under-Secretary of State for Health

The appropriate interval for follow up appointments will vary between different services or specialties, and between individual patients, depending on the severity of their condition. All follow up appointments (also known as planned, surveillance or recall appointments) should take place when clinically appropriate.

NHS England's guidance, "Recording and reporting referral to treatment (RTT) waiting times for consultant-led elective care" is clear that when patients on planned lists are clinically ready for their care to commence and reach the date for their planned appointment, they should either receive that appointment or be transferred to an active waiting list, meaning a waiting time clock will be started and their wait reported in the relevant statistical return.

Furthermore, the Care Quality Commission (CQC) also assesses providers against the new fundamental standards of safety and quality below which care should never fail. One of the fundamental standards requires that care and treatment must be appropriate and reflect service users' needs and preferences. Another standard requires that care and treatment must be provided in a safe way. The CQC will require a provider to improve where it is not meeting these standards.

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26 APR 2016

Health Select Committee

Today the Health Select Committee met to discuss the impact of membership of the EU on health policy in the UK

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25 APR 2016

Junior Doctors Contracts

Sarah Wollaston Chair, Health Committee

There are only losers in this bitter dispute, but those who have the most to lose are patients and their families. Tomorrow people will visit hospitals to see those whom they care about more than anything in the world, and will ask themselves why the doctors on the picket line are not inside looking after the people they love. May I ask the British Medical Association directly whether it will show dignity, put patients first, and draw back from this dangerous escalation? May I ask all sides, whatever provocation they may feel, to put patients first in this dispute?

Jeremy Hunt The Secretary of State for Health

My hon. Friend has spoken very wisely. She recently wrote, inThe Guardian, something with which I profoundly agree: she wrote that there could have been a solution to this problem back in February, when a very fair compromise was put on the table in relation to the one outstanding issue of substance, Saturday pay.

I understand that this is a very emotive issue. The Government initially wanted there to be no premium pay on Saturdays, but in the end we agreed to premium pay for anyone who works one Saturday a month or more. That will cover more than half the number of junior doctors working on Saturdays. It was a fair compromise, and there was an opportunity to settle the dispute, but unfortunately the BMAnegotiators were not willing to take that opportunity. I, too, urge them, whatever their differences with me and whatever their differences with the Government, to think about patients tomorrow. It would be an absolute tragedy for the NHS if something went wrong in the next couple of days, and they have a duty to make sure that it does not.

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25 APR 2016

Meningitis B Vaccine

Sarah Wollaston Chair, Health Committee

It is a pleasure to follow my hon. Friend Peter Heaton-Jones, and I apologise to my hon. Friend Ben Howlett for missing his opening statement, because of a statement in the main Chamber.

I start by thanking all the families who gave evidence to the Petitions Committee and the Health Committee. Through their very brave and dignified testimony, they have done more to raise awareness and save lives than any Government-led awareness campaign could possibly hope to achieve.

It is wonderful to be in a debate in which we are airing the positive benefits of vaccination, which has undoubtedly been one of the greatest achievements of modern science. We stand on the brink of eradicating polio from the world, and it is worth pausing to thank all those who have been involved in the development of vaccination over the years.

Neil CarmichaelChair, Education Committee, Chair, Education, Skills and the Economy Sub-Committee

At this point, I would like to salute Dr Edward Jenner, who worked on a smallpox vaccination and was based in myconstituency. That underlines the important of vaccination, and that work then is directly linked to the work on meningitis now.

Sarah Wollaston Chair, Health Committee

I thank my hon. Friend. In fact, I will take us back even further by mentioning Ben Franklin, who said that

"an Ounce of Prevention is worth a Pound of Cure."

He was referring to fire services in Philadelphia, of course, but the principle still stands.

In paying tribute to all who have brought us to where we are today, we should remind ourselves that vaccination is becoming increasingly complex to develop. Bexsero is being developed through reverse antigen mining and is extraordinarily expensive. That is why we have to consider cost-effectiveness, because in a system where finances are limited, what might be displaced if a new intervention is funded? In other words, we in this House and beyond have a responsibility to ensure that the money we spend can save as many lives as possible, and to consider that in the round.

That is why it is important to take account of the work of theJoint Committee on Vaccination and Immunisation in making its incredibly difficult decisions and judgments. It is absolutely important that we allow the JCVI to carry out its work without undue political interference. The role of this House is, of course, to raise awareness and to hold the Government to account for the way in which—and the framework under which—the JCVI operates. However, our role must never be to lean directly on members of that committee in the very difficult decisions that they make. I pay tribute the JCVI—to Professor Andrew Pollard and his team—for their work. Their decisions are extraordinarily difficult, and they need to apply the science a combination of judgment and sensitivity. It is absolutely right that we regularly review the criteria that they are able to take into account.

I thank the Minister for her letter today confirming that the cost-effectiveness methodology for immunisation programmes and procurements working group, or CEMIPP—it may need a catchier title—is going to publish its work in full. Perhaps she will say whether she has now received that report. It is absolutely important that the principle of transparency applies, so that we can all be clear about the decision-making process.

I support Members who have said that we should review the so-called discounting rate if it means that, as my hon. FriendHelen Whately has pointed out, by the time someone is in their 20s, effectively no account is taken of them. It clearly seems reasonable that we apply the same principle that is applied to public health decision making in the NICEmethodology, with its lower discount rate, so that we can take full account of that situation. It is also right for the House to reflect on views beyond this place by thinking, for example, about the social costs. I do not wish to repeat the many important points that have been made about that today.

The JCVI's independence is absolutely vital. We in this House are not in a position to make judgments about the effectiveness and safety of vaccination. We have to rely on experts, and we are very grateful to them for their work. However, one thing that we have to do is hold the Secretary of State to account for implementing the decisions of the JCVI in a timely manner and for the time that it takes to carry out the negotiations on the cost of vaccines.

I would like to make a further point, which I do not think Members have brought up today. The level of variation in the roll-out of existing vaccinations needs to be looked at. During the Health Committee's current inquiry into public health, we have been hearing evidence about the difficulty that public health professionals and directors of public health have in being able to access the data and information that they need to tell them where the gaps are in the roll-out of vaccination. Perhaps the Minister will update the House on where we are in that regard, because it clearly cannot make sense that artificial barriers have sprung up between those who are responsible for implementing the programme and those who are delivering it on the ground. It would be helpful to have an update on that issue.

It is also absolutely right that the House holds the Minister to account on what is being done to follow up the work that is happening on sepsis. As she will know, early diagnosis is critical. Although we want to focus on the number of cases that we can prevent, we cannot prevent them all, so we must also focus on early diagnosis and intervention and on ensuring that we have the right pathways in hospitals, so that the time it takes from the moment someone enters a hospital until they receive life-saving antibiotic therapy is kept to a minimum. Perhaps the Minister will update us on that.

Geoffrey Clifton-Brown Conservative, The Cotswolds

I hesitate to intervene on my hon. Friend, especially as she is such an expert on this subject, but as I understand it, Bexsero was licensed by the European Medicines Agency on 1 January2013. It was not introduced in this country until more than two and a half years later, and people will have died of the disease in the interim. Does my hon. Friend not think that is too long a process when the argument is not about the safety of the drug but purely about the price? Something needs to change. The negotiation with the drugs companies needs to be done in a different way.

Sarah Wollaston Chair, Health Committee

I agree that there needs to be a better and faster procedure for negotiating about cost, but we cannot get away from cost, because, as I mentioned, cost-effectiveness is not an abstract concept. It means asking, could we save more lives by spending the same amount of money differently? If the cost of the drug is exorbitantly high, would it be better to invest the money in, for example, early diagnosis and intervention? Those complex decisions should not be made by politicians. Politicians and the public should be part of the process that sets the guidelines and advises the committee, but it is not for this House to make those decisions, although I absolutely agree that of course it would be better if the negotiations could be done more quickly.

I end where I began, by paying tribute to the very brave families for the evidence that they gave. I hope that the Minister will do everything in her power to ensure that we reach decisions as quickly and as fairly as possible.

.........

Sarah Wollaston Chair, Health Committee

I am intervening because the Minister mentioned that she is drawing her remarks to a close. Can she comment on the issue I raised about the variation in roll-out and the communication issues for public health directors in being able to assess the variation in their areas?

Jane EllisonThe Parliamentary Under-Secretary of State for Health

I am not able to give my hon. Friend an answer today. If she does not mind, I will write to her about that. I have had a conversation about that with the public health director in my own borough, so I am aware of some of the frustrations that have been expressed. If my hon. Friend does not mind, I will write to her with more detail rather than give a response off the top of my head—her question deserves a better answer.

I want to put on the record my thanks to the meningitis charities that work tirelessly to support families affected by this terrible disease and have done so much to advance their cause. Many of them have circulated their 10-point action plan. I have touched on most of those points and indicated how the Government are responding.

Like other Members, I recognise the courage and dignity that, as has rightly been said, Mr and Mrs Burdett and the other families affected by meningitis in such a tragic way have shown over recent weeks. Nothing I can say today can make up for their loss, but I have listened very carefully to the evidence that they have bravely given to the Select Committees, and particularly the emphasis that they have put on raising awareness, which they have done so much about. I hope it is some comfort to them to know that not only their own efforts in bearing testimony but the new awareness campaign, alongside our vaccination programmes, will save lives in future.

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20 APR 2016

Department of Health: Databases

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, whether he expects to be consulted in cases where a Bulk Personal Dataset is required from his Department by an Agency under the provisions of Part 7 of the Investigatory Powers Bill.

 

George Freeman The Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

The Investigatory Powers Bill does not include any powers to require the provision of a bulk personal dataset (BPD) to a security and intelligence agency. It does require that there should be robust and transparent safeguards relating to such an agency's use of BPDs. This includes a new requirement for warrants to authorise the retention and examination of BPDs.

The Bill provides for both class BPD warrants, covering datasets of a particular class, and specific BPD warrants, covering an individual dataset. The draft statutory Code of Practice provides further guidance on the factors that the security and intelligence agencies should consider in determining which type of warrant to apply for. These include whether the nature or provenance of the dataset raises particularly novel or contentious issues; whether it contains a significant component of intrusive data; and whether it contains a significant component of confidential information relating to members of sensitive professions. All warrants will be subject to the 'double-lock' safeguard meaning that they will be subject to approval by both a Secretary of State and a Judicial Commissioner.

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19 APR 2016

Planning Obligations

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, whether Section 106 contributions for highways infrastructure works can be used to pay for (a) the costs of administrative, legal or design work or general highways maintenance works required prior to the installation of highways infrastructure works and (b) other associated overhead costs incurred by the local highways authority or its contractors.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, in the event that the actual cost of a Section 106 highway infrastructure scheme exceeds the previously estimated and agreed contribution, (a) what options exist for making good that shortfall, (b) whether the local authority or the developer is liable for any additional costs and (c) whether Section 106 contributions originally allocated for other schemes may be reallocated to cover such costs.

Brandon Lewis Minister of State (Communities and Local Government)

It is for the local planning authority to determine what is required and seek planning obligations through a Section 106 agreement in order to make a development acceptable in planning terms. There are three statutory tests that need to be applied when considering a planning obligation, that it is: necessary to make the development acceptable in planning terms; directly related to the development; and fairly and reasonably related in scale and kind to the development.

Developers may be asked to provide contributions for infrastructure in several ways. This may be by way of planning obligations in the form of Section 106 agreements but can also include contributions through payment of theCommunity Infrastructure Levy and Section 278 highway agreements.

It is for local planning authorities to decide what provisions they make in Section 106 agreements, and agree these with the interested parties, and therefore any liabilities would depend on the individual agreement. Local authorities and developers can renegotiate planning obligations by mutual agreement at any time or under Section 106A of the Town and Country Planning Act 1990. However, Local planning authorities are expected to use all of the funding they receive through planning obligations in accordance with the terms of the individual planning obligation agreement. This is to ensure that new developments are acceptable in planning terms; benefit local communities and support the provision of local infrastructure.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, whether regulations are in place to ensure that (a) town councils, (b) parish councils and (c) local communities receive regular updates from highways authorities about (i) the sum total for Section 106contributions for highways infrastructure works promised and delivered within their areas each year and (ii) a breakdown of expenditure on individual works within their areas.

Brandon LewisMinister of State (Communities and Local Government)

Section 106 agreements are negotiated and agreed between a local planning authority and a developer and/or landowner along with other interested parties in the land, such as mortgage providers. National planning policy makes clear that Section 106 requirements, modifications and discharges should be transparent and available for inspection.

Local planning authorities are expected to use all of the funding they receive through planning obligations in accordance with the terms of the individual planning obligation agreement. This is to ensure that new developments are acceptable in planning terms; benefit local communities and support the provision of local infrastructure.

Planning decisions should be based on Local Plan policy unless material considerations indicate otherwise. Representations from interested third parties may constitute material considerations. Town councils, parish councils and local communities can influence infrastructure and other considerations in Local Plans through the consultation process.

The Community Infrastructure Levy was introduced to provide a faster, fairer and more transparent approach to collecting developer contributions toward infrastructure. The Government launched a review of the Levy in 2015. This review will consider a range of issues, including the relationship between the Levy and Section 106 planning obligations.

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18 APR 2016

Junior Doctors Contracts

Sarah Wollaston Chair, Health Committee

We are eight days away from an unprecedented full walkout of junior doctors, including the withdrawal of emergency care. Our constituents want to know whether they will be safe on the strike days. Will the Secretary of State and theshadow Secretary of State join me in calling on the BMA at least to exempt casualty departments and maternity units from this walkout? We know that, even with goodwill arrangements in place to bring people back in when hospitals are overwhelmed, the delays will cost lives.

Jeremy Hunt The Secretary of State for Health

As ever, my hon. Friend speaks very constructively on this issue. She is absolutely right to say that the departments at most risk are emergency departments, maternity departments and intensive care units. Those are the areas that we are most keen to ensure will maintain critical doctor cover over the two strike days that are planned. I really hope that the BMA will co-operate with NHS England as we identify where we think the gaps might be. We will share that information with the BMA and I hope very much that it will help us to plug those gaps with junior doctors, because in the end no one wants there to be any kind of tragedy. We all have a responsibility to work to ensure that that happens.

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11 APR 2016

Databases

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for the Home Department, whether, when considering whether to acquire a bulk personal dataset from another government department under the Investigatory Powers Bill, she plans to consult theSecretary of State for that department.

 

Mike PenningThe Minister of State, Home Department, The Minister of State, Ministry of Justice

The Investigatory Powers Bill provides for robust and transparent safeguards relating to the security and intelligence agencies' use of bulk personal datasets (BPDs). This includes a new requirement for warrants to authorise the retention and examination of BPDs. The Bill provides for both class BPD warrants, covering datasets of a particular class, and specific BPD warrants, covering an individual dataset. The draft statutory Code of Practice provides further guidance on the factors that the security and intelligence agencies should consider in determining which type of warrant to apply for. These include whether the nature or the provenance of the dataset raises particularly novel or contentious issues; whether it contains a significant component of intrusive data; and whether it contains a significant component of confidential information relating to members of sensitive professions. All warrants will be subject to the 'double-lock' safeguard meaning that they will be subject to approval by both a Secretary of State and aJudicial Commissioner.

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24 MAR 2016

Home Education

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what steps the Government has taken to assess whether the home education of children in consistent with Article 12 of the UN Convention on the Rights of the Child.

 

Edward Timpson The Minister for Schools

The Department for Education has published guidance on 'Listening to and involving children and young people', which makes clear that in keeping with Article 12 of the UN Convention on the Rights of the Child, local authorities (LAs) should take steps to ensure that the views of children are obtained and taken into account. This published guidance is available on GOV.UK at:

https://www.gov.uk/government/publications/listening-to-and-involving-children-and-young-people

The guidance is issued under s.176 of the Education Act 2002, which requires LAs to use guidance on consulting children when they exercise their functions in relation both to schools and to elective home education. It is for each local authority to decide how best to take account of the views of children who are being educated at home.

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24 MAR 2016

Home Education: Regulation

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what steps the Government is taking to work with local authorities to ensure that the education provided to home educated children is effectively regulated and safeguarded.

 

Edward Timpson The Minister for Schools

The Department for Education has frequent contact with local authority officers and elected members on the subject of elective home education. Published guidance for local authorities is available on the GOV.UK website at:https://www.gov.uk/government/publications/elective-home-education

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24 MAR 2016

Developing Countries: Children

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for International Development, what steps her Department is taking to encourage its bilateral partners to adopt a co-ordinated early childhood development approach to provide nutritional, medical and educational support for children.

 

Nick Hurd The Parliamentary Under-Secretary of State for International Development

There is strong evidence that supporting children in their early years with health, education, nutrition and stimulation interventions maximises their learning potential and yields long term benefits. In January DFID held a high level meeting in London, bringing together Ministers and policy makers from developing countries, academic experts and development agencies to explore how to provide cross-sectoral support to young children at scale. Drawing on the evidence base, DFID is exploring with country governments how to co-ordinate early childhood support and how to adapt our existing programmes to encompass early childhood development principles.

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23 MAR 2016

APPG Human Rights

Today, I chaired a meeting in Parliament on supporting human rights defenders in Saudi for the All Party Human Rights Group.

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22 MAR 2016

Health: Topical Questions

Sarah Wollaston Chair, Health Committee

Following the very welcome announcement of a graduated levy on sugar, sweet and drinks manufacturers, will theMinister please tell the House what discussions she is having with manufacturers to speed up the reformulation process and also to introduce a differential in price at the point of sale? Given the importance of childhood obesity, will the Department welcome the opportunity to take over the lead on this strategy so that we can make progress on this vital issue?

Jane EllisonThe Parliamentary Under-Secretary of State for Health

There are a number of invitations there, some of which I will resist. My hon. Friend is absolutely right to highlight the importance of this announcement. Obviously, it is the first step towards the Government's comprehensive childhood obesity strategy, which we will be launching in the summer. The Chancellor of the Exchequer was absolutely right to go ahead with this and to move forward. The burden of childhood obesity, as she knows all too well, falls very, very heavily on poorer communities, and my right hon. Friend was absolutely right to champion that measure, because it will make the most difference in the poorest areas.

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16 MAR 2016

Access to Palliative Care

Palliative and end of life care affect us all.

Many of us will know somebody who has used hospice services, and many of us support organisations like Marie Curie and Macmillan. These national charities, as well as small and independent providers across the country, are the reason why a recent Economist report listed palliative care in Britain as the best in the world. Last week, together with Baroness Ilora Finlay, I hosted a reception in Parliament to celebrate the work of the doctors, nurses and carers who support people at incredibly difficult times in their lives. It was a chance to recognise those who change people's lives every day and to thank them and give them the chance to speak with their MPs about their experiences. We invited care assistants, consultants and nurses from all corners of England to come to meet their MPs in the beautiful setting of the State Rooms of Speaker's House.

I was very pleased that Heidi Alexander, the Shadow Health Secretary and Ben Gummer, Minister for Care Quality, joined us to speak. It is a year since the independent Choice in End of Life Care review was published and the Health Committee's report into improving end of life care and this was a further chance to press for a full government response following on from the debate which I opened recently in Parliament.

It was inspiring to hear from Sarah Ezekiel, who lives with Motor Neurone Disease and continues her work as an artist and caring for her family with support from Marie Curie and the help of eye movement tracking technology.

Of course, as MP for Totnes, holding an event celebrating hospices, how could I not mention Rowcroft and St Lukes? The whole team at Rowcroft Hospice provide high quality palliative and end of life care across South Devon.

There is often the mistaken belief that our local hospices receive funding from the larger national cancer charities; and over the last 105 years Macmillan has become the shorthand term for cancer nursing. Understandably, when at the stage of needing palliative care, the name of the charity is not deemed important, but the standard of care; so Rowcroft Hospice and Macmillan have prepared a leaflet to show how people can benefit from both charities; the leaflet explains how they work independently and together, but are still two very separate organisations.

From their work in the community, including Hospice at Home to their inpatient units, I am incredibly proud that we have such excellent local hospices serving the people of South Devon in St Luke's, Plymouth, Rowcroft in Torbay and the Children's Hospice South West.

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15 MAR 2016

Meningitis B Vaccine

Today the Petitions Committee discussed the meningitis B vaccine

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08 MAR 2016

Health Select Committee

Today the Health Committee held an oral evidence session with NHS Chief Executive, Chris Hopson and other health representatives as part of its inquiry into the impact of the Comprehensive Spending Review on health and social care.

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08 MAR 2016

International Women's Day

I was joined in Westminster today by Georgina, Darcey, Annabelle and Molly from Kingsbridge Community College to celebrate International Women's Day.

Thank you to Great Western Railway for providing their rail tickets

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07 MAR 2016

Policing and Crime Bill

Sarah Wollaston  Totnes

Will the Home Secretary join me in commending Devon and Cornwall police, who, through careful joint working, have made great strides in reducing the use of cells under section 136 over the past year? Does she agree that police forces also need to collect data on how long people are being detained in police vans? We do not want police cells to be substituted by police vans.

Theresa May The Secretary of State for the Home Department

My hon. Friend raises an important point. Whenever we legislate, we have to consider the possible unintended consequences. Of course, the whole point of the street triage pilots and the availability of advice from mental healthcare professionals to the police is to ensure that somebody can be taken to a place of safety, not a police cell. A van is not an appropriate place to hold people, either. My hon. Friend is certainly right that we should look at the issues to make sure that we are not inadvertently creating another problem.

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04 MAR 2016

Cirl Buntings

Today I wrote the following blog for the RSPB to highlight a new partnership, funded by the Heritage Lottery Fund, designed to bring threatened species back from the brink. A MP Species Champion programme designed to raise the political profile of threatened species conservation. I am delighted to be the Species Champions for the Cirl Bunting

(photograph courtesy of Matt Adam Williams)

Ask your average political pundit what MPs Jess Philips, Norman Lamb and Desmond Swayne have in common and they might be hard pressed to answer. In fact, they're just three of the nearly two dozen MPs who have come forward to stand up for a threatened UK species as part of the MP Species Champions programme. This week, we met with the RSPB and other conservation organisations in Westminster to discuss what we can do together to reverse species declines across the UK.

MPs are championing a range of species, from the smooth snake, to the Hen Harrier, to the Fen Orchid. Some species are iconic, like the Barn Owl, others are more every day like the charming dunnock, a familiar sight amongst participants of RSPB's Big Garden Birdwatch. The scheme is a fantastic way to showcase the range of wildlife that we have here in England, and how much poorer we would be for the loss of these species.

Sadly, that risk of loss is very real. Rachael Maskell, MP for York Central, is championing the Tansy Beetle – a creature so rare that almost the entire UK population is resident in or around her constituency. The Bittern, championed by Therese Coffey, was seeing huge declines, but is now making a marked recovery thanks to conservation efforts.

Perhaps the most remarkable good news story comes from my own species. I have been a champion for the plucky cirl bunting since 2014. Back in 1989, this beautiful farmland bird was on the brink of extinction with just 120 breeding pairs left in the wild. Real collaboration between NGOs, government agencies and crucially farmers has seen the species make a huge recovery, and we hope this year to see the population reach around 1000 pairs.

The cirl bunting recovery is one of the great successes of the Countryside Stewardship scheme. It shows what can be achieved through understanding the science behind species decline and applying practical solutions. There is much we can learn from the work of the dedicated conservationists and farmers involved in the project.

These efforts to work together are needed more than ever. We are seeing increasing pressures on precious habitats and wild spaces across the UK. In my own area there are concerns that changes to the National Planning Policy Framework could lead to applications for more large scale development within South Devon AONB. The RSPB and others have concerns about proposals in the Housing and Planning Bill to allow 'permission in principle' for development on land registered as brownfield, without a guarantee that land of high environmental value will be excluded from such a register.

All the while report after report comes out showing the benefits of access to the natural environment for physical and mental health, particularly for children. We must not lose sights of these benefits when set against the pressures for housing and infrastructure that are so desperately needed.

The cirl bunting's remarkable recovery has shown what can be done for nature when we work together. It was wonderful this week to see so many other MPs determined to improve the fate of threatened species in their own local areas. I hope as the Species Champions project progresses, we will have more inspiring stories to tell of species recovering against the odds - and many more MPs will join us in taking a stand for nature.

