Browse content similar to 24/10/2016. Check below for episodes and series from the same categories and more!
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parts of my constituency but I would be delighted to visit. As wd get | :00:00. | :00:00. | |
towards Christmas, people should try to shop local. Order, order. Will | :00:00. | :00:12. | |
the member wishing to take her seat please come to the table? | :00:13. | :00:41. | |
I swear by Almighty God that I will be faithful and bear true allegiance | :00:42. | :00:52. | |
to Her Majesty Queen Elizabdth, her heirs and successors, according to | :00:53. | :00:59. | |
law, so help me God. You've got me now. | :01:00. | :01:22. | |
Tracey Babin, member for Batley and spend. | :01:23. | :01:42. | |
Order, order. Will the membdr wishing to take his seat pldase come | :01:43. | :01:49. | |
to the table? I swear by Almighty God that I will | :01:50. | :02:24. | |
be faithful and bear true allegiance to Her Majesty Queen Elizabdth, her | :02:25. | :02:28. | |
heirs and successors, according to law, so help me God. | :02:29. | :03:00. | |
Order. We will come to points of order later but in the usual way, | :03:01. | :03:41. | |
and FLV to attend to a point of order later. Statement, the Prime | :03:42. | :03:50. | |
Minister. With permission, H would like to make a statement on my one | :03:51. | :03:56. | |
be in Council last week. I went to this council with a clear mdssage | :03:57. | :04:01. | |
for my 27 European counterp`rts The UK is leaving the EU but not Europe | :04:02. | :04:06. | |
and we are not turning our backs on our friends and allies. For as long | :04:07. | :04:12. | |
as we are members of the EU we will play a full and active role, and | :04:13. | :04:18. | |
after we leave we will be a confident outward looking country, | :04:19. | :04:23. | |
enthusiastic about trading with our European neighbours and cooperating | :04:24. | :04:28. | |
on shared security interests, including law enforcement and | :04:29. | :04:31. | |
counterterrorism. That is the right approach and it was in the spirit we | :04:32. | :04:37. | |
made a significant contribution at this council to ensure a robust | :04:38. | :04:42. | |
European stance in the face of Russian aggression, addresshng the | :04:43. | :04:46. | |
root causes of mass migration and championing free trade around the | :04:47. | :04:53. | |
world. Let me say a word about each. Russia's indiscriminate bombing of | :04:54. | :04:57. | |
civilians in Aleppo and the atrocities we have seen elsdwhere in | :04:58. | :05:03. | |
Syria are horrific. It is vhtal we keep up the pressure on Russia and | :05:04. | :05:07. | |
the Syrian regime to stop its appalling actions and creatd the | :05:08. | :05:11. | |
space for a genuine politic`l transition in Syria. The UK put this | :05:12. | :05:18. | |
issue on the agenda for the council. The Foreign Secretary made the case | :05:19. | :05:23. | |
for a robust response at thd Foreign Affairs Council last Monday and I | :05:24. | :05:28. | |
spoke personally to Chancellor Merkel and President Donald Tusk | :05:29. | :05:33. | |
ahead of the Council last wdek. The council strongly condemned the | :05:34. | :05:37. | |
attacks, called for a cessation of facilities and demand that those | :05:38. | :05:41. | |
responsible for breaches of humanitarian law be held | :05:42. | :05:46. | |
accountable, and we need to go further, which is why we agreed if | :05:47. | :05:51. | |
current atrocities continue, the EU will consider all available options. | :05:52. | :05:56. | |
The agreed everything should be done to bring in humanitarian aid to | :05:57. | :06:02. | |
civilians. On Friday, the UK secured an extraordinary session of the UN | :06:03. | :06:07. | |
human rights Council to press for a ceasefire to enable humanit`rian | :06:08. | :06:12. | |
access to Aleppo. Millions of civilians are trapped there and | :06:13. | :06:18. | |
across Syria in desperate nded of food, shelter and health care. The | :06:19. | :06:22. | |
UK is already the second largest a lot aerial -- bilateral hum`nitarian | :06:23. | :06:29. | |
donor to this crisis and evdry secure access to these areas, we are | :06:30. | :06:35. | |
ready to accelerate over ?23 million of aid to help the most vulnerable | :06:36. | :06:39. | |
in the hardest to reach parts of Syria. Turning to migration, the | :06:40. | :06:45. | |
Home Secretary will give a statement on Calle shortly. At the European | :06:46. | :06:50. | |
Council I confirmed the UK will provide practical support to Europe, | :06:51. | :06:57. | |
including our naval presencd in the Aegean and Mediterranean, and as | :06:58. | :07:02. | |
part of that effort, HMS echo will take over in the Central military | :07:03. | :07:08. | |
knee and early next year. I reiterated that case I made at the | :07:09. | :07:12. | |
UN for a global approach to migration waste on three prhnciples. | :07:13. | :07:19. | |
First, ensuring refugees cl`im asylum in the first save cotntry | :07:20. | :07:25. | |
they reach. Second, improving the way we distinguish between refugees | :07:26. | :07:30. | |
and economic migrants, and third, developing a better overall approach | :07:31. | :07:35. | |
to managing economic migrathon, which recognises that all countries | :07:36. | :07:39. | |
have the right to control their borders and must commit to `ccepting | :07:40. | :07:43. | |
the return of their own nathonals when they have no right to remain | :07:44. | :07:48. | |
elsewhere. This includes working more closely with sauce and transit | :07:49. | :07:52. | |
countries and the council agreed to do more to help these countries | :07:53. | :07:56. | |
prevent illegal migration and return migrants who have no right to stay | :07:57. | :08:01. | |
in EU countries. Turning to trade, I am determined that Britain will be | :08:02. | :08:07. | |
the most passionate, consistent and convincing advocate of free trade | :08:08. | :08:13. | |
anywhere in the world. As wd look beyond our confident, we will seize | :08:14. | :08:17. | |
the opportunities of Brexit to forge an ambitious new role for Britain in | :08:18. | :08:23. | |
the world, and as part of this in the UK is already discussing our | :08:24. | :08:27. | |
future trading relationships with third countries. As I made clear to | :08:28. | :08:32. | |
other member states, this whll not undermine the EU trade agenda, it is | :08:33. | :08:38. | |
not even in competition with it and as long as we remain a membdr of the | :08:39. | :08:44. | |
EU we will continue to back the EU's free trade negotiations. I share | :08:45. | :08:49. | |
everyone's disappointment over the stalled talks between the ET and | :08:50. | :08:54. | |
Canada and we will do what we can to help get these discussions by | :08:55. | :08:58. | |
contract, but to those who suggest these difficulties have a bdaring on | :08:59. | :09:03. | |
our own negotiations, I remhnd them we are not seeking to replicate any | :09:04. | :09:06. | |
existing model another country has in trading with the EU. We will | :09:07. | :09:17. | |
develop our own British moddl. A new relationship for the UK with the EU, | :09:18. | :09:22. | |
to be there for when you're outside the EU, a deal that is ambitious and | :09:23. | :09:30. | |
gold for Britain. I also updated the European Council on Brexit, I said | :09:31. | :09:34. | |
we will invoke Article 50 no later than the end of March next xear and | :09:35. | :09:39. | |
is part of the withdrawal process we will put before Parliament ` great | :09:40. | :09:43. | |
repeal bill which will remove from the statute book once and for all | :09:44. | :09:49. | |
the European Communities Act, so the legislation that gives effect to all | :09:50. | :09:53. | |
EU law in Britain but no longer apply from the data we form`lly | :09:54. | :09:57. | |
leave the EU and the authorhty of EU law in Britain will end. Thd | :09:58. | :10:02. | |
Government will also give the parliament the chance to discuss our | :10:03. | :10:06. | |
approach to leaving the EU, so in addition to regular up dates from my | :10:07. | :10:12. | |
honourable friend, my own statements following council meetings `nd the | :10:13. | :10:17. | |
deliberations of the new select committee on exiting the EU, the | :10:18. | :10:23. | |
Government will take time available for a series of debates on our | :10:24. | :10:27. | |
future relationship with thd EU These will take place beford and | :10:28. | :10:31. | |
after the Christmas recess `nd will include debate on the princhples the | :10:32. | :10:35. | |
Government will pursue in negotiations. Members on all sides | :10:36. | :10:41. | |
will note the Government will not show its hand in detail as we enter | :10:42. | :10:43. | |
into these negotiations. But it is important that melbers | :10:44. | :11:02. | |
have this chance to speak on the issues that matter to their | :11:03. | :11:05. | |
constituents as we prepare to leave the EU. Well we have not yet started | :11:06. | :11:12. | |
the Brexit negotiations, I've made clear last week that my aim is to | :11:13. | :11:16. | |
cement Britain as a close p`rtner of the EU once we have left. I want a | :11:17. | :11:23. | |
deal to reflect the kind of mature, cooperative relationship th`t close | :11:24. | :11:26. | |
friends and allies enjoy, a deal that gives British companies freedom | :11:27. | :11:33. | |
to trade and operate within the European market and allow Etropean | :11:34. | :11:36. | |
businesses to do the same hdre, a deal that delivers the deepdst | :11:37. | :11:41. | |
support cooperation to ensure our national security and that of our | :11:42. | :11:47. | |
allies, a deal that is in Britain's interests and the interests of all | :11:48. | :11:52. | |
our European partners, but ` deal that ensures we are a fully | :11:53. | :11:56. | |
independent sovereign nation, able to do what sovereign nations do | :11:57. | :12:01. | |
Deeside for ourselves how wd control immigration. | :12:02. | :12:08. | |
It will mean our laws will be made here and not in Brussels and the | :12:09. | :12:14. | |
judges interpreting those l`ws will fit not in Luxembourg but hdre in | :12:15. | :12:18. | |
Britain. The negotiations whll take time. There will be different | :12:19. | :12:23. | |
moments ahead and have I have said before it will require patidnce and | :12:24. | :12:27. | |
some give and take. But I fhrmly believe that if we approach this in | :12:28. | :12:31. | |
a constructive spirit, we c`n ensure a smooth departure. We can build a | :12:32. | :12:34. | |
powerful relationship that works both for the UK and the countries of | :12:35. | :12:39. | |
the EU, and we can secure the deal that is right for the British | :12:40. | :12:43. | |
people, whose instruction it is our duty to deliver, and I commdnd this | :12:44. | :12:49. | |
statement to the House. Mr Jeremy Corbyn. | :12:50. | :12:56. | |
Thank you, Mr Speaker. I wotld like to thank the Prime Minister for the | :12:57. | :12:59. | |
advance copy of the statement she has just given us. Funnily dnough I | :13:00. | :13:05. | |
too was in Brussels last Thtrsday, meeting Socialist leaders and their | :13:06. | :13:11. | |
counterparts. I have to say, I was given a little longer to spdak that | :13:12. | :13:17. | |
the five minutes the Prime Linister had at dinner and at a more | :13:18. | :13:23. | |
reasonable time of the day. And indeed, I was listened to vdry | :13:24. | :13:26. | |
carefully by all those around the table. I made it clear, Mr Speaker, | :13:27. | :13:33. | |
to the other leaders, that Britain should continue to be a full and | :13:34. | :13:37. | |
active member of the Europe`n Union until mid-ocean oceans on otr exit | :13:38. | :13:42. | |
are complete. I think the Prime Minister was trying to send the same | :13:43. | :13:46. | |
message, but the manner in which she conveyed it was rather diffdrent. | :13:47. | :13:52. | |
She seemed to be not trying to build a consensus that is necessary, or to | :13:53. | :13:57. | |
shape a future relationship with the European Union that is beneficial to | :13:58. | :14:02. | |
everybody. She had a very dhfferent approach. Mr Speaker, the mdssage | :14:03. | :14:07. | |
that came to me loud and cldar from European leaders last week, was the | :14:08. | :14:11. | |
tone taken by this Tory govdrnment since their Tory party confdrence | :14:12. | :14:15. | |
earlier this month, has dam`ged our global reputation and staff a lot of | :14:16. | :14:21. | |
good will, not just in Europe, but around the world. And althotgh the | :14:22. | :14:25. | |
Prime Minister's words may have appeased the hardline voices behind | :14:26. | :14:29. | |
her, they have only spread `nger and resentment all across Europd by the | :14:30. | :14:32. | |
approach that she and her p`rty have taken. I do not believe we will get | :14:33. | :14:37. | |
the best deal for this country by using threats, hectoring or nectar | :14:38. | :14:44. | |
in of the European Union. For these negotiations to succeed, thd | :14:45. | :14:47. | |
Government frankly needs to adopt a slightly more grown-up approach For | :14:48. | :14:51. | |
negotiations to succeed, Brhtain needs a plan. What is clear to | :14:52. | :14:57. | |
everybody calm from European leaders and business, is quite clearly the | :14:58. | :15:04. | |
Government does not have ond. Can the Prime Minister to the House if | :15:05. | :15:07. | |
any progress has been made since the council meeting last week? Hs she | :15:08. | :15:12. | |
willing to tell us if access to the single market is a red line for her | :15:13. | :15:19. | |
government is or not? The Prime Minister has made it clear wants to | :15:20. | :15:23. | |
end freedom of movement that has not made it clear what will be hn its | :15:24. | :15:27. | |
place, causing uncertainty for business and for the many ET | :15:28. | :15:30. | |
nationals who reside in this country and make such a great contrhbution | :15:31. | :15:34. | |
for our economy. And can shd also tell us that if our governmdnt is | :15:35. | :15:38. | |
supporting moves by senior Conservatives to amend the great | :15:39. | :15:42. | |
repeal bill by adding a sunset clause allowing ministers to strip | :15:43. | :15:47. | |
away EU laws on workers' rights and environmental protection in the | :15:48. | :15:53. | |
years that succeed the exit from the European Union? And also tell us how | :15:54. | :15:56. | |
the Government plan to make up the shortfall of funding to those | :15:57. | :16:01. | |
regions resulting from the loss of structural funding to vital capital | :16:02. | :16:06. | |
programmes all over this cotntry? One week the Secretary of State for | :16:07. | :16:10. | |
Britain exiting the European Union will say one thing, the next the | :16:11. | :16:13. | |
Chancellor will say another. Meanwhile, the Prime Ministdr says | :16:14. | :16:18. | |
very little other than Brexht means Brexit, and we went provide a | :16:19. | :16:21. | |
running commentary. The rest of the world looks on and concludes Britain | :16:22. | :16:27. | |
hasn't got a clue. The truth is this isn't a soft Brexit or even a | :16:28. | :16:31. | |
hard Brexit, it is simply a chaotic Brexit. Because, with all the some | :16:32. | :16:38. | |
certainty, and all these mixed messages, day by day, confidence in | :16:39. | :16:42. | |
this economy falls, and the British people become more worried `bout | :16:43. | :16:47. | |
their future. Two weeks ago, the Treasury said that leaving the | :16:48. | :16:51. | |
single market would lead to a 6 billion loss to the economy. The | :16:52. | :16:56. | |
trade deficit is widening, the value of the pound has already fallen by | :16:57. | :17:03. | |
18%. Industries such as the auto industry and others are del`ying | :17:04. | :17:07. | |
vital investment decisions `nd the Bank of England looking to | :17:08. | :17:11. | |
re-locate. This indecision `nd poor economic management is starting to | :17:12. | :17:15. | |
hit our economy severely, wdakening the hand, as we walk into the most | :17:16. | :17:19. | |
important delegations for generations. We on this sidd of the | :17:20. | :17:25. | |
House respect the referendul result and we accept that Britain lust | :17:26. | :17:29. | |
leave the European Union. Wd also understand that this will bd a money | :17:30. | :17:33. | |
mental exercise, with the ddcisions made now affecting the lives of | :17:34. | :17:38. | |
British people for years to come. The Prime Minister appeared to be | :17:39. | :17:43. | |
making some sort of concesshon about parliamentary scrutiny. I would be | :17:44. | :17:45. | |
grateful if you would explahn exactly what the nature of these | :17:46. | :17:48. | |
debates were going to be each side of the Christmas recess. We as an | :17:49. | :17:53. | |
opposition will not to stand by and let this government choose the terms | :17:54. | :17:59. | |
of Brexit unopposed. It is our duty to scrutinise and our duty to make | :18:00. | :18:02. | |
sure this government does h`ve a Brexit plan for our country. Not | :18:03. | :18:07. | |
just a Brexit plan for the Eurosceptics behind her. And we will | :18:08. | :18:11. | |
continue to push for this p`rliament to have a very full slate in this | :18:12. | :18:17. | |
matter whatever happens in the debates around the Christmas recess. | :18:18. | :18:21. | |
Today, Mr Speaker, the French authorities begin the formal closure | :18:22. | :18:25. | |
of the Calle camp. I would like to take this opportunity to welcome | :18:26. | :18:28. | |
those children who have alrdady arrived in this country, as well as | :18:29. | :18:32. | |
others who have family conndctions. This camp, Mr Speaker, and H have | :18:33. | :18:37. | |
seen it for myself, has become a hellish place where a few of the | :18:38. | :18:40. | |
world's most vulnerable people have come to try and survive and call it | :18:41. | :18:47. | |
their home. Yet it still relains unclear what process and tiletable | :18:48. | :18:51. | |
her government is working under to bring refugee children here who are | :18:52. | :18:56. | |
entitled under international law to refuge in the UK. I read to rate the | :18:57. | :19:02. | |
urgency of the letter I sent to the Prime Minister last week, to | :19:03. | :19:07. | |
personally intervene in our country, and to be open and accommod`ting to | :19:08. | :19:11. | |
those children. I'm grateful to the reply I received an hour ago to my | :19:12. | :19:16. | |
letter but I would be grateful if the Prime Minister could indicate | :19:17. | :19:19. | |
something more precise about the timetable for allowing children and | :19:20. | :19:24. | |
others who have family conndctions to come to this country, and that | :19:25. | :19:28. | |
Britain does not evade its responsibility in helping those who | :19:29. | :19:31. | |
have suffered the biggest global displacement since the end of World | :19:32. | :19:35. | |
War II. This displacement is primarily caused by atrocithes in | :19:36. | :19:40. | |
Syria, and we utterly and totally condemn indiscriminate bombhng. The | :19:41. | :19:45. | |
only solution in Syria is a political one. Mr Speaker, these | :19:46. | :19:48. | |
issues are the one future generations will look back on when | :19:49. | :19:53. | |
it comes to defining this political generation. If we continue to | :19:54. | :19:54. | |
approach the challenges we face in a manner they will only grow | :19:55. | :20:11. | |
larger. We can instead work together in this House with our European | :20:12. | :20:14. | |
partners and the rest of thd world, we may quickly find the large | :20:15. | :20:16. | |
problems we face today appe`r smaller than we first thought, if we | :20:17. | :20:19. | |
work together to help those desperate people all around the | :20:20. | :20:23. | |
globe. Thank you Mr Speaker. The right honourable gentleman said he | :20:24. | :20:26. | |
had been in Brussels last Thursday meeting with various socialhst | :20:27. | :20:30. | |
leaders who were listening to him. I suppose, from his point of view it | :20:31. | :20:33. | |
is good to know that somebody is listening to him! Can I address the | :20:34. | :20:40. | |
last two issues that he refdrred to. He talked about Calais. As H said in | :20:41. | :20:46. | |
my statement, and as he will know, my right honourable friend the Home | :20:47. | :20:49. | |
Secretary will be making a statement on Calais and our response to | :20:50. | :20:54. | |
unaccompanied children and bringing children here into the Unitdd | :20:55. | :20:58. | |
Kingdom, with detail in that. All I will say now is this: we have been | :20:59. | :21:02. | |
working very carefully for ` considerable time now with the | :21:03. | :21:06. | |
French government, both to hmprove matters in relation to Calahs, but | :21:07. | :21:12. | |
also to ensure that we were abiding by our requirements under the Dublin | :21:13. | :21:17. | |
regulations to bring childrdn here who had family links here in the UK. | :21:18. | :21:21. | |
That process speeded up, we have put extra resource in it from the Home | :21:22. | :21:25. | |
Office and we have seen mord children being brought here. We have | :21:26. | :21:30. | |
also adopted a scheme to brhng 000 vulnerable children from thd region, | :21:31. | :21:34. | |
from the Middle East and North Africa, here to the UK, working with | :21:35. | :21:41. | |
UNHCR, and we are putting in place the amendment which the Immhgration | :21:42. | :21:45. | |
Act proposals, which of course required us to first negoti`te, | :21:46. | :21:49. | |
discuss with local authorithes about their ability to receive chhldren | :21:50. | :21:54. | |
here in the UK. Because the overriding aim of everyone of us in | :21:55. | :21:58. | |
this House should be to enstre that it is in the best interests of the | :21:59. | :22:03. | |
children that are being looked at and dealt with, and it is no help | :22:04. | :22:07. | |
for those children if we ard not able properly to provide for them | :22:08. | :22:12. | |
when they come here into thd United Kingdom. He did not talk about the | :22:13. | :22:19. | |
wider migration crisis, excdpt a reference that it was mainlx due to | :22:20. | :22:24. | |
Syrian refugees. Of course what we have seen is large number for people | :22:25. | :22:28. | |
moving not from Syria, but from parts of Africa, which is why the UK | :22:29. | :22:32. | |
has consistently been arguing for more work upstream is to stop the | :22:33. | :22:38. | |
numbers of people coming through and ensure that people have got | :22:39. | :22:43. | |
opportunities in source and transit countries, rather than requhring | :22:44. | :22:46. | |
them to come here to the Unhted Kingdom. In relation to Russia, he | :22:47. | :22:50. | |
made a reference to the indiscriminate bombing in Aleppo. | :22:51. | :22:55. | |
I've see with that that he hs referring to Russian action as well | :22:56. | :23:00. | |
Syrian regime action. It was important that we as the UK put this | :23:01. | :23:05. | |
matter on the table and the agenda of the European Council. Thdy made | :23:06. | :23:09. | |
the agreement that they did. And then if I just come on to the issue | :23:10. | :23:14. | |
about the Brexit arrangements. He referred to the tone that h`s taken | :23:15. | :23:18. | |
place since the Conservativd Party conference. I have to say to the | :23:19. | :23:21. | |
right honourable gentleman that what I found in the European Council last | :23:22. | :23:25. | |
week was a number of Europe`n leaders actually commending the | :23:26. | :23:29. | |
speech I had given at the Conservative Party conference. | :23:30. | :23:43. | |
Including, I have to say, one or two of the socialist leaders who might | :23:44. | :23:47. | |
have been talking to him at the time. He says we don't have a plan. | :23:48. | :23:56. | |
We have a plan, which is not to set out at every stage of these to | :23:57. | :24:00. | |
gauche Asians the detail of these the gauche Asians, because that | :24:01. | :24:03. | |
would be the best way to ensure we did not get the best deal for the | :24:04. | :24:09. | |
UK. He talked about free movement. I noticed that his Shadow Fordign | :24:10. | :24:14. | |
Secretary again refused to say what the Labour Party's statement was and | :24:15. | :24:18. | |
he talked about indecision. I have to say to the Leader of the | :24:19. | :24:21. | |
Opposition he could not guide whether we should be in or out of | :24:22. | :24:25. | |
the European Union, he could not decide when we should be invoking | :24:26. | :24:29. | |
article 50, the only thing he could say is that he would have unfettered | :24:30. | :24:33. | |
immigration into this country, the very thing the British people have | :24:34. | :24:38. | |
told us they don't want. Unlike him, the Conservative Party is lhstening | :24:39. | :24:49. | |
to the British people. Willham Cash. In congratulating my right | :24:50. | :24:53. | |
honourable friend on her prhncipled stand in implementing the vdrdict of | :24:54. | :24:57. | |
the British people, despite the doom and gloom which pours out of parts | :24:58. | :25:02. | |
of the media, is my right honourable friend where that last week, the | :25:03. | :25:06. | |
chairman on the committee for the budgets of the European Parliament, | :25:07. | :25:10. | |
stated the EU was too intrusive it breaks so rules, the member state | :25:11. | :25:15. | |
trust one another and it nedds, as he put it, an electric shock? Does | :25:16. | :25:19. | |
my right honourable friend `gree therefore that the EU itself is | :25:20. | :25:22. | |
trouble. They know it and the British people got it right? Well, I | :25:23. | :25:30. | |
think one of the challenges for the 27 remaining states of the Duropean | :25:31. | :25:34. | |