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02 MAR 2016

End of Life Care

Click here to listen to the Debate on End of Life Care

Sarah Wollaston Chair, Health Committee

The care that people receive at the end of their lives has a profound impact, not only on them but on their families and carers. All Members of the House want people to be able to access the highest quality care, irrespective of their age, diagnosis, where they live or the setting in which they are treated. We know how to deliver world-class care—indeed, we know how to deliver globally inspiring care. To start on a positive note, I should say that The Economist ranks Britain as the best in the world, from among 80 nations, for delivering end-of-life care, and we should be proud of that. The disadvantage is that that care is not available everywhere to everyone, and that is the challenge we face today. In the 2015 report “Dying without dignity”, the Parliamentary and Health Service Ombudsman set out some starkly worrying cases of poor care that highlighted a theme, and she was clear that it is a recurring and consistent theme in her casework. For that reason, the Minister must look carefully at the themes in that report, and also at other reports that have been produced. At the end of the previous Parliament, the Health Committee produced a report on end-of-life care, and I thank all members of that Committee, the Committee staff and our Committee specialist advisors for their valuable input, as well as the very many people and organisations from around the country who contributed.

The full debate can be read through the following links

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01 MAR 2016

Health Select Committee

The Health Select Committee met today to discuss Public Health post-2013 – structures, organisation, funding and delivery.

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29 FEB 2016

EU Referendum: Civil Service Guidance

Sarah Wollaston Totnes                 Click here to watch Sarah speak

Will the Minister set out what the harm would be in allowing full transparency of these data? Surely there would be much greater harm if at the end of the referendum we were left with people feeling that it had been an unfair process.

 

 

Matthew Hancock The Minister for the Cabinet Office and Paymaster General

The challenge of taking a position other than the one the Government have taken is that it would require civil servants to do work that was not in support of the Government's position. The Government have a position, and it is part of the civil service code, and it is put into law in the Constitutional Reform and Governance Act 2010, that civil servants should support the position of the Government. It would put civil servants in a very difficult position if we were to do anything other than that.

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29 FEB 2016

Child Refugees: Calais

Sarah Wollaston Totnes     Click here to watch Sarah speak

Will the Minister give a categorical assurance that children and young people who have a legitimate claim to be in the UK because of having close family relatives here will not be disadvantaged by starting their asylum claim in France? Although he has made it clear that there is not currently any formal process for the UNHCR to be involved in processing such claims, will he consider that for the future?

 

James BrokenshireMinister of State (Home Office) (Security and Immigration)

I can certainly say that if there are children who qualify under the Dublin regulation—in other words, if they have close family here—we will stand by our obligations. We will ensure that they are processed efficiently and effectively, which is precisely why we are taking the action we are with the French Government.

My hon. Friend highlights the issue of the UNHCR's role. There is a clear process, and we are working to ensure that it operates. As I have said, we believe that it can be made to operate efficiently and effectively, and we will work with the French Government to achieve that.

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24 FEB 2016

Community Energy

Representatives from TRESOC, Sustainable South Brent, and Regen SW met with Minister, Andrea Leadsom in Westminster today to discuss the benefits of Community Energy

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23 FEB 2016

Health Select Committee

Today the Health Select Committee heard about the impact of the Comprehensive Spending Review on health and social care

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23 FEB 2016

Mental Health Task Force

Sarah Wollaston Totnes

I remind the House that I am married to the registrar of theRoyal College of Psychiatrists. I join the Minister in thanking the independent mental health taskforce for the work it has done. Will he go further on how we are going to track, with greater transparency, this money to ensure it is spent in the right place, not just within health, but within social care? He will know that many of those who are suffering from mental health problems are cared for in the community, under social care, and it is therefore vital that we have parity of esteem across both health and social care.

Alistair Burt The Minister of State, Department of Health

Yes, I thank my hon. Friend for that and recognise the work of the royal college. Its president, Simon Wessely, was also much involved in the report, as was the college, so I thank them for that. It is very important to track this money. TheCCG assessment framework will help us to do that through the health service. The money that the Prime Ministerannounced in relation to community crisis care—the extra £400 million announced in January—will be spent throughout the community, and it is essential that we track it.

There has been a data lack; Luciana Berger knows about that well, because I answer far too many of her questions by saying, "This information is not collected" or, "This information is not collected centrally". [Interruption.] I have noticed that. We are in the process of changing that situation; the dataset was in the process of being changed and more information will be available. In order to track things properly, we have to have the information available. The question is right and we are improving the data. It is important to track this, both in local authority work and in NHS work.

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12 FEB 2016

Vaccination: Males

Written Answers

Sarah Wollaston Totnes

To ask the Secretary of State for Health, if he will ask theJoint Committee on Vaccination and Immunisation to conduct an equality impact assessment as part of its decision-making process on the vaccination of adolescent boys.

Jane EllisonThe Parliamentary Under-Secretary of State for Health

I refer the hon. Member to the Written Answer I gave the hon. Member for Basildon and Billericay (Mr John Baron) on 20July 2015 to Question 7298.

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12 FEB 2016

Human Papillomavirus: Vaccination

Written Answers

Sarah Wollaston Totnes

To ask the Secretary of State for Health, what estimate his Department has made of how many men who have sex with men (MSM) are expected to receive the HPV vaccine each year as a result of the Joint Committee on Vaccination and Immunisation's recommendation that it be offered at sexual health clinics; and what proportion of the MSM population aged up to 45 his Department estimates will have been vaccinated within (a) one year, (b) five years and (c) 10 years of that vaccine first being so offered.

Jane Ellison The Parliamentary Under-Secretary of State for Health

In November 2015, the Joint Committee on Vaccination and Immunisation (JCVI), the expert body that advises the Government on all immunisation matters, advised that a targeted human papillomavirus vaccination programme should be undertaken for men who have sex with men (MSM) up to 45 years of age who attend genitourinary medicine and HIV clinics. They noted that this should be subject to procurement of the vaccine and delivery of the programme at a cost-effective price. JCVI acknowledged that finding a way to implement its advice would be challenging and made clear that work was needed by the Department and others to consider commissioning and delivery routes for this programme. This work is already underway and we will announce our plans as soon as we can.

The Department is not yet in a position to suggest estimates of the numbers or proportion of MSM who might be vaccinated from this potential vaccination programme.

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11 FEB 2016

Junior Doctors Contracts

Sarah Wollaston Totnes

I know colleagues across the House will want to join me in thanking junior doctors for the valuable work they do for patients across the NHS. [Hon. Members: "Hear, hear."] I hope that they will look very carefully at the improvements in the offer, with a 13.5% increase in the basic rate and the very important safeguard that will discourage over-rostering at weekends by giving them premium rates if they have to work more than, or including, one in four weekends. I hope theBMA will also recognise and welcome the very important appointment of Professor Dame Sue Bailey to lead an inquiry into all the other aspects that lead to discontent with junior doctors. I wonder if the Secretary of State agrees that what we now need is to move forward in a positive spirit that brings this dispute to an end, takes the temperature down and recognises that we all want the same thing: safety for patients.

Jeremy Hunt The Secretary of State for Health

I thank my hon. Friend for her very constructive comments. She is right. A 13.5% increase in basic pay is very significant, because, unlike overtime and premium pay, it is pensionable. It will help when applying for a mortgage and will mean more money on maternity leave. I think it will be much better for junior doctors.

The review that Dame Sue Bailey is doing, which was much-derided by the Opposition when I mentioned it in my statement, is actually very significant. One of the things that has gone wrong in training is that since the implementation of the European working time directive, we have moved away from the old "firm" system, which would mean that junior doctors were assigned to a consultant, who they would see on a regular basis and who was able to coach them on a continuous basis over weeks and months. That has been lost and many people think that that has led to much lower morale. We want to see what we can do to sort that out.

Finally, I want to echo what my hon. Friend said about going forward in a positive and constructive spirit. When, as a Government, we took the decision to proceed with implementing new contracts, we had the choice of many different routes, because, essentially, we can decide exactly what to choose. We have chosen to implement the contract recommended by NHS chief executives as being fair and reasonable. That is different from our original position. We have moved a considerable distance on most of the major issues, but it is what the NHS thinks is a fair and reasonable contract and we need to move forward.

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10 FEB 2016

Human Papillomavirus: Vaccination

Sarah Wollaston Totnes    Written Answer

To ask the Secretary of State for Health, whether he has received requests to expedite the timetable of the Joint Committee on Vaccination and Immunisation for a decision on HPV vaccination for boys; and whether he plans to review that timetable.

Jane Ellison The Parliamentary Under-Secretary of State for Health

The Department and Public Health England (PHE) have received correspondence from hon. members, organisations and members of the public asking for the Joint Committee on Vaccination and Immunisation's (JCVI's) advice to be expedited.

The JCVI has requested modelling work to help inform whether a human papillomavirus vaccination programme for boys would be cost-effective. It is anticipated that PHE will submit this to JCVI by early 2017. This is not an issue of resources, as the process of model development and checking the validity of the results is complex and requires close working between the modelling team and the scientific and clinical experts. We need to follow due process and ensure that decisions are based upon robust and rigorous cost-effectiveness analysis.


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10 FEB 2016

Police Grant Report: Local Government Finance

Sarah Wollaston Totnes

Is it not true that the long-standing unfairness has been the penalty against rural areas? Areas such as Devon have a low-wage economy, but the highest council taxes. This settlement addresses that imbalance without penalising areas such as Torbay. I therefore congratulate my right hon. Friend on a very sensible settlement.

Greg Clark The Secretary of State for Communities and Local Government

I am very grateful to my hon. Friend. Every local government finance settlement has to strike a balance between the very different needs of different areas of the country. Most people who have reflected on the settlement that I have proposed, including the Local Government Association and the Institute for Fiscal Studies, have recognised that I have been fair to places, such as those she mentions, that have higher costs—Torbay has benefited from the change in the formula—and that I have committed to making sure that the new system for 100% business rate retention is founded on an accepted analysis of the costs and pressures that different authorities face.

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09 FEB 2016

Health

Oral Answers to Questions

Sarah Wollaston Totnes

In asking a question about mental health, may I remind the House that I am married to an NHS forensic psychiatrist, who is also registrar of the Royal College of Psychiatrists? Have the Government looked carefully at today's report from the independent commission on improving mental health services, particularly its finding that provision nationally for the most severely ill acute patients is inadequate? Will the Government set out what measures they will take to make sure we really see progress on parity of esteem and on improving access to such severely ill patients?

Alistair Burt The Minister of State, Department of Health

I thank my hon. Friend for her question, and the Royal College of Psychiatristsfor its work on Lord Nigel Crisp's commission, which we have supported. The report and recommendations have only just come to us, but they certainly travel in the direction in which the Government are already going. We want to reduce out-of-area placements. The NHS is already committed to that, and is working on moving to a definitive target to reduce the number of them and, I hope, eventually to scrap them. I was up in Hull last week to look at problems in that particular area. The recommendations on waiting times are very important. As we all know, this area has been undervalued in the past. It is under greater scrutiny, and more investment and support are going in through the Government. Today's report will help us in relation to that.

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08 FEB 2016

Great Western Railway Routes

Sarah Wollaston Totnes

In highlighting the beauty of the line to Exeter, may I encourage the right hon. Gentleman to stay on the train and see how even more beautiful the line gets once it passes along the coast? It is not just about the beauty of the line, which I hope everyone will experience, but the economic importance of the line via Dawlish to the economies of south Devon. Will he join me in saying that whatever we do we must protect the line through Dawlish and protect the economies of south Devon?

Ben Bradshaw Labour, Exeter

I know the line through Dawlish very well. I spent childhood holidays in Salcombe. In fact, my parents used to get a train all the way to Kingsbridge in the good old days before Beeching took his axe to our rural rail network. It is beautiful, but vulnerable. I will come on to say something about it in a second.

Having said all those positive things, we still have rolling stock that was introduced, I think, in the early 1970s. As I have said, travel speeds have not actually increased very much for decades, if not for a century. I mentioned the loos and the heating, and the hon. Member for Torbay mentioned electrification. It is puzzling that Spain and Italy have full comprehensive networks of high-speed electric trains, but in this country we still do not have a network of high-speed trains. We are getting one slowly, but in the south-west we are set to be probably the only major region with big cities left in western Europe that does not have either high-speed trains or electrification. There is absolutely no reason why we should not already have electrification down to Exeter. There have been technical challenges, but having been on electric trains in the Alps that go up steep gradients I have never quite understood what the barrier is to electrification where there are gradients. As the hon. Member for Torbay says, we will very soon have the technology to overcome that.

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08 FEB 2016

Local Government Finance

Sarah Wollaston Totnes

I warmly welcome the Secretary of State's statement today and thank him for listening to the concerns of rural areas. He will know, however, that the demographic pressures in places such as Devon are severe, and that the precept, welcome as it is, will quite meet the cost of the rise in the national living wage. During his review, will he set out whether he will listen to other proposals to create a sustainable long-term settlement for social care, which has been described as unfinished business in the "Five Year Forward View"?

Greg Clark The Secretary of State for Communities and Local Government

I certainly will. I am grateful for my hon. Friend's words. One knows that more people choose to retire to places such as Devon than to other parts of the country, and it is important that that is recognised in the funds that are available. As everyone knows, my hon. Friend chairs a very important Committee of this House, and one of the essential tasks of this Government over the years ahead will be to make sure that health and social care come together. They are two sides of the same coin. The same people are being looked after, whether by councils or by the NHS. One of the things I am determined to do is to make sure that we have a much better connection between the NHS and social care, and I would be grateful for her advice and that of her Committee in how we do that.

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08 FEB 2016

Junior Doctors' Contract Negotiations

Sarah Wollaston Totnes

Under the current contract, too many junior doctors are forced to work excessive hours and are overstretched during the hours they work. Will the Minister, having set out that the hours will be reduced, reassure the House about what measures will be put in place to make sure that managers do not let this slip and that we do not return to the days of overworked junior doctors?

Ben Gummer The Parliamentary Under-Secretary of State for Health

My hon. Friend is right that new measures have been introduced in the proposed contract. A new guardian role, which was proposed byNHS Employers, will help to protect the hours of junior doctors in individual trusts. That has been a point of success in the negotiation between the BMA and NHS Employers. A new fines system, which is not currently in place, will penalise trusts and ensure that the moneys that are generated by the fines go towards enhancing the general wellbeing and training of doctors within those trusts.

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05 FEB 2016

Mental Health Services: Children and Young People

Written Answers

Sarah Wollaston Totnes

To ask the Secretary of State for Health, how many children and young people in need of specialist mental health support as a result of (a) experiences of sexual abuse, (b) non-sexual physical abuse or neglect, (c) emotional abuse or neglect, (d) bereavement or (e) other trauma have been (i) granted and (ii) not granted access to Child and Adolescent Mental Health Services

Sarah Wollaston Totnes

To ask the Secretary of State for Health, what steps his Department has taken to improve access to mental health services for children who have (a) been the victims of abuse and (b) experienced other trauma.

Alistair Burt The Minister of State, Department of Health

The information needed to link individuals who have experienced various forms of trauma with those who have experienced mental health problems is not collected centrally.

We are committed to improving child and adolescent mental health services, which is why we are investing an additional £1.4 billion in services for children and young people with mental health problems over the course of this Parliament. The guidance issued by NHS England in August last year on Local Transformation Plans for children and young people's mental health and wellbeing specified that the plans should address the full spectrum of need including those with particular vulnerability to mental health problems such as those who have been sexually abused or exploited. The bespoke assurance process that was undertaken by NHS England will therefore have addressed the extent to which this has been addressed in local plans.

NHS England has commissioned a quantitative and qualitative analysis of the Local Transformation Plans, in order to support policy makers, local commissioners and services to understand and use the data that is contained within the plans to drive further improvements. Local Transformation Plans will be reviewed from a narrative, analytical and financial perspective, with thematic reviews carried out in key focus areas that align with Future in Mindprinciples.

Sensitive and routine enquiry will be introduced in targeted health services, such as sexual health clinics and mental health services, to help identify those children who have been subjected to abuse and other traumatic experiences.

NHS England also published a Commissioning Framework for Adult and Paediatric Sexual Assault Referral Centre (SARC) Services in August 2015 which outlines the core services in SARCs and referral pathways to other services. These are now being rolled out throughout England and should lead to improved services for those who have experienced sexual assault, including children and young people.

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Sarah Wollaston Totnes

To ask the Secretary of State for Health, whether, as part of the NHS Five Year Forward View, local sustainability and transformation plans should include measures to improve children and young people's mental health; and on what outcomes they will be assessed.

Alistair Burt The Minister of State, Department of Health

Local health economies are developing a five year Sustainability and Transformation Plan which will set out how they will implement the Five Year Forward View in their area. They will identify and collectively agree the priorities to address over the next five years. We expect the improvement of children and young people's mental health to be a key priority for many local health economies and NHS England will support these areas to develop transformative plans for these services. Clinical commissioning groups (CCGs) will be assessed through a new CCG assessment framework and their progress with transformation will be included.

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Sarah Wollaston Totnes

To ask the Secretary of State for Education, what plans she has to extend the mental health and schools link pilot scheme to post-16 further education establishments.

Edward Timpson The Minister for Schools

The Department will make a decision on how to build on the outcome of the pilot once the training workshops have been delivered and the evaluation has been completed. This pilot is currently running in 27Clinical Commissioning Group areas.

Officials are working with the Association of Colleges to ensure that effective links are being made between the pilot areas and their local colleges, so that they are involved in the development of shared protocols and longer term planning for the provision of children's mental health services.

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03 FEB 2016

UK-EU Renegotiation

Sarah Wollaston Totnes

The Prime Minister has set out the many things that remain to be reformed, but if this grudging and threadbare deal is the best the EU is prepared to concede, what serious hope is there of meaningful renegotiation if or when we are tied in long term under a referendum?

David Cameron The Prime Minister, Leader of the Conservative Party

I would make two points to my hon. Friend. First, this is not coming at the time of a more general treaty change; it is a one-off. We are the first Government, and I am the first Prime Minister, I can think of who from a standing start have achieved a unilateral agreement for the good of their country inside the EU. I do not think it is threadbare; as others have said, it is very solid. I am sure that treaty changes will be coming down the track—the process of reform is never fully completed—but there is no danger, once the agreement is signed and, I hope, confirmed in a referendum, of Europe running away with a whole lot of other plans for Britain, because we have the referendum lock. Nothing can happen to Britain without a referendum in this country. That was such an important piece of legislation back in 2010, but I think sometimes we forget about it.

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03 FEB 2016

Cycling: Government Investment

Sarah Wollaston  Totnes

Having been a member of the all-party group, which produced the report on how we "Get Britain Cycling", I wonder whether my hon. Friend agrees with me, with the report's findings and with the Select Committee on Health that the benefit of cycling is that active travel is the type of physical activity that people are most likely to sustain throughout their whole lives. We should really focus on that if we really are going to get Britain moving as well as cycling.

Chris Green Conservative, Bolton West

I absolutely agree, and this debate is a great opportunity to reinforce that message to the Minister.

The members of the all-party group are not the only ones who want investment at £20 per head; a Sustrans survey suggests that the public want to see investment of £26 per head on an annual basis. More important than pinpointing an exact figure for investment is ensuring that current investment provides good value for money and is adequately utilised by the main practitioner of the funds, which is local authorities. Making cycling ambitions a reality requires collaboration at all levels of government.

The Department for Transport is giving local authorities significant amounts of funding to improve their road infrastructure and to support cycling at a local level. That funding is not ring-fenced and allows local authorities to decide on and implement solutions that best suit their needs. I am pleased that the Government are encouraging all local authorities to have a cycling champion—an official to take cycling development forward in their area and to champion cycling in their area.

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01 FEB 2016

Department for Transport: Roads: Finance

Written Answer

Sarah Wollaston Totnes

To ask the Secretary of State for Transport, what plans his Department has to use the (a) £175 million cycling, safety and integration fund and (b) £75 million air quality investment fund referred to in the Government's Road Investment Strategy for the period 2015-16 to 2019-20.

Robert Goodwill Parliamentary Under-Secretary (Department for Transport)

a) £175 million cycling, safety and integration fund

Highways England is developing a programme of initiatives to improve the safety of the network and to also improve facilities for cyclists, pedestrians and equestrians, identifying further opportunities for improved integration with wider transport networks such as Park & Ride.

This fund supports their ambition to reduce the number of casualties on the strategic road network and encourage walking and cycling as an everyday mode of travel, as set out in the DfT Cycling and Walking Investment Strategy.

(b) £75 million air quality investment fund referred to in the Government's Road Investment Strategy for the period 2015-16 to 2019-20.

Highways England's Delivery Plan commits them to start 10 air quality pilot studies in the first 2 years of this road investment period.

These studies are designed to identify new and innovative solutions that will be funded using the air quality designated fund, to improve air quality alongside the strategic road network and support delivery of the major improvement schemes identified in the Road Investment Strategy.

Highways England's work in relation to air quality, and the use of the £75million air quality designated fund (2015 – 20), is in support of the Government's National Air Quality Plan.

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01 FEB 2016

NHS Trusts: Finances

Sarah Wollaston Totnes

We all welcome the front-loading of the NHS settlement, and want to congratulate NHS staff on the extraordinary efforts they are putting in to improve quality, alongside coping with rising demand. If NHS Improvement is tasking management consultants to come in and advise trusts on turning around financial problems, will the Minister also task it with looking specifically at issues of social care and how the interrelation between underfunding of social care impacts on the health economies of local trusts, and with looking at improvement and prevention, because prevention was also noted by Simon Stevens to be unfinished business from the spending review?

Ben Gummer The Parliamentary Under-Secretary of State for Health

My hon. Friend will be aware of the increase in the better care fund that this Government have introduced and the 2% precept on council tax bills that will deliver increases for social care. She will also be aware that "Five Year Forward View" is a holistic understanding of the healthcare system that includes transformation of the NHS and social care towards that point. That is why we are proud to fund "Five Year Forward View" in the manner that Simon Stevensrequested —front-loaded, with £3.8 billion in the next year. The manner of that bottom-up integration over the next few years will ensure that the challenge around social care that my hon. Friend identifies will be addressed in years to come.

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28 JAN 2016

NHS and Social Care Commission

Dr Sarah Wollaston (Totnes) (Con): I thank the right hon. Member for North Norfolk (Norman Lamb) and pay tribute to him, particularly for his work as a Minister in the coalition Government and for his personal commitment to mental health services. I welcome his call for real focus and cross-party agreement on this long-standing problem. We need that if we are to solve the problem and create a health and social care service that is fit for purpose for the next century.

I would sound one note of caution. I am very relieved that the right hon. Gentleman is not calling for a royal commission, as there is no shortage of commissions in this place. We are just a year from the Barker commission, the highly respected independent commission set up by the King's Fund, which very clearly laid out the problems we face and suggested a number of options. Hard choices will have to be made if we are to raise the share of our GDP that we spend on health and social care to 11%, which I know many Members would support.

We know the options. The difficulty is a political one. I question whether we need a commission, and would ask whether we do not in fact need a commitment from the leaders of all political parties in England to come together to look at the proposals seriously, and get away from the endless bickering in this place about the choices before us and the pretence that this is somehow not going to happen. Unless we make such changes, we will have to start thinking rapidly about plan B as an alternative.

.......

Dr Wollaston: In this place, we sometimes push issues into commissions, which debate them endlessly and come to no agreement. I would say the urgency of this issue demands that the leaders of all political parties sit down together and agree.

......

Dr Wollaston: I thank the right hon. Gentleman for his clarification. I agree that we are looking for a process to which everyone can commit. We are not looking for a commission that will go away and examine the problems. We know the issues, which have been set out in very stark terms. The King's Fund's excellent independent Barker commission set out the whole range of options. What we have always lacked is the political buy-in and determination to move forward. I would join in making a request for any process that will make that happen, but not for something that pushes it away for three years, because, as we all know, the closer we get to a general election, the more challenging it will be to have a genuine political agreement. It therefore needs to happen as rapidly as possible.

.....

Dr Wollaston: I agree with my right hon. Friend. However, in parallel with the process of looking at long-term funding arrangements and settlements, we must get on—here and now—with changes that are needed in the short term. I want to touch on a few such areas.