Union will be for them to ddcide the shape and way in which the Duropean | :25:35. | :25:38. | |
Union acts as it goes forward. I think they will have seen the views | :25:39. | :25:41. | |
of the British people. They will have seen that there were a number | :25:42. | :25:46. | |
of elements that led to the British people deciding to leave thd EU and | :25:47. | :25:49. | |
I think it is for the remaining 27 to think Frei carefully abott how | :25:50. | :25:53. | |
they want to take the EU forward in the future. -- to think verx | :25:54. | :26:00. | |
carefully. I thank the Primd Minister for advance sight of her | :26:01. | :26:05. | |
statement. 52% of voters in Scotland voted to remain in the European | :26:06. | :26:11. | |
Union. Since then, we have heard regularly that apparently Scotland | :26:12. | :26:16. | |
matters to the United Kingdom government. Indeed we hear that | :26:17. | :26:22. | |
Scotland is an equal partner in the United Kingdom. Given that, I | :26:23. | :26:26. | |
imagine the Prime Minister lust have raised this at the European Union | :26:27. | :26:31. | |
Council meeting, but for sole inexplicable reason, she has not | :26:32. | :26:34. | |
made mention of that in her statement today. Can she perhaps | :26:35. | :26:39. | |
tell the House which specifhc issues raised by the Scottish Government | :26:40. | :26:44. | |
she shared at the EU Council meeting? On the meetings shd held | :26:45. | :26:48. | |
today on relation to the cotncil when she met with the governments of | :26:49. | :26:51. | |
Scotland, Wales and Northern Ireland, they have reacted since | :26:52. | :26:57. | |
with frustration. The Welsh First Minister Carwyn Jones has s`id: if | :26:58. | :27:01. | |
the UK Government cannot negotiate an agreed position with a ddvolved | :27:02. | :27:06. | |
administration, then it has little hope of negotiating a good Brexit | :27:07. | :27:13. | |
deal with 27 other EU countries And Scotland's First Minister Nhcola | :27:14. | :27:16. | |
Sturgeon said she had received no more information or detail `bout the | :27:17. | :27:20. | |
UK's negotiating position. Given that the Institute for | :27:21. | :27:32. | |
Government has warned that hmposing a settlement on the regions may | :27:33. | :27:37. | |
provide in a serious breakdown in relations within the UK, thd Prime | :27:38. | :27:42. | |
Minister cannot pretend to take the interests of Scotland, Wales, | :27:43. | :27:46. | |
Northern Ireland and Gibraltar seriously. Either she will rush you | :27:47. | :27:52. | |
will not, and if she will not, Scotland is right to hold an | :27:53. | :27:57. | |
independent referendum and we will protect our place in Europe. He asks | :27:58. | :28:04. | |
me to take seriously the vidws of the Scottish Government and the | :28:05. | :28:08. | |
other devolved administrators, and that was why we were sitting around | :28:09. | :28:14. | |
in the joint Council session this morning, it is quite I have said to | :28:15. | :28:20. | |
the First Minister 's that we will have more of those meetings so we | :28:21. | :28:24. | |
have a greater level of communication with those | :28:25. | :28:28. | |
governments. I want for us hn determining the UK's position, | :28:29. | :28:34. | |
because it will be the UK negotiating with the EU, but we take | :28:35. | :28:41. | |
into full account and understand the impacts and particular issuds that | :28:42. | :28:45. | |
are of concern to the devolved administrations and that is what we | :28:46. | :28:48. | |
discussed today, what we will discuss in detail over the coming | :28:49. | :28:54. | |
weeks and months, and of cotrse there are particular religions, in | :28:55. | :29:00. | |
Northern Ireland the issue of the border is a specific concern we are | :29:01. | :29:04. | |
working on and it is that understanding we want for the | :29:05. | :29:09. | |
future, and I would say when he refers to the possibility of another | :29:10. | :29:14. | |
referendum in relation to Scottish independence, if he wants to ensure | :29:15. | :29:19. | |
that the future prosperity of the Scottish economy, he looks `t the | :29:20. | :29:24. | |
fact that Scotland has more imports and trade arrangements with the rest | :29:25. | :29:30. | |
of the UK then it does with the EU. It is first and foremost desired | :29:31. | :29:37. | |
should be to remain part of the UK. I strongly welcomed the statement. | :29:38. | :29:42. | |
Will she confirm this Parli`ment gave the incision to the Brhtish | :29:43. | :29:48. | |
people on EU membership, so it is now the duty of this Parlialent to | :29:49. | :29:54. | |
implement their wishes? I agree with my right honourable friend, this | :29:55. | :30:00. | |
Parliament voted six to one for the British people to decide whdther we | :30:01. | :30:06. | |
leave or remain in the EU. They gave their verdict, it is now our job to | :30:07. | :30:17. | |
make a success of it. Thank you Mr Speaker. In preparation for the | :30:18. | :30:24. | |
council meeting, did the Prhme Minister commission any English | :30:25. | :30:28. | |
regional impact assessments of Brexit? DBE cargo, whose | :30:29. | :30:37. | |
headquarters are in Dong cursed -- Doncaster, last week announced 93 | :30:38. | :30:47. | |
redundancies, saying that the Brexit effect means investment dechsions on | :30:48. | :30:51. | |
major infrastructure projects have been delayed or stopped altogether, | :30:52. | :30:57. | |
and customers have decreased or cancelled orders. Will the Prime | :30:58. | :31:02. | |
Minister undertake to publish Brexit regional impact assessments and how | :31:03. | :31:08. | |
will she insure the voice of the English regions are heard dtring | :31:09. | :31:15. | |
Brexit negotiations? The right honourable lady makes an important | :31:16. | :31:20. | |
point about the impact drags it will have on the economy generally, as we | :31:21. | :31:25. | |
go through these negotiations, and well people often talk about the | :31:26. | :31:28. | |
impact on Scotland, Wales and Northern Ireland, there will be | :31:29. | :31:33. | |
potential impacts on differdnt parts of the UK. The Department for | :31:34. | :31:40. | |
exiting the European Union hs talking to departments throtghout | :31:41. | :31:47. | |
the UK to understand the impact so we negotiate the best possible deal | :31:48. | :31:52. | |
that will be right not just for the poor nations but as a country that | :31:53. | :31:59. | |
works for everyone. May I congratulate my right honourable | :32:00. | :32:02. | |
friend on the positive mess`ge she delivered in Brussels about future | :32:03. | :32:07. | |
cooperation and free trade, and her desire to continue are free trade | :32:08. | :32:13. | |
between ourselves and Europd. Did any of her European colleagtes | :32:14. | :32:18. | |
advocate to her the return of tariffs on trade between us and | :32:19. | :32:25. | |
Europe? I thank him for his question and I know he has long been an | :32:26. | :32:31. | |
advocate of leaving the EU `nd trade possibilities that would be | :32:32. | :32:35. | |
available to was thereafter. We didn't have a detailed disctssion | :32:36. | :32:40. | |
about these matters, precisdly because we haven't yet started the | :32:41. | :32:47. | |
formal negotiations. The Prhme Minister is about to embark on a | :32:48. | :32:51. | |
very complex set of negotiations with her European counterparts, and | :32:52. | :32:56. | |
everyone recognises she will not want to reveal the details of our | :32:57. | :33:02. | |
negotiating hand, but that hs very different from setting out her | :33:03. | :33:05. | |
objectives, which I hope will contain a lot more details than just | :33:06. | :33:12. | |
high-level principles, so c`n I ask the Prime Minister to give the House | :33:13. | :33:17. | |
an undertaking that she will publish her negotiating objectives hn time | :33:18. | :33:22. | |
for the House and the new sdlect them before she presents thdm to the | :33:23. | :33:28. | |
other member states? I have set out the objectives we wish to ahm for in | :33:29. | :33:33. | |
relation to the negotiation we will undertake. Can I congratulate them | :33:34. | :33:40. | |
for having been elected as chairman of the new select committee? His | :33:41. | :33:43. | |
committee will look at issuds to do with Brexit. There are alre`dy over | :33:44. | :33:50. | |
30 different reviews and investigations by Parliament in two | :33:51. | :33:53. | |
different aspects of Brexit, so Parliament can consider the issues | :33:54. | :34:00. | |
involved. Rolls-Royce, a magnificent British country, -- company, employs | :34:01. | :34:08. | |
a number of my constituents, including apprentices. I saw them on | :34:09. | :34:13. | |
Friday and they told me of their concerns, shared through thd | :34:14. | :34:17. | |
aerospace and automotive sectors, about the consequences of otr nation | :34:18. | :34:23. | |
leaving the single market and also the customs union. Could thd Prime | :34:24. | :34:28. | |
Minister assure British bushness that she will listen to thehr needs | :34:29. | :34:33. | |
and concerns as we now move to leaving the European Union? My | :34:34. | :34:39. | |
honourable friend makes an hmportant point about the quality of | :34:40. | :34:44. | |
businesses we have here in the UK. Rolls-Royce is one of those | :34:45. | :34:49. | |
businesses, which is a fine example, including the ways they takd on | :34:50. | :34:53. | |
apprenticeships and contribtte to the growth of our economy. H and all | :34:54. | :34:59. | |
those involved in negotiations will listen to business, that work has | :35:00. | :35:06. | |
already started, the Secret`ry of State for exiting the Europdan Union | :35:07. | :35:10. | |
has been holding those disctssions, I have held round tables with | :35:11. | :35:13. | |
businesses to hear the concdrns The overwhelming view is that h`ving | :35:14. | :35:20. | |
taken the decision to leave the EU, business wants to work with us to | :35:21. | :35:25. | |
make sure we can make every success of opportunities outside thd EU In | :35:26. | :35:33. | |
negotiations with European Council members, was she able to spdll out | :35:34. | :35:37. | |
that despite the negotiations ahead, the British people expect in the | :35:38. | :35:42. | |
next general election to have the final vote and say on our | :35:43. | :35:49. | |
immigration and trade poliches and the final say over EU laws? I have | :35:50. | :35:57. | |
said on a number of occasions that the vote to leave the EU was a vote | :35:58. | :36:03. | |
to ensure we have control over our budget, laws and rules on | :36:04. | :36:12. | |
immigration. It is clear from her welcome endorsement of free trade | :36:13. | :36:19. | |
that she will be seeking thd closest possible engagement for a sovereign | :36:20. | :36:22. | |
country with the European shngle market. Does she agree this | :36:23. | :36:27. | |
objective would be better sdrved by lobbying our partners rather than | :36:28. | :36:32. | |
throwing dust in the eye of the proletariat here? I agree whth Mike | :36:33. | :36:39. | |
honourable friend that it is important that we acknowledge that | :36:40. | :36:45. | |
the work that is done will be done sitting around a table with our | :36:46. | :36:48. | |
European partners and negothating with them. There will be colments | :36:49. | :36:53. | |
made here and elsewhere in public about what is happening but what | :36:54. | :36:57. | |
will matter is the discussions that take place around that tabld. I | :36:58. | :37:03. | |
thank the Prime Minister for advance sight of her statement, but it is a | :37:04. | :37:08. | |
sad day when a government whll compromise the safety of its | :37:09. | :37:14. | |
citizens to appease the dangerous ideology of a feud, so will she | :37:15. | :37:20. | |
confirm now that we will relain an active member of Europol and we will | :37:21. | :37:26. | |
urgently opt in to this critical aspect of European cross-border | :37:27. | :37:31. | |
security for which the regulations were formed in May this year, to | :37:32. | :37:35. | |
defend ourselves from terrorists, organised crime, drug traffhcking, | :37:36. | :37:43. | |
paedophilia and people trafficking? He doesn't need to tell me `bout the | :37:44. | :37:49. | |
importance of our security `nd law enforcement cooperation with our | :37:50. | :37:54. | |
European partners and I refdr him to my statement where I said after we | :37:55. | :37:59. | |
leave we will be an outward looking country, enthusiastic about trading | :38:00. | :38:04. | |
freely with our neighbours `nd cooperating on security intdrests, | :38:05. | :38:08. | |
shared including law enforcdment and counterterrorism. I wonder hf the | :38:09. | :38:13. | |
chair of the select committde does not have a point in arguing that we | :38:14. | :38:21. | |
should soon publish our objdctive. It is not our objective that we want | :38:22. | :38:26. | |
to conclude, having adopted every last EU law into our laws on Brexit, | :38:27. | :38:32. | |
we want to conclude a free trade agreement which is overwhellingly in | :38:33. | :38:36. | |
the interests of the rest of Europe, and this would do so much for the | :38:37. | :38:41. | |
poorest nations in the world as we lead the battle for free tr`de and a | :38:42. | :38:51. | |
prosperous world. I agree. Just to be clear on the Prime Minister's | :38:52. | :38:57. | |
statement, is it her intenthon that the UK will be leaving the customs | :38:58. | :39:07. | |
union? I could give a link the answer to the right honourable | :39:08. | :39:15. | |
gentleman about that and serve. . The Shadow Foreign Secretarx talks | :39:16. | :39:17. | |
about substance, the import`nt point about the customs union is not a | :39:18. | :39:25. | |
binary choice. There are different aspects to the customs union and | :39:26. | :39:28. | |
that is quite it is important to look at the detail and get the | :39:29. | :39:36. | |
answer right. As we proceed with new bilaterals, none of us want to see | :39:37. | :39:41. | |
European first-class goods `nd services becoming uncompetitive and | :39:42. | :39:47. | |
I understood that there is no proposition to put tariffs between | :39:48. | :39:53. | |
us and our European partners. Will she confirm she can offer them a | :39:54. | :40:03. | |
free trade deal bilaterally? At risk of repeating yet again what I have | :40:04. | :40:07. | |
said previously, what we want is the right deal, the best possible deal | :40:08. | :40:12. | |
for the maximum opportunitids for British businesses to trade within | :40:13. | :40:18. | |
the single market, to trade in both goods and services, that is our aim, | :40:19. | :40:24. | |
to have that good trading relationship with the EU but there | :40:25. | :40:28. | |
are other things we will do like ensuring we can control the movement | :40:29. | :40:35. | |
of people from the EU into the UK. We welcome the Prime Ministdr's | :40:36. | :40:40. | |
meeting with the first ministers of the devolved administrations and we | :40:41. | :40:44. | |
hope that will continue to be a meaningful engagement. It is vital | :40:45. | :40:51. | |
we support industry. Could the Prime Minister comment on speculation we | :40:52. | :40:56. | |
are considering a cut incorporation tax, which we would welcome in | :40:57. | :41:02. | |
Northern Ireland? He shouldn't believe everything he reads in the | :41:03. | :41:08. | |
newspapers. On migration, b`ck and set timbre that commission hn its | :41:09. | :41:14. | |
communicate to the council said that we should establish a Europdan | :41:15. | :41:20. | |
travel information and authorisation system by November. With Grdece now | :41:21. | :41:26. | |
objecting to the common European asylum system, where does this leave | :41:27. | :41:35. | |
that proposed agency? The proposal for pop the European Union described | :41:36. | :41:39. | |
as a smart borders system is something they have been looking at | :41:40. | :41:42. | |
for some time, looking at the model of the system used in the United | :41:43. | :41:49. | |
States. A separate issue is about the security of the external border | :41:50. | :41:55. | |
of the EU, there is a separ`te issue about arrangements with increase in | :41:56. | :41:59. | |
relation to the asylum systdm and the Greek government has made some | :42:00. | :42:03. | |
changes to the way they deal with asylum claims in response to the | :42:04. | :42:06. | |
requirements of the EU- Turkey deal. The Prime Minister is being in | :42:07. | :42:18. | |
characteristically coy of the negotiation to leave the European | :42:19. | :42:22. | |
Union, and yet we know once the papers are given to the comlission, | :42:23. | :42:26. | |
they will be shared with thd European Parliament. Will she not | :42:27. | :42:30. | |
now undertake that she will share those papers with this Parlhament, | :42:31. | :42:35. | |
the sovereign parliament, so that we can have a proper opportunity to | :42:36. | :42:39. | |
look at the position the Government is taking, and comment upon it? I | :42:40. | :42:45. | |
can assure this House as I have done before, that this House will have a | :42:46. | :42:49. | |
proper opportunity to look `t these issues as we go through. But not | :42:50. | :42:53. | |
just a one-off opportunity. There will be a number of debates which | :42:54. | :42:58. | |
will enable members of this House to give more detailed comments on | :42:59. | :43:03. | |
various aspects on the impact of Brexit on different sectors of the | :43:04. | :43:08. | |
economy, for example. Given that the public adminhstration | :43:09. | :43:14. | |
on constitutional affairs committee is now conducting an enquirx and | :43:15. | :43:19. | |
drafting a report on institttional relationships in the UK, can I | :43:20. | :43:23. | |
welcome a meeting of the johnt ministerial Council this morning. | :43:24. | :43:26. | |
Can she say a bit more about this? Can she say if she will in future | :43:27. | :43:31. | |
give all statements to the House all meetings of the joint ministerial | :43:32. | :43:37. | |
Council, two of the size thd importance of these meetings, and | :43:38. | :43:39. | |
did the other Administration is accept the principle that there | :43:40. | :43:42. | |
should be a subcommittee looking at the issue of Brexit? | :43:43. | :43:47. | |
The discussion we had was about having more meetings of the plenary | :43:48. | :43:52. | |
session which was the one that I chaired this morning and those | :43:53. | :43:55. | |
further meetings will take place in due course. But we did agred that | :43:56. | :44:01. | |
there will be set up a joint ministerial Council subcommhttee, | :44:02. | :44:03. | |
which will be dealing with the negotiations looking at the issues | :44:04. | :44:08. | |
around the negotiations for leaving the European Union. That was | :44:09. | :44:11. | |
welcomed by all of the devolved administrations and I look forward | :44:12. | :44:14. | |
to that being a constructivd discussion around the table. It is | :44:15. | :44:18. | |
important that as we put together the UK's position in relation to | :44:19. | :44:22. | |
these matters, that we fullx understand the impact on thd various | :44:23. | :44:28. | |
parts of the United Kingdom. The Prime Minister speaks in a statement | :44:29. | :44:32. | |
of negotiating to reflect the kind of mature corporation that `llies | :44:33. | :44:40. | |
enjoy. If Northern Ireland can get a special deal and if the Citx of | :44:41. | :44:44. | |
London is being considered for one as well, why is it so polithcally | :44:45. | :44:48. | |
difficult for the Prime Minhster to comprehend a deal for Scotl`nd which | :44:49. | :44:54. | |
is welcomed by the voters and the Scottish Parliament? The de`l we | :44:55. | :44:57. | |
will be negotiating will be the right deal for the UK. It whll take | :44:58. | :45:01. | |
into account the concerns and implications for various parts of | :45:02. | :45:05. | |
the UK for different sectors of our economy. The position of Northern | :45:06. | :45:09. | |
Ireland will be a particular position, because Northern Hreland | :45:10. | :45:11. | |
will be one part of the UK with a land border with a country which | :45:12. | :45:19. | |
will be remaining inside thd European Union. And so given that | :45:20. | :45:21. | |
fact, there is goodwill and good spirit from both this government and | :45:22. | :45:25. | |
the Government of the Republic of Ireland, to assure that arr`ngements | :45:26. | :45:28. | |
which are put in place in the future do not return to borders of the | :45:29. | :45:34. | |
past. The Government's policy of saying as | :45:35. | :45:38. | |
little as possible is going to become increasingly unsustahnable. | :45:39. | :45:43. | |
The vacuum is already being felt with leeks not from the comlission, | :45:44. | :45:49. | |
but from her own Cabinet Brdxit committee colleagues. Does the Prime | :45:50. | :45:53. | |
Minister accept that unless the Government can provide at ldast some | :45:54. | :45:57. | |
clarity about its direction of travel soon, many financial and | :45:58. | :45:59. | |
other businesses, which havd been in touch with me about this, whll | :46:00. | :46:04. | |
respond to the uncertainty, plan for the worst, and that will be at | :46:05. | :46:10. | |
considerable cost for the UK? I say to my honourable friend I al well | :46:11. | :46:14. | |
aware of the impact that uncertainty has an businesses who are m`king | :46:15. | :46:18. | |
future decisions about investment here in the United Kingdom. It was | :46:19. | :46:22. | |
in that light that I have already set out the framework of thd | :46:23. | :46:26. | |
timetable for invoking article 0 and given clarity to both elployers | :46:27. | :46:30. | |
and indeed employees about the legislative position that whll apply | :46:31. | :46:36. | |
a one that we leave the European Union, ie that EU law will be | :46:37. | :46:41. | |
brought into UK law to make sure there is not a legal vacuum. I will | :46:42. | :46:46. | |
continue and the Government will continue to speak about these | :46:47. | :46:50. | |
matters, but we will not and I understand the point my honourable | :46:51. | :46:53. | |
friend was making, but I thhnk he knows full well that if this | :46:54. | :46:58. | |
government was to set out every jot and tittle of our negotiation | :46:59. | :47:01. | |
position that would be the best way to get the worst deal for the UK. | :47:02. | :47:06. | |
The Prime Minister failed adequately to answer the question from my right | :47:07. | :47:12. | |
honourable friend from Donc`ster Central. Has she carried out any | :47:13. | :47:18. | |
detailed impact of the analxsis that the harder form of Brexit whll have | :47:19. | :47:23. | |
an economy is in the north. If she has, will she publish it? And if she | :47:24. | :47:27. | |
hasn't, will she concedes hdr anti-EU rhetoric and her talking up | :47:28. | :47:31. | |
of a hard Brexit over the l`st month has been deeply irresponsible? First | :47:32. | :47:37. | |
of all, as I said in response to his right honourable friend, we are | :47:38. | :47:41. | |
looking at the impact on different parts of the United Kingdom. But the | :47:42. | :47:45. | |
premise of his question is ` false one. He talks about hard Brdxit that | :47:46. | :47:49. | |
the Government is going to take this country into. There is no stggestion | :47:50. | :47:56. | |
of that whatsoever. That is because the right honourable gentlelan seems | :47:57. | :47:59. | |
to think that all of these latters are binary decisions that ehther you | :48:00. | :48:03. | |
are able to control immigration or you have some sort of decent trade | :48:04. | :48:07. | |
arrangements. That is not the case. We are going to be ambitious for | :48:08. | :48:11. | |
what we obtained for the UK and that means a good trade deal as well as | :48:12. | :48:16. | |
control of immigration. Mr Speaker, it seems to me that | :48:17. | :48:21. | |
we're much more likely to achieve our foreign policy objectivds | :48:22. | :48:24. | |
working together, so I welcome the Prime Minister's moves to ptt | :48:25. | :48:29. | |
Russia's behaviour on the council's agenda. She may have noticed the | :48:30. | :48:32. | |
very robust statement at wedkend by the new shadow Secretary of State | :48:33. | :48:39. | |
for Defence for condemning Russia's behaviour. When the she think the | :48:40. | :48:44. | |
Leader of the Opposition will join the shadow Secretary of State for | :48:45. | :48:47. | |
criticising Russia for the indiscriminate bombing taking place | :48:48. | :48:51. | |
in Syria and recognise its part in the Syrian refugee crisis that we | :48:52. | :48:56. | |
are all trying to deal with? My right honourable friend makds a very | :48:57. | :49:00. | |
valid and important point. H note that although the European Council | :49:01. | :49:04. | |
discussed the role that Russia was taking in indiscriminate bolbing in | :49:05. | :49:08. | |
Syria, the right honourable gentleman the Leader of the | :49:09. | :49:12. | |
Opposition failed to refer to Russia and his actions on Syria whdn he | :49:13. | :49:16. | |
came to the dispatch box. I hope he will not be too slow in comhng | :49:17. | :49:22. | |
forward to make clear he dods condemn Russia's activities, | :49:23. | :49:24. | |
otherwise people will assumd that he does not. | :49:25. | :49:29. | |
The European investment bank provides vital funds for affordable | :49:30. | :49:34. | |
housing, hospitals, investmdnt in new technologies and utilithes. We | :49:35. | :49:38. | |
received 5.6 billion last ydar for projects up and down the cotntry. | :49:39. | :49:43. | |
Has the Prime Minister had `ny discussions about our stake in the | :49:44. | :49:46. | |
European investment bank and will she confirm that she will do nothing | :49:47. | :49:51. | |
to put this at risk? The honourable lady makes an important point and I | :49:52. | :49:55. | |
inform her that the Treasurx is in discussion with the European | :49:56. | :49:59. | |
investment bank. We recognise the important role it plays and want to | :50:00. | :50:07. | |
assure that nobody loses out as a result of the decisions which have | :50:08. | :50:09. | |
been taken by the British pdople. Those discussions are ongoing with | :50:10. | :50:14. | |
the European investment bank. Although a committed Europe`n, Tony | :50:15. | :50:17. | |
Blair once said that he facdd the European summit with a sinkhng | :50:18. | :50:22. | |
heart. So can I say how ple`sed I am that the Prime Minister enjoyed her | :50:23. | :50:27. | |
first summit? But doesn't the experience with the Walloni`ns | :50:28. | :50:36. | |
dictating to Belgium, and c`using a walk-out by the Canadians, show that | :50:37. | :50:42. | |
Brexit must not only be for England and Wales but for the whole United | :50:43. | :50:47. | |
Kingdom? I thank my honourable friend. He is absolutely right. The | :50:48. | :50:51. | |
decision that was taken to leave the EU will be a discussion -- decision | :50:52. | :51:02. | |
taken by the United Kingdom. Our National Health Service, | :51:03. | :51:04. | |
universities and businesses are already losing talent because of the | :51:05. | :51:08. | |
uncertainty of the status of EU citizens here over Brexit. Ht is an | :51:09. | :51:15. | |
uncertainty that she could dnd now. Why won't she? I expect to guarantee | :51:16. | :51:20. | |
the status of EU citizens hdre in the United Kingdom and I intend and | :51:21. | :51:27. | |
want to do that. But the st`tus -- but that may not be possibld if the | :51:28. | :51:32. | |
status of UK citizens in EU member states is not guaranteed and that is | :51:33. | :51:36. | |
a discussion I have said we hope to have at an early stage. | :51:37. | :51:42. | |
Someone who campaigned to ldave the European Union, I am grateftl to see | :51:43. | :51:45. | |
my right honourable friend's commitment to honouring the will of | :51:46. | :51:49. | |
the British people and forghng a successful future for our country | :51:50. | :51:53. | |
outside the EU. Will my right honourable friend agree with me that | :51:54. | :51:56. | |
her starting position in thd forthcoming negotiations is a strong | :51:57. | :52:00. | |
one, and we are beginning to see positive revisions of growth, | :52:01. | :52:04. | |
steadily lower unemployment and exports set to outpace imports, | :52:05. | :52:10. | |
proving that the scaremongers who predicted dire recession absolutely | :52:11. | :52:17. | |
wrong? I say to my honourable friend, of course as she will have | :52:18. | :52:20. | |
seen from the economic data which came out since the vote on the | :52:21. | :52:23. | |
referendum was more positivd than had been predicted prior to the vote | :52:24. | :52:27. | |
being taken. But I will not pretend it is going to be plain sailing in | :52:28. | :52:30. | |
the future. There will be ups and downs. There will be diffictlt | :52:31. | :52:39. | |
moments as I have said. But we will maintain a clear focus on ddlivering | :52:40. | :52:42. | |
what the British people want which is leaving the European Union. | :52:43. | :52:48. | |
In her lipstick words on migration, is the Prime Minister and eluding to | :52:49. | :52:53. | |
the UK and EU's interest in making President Bashir indicted bx the | :52:54. | :52:58. | |
International Criminal Court, a partner in managing migration and | :52:59. | :53:03. | |
countering terrorism? She ndeds to be more explicit about what she and | :53:04. | :53:07. | |
her colleagues envisage in the process and what it means for the | :53:08. | :53:12. | |
wards of refugees from Sudan and through Sudan? Yes, what we are | :53:13. | :53:19. | |
doing and what the European Union is doing is looking initially `t a | :53:20. | :53:23. | |
small number of countries in Africa, to work with them, on ensurhng that | :53:24. | :53:27. | |
their support available, th`t can reduce the numbers of peopld who | :53:28. | :53:32. | |
wish move to Europe? The Kh`rtoum process is an important elelent of | :53:33. | :53:36. | |
the work that is being done. The UK has consistently said that we need | :53:37. | :53:40. | |
to operate upstream and that is about working with source countries. | :53:41. | :53:45. | |
It is also about working with the transit countries, and dealhng with | :53:46. | :53:50. | |
the organised crime groups, who are dealing in this horrific crhme of | :53:51. | :53:54. | |
people smuggling and people trafficking which is leading to | :53:55. | :53:58. | |
misery. The European Union hs looking as I say at dealing with | :53:59. | :54:01. | |
initially a small number of countries, and of course we | :54:02. | :54:05. | |
recognise that there are those countries why there are reasons why | :54:06. | :54:09. | |
it is difficult to be able to return people to those countries. Ht is | :54:10. | :54:13. | |
important that we accept thd principle and start to put hnto | :54:14. | :54:16. | |
practice the process of working with people upstream. | :54:17. | :54:22. | |
Mr Speaker, it seems to be the case that technically the UK cannot enter | :54:23. | :54:26. | |
into trade deals with third,party countries whilst we are still a | :54:27. | :54:30. | |
member of the EU. It is gendrally being acknowledge that we whll | :54:31. | :54:34. | |
actually start doing this at some point before we leave. Is this an | :54:35. | :54:39. | |
issue that my right honourable friend has looked at? Is thdre some | :54:40. | :54:43. | |
type of timetable here and was mentioned at the summit? As far as | :54:44. | :54:47. | |
the summit was concerned, the point that I made was that any discussions | :54:48. | :54:51. | |
we have with third countries in relation to trade deals are not in | :54:52. | :54:54. | |
competition to what the European Union is doing. We continue to press | :54:55. | :54:59. | |
for the European Union to pound deal. We continue to press the | :55:00. | :55:08. | |
benefits of TTIP. There is ` limit in what we can do in terms of | :55:09. | :55:12. | |
entering into a trade arrangement before we have left the European | :55:13. | :55:17. | |
Union, but that does not me`n we can scope out negotiations and start to | :55:18. | :55:20. | |
have those discussions and hndeed we are doing so with a number of | :55:21. | :55:23. | |
countries. The prime in Mr gave quite revealing | :55:24. | :55:26. | |
statement today when she sahd she will not be seeking to replhcate any | :55:27. | :55:31. | |
parts of the Canadian Europdan Union trade deal. We know that is stalling | :55:32. | :55:40. | |
guarantees around Labour environmental and consumer | :55:41. | :55:42. | |
protection. We know what shd is ruling out. Can she tell us what | :55:43. | :55:45. | |
she's ruling in? I have to say nice try but I did not say I was ruling | :55:46. | :55:50. | |
out bits of the Canadian de`l? I said we would not be replic`ting the | :55:51. | :55:54. | |
EU Canada deal, just as we're not trying to replicate the Norway model | :55:55. | :55:59. | |
or the Switzerland model. What we are trying to do is deliver for the | :56:00. | :56:02. | |
United Kingdom the deal that is right for the UK. | :56:03. | :56:07. | |
Can I commend my right honotrable friend for the way she improved her | :56:08. | :56:15. | |
first EU summit. 61 people ,- 6 % of people in Kettering voted to leave | :56:16. | :56:20. | |
the EU say we get control over our budget, borders and trade policy. | :56:21. | :56:24. | |
Whilst there might be 500 mdmbers of this House who were remainddrs and | :56:25. | :56:34. | |
are now Remoaners, she is trying to get the best deal for this country. | :56:35. | :56:41. | |
Regardless of which side of the debate members of this Housd work on | :56:42. | :56:48. | |
prior to the 23rd of June, we should all accept the voice of the British | :56:49. | :56:55. | |
people and put that in practice I congratulate the Prime Minister of | :56:56. | :56:59. | |
her handling of her first ET summit. I won't ask if she enjoyed ht but | :57:00. | :57:03. | |
does she accept that millions of people who would have to le`ve, | :57:04. | :57:12. | |
including Labour voters, will only believe we are really believing when | :57:13. | :57:18. | |
we invoked Article 50, so whll she assure the House she will not be | :57:19. | :57:22. | |
taken in by those who want to delay in the hope that somewhere they will | :57:23. | :57:29. | |
get another referendum? There is no question of another referendum. | :57:30. | :57:35. | |
While I felt it was right wd took time to prepare prior to thd start | :57:36. | :57:38. | |
of negotiations through invoking Article 50, it is also right that | :57:39. | :57:44. | |
members of the public will want to see it invoked so they know it will | :57:45. | :57:49. | |
happen. That is why I think saying we will invoked by the end of March | :57:50. | :57:57. | |
is the right one. Thank you, Mr Speaker. The people of Somerset are | :57:58. | :58:05. | |
rejoicing at the Prime Minister s clarity in her approach to leaving | :58:06. | :58:09. | |
the EU, and should each she confirm my understanding that once we leave | :58:10. | :58:17. | |
the EU, the European Court of Justice will have no jurisdhction as | :58:18. | :58:21. | |
the final arbiter of any UK law When we leave the EU UK laws will be | :58:22. | :58:29. | |
determined here in the UK, ht will be British judges who will be | :58:30. | :58:34. | |
opining on the application of those laws and this House will determine | :58:35. | :58:38. | |
the legislation that comes to the British people. Given that our | :58:39. | :58:46. | |
European partners have not xet committed to trade negotiathons | :58:47. | :58:50. | |
alongside negotiations on Article 50, what assurances can she give | :58:51. | :58:55. | |
British business that in March 019 when leave the EU, they will not | :58:56. | :59:05. | |
face WTO rules and tariffs? We are looking to not just negotiated exit | :59:06. | :59:09. | |
from the EU but also a new relationship and it is very... Our | :59:10. | :59:18. | |
ambition in doing that is to ensure we get the best possible de`l in | :59:19. | :59:23. | |
trade with an operation within the European market. That is wh`t the | :59:24. | :59:32. | |
Government is working on. The terrible migration problem we are | :59:33. | :59:36. | |
seeing at the moment is due largely to human trafficking gangs `nd one | :59:37. | :59:41. | |
of the great legacies of thd previous Prime Minister and the | :59:42. | :59:45. | |
previous Home Secretary is we now lead the fight against human | :59:46. | :59:49. | |
trafficking, but with the Prime Minister agreed we have to build | :59:50. | :59:52. | |
relationships not just with the European Union but with all European | :59:53. | :59:57. | |
countries to deal with this evil trade? He is right and he h`s taken | :59:58. | :00:04. | |
an interest in this issue and the excellent work in relation to | :00:05. | :00:09. | |
encouraging activity that rdduce and stops human trafficking. Thdre are | :00:10. | :00:14. | |
countries like Albania wherd it s important for us to be oper`ting and | :00:15. | :00:18. | |
big government has been working with them to reduced trafficking, and it | :00:19. | :00:24. | |
is also important to work whth countries like Nigeria that are | :00:25. | :00:29. | |
often source countries for ` young woman trafficked into sexual | :00:30. | :00:33. | |
exploitation, to make sure we reduced the chances for the criminal | :00:34. | :00:37. | |
gangs to ply their trade. Ftrther to the question from the honourable | :00:38. | :00:43. | |
member for Wellingborough, the situation in Libya is becomhng | :00:44. | :00:48. | |
beyond a crisis. 150,000 people have crossed the Mediterranean, 3000 have | :00:49. | :00:55. | |
died under way. Was there any discussion about sending thd high | :00:56. | :01:00. | |
representative from the EU to Tripoli, perhaps with our Foreign | :01:01. | :01:05. | |
Secretary, to work directly with the Libyan government to deal whth human | :01:06. | :01:08. | |
traffickers but also to stop people setting off in the first pl`ce. The | :01:09. | :01:14. | |
European high representativd has made a number of visits to North | :01:15. | :01:21. | |
Africa, either source countries or transit countries for the mhgration | :01:22. | :01:26. | |
crisis. He is right, there `re many people coming across from Lhbya into | :01:27. | :01:33. | |
Italy. It was the UK that w`s instrumental in getting a UN | :01:34. | :01:37. | |
Security Council resolution to enable action of the Libyan coast, | :01:38. | :01:42. | |
and as well as rescuing thotsands of people, sadly there are still those | :01:43. | :01:48. | |
who die in the Mediterranean, but the Royal Navy has also been | :01:49. | :01:52. | |
involved in bricking up boats used by criminal gangs but this hs an | :01:53. | :01:56. | |
ongoing activity and we need to take every step to stop this trade in | :01:57. | :02:00. | |
human beings that brings so much misery. The University of Portsmouth | :02:01. | :02:08. | |
depends on the interchange of people and ideas with the EU countries and | :02:09. | :02:15. | |
countries around the world. How will the Government assure students and | :02:16. | :02:18. | |
academics that the UK acadelic sector remains open and inclusive? | :02:19. | :02:25. | |
We want to ensure that Brit`in is open to business for those sorts of | :02:26. | :02:29. | |
exchanges and this is what we have done in relation to people coming | :02:30. | :02:35. | |
from outside the EU, but we have also given some reassurance to | :02:36. | :02:39. | |
universities in relation to arrangements they are putting in | :02:40. | :02:43. | |
place with other member states prior to leaving, and we make cle`r that | :02:44. | :02:49. | |
funding arrangements when they meet our priorities will be conthnued | :02:50. | :02:55. | |
beyond the period at which we leave. May I suggest that the country | :02:56. | :03:00. | |
believe she is going to lead this country into Europe and thex do not | :03:01. | :03:04. | |
judge like when she will activate Article 50 if they know what the | :03:05. | :03:11. | |
hell that Article 50 means. Might I suggest, given that as time goes on | :03:12. | :03:16. | |
we have realised the enormity of the task, she will only invoke @rticle | :03:17. | :03:22. | |
50 if it is truly in the interests of this country by March next year? | :03:23. | :03:27. | |
I thank him for the question he has put. I would simply say, as I did in | :03:28. | :03:34. | |
response to his honourable friend earlier, but I think for thd British | :03:35. | :03:39. | |
people they want to see acthon taken to ensure we leave the EU. H believe | :03:40. | :03:45. | |
we are doing the preparatorx work and while I have not set a specific | :03:46. | :03:51. | |
date, I think invoking by the end of March is the right time lind. I too | :03:52. | :04:00. | |
rejoiced that my right honotrable friend's iron resolve that Brexit | :04:01. | :04:03. | |
means Brexit is a clear message to the British people, but I also | :04:04. | :04:09. | |
invite my right honourable friend to remind the country that while it is | :04:10. | :04:13. | |
necessary to discuss with the number of interested parties, not least the | :04:14. | :04:20. | |
devolved assemblies, that in this matter she speaks for 17 million | :04:21. | :04:24. | |
people, Nicola Sturgeon spe`ks for 1.7 million. I thank him, I think | :04:25. | :04:34. | |
the important point is that over 17 million people voted to leave the | :04:35. | :04:40. | |
EU. It was a majority vote hn the UK to leave the EU and it is the UK | :04:41. | :04:45. | |
that will negotiate our rel`tionship with the EU in future. The City of | :04:46. | :04:54. | |
London is determined to rem`in in the single market and it once a | :04:55. | :05:01. | |
bespoke arrangement to do so as far as financial services are concerned. | :05:02. | :05:04. | |
It is understood the Prime Linister has ruled this out. Will shd | :05:05. | :05:10. | |
consider a similar bespoke arrangement for the financi`l sector | :05:11. | :05:14. | |
in Edinburgh, the second largest in the UK? As I have said before, | :05:15. | :05:20. | |
people talk about being in the single market for access to the | :05:21. | :05:27. | |
single market at what matters is relationship with the EU th`t | :05:28. | :05:31. | |
enables the maximum possibility to operate within that European market | :05:32. | :05:36. | |
and we will negotiate on thd half of the financial sector across the | :05:37. | :05:42. | |
whole UK. Being in the European Union has been compared to being in | :05:43. | :05:47. | |
the back of a credit taxi hdading in the wrong direction. Does she agree | :05:48. | :05:51. | |
with me that in the event the European Union, every remain in the | :05:52. | :05:56. | |
single market we will know longer be in the taxi but tied up in the boot? | :05:57. | :06:03. | |
I think it is important that as we look to get the right heel for the | :06:04. | :06:09. | |
UK, we are negotiating a new relationship for the UK with the EU | :06:10. | :06:15. | |
and that ensures our businesses can trade and operate within thd | :06:16. | :06:19. | |
European market and also we put into place other things I believd is | :06:20. | :06:23. | |
required by the British people like control of immigration. Doesn't that | :06:24. | :06:29. | |
referendum decision deserves some respect to the public majorhty to | :06:30. | :06:41. | |
the name Boaty McBoatface that was taken? Does she realised thdre has | :06:42. | :06:49. | |
been a strong move against Brexit gets people realise that promises | :06:50. | :06:53. | |
made by the Brexiteers will not be honoured. There will be an `wful | :06:54. | :06:59. | |
result in Ireland to fixed hard borders that will not be in | :07:00. | :07:03. | |
forcible, that will be hugely expensive. She is ignoring the views | :07:04. | :07:10. | |
of the people of Scotland. Does she think Little may appear will lead to | :07:11. | :07:18. | |
the break-up of the United Kingdom? The United Kingdom voted to leave | :07:19. | :07:24. | |
the EU. This Government is putting that into practice and he and others | :07:25. | :07:28. | |
can try all they like to reverse that decision, to try to delay the | :07:29. | :07:35. | |
implications, to delay the application or weasel around the | :07:36. | :07:40. | |
decision. The British peopld spoke, this Parliament said to the British | :07:41. | :07:45. | |
people, it is your choice. They chose, we will now do it. In the UK | :07:46. | :07:53. | |
than the rest of that you combine and I have spent nine years trying | :07:54. | :08:02. | |
to negotiate an EU deal. Wh`t plans does she have to visit Indi` and an | :08:03. | :08:09. | |
agreement between us which `lmost be made in heaven? She is very | :08:10. | :08:15. | |
perceptive because I will vhsit India in early November and I'm | :08:16. | :08:21. | |
pleased to say I will be taking a trade delegation with me th`t will | :08:22. | :08:26. | |
focus on small and medium-shzed enterprises to boost the | :08:27. | :08:30. | |
relationships between smalldr and medium-sized businesses in the UK | :08:31. | :08:37. | |
with the important Indian m`rket. Russia's behaviour and Syri` has | :08:38. | :08:40. | |
been despicable but it was especially worrying to see the | :08:41. | :08:48. | |
battleship sailing through the endless channel this weekend on its | :08:49. | :08:52. | |
way to smash what is left of Aleppo into smithereens, so I am ddlighted | :08:53. | :08:57. | |
that the Prime Minister wants to have a strong position with European | :08:58. | :09:03. | |
colleagues in relation to Rtssia, but one thing we can do, whhch the | :09:04. | :09:08. | |
Americans have done, so anyone involved in the murder of Sdrgei | :09:09. | :09:13. | |
Mike Netscape or the corruption he unveiled is not welcome in this | :09:14. | :09:19. | |
country, they will not come to this country and I know she is bding | :09:20. | :09:23. | |
advised that others will end up going back to the camera position, | :09:24. | :09:29. | |
but I suggest this is something we could do with make a differdnce | :09:30. | :09:33. | |
This is an issue he has campaigned long and hard on, he asked this | :09:34. | :09:39. | |
question of David Cameron and of me as Home Secretary, he has asked this | :09:40. | :09:47. | |
previous Foreign Secretary. We have our own rules and terms of how we | :09:48. | :09:52. | |
determine who can enter the UK and he talks about the old position of | :09:53. | :09:57. | |
the UK Government and it relains our position. There is much to be said | :09:58. | :10:05. | |
for a bit of repetition, whhch is not a novel thing in the Hotse of | :10:06. | :10:11. | |
Commons. A majority of voters in South Dorset congratulates the Prime | :10:12. | :10:14. | |
Minister on her stance. Richie Gray that voters of EU countries will | :10:15. | :10:20. | |
scrutinise our politicians `s they negotiate are except and will vote | :10:21. | :10:25. | |
accordingly if they perceivd that leaders do anything to endanger jobs | :10:26. | :10:32. | |
and prosperity to endanger ,- to maintain a European project? It s | :10:33. | :10:39. | |
important that leaders of the remaining 27 think about wh`t the | :10:40. | :10:42. | |
nature of the EU going forw`rd should be, but the vote was not an | :10:43. | :10:49. | |
attempt to break up the EU. We have an interest in seeing a strong | :10:50. | :10:55. | |
European Union and we have `n interest in working with th`t, being | :10:56. | :11:01. | |
a dependable partner, but I think other EU leaders should consider the | :11:02. | :11:05. | |
message given by the British people when they voted in June. Thd head of | :11:06. | :11:14. | |
the British Bankers' Associ`tion and a former adviser to the current | :11:15. | :11:18. | |
Foreign Secretary warned th`t Britain's biggest banks are | :11:19. | :11:25. | |
preparing to relocate in early 017. Some 70,000 jobs could be at risk, | :11:26. | :11:31. | |
many of them in my constitudncy Can the Prime Minister say how the | :11:32. | :11:34. | |
Government intends to make sure the UK banking sector remains | :11:35. | :11:39. | |
passporting rights to operate anywhere else within the EU? The | :11:40. | :11:47. | |
importance that we place on being able to trade with and oper`te | :11:48. | :11:52. | |
within the European market, for both goods and services, I am aw`re of | :11:53. | :12:00. | |
the importance the financial services have two the UK, in | :12:01. | :12:07. | |
particular certain that UN says there are other parts of our | :12:08. | :12:11. | |
professional services like legal services were the ability to operate | :12:12. | :12:17. | |
in the EU is important, we `re discussions within the financial | :12:18. | :12:24. | |
sector so we can ensure as part of the negotiations we can get the best | :12:25. | :12:26. | |
deal possible. Would my right honourable friend | :12:27. | :12:34. | |
agree that in a freezer Siddy, there is no obligation on anyone to change | :12:35. | :12:38. | |
their views just because thd majority have voted otherwise. But | :12:39. | :12:42. | |
there is an obligation on all of us, including on those of us who voted | :12:43. | :12:45. | |
to remain to work in the national interest and not to undermine it by | :12:46. | :12:49. | |
tying the hands of the Primd Minister and the Government, in a | :12:50. | :12:55. | |
way you would never do in commerce or private negotiations? I speak | :12:56. | :13:03. | |
with the voice of experiencd on that matter and that is the point. If we | :13:04. | :13:06. | |
are to get the best deal possible for the United Kingdom it is | :13:07. | :13:10. | |
important we are able to enter those negotiations having not set out a | :13:11. | :13:14. | |
whole series of red lines and not set out in detail what our | :13:15. | :13:18. | |
negotiating position is. We need to negotiate the best deal possible for | :13:19. | :13:22. | |
the UK, and tying the Government's hands in doing that would bd the | :13:23. | :13:26. | |
best way of getting the worst deal for the UK. I welcome the f`ct that | :13:27. | :13:33. | |
you met the leaders of the devolved governments this morning, btt | :13:34. | :13:37. | |
uncertainty is what is really giving everyone doubt about Brexit, | :13:38. | :13:40. | |
particularly in Northern Irdland where we have one member of the | :13:41. | :13:43. | |
executive who is four in and one for out. We don't know where we are | :13:44. | :13:48. | |
going. Who do we have on thd ground in Europe making sure we ard | :13:49. | :13:51. | |
gathering the intelligence `nd advice and we are ready to fight the | :13:52. | :13:55. | |
corner to make sure we do gdt the best interests of the whole of the | :13:56. | :14:02. | |
UK together? It is important that we understand the possibilities of the | :14:03. | :14:05. | |
future relationship that we have with the European Union. Th`t is why | :14:06. | :14:09. | |
I thought it was important hn these negotiations which will be lengthy, | :14:10. | :14:13. | |
and I recognise, until we h`ve the deal agreed, of course therd will be | :14:14. | :14:18. | |
an element of uncertainty. That is why I set up a department to do the | :14:19. | :14:23. | |
work, not just of understanding what is important for us here in the UK, | :14:24. | :14:29. | |
but also for understanding what is of importance for the 27 melber | :14:30. | :14:32. | |
states of the European Union. This is not going to be a deal which is | :14:33. | :14:37. | |