The first area is prevention. I absolutely agree with the right hon. Member for North Norfolk that it is bad practice to cut money from public health, simply because of the challenges we face. If we look at the NHS budget, we can see that 70% of it goes on helping those living with long-term conditions. We know that many future problems are brewing here and now.

Let us just take childhood obesity, which we discussed at length last week. A quarter of the most disadvantaged children now leave primary school not just overweight, but actually obese. Given the problems that that is saving up, in the personal cost to those children and the wider costs to the NHS—nearly 10% of the entire NHS budget already goes towards treating type 2 diabetes—how can we not be grasping that nettle as a matter of urgent prevention to save money for the whole system?

.....

Dr Wollaston: Indeed. The data from Public Heath England are absolutely stark: from looking at the index of multiple deprivation and the incidence of childhood obesity, we can see that not only is there a large gap, but that that gap is widening. As part of the strategy, the Government must aim not only to lower overall levels of childhood obesity, but to narrow that gap, particularly by looking at measures that will help to do so. I thank the hon. Gentleman for making that point.

The right hon. Member for North Norfolk referred to the need for self-care, and we know that we need a much greater focus on how we can support people to improve their own health. If we are going to raise money for the whole health and care system, there are mechanisms to do so that will also help to prevent ill health in the future. One example is a sugary drinks tax, which could lever money into a very straitened public health budget to put in place measures that we know will help. We need the NHS to get on with prevention, and in my view we need more of the funding that is available to go into saving money for the future.

......

Dr Wollaston: I thank my hon. Friend for mentioning the "Five Year Forward View", but I would respond by saying that Simon Stevens has referred to prevention and social care as "unfinished business" from the spending review. If we are to deliver the plan, we need to listen to his views and be mindful of the fact that spending on social care actually saves the NHS money. We cannot separate social care from the NHS, and we should not ignore his wise words on the importance of prevention in delivering the "Five Year Forward View".

.....

Dr Wollaston: Indeed; I remember that too. I agree that unless we up our game and redouble our efforts on prevention, we will not achieve the savings that are required to close the gap in the "Five Year Forward View". That is why I wanted to touch on prevention first.

There is another area that we need to do much more on here and now. We need to have a relentless focus on variation across the NHS. We hear examples of local systems that are making things work, but the NHS has a long history of failing to roll out best practice. The "Growing old together" report, which was published today by a commission set up by the NHS Confederation, gives examples of good practice across the NHS and social care in which integrated practice is not only delivering better care for individuals, but saving money. The only depressing aspect of that is that one has to ask why it is not happening everywhere. Rather than endlessly focusing on the negatives in the NHS, let us focus more on the positives and on facilitating their roll-out.

.....

Dr Wollaston: If that were the case, it would be a problem. I think that the two things could happen in parallel. We could work towards a consensus about future funding at the same time as focusing relentlessly on what needs to be done in the here and now. However, I agree that if it were a distraction, it would be a problem.

As well as continuing to have a relentless focus on tackling variation, we need to follow the evidence in healthcare. When money is stretched, we must be sure not only that we spend it in a way that follows the evidence, but that we do not waste money in the system. I caution the Minister on the issue of seven-day services, which we have discussed at the Health Committee. If there is evidence that GP surgeries are empty on a Sunday afternoon because there is no demand, and in parallel with that we are being told that out-of-hours services are in danger of collapse because, in a financially stretched system, there are not the resources or manpower to offer both, we must be led by the evidence and be

When money is tight, we owe it to our patients to focus on the things that really will improve their care. There must be no delay in making changes when we know that something that has been put in place with the best possible intentions may be having unintended consequences. We must be clear that we will follow the evidence on best practice and value for money, so that patients get the best outcomes in a financially stretched system.

.....

Dr Wollaston: I have to declare a personal interest here, because one reason why my daughter, who is a junior doctor, has spent a year in Australia is that there are sometimes difficulties with married couples—or, indeed, people in any relationship—being able to work in the same part of the country. There is far more that could be done to help junior doctors, in addition to the contract negotiation about money. However, as I have a personal interest, it is probably best if I do not comment further on that.

I want to draw attention to the role of the voluntary sector, which the right hon. Member for North Norfolk referred to. I pay tribute to the voluntary sector partners in my constituency—bodies such as Dartmouth Caring and Brixham Does Care. Across the constituency, a number of organisations are making a real difference to people's lives, yet very many voluntary sector organisations are coming under extreme pressure. I could give examples of voluntary sector partners that have had to close, sometimes for the want of very small amounts of money, even though they have delivered enormous value. These are locally-facing organisations.

It was welcome that Simon Stevens gave a commitment to look at making the arrangements for commissioning voluntary sector partners easier. Even though those commissioning arrangements may have been made easier, often the resources are not there to fund such organisations. We need to look again at how we can deliver best value for patients by supporting voluntary sector partners across all our constituencies.

Those are the areas that I want the Minister to focus on in the here and now, but I agree that in the long term, we must look at funding. One challenge in this country—and I think it is a wonderful thing—is that almost all the funding for the health service comes directly from taxation or national insurance. We are almost unique in that. Only two other countries exceed us in that regard. Government funding for the NHS accounts for 7.3% of GDP and only an additional 1.5% is levered in from the private sector.

The choice before us is whether to expand the amount that we raise through charging and top-ups. Personally, I do not support that. The Barker commission did not support it either. Top-ups and charging do not raise as much as people imagine by the time the bureaucracy involved in collecting the money and the unintended consequences that are often found, such as widening health inequalities, are accounted for. I hope that we do not choose to go down that route. The most equitable funding mechanism is taxation.

There is an issue of intergenerational fairness here, as the right hon. Member for North Norfolk said, and we need to consider it. These are hard political choices, which can no longer be ducked. Given the demographic challenge and the challenge of complexity that we face, the alternatives are appalling. The alternatives are to abandon our older people. The pressures that our hospitals face from those who cannot be discharged into the community and those in the community who cannot get into hospital are mounting. We can ignore them no longer.

I call on the Government to consider very carefully working with our Opposition partners at scale and at pace to bring forward an agreement on how we will bring more money into the system as a whole, and in the meantime, to make sure that the money we do spend is spent in the best interests of patients.

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26 JAN 2016

111 Helpline

Sarah Wollaston :Totnes Click here to watch Sarah speak

I join colleagues from across the House in sending deepest condolences to William's parents. I welcome the Secretary of State's response that he will put into action the recommendation from today's report. May I draw out one aspect that has not been touched on so far, which is the comment in the report that out-of-hours services did not have access to William's clinical records, and that had they been able to do so they would have seen how many times a doctor had been consulted, and that that would have been a clear red flag? Will he reassure me that that matter will be addressed across the NHS, so that all services have access to patients' clinical records—of course with their consent?

Jeremy Hunt The Secretary of State for Health

My hon. Friend is absolutely right. There is so much in this report, but we must not let some very important recommendation slip under the carpet, and that is one of them. We have a commitment to a paperless NHS, which involves the proper sharing of electronic medical records across the system. We have also instructed clinical commissioning groups to integrate the commissioning of out-of-hours care with the commissioning of their 111 services to ensure that those are joined up. It is a big IT project, and we are making progress. Two thirds of A&E departments can now access GP medical records, but she is absolutely right to say that it is a priority.

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25 JAN 2016

Education: Mental Health

Dr Sarah Wollaston (Totnes) (Con): In the last Parliament, the Health Committee heard compelling evidence of the need to focus on prevention and early intervention. Much of that, as the Secretary of State will know, is being funded from public health budgets. Will the Secretary of State set out what discussions she will have, and reassure the House that as those budgets come under pressure the very valuable services being put in place will not be affected?

Nicky Morgan: I read with interest the Health Committee report in the last Parliament, and I and the Under-Secretary, my hon. Friend the Member for East Surrey (Mr Gyimah), have regular conversations with our colleagues in the Department of Health and across Government on this issue. Early insights from the local transformation plans, which my hon. Friend the Member for Totnes (Dr Wollaston) will know about, indicate that some areas are already running their own activities to decrease stigma and discrimination, or are planning to do so. Sadly, there remains discrimination against the prioritisation of mental health services even within some parts of the NHS. We have to change that.

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21 JAN 2016

Childhood Obesity Strategy

Sarah Wollaston Totnes Constituency

I beg to move, that this House calls on the Government to bring forward a bold and effective strategy to tackle childhood obesity.

I want to thank the Backbench Business Committee for granting time for this debate. I also want to thank all my colleagues from across the House who are members of theHealth Select Committee—and the staff of the Committee, particularly Laura Daniels—for their work on the report on childhood obesity that was published recently. Outside this House, there are also many organisations and individuals who have campaigned tirelessly to improve children's health.

Perhaps we can start by looking at the example of Team GBand their success in the Olympics. On the morning of their track cycling victory, the architect of the team's success, Sir David Brailsford, put their success down to the principle of marginal gains and their relentless pursuit of identifying every efficiency in the rider, the bike, the environment around them and their training regime. All those marginal gains were added together to win gold for Team GB in the Olympics. I think we need to adopt the same principle when it comes to tackling childhood obesity.

Too often, I hear people saying that it is all about education, or about getting children to move more in PE at school, but I would say that there is no single measure. We all know that this is an extremely complex problem that requires action at every level. I therefore call on the Minister to look at every single aspect of tackling childhood obesity. If we were running a cycling team hoping to win the Olympics, we would realise that we could not achieve success if we left any of the factors out, so let us apply that principle here.

Let me set the scene by telling the House why this subject matters so much. We know from the child measurement programme in our schools that around one in five of our children who enter reception class are either obese or overweight. However, by the time they leave in year 6, a third of our children are either obese or overweight. Perhaps even more worrying are the stark data on the health inequality of obesity. A quarter of the children from the most disadvantaged groups in our society are leaving school not just overweight but obese, which is now more than twice the rate among children from the most advantaged families. My first question for the Minister is this: will the childhood obesity strategy not only tackle the overall levels of obesity but seek to narrow that yawning and growing gap in our society between the least and most advantaged children? Any strategy that fails to narrow that gap will have failed our children.

.........

Sarah Wollaston Totnes Constituency

Indeed. I completely agree with the hon. Gentleman, and I shall come on to that subject later. I am relieved to hear that he is not on a sugar high for the debate.

I want to set out not only the scale of the problem but its consequences. It has consequences for the whole lifetime of our children, in relation to their physical and emotional health. They also suffer the impact of bullying at school, as they are too often stigmatised in the classroom because of their weight. There is increasing evidence that obesity is a factor in causing many preventable cancers, and it also has an impact on conditions such as diabetes and heart disease. This has a cost not only to individuals but to wider society and to the NHS.

The Minister will know how essential it is that, as part of the five-year forward view, we tackle the issue of prevention. We cannot do that without tackling obesity, particularly among children, given the lifetime impact and consequences of the condition. She will know that 9p in every £1 we spend in the NHS is spent on diabetes. We estimate from the evidence that the Health Committee took during our hearings that the overall cost of obesity to the NHS is now £5.1 billion a year, and the wider costs to society have been estimated to be as high as £27 billion, although the estimates vary. We simply cannot afford to take no action.

Physical activity is of course extraordinarily important and I am confident that it will feature strongly in the Government's strategy, but it is no good focusing solely on that. Physical activity is good for children, whatever their weight. Indeed, it is good for all of us, whatever our age. However, any strategy that assumes that we can tackle childhood obesity solely through physical activity will simply be ignoring the overwhelming evidence that most of the gain will be in reducing calories. That is not just about sugar, however. It is easy to be accused of demonising sugar. The fact is that children have more than three times the recommended amount of sugar in their diet, but that is perhaps the easiest aspect of the problem to tackle. The Minister will recognise the fact that we are talking about overall calories, which also include fats.

......

Sarah Wollaston Totnes Constituency

I thank my hon. Friend from mentioning that. I was going to come on to that point and he has saved me from doing so. I completely agree that we must not forget the impact of sugar on children's teeth. He will recognise that there are great health inequalities relating to that issue as well.

So how should we tackle this? I have spoken many times about a sugary drinks tax, but I recognise that that is not where the greatest gain lies when it comes to tackling childhood obesity. As the Minister will recognise from the evidence presented by Public Health England, price promotions will need to form an extraordinarily important part of the childhood obesity strategy if it is to be effective. It is a staggering fact that around 40% of what we spend on our consumption of food and drink at home is spent on price promotions. Unfortunately, however, they do not save us as much money as we assume. They encourage us to consume more. In British supermarkets, a huge number of those promotions relate to sugary and other unhealthy products. I call on the Government to tackle that as part of their strategy. We need a level playing field as we seek to rebalance price promotions, but that has to be done in a way that does not simply drive us towards promoting other products such as alcohol. We need to take a careful, evidence-based look at all this.

.........

Sarah Wollaston Totnes Constituency

I thank the right hon. Gentleman for his point, which prompts me to address the issue of a sugary drinks tax. We looked at examples of where taxation can be applied across sugar more broadly, perhaps to incentivise reductions within reformulation, as some countries have done. However, we wanted to address the single biggest component of sugar in children's diets, which is sugary drinks. The Committeerecommended a sugary drinks tax rather than a wider sugar tax, and there are several reasons for doing that. First, we know that it works. Secondly, it addresses that point about health inequality.

Mexico introduced a 1 peso per litre tax on sugary drinks and by the end of the year the greatest reduction in use—17% by the end of the year—was among the highest consumers of sugary drinks. The tax drove a change in behaviour. The whole point of this sugary drinks tax is that nobody should have to pay it at all. To those who say it is regressive, I say no it is not; the regressive situation is the current one, where the greatest harms fall on the least advantaged in society. As we have seen with the plastic bag tax, the tax aims to nudge a change in behaviour among parents, with a simple price differential between a product that is full of sugar, and causes all the harms that we have heard about, including to children's teeth, and an identical but sugar-free product—or, better still, water.

.........

Sarah Wollaston Totnes Constituency

I thank the right hon. Gentleman for that and welcome what he describes. That movement is not just happening in City Hall, because it is being recommended within the NHS bySimon Stevens. I also congratulate Jamie Oliver and the many other outlets that are introducing such an approach. The other point to make is about public acceptability, because all the money raised goes towards good causes. As we have seen with the plastic bag tax, the fact that the levy is going to good causes increases its public support. That levy has been extraordinarily effective, as plastic bag usage has dropped by 78%. That is partly because we all knew we needed to change but we just needed that final nudge. That is what this is about: that final nudge to change people to a different pattern of buying. It has a halo effect, because it adds a health education message and that is part of its effectiveness.

.......

Sarah Wollaston  Totnes Constituency

I thank my hon. Friend and fellow member of the Health Committee for her intervention. At a time of shrinking public health budgets, there is a huge additional benefit from having this kind of levy, in that many of the other measures that the Minister will want to see in the strategy—on exercise in schools, teaching in cookery lessons and health education—could be funded in part through a sugary drinks tax. I hope she will look carefully at this idea and consider introducing it

........

Sarah Wollaston Totnes Constituency

I thank the hon. Gentleman for that, which brings me on to reformulation. It will also form a core part of the strategy. Our view was that we should have a centrally-led programme of reformulation across foods and drinks, and that what manufacturers want is a level playing field. The trouble with reformulation is that it takes time; there has been an effective programme on salt, but that has happened very gradually, over a 10-year period. There is no reason why these things should be mutually exclusive; I come back to that point about marginal gains and say let us do all of the above. I know that the Minister is looking closely at reformulation and understands how powerful it will be. The evidence we heard was that it could take 6% of the sugar out of children's diets. Reformulation, alongside other programmes, will play a part, but it will not work on its own and, unfortunately, it will take longer.

We also need to examine the pervasive effect of marketing and promotion. Do I want to have a kilogram of chocolate for almost nothing when I buy my newspaper? Of course I do, but please do not offer it to me. Please do not make me walk past the chicanes of sugar at the checkout or when I am queuing to pay for petrol. We know that 37% of all the confectionary we buy is bought on impulse. It does not matter how much we are intending not to buy it, if it is presented to us on impulse, we buy it, as impulse is an extraordinarily powerful driver. I therefore hope that any strategy will tackle that part of consumption, along with portion sizing. The supersizing of our society is in part down to the supersizing of portions and offers. All of this needs to be included in our approach, as does dealing with advertising. This advertising is pervasive and it is hitting our children everywhere they go, on television, online and through the influence of "advergames". We know that this is very powerful in driving choices for children, so I hope the Minister will look carefully at that. She will have seen our recommendation of a watershed of 9 pm.

Time is running short, so I shall close my remarks, as I know other Members will want to cover many other aspects, such as exercise, the effect of what local authorities do, how much more powerful they could be in their roles if we gave them greater planning powers, and so on. Early intervention, research, education, teaspoon labelling—please do it all. We need a bold, brave and effective strategy, and we need to learn from British cycling and the law of marginal gains.

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19 JAN 2016

Health Select Committee

Today the Health Select Committee held a post-appointment hearing with the Chair and Chief Executive, NHS Improvement

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18 JAN 2016

Donald Trump

Sarah Wollaston Totnes Constituency

I think the question for my right hon. Friend the Home Secretary is this: is Donald Trump conducive to the public good? We have heard a lot of talk in this debate about buffoonery and terms such as "blunt directness". If I were Muslim—I am not; I speak as a gentle atheist—I would find repulsive the thought that I should be excluded from the United States of America for no reason other than that I was a Muslim.

I am proud to represent Dartmouth. It was from Dartmouth, nearly 400 years ago, that the Pilgrim Fathers sailed to the Americas, and they sailed to escape from the kind of religious persecution that we are addressing today. We have seen in Europe what happens when an entire people are demonised for no reason other than their race, so I do not think that we should trivialise this discussion; it is a really important debate. Nor do I think that the result of the US presidential election will be decided on whether the Home Secretary decides to exclude Donald Trump. In fact, I would argue that, should Donald Trump be excluded from one of the US's oldest allies, that would send a very clear message to the people of the United States about what we feel about those who demonise an entire people for no reason other than their religion.

I do not think that there is any realistic prospect that the Home Secretary will ban Donald Trump, but let us in this House send a very clear message to Muslims in this country, to British Muslims: we value you, we value your contribution and we will take this petition very seriously. Perhaps those arguments about religious freedom matter as much now as they did 400 years ago. I would welcome everyone across the pond in the United States who may be following this debate back to my constituency —the most beautiful constituency in Britain—to see Dartmouth, where the Pilgrim Fathers sailed from. The anniversary is in 2020.

I say this to Donald Trump. Just reflect on the consequences of your kind of religious bigotry. This is not a laughing matter. Think again, and if you do visit this country, take time to visit the mosques; take time to meet Muslims; take time to understand just how profoundly offensive and dangerous that kind of thinking is. There is no place for it in this country or in the United States.

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Sarah Wollaston Totnes Constituency

Does the hon. and learned Gentleman agree that the consequences of such hate speech are greater when it comes from high-profile individuals? At the heart of this debate is whether Donald Trump's presence in the UK is conducive to the public good. We have heard repeatedly about the harm, and the hon. and learned Gentleman himself has elucidated the kinds of hate crimes about which we are talking.

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14 JAN 2016

Stoke Gabriel and Landscove Primary Schools

Thank you to Stoke Gabriel and Landscove Primary Schools for coming to Westminster and visiting the amazing new Education Centre

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13 JAN 2016

Compulsorily Detained Mental Patients: Children

Written Answer

Sarah Wollaston Totnes

To ask the Secretary of State for the Home Department, for how long people under the age of 18 who were transferred to a place of safety under section 136 of the Mental Health Act 1983 were detained on average in (a) a police cell and (b) a police vehicle in England and Wales in each of the last 10 years.

Mike Penning The Minister of State, Home Department, The Minister of State, Ministry of Justice

The information requested is not held centrally.

However, the use of police cells as a place of safety for all persons detained under section 136 of the Mental Health Act 1983 has more than halved since 2011/12 (when figures were first collated) as shown in the following table. A joint inspection by Her Majesty's Inspectorate of Constabulary (HMIC); Her Majesty's Inspectorate of Prisons (HMIP); the Care Quality Commission (CQC); and Healthcare Inspectorate Wales (HIW) (published in 2013) found that the average time that each such person spent in police custody was 10 hours 32 minutes.

The Government intends to make provision in the Policing and Crime Bill, to be introduced in Parliament soon, to prohibit the use of police cells as places of safety for people under the age of 18, and to further limit their use in the case of adults. The maximum period for which a person may be detained pending a mental health assessment will also be reduced.

Table 1: number of times a police station was used as a place of safety for people detained under Section 136 Mental Health Act 1983 (England only)

Year Section 136 detentions in police stations

Percentage reduction year on year
(to nearest whole number)

2011-2012 8667 No data on use of police stations is available for 2010-2011
2012-2013 7881 -9%
2013-2014 6028 -24%
2014-2015 2996 -34%

Source: Health and Social Care Information Centre

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13 JAN 2016

Association of Directors of Adult Social Services

I met with Ray James, President of the Association of Directors of Adult Social Services to discuss the challenges we face in social care.

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12 JAN 2016

Financial penalty as alternative to prosecution under Housing Act 2004

Sarah Wollaston , Totnes          Click here to watch Sarah speak

I thank the hon. Gentleman for giving way. He will know I have a great deal of respect for him. He talks about how this feels for him and his colleagues. How it feels for my constituents in south Devon is that an historic injustice has been righted. I put it to him that they feel they have been under-represented, and that we care about our constituents in this House, not ourselves.

 

Pete Wishart Shadow SNP Westminster Group Leader (Leader of the House of Commons), Chair, Scottish Affairs Committee

Here is something for the hon. Lady, for whom I have a great deal of respect, to consider: how about if we all retain equality in the House of Commons? How about we retain the same rights and privileges, just like we did just a few short weeks ago? The hon. Lady and all her hon. Friends obviously feel very strongly about this. I understand the passion of English Members of Parliament on this issue. How about they create a Parliament? How about designing a Parliament in their own image, where they can look after these issues like we do in theScottish Parliament? Why do not they not have a Parliament, one that does not necessarily sit in this House but in one of the other great cities throughout the United Kingdom, where democracy could be seen in action? How about that as a solution? We could then come back together to this House as equal Members and consider the great reserved issues of foreign affairs, defence and international relations. That is how most other nations do it. It is calledfederalism and it seems to work quite adequately in most other nations.

What Conservative Members have done today is create this absolute mess—a bourach guddle. Nobody even understands how it works! We have just rung the Division bells to suspend proceedings, so that the Speaker can scurry off and consult the Clerks to decide whether it is necessary to recertify certain pieces of proposed legislation. This is what has happened to the business of this great Parliament. This is what we have resorted to today.

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12 JAN 2016

Health Select Committee

Today the Health Select Committee held the final evidence session on its inquiry into Primary Care. Evidence was given by Alistair Burt MP, Minister for Community and Social Care.

To watch the meeting click here

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12 JAN 2016

Devon County Council

I met with Cllr Andrew Leadbetter and Cllr John Hart, the Leader of Devon County Council, to discuss Devon Council's budget settlement. The Council made £174m in savings during 2010-15 and are looking at a further £110m of savings which are likely to be needed over the next 4 years, with up to £40m of this in the coming year 2016/17.You can help to influence Devon County Council's decisions about how future savings are made by telling them your priorities and how they affect your community.Over 3,600 people have visited their website and around 500 have completed a budget priorities survey or attended a consultation event. This review ends on the 29th January 2016

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12 JAN 2016

General Pharmaceutical Council

Good to meet up with Nigel Clarke, Chair, and Duncan Rudkin, Chief Executive of the General Pharmaceutical Council today. The role of pharmacists is changing and over future years we can expect to see many more pharmacists working alongside GPs within theirs surgeries and providing a wider range of services directly to the public within surgeries so that patients can seek advice without having to make an appointment with their GP. It was useful to catch up on a range of issues including the regulation and training of pharmacists and the role of online pharmacies.

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11 JAN 2016

Department for Education: Personal, Social, Health and Economic Education

Wtitten Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what assessment she has made of the potential merits of statutory PSHE education for the health of school pupils; and if she will make a statement.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what discussions she has had with the Secretary of State for Health on the Chief Medical Officer's recommendations that PSHE education be made a routine part of children's education.

Edward Timpson The Minister for Schools

We want all children to lead healthy and active lives. Schools have a key role to play in supporting this; the new national curriculum sets the expectation that pupils are taught, across a variety of subjects, about the importance of leading healthy and active lives.

Schools and teachers already recognise the importance of good PSHEeducation and know that healthy, resilient, confident pupils are better placed to achieve academically and to be stretched further. In the introduction to the national curriculum, we have made clear that all schools should make provision for PSHE, drawing on examples of good practice.

The Secretary of State for Education has regular discussions with the Secretary of State for Health about children's health and the role schools can play in tackling childhood obesity.

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Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what assessment she has made of the potential effect of statutory PSHE education on lowering the level of violence against women and girls; and if she will make a statement.

Edward Timpson The Minister for Schools

High quality Personal, Social, Health and Economic (PSHE) education has a vital role to play in ensuring that young people leave school prepared for life in modern Britain, helping them develop healthy relationships and recognise unhealthy relationships. It can also give them the skills and knowledge to help keep themselves, and each other, safe. The Government has made it clear in the introduction to the framework to the national curriculum that all schools should teach PSHE. Schools and teachers are best placed to develop their own PSHE curriculum based on the needs of their pupils, drawing on guidance provided by expert organisations such as the PSHE Association.

As stated in the Government response to the select committee report, we will take forward work with the sector to improve the quality of PSHE, and intend to make significant progress on this issue during this parliament.

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11 JAN 2016

Local Government Funding: Rural Areas

Sarah Wollaston  Totnes        Click here to watch Sarah speak

I thank my hon. Friend for his magnificent campaign. Does he agree that we must dispel the myth that there is no deprivation in rural areas, and make it clear that people in those areas are doubly disadvantaged by the lack of access to services such as transport?

 

Graham Stuart Conservative, Beverley and Holderness

My hon. Friend is absolutely right. Withernsea, a town in my constituency, is among the 10% most deprived areas in the country, and I know that similar stories can be told about colleagues' constituencies throughout England. It is not true that there is no deprivation in rural areas. On average, it is not true. On average, the urban resident receives more. Urban areas do not consist of the most deprived, concentrated communities. They contain some communities of that kind, but on average people in urban areas earn a great deal more than those in rural areas.

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07 JAN 2016

Seafish UK

Thank you to Dr Tom Pickerell, the Technical Director from Seafish for coming to share his views on fisheries science and sustainability. The mission of Seafish is to support a profitable, sustainable and socially responsible future for the seafood industry.

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05 JAN 2016

Health: Saudi Arabia

Sarah Wollaston Totnes Constituency

The execution of Sheikh al-Nimr has had disastrous consequences and is a gift to Daesh. Has the Minister made a calculation of the effect of the failure to deliver a straightforward condemnation on relations with other regional powers?

Tobias EllwoodThe Parliamentary Under-Secretary of State for Foreign and Commonwealth Affairs

My hon. Friend is right to recognise that Daesh benefits when there are disagreements between the regional players, which is why it is important that we de-escalate tensions.

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05 JAN 2016

Health: Topical Questions

Sarah Wollaston Totnes Constituency

Nobody wants to return to the days of exhausted junior doctors being forced to work excessive hours, and the Secretary of State will know that that is why junior doctors have expressed concern about the potential impact of removing financial penalties from trusts. Will theSecretary of State set out what has happened during the negotiations to reassure the public and doctors about patient safety?

Jeremy Hunt The Secretary of State for Health

I hope I can reassure my hon. Friend, because we have said that we will not remove financial penalties when doctors are asked to work excessive hours. To quote from the letter that I received from the chief negotiator about our offer to the British Medical Association:

"Any fines will be paid to the Guardian at each Trust, allowing them to spend the money on supporting the working conditions or education of doctors in training in the institution."

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18 DEC 2015

Department for Transport: Cycling

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Transport, if he will make it his policy to include a commitment to constructing safe paths alongside busy roads in rural areas in the forthcoming National Road Safety Strategy to improve cycle safety.

Robert Goodwill Parliamentary Under-Secretary (Department for Transport)

The Conservative Manifesto 2015 had a commitment to reduce the number of cyclists and other road users killed or injured on our roads every year. We have been working closely with road safety groups to consider what more can be done and expect to publish our Road Safety Statement shortly.

The Road Safety Statement will set out the high level plan and overarching approach to road safety that we expect to take over the rest of the Parliament, and will be followed by a series of more detailed proposals and consultations. The Department for Transport will publish a Cycling and Walking Investment Strategy in 2016 which will set out our plans for investment in safer cycling and walking infrastructure.

Busy roads in rural areas will either be the responsibility of Highways Englandor local authorities.

Highways England have committed to provide a safer, integrated and more accessible strategic road network for cyclists and other vulnerable road users. To support this, the Government has outlined a commitment to invest £100m between 2015/16 and 2020/21 to improve provision for cyclists on the strategic road network.

On a local level, provision of cycling infrastructure is for local traffic authorities. The Department encourages them to ensure cycling is considered as part of the planning process.The Department for Transport's Cycle Infrastructure Design guidance supports local authorities on providing cycle-safe infrastructure for cyclists.

It is also worth noting that from within the record £6 billion to be allocated to local highways authorities between 2015 and 2021 for road maintenance, from 2018/19 the plan is to change the formula used to allocate local highways maintenance capital funding so that it also takes into account footways and cycleways as well as the roads, bridges and street lighting, which it is currently based on. Once implemented, around 9% of the funding will be based on footway and cycleway lengths.

 

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Transport, what funding his Department plans to allocate to (a) increasing the number of journeys undertaken by bicycle and (b) reducing the number of cyclists killed or seriously injured on roads over the next five years.

Robert Goodwill Parliamentary Under-Secretary (Department for Transport)

The Government remains committed to its manifesto targets to double cycling and make cycling safer.

The Government recently reaffirmed its commitment to cycling and walking, with SR2015 announcing funding support of over £300m. This includes delivering the Cycle City Ambition programme in full, and funding the Bikeability cycle training programme, which increases cycle proficiency amongst school children.

The Cycling and Walking Investment Strategy, to be published in summer 2016, will explain the Government's investment strategy for cycling and walking.

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16 DEC 2015

Mental Health Services: Finance

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what steps he is taking to ensure that funding is sufficient to meet patient demand in (a) community mental healthcare and (b) inpatient mental healthcare; and if he will make a statement.

Alistair Burt The Minister of State, Department of Health

NHS England's Planning Guidance for 2015/16, Forward View into action: planning for 2015-16, sets out the expectation that clinical commissioning groups' (CCGs) spending on mental health services in 2015/16 should increase in real terms, and grow by at least as much as each CCG's allocation increase to support the ambition of parity between mental and physical health. Compliance with the Planning Guidance is being assured at national and Area Team level.

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15 DEC 2015

Obesity: Surgery

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what account will be taken of NICE's clinical guidelines on levels of patient access in setting the budgets devolved by NHS England to clinical commissioning groups for obesity surgery from April 2016.

George FreemanThe Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

NHS England would expect commissioners to take account of this guidance when commissioning services.

Any transfer of budget from NHS England to devolved areas will be on the basis of existing contractual activity.

Before the transfer of services, NHS England will complete a data capture exercise, working with providers through the specialised commissioning hubs, to collect the current activity level. This will provide the basis for the transfer of the budget. Governance sign off will then be agreed at NHS England Board level.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, when NHS England's Clinical Reference Group for Severe and Complex Obesity will publish its proposed template for clinical commissioning groups on access to obesity surgery pathways and follow-up treatment.

George FreemanThe Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

The template is in development and the draft will be shared in January 2016.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, what assessment he has made of the potential effect on patient outcomes of the planned transfer of obesity surgery commissioning responsibilities to clinical commissioning groups from April 2016.

George FreemanThe Parliamentary Under-Secretary of State for Business, Innovation and Skills, The Parliamentary Under-Secretary of State for Health

We do not expect obesity outcomes to be affected, as the change will primarily be in regard to commissioning responsibilities. However, we believe the transfer should support better integration between Tier 3 and Tier 4 services (which include obesity services) which in turn should improve patient pathways.

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15 DEC 2015

Royal College of Surgeons

Thank you to Clare Marx, President of the Royal College of Surgeons of England for meeting with me today to discuss a range of issues including morale, access and regulation

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14 DEC 2015

Climate Change Agreement

Sarah Wollaston Chair, Health Committee     Click here to watch Sarah speak

I congratulate the Secretary of State and her whole team on the part they played in reaching this historic deal. She will know that it is not only about acting globally, but about acting locally. Will she join me in paying tribute to community groups, such as Transition Town Totnes and Sustainable South Brent, and to groups all around the country? They are keen to meet her to talk further about the role they can play to further the goals.

Amber Rudd The Secretary of State for Energy and Climate Change

I will always be delighted to meet my hon. Friend's constituents. She is right that it is much more effective if these actions are taken locally and nationally, but above all not top-down internationally.

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14 DEC 2015

Communities and Local Government: Topical Questions

Oral Answer to Question

Sarah Wollaston Chair, Health Committee

Simon Stevens has described social care funding as "unresolved business" from the spending review. Does the Secretary of State agree with him that it is time for a fundamental rethink about how we fund social care in the future?

Greg Clark The Secretary of State for Communities and Local Government

My hon. Friend, who has a deep and long-standing interest in the matter, will know that the funding of adult care needs to be done jointly between local councils and the NHS. The Health Secretary and I are working very closely to make sure that the funds that the Chancellor has made available are put to good use so that our elderly people are properly cared for, whether they are in the charge of councils or in our hospitals

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10 DEC 2015

M6: Southern Health NHS Foundation Trust

Sarah Wollaston Chair, Health Committee

The allegations in the draft report about Southern Health are deeply disturbing, and I welcome the steps that the Secretary of State has announced. In particular, I am pleased that he will not treat this as an isolated incident. The key findings of the draft report show that in nearly two thirds of the investigations, there was no family involvement. Will he immediately send the message out to all trusts that it is vital to involve family members, particularly when we are talking about those who cannot speak for themselves?

Jeremy Hunt The Secretary of State for Health

I will do that, and I am very grateful to my hon. Friend for giving me the opportunity to do so. We see this situation all too often. There was a story in the Sunday newspapers about a family being shut out of a very important decision about the unexpected death of a baby. It is incredibly important to involve families, even more so in the case of people with mental health problems or learning disabilities. The family may be the best possible advocates for someone's needs.

We need to change the assumption that things will become more difficult if we involve families. More often than not, something like litigation will melt away if the family is involved properly from the outset of a problem. It is when families feel that the door is being slammed in their face that they think they have to resort to the courts, which is in no one's interests.

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08 DEC 2015

Areas of Outstanding Natural Beauty: Planning Permission

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, what recent assessment he has made of the effectiveness of the planning protection for Areas of Outstanding Natural Beauty; and if he will make a statement.

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Communities and Local Government, what plans he has to provide additional practice guidance on applying planning policy and legislation in Areas of Outstanding Natural Beauty.

James WhartonParliamentary Under-Secretary of State (Department for Communities and Local Government) (Northern Powerhouse)

The National Planning Policy Framework provides strong protection for Areas of Outstanding Natural Beauty. It is for decision makers to apply that policy and related legislation. The local planning authorities have responsibility for determining planning applications and developing local plan policies in the first instance.

The strong protection for these valued areas is supported by planning guidance. We keep this guidance under review to ensure it reflects up-to-date planning policy.

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08 DEC 2015

Disability Living Allowance: Children

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Work and Pensions, if he will make one of the qualifying criteria for children under three years of age to access the mobility component of the disability living allowance possession of a blue badge by either of a child's parents.

Justin TomlinsonParliamentary Under-Secretary of State (Department for Work and Pensions) (Disabled People)

I refer the honourable lady to the answer provided to her on 2 November (13660).

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03 DEC 2015

Fisheries Policy

Sarah Wollaston Chair, Health Committee   Click here to watch Sarah speak

It is a pleasure to serve under your expert chairmanship, Mr Nuttall. I thank and pay tribute to my hon. Friend Mrs Murray, who spoke on a complex subject with her customary expertise and set out the difficulties faced by the fisheries industry. I join her in paying tribute to our fishermen, who put their lives on the line by taking to sea to put food on our plates. Likewise, I pay tribute to all those in the rescue services and those who raise money for charitable causes throughout our fishing industry and beyond.

I have the great honour of representing Brixham, Dartmouth and Salcombe. The fishing industry's contribution to our local economy cannot be overestimated. Brixham lands the highest-value catch in England, and has added an extraordinary amount to our economy. Although the catch has increased by 5% since last year— largely because this year we have not had the appalling winter storms that we suffered in 2014—we still have not recovered to the level we were at five years ago, and much of the uplift in fishermen's income has come because of factors such as falling oil prices, rather than because the challenges they face at sea are being addressed.

It is not just the fishermen themselves who contribute to our local economy; the wider industry on land does too. There is not only the processing sector but the engineers, electricians, painters, riggers and marine scientists, so the impact on our wider economy cannot be overestimated. It is not just about the value of the catch, which this year alone was £21.441 million; we need to bear in mind the effect across the wider economy rather than focus only on the fishing industry.

I do not want to repeat the points about the quotas that my hon. Friend the Member for South East Cornwall made so eloquently, but will the Minister bear in mind the fact that in a mixed fishery the implementation of the discard ban has unintended consequences? Everyone recognises that there can be no morality in discarding perfectly good dead fish at sea. We have to be careful that implementing the policy does not just equate to discarding on land, and that discarding does not continue in the run-up to the introduction of the total ban.

In our mixed fisheries, particularly where species are recovering, if changes along the lines of those that my hon. Friend suggested are not made, we will see considerable, completely wasteful discarding this year. Will the Minister look into that? I hope that he will make the point very strongly that if we expect our fishermen to support changes that sometimes demand reductions in catches, we expect the same rigour to be applied when there is a clear increase in biomass and a compelling case to send things in the other direction. My hon. Friend's point about the arbitrary 15% limit on the maximum uplift is right—surely that is wholly unacceptable. Will the Minister will set out the points he will make at the Fisheries Council to try to get things to work in the other direction?

We should be going further on the issue of bass. No one in this Chamber is unconcerned about bass stocks. Although it was difficult for some sectors, the important change that was made to bring to an end pair trawling and increase the minimum landing size has received widespread support. Nevertheless, closing the fishery entirely for six months appears draconian, and it will have huge unintended consequences for other species. Fishermen will be forced to switch their effort to other species, and we are likely to see an increase in wreck netting, for example. There are also implications for the spawning stock of fish such as pollock.

We need to look at the bigger picture. Fishermen make a strong case that we risk seeing the destruction of our sustainable under-10 metre fleet, which includes many rod-and-line fishermen who face becoming entirely unsustainable. That case has been put forcibly by a number of fishermen from the under-10 metre fleet. Rather than agreeing to conditions that will effectively put them out of business forever, will the Minister consider asking whether we can have a little more time to see the impact of important measures that have not yet been given a chance to take effect? Might there be a compromise that addresses the fact that such fishermen will be changing their effort?

We must also consider the fact that some fishermen in small vessels will be put at personal risk if they are driven further out to sea in dangerous conditions in order to sustain a livelihood. Will the Minister give us more detail about the measures he is going to put in place? The difficulty in trying to impose a one fish per angler bag limit on recreational anglers is that it is likely to be ignored. We want to carry recreational anglers with us. We must at least ask how the limit is going to be policed, because it is not clear at the moment.

On the science of our seas, we all know that we are in challenging times financially, but the importance of good science to guide the decisions made in Europe cannot be overstated. Will the Minister set out what he is doing to support the science behind our fisheries to ensure that future decisions are based on the best possible science?

Peter Aldous Conservative, Waveney

My hon. Friend is spot on about the importance of science. Hidden away in last week's autumn statement was the announcement of a significant £5 million investment in theCentre for Environment, Fisheries and Aquaculture Science, which is the marine science arm of the Department for Environment, Food and Rural Affairs, to be spent on refurbishing its premises in Lowestoft. That will give it the opportunity to work up exciting plans to carry forward its great work.

Sarah Wollaston Chair, Health Committee

I am delighted to hear that that is happening in my hon. Friend's area. We would like to see that kind of investment around the UK, and we would like more scientists out on boats with our fishermen to collect the evidence that they need in real time. We should focus on basic marine science as well. My hon. Friend will know, for example, that theAstraZeneca premises in my constituency were taken over byPlymouth University. I hope that there will be a strong focus on everything we can do to improve our knowledge of marine science.

I know that many Members wish to speak, so I will bring my remarks to a close. I say again that I hope my hon. Friend the Ministerwill stress as firmly as he can that in a mixed fishery, particularly as biomass is increasing, the proposed quotas will not save a single fish unless we see the right level of uplift for some species. The fish will still be discarded at sea, perfectly healthy to eat, but dead. No one in this Chamber or beyond would support that.

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

Sarah Wollaston Chair, Health Committee

Does the hon. Gentleman acknowledge, though, that there is a value attached to these quotas, and that there should be full compensation if they are removed unilaterally? As my hon. Friend Mrs Murray said, we need to recognise that the bulk of the fish on our plates must come from the large fleet.

 

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03 DEC 2015

Fisheries Debate

Thank you to Jim Portus of Fishstock and Fishsock for coming to Westminster today to attend the Fisheries Debate

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02 DEC 2015

ISIL Syria

Dr Sarah Wollaston (Totnes) (Con): Click here to watch Sarah speak

I have the greatest respect for all colleagues in all parties who have spoken so eloquently against military action in Syria. The right hon. Member for Gordon (Alex Salmond) spoke passionately about the risks of being drawn into a vicious civil war. That is why I voted against taking action in Syria two years ago. However, I believe that this has gone beyond a civil war and that ISIS is bringing the fight to us and would do so again on the streets of Britain as it has on the beaches of Tunisia and in Paris. This is an enemy with which there can be no dialogue. This is an enemy that has perpetrated enslavement, rape, child rape, torture and mass murder throughout the territories that it now controls. I believe that there is a compelling case for us not only to stand with our allies tonight, but to stand with the United Nations as it calls for us to take every action that we can against Daesh. I believe that there is also a case for standing with the civilians on the ground, given that our military action against Daesh in Iraq has so far helped to push it back, and to prevent the kind of atrocities that we have been witnessing across Syria and Iraq today.

 

Kirsty Blackman: Airstrikes, by their nature, are intended to inflict death, pain and suffering on people and families, some of whom will be innocent. Will someone please tell me how this action will stop new people becoming radicalised, how it will stop new terrorists, and how it will improve the human rights situation on the ground?

 

Dr Wollaston: I thank the hon. Lady for her intervention, because I think that it goes to the heart of the matter—and the heart of the matter, I would say to her, is that people are already suffering and being tortured throughout these territories. I would say to her that the action we have taken so far in Iraq—very careful, measured action—has, in fact, reduced the kind of civilian casualties to which she has referred. I am wrestling with this, just as she is, on behalf of my constituents, and I would say that the majority of my constituents who have contacted me agree with her. It is, therefore, with a very heavy heart that I am trying to make the case to them for my belief that action is now not only in our national interest, but in the interest of the civilians who risk being taken over by an evil that is beyond our imagining, here in the comfortable world that we inhabit in the UK.

I would say to the hon. Lady that these people have no hesitation whatsoever in perpetrating the most barbaric atrocities. I would point to the Yazidi women and girls—more than 5,000 of them—who have been kidnapped and are being held in conditions of enforced slavery, and, indeed, to child rape, which is allowed by Daesh. I would ask the hon. Lady whether she would like to spare civilians across Iraq and Syria that fate—the fate that awaits them. But I agree that these are very heavy considerations.

I would also say, as the proud daughter of an air force family, that our air forces are already putting their lives on the line in the skies above Iraq. I would like to call on the Leader of the Opposition—but he is no longer in the Chamber—to reflect on how much it will mean to the forces’ families who are following the debate today to know that they cannot count on his support. I think that although we all take, respectfully, different views about the risks, or indeed the consequences, of extending our action to Syria, it is essential for him to state unequivocally his support for our armed forces in the skies above Iraq.

For the benefit of any of us who are considering how to vote, let me focus for a moment on the consequences of inaction. Our first responsibility in the House is to protect the citizens of this country, and I believe that it is only a matter of time before mass casualty attacks such as those that we have witnessed on the streets of Paris and around the world are perpetrated in the UK. I think that we must all ask ourselves whether there is a greater sin in omission than in commission. I feel, very strongly, that there is now a compelling case for us to be able to look in the eye the families of those who may lose their lives in future, and to be able to say that we did absolutely everything we could to diminish the powers of this evil organisation.

This is the fascist war of our generation. We had to take action against fascism in Europe, and I think there is a compelling case for us to say that we have done everything we can today.

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ile that can be launched from an RAF jet and target ISIL in such a way as to avoid civilian casualties. Lieutenant-General Gordon Messenger, the deputy chief of the defence staff, said:

“The thresholds for approving the strikes are high and the skills sets are high, as yet the UK has not had a civilian casualty incident after months of bombing”—

and he means in Iraq. We have heard much about the Syrian ground forces that can or cannot help to destroy ISIL. The strategy on the ground should not prevent the RAF’s involvement in air strikes. The ISIL strategy must be implemented first to suppress its ability to launch attacks on our streets. If the air strikes limit the opportunity of ISIL to attack us, we should take part in them. I believe it is important that we support our allies.

I do not know how I could face my constituents if we voted no tonight and, God forbid, there was a terrorist attack in the UK or on a beach in Tunisia and we had not done everything in our power to prevent it. What do we say to our allies who are taking military action when we are not with them after such an incident? Do we say, “Get on with it, but sorry, our involvement in military action in Syria stops on the Iraqi side of the border”, even though we know the attack on the UK was organised from Syria? If we do not take part in this action, I believe we will be letting down our country and our allies, and will reduce our credibility in the international arena.

My prime motivation for supporting this motion today is the protection of our citizens. The wider strategy, both political and diplomatic, is important. It will not happen overnight, and neither will the involvement of ground forces. Our military involvement may be small, but our aircraft can use weaponry that the coalition does not have—weaponry that is precise, limits casualties and can suppress ISIL activities. It is not a complete answer in itself, but it is a start. It will buy us time to deploy a wider strategy. I feel uneasy about Britain not taking part in airstrikes when we know that it is a matter of self-defence. I will therefore support the motion tonight.

6.24 pm

Dr Sarah Wollaston (Totnes) (Con): I have the greatest respect for all colleagues in all parties who have spoken so eloquently against military action in Syria. The right hon. Member for Gordon (Alex Salmond) spoke passionately about the risks of being drawn into a vicious civil war. That is why I voted against taking action in Syria two years ago. However, I believe that this has gone beyond a civil war and that ISIS is 

2 Dec 2015 : Column 431

bringing the fight to us and would do so again on the streets of Britain as it has on the beaches of Tunisia and in Paris. This is an enemy with which there can be no dialogue. This is an enemy that has perpetrated enslavement, rape, child rape, torture and mass murder throughout the territories that it now controls. I believe that there is a compelling case for us not only to stand with our allies tonight, but to stand with the United Nations as it calls for us to take every action that we can against Daesh. I believe that there is also a case for standing with the civilians on the ground, given that our military action against Daesh in Iraq has so far helped to push it back, and to prevent the kind of atrocities that we have been witnessing across Syria and Iraq today.

Kirsty Blackman: Airstrikes, by their nature, are intended to inflict death, pain and suffering on people and families, some of whom will be innocent. Will someone please tell me how this action will stop new people becoming radicalised, how it will stop new terrorists, and how it will improve the human rights situation on the ground?

Dr Wollaston: I thank the hon. Lady for her intervention, because I think that it goes to the heart of the matter—and the heart of the matter, I would say to her, is that people are already suffering and being tortured throughout these territories. I would say to her that the action we have taken so far in Iraq—very careful, measured action—has, in fact, reduced the kind of civilian casualties to which she has referred. I am wrestling with this, just as she is, on behalf of my constituents, and I would say that the majority of my constituents who have contacted me agree with her. It is, therefore, with a very heavy heart that I am trying to make the case to them for my belief that action is now not only in our national interest, but in the interest of the civilians who risk being taken over by an evil that is beyond our imagining, here in the comfortable world that we inhabit in the UK.