just about the UK, it is about a deal which works for both shdes | :14:38. | :14:44. | |
On Syria, paragraph 50 talkdd about the credible political procdss, is | :14:45. | :14:51. | |
it in line with Geneva one `nd two of the peace process to asstre that | :14:52. | :14:53. | |
the opposition get the right insurance is for a fair deal, rather | :14:54. | :14:58. | |
than go to the talks and accept the diktats by the Russians bec`use the | :14:59. | :15:04. | |
upper hand in aggression and killing civilians on the ground? My | :15:05. | :15:07. | |
honourable friend knows we do want to see an ability to return to talks | :15:08. | :15:12. | |
which can lead to a proper political transition in Syria. The UK I think | :15:13. | :15:15. | |
has played an important rold and will continue to play an important | :15:16. | :15:19. | |
role in supporting the opposition. It was a matter of two or three | :15:20. | :15:22. | |
weeks ago when my right honourable friend hosted Syrian opposition | :15:23. | :15:28. | |
parties here in London in which they set out their future aims and future | :15:29. | :15:32. | |
revision for Syria. That was important. The Prime Ministdr has | :15:33. | :15:40. | |
said she wanted the UK to bd the most hash in it, commitment and | :15:41. | :15:44. | |
committed advocate of free trade anywhere in the world. Isn't that | :15:45. | :15:48. | |
best demonstrated by the UK remaining a member of the shngle | :15:49. | :15:54. | |
European market, that market of ?9 trillion which would protect the | :15:55. | :15:58. | |
jobs and incomes of my constituents in Wakefield, and does she `gree | :15:59. | :16:02. | |
that following the process set out by Canada, seven years to ndgotiate | :16:03. | :16:07. | |
a trade deal, only to see it fall at the 11th hour, because it w`s | :16:08. | :16:12. | |
rejected by one of Belgian's seven parliaments, is not something we | :16:13. | :16:17. | |
should aspire to. On the Canadian deal, what I would say to this House | :16:18. | :16:22. | |
is that I understand that while the discussions have stalled, there are | :16:23. | :16:25. | |
still attempts being made to ensure that that deal can go ahead, and we | :16:26. | :16:29. | |
would encourage that deal to go ahead. On the wider point that she | :16:30. | :16:33. | |
makes, and I'm sorry, but I am going to repeat what I said previously, | :16:34. | :16:38. | |
for people who put this purdly in terms of some variation of `ccess | :16:39. | :16:45. | |
market, what matters is what the trading relationship is. If we hide | :16:46. | :16:50. | |
bind ourselves by saying th`t it has to be in this particular form at | :16:51. | :16:54. | |
this stage, then it will not be open to us to negotiate the best possible | :16:55. | :17:00. | |
deal. What matters is if we have the maximum possibility to tradd with | :17:01. | :17:04. | |
and operate within the single European market, and to do that | :17:05. | :17:08. | |
across both goods and services, and that is what we are aiming for. Does | :17:09. | :17:16. | |
the Prime Minister agree th`t when negotiating for Brexit, it hs | :17:17. | :17:20. | |
important not only to negothate collectively with the member states | :17:21. | :17:24. | |
through the European Council, but equally, if not more import`nt, to | :17:25. | :17:28. | |
have conversations individu`lly with each member state, which has been | :17:29. | :17:33. | |
shown by the experience negotiation with the Canadian trade deal. That | :17:34. | :17:42. | |
is why I and other ministers are interacting with European Union in | :17:43. | :17:47. | |
its various forms but are also discussing, I have made a ntmber of | :17:48. | :17:57. | |
trips to meet with European ministers because we want a good | :17:58. | :18:00. | |
relationship with those countries by laterally as well as having a good | :18:01. | :18:05. | |
relationship with the EU -- by laterally. | :18:06. | :18:09. | |
A report highlighted that young people are more internation`list in | :18:10. | :18:12. | |
their outlook and voted overwhelmingly to remain in the EU. | :18:13. | :18:17. | |
Can I ask the Prime Minister what discussions she had with her | :18:18. | :18:21. | |
European counterparts about protecting the opportunities the EU | :18:22. | :18:24. | |
provides for young people in my constituency and across the whole | :18:25. | :18:28. | |
UK. The negotiations have not formally started with the ET but the | :18:29. | :18:33. | |
sort of deal we are talking about, the sort of deal we want to get | :18:34. | :18:36. | |
which will enhance prosperity and ensure jobs for the future will be | :18:37. | :18:40. | |
of good for all generations here in the UK. Can I ask my right | :18:41. | :18:46. | |
honourable friend if our European partners have realised the new EU UK | :18:47. | :18:53. | |
free trade agreements will be good as a positive sum game for `ll | :18:54. | :18:58. | |
concerned, given that 22 out of 27 of them have a trade surplus with | :18:59. | :19:03. | |
us? Is she detecting that common sense is finally starting to | :19:04. | :19:09. | |
prevail? I say that increashngly member states and the EU ard looking | :19:10. | :19:13. | |
at this in relation to not just what it means for the UK, but wh`t it | :19:14. | :19:17. | |
means for them as well. I h`ve said consistently this is not just about | :19:18. | :19:22. | |
the UK being a supplicant to the remaining 27, it is about | :19:23. | :19:25. | |
negotiating a relationship that works for both sides. Article 5 | :19:26. | :19:33. | |
puts any countries seeking to leave the EU at a disadvantage, in that if | :19:34. | :19:36. | |
you have not got the deal you want within two years, you can flip onto | :19:37. | :19:43. | |
trading with them on WTO terms, putting your companies and sectors | :19:44. | :19:47. | |
that huge disadvantage. With that in mind, we need to create a cdrtain | :19:48. | :19:51. | |
amount of goodwill from our European partners, and making them think that | :19:52. | :19:55. | |
European citizens living here is the cause of all our problems is not the | :19:56. | :19:59. | |
way to build goodwill. Can she therefore guaranteed to us, and | :20:00. | :20:04. | |
accept she will want to find reforms to the way immigration works, but | :20:05. | :20:08. | |
can she guarantee that her Cabinet will exercise more care in the | :20:09. | :20:11. | |
language that they use on these matters? The Government and all | :20:12. | :20:18. | |
ministers in the Government exercise every care when they use language in | :20:19. | :20:21. | |
relation to these matters and I have to say to the honourable gentleman | :20:22. | :20:26. | |
the image that he portrays of the impression we have given for EU | :20:27. | :20:30. | |
citizens is quite the wrong one I have been very clear about our | :20:31. | :20:36. | |
expectations and intentions in relation to EU citizens livhng here | :20:37. | :20:40. | |
in the UK, but he must accept, as most other members of this House, | :20:41. | :20:44. | |
that we also have a duty to British citizens living in EU member states, | :20:45. | :20:49. | |
and that is why I want to m`ke sure the status of both is guaranteed. | :20:50. | :20:55. | |
I am very pleased that my rhght honourable friend raised thd matter | :20:56. | :21:02. | |
of the crisis in Syria at the European Council. I am wonddring | :21:03. | :21:06. | |
though whether any spotlight was put on the crisis in Yemen? There, | :21:07. | :21:14. | |
approaching 7000 people havd been killed. When 7000 people were killed | :21:15. | :21:23. | |
in July 1995, at Schlupp nedds, the international community movdd into | :21:24. | :21:25. | |
high gear to sort it out -- Srebrenica. Can I ask my right | :21:26. | :21:32. | |
honourable friend whether the European Union has any plans to try | :21:33. | :21:37. | |
and expedite the appalling crisis, sort out the appalling crishs which | :21:38. | :21:42. | |
is happening in Yemen? My honourable friend is right to draw attdntion to | :21:43. | :21:46. | |
the problems that are being experienced by many people hn Yemen, | :21:47. | :21:52. | |
and what is happening in Yelen. We want to see a political solttion to | :21:53. | :21:57. | |
the Yemen, as we want to sed a political solution in relathon to | :21:58. | :22:01. | |
Syria. That is the only way to get long-lasting peace and stabhlity for | :22:02. | :22:04. | |
the country. I'm pleased to say that has been at least a temporary | :22:05. | :22:09. | |
cessation of hostilities in Yemen. I spoke at the weekend to the Crown | :22:10. | :22:15. | |
prince of Abu Dhabi, and ond of the issues I raised in that conversation | :22:16. | :22:18. | |
was the importance of sustahning the hostilities for all involved. | :22:19. | :22:25. | |
The Prime Minister has had ` lot of questions about the customs union, | :22:26. | :22:30. | |
and that is because, for exporter 's into the EU, having to comply with | :22:31. | :22:35. | |
the rules of origin from thd outside would raise costs by 25%. The Prime | :22:36. | :22:41. | |
Minister knows that Nissan hs one of those exporters. It has an dxtremely | :22:42. | :22:48. | |
important role in the north,east. When they left their meeting with | :22:49. | :22:53. | |
her, they seemed quite a lot happier and satisfied with what the Prime | :22:54. | :22:56. | |
Minister said, so could she share with the House what she said to | :22:57. | :23:01. | |
them? First of all, in relation to the issue with the customs tnion, | :23:02. | :23:05. | |
I'm sure the honourable ladx knows, as I said in answer to an e`rlier | :23:06. | :23:09. | |
question from one of her honourable friend, the customs union is a more | :23:10. | :23:17. | |
complex issue than it first seems when people describe it oftdn in | :23:18. | :23:20. | |
public. I am broke clear and we have been discussing with a numbdr of | :23:21. | :23:24. | |
countries, about the intenthon of this government, to ensure ` | :23:25. | :23:27. | |
competitive market and to ensure that people are able to be here in | :23:28. | :23:32. | |
the United Kingdom prospering here in the United Kingdom and adding to | :23:33. | :23:38. | |
our economic growth. Can I thank the Prime Minister for | :23:39. | :23:44. | |
her statement? Can I say th`t I entirely agree with her that until | :23:45. | :23:51. | |
we leave the European Union, we should continue to play our full | :23:52. | :23:55. | |
part in its affairs, not le`st because I expect the EU will want us | :23:56. | :24:01. | |
to keep paying our full contributions until we do ldave | :24:02. | :24:04. | |
Does my right honourable frhend agree that her -- does she think | :24:05. | :24:10. | |
that her fellow EU leaders understand that if we leave the EU | :24:11. | :24:16. | |
and we have to follow WTO t`riffs, according to today's report, EU | :24:17. | :24:21. | |
exporters would be liable to pay nine Ashman ?12.9 billion a year, | :24:22. | :24:26. | |
more than twice the ?5.2 billion a year that UK exporters would be | :24:27. | :24:29. | |
liable to pay, and it is thdrefore very much in the interests of the | :24:30. | :24:37. | |
rest of the EU to agree tarhff tariff free deal with ourselves My | :24:38. | :24:41. | |
honourable friend makes a vdry important point. It is not just | :24:42. | :24:45. | |
about the United Kingdom. It is about the future impact of the | :24:46. | :24:49. | |
economies of the member states of the European Union, and he hs | :24:50. | :24:53. | |
absolutely right that as we go into the negotiations, it will bd for | :24:54. | :24:56. | |
member states to recognise that there are implications for them and | :24:57. | :25:00. | |
those could be negative for their businesses and jobs in their | :25:01. | :25:03. | |
countries, and that is why ht is in the interests of all of us to get | :25:04. | :25:06. | |
the best possible deal in rdlation to trade. | :25:07. | :25:11. | |
The president of the Europe`n Council Donald Tusk recentlx issued | :25:12. | :25:14. | |
a statement in which he said there will be no soft Brexit, there is | :25:15. | :25:18. | |
either a hard Brexit or no Brexit at all. Given that the Prime Mhnister | :25:19. | :25:24. | |
was just in Brussels, did she pick up this hardening political mood | :25:25. | :25:28. | |
music which makes absolutelx clear that the idea of the unfettdred | :25:29. | :25:32. | |
access to the single market that we so desperately need is rapidly | :25:33. | :25:39. | |
becoming a pipe dream? I repeat what I said earlier that we have not | :25:40. | :25:43. | |
started negotiations, but what I found when I talked to other leaders | :25:44. | :25:46. | |
and colleagues in the Europdan Council at the end of last week was | :25:47. | :25:50. | |
a recognition that first of all this is a complex matter we have to | :25:51. | :25:54. | |
negotiate, and secondly, an increasing recognition that we have | :25:55. | :25:57. | |
to ensure the deal would get is a positive deal, both for the European | :25:58. | :26:05. | |
and the United Kingdom. I got the impression and what was being said | :26:06. | :26:08. | |
to me shows we will be able to sit down around the table and gdt the | :26:09. | :26:10. | |
best in macro best possible deal for both sides. | :26:11. | :26:16. | |
During a recent visit to Berlin there was genuine goodwill towards | :26:17. | :26:24. | |
the UK, as well as an understanding there aren't detailed negothations | :26:25. | :26:29. | |
ahead. There are shared intdrests with member states, but there are | :26:30. | :26:35. | |
also common security concerns relating to Russia as well `s | :26:36. | :26:38. | |
counterterrorism issues that will help focus the minds of EU | :26:39. | :26:43. | |
negotiators at arriving at ` positive outcome. That is an | :26:44. | :26:49. | |
excellent point, much discussion focuses on Mark Craig relathonship | :26:50. | :26:55. | |
but there are other areas where we cooperate with the EU, law | :26:56. | :27:00. | |
enforcement and security whdre we want to have a close and enduring | :27:01. | :27:12. | |
partnership once we leave. H'm sure the Prime Minister understands the | :27:13. | :27:16. | |
concerns of the British medhcal research Centre about their | :27:17. | :27:20. | |
continued access to vital Etropean medical networks after Brexht. | :27:21. | :27:26. | |
Without revealing her hand, can she give an assurance she has a plan to | :27:27. | :27:30. | |
protect access for this vit`l research? The assumption behind the | :27:31. | :27:38. | |
question that the only way to access those research networks is to being | :27:39. | :27:44. | |
a member of the EU, there are those here who are members of a ntmber of | :27:45. | :27:50. | |
research networks which operate as effectively but have nothing to do | :27:51. | :27:55. | |
with the EU, but I can assure him this is another aspect of the future | :27:56. | :27:59. | |
implications we are aware of and will consider. There is a d`ngerous | :28:00. | :28:07. | |
political crisis in the Democratic Republic of Congo, which has seen 6 | :28:08. | :28:12. | |
million people die in the p`st 0 years. There is a crisis in Burundi | :28:13. | :28:19. | |
with extrajudicial killings every week and there is a bloodbath inside | :28:20. | :28:23. | |
Suzanne. All of these are rough concerned to the EU and the UK. Were | :28:24. | :28:29. | |
any of these discussed at the subject is like the summit? No, the | :28:30. | :28:38. | |
subjects were Russia, Syria, migration and trade, so the issue of | :28:39. | :28:44. | |
Congo and South Sudan were not discussed but I am well aware of the | :28:45. | :28:48. | |
concerns he and others have about what has been happening, especially | :28:49. | :28:55. | |
recently, and this is a matter the Foreign Secretary is looking at | :28:56. | :29:00. | |
closely. Earlier the Prime Minister `ssured | :29:01. | :29:07. | |
that she was looking to raise the concerns of UK citizens livhng | :29:08. | :29:10. | |
elsewhere in the EU and EU citizens in the UK. Can she tell us hf she | :29:11. | :29:16. | |
raised those concerns at an early stage last week and if not why not? | :29:17. | :29:23. | |
I have said on a number of occasions that this is an issue I hopd to | :29:24. | :29:28. | |
address at an early stage. H repeat the comments I made earlier in | :29:29. | :29:34. | |
relation to our expectation for EU citizens, but it is for this House, | :29:35. | :29:40. | |
not simply to ignore the interests of British citizens living hn EU | :29:41. | :29:46. | |
member states. We must make sure their rights are guaranteed. I very | :29:47. | :29:54. | |
much commend my right honourable friend's statement to the House | :29:55. | :30:01. | |
Last Friday I held a public meeting for EU nationals concerned `bout the | :30:02. | :30:06. | |
Brexit vote and was heartendd by a majority seeing the opportunities of | :30:07. | :30:14. | |
the UK leaving the EU, posshbly leading to reform for their home | :30:15. | :30:19. | |
countries in future. Given the fact of one lonely and V2 on the Canada | :30:20. | :30:26. | |
EU agreements -- effective one lonely and veto. What discussion was | :30:27. | :30:38. | |
there about reform? It is up to the 27 to discuss among themselves the | :30:39. | :30:43. | |
future shape of the EU. I h`ve raised with other leaders the | :30:44. | :30:46. | |
importance I think of them paying attention to the message given by | :30:47. | :30:53. | |
the UK vote to leave the EU but I leave it to them to discuss the | :30:54. | :31:01. | |
future of the EU without thd UK Last week the Treasury commhttee | :31:02. | :31:03. | |
heard from the Chancellor and we were told the Treasury is modelling | :31:04. | :31:10. | |
the range of options presented to the Government to look at the | :31:11. | :31:15. | |
economic implications. Todax the Prime Minister confirmed shd is | :31:16. | :31:19. | |
looking at the regional imp`cts of those options. Given the colmitment | :31:20. | :31:24. | |
to a series of debates in the House of Commons, she must agree that | :31:25. | :31:28. | |
debate would be better informed if we have the evidence before us, so | :31:29. | :31:33. | |
will she commit to publish those options so this House and the public | :31:34. | :31:40. | |
can have an informed debate? We want to ensure that debates in this House | :31:41. | :31:45. | |
are as informed as possible. There is a wide variety of pieces of work | :31:46. | :31:51. | |
being undertaken, not just by government, about the implications | :31:52. | :31:59. | |
of leaving the EU. My right honourable friend was right to | :32:00. | :32:03. | |
stress that we are not leavhng Europe. Would she confirm that when | :32:04. | :32:09. | |
we leave the EU we will continue to play a full and active part in the | :32:10. | :32:14. | |
Council of Europe, working together on the basis of friendship `nd | :32:15. | :32:20. | |
cooperation, not political tnion? The UK will continue to plax its | :32:21. | :32:25. | |
role within the Council of Durope. I want us to have a good relationship | :32:26. | :32:30. | |
with member states and the DU asked itself, that is in all our | :32:31. | :32:38. | |
interests. Did the Prime Minister find time to emphasise to Etropean | :32:39. | :32:42. | |
colleagues how much we valud things like the prisoner transfer | :32:43. | :32:47. | |
agreement, Europol and the Duropean arrest warrant, and will shd agree | :32:48. | :32:53. | |
that whatever negotiating she does, nothing will water down those | :32:54. | :32:59. | |
commitments? My commitment to our relationship with other member | :33:00. | :33:02. | |
states in relation to justice and home affairs, but I have had a lot | :33:03. | :33:08. | |
of questions about the detahl of discussions I had an Brexit at the | :33:09. | :33:13. | |
European Council. The main topics we discussed were Russia, migr`tion and | :33:14. | :33:21. | |
trade. Negotiations on the detail of our negotiations will be for the | :33:22. | :33:26. | |
future. The people of Skegndss voted more than any other to leavd the EU | :33:27. | :33:33. | |
and no constituency approves more of this approach but will she `gree | :33:34. | :33:38. | |
with me that they deserved this TD triggering of Article 50, speedy | :33:39. | :33:44. | |
commencement of trade negothations and a speedy roll-out of thd | :33:45. | :33:51. | |
controlling migration fund. I note he slipped in at the end of his | :33:52. | :33:58. | |
question. I think it is right, and as I said in response to a couple of | :33:59. | :34:03. | |
questions from the opposition, it is important people see we are | :34:04. | :34:07. | |
committed to Article 50 bec`use I fear there are those who wish to | :34:08. | :34:12. | |
delay the invocation of Arthcle 50 to as a proxy for not leaving the EU | :34:13. | :34:17. | |
but it's important we give people the certainty and that is why we | :34:18. | :34:21. | |
will invoke Article 50 by the end of March. The Prime Minister s`id that | :34:22. | :34:30. | |
topic of trade discussed in the EU Council is a topic for the future, | :34:31. | :34:35. | |
but her cheese of staff seels to note that and's hand very wdll and | :34:36. | :34:41. | |
says we do not have to accept something like Chinese steel and | :34:42. | :34:45. | |
could impose retaliatory tariffs on Chinese steel, but it is thd UK | :34:46. | :34:50. | |
Government's policy to oppose these measures. Isn't it the case that the | :34:51. | :34:57. | |
British Government is tying the hands of British duo workers as we | :34:58. | :35:03. | |
speak? The Government has stpported steel production here, as hd will | :35:04. | :35:09. | |
know in terms of compensation, also in relation to the ability to take | :35:10. | :35:15. | |
social issues into concern when deciding about requirement of steel, | :35:16. | :35:22. | |
a range of measures. In rel`tion to action taken by the EU, we decided | :35:23. | :35:27. | |
last week to modernise the trade defence instruments but we will do | :35:28. | :35:31. | |
that enable balanced way, b`lancing the interests of users and | :35:32. | :35:37. | |
consumers, and the applicathon of lesser duty relief means for certain | :35:38. | :35:43. | |
parts of the UK steel industry, imports from China have dropped by | :35:44. | :35:52. | |
90%. Of all the European laws and regulations she wants to | :35:53. | :35:56. | |
democratically reincorporatd into UK law through the Great Repeal Bill, | :35:57. | :36:01. | |
which of them but she want to abolish or amend first? It will be | :36:02. | :36:10. | |
for this Parliament to decide how we deal with the regulations and laws | :36:11. | :36:14. | |
once brought into UK law, btt two points I would make, it is right to | :36:15. | :36:21. | |
bring that into UK law at the point when we leave the EU to enstre there | :36:22. | :36:27. | |
is no legal gap and everyond has certainty of the legislation they | :36:28. | :36:33. | |
will operate under, and also, once that has happened, it will be for | :36:34. | :36:37. | |
this Parliament to decide and be sovereign in determining those laws. | :36:38. | :36:45. | |
Could the Prime Minister enlighten us further discussions that on the | :36:46. | :36:50. | |
subject of higher education and are there any clues as to whethdr UK | :36:51. | :36:55. | |
universities will retain access to EU research projects after we leave, | :36:56. | :37:01. | |
and also the fee status of DU students in 2010 and beyond? We have | :37:02. | :37:07. | |
heard anecdotal evidence th`t British researchers have bedn turned | :37:08. | :37:13. | |
down for Horizon 2020 funds, and my written questions remain un`nswered. | :37:14. | :37:21. | |
She will get responses to qtestions. A concern has been raised whth me by | :37:22. | :37:26. | |
people that the risk and approach being taken in relation to | :37:27. | :37:30. | |
universities that as we havd decided to leave, we should be treated | :37:31. | :37:36. | |
differently while still in the EU. What is important is that wd | :37:37. | :37:39. | |
emphasise that while we are still members of the EU, we are treated as | :37:40. | :37:45. | |
full members and have access to the projects the honourable ladx is | :37:46. | :37:54. | |
talking about. Here's me, you saved the best for last. The | :37:55. | :38:00. | |
Secretary-General of Nato c`lled the EU an essential partner for Nato and | :38:01. | :38:05. | |
said Nato has every chance to strengthen our unity and pr`ctical | :38:06. | :38:11. | |
cooperation even further, therefore how can he newly confirmed Prince of | :38:12. | :38:18. | |
Prime Minister deliver security without even closer union whth the | :38:19. | :38:28. | |
EU is accepted by our Nato `llies? I think that quote he gave was the | :38:29. | :38:32. | |
secretary-general of Nato t`lking about the energy defence | :38:33. | :38:36. | |
arrangements in the EU, not about the UK being part of some stronger | :38:37. | :38:42. | |
defence in the EU. We will play a leading role in Nato, as we have | :38:43. | :38:48. | |
done, we will continue to h`ve a close relationship and you `nd it | :38:49. | :38:54. | |
will be in all our interests to work together for the collective defence | :38:55. | :39:00. | |
of member states and of Europe. White is the Prime Minister in a | :39:01. | :39:07. | |
position to offer specific assurances to Nissan motors but not | :39:08. | :39:12. | |
to 3.3 million EU citizen 's who make such a vital contributhon to | :39:13. | :39:19. | |
our economy? I will repeat ht again as he didn't appear to hear the | :39:20. | :39:25. | |
answer previously. I expect to be able to and I want to guarantee the | :39:26. | :39:31. | |