I would say to the hon. Lady that these people have no hesitation whatsoever in perpetrating the most barbaric atrocities. I would point to the Yazidi women and girls—more than 5,000 of them—who have been kidnapped and are being held in conditions of enforced slavery, and, indeed, to child rape, which is allowed by Daesh. I would ask the hon. Lady whether she would like to spare civilians across Iraq and Syria that fate—the fate that awaits them. But I agree that these are very heavy considerations.

I would also say, as the proud daughter of an air force family, that our air forces are already putting their lives on the line in the skies above Iraq. I would like to call on the Leader of the Opposition—but he is no longer in the Chamber—to reflect on how much it will mean to the forces’ families who are following the debate today to know that they cannot count on his support. I think that although we all take, respectfully, different views about the risks, or indeed the consequences, of extending our action to Syria, it is essential for him to state unequivocally his support for our armed forces in the skies above Iraq.

For the benefit of any of us who are considering how to vote, let me focus for a moment on the consequences of inaction. Our first responsibility in the House is to protect the citizens of this country, and I believe that it 

2 Dec 2015 : Column 432

is only a matter of time before mass casualty attacks such as those that we have witnessed on the streets of Paris and around the world are perpetrated in the UK. I think that we must all ask ourselves whether there is a greater sin in omission than in commission. I feel, very strongly, that there is now a compelling case for us to be able to look in the eye the families of those who may lose their lives in future, and to be able to say that we did absolutely everything we could to diminish the powers of this evil organisation.

This is the fascist war of our generation. We had to take action against fascism in Europe, and I think there is a compelling case for us to say that we have done everything we can today.

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01 DEC 2015

Teachers: Qualifications

Written Questions

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, for what reason the Final version of the Specification for Mandatory Qualifications for specialist teachers of children and young people who are deaf was revised between 6 and 13 October 2015.




Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, if she will revise the changes made to the Final version of the Specification for Mandatory Qualifications for specialist teachers of children and young people who are deaf between 6 and 13 October 2015.

Edward Timpson The Minister for Schools

Our aim is always to ensure that the Mandatory Qualifications (MQ) continue to be a high quality qualification that is flexible in its content and in its model of delivery in order to meet the needs of the sector.

We work closely with the National Sensory Impairment Partnership (NatSIP) as representatives of the sector. We ran a consultation with the sector to make sure that the MQ remained current and reflected changes in policy. As a result of the consultation we made a number of changes to the MQ specification. We published the revised specification on 7 September 2015 on GOV.uk.

After publication, we responded to advice from NatSIP and made a furtheramendment to the specification making it clearer that the specification reflects the minimum skills required to be a teacher of the deaf.

We have no plans to make changes to the final version of the specification; we will keep the specification under review and continue to engage with the sector through NatSIP.

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30 NOV 2015

Sugary Drinks Tax

Sarah Wollaston Chair, Health Committee      To watch the full debate click here

I absolutely recognise that physical activity is important and that it should be for everyone, irrespective of their weight or age. Like me, the hon. Lady will remember Julie Creffield, who spoke so powerfully before our Committee in the last Parliament. However, the current Committee felt that it did not want to be distracted by something we had already produced some work on. We therefore wanted to endorse everything that was said by our predecessor Committee, rather than to go over that ground again........................

 

Sarah Wollaston Chair, Health Committee

I pay tribute to Helen Jones, Jamie Oliver and Sustain for giving us an opportunity to discuss the issue raised by the petition. I also thank all the members of the Health Committee and the Committee team, particularly Huw Yardley and Laura Daniels, for their contribution to today's report, "Childhood obesity—brave and bold action". Brave and bold action is what we need.

The first question is: how important is this issue? The answer is starkly set out in the first few pages of our report. There is a graph showing that a quarter of children leave primary school not just overweight but obese, and that an enormous and entirely unacceptable health inequality gap is opening up, and getting ever wider, between the most advantaged and the disadvantaged children in our society. Overall, a third of children are either obese or overweight by the time they leave school, which has enormous implications for them as individuals—it will blight their future life chances, and it exposes them to bullying when they are at school—and for the NHS.

As we heard, the estimated cost of obesity to the NHS is £5.1 billion. Obesity is one of the major contributing factors to developing type 2 diabetes. Diabetes now accounts for 9% of the entire NHS budget. If we are looking to make the NHS live within its means by preventing illness, we have to do something about childhood obesity. Most of all, we need to do it for the sake of the children. We need to be clear that no single measure will be the answer. We need a package of measures, and we have considered the issues in our report.

The Committee did not focus on the role of exercise in our report, primarily because we looked into physical activity and health just before the last election and we wanted to endorse the findings of that report. The message is clear: whatever someone's weight or age, exercise is enormously beneficial, but we must not be distracted into thinking that increasing exercise alone will be the answer to childhood obesity. We often hear that view from industry—that all we need is a bit more education and a bit more exercise—but we will be disappointed if we go down that route. Of course those things are important, but ultimately, unless we address the food environment in which we live, we will not make a meaningful difference to childhood obesity. Yes, let us put exercise and education firmly within the obesity strategy—I am sure that theMinister will do just that—but we need to go further.

We made recommendations in a number of areas, for example on promotions. We considered marketing and the pervasive advertising to which children are now exposed wherever they go. We considered the role of reformulation and of clearer labelling, endorsing the powerful point made about teaspoon labelling in particular. We considered improving information about food and education in schools, and school food standards. We also touched on the powerful role that local authorities can play and how we can support that.

However, as I said, we also considered whether we should introduce a sugary drinks tax, and that is what I will discuss in this debate, because the Government have indicated that they will not take action in that area. I would like to make the case to the Minister for why we felt that that should be an important part of an overall strategy.

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26 NOV 2015

Syria

Sarah Wollaston Chair, Health Committee                      Click here to watch Sarah speak

The Prime Minister has made a compelling and considered case today. Having voted against action last time this subject came to the House, I would like to say that I will join him in standing with not only our allies, but the countless thousands of Muslims across the region who have been enslaved, massacred and tortured. What reassurance can he give our forces who are supporting Kurds and other local forces on the ground that they will not be bombed by Russia?

David Cameron The Prime Minister, Leader of the Conservative Party

May I thank my hon. Friend for her support? This is a different question that the House is considering, and I do not want to go back over past ground. This is a new question, and I would appeal to colleagues right across the House to respond in the way that she has done.

In terms of the moderate forces, this is the remaining disagreement between us and Russia. So far, Russia has done more to inflict damage on the moderate forces than on ISIL. There are some signs of that changing, and we need to encourage that to change more, not least because in the processes we have had in the past, including the Geneva processes, the Russians have accepted that people such as the Free Syrian Army and their civilian representatives should play a part in the future of Syria

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25 NOV 2015

Broadband

Today I met up with representatives from Connecting Devon and Somerset (CDS) – the organisation responsible for the roll-out of superfast broadband in our area – for an update on their progress.In the Totnes constituency, there are already 8,273 properties connected to superfast broadband with an additional 2,034 coming online shortly. I was pleased to hear that areas connected to exchanges in Bigbury, Blackawton, Dittisham, Dartmouth, Kingswear, Paignton, Salcombe, South Brent, Staverton, Stoke Fleming and Stoke Gabriel will be connecting to superfast soon and that the infrastructure for those areas has now been put in place.

By the end of 'Phase One' of the rollout in 2016, CDS estimates that 89% of properties will be connected to superfast. The remaining 11% will be delivered through 'Phase Two' and discussions are ongoing ahead of the process to decide which provider will be awarded the contract to deliver this. CDS are currently negotiating an agreement for State Aid Notification with the European Commission, which is necessary before the tender process can begin and it is hoped that this will be concluded by February. The contract will then go out to tender for 12-16 weeks before a provider will be decided and work on connecting the final 11% will begin.

Residents can check whether their property can receive superfast broadband or see when their area will go online via the following link

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18 NOV 2015

Further Education

Sarah Wollaston Chair, Health Committee

South Devon College in my constituency is just such an example of a fantastic sixth-form college doing amazing work in the further education sector. Everyone in the House hopes that the Chancellorwill be as generous as possible to further education, but another challenge that these institutions face is that they need multi-annual settlements so that they can make forward plans. Will the hon. Lady join me in asking for such a measure to be introduced?

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17 NOV 2015

National Data Guardian for health and social care

Good to talk data sharing and security issues with Dame Fiona Caldicott today. The consultation seeking views on the roles and functions of the National Data Guardian for health and social care closes on the 17th December 2015.

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17 NOV 2015

Junior Doctors (New Contract)

Sarah Wollaston Chair, Health Committee

I am deeply concerned about the impact on patient care caused by the proposed three days of industrial action, including two days of a full walk-out. Will the Secretary of State say what advance preparations are taking place to ensure patient safety? Will he reassure the House that there are no preconditions that will act as barriers and to which the BMA has to agree before negotiations can take place?

Jeremy Hunt The Secretary of State for Health

I absolutely give my hon. Friend that reassurance. There are no preconditions, and this morning I wrote again to the BMA to reiterate that point. Of course, if we fail to make progress we have to implement our manifesto commitments, but we are willing to talk about absolutely everything. I agree strongly with my hon. Friend that it will be difficult to avoid harm to patients during those three days of industrial action. Delaying a cancer clinic might mean that someone gets a later diagnosis than they should get, and a hip operation might be delayed when someone is in a great deal of pain. It will be hard to avoid such things impacting on patients, and I urge the BMA to listen to the royal colleges—and many others—and call off the strike.

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16 NOV 2015

Charles Bonnet Syndrome Reception

Thanks to Judith and Dominic for Esme's Umbrella campaign to help Charles Bonnet syndrome.

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16 NOV 2015

Sense about Science

Thank you to Stephen Sedley and Prateek Buch from Sense about Science, for coming to discuss the inquiry into the publication, commissioning and conduct of Government research.

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16 NOV 2015

Syrian Refugees

Sarah Wollaston Chair, Health Committee Click here to watch Sarah speak

Like colleagues across the House, I have received many generous offers of support from my constituents for refugees fleeing unimaginable violence in Syria. Will the Home Secretary join me in thanking Dartington Hall in my constituency, which is offering not only to house refugees, but to provide them with valuable support? Will she assure me that everything is being done to make sure that such clear and credible offers of support are generously followed up?

Theresa May The Secretary of State for the Home Department

I am happy to join my hon. Friend in welcoming the offer that has been made by Dartington Hall in respect not just of accommodation, but of support for refugees. That has been mirrored by organisations around the country. It is right that the Under-Secretary of State for Refugees has been working with charities, faith groups and other organisations to make sure not only that all the offers of help are listed and looked at, but that we can turn them into practical help forSyrian refugees, depending on what support is appropriate in the circumstances of the refugees that come to any particular region, such as my hon. Friend's constituency.

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09 NOV 2015

Communities and Local Government: Police Funding Formula

Sarah Wollaston Chair, Health Committee Click here to watch Sarah speak

I welcome the Minister's apology and congratulate Tony Hogg and his team on uncovering this inadvertent error. Will the Minister confirm to my constituents and to those across Devon and Cornwall that in reviewing this situation he will take full account of the impact of rural policing and tourism on policing costs?

 

 

Mike Penning The Minister of State, Home Department, The Minister of State, Ministry of Justice

I have apologised to the 43 authorities and I apologise in particular to Devon and Cornwall, which highlighted the information that was wrong in the letters I sent out to those 43 authorities. Getting the decisions right about rural and other issues within the formula was exactly what we were trying to do in the first place, as it was mostly the rural constituencies that were most upset with the existing formula, but I can assure Members that we will now get it right.

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03 NOV 2015

Access to Medical Treatments (Innovation) Bill

Sarah Wollaston Chair, Health Committee  Click here to watch Sarah speak

On a point of order, Madam Deputy Speaker. Is it in order for the Government to be neutral on a Bill if the payroll vote is whipped for that vote?

 

 

 

Natascha Engel Second Deputy Chairman of Ways and Means

That is a matter for the Government, rather than for the Chair.

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

Sarah Wollaston Chair, Health Committee

Does the Minister accept, however, that the Association of Medical Research Charities, the Academy of Royal Medical Colleges, the British Medical Association, and an A to Z of other organisations involved with medical research are very clear that this does undermine participation in medical research? He should listen to those concerns and acknowledge that they are genuine.

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

Sarah Wollaston Chair, Health Committee 3:46 pm, 3rd November 2015

I rise to oppose the money resolution because this is bad legislation. It is unnecessary and could undermine essential protections for our patients. That is why an A to Z of medical royal colleges and research charities oppose the Bill, as does Action against Medical Accidents, the British Medical Association and so on—the list goes on. This is the time at which the House must bring the legislation to an end.

I am concerned at the selective misquoting of a number of bodies. Many of the medical royal colleges have objected to being selectively misquoted during debates on the Bill. I will quote from just one of the royal colleges; the president of the Royal College of Physicians, Jane Dacre, would like to put the college's views on the record. She says: "The RCP does not support the progression of the Access to Medical Treatments Bill through Parliament. The primary objective of the Bill to create a parallel innovation process may result in unforeseen consequences that negatively impact on patient safety. The Bill may further undermine and overcomplicate the established existing process for conducting innovation, damaging the UK's innovation process. As the RCP has previously stated prior to previous readings of the Access to Medical Treatment Bill and the Medical Innovation Bill it is unclear how the legislation will improve upon the existing innovation process or address the real barriers to conducting innovation. The RCP does not support the Bill's progress through Parliament."

We should also be clear that the Minister does not need the legislation in order to introduce the processes that all hon. Members would support to facilitate communication between research bodies about genuine innovations. We need to simplify the processes by which patients understand which research trials are out there from which they could benefit. When I started in medicine 24 years ago, many of the children I treated for leukaemia were dying. Children today with the same conditions survive not as a result of a series of unconnected, anecdotal, have-a-go treatments, but because of the medical research that built the foundation for the treatments from which they now benefit.

Our patients and our constituents want to contribute to research that benefits future generations, but they cannot do so through an unconnected database of anecdotal treatments. A series of anecdotes does not constitute evidence. We need to be careful of that. I thank my hon. Friend Chris Heaton-Harris. He has good intentions, but I simply do not agree with the Bill.

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02 NOV 2015

Disability: Children

Written Answer

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Work and Pensions, what plans he has to provide financial support to help children under the age of three who are eligible for a disabled parking badge but are not eligible for the mobility component of the disability living allowance.

 

Justin Tomlinson Parliamentary Under-Secretary of State (Department for Work and Pensions) (Disabled People)

The principle underpinning Disability Living Allowance (DLA) is that payments are made to families who incur extra costs as a result of meeting the additional care and/or mobility needs of a disabled child.

In deciding to set the lower age limit for entitlement to the higher rate mobility component at 3 years of age, the department considered views of medical advisors and independent research that the majority of children could walk at the age of 2½. By the age of 3 it was realistically possible in the majority of cases to make an informed decision as to whether an inability to walk was the result of disability.

We have no plans to make changes to DLA for children under the age of 3.

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28 OCT 2015

Department of Health: Health: Children

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, how he plans for the Public Health Outcomes Framework to continue to give a comprehensive picture of children's school readiness, when the Early Years Foundation Stage Profile becomes non-compulsory in September 2016; and if he will make a statement.

 

Jane Ellison The Parliamentary Under-Secretary of State for Health

The consultation on updating the Public Health Outcomes Framework was published on 3 September and closed on 2 October. We are considering the responses and intend to publish our proposals early next year.

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28 OCT 2015

Department for Education: Children: Health

Written Answers

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Education, what plans she has for consistent monitoring of the emotional, social and physical development of children in their early years, after the Early Years Foundation Profile becomes non-compulsory in September 2016; and if she will make a statement.

 

Sam Gyimah The Parliamentary Under-Secretary of State for Education

It is important for parents and teachers to know how well a child is progressing. As such, communication and language, physical development and personal, social and emotional development are set out in the Early Years Foundation Stage (EYFS) statutory framework as prime learning areas for children from birth to age five.

As part of the wider reforms to the accountability system for primary schools and the national curriculum we have introduced the reception baseline assessment for the 2015/16 academic year.

The reception baseline forms one part of a teacher's wider assessments in reception and we will expect early years practitioners to continue to carry out the appropriate ongoing, formative assessment of children of reception age.

The EYFS statutory framework will also still require early years practitioners to carry out a progress check against the three prime areas of learning at age two, and we are improving this check for parents by bringing it together with health visitor checks in the form of new Integrated Reviews.

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28 OCT 2015

Junior Doctors' Contracts

Sarah Wollaston Chair, Health Committee     Click here to watch Sarah speak

I thank my hon. Friend for his intervention. There is much to be welcomed in the new contract, but we need honesty about some of this. I am very pleased that the Secretary of State has given an assurance today that no junior doctor will be worse off, but I hope that when he sums up the debate, he will tell us what will happen to a junior doctor working 70 hours a week, perhaps in a specialty such as accident and emergency or anaesthetics. If the pay envelope is the same and some junior doctors will be better off, the maths indicates that some will be worse off and we need to clarify which ones. We need much more clarity, not just about whether an individual will be no worse off as a result of changing from one job to the next over the transition period, but about what will happen to the pay for that post over the coming years.

While I welcome many of the elements of the junior contract, I feel that, because the debate has become rather toxic, we should take the opportunity to begin again to examine all the issues in the round, and ask junior doctors themselves to work with the Secretary of State in establishing how we can achieve our common aims on behalf of patients. We should also take the opportunity once more to welcome junior doctors and value everything that they do.

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28 OCT 2015

APPG Medical Research Roundtable

This morning I attended a meeting hosted by the APPG for Medical Research where we discussed the Access to Medical Treatments, Innovations Bill and the importance of patients being empowered in their care by participating in medical research.

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27 OCT 2015

Healthwatch England

Thanks to Healthwatch Devon and Healthwatch Torbay for coming to Parliament to discuss the work of Healthwatch

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26 OCT 2015

National Pathology Week Exhibition

Meeting with Suzy Lishman, President of the Royal College of Pathologists at the opening of the National Pathology Week Exhibition

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21 OCT 2015

Royal College of Obstetricians and Gynaecologists

I met with Dr David Richmond, President of the Royal College of Obstetricians and Gynaecologists, were we discussed Each Baby Counts, a project which aims to reduce the number of babies who die or are left severely disabled as a result of incidents occurring during term labour.

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20 OCT 2015

Health Select Committee

Today the Health Select Committee met to discuss the Childhood Obesity Strategy.

To watch the meeting click here

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19 OCT 2015

Health Select Committee

Today the Health Select Committee met to discuss the Childhood Obesity Strategy.

Giving evidence were:

Duncan Selbie (Chief Executive, Public Health England)

Jamie Oliver

To watch the meeting click here

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19 OCT 2015

Devon Local Pharmaceutical Committee

Thank you to Devon Local Pharmaceutical Committee for coming to Parliament to discuss Community Pharmacies, and their place in primary care.

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16 OCT 2015

Access to Medical Treatments (Innovation) Bill - 2nd reading

Click here to watch Sarah speak

Sarah Wollaston Chair, Health Committee

Would my hon. Friend accept that such a database could be set up anyway, without this Bill, and that what is really needed if we are to record medical innovations is adequate funding? This does not require legislation.

...........

Sarah Wollaston Chair, Health Committee

My hon. Friend has quoted a number of organisations. Does he accept that all those organisations oppose the Bill? He needs to make that explicit to the House. It is not fair to quote the Royal College of Surgeons, for example, without making it clear that it has explicitly opposed this Bill.

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

Sarah Wollaston Chair, Health Committee 10:14 am, 16th October 2015

As with any book, we should not judge a Bill by its cover. All Members want to improve access to innovative medical treatments, but I sincerely believe that the Bill is not the right way forward. My hon. Friend the Member for Daventry (Chris Heaton-Harris) referred to a number of organisations, implying that they are in favour of the Bill, but he knows that the overwhelming majority of research and charitable organisations are ranged against it. It is opposed by the Association of Medical Research Charities, whose membership reads like an "A to Z" of expertise, including bodies such as Cancer Research UK, the Wellcome Trust—the list is very long, so I will not detain the House by reading it out. The Academy of Medical Sciences opposes the Bill, as does the Academy of Medical Royal Colleges, including all those he quoted in his speech.

The General Medical Council, the British Medical Association and the Patients Association oppose the Bill, and I direct my hon. Friend to their article in The Guardian. Action against Medical Accidents, and even the Association of the British Pharmaceutical Industry, oppose the Bill because of its unintended consequences. Legal experts, including Sir Robert Francis, firmly oppose the Bill. All those organisations oppose the Bill because it is unnecessary, it is unworkable, it would unravel important patient protections and, most importantly, it would have unintended and dangerous consequences for research.

I pay tribute to all the Bill's sponsors and absolutely understand that they are motivated by very good intentions. I would love to sit down and work with them on how we genuinely improve access to innovative treatments. I hope they understand that I oppose the Bill because I sincerely believe that it is the wrong way forward.

The Secretary of State already has the power, as the hon. Member for Lewisham East (Heidi Alexander) pointed out, to set up a register of innovative treatments, so we simply do not need that provision. We also do not need the heavy hand of legislation. We do need a register, but it needs to be set up by the research bodies themselves and to be adequately funded. We absolutely need transparency. There is a danger that we will misunderstand the science.

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15 OCT 2015

Addaction UK

Thank you to Simon Antrobus Chief Executive of Addaction UK for a thoughtful discussion on preventing and helping fight addiction.

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14 OCT 2015

Unison

I met today with Christina McAnea, Head of Health at UNISON and her team; it was a great opportunity to discuss their insight on NHS issues and the need for extra NHS funding to be front loaded.

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14 OCT 2015

Wellcome Trust

Thank you to Nicola Perrin, Head of Policy for the Wellcome Trust, for taking the time to discuss the dangers of Access to Medical Treatment (Innovations) Bill

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14 OCT 2015

BASHH

I met with Dr Jan Clarke, President of the British Association of Sexual Health and HIV (BASHH) to discuss the commissioning of sexual health and HIV services.

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13 OCT 2015

Health

Sarah Wollaston Chair, Health Committee.   Click here to watch Sarah speak

Delayed publication of evidence is as damaging as non-publication, which is why we rightly expect clinicians, researchers and managers to publish their evidence and data in a timely and transparent manner. It is a matter of great regret to the Health Committee that we started our inquiry today without access to the detailed and impartial review of the evidence that we need to make a contribution to this inquiry. Will the Secretary of State please set out when he will publish it?

Jeremy Hunt The Secretary of State for Health

I agree with my hon. Friend about the importance of transparency and publishing in a timely manner. I will look again at the planned publication date for the report she wants to see, which will be published so that Parliament can debate it properly. The normal practice is for advice to Ministers to be published at the same time as policy decisions are made, as happened with the Chantler review and the Francis report.

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13 OCT 2015

Health Select Committee

Today the Health Select Committee met to discuss the Childhood Obesity Strategy.

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12 OCT 2015

Home Department: Right to Buy

Sarah Wollaston Chair, Health Committee. To watch Sarah speak, click here

I welcome the Minister's confirmation that housing associations in rural areas will continue to have an exemption. However, can he reassure those small communities in rural areas with very high housing costs, such as those in my constituency, that if the housing associations choose not to avail themselves of the exemption, any like-for-like replacement will be provided in the same area? If such replacement were provided in a distant town, our rural communities would be depleted.

Brandon Lewis Minister of State (Communities and Local Government)

My hon. Friend makes a good point, and I thank her and her colleagues for the time that they put in over the summer to talk to their local housing associations about the deal that the associations were working towards putting to us. It is important that people recognise that the rural exemptions will continue. We are extending right to buy and the rural exemptions are in right to buy. She will also be able to look at the portable option that the housing associations are putting forward.

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12 OCT 2015

NHS: Financial Performance

Sarah Wollaston Chair, Health Committee. To watch Sarah speak , click here

I welcome the Minister's statement, particularly the confirmation that the £8 billion will be forthcoming. He says that the money is already in the system, but what the NHS really needs is to be reassured about how much of that £8 billion will be front-loaded in the spending review. Will he reassure the House that he will set out in the clearest possible terms that it needs to be delivered as early as possible?

Ben Gummer The Parliamentary Under-Secretary of State for Health

When my right hon. Friend the Chancellor made his commitment in the autumn statement on this year's spending, he said it was a down payment on the five-year forward view and expressed his determination to ensure that the NHS is protected and promoted in all areas of Government.

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16 SEP 2015

Innovation and Skills: Medicine: Education

Written Answers

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Business, Innovation and Skills, what estimate his Department has made of the change in the number of people applying to study medicine in 2014 relative to previous years; and if his Department will assess what effect (a) increases in tuition fees and (b) fear of increased debt may have on such applications.

Jo Johnson Minister of State (Universities and Science)

Information published by UCAS on the numbers of applications since 2009 is shown in the table. UCAS have not yet published comparable figures for 2015.

Medicine remains a very popular course that attracts many prospective students. There are no upfront fees and a progressive, income-contingent loan available for those applying for degrees.

Applications from UK domiciled applicants1 to pre-clinical medicine

Year of entry 2090 2010 2011 2012 2013 2014
             
 Applications  56,055  62,855  65,270  63,120  64,000 64,345

Source: UCAS. Numbers have been rounded to the nearest 5.

1. Each applicant can submit up to four applications for pre-clinical medicine. UCAS have not released figures showing the number of applicants who have made one or more applications to pre-clinical medicine.

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15 SEP 2015

Health Select Committee

Today the Health Select Committee held an oral evidence session on the work of the Secretary of State for Health.

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14 SEP 2015

Innovation and Skills: Medicine: Education

Written Answers

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Business, Innovation and Skills, whether the removal of the cap on student numbers applies to (a) medical students and (b) the 7.5 per cent cap on UK medical school places for international students.

Jo Johnson Minister of State (Universities and Science)

For many years, the Government has controlled undergraduate entrant numbers to medicine and dentistry courses at university. The Grant letter of 29 January 2015 to the Higher Education Funding Council for England (HEFCE) said that, at this stage, the Government is retaining intake targets for undergraduates on medicine and dentistry courses, reflecting the high cost of this training to the public purse.

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14 SEP 2015

Innovation and Skills: Medicine: Education

Written Answer

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Business, Innovation and Skills, what steps his Department is taking to encourage students from the lowest socio-economic groups to apply to study medicine.

Jo Johnson Minister of State (Universities and Science)

Latest data from UCAS shows that the application rate to higher education for 18 years olds from disadvantaged backgrounds is at a record level. All institutions wishing to charge fees above the basic level must agree an Access Agreement with the independent Director of Fair Access (DFA) on their measures to widen access to higher education. This Government has extended the term of office for the current Director.

In his latest guidance to Institutions on how to produce access agreements the DFA has asked all Institutions with medical schools to consider the guidance on improving access to medical courses for those from lower socio-economic groups, developed by the Medical Schools Council and published in December 2014. The guidance from the medical schools council was developed in response to the Government call for more to be done to widen participation to medicine.

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14 SEP 2015

Innovation and Skills: Students: Loans

 

Written Answer

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Business, Innovation and Skills, what steps he plans to take to ensure that students from lower socio-economic groups are not disincentivised from applying to university by fear of increased debt when student maintenance grants are replaced by new maintenance loan support.

Jo Johnson Minister of State (Universities and Science)

We are increasing the overall amount of cash in hand we provide students to support the cost of living to the highest ever amount. For new full-time students starting their courses on or after 1 August 2016, maintenance grants will be replaced by maintenance loans. Eligible students on low incomes will qualify for a maximum maintenance loan that is 10.3% higher than the maximum maintenance grant and loan support available in 2015/16. Higher education remains free at the point of entry, with students able to fund their studies through loans which they only repay when they are earning above £21,000.

All institutions wishing to charge fees above the basic level must agree an Access Agreement with the independent Director of Fair Access. In July, the Director of Fair Access announced that he has approved 183 Access Agreements for 2016/17. Institutions expect to spend £745.5m on widening access in 2016/17, rising to £750.8m in 2019/20.

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14 SEP 2015

NHS (Contracts and Conditions)

Sarah Wollaston Conservative, Totnes

It is a pleasure to serve under your chairmanship, Ms Vaz, particularly as recently you were a fellow member of the Select Committee on Health. For the record, I am married to a full-time NHS forensic psychiatrist, although one might say that I do not have a dog in this fight, because he already works weekends.

It may help the House if I comment quickly on the background. I thank Professor Freemantle and his team for their excellent updating of the data following the last analysis of data in 2009-10. He and his colleagues carried out the exercise again based on data from 2013-14, and it may help if I put some of that in context. What he shows is that 1.8% of NHS patients will die within 30 days of admission. It is important that we look not only at the data relating to what happens within a few days, which he has also analysed, but at the longer-term data. He shows a very real effect: if someone is admitted to hospital on a Friday, there is a 2% increase in the risk that they will die within 30 days; if they are admitted on a Saturday, the increase is 10%; if they are admitted on a Sunday, the increase is 15%; and if they are admitted on a Monday, the increase is 5%. Those are relative, not absolute, statistics and are on a background rate of 1.8%, so it is important that we do not alarm people unduly with those data. However, they mean, very importantly, that around 11,000 more people die if they are admitted between a Friday and a Monday, relative to what we would expect had they been admitted on a Wednesday.

That is extremely important, and the Secretary of State is absolutely right to take that very seriously, but we need to look at it in its wider context. Is it simply because a different group of people are being admitted in the middle of the week than are being admitted at weekends? Is it because they are a sicker group of people? Both of those are true, which is why it was important that Professor Freemantle made adjustments for those kinds of data. He showed that even if we take account of the fact that there genuinely are sicker people coming into our hospitals at the weekend, the effect was still present, but it was reduced. There was a 7% increase on a Saturday and a 10% increase on a Sunday, so it was still important. As for people admitted to hospital for routine procedures, it was shown that the nearer it gets to the weekend, the more their chances of mortality increase.

To go back to my earlier point, the Secretary of State is absolutely right to take this issue seriously. This is not just an effect in Britain; it is observed internationally, but it matters. Yes, those people are sicker, and yes, a different group of people is coming in, but there is also the issue of what we should do about it. We must not give the impression that all those 11,000 deaths are preventable. We have to be very careful not to rush into action that leads to a levelling down, rather than a levelling up. We want to bring the data up as far as we can, but when hospitals have done a deep analysis of the deaths that have occurred within 30 days of people being admitted at weekends, it is sometimes very difficult to say what could have happened differently.

We need to look at this issue, but it is not just about consultant presence. Senior supervision at weekends is undoubtedly part of it and is very important, but other issues are at stake. Is there access to diagnostic tests? We need to look beyond this being just about consultants; it is about nursing staff, too. We have to be careful not to shift resources into trying to sort out one part of the issue—consultant presence—because if that means a continuation of a worrying trend of shifting resources out of primary care, we could inadvertently end up with a sicker group of people coming into hospitals at weekends. In other words, we have to be very careful about the balance and potential unintended consequences of what we do.

Undoubtedly, at the root of all this—this issue would face whoever was sitting behind the Secretary of State's desk—are the issues of financing and resources for the NHS. I hope, as we come closer to the spending announcements, that as much as possible of the £8 billion announced will be front-loaded, so that some of these issues can be addressed. Resourcing and how we spread it across the wider NHS lies at the heart of this question, and it is important that we do not focus entirely on hospitals.

I want to talk more widely about the seven-day NHS. I hope that the Secretary of State will look carefully at what that is for. Is it about trying to reduce that excess weekend mortality? Yes, it should be about that. Should it be about reducing avoidable, unnecessary admissions to hospital? Absolutely. We know that people do not want to be in hospital. It is a dangerous place for someone to be if they do not need to be there, particularly if they are frail and elderly and would be better looked after in the community, so yes—let us reduce avoidable admissions.

Should the seven-day NHS be about accessing the kind of specialist advice that makes a real difference to people's lives? I am very conscious that this House debated on Friday whether people should have the right to medical assistance in ending their life. It was a controversial debate. I think the House made the right decision, but there was absolute consensus within that debate about the need for greater access to specialist palliative care advice. I would include that kind of thing in a seven-day NHS, because people's quality of life at the end of their life has an extraordinary impact not only on them, but on their whole family. Seven-day services should be about addressing quality, and I would love the Minister to comment further on how we can bring about sustainable funding for specialist palliative care. That is absolutely part of what we should be doing on seven-day services.

However, there is another aspect, which is more difficult. When resources are very restricted, should we prioritise access to primary care out of hours for people who would prefer to be seen at the weekend than mid-week? I am sure we all understand that—in our busy lives, it is sometimes difficult to take time off work—but it might not be the priority when resources are tight. I speak as someone who, before I came to this House, was a clinician in rural Dartmoor in a two whole-time-equivalent practice. It was a very rural setting, and if we were to try to provide an 8-till-8 service on Saturdays and Sundays for routine GP appointments—if we were, as this is sometimes presented to the public, to enable people to see their doctor at any time—the cost would be enormous. There are extra costs involved in manning surgeries at those times, and there are also issues to do with staff availability.

I visited several practices in my area over the summer recess, and I see there genuine concern about not only the GP workforce, but the wider primary and community care workforce. We have to be very careful. If we prioritise issues such as making it possible to have a routine appointment from 8 till 8 on Saturdays and Sundays—much as I can see merit in that—it will take resources away from the other things on that list of four. We should focus on other priorities on this stage and be clear that there are other risks, such as undermining other out-of-hours services.

I would like the Secretary of State to be very clear about what he means by a seven-day NHS when it comes to primary care, and about how we will make those fair funding decisions and divide the cake, so that we get the very best for people. We absolutely have to address the excess mortality, but we have to look at the reasons behind the data to be realistic about what we can achieve. We have to make sure that we bring the quality up and that we do not inadvertently end up bringing it down by having sicker people coming into hospital, which is one of the drivers of the data that we are trying to address.

Many Members want to speak, and I, along with colleagues, have the opportunity to question the Secretary of State at the Health Committee tomorrow, so I will draw my remarks to an end. However, I hope that those points can be addressed.

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11 SEP 2015

Assisted Dying

Sarah Wollaston Conservative, Totnes (Click here to watch Sarah speak)

So many of us bring deeply personal perspectives to this debate. We also bring the voices of our constituents, and I thank everyone who has written in telling of their experiences both for and against.

I would like to add a clinical perspective. There are two conflicting principles here. There is the fundamental principle that doctors should do no harm—and this House must think very carefully before we remove that cornerstone of ethical medical practice—but that comes up against another very important principle: the principle of self-determination about which so many Members have spoken very powerfully. If we are to apply that principle, however, I ask where it will take us. If we are to argue that Diane Pretty, for example, had the right at a time of her choosing to end her life because of intolerable suffering—a quick death, without pain, at home, surrounded by her family—why should we deny that to somebody with mental capacity with locked-in syndrome such as Tony Nicklinson, or indeed a young man who has a high spinal injury?

Also, if we are to apply that principle further, what is intolerable suffering? Intolerable suffering is what is intolerable to us. We have seen that definition extend in Switzerland. Indeed, a British citizen—a retired nurse— took her life in Switzerland last year because she was afraid of getting old. We have seen the definition applied to people with depression, and in other countries to children. That starts to bleed into questions about capacity.

As a clinician, I have had the privilege to sit with many people at the end of their lives, and often people contemplate taking their life. People have asked me to help them do so. They do that because of fear or a deep depression, or sometimes a profound sense that they are a burden on their families. With time, I have seen many people come through that to find real meaning in their lives. We need to think very carefully before we take that away. Of course people say to me, "Who are you to say whether or not they should take that journey?"—or even whether they would come through that period, because some of course do not—but I say to the House that we have to consider the harms as well as the benefits.

We have to consider the impact on wider society, too. I believe it is inevitable that we would slide towards the Swiss position, and we must consider what message it would send to people if we say that it is all right in society to end one's life from fear of growing old. In Switzerland there is a high preponderance of people who live alone, who have been divorced, and who are women, and we have to think about why they have come to that position. What does it say if we have an attitudinal shift in our society, as I believe is inevitable, which changes the way we feel about the value of life? We have to consider not just the rights of the individual to self-determination, but the inevitable wider effects on society, and the pressure people will inevitably feel at the end of their life.

I hope that Members will look at the report on end-of-life care by the Health Committee, which I was privileged to Chair, and think again about how we can refocus on what the duties of a doctor should be. A doctor's duties should be to improve the quality at the end of life, not shorten it.

Let us look at how the House can work together to improve access to high-quality specialist palliative care, and how we can address variations in that access, and put the funding of our hospices on a long-term sustainable footing. I would like us to provide free social care at the end of life, so that more people can be at home surrounded by their loved ones in a place of their choosing if that is what they want.

I would also like us to bring forward discussions about dying, because there are many ways in which people can express their preferences at the end of life. Let us bring forward better care planning, bring forward those conversations, and bring forward access to specialist care, but please let us also consider the wider consequences and vote against this Bill.

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21 JUL 2015

Health Select Committee

The Health Committee heard oral evidence from Simon Stevens, Chief Executive of NHS England today.

To watch the meeting click here

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20 JUL 2015

Children in Care: Mental Health

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Education, if she will implement the recommendations of the report published by the NSPCC in June 2015 entitled Achieving emotional wellbeing for looked after children, on the mental health needs of children in care.

Edward Timpson The Minister for Schools

In March my Department and the Department of Health published joint statutory guidance on promoting the health and well-being of looked-after children. This emphasises the importance of emotional well-being and mental as well as physical health. Support to vulnerable groups, including looked-after children, was also a focus of the work leading up to the publication of Future in Mind.

This report makes a valuable contribution to the development of policy and practice around how to improve the emotional wellbeing and mental health of looked-after children and care leavers. Promoting the emotional wellbeing and mental health of looked-after children is a key priority for this government. We look forward to discussing with the NSPCC and others the findings it presents and what more can be done to improve emotional and mental health outcomes for this vulnerable group.

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16 JUL 2015

NHS Reform

Sarah Wollaston Conservative, Totnes  Click here to watch Sarah speak

I welcome the Secretary of State's vision of an NHS that is empowered to focus more fully on the people and communities it serves and that is more transparent, less bureaucratic and as safe on a Sunday as it is on a Wednesday, and I welcome his comments about culture change. Does he agree that meeting that challenge will also depend on financing? As welcome as the extra £8 billion announced in the Budget is, will he join me in urging colleagues to ensure that as much of that as possible is front-loaded, because it is so necessary for the transformational changes he has talked about? In encouraging leadership across the NHS, will he ensure that the changes that are needed at a local level, and the systems we can integrate for the benefit of patients, can be introduced more quickly and effectively?

Jeremy Hunt The Secretary of State for Health

I thank my hon. Friend for her important comments, and for sitting through a very long speech I gave this morning. We are trying to achieve many things. At their heart, as she rightly says, is a recognition that culture change does not happen overnight. She is right that the profiling of the extra money that the Government are investing in the NHS is important, because we need to spend money soon on some things, such as additional capacity in primary care, as in two to three years' time that will significantly reduce the need for expensive hospital care. We are going through those numbers carefully. She is also right that local leadership really matters. I know that she will agree, especially as she comes from Devon, that leadership needs to be good at a CCG level as well as a trust level, because CCGs have a really important role in commissioning healthcare in local communities. That is an area where we need to make a lot of improvements.

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15 JUL 2015

Asylum: Finance

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for the Home Department, if she will make it her policy to commission an independent review of support rates paid to asylum applicants under section 95 of the Immigration and Asylum Act 1999 before making changes to that level of support.

 

James Brokenshire Minister of State (Home Office) (Security and Immigration)

Asylum seekers who are destitute are provided with accommodation and a cash allowance to cover their essential living needs. The level of the allowance is kept under regular review. If they are recognised as refugees they are able to claim mainstream benefits in the normal way.

The Government currently has no plans to establish an independent review of these arrangements.

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14 JUL 2015

Fire Services: Pensions

Written Answer

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Communities and Local Government, when he plans to publish the revised commutation factors for the firefighters pension scheme.

 

Mark Francois Minister of State (Communities and Local Government)

The Government accepts in full the Pension Ombudsman's recent determination regarding commutation factors used to calculate lump sum payments for certain firefighters and police officers. It also recognises that there are other individuals who are affected by the principles set out in this determination, and is working with pension administrators to identify these and ensure that appropriate payments are made as quickly as possible. The Government Actuary's Department is preparing detailed guidance for administrators to aid them in calculating the amounts owed. They intend to issue this guidance, as well as tables of revised commutation factors, to administrators in the near future. At this point, they will also be made available online.

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08 JUL 2015

South-West England (Long-Term Economic Plan)

Sarah Wollaston Conservative, Totnes

Does my right hon. Friend agree that when it comes to local authority and health funding, there is not only the higher cost of delivery in rural areas, but the fact that we have a higher age demographic in Devon and much greater need, which is not reflected in the current formula?

 

Liam Fox Conservative, North Somerset

My hon. Friend, typically, makes an excellent point. We are a part of the country that is a very attractive place for people to go to when they retire, but that brings its own financial problems for funding our local facilities. My hon. Friend is all too aware of the fact that as we get a more elderly population, that brings with it more complex medical needs. It is the complexity of the medical needs that adds to the cost, as well as the number of individuals involved, and that will continue to rise, so we must have a proper match between the funding and the demand if we are to be able to cope with the pressures that are coming.

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07 JUL 2015

NHS Efficiency Savings

Sarah Wollaston Conservative, Totnes.  Click here to watch Sarah speak

In trying to reduce waste as part of the drive for efficiency savings identified in the "Five Year Forward View", the Secretary of State spoke recently about the possibility of putting a price label on high-value items in prescriptions alongside a label saying that they are paid for by the taxpayer. Will he reassure the House that such a measure would be carefully piloted and evaluated first, so that we can avoid any unintended consequences for those who might consider discontinuing very important medication?

Jeremy Hunt The Secretary of State for Health

We will look at all the evidence. The evidence we have seen from other countries is very encouraging. Apart from ensuring that NHS patients and the public understand the cost of NHS care, one of the main reasons why we want to do that is to improve adherence to drug regimes by making people understand just how expensive the drugs are that they have been prescribed. We will of course look at all the international evidence.

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01 JUL 2015

Poverty; why measurement matters

There has been some controversy over the proposed changes to the way that we record poverty. We currently use relative poverty, defined as earning below 60% of median income. This means however, that the income below which people are classified as living in poverty is constantly changing, in line with changes to levels and distribution of wealth. Historically, the alternative measure, absolute poverty, was defined as lacking the resources needed for basic subsistence. In the UK, where the number of people of people who would fall into this category is relatively small, it usually means those people whose income falls below a certain level, often by comparison with a base year. For example in the Household Below Average Income Report, published annually by the Department for Work and Pensions, absolute poverty is defined as below 60% of the average earnings of individuals in 2010/11, adjusted for inflation.

Relative poverty is more a measure of inequality than a true measure of poverty and the current measure of absolute poverty is also flawed.

Current measures can produce misleading results; David Cameron noted in a speech last month that, because of the way that relative poverty is calculated, if the Government increased the state pension, child poverty could technically go up because of a rise in median income.

What is needed, instead, is a measure of poverty which can change policy in a way that benefits children. The conclusion of a consultation organised by the coalition Government in November 2012, called for a new measure of poverty which would take into account factors such as worklessness and poor housing, alongside low income, to 'capture the reality of child poverty in the UK'. Such a measure would also take health into account, as poor health can be both a cause and consequence of poverty. For example rates of diabetes and obesity are significantly higher in the least wealthy fifth of the population whilst 21% of five year olds entitled to free school meals have severe or extensive tooth decay, far higher than the 11% of those who do not. Importantly, the old measures will continue to be published to allow for comparisons of income inequality alongside the new measures which are designed to help reduce the inequalities blighting our children's life chances.

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01 JUL 2015

Child Poverty

Sarah Wollaston Conservative, Totnes Click here to watch Sarah speak

I welcome the Secretary of State's determination to break the cycle of disadvantage and to focus instead on outcomes. As he knows, health inequality also traps children in disadvantage. He has touched on alcohol and drug addiction, but will he also look at the burdens of mental health inequalities, and obesity and tooth decay, because those too are having a massive impact on children's life chances? I hope that he will work across Government Departments to make sure that they are tackled as well.

Iain Duncan Smith The Secretary of State for Work and Pensions

I am happy to work with my hon. Friend on this. I agree with her about poor health outcomes, which often involve mental health issues. Some of those are swept up within the work that we are already doing. We will bring forward further proposals on how we can improve outcomes for people with mental health conditions by getting them to treatment much quicker. I am happy to discuss those matters, in line with the areas that I spoke about earlier.

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29 JUN 2015

Tunisia, and European Council

Sarah Wollaston Conservative, Totnes Click here to watch Sarah speak

Does the Prime Minister agree that, just as we need to do all we can to disrupt vile propaganda from ISIL on social media, it is time for our mainstream broadcast and print media to review their editorial policies and stop publishing stills from snuff videos and blasting us with the faces of smirking terrorists? Instead, let us see the faces of those Tunisians who stood arm in arm to protect innocent tourists.

David Cameron The Prime Minister, Leader of the Conservative Party

My hon. Friend makes an important point. The media have to exercise their own view about social responsibility and what they should and should not publish. I really hope that the BBC can look again at calling the organisation "Islamic State". It is not Islamic and it is not a state. It is a terrorist organisation. Call it ISIL, call it Daesh, but do not give it the dignity that it is asking for.

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25 JUN 2015

Education and Adoptions Bill

This week, the Education and Adoptions Bill was passed by the House of Commons on its second reading. This Bill is designed to tackle underperforming schools to ensure that all our children have access to a first rate education. The Bill will require that any school judged to be 'inadequate' by Ofsted is turned into a sponsored academy, reforming its management structure and providing it with assistance from a sponsor, such as a community organisation or successful local business. In addition the Bill will make it easier for the Education Secretary to intervene in any school considered to be underperforming or 'coasting', requiring them to implement radical reforms.

When underperforming schools are tolerated it is usually the children of the least advantaged in our communities who suffer most. An OECD survey, published in 2013, found that, out of 24 countries studied, England ranked 22nd for literacy and 21st for numeracy. We should not view this as acceptable.

For more information on the Education and Adoptions Bill please click here and here.

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24 JUN 2015

A & E Services

Sarah Wollaston Conservative, Totnes  Click here to watch Sarah speak

It is a pleasure to follow the hon. Member for Central Ayrshire (Dr Whitford). The House should listen to what she says about the point of targets.

I thank NHS staff across the UK and, given the subject of this debate, particularly those who work in the 181 emergency departments across England. Those people face immense challenges. Last year, they cared for 14.5 million patients—an increase of 500,000 on the previous year. As the hon. Lady said, this debate is about not just numbers, but complexity. We have to face that. It is a disappointment to those NHS staff when they see the debate descend into political diatribes. They want to hear constructive diagnoses and solutions from this House; they do not want to see this issue being used as a football. Let us move forward in that vein in this debate and look at the challenges.

This issue is immensely complex. Anyone who says that there is a single answer is not looking at the scale of the problem. In the few minutes I have, it would be impossible to address all the issues, so I will focus on the workforce challenge, which is key. That challenge does not relate just to emergency departments; there is a complex interaction that includes primary care, ambulance services and the voluntary sector.

We know that about 15% to 20% of people who are seen in emergency departments would be better seen in another context. How do we get the skill mix right? We need to consider the fact that not every place needs the same solutions. The solutions that are right in a rural constituency are very different from the solutions that are right in an urban area.

We need to look at the challenges of recruitment, retention and retirement. We have heard that 50% of training places are not being filled, but there is also the leaky bucket of those leaving the profession. We must consider the fact that it costs about £600,000 to train someone to senior registrar level in emergency care. The scale of the brain drain is enormous, particularly to Australia and New Zealand. How do we address that? Of course, there will always be junior doctors who want to spend a year working abroad and then return with the skills that they acquire. We should not discourage that, but we could do more to make it a two-way process. The main problem is the loss of those higher professionals who have not only the skills that are needed to look after the most unwell patients in our emergency departments, but the confidence and decision-making skills that are required to know when it is safe for patients to go home.

Tania Mathias Conservative, Twickenham

I absolutely appreciate what my hon. Friend says about the leaky bucket. Does she agree that every school and every careers adviser should be advising people to go into the NHS, given the 300 careers that it offers?