status of the uses and is lhving there, but the only circumstances | :39:32. | :39:35. | |
that would not be possible hf the status of criticisms, including | :39:36. | :39:41. | |
people from Scotland, was not guaranteed in return. We cannot | :39:42. | :39:52. | |
abandon British citizens. Statement, the Secretary of State for the Home | :39:53. | :39:59. | |
Department, Secretary Amber Rudd. Thank you, Mr Speaker. I wotld like | :40:00. | :40:04. | |
to make a statement on Calahs. The French government to Dave bdgan | :40:05. | :40:11. | |
clearing the migrant camp. This is in the interests of the UK `nd | :40:12. | :40:17. | |
France, the start of a necessary humanitarian operation and `n | :40:18. | :40:20. | |
important step to end the dhfficult situation. Our priorities are to | :40:21. | :40:25. | |
keep our borders secure, tackle the gangs who profit from the vtlnerable | :40:26. | :40:30. | |
and ensure those in need of protection are move to placds of | :40:31. | :40:36. | |
safety. Today's come clear hn support of these objectives. On the | :40:37. | :40:42. | |
10th of October it up out of the House after admitting my Frdnch | :40:43. | :40:46. | |
counterpart. We had discussdd the importance of keeping all children | :40:47. | :40:51. | |
safe during the clearance operation. My officials have been workhng with | :40:52. | :40:56. | |
French authorities to make sure this protection is provided and TK | :40:57. | :41:00. | |
personnel are taking an acthve role on the ground today to move all | :41:01. | :41:07. | |
children to a place of safety and they will continue to do so for as | :41:08. | :41:10. | |
long as necessary. That meeting was one of many in the past few months | :41:11. | :41:15. | |
and we have made good progrdss to speed up the process for | :41:16. | :41:18. | |
transferring children with ` close family link to the UK. More than 80 | :41:19. | :41:23. | |
children were transferred from France in the first nine months of | :41:24. | :41:27. | |
this year under the Dublin regulation that I have been pressing | :41:28. | :41:31. | |
to go further in this House will recall that on the 10th of October I | :41:32. | :41:37. | |
stated my commitment to bring to the UK as many children as posshble with | :41:38. | :41:40. | |
close family links before the closure of the camp, and I lade | :41:41. | :41:47. | |
clear my intention to transfer unaccompanied children from Calais | :41:48. | :41:51. | |
who meet the criteria of thd dubs amendment to the immigration act of | :41:52. | :41:52. | |
2016. Since my statement, working in | :41:53. | :42:01. | |
partnership with the French, we have transferred more than 200 children. | :42:02. | :42:07. | |
This includes 60 girls, manx of whom have been identified at high risk of | :42:08. | :42:12. | |
sexual exploitation. I want to make clear to the House, the Govdrnment | :42:13. | :42:16. | |
has sought every opportunitx to expedite the process to transfer | :42:17. | :42:19. | |
children to the UK. My officials were only given access to the camp | :42:20. | :42:24. | |
to interview children in thd last week, and similarly, we havd only | :42:25. | :42:27. | |
recently received agreement from the French government that we could | :42:28. | :42:33. | |
bring dubs cases to the UK. For this, we work closely with the | :42:34. | :42:37. | |
French behind-the-scenes but without their agreement it was not possible | :42:38. | :42:42. | |
to make progress on taking nonfamily cases from Calais. In the l`st seven | :42:43. | :42:47. | |
days, my officials have intdrviewed 800 children in the camp cl`iming to | :42:48. | :42:52. | |
have close family links in the UK, working closely with NGOs and | :42:53. | :42:57. | |
charities. Every child in the last week has been interviewed bx UK | :42:58. | :43:01. | |
staff. Much of this work has been carried out in difficult conditions | :43:02. | :43:05. | |
and on a number of occasions interviews have been paused and UK | :43:06. | :43:10. | |
staff have withdrawn for safety reasons. I would like to th`nk the | :43:11. | :43:17. | |
French staff and put on record the gratitude from my staff or what have | :43:18. | :43:21. | |
been pretty challenging conditions. Until a few months ago, the French | :43:22. | :43:26. | |
government requested we did not transfer children outside the Dublin | :43:27. | :43:30. | |
regulation process. This was due to their concerns it would encourage | :43:31. | :43:34. | |
more children to come to Calais That is why we focused our `greement | :43:35. | :43:40. | |
and the Dubs amendments on children from Greece and Italy. It is only | :43:41. | :43:44. | |
recently this has changed. Looking ahead, we will bring more children | :43:45. | :43:48. | |
from Calais to the UK in thd coming weeks and months. We will continue | :43:49. | :43:54. | |
to transfer unaccompanied rdfugee children from Calais and thd wider | :43:55. | :44:00. | |
criteria of the Dubs Amendmdnt. We will be following three guiding | :44:01. | :44:03. | |
principles in determining who we bring to the UK from Calais. We will | :44:04. | :44:10. | |
are ties those likely to be granted refugee status in the UK. Wd will | :44:11. | :44:15. | |
also prioritise those 12-ye`r-olds and under, and we will conshder | :44:16. | :44:19. | |
those assessed of being at high risk of sexual exploitation. In doing | :44:20. | :44:25. | |
this, we will establish whether it is in each child's best intdrests to | :44:26. | :44:29. | |
come here. But through this process, it is important that we do not | :44:30. | :44:34. | |
encourage more children to head to Calais, risking their lives in the | :44:35. | :44:38. | |
hands of traffickers. That hs why we will only consider those prdsent in | :44:39. | :44:42. | |
the camps before the start of clearance operations today. We will | :44:43. | :44:47. | |
continue to do this quickly but it is essential we carry out the proper | :44:48. | :44:51. | |
safeguarding, age assessment and security checks, working closely | :44:52. | :44:54. | |
with local authorities and social workers here in the UK, to dnsure | :44:55. | :44:58. | |
that the children are eligible and it is in their best interests to | :44:59. | :45:02. | |
come. I'm pleased to say my French counterpart has agreed to stpport | :45:03. | :45:07. | |
minors unsafe facilities in France, during the weeks we now need to | :45:08. | :45:11. | |
carry out these important checks. It is also important that on arrival in | :45:12. | :45:16. | |
the UK these identities of these Trojan are not compromised `nd they | :45:17. | :45:20. | |
are allowed to begin their life here with the support they need ,- the | :45:21. | :45:27. | |
identities of these children. As part of our commitments we have been | :45:28. | :45:31. | |
consulting with local authorities on capacity. It's clear that there is | :45:32. | :45:35. | |
the capacity to support the children we intend to take from Calahs, as | :45:36. | :45:39. | |
well as meeting our other commitments. The key now is to make | :45:40. | :45:43. | |
sure we get these places up and running as soon as possible. I would | :45:44. | :45:49. | |
like to pay tribute to the work and generosity of local authorities so | :45:50. | :45:53. | |
far, in providing both the temporary and permanent support that the | :45:54. | :45:57. | |
children arriving require. However, as more children arrive in the | :45:58. | :46:00. | |
coming weeks, we will need to identify further places, and we will | :46:01. | :46:03. | |
be working with local authorities and the coming days to ensure that | :46:04. | :46:08. | |
that happens. Whilst responsibility for Calais lies with the Frdnch | :46:09. | :46:11. | |
government, the juxtaposed controls are a vital part of the UK's border | :46:12. | :46:17. | |
security and are a vital economic link. That is why the UK Government | :46:18. | :46:21. | |
will be contributing up to ?36 million to maintain the sectrity of | :46:22. | :46:25. | |
these controls, to support the camp clearance, and is sure in the | :46:26. | :46:30. | |
long-term that the camp is kept closed. This funding will also be | :46:31. | :46:34. | |
used to help keep children safe in France. This contribution is not | :46:35. | :46:38. | |
made unconditionally, and wd will continue to work with the French | :46:39. | :46:41. | |
government, to assure that the clearance operation is full and | :46:42. | :46:46. | |
lasting. Work in Calais is important, but the situation there | :46:47. | :46:50. | |
is a symptom of a wider migration crisis. We are clear about our moral | :46:51. | :46:56. | |
responsibility to assist those who are suffering, including by | :46:57. | :47:00. | |
providing support in conflict regions, development work upstream, | :47:01. | :47:03. | |
and by providing protection for those who need it. Mr Speakdr, the | :47:04. | :47:07. | |
French authorities face a htge challenge over the coming d`ys and | :47:08. | :47:11. | |
weeks, to move people out of the camp in Calais. But let me be clear. | :47:12. | :47:17. | |
Neither government is prepared to allow people to continue to live in | :47:18. | :47:20. | |
those conditions, and neithdr government is prepared to allow | :47:21. | :47:24. | |
people smugglers to continud to profit from risking the livds of the | :47:25. | :47:29. | |
people there. We will continue to support the French government in the | :47:30. | :47:33. | |
operation and will continue with our progress in bringing those children, | :47:34. | :47:37. | |
with a right to come to the UK, as quickly and as safely as possible. | :47:38. | :47:42. | |
Clearing the camp is not just about our legal and moral obligathons It | :47:43. | :47:47. | |
is also in our national intdrest. The rise in the number of pdople has | :47:48. | :47:53. | |
led some in France to questhon the agreement. This agreement h`s | :47:54. | :47:58. | |
allowed us to better protect our borders and ensured strong trade | :47:59. | :48:02. | |
links between Britain and France. By clearing the camp, we can hdlp | :48:03. | :48:06. | |
secure the future of the juxtaposed controls, as well as playing our | :48:07. | :48:11. | |
part, to help those most in need in Calais. I commend this statdment to | :48:12. | :48:18. | |
the House. Diane Abbott. Mr Speaker, as we speak, thousands | :48:19. | :48:22. | |
of men and women are being bussed out of Calais, one more leg in a | :48:23. | :48:30. | |
desperate odyssey which has taken some of them halfway around the | :48:31. | :48:35. | |
world. It is worth noting that the situation in Calais represents | :48:36. | :48:42. | |
everything that is wrong about Europe's response to the refugee | :48:43. | :48:47. | |
crisis. There was not enough cooperation. The French clahm that | :48:48. | :48:49. | |
because the migrants said they wanted to go to the UK they were | :48:50. | :48:54. | |
somehow not their responsibhlity, while we refused for far too long to | :48:55. | :48:58. | |
go into the camp and identify those who might have a legal right to come | :48:59. | :49:05. | |
to the UK. The men, women and children in the Calais camp were | :49:06. | :49:10. | |
treated by the French and the UK like pawns, but these are rdal | :49:11. | :49:15. | |
people fleeing war and economic devastation, who were living in | :49:16. | :49:21. | |
appalling conditions, and in the absence of any proactive action by | :49:22. | :49:24. | |
the British or the French, those people were at the mercy of people | :49:25. | :49:30. | |
smugglers and criminal gangs, who were in and out of the camp, as I | :49:31. | :49:34. | |
discovered when I visited the camp in January. It was left to | :49:35. | :49:40. | |
charities, church groups and individual volunteers to go across | :49:41. | :49:45. | |
and provide basic support and services in the Calais camp. So I | :49:46. | :49:49. | |
would like to take this opportunity to pay tribute to all of those | :49:50. | :49:54. | |
selfless volunteers. I would like to thank the UK staff now workhng in | :49:55. | :49:58. | |
the camp in difficult and d`ngerous conditions and I would like to | :49:59. | :50:01. | |
congratulate the local authorities who are providing temporary and | :50:02. | :50:06. | |
permanent support. I accept that the Home Office has accelerated the | :50:07. | :50:10. | |
processing of child refugees in recent weeks, but the Home Office | :50:11. | :50:14. | |
has known for months that the camp was to close. More should h`ve been | :50:15. | :50:19. | |
done to persuade the French, either to process all the children | :50:20. | :50:23. | |
themselves, or allow thin. The truth is, we should have made it to the | :50:24. | :50:29. | |
French, that the camp should not have been demolished until we had | :50:30. | :50:33. | |
processed all the children. The media is an uproar about thd | :50:34. | :50:38. | |
supposed failings in the processing. And commentators are in a l`ther | :50:39. | :50:43. | |
about whether some of these children are 17 and a half, 18 and a half or | :50:44. | :50:49. | |
god forbid 19 and a half, as if being a year over the legal | :50:50. | :50:55. | |
definition of childhood makd you miraculously imu into illness caused | :50:56. | :50:58. | |
by freezing temperatures and raw sewage in front of your tent, fear | :50:59. | :51:03. | |
caused by violence and the deadly attentions of sex traffickers. If | :51:04. | :51:07. | |
the commentators who are now suggesting that these young people | :51:08. | :51:10. | |
should be treated like cattle and have their teeth tested had made as | :51:11. | :51:17. | |
much noise about the Governlent s slowness in processing thesd child | :51:18. | :51:20. | |
refugees in the first place, we would not be in the situation we are | :51:21. | :51:27. | |
in. We know that the last thme there was an eviction, more than 000 | :51:28. | :51:32. | |
children went missing, before that eviction, because that eviction | :51:33. | :51:37. | |
began before their safety w`s guaranteed. If children go lissing | :51:38. | :51:42. | |
this time, the fear must be they will disappear into the hands of | :51:43. | :51:45. | |
people smugglers and sex traffickers. So, can the Hole | :51:46. | :51:52. | |
Secretary give the estimated timings for the processing of what H | :51:53. | :51:57. | |
understand is the remaining 100 children left in the camp? Will she | :51:58. | :52:01. | |
noted that on this side we regret that any new children arrivhng in | :52:02. | :52:09. | |
the Calais camp will not be able to access family reunions? I al glad to | :52:10. | :52:13. | |
hear there is work being done in Greece and Italy because obviously, | :52:14. | :52:17. | |
Calais is not the only refugee camp. I have visited the camps in Lesbos | :52:18. | :52:22. | |
in Greece. I have seen the traumatised men, women and children | :52:23. | :52:26. | |
there. They had already risked their lives crossing the Mediterr`nean. | :52:27. | :52:31. | |
These children will have sedn others, perhaps family membdrs or | :52:32. | :52:35. | |
friends perish at sea. Thesd children should not feel th`t they | :52:36. | :52:39. | |
have no option but to make their way across France and attempt the | :52:40. | :52:43. | |
dangerous journey to the UK. So will the Home Secretary say more about | :52:44. | :52:48. | |
her plans to create similarly expedited family reunions and Dubs | :52:49. | :52:53. | |
transfers in countries like Greece and Italy? And how long does the | :52:54. | :52:57. | |
Home Secretary estimate that the Dublin children will be held in the | :52:58. | :53:02. | |
temporary accommodation centres in the UK, either before being reunited | :53:03. | :53:05. | |
with their families or placdd into the transfer scheme? And will there | :53:06. | :53:11. | |
be funding and support for the local authorities who are stepping up to | :53:12. | :53:17. | |
play their part in helping these traumatised child refugees? This | :53:18. | :53:26. | |
House knows that from 1999 to 2 02, there was a migrant camp ne`r Calais | :53:27. | :53:36. | |
at Sangatte. There were over 20 0 men, women and children livhng in | :53:37. | :53:40. | |
appalling conditions. That camp was closed with great fanfare 14 years | :53:41. | :53:44. | |
ago. But this new encampment that the French are attempting to close | :53:45. | :53:48. | |
had four times as many people and the conditions were even worse. The | :53:49. | :53:54. | |
French may be closing this camp now, but there is an urgent need for more | :53:55. | :54:00. | |
corporation, Europe wide on migration issues, and unless, as the | :54:01. | :54:06. | |
Home Secretary noted, we de`l with the underlying issues of poverty, | :54:07. | :54:13. | |
Civil War and ill-conceived foreign interventions, this will not be the | :54:14. | :54:19. | |
last time this House have to debate encampments of desperate people in | :54:20. | :54:23. | |
appalling conditions in Cal`is. I am glad we are moving to help the child | :54:24. | :54:29. | |
refugees. I think more could have been done earlier despite the Home | :54:30. | :54:33. | |
Secretary's attempts to hidd behind the French, but let us remelber let | :54:34. | :54:40. | |
us remember that all those people in that camp, which I have vishted are | :54:41. | :54:47. | |
human beings. We will do wh`t we can do for the children, but we need a | :54:48. | :54:51. | |
more considered and Europe wide strategy to deal with the tragedy of | :54:52. | :55:01. | |
refugees moving across Europe. Well, the right honourable lady has | :55:02. | :55:04. | |
raised some important points, and I would first of all draw her | :55:05. | :55:07. | |
attention to some of the colments the Prime Minister made abott the | :55:08. | :55:11. | |
important work the European Union is making, some of which we ard leading | :55:12. | :55:16. | |
on, an upstream funding to lake sure this terrible tragedy of refugees | :55:17. | :55:20. | |
moving, quite often from Central and East and west African countries is | :55:21. | :55:25. | |
stopped. We do that by being one of the largest donors, by workhng in | :55:26. | :55:28. | |
partnership arrangements, and I share her view, that if we can stop | :55:29. | :55:32. | |
the scale of movement, then that is dealing with the most important | :55:33. | :55:35. | |
element of why people come over to Europe and then make their way | :55:36. | :55:39. | |
across France. But I do not need reminding by the lady about the | :55:40. | :55:43. | |
scale of misery that is going on in the camp there in Calais. That is | :55:44. | :55:47. | |
why I have made it such a priority to work with my French counterpart | :55:48. | :55:51. | |
to see the end of that camp and I believe to see the end of the misery | :55:52. | :55:55. | |
that is taking place there. Protecting children has alw`ys been | :55:56. | :55:58. | |
at the forefront of what we are doing. She has referred to the scale | :55:59. | :56:03. | |
of the Dubs Amendment and what else we are doing to make sure wd take | :56:04. | :56:06. | |
children according to that, and I can tell her that we are continuing | :56:07. | :56:10. | |
to interview to make sure that over the next three weeks, she asked | :56:11. | :56:13. | |
particularly about the time frame, we continue to take several hundred | :56:14. | :56:18. | |
more children in addition to the 200 we have already taken. And xes, we | :56:19. | :56:22. | |
are continuing to work on the children who will be eligible in | :56:23. | :56:25. | |
Greece and Italy, and we will be bringing some over the from there | :56:26. | :56:30. | |
soon. In terms of funding and support for the local authorities, | :56:31. | :56:34. | |
there is a funding arrangemdnt for local authorities, for each child | :56:35. | :56:38. | |
that is put in place as thex arrive. She referred particularly to | :56:39. | :56:43. | |
Sangatte in 2002. She is right that camp was ended. There were | :56:44. | :56:47. | |
approximately 2000 people that and at that time the UK agreed to take | :56:48. | :56:51. | |
half of the adults. That is not an agreement we have put in pl`ce this | :56:52. | :56:55. | |
time. Instead we are taking some of the most vulnerable which whll be | :56:56. | :57:03. | |
largely children. But there have been lessons learned from the ending | :57:04. | :57:06. | |
of the Sangatte camp. Camps did come in place swiftly afterwards and in | :57:07. | :57:10. | |
particular the Calais camp which is several times larger than S`ngatte | :57:11. | :57:11. | |
ever was. Part of funding commitment to the | :57:12. | :57:20. | |
French is based on securing the camp as it is, ie once it has bedn | :57:21. | :57:26. | |
closed, we want to make surd we work closely with them so that no future | :57:27. | :57:30. | |
camp is erected there. If there is no camp there for people to come, it | :57:31. | :57:35. | |
will stop the dreadful pass`ge of people across France and thd | :57:36. | :57:38. | |
dreadful endeavour is that people put themselves through to throw | :57:39. | :57:42. | |
themselves on lorries, trucks, in order to get to the UK. And I | :57:43. | :57:49. | |
believe it will stop them bding easy prey to the traffickers I note she | :57:50. | :57:59. | |
and I both abhor. What succdss of the authorities had in arresting or | :58:00. | :58:02. | |
stopping the people traffickers and what more can be done to do that and | :58:03. | :58:08. | |
how can we persuade any adult from committing money and child to these | :58:09. | :58:16. | |
dreadful people? The Nation`l crime agency works closely with the French | :58:17. | :58:20. | |
border Forest and the UK border Forest and we have had succdss of | :58:21. | :58:24. | |
arresting traffickers and there is so much more that we can do. It is | :58:25. | :58:29. | |
one of the reasons why we w`nt to protect the agreement which allows | :58:30. | :58:33. | |
us to work closely together to try and intervene and stop thosd | :58:34. | :58:40. | |
traffickers plying their tr`de. Thank you, Mr Speaker. I wotld like | :58:41. | :58:44. | |
to welcome the Home Secretary statement and the news that the UK | :58:45. | :58:47. | |
has now brought unaccompanidd children to the UK both unddr the | :58:48. | :58:53. | |
Dublin regulation and the Lord dubs scheme from the cab at Calahs and | :58:54. | :58:56. | |
also welcome her confirmation we will continue do so. I would like to | :58:57. | :59:01. | |
congratulate her on the fact that she has certainly got things moving | :59:02. | :59:04. | |
in the last couple of weeks. There has been delay in the past but | :59:05. | :59:08. | |
credits are due, things are moving now. I would like to thank her for | :59:09. | :59:11. | |
keeping me informed of what she has been doing and I am very gr`teful to | :59:12. | :59:15. | |
her for a personal acknowledgement of the contribution that has been | :59:16. | :59:19. | |
made to preparations that these children's by local authorities in | :59:20. | :59:24. | |
Scotland and the Convention of Scottish local authorities. I would | :59:25. | :59:28. | |
also like to join her in th`nking the staff who were there at the | :59:29. | :59:31. | |
moment doing difficult work and I would like to add to that mx thanks | :59:32. | :59:36. | |
and the thanks of the Scotthsh National party to all the NGOs and | :59:37. | :59:40. | |
British and Irish volunteers working in that camp over the last few years | :59:41. | :59:43. | |
when there were no official staff there. Mr Speaker, and numbdr of | :59:44. | :59:50. | |
concerns do remain. There h`ve been reports today that the Calahs Police | :59:51. | :59:53. | |
Commissioner has told migrants there is not enough buses to transport | :59:54. | :59:57. | |
them to the time. This is worrying and points to a lack of adepuate | :59:58. | :00:01. | |
planning and preparation for the evacuation on the part of the | :00:02. | :00:04. | |
French. It does not bode well for those vulnerable people and children | :00:05. | :00:08. | |
in the camp who are at serious risk of getting lost in the chaos. Can I | :00:09. | :00:13. | |
pressed her to confirm what plans the UK and French governments have | :00:14. | :00:18. | |
made to ensure that these unaccompanied children don't get | :00:19. | :00:20. | |
lost in the chaos and are protected from falling prey to smuggldrs are | :00:21. | :00:23. | |
going missing, as we know h`ppened last time round? Can suppressor to | :00:24. | :00:28. | |
give an estimate of timings through the processing of the remaining | :00:29. | :00:33. | |
children left in the camp is 's and finally, Mr Speaker, moving the camp | :00:34. | :00:37. | |
doesn't remove the need for a long-term solution to the mhgrant | :00:38. | :00:40. | |
and refugee crisis. What pl`ns does the Home Secretary have to create | :00:41. | :00:47. | |
similar expedited family retnion and dubs transfers another year EU | :00:48. | :00:49. | |
countries such as Greece and Italy to stop children feeling forced to | :00:50. | :00:53. | |
make a journey across Europd to try and get to the UK? I thank the | :00:54. | :00:58. | |
honourable lady further questions and I agree that we should be | :00:59. | :01:04. | |
thanking also the NGOs and the volunteers who have been dohng great | :01:05. | :01:08. | |
work there to protect vulnerable children and actually going to be | :01:09. | :01:11. | |
integral to the closure of the camp over the few days and weeks in terms | :01:12. | :01:16. | |
of protecting the children because sometimes there is very much a lack | :01:17. | :01:21. | |
of trust between Government agencies and the refugees are asylum seekers | :01:22. | :01:25. | |
who are there. Their role is critical in order to try and reach a | :01:26. | :01:29. | |
resolution. She mentions reports from Calais, I haven't heard that | :01:30. | :01:34. | |
particular one. In this sort of environment, Dara a lot of reports | :01:35. | :01:38. | |
and counter news going around. We are very clear that we try to keep | :01:39. | :01:41. | |
everybody informed when we `re there about what's going on but I must | :01:42. | :01:45. | |
respectfully point out this is a pretty tricky situation where we are | :01:46. | :01:50. | |
dealing with a lot of volathle people in some cases. A lot of | :01:51. | :01:54. | |
misinformation and our staff are doing the best to make sure | :01:55. | :01:57. | |
everybody is kept informed. In terms of protecting children, I h`ve | :01:58. | :02:01. | |
repeatedly stated to the Frdnch that it is our priority to ensurd that | :02:02. | :02:06. | |
those children are kept safd and we have agreed to transfer all the | :02:07. | :02:12. | |
children as the camp is cle`red into a secure area. It will be lhkely | :02:13. | :02:15. | |
that wanted children are in a secure area, we should be able to dxpedite | :02:16. | :02:18. | |
our intervene process and bd able to make sure that we keep track of the | :02:19. | :02:21. | |
children that we would like to transfer to the UK. Frankly, over | :02:22. | :02:27. | |
the past few days, it has bden difficult to then find them on the | :02:28. | :02:31. | |
day in order to make sure that began on the buses. I hope with the | :02:32. | :02:35. | |
children held securely in this area of the camp but that will ilprove. | :02:36. | :02:39. | |
In terms of other transfers, there has been a lot with light and I hope | :02:40. | :02:43. | |
we can speed up other areas of the world in terms of Italy and Greece. | :02:44. | :02:51. | |
Those relatively few members of those house who have in the past | :02:52. | :02:55. | |
accommodated young asylum sdekers in their own homes are in a position to | :02:56. | :02:58. | |
be able to confirm to my right honourable friend that this is not | :02:59. | :03:03. | |
something that can be taken lightly, proper preparation needs to be made. | :03:04. | :03:07. | |
If this humanitarian exercise is not to end in tears, it is vital that | :03:08. | :03:12. | |
the Home Secretary sticks to her guns. Can she reassure us that this | :03:13. | :03:20. | |
is any -- before any child hs admitted, the family will bd | :03:21. | :03:23. | |
properly screened and in thd interest of national security, every | :03:24. | :03:28. | |
young adult committed to thd United Kingdom is screened before the late | :03:29. | :03:34. | |
into the country? I thank mx honourable friend to that qtestion | :03:35. | :03:38. | |
and I know that he has housdd asylum seekers in the past and I v`lue his | :03:39. | :03:43. | |
experience in this area and I can reassure him that we will always | :03:44. | :03:46. | |
make the correct safeguarding checks and we will always make surd that | :03:47. | :03:51. | |
the families are prepared. We will not take any risks for this country | :03:52. | :03:54. | |
either in terms of national security or on behalf of the children who are | :03:55. | :04:00. | |
moving here. Thank you, Mr Speaker. Can I also welcome the progress the | :04:01. | :04:05. | |
Home Secretary has made since her last statement and also her | :04:06. | :04:08. | |
commitment to take several hundred more child -- child refugees as well | :04:09. | :04:13. | |
and join the tributes to all those including charities and loc`l | :04:14. | :04:16. | |
councils who are making it possible for Britain to do what it h`s always | :04:17. | :04:20. | |
done and help those who are most vulnerable. She will know mx concern | :04:21. | :04:24. | |
that this is obviously started so late and therefore the risks of | :04:25. | :04:30. | |
trafficking and disappearing of the many of those who are still left, | :04:31. | :04:36. | |
can she confirm that up to 0000 children and teenagers are dxpected | :04:37. | :04:40. | |
to stay in the container calps overnight tonight and that refugees | :04:41. | :04:46. | |
have warned the are concerndd there will be no youth workers or social | :04:47. | :04:50. | |
workers staying with them, could she urgently make representations to the | :04:51. | :04:53. | |
French Government to ensure there is enough support to keep them safe and | :04:54. | :04:58. | |
particularly that there are additional arrangements for the | :04:59. | :05:01. | |
girls and young women who are there in the camp tonight? I thank the | :05:02. | :05:07. | |
right honourable lady for that question and she has done so much to | :05:08. | :05:12. | |
raise this issue. She is right to do so. I can tell her it is thd plan | :05:13. | :05:16. | |
and it's what the French have said they are doing to maintain the 000 | :05:17. | :05:21. | |
plus children and miners in the secure area as the camp. We think | :05:22. | :05:25. | |
this will help us process in order to expedite bringing some of them | :05:26. | :05:30. | |
over here over the next few weeks. We expect a three-week period but we | :05:31. | :05:34. | |
will be moving straightaway. Bill Tilden are moving today. In terms of | :05:35. | :05:38. | |
the support offered to the children there, I haven't followed up yet | :05:39. | :05:41. | |
with the French but I will lake sure I do. Colleagues will want to | :05:42. | :05:49. | |
congratulate the lady on thd home of various committee. One of the | :05:50. | :05:55. | |
classic roots of trafficking is to bring young children -- teenage | :05:56. | :06:00. | |
children, particularly young girls into this country, put them into | :06:01. | :06:05. | |
Government care and within weeks, they have disappeared back hnto | :06:06. | :06:08. | |
trafficking. Could the Home Secretary interest on this occasion | :06:09. | :06:12. | |
that every single child that is permitted to this country whll be | :06:13. | :06:17. | |
monitored and can we have a written statement each month to confirm that | :06:18. | :06:21. | |
those children are still behng looked after and have not bden | :06:22. | :06:27. | |
re-trafficked? My honourabld friend raises an important point and it's | :06:28. | :06:30. | |
an area he has done a lot of work in as well. He is absolutely rhght | :06:31. | :06:34. | |
There is always a risk to accepting these young women but it is because | :06:35. | :06:39. | |
they are at risk that we had to be so keen to prioritise them `nd of | :06:40. | :06:43. | |
the nearly 200 that we have taken over this past weekend, nearly one | :06:44. | :06:47. | |
third have been young women in order to protect them from the dangers he | :06:48. | :06:52. | |
sets out. I can reassure hil that we will be making constant safdguarding | :06:53. | :06:56. | |
checks and I will write to him more fully to set exactly what wd are | :06:57. | :07:02. | |
doing. Can I thank the Home Secretary for statement and indeed | :07:03. | :07:07. | |
for her work in recent days in trying to expedite this crisis. Just | :07:08. | :07:13. | |
you referred to some of the comments made this afternoon and this evening | :07:14. | :07:19. | |
that somehow human traffickhng is the cause and source of the crisis | :07:20. | :07:23. | |
we are talking about and to challenge that and to suggest that | :07:24. | :07:26. | |
human traffickers are wicked people who exploit a crisis on a global and | :07:27. | :07:34. | |
European one, I am trying to challenge this. Specific to Calais, | :07:35. | :07:37. | |
many of the vulnerable children brought to the UK will have family | :07:38. | :07:42. | |
somewhere even if the are ctrrently separated. The UK is the only | :07:43. | :07:47. | |
European country I understand that does not allow unaccompanied | :07:48. | :07:53. | |
children with refugee status the right to sponsor immediate family, | :07:54. | :07:56. | |
including parents, to join them Given the importance of keeping | :07:57. | :08:03. | |
families together, will she ensure that unaccompanied refugee children | :08:04. | :08:06. | |
are able to sponsor their p`rents for the purpose of refugee family | :08:07. | :08:13. | |
reunion if and when they ard found? I thank the honourable gentleman for | :08:14. | :08:16. | |
his question and he is right that traffickers are at the heart of the | :08:17. | :08:20. | |
problem, not the whole problem. He and I know as the Woolhouse does | :08:21. | :08:24. | |
there are many reasons why this takes place and it starts whth the | :08:25. | :08:27. | |
upstream problem that we ard trying to address with other countries | :08:28. | :08:32. | |
internationally about supporting African countries from wherd these | :08:33. | :08:37. | |
refugees are coming. In terls of changing to our immigration policy, | :08:38. | :08:44. | |
there are no plans to changd it I would like to give my thanks to the | :08:45. | :08:48. | |
Home Secretary for statement today and he asked in working to transfer | :08:49. | :08:53. | |
these eligible children frol Calais -- Calais to the UK, can my right | :08:54. | :08:57. | |
honourable friend confirm that this has been done through a proper and | :08:58. | :09:02. | |
process with the agreement of the French and that all of the children | :09:03. | :09:05. | |
who are coming over will undergo the appropriate security checks? She is | :09:06. | :09:13. | |
absolutely right. We are only doing this work by making initially proper | :09:14. | :09:17. | |
checks on every individual, every child or minor he was brought | :09:18. | :09:21. | |
across. We have two insure ht the safeguard an interest of thd child | :09:22. | :09:24. | |
is served first before bringing them over to the UK. The checks `re | :09:25. | :09:30. | |
always been done. Can I join with you in congratulating my honourable | :09:31. | :09:37. | |
friend on her election as chair of the home affairs committee `s she | :09:38. | :09:41. | |
will do an excellent job. Does the Home Secretary agree with md that | :09:42. | :09:44. | |
the primary responsibility for the disturbing thing is that we are | :09:45. | :09:48. | |
seeing lies with the French Government? This is France `nd I | :09:49. | :09:51. | |
don't believe that we in thhs country would have allowed the | :09:52. | :09:54. | |
development of the cab in this way. We want this to end as quickly as | :09:55. | :10:00. | |
possible but my concern in welcoming her strong commitments on child | :10:01. | :10:03. | |
protection is that the problem is going to be displaced to Holland and | :10:04. | :10:09. | |
Denmark. That is already evhdence the people traffickers are loving | :10:10. | :10:13. | |
away from Calais into other areas and can she assured the house there | :10:14. | :10:18. | |
are small ports and airports will get the security back-up th`t they | :10:19. | :10:22. | |
need in order to protect thdm from this activity? I thank the right | :10:23. | :10:28. | |
honourable gentleman for his question. He is right that this is | :10:29. | :10:33. | |
taking place in France and this is largely a problem for the French to | :10:34. | :10:37. | |
address but it is so much in the UK's interest that this is `ddressed | :10:38. | :10:41. | |
that the camp is dealt with in this way and that the agreement hs | :10:42. | :10:44. | |
maintained that we are playhng an active role. He is right to point | :10:45. | :10:49. | |
out the danger of displacemdnt and we are talking to French | :10:50. | :10:52. | |
counterparts and with our intelligence services, borddr forces | :10:53. | :10:55. | |
and police forces to make stre we keep an aye on where it might happen | :10:56. | :11:00. | |
and we will support our ports to address it. May I congratul`te the | :11:01. | :11:05. | |
Home Secretary on her department, 800 injuries have taken place so | :11:06. | :11:08. | |
swiftly in difficult circumstances. Can I ask what is being dond to | :11:09. | :11:12. | |
prioritise the most vulnerable children? He is right. We are | :11:13. | :11:17. | |
committed to prioritising the most vulnerable which is the youngest, | :11:18. | :11:22. | |
miners who are risk of sexu`l exploitation and we will always make | :11:23. | :11:26. | |
sure that we do that. We ard putting them at the front of the kex in | :11:27. | :11:29. | |
terms of interviewing MBI are the ones who are most likely to qualify | :11:30. | :11:33. | |
under the Dubs Amendment whdn it comes most clear that they `re | :11:34. | :11:38. | |
better served by being in the UK. Thank you, Mr Speaker. May H | :11:39. | :11:42. | |
associate myself with the comment of the new home affairs select | :11:43. | :11:45. | |
committee chair about the progress being made and pick up on what the | :11:46. | :11:49. | |
Home Secretary said about the reports from the camp today and the | :11:50. | :11:53. | |
chaos that we are seeing as the camp is being closed. I have det`iled | :11:54. | :11:58. | |
with me of 49 children under the age of 13 who today the voluntary | :11:59. | :12:01. | |
agencies say could not register at the warehouse. I am happy to share | :12:02. | :12:07. | |
those with the Home Secretary and her officials directly. Will she | :12:08. | :12:10. | |
give me a personal assurancd that she will investigate the fate of | :12:11. | :12:14. | |
those 49, including three under the age of 11? Was she make an `ssurance | :12:15. | :12:19. | |
that any child brought here under the legal process will not be put in | :12:20. | :12:21. | |
a Rules are surprised to hear the | :12:22. | :12:31. | |
honourable lady talk about ` detention centre. | :12:32. | :12:34. | |
We are making sure all the children who comes here are looked after in a | :12:35. | :12:39. | |
way that we as a proud uncompassionate lesion can call the | :12:40. | :12:44. | |
right way. If she has any additional information she's welcome to give it | :12:45. | :12:49. | |
to me. -- end a proud uncompassionate way. We havd 36 | :12:50. | :12:55. | |
staff on the ground to do this and they are engaged with the NGOs. | :12:56. | :13:01. | |
There is no them and others feelings in the camp and I would ask her to | :13:02. | :13:06. | |
bear that in mind, that we want to get the most vulnerable outs and the | :13:07. | :13:11. | |
children out. There is nothhng but good intentions on the side to | :13:12. | :13:16. | |
achieve that. I thank the Home Secretary for her | :13:17. | :13:21. | |
comprehensive statement. It will not have gone unnoticed from media | :13:22. | :13:26. | |
reports the number of the children coming to Europe appear to be young | :13:27. | :13:31. | |
men. Can my honourable friend confirm how many people bec`use of | :13:32. | :13:35. | |
us have rejected on the grotnds of age. -- coming here to Brit`in. He | :13:36. | :13:42. | |
is right and that has been reports about some turning out to the older | :13:43. | :13:47. | |
than 17. We carry out a Starbuck checks as possible in an environment | :13:48. | :13:55. | |
which is -- we do a thorough checks. I was asked if ousted with ts while | :13:56. | :14:01. | |
we deliver the best for the young people there -- bear with us for the | :14:02. | :14:06. | |
children who need to come hdre for safety reasons but we take `ll | :14:07. | :14:11. | |
assessments very seriously `nd will continue to prioritise the lost | :14:12. | :14:13. | |
vulnerable, which will be the youngest. | :14:14. | :14:23. | |
I am grateful for her comments about frustrating misdeeds of crilinal | :14:24. | :14:28. | |
gangs preying on vulnerable but having mentioned this placelent in | :14:29. | :14:33. | |
Belgium or in Denmark are wd not dealing with the consequencds of | :14:34. | :14:37. | |
their actions rather than frustrating them in the first place? | :14:38. | :14:43. | |
So rather than talk of the relationships between this country | :14:44. | :14:46. | |
and France can Home Secretary and get what work has gone on whth | :14:47. | :14:50. | |
Interpol across the Mediterranean to make sure people are frustr`ted from | :14:51. | :14:54. | |
sending people here in the first place rather than dealing whth the | :14:55. | :14:58. | |
consequences? The honourable gentleman is right. | :14:59. | :15:03. | |
More work must be done upstream to stop people coming here in the first | :15:04. | :15:06. | |
place and stop these scenes of people arriving and not getting into | :15:07. | :15:12. | |
the country and stop the drdadful scenes of people around me hn the | :15:13. | :15:16. | |
Mediterranean and the Prime Minister referred earlier to work we are | :15:17. | :15:22. | |
doing with the UN, with HMS enterprise there at the momdnt to | :15:23. | :15:26. | |
make sure we play our bets, our leading role in stopping thd | :15:27. | :15:29. | |
dreadful people smuggling from Libya. | :15:30. | :15:37. | |
I commend the Home Secretarx for her statement. Notwithstanding the | :15:38. | :15:42. | |
obduracy of the French, the situation has not been improved by | :15:43. | :15:46. | |
the catastrophic decision of the German Government to disreg`rd the | :15:47. | :15:51. | |
Dublin protocol in respect of processing refugees. I belidve the | :15:52. | :15:56. | |
decision to close the camp hs right because it will save lives by | :15:57. | :16:01. | |
stymieing the evil work people traffickers. Specifically, what | :16:02. | :16:04. | |
efforts are the Home Office making to assist the 10% of the calp who | :16:05. | :16:11. | |
are vulnerable women? I thank my friend for a support and | :16:12. | :16:15. | |
he is right, the ending of the camp is in the interests of everxbody in | :16:16. | :16:20. | |
this country as well as France. Only 10% of the camp is made up of women, | :16:21. | :16:25. | |
we believe, and we make surd to prioritise them because thex are the | :16:26. | :16:28. | |
most likely to be vulnerabld to sexual exploitation and currently we | :16:29. | :16:34. | |
have about one third of int`ke are women, which is a positive result, | :16:35. | :16:39. | |
compared to only 10% of the camp being young woman. | :16:40. | :16:42. | |
I was pleased to the Home Sdcretary sent a clear message regardhng the | :16:43. | :16:46. | |
recent media practice of photographic migrants coming to this | :16:47. | :16:51. | |
country through Calais, children or young adults, can she said that | :16:52. | :16:55. | |
message loud and clear that this is a reckless behaviour that ptts | :16:56. | :16:59. | |
people at risk and banshee `lso deplore media practices we see today | :17:00. | :17:03. | |
which appear to be identifyhng temporary reception centres. -- that | :17:04. | :17:10. | |
raises both security and safeguarding risks. Can she urged | :17:11. | :17:14. | |
caution and care and how thdse operators are reported? The | :17:15. | :17:18. | |
honourable lady is quite right, it is essential we maintain thd | :17:19. | :17:22. | |
anonymity of the young people over here, coming over here, and one of | :17:23. | :17:27. | |
the reasons pointed out to le is some of them, particularly xoung | :17:28. | :17:31. | |
women, are claimed by peopld smugglers to owe them money and if | :17:32. | :17:36. | |
they see the pictures they lay come after them. By keeping their faces | :17:37. | :17:40. | |
discreet and location secret we keep them safe. | :17:41. | :17:45. | |
When I raised the question of returns with... In May he told me | :17:46. | :17:54. | |
his priority was with his pdople who were taking the fight to thd Caliban | :17:55. | :17:58. | |
and only then could return to the needs of those who had given up on | :17:59. | :18:03. | |
his country and gone away. Those were hard was not will she reflect | :18:04. | :18:09. | |
on them when she attaches priority to the most vulnerable and | :18:10. | :18:14. | |
deserving? My honourable friend is right. | :18:15. | :18:18. | |
Returns are an important part of a strong immigration policy and we are | :18:19. | :18:22. | |
constantly working with othdr countries to make sure we c`n have | :18:23. | :18:26. | |
that consent in place and demonstrate how it is in both of our | :18:27. | :18:30. | |
interest to make sure that hts employees. | :18:31. | :18:37. | |
-- that is in place. Much of what the Home Secretary has said is | :18:38. | :18:41. | |
welcome but can I ask what has she instructed officials to do hf an | :18:42. | :18:45. | |
unaccompanied English-speakhng 12-year-old girl appears in Calais | :18:46. | :18:50. | |
next week, a child who best interests are clear which sdrved by | :18:51. | :18:56. | |
being resettled in the UK? Will officials be permitted to bd | :18:57. | :18:59. | |
flexible with a cup of data in such circumstances? | :19:00. | :19:07. | |
-- cut off date. I would expect her to claim asylum in France btt I hope | :19:08. | :19:13. | |
that you bed never comes to pass. -- hope that event. | :19:14. | :19:19. | |
At the home of the select committee we challenge the Calais mayor and | :19:20. | :19:25. | |
other French officials months ago to deliver plans to clear up the camp | :19:26. | :19:28. | |
and no doubt the minister c`n confirm it is not possible for the | :19:29. | :19:32. | |
British Government to do anxthing in Calais without French agreelent | :19:33. | :19:39. | |
Where we can take the reeds, is in tackling the people traffickers Can | :19:40. | :19:42. | |
my right honourable friend tell me how many criminal gangs havd been | :19:43. | :19:46. | |
stopped thanks to the work of UK security forces? | :19:47. | :19:51. | |
I thank my honourable friend and she is right. We have been urging the | :19:52. | :19:55. | |
French to take action for a while and working closely with thdm but it | :19:56. | :20:00. | |
is, in the past few weeks and days we have been able to really engage | :20:01. | :20:04. | |
and conduct these interviews and a way that is quick and effective and | :20:05. | :20:10. | |
yielded results. She is also right that allows us to make more progress | :20:11. | :20:13. | |
in terms of arresting criminal gangs. | :20:14. | :20:17. | |
The Home Secretary gave asstrances earlier about the importancd of the | :20:18. | :20:22. | |
safety of children and tracking of them in Parliament -- being | :20:23. | :20:29. | |
paramount. I have been made aware of allegations of children going | :20:30. | :20:34. | |
missing. Will she, too investigating such cases of those? Wiltshhre, she, | :20:35. | :20:41. | |
too investigating and trackhng about what happened to those people and if | :20:42. | :20:45. | |
that safety is at risk? The honourable gentleman is welcome | :20:46. | :20:50. | |
to send me information he h`s what I would say we happened situated in | :20:51. | :20:54. | |
the past few days where we have expected children to be avahlable to | :20:55. | :20:59. | |
board the bus to come to thd UK and sometimes NGOs themselves h`ve been | :21:00. | :21:02. | |
surprised that could not find the children. It is not as | :21:03. | :21:06. | |
straightforward as we wished it could be but I cope what thdse | :21:07. | :21:10. | |
changes we will have the chhldren all in one secure area it whll be | :21:11. | :21:16. | |
more straightforward to bring a child to the UK that we havd | :21:17. | :21:21. | |
committed to. Can I thank the Home Secret`ry for | :21:22. | :21:25. | |
her statement and can my right honourable friend tell the house how | :21:26. | :21:30. | |
much the Government has invdsted in reinforcing the border at C`lais? | :21:31. | :21:38. | |
The total package is ?36 million, of which 40 million is for sectrity. | :21:39. | :21:43. | |
That security being in placd in Calais is in our interest to make | :21:44. | :21:48. | |
sure we can predict tourists, truckers, the economy and going | :21:49. | :21:51. | |
about their normal course of business which I hope will be much | :21:52. | :21:59. | |
improved once the camp is cleared. Can the Home Secretary reassure us | :22:00. | :22:03. | |
local authorities will be adequately funded and see how they will be | :22:04. | :22:09. | |
compensated and more import`ntly that adequate accommodation is | :22:10. | :22:14. | |
provided for these children and not institutionalised. | :22:15. | :22:17. | |
The honourable gentleman max be aware the Dubbs Ammendment can only | :22:18. | :22:20. | |
be implemented if local authorities, for what volunteered to takd those | :22:21. | :22:27. | |
children. Subversion local authorities have come forward but we | :22:28. | :22:32. | |
will need more over -- suffhcient local authorities have come forward | :22:33. | :22:39. | |
but we need father places. ,- further places. They are aw`re of | :22:40. | :22:46. | |
the rate weepy and I hope they will consider that adequate compdnsation. | :22:47. | :22:52. | |
-- the rate we pay. I welcome comments on my right | :22:53. | :22:56. | |
honourable friend has made `bout the robustness of the checking process | :22:57. | :23:01. | |
of those eligible to be relocated to the UK because there are legitimate | :23:02. | :23:06. | |
concerns about that. One of the reception centres is in West Sussex | :23:07. | :23:12. | |
and can I have assurances the county council there will indeed gdt back | :23:13. | :23:16. | |
on going support because thdre are already pressures on their budget to | :23:17. | :23:23. | |
ensure this will not, this will be beneficial to those children and not | :23:24. | :23:26. | |
detrimental to others in thd West Sussex. | :23:27. | :23:31. | |
We are always grateful for the generous way in which local | :23:32. | :23:35. | |
authorities come forward and have positively responded to the call we | :23:36. | :23:38. | |
put out. I would particularly like to say thank you to West Sussex | :23:39. | :23:43. | |
fought the good work they h`ve been doing and hosting one of thd | :23:44. | :23:47. | |
dispersal centres and we will work closely with them to ensure that | :23:48. | :23:53. | |
good relationship continues. I have listened closely to the Home | :23:54. | :23:59. | |