Sarah Wollaston Conservative, Totnes

Indeed. I was going to comment further on the issue of the skill mix. This is about not only those higher skill professionals, but the mix within the NHS. I do not think that we should talk that down. We simply will not be able to manage unless we broaden the skill mix. Healthcare assistants, for example, make an extraordinary contribution to the NHS and social care. One of the reasons we lose so many of them is the lack of access to higher professional development; it is not just about a low-wage economy. This is about how we can create more pathways to becoming, for example, assistant practitioners and physician assistants, how we can use them and how we can bring in more pharmacists, who train for five years in their specialty, into what we do across the NHS?

Helen Whately Conservative, Faversham and Mid Kent

Picking up on my hon. Friend's point about healthcare assistants, does she agree that improving the opportunities for healthcare assistants is a huge opportunity for the NHS at the moment?

Sarah Wollaston Conservative, Totnes

It is a huge opportunity and we must go further with that, because continuing professional development across the NHS workforce is part of addressing the burnout that the hon. Member for Central Ayrshire talked about. We must do more to address the rotas and see what is causing our staff to leave the NHS, because it is not just about pay or the allure of working in a sunnier climate—we cannot do much about that. It is also often about the work-life balance they face and how that compares with abroad. We have got into a vicious circle of increasingly having to rely on locums to fill those gaps, and that money could be far better spent addressing why the NHS is haemorrhaging so many skilled staff abroad and to outside professions.

When we talk in this House about the challenges facing primary care and A&E departments, we must be careful not to talk them down. We know that medical students find going into A&E attractive, so let us not cut off the supply any further by talking about it in terms of doom and gloom. There are things we can do to improve the working lives of people in A&E, so we should get on and do the job, and I think that this House should do so in a far more constructive frame of mind. It is time to put aside the difference we have had in the election. We have five years to go until the next election. Let us show an example to those following this debate outside by looking at this in entirely constructive terms.

I want to return to an issue the hon. Member for Central Ayrshire touched on: seven-day working. Just as we should not be trapped by targets, let us not be trapped by political dogma. Let us look at what the unintended consequences sometimes can be if we are driven by the mantra that it must be 8 till 8 and seven days a week in every situation. I used to practise in a rural community. If we create a system in which we make it deeply unattractive to work in small, rural practices and in which we divert resources from the key priorities of seven-day working—which should be to reduce avoidable mortality and unnecessary hospital admissions—and if we take our eyes off that as the key priority and drive towards having to achieve 8 till 8 in every location, we could find that we have a further recruitment shortfall, as has happened in my constituency. That can translate into real unintended harms, such as the closure of many beds at Brixham hospital because the GPs could no longer safely man the in-patient beds. We could find ourselves in a spiral of unintended consequences. Let us listen to those on the front line and to our patients and keep them first and foremost in our minds when we consider what we are doing in the NHS.

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22 JUN 2015

Onshore Wind Subsidies

Sarah Wollaston Conservative, Totnes

I welcome the Secretary of State's announcement and it is great to hear that we are on course to meet 30% of our electricity generation from renewables. She is right to divert the resources into less mature technologies, but can she reassure my constituents that that will not mean that we see a further expansion in very large-scale field solar across south Devon? Perhaps we will see more support for community energy schemes, and I hope that she will take me up on an offer to visit Totnes to see how those work in action.

Amber Rudd The Secretary of State for Energy and Climate Change

I wholeheartedly agree with my hon. Friend and her constituents sound very similar to mine. We support the desire to make sure that we address the issue of climate change: the problem is that we do not want large-scale solar. In fact, large-scale solar has already been taken out of the renewables obligation, but we are trying to support solar so that we have as much as possible through community energy, on people's houses and on other buildings. There is a great opportunity there.

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18 JUN 2015

Fish: Conservation

Written Question.

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Environment, Food and Rural Affairs, what discussions she has had with her counterparts in other EU member states on the effect of proposed changes to the minimum landing size of bass on salmon and sea trout stocks.

 

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

There have been extensive discussions with other EU Member States and the European Commission on the proposed changes to the minimum landing size of bass during the current process of agreeing bass management measures. To date these discussions have not included consideration of possible effects of these measures on salmon and sea trout stocks, although our general expectation is that any decrease in bass fishing effort will also help protect salmonids.

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18 JUN 2015

Entitlement to Vote in the Referendum

Entitlement to Vote in the Referendum

Click here to watch Sarah speak

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17 JUN 2015

Climate Change

Thanks to everyone from Brixham & Totnes who came to Parliament to discuss climate change.

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17 JUN 2015

Fish

Written Answers

Sarah Wollaston Conservative, Totnes

To ask the Secretary of State for Environment, Food and Rural Affairs, if the Government will conduct an assessment on the effect on salmon and sea trout stocks of an increase in the bass stock.

 

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

The Government has no plans to conduct an assessment on the effect on salmon and trout stocks of such an increase, but previous studies show that salmon have a number of predators including pike, cod, sea trout and bass.

Current assessment of the EU bass stocks indicate a rapidly declining biomass due to an extended period of poor reproduction and increasing fishing mortality. There is no obvious correlation between bass predation and salmon stocks since both have been declining.

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16 JUN 2015

Salcombe and Kingsbridge Primary visit Westminster

 

 

 

 

Salcombe Primary

 

 

 

 

Kingsbridge Primary

It was a real pleasure to welcome pupils and teachers from Kingswear Primary and Salcombe Primary, to the Houses of Parliament yesterday. The topics were different but as always, the questions were wide ranging from life in Parliament, why I decided to go into politics and how being an MP compares to my former job as a GP. Animal welfare and how to get young people more engaged with politics were also up for discussion and it was good to catch up with views on tests at school and school food.

Please contact my office on 020 7219 5129 if your school would like to visit, the tours are terrific fun and I will always make every effort to meet up afterwards.

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23 MAR 2015

Offences against Children

Written Answers

Sarah Wollaston Chair, Health Committee 23rd March 2015

 

 

  • To ask the Secretary of State for Justice, what steps the Government has taken to protect children from a parent who has been convicted of child sexual abuse.
  • To ask the Secretary of State for Justice, what provisions are in place to support the non-abusing parent of a child who has a parent convicted of child sexual abuse; and what assessment he has made of the effectiveness of those provisions.
  • To ask the Secretary of State for Justice, what assessment he has made of the merits of restricting the access of parents who have been convicted of sexually abusing a child to their own children.
  • To ask the Secretary of State for Justice, what assessment he has made of the effectiveness of measures to protect children from a parent who has been convicted of child sexual abuse.

Simon Hughes The Minister of State, Ministry of Justice 23rd March 2015

The Government takes very seriously the need to protect children at risk of harm from their parents. The Government is also aware of the concerns regarding the exercise of parental responsibility by a parent who has been convicted of sexual abuse of a child.

Under the Children Act 1989, parents and guardians, as well as others who are entitled, can apply to a family court for a section 8 order in cases where a question arises in relation to the welfare of a child. These orders include prohibited steps orders and specific issue orders to restrict the exercise of parental responsibility. The court can also make child arrangements orders with provisions to protect a child, perhaps by providing for 'no contact' with a parent where this is considered to be in the best interests of the child.

The Government believes that these provisions provide good protection for children where a parent has been convicted of child abuse, including abuse of the child concerned, but we always keep the law and the practice in this area under review and are very conscious of the need to have the maximum possible protection of children and young people at all times.

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23 MAR 2015

Antibiotics

Written Answers

Sarah Wollaston Chair, Health Committee 23rd March 2015

To ask the Secretary of State for Health, whether the General Medical Council (a) has undertaken and (b) plans to undertake any reviews of online prescribing of oral antibiotics.

 

Daniel Poulter The Parliamentary Under-Secretary of State for Health 23rd March 2015

The General Medical Council (GMC) is an independent body and responsible for matters concerning the discharge of its statutory duties.

The GMC has advised that on 31 January 2013, it published Good practice in prescribing and managing medicines and devices, which came into effect on 25 February 2013. In relation to online prescribing, this guidance is clear on the need for an adequate assessment of the patient's health, meaningful dialogue and consent, and for the doctor to be satisfied the medicines are appropriate for the patient's needs. The GMC has a duty to look into concerns raised about individual doctors who are not following this guidance.

The GMC has confirmed that it does not currently have plans to further review its guidance on prescribing and managing medicines and devices.

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19 MAR 2015

Antibiotics

Written Answer

Sarah Wollaston Chair, Health Committee 19th March 2015

To ask the Secretary of State for Health, what assessment Public Health England has made of the effect of remote prescribing of oral antibiotics through online pharmacies on resistance to antibiotics.

 

Jane Ellison The Parliamentary Under-Secretary of State for Health 19th March 2015

National Health Service community prescriptions, delivered online and in person, are collated by NHS Business Services Authority and shared with the Health and Social Care Information Centre and Public Health England (PHE), through an open government license. PHE, through the English Surveillance Programme on Antimicrobial Utilisation and Resistance, released the first national report collating antibiotic use and resistance across the healthcare economy in 2014. The report is available at:

https://www.gov.uk/government/publications/english-surveillance-programme-antimicrobial-utilisation-and-resistance-espaur-report

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19 MAR 2015

Pharmacy: Internet

Written Answer

Sarah Wollaston Chair, Health Committee 19th March 2015

 

 

  • To ask the Secretary of State for Health, what assessment he has made of the adequacy of clinical consultations conducted by online pharmacies.
  • To ask the Secretary of State for Health, what steps he is taking to ensure that online pharmacies adhere to national best practice guidelines.
  • To ask the Secretary of State for Health, what regulatory powers the General Medical Council has to review online prescribing where there is evidence that patients may be being prescribed suboptimal treatment.

Daniel Poulter The Parliamentary Under-Secretary of State for Health 19th March 2015

The General Medical Council (GMC) guidance on remote prescribing makes absolutely clear that doctors must feel satisfied that they can make an adequate assessment, establish a dialogue and obtain the patient's consent. The GMC expect all doctors to take account of GMC guidance and relevant clinical and other guidelines regardless of how they are prescribing. 

 

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19 MAR 2015

Planning Permission

Written Answer

Sarah Wollaston Chair, Health Committee 19th March 2015

To ask the Secretary of State for Communities and Local Government, what estimate he has made of the average cost to the public purse of a request for him to call in a planning application in each of the last five years.

 

Brandon Lewis Minister of State (Communities and Local Government) 19th March 2015

Very few planning applications are called in each year - an average of only 8 cases in each of the last five years. In all these cases the parties who take part in the planning inquiry are expected to meet their own costs in preparing and presenting evidence. The cost to the public purse is therefore limited. It varies considerably between cases, depending on factors including the complexity of each project and the length of the planning inquiry, and whether there is any litigation following the issue of a decision.

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18 MAR 2015

Mobile Homes

Written Answers

Sarah Wollaston Chair, Health Committee 18th March 2015

  • To ask the Secretary of State for Communities and Local Government, in how many local authority areas park home site owners have breached their site licences more than three times in the last two years.
  • To ask the Secretary of State for Communities and Local Government, how many local authorities are taking proceedings against park home site owners who have breached their site licences more than three times in the last two years.
  • To ask the Secretary of State for Communities and Local Government, how many local authorities have revoked the licences of park home site owners who have breached their site licences more than three times in the last two years.

Stephen Williams The Parliamentary Under-Secretary of State for Communities and Local Government 18th March 2015

The Department for Communities and Local Government does not hold details of the number of local authority areas where site owners have breached their site licences, or details of the number of local authorities taking proceedings against site owners, or the number of local authorities who have revoked the licences of park home site owners who have breached their site licences.

This Government is determined to improve life for park home residents and we have already given residents important new rights to improve their lives and protect them from rogue site owners.

We know that a source of real anxiety for residents is the poor state of some sites and the lack of routine maintenance and repairs. That is why this Government has given local authorities, for the first time, powers to issue compliance notices requiring a site owner to carry out any necessary work to the site to comply with their licence obligations. If the site owner fails to comply, the local authority will be able to prosecute them and if convicted they will face an unlimited fine. The local authority may then enter the site and do the necessary works. In an emergency, a local authority may also enter a site and do the works if it considers there is an imminent risk to the health and safety of residents. The authority will in any of these cases be able to recover all its enforcement costs directly from the site owner. We have published guidance for local authorities on how to use their new powers to best effect.

We have also given local authorities powers to refuse to grant a new application or transfer of a site licence. We have issued guidance which sets out the matters an authority can take into account when considering an application including the funding and management arrangements in place for managing the site and complying with the licence.

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16 MAR 2015

Genito-urinary Medicine

Written Answer

Sarah Wollaston Chair, Health Committee 16th March 2015

To ask the Secretary of State for Health, what analysis his Department has made of the adequacy of the provision of workforce training within service specifications for sexual health services.

 

Jane Ellison The Parliamentary Under-Secretary of State for Health 16th March 2015

The content and standards of professional healthcare training is the responsibility of the professional regulators, which have the general function of promoting high standards of education to ensure that healthcare professionals are equipped with the knowledge, skills and attitudes essential for professional practice. The Department published a model service specification for integrated sexual health services in May 2013:

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/210726/Service_Specification_with_covering_note.pdf

Provision of workforce training and education features prominently in this document.

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11 MAR 2015

Health Select Committee

The Health Select Committee met today the subject was the 2015 accountability hearing with the General Dental Council

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05 MAR 2015

Department of Health: Carers

Written Answers

Sarah Wollaston Chair, Health Committee

  • To ask the Secretary of State for Health, what steps the Government is taking to prevent discrimination against former carers.
  • To ask the Secretary of State for Health, what support the Government provides to former carers entering employment or training following the death of the person they are caring for.
  • To ask the Secretary of State for Health, what support the Government provides to former carers entering employment or training following the death of the person they are caring for.
  • To ask the Secretary of State for Health, how many carers over the age of 50 have become unemployed after the death of the person they were caring for since 2010.
  • To ask the Secretary of State for Health, what assessment he has made of the number of carers over the age of 50 who have obtained full-time work within a period of (a) three and (b) six months following the death of the person they were caring for since 2010.
  • To ask the Secretary of State for Health, if the Government will bring forward legislative proposals to protect former carers from discrimination.
  • To ask the Secretary of State for Health, what estimate he has made of the number of carers over the age of 50 who have not obtained full-time work within a period of (a) three and (b) six months following the death of the person they were caring for since 2010.

Norman Lamb The Minister of State, Department of Health

The Government recognises the valuable contribution made by carers, many of whom spend a significant proportion of their life providing support to family members or friends.

We know that former carers need to adjust to life after caring, so it is important that they receive support to cope and are signposted to relevant advice and support, including return to work programmes.

We have also legislated to give all carers new rights under the Care Act, which includes a principle to promote individual well-being. We have ensured that the definition of well-being in the Act includes participation in work, education and training. Local authorities must therefore consider these as relevant considerations when they are conducting an assessment or working on a support plan with a carer.

Any change of circumstances should trigger a review of circumstances. Support and planning should include planning for the end of a caring role, where relevant.

In 2002, the Government established a Task and Finish Group jointly with Employers for Carers in 2012 which looked into the factors affecting carers, including former carers wishing to return to work. We are taking forward its recommendations and have recently launched nine local authority pilots that are exploring ways in which people can be supported to combine work and care.

The Department for Work and Pensions continues to invest in supporting carers to return to work. If someone who was previously a carer and is fit for and looking for work, they would make a claim for Job Seekers Allowance and if eligible, will have access to the full Job Centre Plus offer, a core regime that provides:

- Mandatory interventions and additional flexible interventions. The interventions provide the contact with claimants so that a work coach can offer them help and support to return to work or move closer to the labour market; and

- The model has three elements: a core regime of regular face-to-face meetings, flexible work coach support and access to a menu of support options including work experience, skills provision and job search help, including provision funded through the Flexible Support Fund.

Former carers can continue to get Carer's Allowance for up to eight weeks after the death of the person they were caring for.

Carers already have a legal right to request flexible working arrangements after 26 weeks of continuous employment. Through the Children and Families Act 2014, this right was extended to all employees from 30 June 2014, helping to normalise flexible working practices within the workplace.

As with other employees or potential employees, the Equality Act 2010 protects former carers from direct and indirect discrimination in employment on grounds such as age and sex. Given the current protection from discrimination for former carers (along with other people seeking work or already employed), such as on grounds of age, sex or disability, we do not believe that additional measures are needed at the present time.

We do not hold records of former carers over the age of 50 who were unemployed or returned to work after the death of the person they were caring for. However, data from the 2011 Census which encompasses the provision of unpaid care in England and Wales showed that 8.9% of men and 11.1% of women who are caring, were unemployed.

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03 MAR 2015

Genito-urinary Medicine

Sarah Wollaston Chair, Health Committee 3rd March 2015

To ask the Secretary of State for Health, what plans are in place for an audit of the commissioning process for sexual health services.

To ask the Secretary of State for Health, what steps he is taking to ensure that standards of patient access, service quality and patient safety are maintained by local authorities in the commissioning of clinical sexual health services.

Jane Ellison The Parliamentary Under-Secretary of State for Health 3rd March 2015

Since March 2013, the Department, Public Health England (PHE) and other partners have produced a range of policy documents and guidance for local authorities, clinical commissioning groups, providers and others to support the provision of joined up, high quality sexual health services. This guidance includes:

A Framework for Sexual Health Improvement in England –

https://www.gov.uk/government/publications/a-framework-for-sexual-health-improvement-in-england

Making it work –

https://www.gov.uk/government/publications/commissioning-sexual-health-reproductive-health-and-hiv-services

HIV, sexual and reproductive health current issues bulletin Issue 1: Payments for patients living outside your local authority -

https://www.gov.uk/government/publications/hiv-sexual-and-reproductive-health-current-issues-bulletin-issue-1-november-2013

HIV, sexual and reproduction health current issues bulletin Issue 2: Commissioning Sexual Health Services from Primary Care –

https://www.gov.uk/government/publications/hiv-sexual-and-reproductive-health-current-issues-bulletin-issue-2-december-2013

HIV, sexual and reproduction health current issues bulletin Issue 3: Commissioning HIV Services –

https://www.gov.uk/government/publications/hiv-sexual-and-reproductive-health-current-issues-bulletin-issue-3-february-2014

HIV, sexual and reproduction health current issues bulletin Issue 4: Tendering Sexual Health Services –

https://www.gov.uk/government/publications/hiv-sexual-and-reproductive-health-current-issues-bulletin-issue-4-may-2014

Sexual Health Clinical Governance: Key principles to assist service commissioners and providers to operate clinical governance systems in sexual health services –

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/252975/Sexual_Health_Clinical_Governance_final.pdf

Commissioning Sexual Health Services and Interventions: Best Practice Guidance for Local Authorities –

https://www.gov.uk/government/publications/commissioning-sexual-health-services-and-interventions-best-practice-guidance-for-local-authorities

Sexual Health: Key Principals for Cross Charging –

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/226325/Sexual_Health_Key_Principles_for_cross_charging.pdf

Integrated Sexual Health Services: National Service Specification –

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/210726/Service_Specification_with_covering_note.pdf

PHE is planning a joint review with the Association of Directors of Public Health and other partners of the current commissioning arrangements for Sexual Health, Reproductive Health and HIV services. The review is intended to look at current commissioning arrangements and identify any issues arising from the changes to the commissioning of services, together with examples of good practice. It will be based on a structured questionnaire which will enable comparable information to be collected through interview with key partners. A summary of the findings will be published in the summer of 2015.

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03 MAR 2015

Human Papillomavirus: Vaccination

Sarah Wollaston Chair, Health Committee

To ask the Secretary of State for Health, when vaccinations for human papillomavirus for men who have sex with men will be implemented.

Jane Ellison The Parliamentary Under-Secretary of State for Health

The Joint Committee on Vaccination and Immunisation (JCVI), the independent expert body that advises the Government on all immunisation matters agreed at its October meeting that further consultation was needed with stakeholders before finalising its advice to ministers on the human papillomavirus (HPV) vaccination of men who have sex with men (MSM). It held a stakeholder consultation between 12 November and 7 January and we understand that the JCVI considered the outcome of the consultation at its meeting on 4 February 2015, as it reviewed its provisional advice on MSM.

Any implementation of an HPV MSM vaccination programme will be dependent on the JCVI's final advice. We look forward to receiving the JCVI's final advice in due course.

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03 MAR 2015

Child and Adolescent Mental Health Services

Sarah Wollaston Chair, Health Committee.  Click here to watch Sarah speak

It is a pleasure to open this debate on our report into child and adolescent mental health services. For the record, I am married to a full-time NHS adult forensic psychiatrist who is also the chair of the Westminster Parliamentary Liaison Committee for the Royal College of Psychiatrists. I thank the many organisations and individuals who have contributed to our report, my fellow Committee members and also the Clerk of our Committee, David Lloyd for his exemplary leadership and work over the course of this Parliament.

May I start by setting the scene? This report was launched in part because of the number of children and young people who were being admitted to hospitals many hundreds of miles from home when they were in mental health crisis and needing the highest level of support.

During the course of our inquiry, we identified serious and deeply ingrained problems with the commissioning and provision of child and adolescent mental health services, and we found that they ran throughout the whole system from prevention and early intervention services to in-patient services for the most vulnerable children and young people.

We welcomed the setting up by the Government of the Children and Young People's Mental Health and Wellbeing Taskforce, and many of our recommendations were directed at that taskforce. I am sorry that it has not yet reported, but I understand that it is to report very shortly, and we look forward to seeing its recommendations. The taskforce knows that it is a matter not just of tweaking the CAMHS system but of fundamental change. I hope that it will clearly set out how that will be implemented. We have legislated for parity of esteem, we have written it into the NHS Mandate, but all that counts for nothing if it does not translate into better services for children and young people.

The key recommendation in our report is about the importance of prevention and early intervention. However, services cannot be planned without knowing the extent of the problem. It is a matter of great regret that the five-yearly prevalence survey was cancelled under the previous Government. That means that our data are 10 years out of date. I very much welcome the reinstatement of that survey. In his response, will the Minister give further details of the extent? I know that he has already announced that the funding has been identified, but many professionals are waiting to hear further detail about exactly what will be included. That would be very welcome.

While we wait for the prevalence data to appear—it would be nice to hear the expected time frame in which we will hear the results—we all acknowledge that there has been an alarming rise in the level of distress and need reported by all those who work in the field, including those in the voluntary sector, in teaching and in CAMHS. There are unprecedented levels of demand at a time when, unfortunately, 60% of local authorities that responded to a survey from YoungMinds report cuts or a freeze in their CAMHS budget. That is where the front line of prevention should be.

The compelling evidence that we heard throughout our report was that early intervention prevents children from presenting when they have become more unwell, so that is where we need to focus our resources. Clearly, the Government were right and everybody welcomes the investment in 50 extra beds in the areas of greatest need—some of which are in my area—but it costs around £25,000 a month for a child or young person to be treated in an in-patient setting. For every young person who is in one of those beds, we have to ask whether they would have needed to be admitted to hospital in the first place had those resources been properly directed to prevention services. We need double running. If we just keep investing in in-patient beds at the expense of prevention, we will fill those beds and there will be a demand for more.

I hope the Minister will recognise the need for double running so that we focus relentlessly on prevention and early intervention. As he will know, if we are looking at in-patients and admissions, the very last place that any young person should be at a time of mental health crisis is in a police cell. I pay tribute to all those who, over a number of years, have campaigned on that. The problem is not new. I am one of the few MPs—or perhaps not so few—who has been inside a police cell at night, because for many years I was a forensic medical examiner. It was always profoundly shocking to think that children as young as 12 or 13 across the west country were being taken into police cells under section 136 of the Mental Health Act 1983—an horrific experience.

It is sometimes an individual case that finally brings an unacceptable practice to an end. I pay tribute to Assistant Chief Constable Paul Netherton of Devon and Cornwall police for highlighting the awful case in Torbay of a child who was detained in a police cell, and I pay tribute to Chief Constable Shaun Sawyer because they have taken steps to bring the practice to an end. Although as a Committee we called for this to be a "never event" within the NHS, in effect the procedures that will be put in place will be equivalent. Finally, on this Government's watch, we will see this unacceptable practice coming to an end. That is long overdue and very welcome.