Secretary and answers about safeguarding and I ask this question | :24:00. | :24:03. | |
because a social worker got in touch with me to say for the children who | :24:04. | :24:08. | |
have started to enter the country it has been a bureaucratic shalbles. | :24:09. | :24:12. | |
She said social services have been given wrong addresses, wrong, | :24:13. | :24:17. | |
contacts and I would like to ask the Home Secretary how she and her | :24:18. | :24:20. | |
department will urgently ensure the correct provisions are in place to | :24:21. | :24:25. | |
support social services to lake sure that once children are here they do | :24:26. | :24:31. | |
not fall through the cracks. I would just say to her somdtimes we | :24:32. | :24:36. | |
do not have all the information we need. One of the reasons whx the | :24:37. | :24:41. | |
full cohort of nearly 200 Dtblin children has not yet been brought | :24:42. | :24:45. | |
over this because we have not been able to establish where thehr close | :24:46. | :24:51. | |
family members are so it max be on the issue she is drawing attention | :24:52. | :24:55. | |
to the close family members who have been claimed and contacted `re not | :24:56. | :25:01. | |
longer quite as contactable once the local authority is addressing it. I | :25:02. | :25:08. | |
would say to her, this can be a complicated process, it is not | :25:09. | :25:12. | |
always the case the contacts we are given straightforward to follow up | :25:13. | :25:17. | |
on what if she wants to send me a particular example I of course we'll | :25:18. | :25:19. | |
look at that. I thank the Home Secretary `nd the | :25:20. | :25:27. | |
talk of the humanitarian opdration because when I was there in February | :25:28. | :25:31. | |
it was far from humanitarian. Can she confirm again the sheltdr will | :25:32. | :25:37. | |
be sufficient to accommodatd all child refugees if not withott the | :25:38. | :25:46. | |
French authorities accepting... Can the secretary of state trulx | :25:47. | :25:49. | |
safeguard the fact children dispersed across centres across the | :25:50. | :25:53. | |
front they will be accommod`ted and those with whom we have a ldgal duty | :25:54. | :25:55. | |
under Dubbs Ammendment? The only reassurance I can give him | :25:56. | :26:04. | |
is what I've been given by the French. We have asked them that the | :26:05. | :26:08. | |
children are kept in a secure area. It was our request that it should be | :26:09. | :26:14. | |
outside the camp, the tools to do it inside reassuring as they could keep | :26:15. | :26:19. | |
the child and secure. We ard in close contact and we have a large | :26:20. | :26:21. | |
number of Home Office representative there as well as the hundreds of | :26:22. | :26:26. | |
border for staff in the are`. We are hopeful we will be able to lake sure | :26:27. | :26:29. | |
we work closely with them to keep them safe but this is a French | :26:30. | :26:33. | |
responsibility although we `re giving them all the support we can. | :26:34. | :26:40. | |
I welcome very much what thd Home Secretary said today about children | :26:41. | :26:43. | |
but we should remind ourselves it is not only children who require | :26:44. | :26:47. | |
international protection. When I visited Calais at Easter, wd met | :26:48. | :26:52. | |
Afghans and we met Kurds who had been previously granted asylum in | :26:53. | :26:57. | |
the UK before returning homd about to flee a second time and h`d ended | :26:58. | :27:01. | |
up at Calais. While the Homd Office would get that set of keys hn terms | :27:02. | :27:07. | |
of who is appropriate for the UK to take responsibility for? In this | :27:08. | :27:12. | |
case, while the camps are bding demolished, we have made a | :27:13. | :27:15. | |
commitment to take the most vulnerable children and within that | :27:16. | :27:19. | |
cohort of children, the ones who are the youngest and the ones who are | :27:20. | :27:23. | |
vulnerable to sexual exploitation. In terms of other people who may be | :27:24. | :27:28. | |
vulnerable, there may be ond or two who qualify under the Dubs | :27:29. | :27:31. | |
Amendment, but otherwise thdy will need to apply for asylum as a normal | :27:32. | :27:35. | |
case in France. We must stick to the general accepted principle that the | :27:36. | :27:41. | |
apply for asylum in the first country of safety. A number of my | :27:42. | :27:45. | |
constituents have got in totch to express compassion for thosd in the | :27:46. | :27:49. | |
Jungle camp but a number of other people are also worried abott the | :27:50. | :27:52. | |
age of those we are being sden to take. Can the Home Secretarx talk a | :27:53. | :27:56. | |
little bit zero -- more abott the numbers we are projecting on the | :27:57. | :28:00. | |
grounds of age but the comprehensive security package around who we take | :28:01. | :28:05. | |
in the first place? I would like to reassure my honourable friend the | :28:06. | :28:10. | |
best way to assess age is bx using experienced social workers. That is | :28:11. | :28:13. | |
what we are doing in terms of assessing the age on the ground | :28:14. | :28:18. | |
Most of the young people we are talking to, children, miners, | :28:19. | :28:21. | |
whatever you call them, are teenagers. Most of them are | :28:22. | :28:28. | |
teenagers and most of them `re young boys. I still think it's thd right | :28:29. | :28:32. | |
thing to do but I would ask him to be sure his constituents th`t we | :28:33. | :28:36. | |
will always do the proper safeguarding checks to insure they | :28:37. | :28:41. | |
are indeed what they say thdy are. Can I commend the Home Secrdtary and | :28:42. | :28:45. | |
her staff are the efforts she has made in accelerating the process of | :28:46. | :28:50. | |
bringing unaccompanied minors to this country. Can I press on the | :28:51. | :28:53. | |
challenges the local authorhties are pressing? My understanding hs that | :28:54. | :28:59. | |
they... The calling the samd number of limited in time and agencies | :29:00. | :29:03. | |
Does she see a more central role for Government in coordinating the | :29:04. | :29:08. | |
availability of places in the independent sector? He raisds an | :29:09. | :29:11. | |
important point and if that were the case, that would not be a stccessful | :29:12. | :29:15. | |
outcome. A lot of the local authorities are choosing to work | :29:16. | :29:18. | |
together and we have got good examples of good practice where five | :29:19. | :29:21. | |
local authorities are getting together, not competing and making a | :29:22. | :29:27. | |
joint offer. I welcome the Home Secretary's statement. Prior to my | :29:28. | :29:31. | |
election to this place, I rdgularly defended the Home Office in many | :29:32. | :29:35. | |
immigration and asylum cases. It is widely accepted by judges and | :29:36. | :29:39. | |
practitioners that aid assessment of undocumented children is notoriously | :29:40. | :29:42. | |
difficult and not an exact science. The rise in cases in the | :29:43. | :29:45. | |
administrative Court reflect this fact. Will my right honourable | :29:46. | :29:50. | |
friend confirms that dental checks are not the appropriate method for | :29:51. | :29:55. | |
an age assessment and guidance exists in the case law and that the | :29:56. | :30:00. | |
practices of the London boroughs of Croydon which have adopted | :30:01. | :30:03. | |
throughout the country which suggest that listing to the history, | :30:04. | :30:09. | |
observers of behaviour and children getting evidence is a much better | :30:10. | :30:14. | |
indicator rather than physical maturity? I thank my honour`ble | :30:15. | :30:17. | |
friend to that question and I know she has substantial experienced in | :30:18. | :30:20. | |
this field having acted as `n immigration officer are comhng into | :30:21. | :30:24. | |
Parliament. The best way to assess age is by using experienced | :30:25. | :30:29. | |
assessors and we will continue to do that. The British dental Association | :30:30. | :30:33. | |
has said that is not the right way to go, it is not effective, | :30:34. | :30:38. | |
reliable. The best way is to use the type of assessment we are which is | :30:39. | :30:44. | |
based on experience. Wouldn't it be in the best interests of thd asylum | :30:45. | :30:49. | |
seekers and local authoritids if the asylum seekers, especially the | :30:50. | :30:54. | |
children, were located my evenly throughout the country. My local | :30:55. | :30:59. | |
authority copes with 500 each year, the constituencies of the present | :31:00. | :31:02. | |
Prime Minister, the previous Bedminster and the previous | :31:03. | :31:07. | |
Chancellor of the Exchequer take none at all. Obviously, while my | :31:08. | :31:13. | |
local authority is doing very well with this, there are strains on the | :31:14. | :31:17. | |
local services, including the schools and the health servhce. As | :31:18. | :31:24. | |
the new comers and the asyltm seekers will be especially | :31:25. | :31:29. | |
vulnerable and many of them without -- with rice health problems than it | :31:30. | :31:32. | |
can she make sure the money given to local authorities is adequate for | :31:33. | :31:35. | |
the long years for which it will be required? There is a nation`l | :31:36. | :31:40. | |
transfer scheme in order to make sure unaccompanied children are | :31:41. | :31:43. | |
fairly shared around the cotntry. We are urging local authorities to step | :31:44. | :31:47. | |
up and I can say to him that we are getting a very strong response from | :31:48. | :31:51. | |
local authorities. This has gone to the heart of people in the country | :31:52. | :31:55. | |
and local authorities who w`nt to participate and want to help and who | :31:56. | :31:58. | |
believe in this as an endeavour to try and address but we will always | :31:59. | :32:03. | |
need more I will in urge ag`in anyone who think their local | :32:04. | :32:08. | |
authorities can help to urgd them to step forward to do so. The situation | :32:09. | :32:12. | |
is fast-moving but the Home Secretary has said her officials | :32:13. | :32:14. | |
have been hard at work in the last week and have conducted 800 | :32:15. | :32:19. | |
interviews. 200 children have been admitted to the UK. For my first | :32:20. | :32:24. | |
question, how many more intdrviews on how many more applications does | :32:25. | :32:29. | |
she expect her staff to process how far through this are away and my | :32:30. | :32:33. | |
second question is, is that ratio of one acceptance to for applications a | :32:34. | :32:38. | |
ratio that we are likely to see continuing? It takes less thme to | :32:39. | :32:47. | |
ask two questions than it took a lot of people to ask one question. I say | :32:48. | :32:53. | |
to my honourable friend that is not quite how it's working out. The 200 | :32:54. | :32:58. | |
are largely made up of the Dubs Amendment children for which they | :32:59. | :33:02. | |
have a strong family tie in the UK. About one quarter are made tp of | :33:03. | :33:05. | |
dogs and the balance of the additional children that we will | :33:06. | :33:09. | |
take will be Dubs Amendment children. The 800 who have been | :33:10. | :33:13. | |
interviewed, the not coming to the UK. We are just processing their | :33:14. | :33:17. | |
claims. There will be anothdr 2 0 300 interviews and we hope to beat a | :33:18. | :33:21. | |
figure of a few hundred mord over the next two to three weeks while | :33:22. | :33:25. | |
the camp is being cleared and then we will have done our commitment to | :33:26. | :33:28. | |
the French which we hope will be approximately half the children who | :33:29. | :33:37. | |
were there. A point of order I raised with the greatest reluctance | :33:38. | :33:41. | |
but it is a matter for you Lr Speaker and a matter of somd | :33:42. | :33:46. | |
urgency. You will recall in November 20 15th the Conservative delegates | :33:47. | :33:52. | |
were queried and there was ` debate in this house when this report was | :33:53. | :33:55. | |
made about the selection of delegates. At the time, you rightly | :33:56. | :34:01. | |
said it wasn't your job to hnterfere with the decisions of partids in the | :34:02. | :34:06. | |
whose delegates they say. I believe there is a decision to be m`de a few | :34:07. | :34:11. | |
errors ago and is not only hmproper but possibly illegal. Until the | :34:12. | :34:14. | |
matter can be resolved, I h`ve to send you an e-mail and a letter | :34:15. | :34:20. | |
about what happened. I'm sure it might be a misunderstanding but can | :34:21. | :34:23. | |
I ask you in the meantime to repeat what you did with the Conservative | :34:24. | :34:28. | |
-- Conservative delegates and declined to send the chosen delegate | :34:29. | :34:32. | |
by the Labour Party to the Council of Europe into the matter h`s been | :34:33. | :34:37. | |
resolved? Can I say to the honourable gentleman, I thank him | :34:38. | :34:42. | |
for his point of order. He did come to the chair earlier and sax to me | :34:43. | :34:45. | |
about this matter and I don't dispute that one moment but I have | :34:46. | :34:48. | |
to say to him that I have not yet seen his e-mail and I think it would | :34:49. | :34:55. | |
be prudent for me to study that and to reflect carefully upon the matter | :34:56. | :35:00. | |
and to take advice before pronouncing of course I will | :35:01. | :35:02. | |
remember the sequence of evdnts to which the honourable gentlelan | :35:03. | :35:07. | |
referred if memory serves md, that is principally concerned melbers | :35:08. | :35:11. | |
from the governing party. In this instance, I think the honourable | :35:12. | :35:15. | |
gentleman is concerned about his own party's delegation. I don't | :35:16. | :35:18. | |
interfere in the choice of lembers of the delegation, that is not a | :35:19. | :35:23. | |
matter for me. I do have a responsibility to notify thd | :35:24. | :35:29. | |
Parliamentary assembly of the decision made here. Of course, I | :35:30. | :35:37. | |
wouldn't wish to do anything that was procedurally improper. H will | :35:38. | :35:41. | |
have to satisfy myself that whatever I am being asked or instructed to do | :35:42. | :35:47. | |
is procedurally proper. I whll not be sending any letter until I have | :35:48. | :35:53. | |
so satisfied myself. I hope that is helpful and admitted that dtty, I | :35:54. | :35:56. | |
will study the letter from the honourable gentleman. If thdre are | :35:57. | :36:01. | |
no further point of order, we proceed now to the main bushness, | :36:02. | :36:07. | |
the orders of the day. Health service medical supplies, sdcond | :36:08. | :36:18. | |
reading. I call the Secretary of State for Health, secretary Jeremy | :36:19. | :36:24. | |
Hunt. I beg to move that thd bill is ready second time. This is ` short | :36:25. | :36:28. | |
and focused bill which is vhtally important not only for the NHS but | :36:29. | :36:34. | |
also for patients. NHS spending on medicines is second only to staffing | :36:35. | :36:40. | |
costs. The health and social care information estimated the NHS | :36:41. | :36:50. | |
England spent over... A risd of nearly 20% since 2010. With advances | :36:51. | :36:55. | |
in science and our ageing population, these costs can only | :36:56. | :36:59. | |
continue to grow. Medicines are a vital part of patient care hn the | :37:00. | :37:03. | |
NHS, both in hospitals and community. Thanks to research and | :37:04. | :37:07. | |
development effort of the science industry which can be checkdd - | :37:08. | :37:13. | |
contributes ?56 million to the UK economy every year our understanding | :37:14. | :37:17. | |
diseases and the best way to treat them has improved dramatically over | :37:18. | :37:21. | |
the last 20 years. Who would have thought that UK work pioneering | :37:22. | :37:28. | |
superconducting magnets would result -- result in MRI scanners which | :37:29. | :37:31. | |
would save hundreds of lives each year through the early detection of | :37:32. | :37:36. | |
breast cancer or that the rdmarkable research by our national Institute | :37:37. | :37:39. | |
for health research into translational medicine would lead to | :37:40. | :37:43. | |
scientific breakthroughs in areas such as gene therapy being taken | :37:44. | :37:46. | |
from the lab to the clinic? Any six-year period, this has ldd to | :37:47. | :37:54. | |
340... Generating ?380 millhon. This Government is committed to dnsuring | :37:55. | :38:00. | |
that patients get access to innovative and cost effective | :38:01. | :38:02. | |
medicines as quickly as possible. I want to pay tribute to the work | :38:03. | :38:06. | |
carried out by my honourabld friend, the member from Norfolk, who worked | :38:07. | :38:11. | |
tirelessly to promote this hndustry and to established the access review | :38:12. | :38:17. | |
to provide clear recommendations on how the Government, NHS and industry | :38:18. | :38:21. | |
can work together to ensure patients benefit from transformative new | :38:22. | :38:25. | |
products much more quickly. That review was published today `nd is an | :38:26. | :38:29. | |
excellent document which ch`llenges everyone in the medicine system to | :38:30. | :38:34. | |
up their game. Eric mission is to continue our progress in ensuring | :38:35. | :38:41. | |
patients get rapid... Howevdr, we also need to ensure we are getting | :38:42. | :38:46. | |
the best value for the NHS which is why we bought this -- brought this | :38:47. | :38:49. | |
bill before the house. The purpose of the bill is to clarify modernise | :38:50. | :38:55. | |
provisions to control the cost of health. These provisions will align | :38:56. | :39:06. | |
its statutory and cost control mechanisms currently in existence, | :39:07. | :39:09. | |
although the Government to control the cost of excessively priced on | :39:10. | :39:13. | |
branded generic medicines and ensure we have compared the data whth which | :39:14. | :39:18. | |
to reimburse people who dispense medicines. Taken together, they will | :39:19. | :39:22. | |
enable us to secure better value for money for the NHS and its spend on | :39:23. | :39:31. | |
medicines. I congratulate hhm on this effort. I received a written | :39:32. | :39:37. | |
answer that last year GPs spent ?85 million prescribing paracet`mol 500 | :39:38. | :39:43. | |
million grams of personal costs ?19 and asked. I just wonder whdther | :39:44. | :39:46. | |
this bill will enable us to look at those sort of costs and whether that | :39:47. | :39:52. | |
is appropriate? I am very grateful to him of reading that issud because | :39:53. | :39:56. | |
what he is doing, although the measures that he's actually talking | :39:57. | :39:59. | |
about are not directly covered in this bill, he's reminding md how is | :40:00. | :40:03. | |
that the business of getting value for money from our drugs business is | :40:04. | :40:08. | |
everyone's business throughout the NHS. We do know that there hs a huge | :40:09. | :40:13. | |
amount of prescribing of medicines which isn't strictly necess`ry and | :40:14. | :40:17. | |
we had further evidence frol the Cabinet of Royal colleges this | :40:18. | :40:23. | |
morning about that. He makes an extremely important point. This bill | :40:24. | :40:27. | |
is part of the effort to get better value for money from our budget The | :40:28. | :40:33. | |
initiative he talks about are equally important. Further to that | :40:34. | :40:39. | |
question, I can see how the bill will deal with the issue of the | :40:40. | :40:44. | |
branding and that's very welcome but I understand there are thred other | :40:45. | :40:48. | |
areas of concern. The questhon of price delay which I think the | :40:49. | :40:53. | |
competition in markets authority have been looking at and thdn | :40:54. | :40:58. | |
there's this problem of so-called loyalty schemes, all of which are | :40:59. | :41:03. | |
used to artificially inflatd the cost of medicines to the NHS. Will | :41:04. | :41:06. | |
we also deal with those are`s? It will deal with some of the | :41:07. | :41:15. | |
concerns of the honourable gentleman and we will listen to all concerns | :41:16. | :41:20. | |
are raised by members during the progress of the Bill but thd | :41:21. | :41:27. | |
particular issue he raises with Competition and Markets Authority | :41:28. | :41:31. | |
are already doing an investhgation as to the behaviour of | :41:32. | :41:36. | |
pharmaceutical companies in certain situations but what has become clear | :41:37. | :41:42. | |
is that there is a particul`rly unethical and unacceptable practice | :41:43. | :41:47. | |
with respect to drugs companies getting control of generic drugs in | :41:48. | :41:54. | |
which they and a monopoly and raising the prices. There w`s one | :41:55. | :42:01. | |
product whose price increasd 12 000% between two and -- 2008 and 201 and | :42:02. | :42:06. | |
if the price had stayed unchanged the NHS would have spent ?58 million | :42:07. | :42:13. | |
less and the Government's concluded the simplest and quickest w`y to | :42:14. | :42:17. | |
sort this is through legisl`tion. I will happily take as other hssues he | :42:18. | :42:22. | |
raised and look into them. I will happily give way. I welcome | :42:23. | :42:29. | |
the provisions of this bill in terms of closing loopholes and de`ling | :42:30. | :42:33. | |
with these terrible examples were the NHS is essentially being | :42:34. | :42:38. | |
exploited. Could he point to the future with the suggestion that the | :42:39. | :42:44. | |
drugs bill will increase to 20 billion by 2020, a much mord | :42:45. | :42:47. | |
significant increase than projected can afford. What better measures | :42:48. | :42:53. | |
must take place for us to substantively deal with this bigger | :42:54. | :42:56. | |
problem? She is right. We see demand for | :42:57. | :43:06. | |
services including treatments and drugs and that will increasd by a | :43:07. | :43:10. | |
total of around 30 billion over the next five-year period which is a | :43:11. | :43:14. | |
huge amount and more than wd can afford as a country without changing | :43:15. | :43:19. | |
practice and that is why ard implementing a very challenging | :43:20. | :43:23. | |
series of efficiency reforms designed to make sure we can afford | :43:24. | :43:29. | |
to continue current levels of NHS service on its ?10 billion hncrease | :43:30. | :43:32. | |
the Government is putting an end. Part of that is managers like those | :43:33. | :43:38. | |
in this bill to control the drugs bill. -- part of that is me`sures | :43:39. | :43:44. | |
like this. With them that the next 25 years what we are seeing is a | :43:45. | :43:48. | |
bigger issue of the pace of innovation in science acceldrating | :43:49. | :43:54. | |
and that provides great opportunities for the NHS btt | :43:55. | :43:57. | |
potentially great pressures on the budget and we will continue to | :43:58. | :44:01. | |
discuss those issues extenshvely in this house. I will happily give way. | :44:02. | :44:09. | |
What assessment has been made of the impact this bill might have on the | :44:10. | :44:13. | |
parallel trade and pharmacetticals which he will now has both costs and | :44:14. | :44:17. | |
benefits for the NHS and for patient care? | :44:18. | :44:23. | |
I think my honourable friend who obviously knows about these matters | :44:24. | :44:29. | |
in a great deal of detail, should be reassured this bill will stop people | :44:30. | :44:38. | |
who are part of a voluntary scheme parallel importing through Duropean | :44:39. | :44:42. | |
subsidiaries which currentlx under the single market rules we `re not | :44:43. | :44:46. | |
able to stop. That football will be closed. The first element of the | :44:47. | :44:55. | |
bill. -- that loophole. The first element relates to court br`nded | :44:56. | :44:59. | |
medicines. We have had both stature and voluntary with the | :45:00. | :45:03. | |
pharmaceutical companies to limit the cost. Companies can join either | :45:04. | :45:11. | |
scheme. Each voluntary schele lasts around five years before a new | :45:12. | :45:15. | |
scheme is negotiated, the ctrrent voluntary scheme is the 2014 | :45:16. | :45:19. | |
pharmaceutical price regulation scheme will stop the objecthves of | :45:20. | :45:25. | |
that agreement include keephng the branded health service medicine bill | :45:26. | :45:29. | |
with an affordable limits while supporting the availability of | :45:30. | :45:34. | |
innovative medicines. For industry this provides companies with the | :45:35. | :45:40. | |
certainty and backing to flourish in the UK and abroad. I will ghve way | :45:41. | :45:46. | |
in the second. The current PPRS operates by requiring participating | :45:47. | :45:50. | |
companies to make a payment to the Department of Health of a pdrcentage | :45:51. | :45:54. | |
of the NHS still be the new web portal sales exceed a certahn amount | :45:55. | :46:00. | |
and that has resulted in 1.2 four billion and payments, all of which | :46:01. | :46:03. | |
has been reinvested for the benefit of patients. | :46:04. | :46:10. | |
The early part of the bill `ppears incredibly torturous becausd it is | :46:11. | :46:13. | |
whether something is under the violent bully a statutory scheme and | :46:14. | :46:21. | |
switching back and forth. -, seems is that because the scheme runs | :46:22. | :46:25. | |
until 2019 and the Government would intent not to renew the schdme then? | :46:26. | :46:30. | |
If the Government looks to consider renewal then why are we havhng these | :46:31. | :46:35. | |
two parallel scheme to complicate the situation? | :46:36. | :46:40. | |
I think the honourable gentleman makes an important point and it will | :46:41. | :46:44. | |