In focusing on the need to keep that timely support for children and young people, I also hope that the taskforce will set out what can be done to address some of the perverse financial incentives in children and young people's mental health services. For example, a child who is admitted to hospital no longer has to be funded by the clinical commissioning group—in other words, they are handed over to specialist commissioning— creating all sorts of inappropriate decision making in the system. It also means that children are more likely to be readmitted because there are no step-down services. Therefore, a focus on active intervention to try to prevent that admission and keep children at home is very important. I also look forward to hearing the taskforce's recommendations on how that can be done consistently across the country, because another issue we raised was the extent of variation in practice.

I will now turn my attention to volunteers. If we are to retain a focus on the earliest intervention and prevention, we have to recognise the value of our volunteers. I would like to pay tribute to a number of volunteers in my constituency. I am a patron of Cool Recovery, a charity that provides mental health support to carers and those affected by mental health problemsacross south Devon. There are many such organisations working directly with young people. Representatives from Spiritulized, which supports young people in Kingsbridge, recently came to Parliament after being shortlisted for an award for the work it is doing in mental health first aid out in the community. In Brixham there is the Youth Genesis Trust and volunteers from The Edge. Work is also being done in schools. Representatives from South Devon college, which is based in my constituency, recently came to Parliament after it received an award for its work in student well-being and prevention of mental health problems.

Those organisations are reporting that both the demand for their services and the level of complexity have never been greater. Part of the reason for that, as the Minister will know, is the increasing waiting times for CAMHS. That means more young people are becoming much more unwell before being seen in the CAMHS setting. I hope that in his response he will be able to say exactly how we can balance that across the whole system. I very much welcome the investment in services for eating disorders and self-harm and early interventions in psychosis, and of course the Improving Access to Psychological Therapies programme. However, as he will know, fundamentally the issue comes down to funding. We will never achieve parity of esteem for mental health unless we address the funding inequality, with 6% of the mental health budget going to services for children and young people, and that budget itself is an inappropriately small slice of the overall funding pot for the NHS. How will we actually drive change in increasing funding?

Norman Lamb The Minister of State, Department of Health

I agree with everything my hon. Friend has said and very much welcome her Committee's report. I agree on the need to address the funding issue. In particular, it is critical that we achieve what I call an equilibrium of rights to access between mental and physical health in order to address the awful problem on waiting times, and that must include children's mental health services.

Sarah Wollaston Chair, Health Committee

I thank the Minister for that intervention. It is very welcome that we now have waiting time targets as a right for people with mental health problems, alongside those for people with physical health problems, but the challenge is not so much about the budget for children and young people's mental health services, but what we take that from, because there are no areas of slack in the mental health budget, as he will know. I think that the mental health budget overall must achieve some parity. Again, if we look at prevention and the

really small amounts of money, in relative terms, that are required to keep excellent voluntary services running in our communities, we see that it would be the greatest waste and tragedy to lose those vital services in our communities for the want of what are really quite small sums. When children, young people and voluntary services came to give evidence to our inquiry, we heard time and again that what they need is stable, long-term funding. They do not require a great deal of money, but they are currently limping from one short-term budget to another. Another issue raised was that if funding is available, it often gets directed to a new start-up project, not towards a project in the same community that may have proven value.

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03 MAR 2015

Maternity Services (Morecambe Bay)

Sarah Wollaston Chair, Health Committee

I join the Secretary of State in paying tribute to James Titcombe and all the families who have fought so long for answers. I also thank Dr Kirkup for his excellent report. I welcome the action that the Secretary of State has announced today, but can he add to that list by saying whether we can bring forward having medical examiners to look into the cause of death before the end of this Parliament and, if not, say what the barriers to introducing that much overdue reform are? Will he also touch on recommendations 20 and 21 in the report, which refer to the need for a national review of maternity and paediatric services in areas that are remote, isolated and hard to recruit to? Indeed, the report goes further and says that the problem extends beyond those services. This is an issue we need to address to improve safety without deterring recruitment in these areas.

Jeremy Hunt The Secretary of State for Health

I am afraid I can only commit now to us introducing independent medical examiners as soon as possible. We are wholeheartedly committed to this. It is incredibly important for relatives, because where they have a concern about a death and possibly a mistake being made in someone's care in their final hours, the availability of an independent examiner has been shown in the trials we have run to be very effective, so we are committed to doing that.

I should have answered the shadow Health Secretary on the point about a review of maternity services, because he raised it as well. NHS England is doing that review; we have already announced that to this House. Today it is publishing the terms of reference of that review. That is important, because there has been a big debate inside the health service—a debate with which many people will be familiar—about what the minimum appropriate size for maternity and birthing units is, and we need to get to the bottom of the latest international evidence.

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02 MAR 2015

Genito-urinary Medicine

Written Answer

Sarah Wollaston Conservative, Totnes 2nd March 2015

To ask the Secretary of State for Health, when his Department plans to publish the review of the first year's operation of the framework for sexual health improvement in England.

 

 

Jane Ellison The Parliamentary Under-Secretary of State for Health 2nd March 2015

The Framework for Sexual Health Improvement in England Progress Report will be published shortly.

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26 FEB 2015

Culture, Media and Sport Committee

Sarah Wollaston Conservative, Totnes. Click here to to watch Sarah speak

Following the point made by my hon. Friend Mr Hollobone about a diversity of views, does my hon. Friend the Chair of the Committee agree that too much of our news coverage has an entirely metropolitan focus? Will he elaborate further on what the report said about how we can encourage more resourcing for, and better coverage of, views from rural parts of Britain?

John Whittingdale Conservative, Maldon

We did look at the slightly London-centric nature of the BBC, and we welcomed the move to MediaCityUK in Salford and the provision of resources. We also expressed the hope that more would be done particularly in relation to the other nations. Northern Ireland made a quite strong case to us that it was poorly treated by the BBC. The question of covering rural issues—like my hon. Friend, I represent a rural constituency—is more challenging. I shall certainly continue to put it to the BBC, because sometimes—my hon. Friend is absolutely correct—these areas do not get the prominence they deserve.

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26 FEB 2015

Jimmy Savile (NHS Investigations)

Sarah Wollaston Conservative, Totnes.   Click here to watch Sarah speak

The Secretary of State has set out in the starkest terms the extent of the vile abuse perpetrated by Savile. It is also chilling to note in Kate Lampard's excellent report that between 60% and 90% of child abuse is still going unreported. Those who perpetrate it are adept at adapting their mechanisms, and recommendation 9 in the report mentions the extent to which abusers use social media to abuse children on hospital sites. Can the Secretary of State tell the House whether he is going to implement recommendation 9, and if so, how that will happen?

Jeremy Hunt The Secretary of State for Health

Yes, we are; that is very important. We absolutely accept the principle that all hospitals must have explicit policies on the use of social media. We must do everything we can. It is difficult to stop people going on to Facebook, for example, but when it comes to internet access by children, there are things that we can do, and we will absolutely be implementing that recommendation.

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24 FEB 2015

Health: Free Social Care

Sarah Wollaston Conservative, Totnes Click here to watch Sarah speak

What assessment he has made of the implications for his policies of Her Majesty's Treasury's costing of free social care at the end of life.

Norman Lamb The Minister of State, Department of Health

HM Treasury's costing demonstrates the limitations of data available nationally in estimating the potential costs of providing free personal care at the end of life. That is why the Department of Health is undertaking further work with stakeholders to develop an evidence base to inform the next spending review.

Sarah Wollaston Conservative, Totnes

I thank the Minister for that reply. He will know that most people want to be able to remain at home at the end of their lives, surrounded by the people they love, and I pay tribute to all the carers, volunteers and health professionals, including Rowcroft's hospice at home, who help to make that possible. Sadly, he will also know that often the situation can break down because of the sheer exhaustion of caring for a loved one at the end of their life. Will he commit that the Government will consider the quality of care as well as the costs when considering introducing free end-of-life social care?

Norman Lamb The Minister of State, Department of Health

I thank my hon. Friend for that question and join her in paying tribute to the work of so many people: volunteers, loved ones and the professionals working in the community. The whole emphasis should be on ensuring that we respect people's choice about where they want to be and that they get the best possible care. Later this week, the independent review of choice at the end of life will be published and I hope that it will inform discussions. I am completely with her in trying to ensure that we can achieve this.

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24 FEB 2015

Health Select Committee

The Health Select Committee met today to discuss Children's oral health.

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23 FEB 2015

Termination of pregnancy on the grounds of the sex of the unborn child

Sarah Wollaston Conservative Totnes

Does the Minister agree that one of the issues is that there are some types of X-linked genetic disorders affecting only one sex that cannot be detected by genetic testing for the specific condition in question, and that that is where the uncertainty arises? In other words, it would be entirely on the basis of the sex of the child. That is why the concern and uncertainty would be increased by the new clause.

Jane Ellison The Parliamentary Under-Secretary of State for Health

My hon. Friend exactly describes the concerns as they have been expressed to me by the RCOG.

It may be helpful for me to give the House some figures on abortions in our country. The House is aware that the vast majority of abortions—91%—are carried out at under 13 weeks' gestation. This is before the gestational age at which the sex of the foetus is routinely identified at the second scan, at around 18 to 21 weeks' gestation. Disclosing the sex of the foetus is a local decision and is based on clinical judgment about the certainty of the assessment and the individual circumstances of each case. Some 98% of all abortions were carried out at under 18 weeks' gestation in England and Wales in 2013. It is also the case that 98% of abortions performed in the independent sector in 2013 were carried out at under 18 weeks. By contrast, in 2013, 94% of reported abortions for foetal abnormality were performed in NHS hospitals. In the light of this, the House would want to consider that the new clause could be thought likely to have greatest potential impact on those health professionals working in our NHS, rather than on independent sector providers.

As the hon. Member for Stockport explained, new clause 25 would require a further assessment of the evidence that terminations are taking place on the ground of the sex of the foetus alone. I have already outlined the analysis that the Department of Health is undertaking on an annual basis in this area. We will also take into consideration any other evidence that comes to light. I stress to the House that we take the issue of coercion and abuse very seriously. Women who present for an abortion will always have the opportunity to speak to a health professional on their own at some point during the consultation. From my perspective as public health Minister, this is the sort of issue that would sensibly be considered as part of any further review, and the Department of Health is already considering what further sources of evidence can contribute to our knowledge on this important issue.

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

Sarah Wollaston, Conservative Totnes

We all agree that it is abhorrent to terminate a pregnancy on the grounds of a belief that daughters are less valuable than sons. However, I will vote against new clause 1 for three reasons: it is unnecessary, there would be unintended consequences and we have insufficient time to debate what would be a fundamental change to an underlying principle of the Abortion Act 1967.

We have heard clearly that it is already illegal to terminate a pregnancy on the grounds of gender alone, and rightly so. That has been clarified since many of us agreed that there was an issue. I agree that there was an issue. It was not possible to bring prosecutions until the clarification was issued by the Department of Health and the chief medical officer.

The updated data on this issue, which examines not only ethnicity but birth order, shows that there is no evidence of a systematic practice of gender-based abortion in this country. It happens in other parts of the world, where it is having a serious distorting effect on societies and on the status of women, but there is no systematic practice here, although I have no doubt that there are individual cases.

New clause 1 would have unintended consequences. At present, women may have the confidence to disclose to a doctor in the confidence of a consulting room that they feel under pressure. If we brought in the new clause, women might feel that they may be criminalised. That would do more harm than good and bring about the exact reverse of the intended consequence of the new clause. We also risk stigmatising communities through the implication that this is a widespread practice, which it is not in the UK. We have to be clear about that.

New clause 1 uses the very emotive term, "the unborn child". That would change the meaning within the Abortion Act. We have to be very careful about that. My hon. Friend Mr Burrowes mentioned that the word "child" appears in the Abortion Act. I accept that, but we must look at the context in which the word is mentioned. It is mentioned in the grounds for terminating a pregnancy when there is a grave risk that a child may suffer a serious abnormality. In other words, it does not confer personhood on the foetus in the way that this change would. It may be the view of the House that that needs to change, but let us come back and debate this incredibly serious ethical point with the time it deserves, not shoehorn it on to the tail end of a new clause with which it is difficult to disagree—as I said earlier, we are all agreed that termination on the grounds that a daughter is somehow of less value than a son is totally abhorrent.

I urge hon. Members please to come back to this issue and give it the time it deserves. Let us debate it on its ethical merits, not try to pretend that we are talking about something else. We are all agreed on the fundamental premise, so let us give it the time it deserves and reject new clause 1 tonight.

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10 FEB 2015

Health Select Committee

The Health Select Committee met today to discuss the impact of physical activity and diet on health.

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09 FEB 2015

Paignton Photonics Delegation Meet Minister

This afternoon, I met with Greg Clark – the Science Minister – as part of a delegation from the Bay to discuss how the Government can better support our local photonics industry. Torbay is recognised by industry as one of the leading centres for electronics and photonics expertise in the country with customers including NASA and the European Space Agency. This important sector already directly supports over 960 high-skilled jobs and contributes over £108m to our local economy.

Cllr Derek Mills and Alan Denby from the Torbay Development Agency joined me in Parliament to meet with the Minister and update him on the further opportunities for photonics. It is terrific news that the Government has committed £4m of Growth Deal funding to develop an Electronic and Photonics Innovation Centre EPIC, at White Rock, which will create 220 new jobs and provide local photonics firms with support for product development and research.

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04 FEB 2015

Bovine Tuberculosis

Written Answers

Sarah Wollaston (Totnes, Conservative)

To ask the Secretary of State for Environment, Food and Rural Affairs, what steps she has taken to keep veterinarians informed on the timetable of her Department's tendering process for testing cattle for tuberculosis.

George Eustice (The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs; Camborne and Redruth, Conservative)

Since the new model for the supply of veterinary services was announced in July 2013, the Animal and Plant Health Agency (APHA) (previously the Animal Health and Veterinary Laboratories Agency) has continuously provided detailed information and progress updates through the APHA website, regular Official Veterinarian (OV) newsletter and in specific letters and briefings sent directly to OVs. This information was also provided to veterinary professional bodies such as the British Veterinary Association (BVA), the British Cattle Veterinary Association (BCVA) and the Royal College of Veterinary Surgeons (RCVS). APHA provided open fora in both Builth Wells (Wales) and Weybridge (England) in September and October 2013.

An Invitation to Tender was published on 9 July 2014 which included a timetable leading to the announcement on contract awards in January 2015. To further aid potential suppliers, two further clarification days were held in Builth Wells and Weybridge in July and August 2014.

On 6 January 2015, prior to the award of contracts for veterinary services, APHA wrote to the BVA, BCVA and RCVS, to update them on the award process and timescales involved. On 27 January, APHA informed professional bodies and OVs of the award of contracts in Wales and will now work with the contractors to inform veterinarians in Wales of the transitional timetable and arrangements. APHA is not yet in a position to award contracts in England, as this is dependent on the outcome of an ongoing legal process, but has reaffirmed its commitment to providing ongoing information and support to the veterinary profession.

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04 FEB 2015

Bovine Tuberculosis

Written Answers

Sarah Wollaston (Totnes, Conservative)

To ask the Secretary of State for Environment, Food and Rural Affairs, what fees her Department has proposed for veterinarians who bid successfully in the tendering process for testing for tuberculosis in cattle.

George Eustice (The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs; Camborne and Redruth, Conservative)

Details of the fees payable by the successful bidders are subject to commercial confidentiality and not shared. Redacted copies of the awarded contracts will be available on Contracts Finder once these have been awarded. However, within the Invitation to Tender documentation it was clear that Defra was seeking the ability to deliver a consistent quality assured service, which would be important in identifying successful suppliers. Other factors, including the provision of a locally responsive service and the use of small businesses which otherwise support a sustainable livestock farming industry and wider rural economy, would also be important whilst cost would still be a factor. Tenderers were invited to submit tenders for each Geographical Lot based on their fees not exceeding the annual reference value of each the Geographical Lots (2013/14) and, in three Geographical Lots, the estimated value of the Total Reference Value less 10%.

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04 FEB 2015

Religious Buildings: Energy Performance Certificates

Written Answers

Sarah Wollaston (Totnes, Conservative)

To ask the Secretary of State for Communities and Local Government, what the definition his Department uses for 'place of worship' is for the purpose of exemption from Energy Performance Certificates.

Stephen Williams (The Parliamentary Under-Secretary of State for Communities and Local Government; Bristol West, Liberal Democrat)

DCLG does not define the term, "buildings used as places of worship" but allows it to take its common sense meaning. However, those responsible for such buildings may wish to seek advice from their local weights and measures authority to ensure that they, as the relevant enforcement body, share the view that the building in question is exempt from the requirement to have an Energy Performance Certificate on sale or rent.

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03 FEB 2015

Health Select Committee

The Health Select Committee met today to discuss the impact of physical activity and diet on health.

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02 FEB 2015

Child and Adolescent Mental Health Services

Sarah Wollaston (Totnes, Conservative) Click here to watch Sarah speak

I welcome the extra beds committed to south Devon. The Minister will know that one of the most frequent points raised with the Health Committee in our recent CAMHS inquiry was the complete absence of accurate prevalence data on children and adolescents' mental health needs and the services required to meet them. He will know that the prevalence data collection that used to happen every five years was cancelled in 2004. The Committee warmly welcomed the commitment to restart that survey. Will he update the House on exactly when that survey will start, whether the funds have been identified, and whether the scope of the prevalence data collection has been identified?

 

Norman Lamb (The Minister of State, Department of Health; North Norfolk, Liberal Democrat)

The hon. Lady is absolutely right. Unless we understand the prevalence of the problem, it is impossible to plan services effectively. I am delighted that we have secured the funding for an updated prevalence survey in 2015-16. It will be an expanded survey compared with the previous one. We want to cover as wide an age range as possible, to cover early years. That will give us the data, information and evidence we need, but I would then want us to do regular repeats to ensure that we maintain an understanding of prevalence.

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28 JAN 2015

Health Select Committee

The Health Select Committee met today to discuss End of Life Care.

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26 JAN 2015

Cycling and Walking Investment Strategies

Sarah Wollaston (Totnes, Conservative) Click here to watch Sarah speak

I warmly welcome the cycling and walking strategy. It is not just a cycling and walking strategy; it is a cycling and walking investment strategy. As the Minister knows, good cycling infrastructure does not happen without that vital investment. I am particularly pleased to see the words "certainty" and "stability" in new clause 13. That is what it is all about, and it is how Holland achieved its objectives. It makes it appropriate for the Minister to be the Member for South Holland and the Deepings. Holland achieved its goals by having £24 a head of stable, long-term investment. If we can get that level of investment—£10 to £20 a head has been called for in the all-party cycling group—we can do the same. I pay tribute to all my colleagues in the all-party cycling group for the work they did, and I commend the cycling report. I warmly welcome the opportunity of discussing the issue with the Minister responsible for cycling, Mr Goodwill, who is in his place.

I think that we can expect an increase in the number of cycling journeys from 2% in 2011 to 10% within a decade, which will have enormous benefits for health. I hope there will be investment in not just infrastructure but training, and that cycle to work schemes will, in some form, be extended to young people. I warmly thank the Secretary of State for tabling the new clause, and look forward to seeing the health and well-being of the nation improve as a result.

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21 JAN 2015

National Health Service

Sarah Wollaston (Totnes, Conservative)

I thank the right hon. Gentleman for giving way. I am concerned. Does he understand the difference between a pilot and an experiment? Does he not think it is right that the Secretary of State should listen to clinically led advice about how we might improve ambulance waiting times, rather than just roll out changes without a pilot, not an experiment?

Andy Burnham (Shadow Secretary of State for Health; Leigh, Labour)

I do not think there is a massive difference between a pilot and an experiment. My objection is that that is being introduced in winter—and a difficult winter at that—in the most troubled ambulance service. I am not against a pilot, but it should be conducted at a quieter time of year. I should have thought that bringing it in now would strike the hon. Lady, with her long experience of the NHS, as more than a slightly risky thing to do.

I need to hear today the Secretary of State's plan. What is his plan to bring standards in ambulance services and A and E back up to where they should be? If he waits much longer to tell us, people will conclude that he simply does not have one. The simple truth is that our hospitals are full and operating way beyond safe bed occupancy levels. It is a system that is visibly creaking at the seams.

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20 JAN 2015

Dental Services: Antibiotics

Written Answers

Sarah Wollaston (Totnes, Conservative)

To ask the Secretary of State for Health, how many antibiotics were prescribed by out-of-hours dentists in each quarter of the last three years.

Daniel Poulter (The Parliamentary Under-Secretary of State for Health; Central Suffolk and North Ipswich, Conservative)

The exact information requested is not available. Dental prescribing data is published annually at national level and antibiotic prescribing by dentists can be found in table 4.2 on page 20 in the report "Prescribing by Dentists, England 2013" which is available at the link below. This information is not collected in a form that separates in and out of hours prescribing, nor is there quarterly data. http://www.hscic.gov.uk/catalogue/PUB14016/pres-dent-eng-2013-rpt.pdf

 

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20 JAN 2015

Health Select Committee

The Health Select Committee met today to discuss End of Life Care.

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15 JAN 2015

Transatlantic Trade and Investment Partnership

Sarah Wollaston (Totnes, Conservative) Click here to watch Sarah speak

It is a pleasure to follow Dr Whiteford. I hope to be able to respond to some ofthe concerns she voiced. I congratulate Geraint Davies on initiating this important debate.

I share the sentiment, which was expressed by many hon. Members, that trade is the cornerstone of our national wealth. We heard my hon. Friend Mr Walter speak about its impact on our economy. Without that trade and our national wealth, there would not be funding for vital services such as our NHS; it is that long-term economic plan that will guarantee its future. However, I would like to speak today about the NHS and express some of my concerns.

The Leader of the Opposition has spoken of his desire to weaponise the NHS. It is shameful in itself, but it also detracts from some of the genuine arguments and important issues that we need to raise about health within TTIP.

Initially, I would like to clear up the points raised by the hon. Member for Banff and Buchan. They are important and I would not support the deal if I thought that it would have the effects she outlined, but I think that they have been rather used as part of that weapon to try to damn this partnership and to damn the Government's record. That is regrettable.

After reading the letter from the European Commission about the NHS, I wrote back because I wanted to clarify some points. As Chair of the Select Committee on Health, I heard back from Jean-Luc Demarty, the director-general for trade. He wrote to me on 11 December and a copy of that letter is available on the Health Committee's website if people want to look at it in detail. He made it absolutely clear that all publicly funded health services, including NHS services, would be protected under TTIP.

I pressed him further on that point, asking about the definition of publicly funded health services—in other words, would they include organisations such as those in the third sector? He was very clear that as long as the services are publicly funded, it does not matter how they are delivered. That is an important point of clarity. He also made the point that any investor-state dispute settlement provisions in TTIP could have no impact on the UK's sovereign right to make changes to the NHS. In other words, that deals with the concerns that have been raised that this is somehow a one-way street and that no future Government would be able to change policy. He is very clear on that point and I urge Members to look at his letter. The issue of ratchet clauses is also very important, and the ratchet clause will not apply in this case.

Jeremy Corbyn (Islington North, Labour)

If an incoming Government decided to terminate a contract in the NHS or in the public social care sector under which that company claimed that a very large investment had been made in building a care home or something similar, would the company not be able to use TTIP to prosecute the Government for the potential loss of investment?

Sarah Wollaston (Totnes, Conservative)

Already within domestic contract law there are provisions that mean that one cannot arbitrarily reverse a contract. A state would be able to announce that it was changing policy and moving forward, but the point about TTIP is that it works on both sides of the Atlantic. We would not wish to have British companies arbitrarily lose their investment in the US. It is about that; it is not some conspiracy of an evil empire, which is how it has been portrayed. I think that that would be a reasonable process.

Margot James (Stourbridge, Conservative)

May I make the point that an ISDS tribunal is empowered to award compensation for genuine loss but is not empowered to overturn policy or national regulation?

Sarah Wollaston (Totnes, Conservative)

Indeed, and that is the point that we want to make clear.

The concern is legitimate and if the NHS were threatened by TTIP we should be explicit about that, but it is not. We need to be clear about that and it would be helpful if Oppo