be for this house and the Government to reflect on prior to 2019 whether | :46:45. | :46:51. | |
it is worth carrying on with two separate schemes. This has been the | :46:52. | :46:55. | |
arrangement -- arrangement for many years and essential that wh`t has | :46:56. | :47:00. | |
happened over successive PPRS voluntary agreements is the | :47:01. | :47:05. | |
agreement has, the vast majority of NHS sales and the statutory scheme | :47:06. | :47:10. | |
has been a back-up for people who do not want to participate in the | :47:11. | :47:12. | |
voluntary scheme but what wd have seen recently is an elegant of | :47:13. | :47:16. | |
gaming the system whereby more and more people move away from the | :47:17. | :47:21. | |
voluntary scheme so what thhs bill is doing is removing the incentives | :47:22. | :47:28. | |
for people to switch between one scheme and the other and making the | :47:29. | :47:32. | |
benefits to the NHS essenti`lly the same whichever scheme peopld choose. | :47:33. | :47:39. | |
It will be for this house to reflect and the Government to consider if | :47:40. | :47:43. | |
that dual structure is right. I will happily give way. | :47:44. | :47:49. | |
He tells us the 1.24 billion has come in after the rebate and many | :47:50. | :47:52. | |
are puzzled as to where that has been. Good the Secretary of State | :47:53. | :48:00. | |
tell us? -- could he tell us? It comes back to the Department of | :48:01. | :48:05. | |
Health and is invested throtgh that in the NHS. It would be wonderful if | :48:06. | :48:10. | |
it was more than 1.24 billion because there is a lot of nded in | :48:11. | :48:14. | |
the NHS right now but it is much needed funds but our concern is | :48:15. | :48:21. | |
companies have been exploithng the fact there are differences between | :48:22. | :48:24. | |
the voluntary and statutory schemes and indeed is exploiting a perpetual | :48:25. | :48:32. | |
loop all this bill seeks to close, which is if they have drugs in both | :48:33. | :48:38. | |
schemes we are unable to regulate at all the prices of schemes, of the | :48:39. | :48:42. | |
drugs that would ordinarily fall under the statutory scheme `nd that | :48:43. | :48:46. | |
is why this bill is so important. I will give way. | :48:47. | :48:51. | |
Notwithstanding the object of the bill which I can see are adlirable | :48:52. | :48:56. | |
can he accept hundreds of mhllions of pounds could be saved on the | :48:57. | :49:01. | |
drugs budget if that was better analysis of prescription patterns. I | :49:02. | :49:04. | |
pulled before the apartment analytical pharmacist to look at the | :49:05. | :49:11. | |
balance between efficiency `nd cost and increase the use of bio some of | :49:12. | :49:16. | |
us were hundreds of millions could be saved, perhaps some of that .24 | :49:17. | :49:21. | |
billion could be invested in that gritter analysis. Indeed. I think | :49:22. | :49:26. | |
honourable gentleman makes `n important point -- in that gritter | :49:27. | :49:31. | |
and I was. The third part of this bill will mean we have greater data | :49:32. | :49:35. | |
collection to allow those analytics to take place but we also sdek to | :49:36. | :49:39. | |
break down barriers between the pharmacy sector and general practice | :49:40. | :49:45. | |
so we built finance 2000 ph`rmacists additionally to work in gendral | :49:46. | :49:49. | |
practice so we can learn ex`ctly the lessons he talks about. Indded, then | :49:50. | :49:56. | |
I will make some progress. Further to that point about bio some | :49:57. | :50:00. | |
others and welcoming this legislation and the opportunity to | :50:01. | :50:07. | |
create savings -- bio simil`r. Would you use it as an opportunitx to | :50:08. | :50:12. | |
address the issues alone is... He will know the member for Mid Norfolk | :50:13. | :50:18. | |
has already updated the house to set out there are barriers and both | :50:19. | :50:21. | |
domestic and European legislation that prevents the use of thhs drug | :50:22. | :50:29. | |
because it is not licensed but the scale of savings could be so vast I | :50:30. | :50:33. | |
feel there is a case for introducing measures in this bill to allow this | :50:34. | :50:37. | |
issue to be addressed. I am happy to look into that, I | :50:38. | :50:44. | |
believe my own constituents have been affected by that very hssue. I | :50:45. | :50:50. | |
am not aware currently therd would be in the bill for putting hnto that | :50:51. | :50:55. | |
important point but this is a moment when we should reflect on whether we | :50:56. | :50:58. | |
can do everything possible to deal with some of the anomalies hn the | :50:59. | :51:04. | |
drug licensing regime but whth two these unintended consequencds she | :51:05. | :51:11. | |
mentions. -- that lead to the unintended consequences. For those | :51:12. | :51:15. | |
not in the PPRS we have a statutory scheme based boycott the list price | :51:16. | :51:19. | |
of products rather than a p`yment mechanism on company sales. Since | :51:20. | :51:23. | |
the introduction of the reb`te mechanism and the second back the | :51:24. | :51:27. | |
volume of drugs going through it has been lower estimated and thd | :51:28. | :51:31. | |
statutory scheme has delivered more savings than projected and the | :51:32. | :51:36. | |
inequity between the two has led to some companies by vesting product | :51:37. | :51:41. | |
from the PPRS into the statttory scheme, further reducing savings for | :51:42. | :51:48. | |
the NHS. We consulted on iddas to reform the statutory scheme to | :51:49. | :51:50. | |
introduce a payment mechanism similar to that currently placed in | :51:51. | :51:57. | |
the PPRS. Our intentions were to put in place both voluntary and | :51:58. | :52:01. | |
statutory scheme broadly colparable in the savings achieved and | :52:02. | :52:05. | |
companies have the freedom to decide which one to join a move from one to | :52:06. | :52:09. | |
the other depending on the other benefits they offer but it hs our | :52:10. | :52:13. | |
position the savings to the NHS of heart by both schemes should be | :52:14. | :52:20. | |
broadly similar. In responsd to the consultation while NHS respondents | :52:21. | :52:24. | |
supported this the pharmacettical industry queried if the Govdrnment | :52:25. | :52:28. | |
have powers to introduce thd statutory payment system so | :52:29. | :52:32. | |
following a legislative revhew an amendment should be made to clarify | :52:33. | :52:36. | |
existing powers to make cle`r the Government does have the power to | :52:37. | :52:40. | |
introduce a payment mechanism in the statutory scheme. The bill does this | :52:41. | :52:44. | |
by clarifying existing provhsions in the NHS act 2006 to put beyond doubt | :52:45. | :52:50. | |
we can introduce a payment lechanism in statutory scheme. Also alends the | :52:51. | :52:55. | |
NHS act 2006 so it contains essential provisions for enforcement | :52:56. | :53:00. | |
action, payment due under ehther a future voluntary scheme will be | :53:01. | :53:04. | |
recoverable through the courts if necessary and this would include | :53:05. | :53:07. | |
power to recover payments dte from any company that leaves one scheme | :53:08. | :53:12. | |
to join the other. The powers to control the cost of medicind | :53:13. | :53:15. | |
proposed in this bill adding modest addition to the powers alre`dy | :53:16. | :53:20. | |
provided for in the 2006 act to control the price of profit | :53:21. | :53:23. | |
associated with medicines used by the health service. However, they | :53:24. | :53:27. | |
are necessary to ensure the Government have the scope and | :53:28. | :53:31. | |
flexibility to respond to changes in the commercial environment. The | :53:32. | :53:34. | |
intended application of the powers will be set out in regulations and I | :53:35. | :53:38. | |
can assure the house we will provide a list of the regulations to | :53:39. | :53:42. | |
reassure the house we will be fair and proportionate in exercising the | :53:43. | :53:48. | |
powers. I am happy to give way. I voted for the build ten ydars ago | :53:49. | :53:54. | |
but I have to say to the Secretary of State, particularly for ` | :53:55. | :53:56. | |
Conservative Government, proper controls is pretty Draconian and | :53:57. | :54:02. | |
this -- proper controls and less Government appears to be extending | :54:03. | :54:08. | |
buzz whereas historically the way we have dealt with this is through | :54:09. | :54:13. | |
taxation, such as the windf`ll tax on backpacks and so on. But the | :54:14. | :54:19. | |
Secretary of State is now proposing something which would be loved by | :54:20. | :54:23. | |
the Leader of the Opposition, to extend profit controls to a big part | :54:24. | :54:30. | |
of the economy. Two is soci`list like me it seems a bit | :54:31. | :54:37. | |
counterintuitive for a Consdrvative to do this. A rock march into the | :54:38. | :54:44. | |
centre ground continues. -- a rock march into the centre ground. Can I | :54:45. | :54:48. | |
reassure the honourable gentleman for his interesting points but we | :54:49. | :54:53. | |
will be very fair and proportionate in our approach. It is not `bout | :54:54. | :54:58. | |
bringing in widespread profht controls and it is important to see | :54:59. | :55:01. | |
we recognise the incredibly important role of the pharm`ceutical | :55:02. | :55:08. | |
industry in medical advance and we want Britain to be the European | :55:09. | :55:14. | |
Central of operations post-Brexit and many people in this house have | :55:15. | :55:18. | |
campaigned on an issue of ddmentia and we are hopeful of a curd, | :55:19. | :55:23. | |
possible in this country. Wd recognise profits are what defines | :55:24. | :55:30. | |
the research to make these remarkable change is possible. I | :55:31. | :55:36. | |
will conclude this point. However, it is important for us to bd able to | :55:37. | :55:41. | |
see what profits are being generated by the company's choice as to | :55:42. | :55:49. | |
whether they use the PPRS scheme of the statutory scheme, as a clue as | :55:50. | :55:54. | |
to whether they are being f`ir in their approach with respect to the | :55:55. | :55:59. | |
NHS and that is why the measures in this bill strike the right balance. | :56:00. | :56:05. | |
I hope there is a reassuring underside of the house is not rather | :56:06. | :56:14. | |
than does the other side. Would he take this opportunity to st`te even | :56:15. | :56:21. | |
further the great contributhon the pharmaceutical industry makds not | :56:22. | :56:24. | |
just in this country that as a global player and as he rightly says | :56:25. | :56:28. | |
that the profit motive -- motive is an important part in ensuring the | :56:29. | :56:33. | |
competition will also mean that we can have this sort of reforls and | :56:34. | :56:37. | |
the sort of new drugs that will transform the lives of us btt also | :56:38. | :56:40. | |
future generations in the ydars to come? I am very happy to give that | :56:41. | :56:47. | |
reassurance. As I said earlher, this is an industry that contribttes ?56 | :56:48. | :56:51. | |
billion to the UK economy, tens of thousands of jobs. When the Prime | :56:52. | :56:57. | |
Minister is talking about where she she sees our competitive advantage, | :56:58. | :57:02. | |
she talks about financial sdrvices and the very next industry she talks | :57:03. | :57:06. | |
about is the sciences industry. I completely agree with my honourable | :57:07. | :57:10. | |
friend about its incredible importance, not just to this country | :57:11. | :57:13. | |
but to the future of humanity. That is why I am sitting in this Bill to | :57:14. | :57:19. | |
establish a fair relationshhp between the NHS, which we h`d to | :57:20. | :57:24. | |
represent as we are finding it to the tax system and the | :57:25. | :57:27. | |
pharmaceutical industry, I think it is also fair to say that thdre have | :57:28. | :57:32. | |
been times when some practices by some pharmaceutical companids have | :57:33. | :57:36. | |
been disappointing and is bdcause we want to make sure that doesn't | :57:37. | :57:40. | |
happen and that we can conthnue with harmonious relationships th`t we are | :57:41. | :57:45. | |
proposing this bill to the house. I will give way and then I will make a | :57:46. | :57:50. | |
little bit of progress. I thank the Secretary of State for giving way, | :57:51. | :57:53. | |
he has been very generous whth his time. This isn't about profhts | :57:54. | :57:57. | |
control, it's about having ` fair return for investment. This is about | :57:58. | :58:01. | |
a business model that is emdrging that could be seen as profiteering. | :58:02. | :58:07. | |
Yes, he's right. Effectivelx, denies with betting is that we are closing | :58:08. | :58:12. | |
a loophole. If one was being less polite, one might say there is a | :58:13. | :58:16. | |
shame having to do that. I think it is nonetheless important to do what | :58:17. | :58:21. | |
we are proposing to the house. We do recognise that has been somdtime | :58:22. | :58:25. | |
since consulted on the options and I would like to reassure honotrable | :58:26. | :58:29. | |
members and those companies in the statue test team that we will | :58:30. | :58:35. | |
confirm the implementation of a mechanism... We estimate th`t 1 | :58:36. | :58:43. | |
companies would be affected by the instruction of the payment lechanism | :58:44. | :58:48. | |
with a companies who are melbers of the PPR is not affected. Our | :58:49. | :58:51. | |
proposals would save the he`lth service across the UK an estimated | :58:52. | :58:57. | |
?90 million a year. I now ttrn to the second key element of this bill | :58:58. | :59:03. | |
which amends the NHS 2006 to strengthen the Government's power to | :59:04. | :59:06. | |
set prices of medicines where companies charge unreasonably high | :59:07. | :59:10. | |
prices for unbranded generic medicines. We rely on competition in | :59:11. | :59:14. | |
the market to keep the prizd of these drugs down. This generally | :59:15. | :59:22. | |
works well and has in combination of lead to significant savings. We are | :59:23. | :59:25. | |
aware in some instances where there is no competition to keep rhses down | :59:26. | :59:29. | |
and companies have raised their prices to what looks like an | :59:30. | :59:31. | |
unreasonable and unjustifiable level. As highlighted by thd Times | :59:32. | :59:36. | |
investigation earlier this xear there are companies who appdar to | :59:37. | :59:40. | |
have made it in their busindss model to purchase medicines for which | :59:41. | :59:45. | |
there are no competitive products. They then exploit a monopolx | :59:46. | :59:50. | |
position to raise prices. Wd cannot allow this practice to conthnue | :59:51. | :59:53. | |
unchallenged. My department has been working closely with the colpetition | :59:54. | :59:58. | |
markets authority to alert them to any cases where there may bd market | :59:59. | :00:02. | |
abuse and provide evidence to support this. We also need to tackle | :00:03. | :00:06. | |
this with an error-free micro-and the costs of medicines and close the | :00:07. | :00:12. | |
loophole of the branding medicines. While the Government's existing | :00:13. | :00:16. | |
powers allow to control the price of any health service medicine, the | :00:17. | :00:18. | |
current terrorist to not allow controls to be placed on unbranded | :00:19. | :00:22. | |
generic medicines where companies are members of the voluntarx PPI ice | :00:23. | :00:28. | |
cream. Most companies have ` mixed portfolio of branded and unbranded | :00:29. | :00:36. | |
generic medicines. For this reason, they are able to use the pe`k PRS | :00:37. | :00:41. | |
membership to avoid Governmdnt control of their prices. It should | :00:42. | :00:45. | |
be said this practice is not widespread. However, there `ppears | :00:46. | :00:49. | |
to be a handful of companies who are exploiting our freedom of pricing | :00:50. | :00:52. | |
for unbranded generic medichnes where there is no competition in the | :00:53. | :00:56. | |
market, leading NHS no choice but to purchase the medicine at grossly | :00:57. | :00:59. | |
inflated prices or to transfer patients to other medicines which | :01:00. | :01:06. | |
are not always suitable. Many in the industry would also like to see this | :01:07. | :01:09. | |
inappropriate behaviour stalped out. I give way to my right honotrable | :01:10. | :01:14. | |
friend. I very much agree whth the point is just made. He talks about | :01:15. | :01:17. | |
collaboration with the compdtition markets authority and can hd give | :01:18. | :01:21. | |
any indication as to whether he expects any action to be taken in | :01:22. | :01:25. | |
terms of abuse in the marketplace, given that there is a small memory | :01:26. | :01:27. | |
of companies who have behavdd appallingly? I can't give you that | :01:28. | :01:35. | |
indication as he will know that they operate completely independdntly. I | :01:36. | :01:39. | |
don't know what their findings are going to be. I would support any | :01:40. | :01:44. | |
action that the recommended. I do think this bill can be therd's some | :01:45. | :01:48. | |
security in the house that hf they are unable to find evidence and in | :01:49. | :01:52. | |
specific cases that they got in front of them, we will be able to | :01:53. | :01:56. | |
take action as the Government providing the house is willhng to | :01:57. | :02:01. | |
support this bill. My right honourable friend. | :02:02. | :02:11. | |
How does it compare to thosd in other health services by other | :02:12. | :02:17. | |
health providers in western European countries? We have made somd | :02:18. | :02:27. | |
assessment of those. Essenthally, our concern is that even without | :02:28. | :02:34. | |
comparison to what's happenhng in other countries, this is | :02:35. | :02:39. | |
unreasonable behaviour. I mdntioned one example to the honourable | :02:40. | :02:41. | |
gentleman other side of the house earlier, there is another one I can | :02:42. | :02:46. | |
give him which is that the price has increased between 2011 and 2016 by | :02:47. | :02:53. | |
3000 600%. I just don't think we can justify that. Given that we want to | :02:54. | :02:58. | |
have strong harmonious positive relationships between the NHS and | :02:59. | :03:01. | |
pharmaceutical industry, we just need to eliminate the possibility of | :03:02. | :03:05. | |
that kind of behaviour happdning going forward. This bill amdnds the | :03:06. | :03:10. | |
NHS act 2006 to allow the Government to control the prices of thdse | :03:11. | :03:12. | |
medicines even when the manufacturers members part of this | :03:13. | :03:21. | |
voluntary scheme. We only whll use this power when charging at an | :03:22. | :03:26. | |
unreasonably high price. Thd representative body are also keen to | :03:27. | :03:31. | |
look at how we exercise this power. I now turn to the final elelent of | :03:32. | :03:35. | |
the bill which will strengthen the Government's powers to gathdr | :03:36. | :03:39. | |
information on the costs of medical supplies and other related products | :03:40. | :03:43. | |
across the supply chain frol factories to those who supply | :03:44. | :03:47. | |
medicines to patients. We ctrrently collect information on the cell and | :03:48. | :03:50. | |
purchase of medicines from various parts of the supply chain under | :03:51. | :03:55. | |
various arrangements and very range of specific purposes. Some of these | :03:56. | :03:59. | |
arrangements are voluntary while others are statutory. The bhll will | :04:00. | :04:02. | |
streamline the existing information requirements in the energy `ct 006 | :04:03. | :04:06. | |
relating to controlling the cost of health care products. It will enable | :04:07. | :04:11. | |
the Government to make regulations for all those involved in the | :04:12. | :04:15. | |
manufacturing distribution of health service medicines, medicine lies or | :04:16. | :04:21. | |
other related products to rdcord and provide information on sales and | :04:22. | :04:28. | |
purchase. The reimbursement of community pharmacies and GPs, | :04:29. | :04:32. | |
determining the value for money supply chain of products and | :04:33. | :04:35. | |
controlling the cost of medhcines. This will enable the Governlent to | :04:36. | :04:40. | |
pick the current voluntary arrangement with manufacturdrs and | :04:41. | :04:43. | |
wholesalers and unbranded J`ck medicines are manufactured specials | :04:44. | :04:48. | |
on the statutory footing. As the arrangements are voluntary, they | :04:49. | :04:50. | |
don't cover all products and companies which limits the | :04:51. | :04:57. | |
robustness of the reimburselent A fitting for data collection is | :04:58. | :04:59. | |
important to the Government can run a request... I know some colleagues | :05:00. | :05:06. | |
have raised concerns about the implications of funding dechsions to | :05:07. | :05:09. | |
community pharmacies and I want to reassure the house that this bill | :05:10. | :05:12. | |
does not impact on those decisions, nor does it remove the requhrement | :05:13. | :05:16. | |
for consultation with the representative body of pharlacy | :05:17. | :05:19. | |
contractors on their funding arrangement in the future. However, | :05:20. | :05:23. | |
the information will give slall data on which to base those disctssions | :05:24. | :05:28. | |
and decisions rather than rdlying on data only available to us under | :05:29. | :05:30. | |
voluntary schemes and arrangements. The information would also dnable | :05:31. | :05:34. | |
the Government to obtain information from across the supply chain to | :05:35. | :05:39. | |
assure itself the supply ch`in or parts of it is delivering v`lue for | :05:40. | :05:43. | |
money for any cheese patients and the taxpayer, something we cannot do | :05:44. | :05:46. | |
with our existing fragmented detail. I am happy to give way. Would buy | :05:47. | :05:54. | |
right honourable friend be giving consideration to asking pharmacists | :05:55. | :05:58. | |
who can prepare their own mddicines which would save the NHS trdmendous | :05:59. | :06:02. | |
amounts of money will you bd considering that in the overall | :06:03. | :06:06. | |
scheme of getting some information on the medicines that you are | :06:07. | :06:13. | |
providing? It may be the case that the information that we collect | :06:14. | :06:17. | |
makes it possible for us to do more robust analysis on issues lhke the | :06:18. | :06:22. | |
one that she rightly brings to the attention of the house. Even if it | :06:23. | :06:26. | |
doesn't, I think this is an issue we should consider and I'm verx happy | :06:27. | :06:29. | |
to write back to her to see whether we can make more progress in that | :06:30. | :06:33. | |
area. I would also like to reassure the house of the application of this | :06:34. | :06:38. | |
information power to the medical technology industry. Over 98% of the | :06:39. | :06:42. | |
company's supplying technology medicines. Their products m`y be | :06:43. | :06:47. | |
less high profile at the latest cancer medicines but no less | :06:48. | :06:51. | |
innovative are vital for patients. We have no interest in plachng | :06:52. | :06:54. | |
additional burdens on these companies. The 2006 act alrdady | :06:55. | :06:59. | |
provides power for the Government to require suppliers of medical | :07:00. | :07:03. | |
technologies to keep and provide information on almost any aspect of | :07:04. | :07:07. | |
their business. This bill whll clarify and modernisers powdrs and I | :07:08. | :07:10. | |
am committed to exercising them in a way which is fair and proportionate | :07:11. | :07:15. | |
to companies to the NHS and to the taxpayer who rightly demand value | :07:16. | :07:18. | |
for money from the supply chain Companies are currently reqtired to | :07:19. | :07:23. | |
hold information on income sales for six years for tax purposes. We work | :07:24. | :07:26. | |
closely with the industry to ensure the requirement to keep and record | :07:27. | :07:30. | |
data does not militantly increase this burden. My officials h`ve | :07:31. | :07:37. | |
already been in discussion for both medicines and medical devicds about | :07:38. | :07:40. | |
these powers to ensure their implementation is robust and | :07:41. | :07:46. | |
proportionate and will provhde us to debate on these provisions. I want | :07:47. | :07:52. | |
to reassure colleagues that a consultation will take placd on the | :07:53. | :07:55. | |
regulations specify the information requirements. I would also like to | :07:56. | :08:01. | |
thank ministers and evolve administrations further constructive | :08:02. | :08:03. | |
input and engagement with mx department with respect to the Bill | :08:04. | :08:06. | |
provisions. Whilst many of the provisions in the Bill are reserved | :08:07. | :08:10. | |
in relation to Scotland and Wales, there are some information | :08:11. | :08:12. | |
requirements which currentlx apply to England only but could also apply | :08:13. | :08:17. | |
in the territories of the ddvolved illustrations. We intend to propose | :08:18. | :08:21. | |
amendments to the builder of the agreement between the Government and | :08:22. | :08:24. | |
evolve demonstrations to th`t information from wholesalers and | :08:25. | :08:27. | |
manufacturers can be collected by the Government for the whold of the | :08:28. | :08:31. | |
UK and shared with the devolved administrations. This avoids the | :08:32. | :08:36. | |
burden created by each country creating the same information. The | :08:37. | :08:39. | |
Welsh Government has also asked me to enable them to maintain | :08:40. | :08:44. | |
information from dispensing GPs a power the Scottish Government and | :08:45. | :08:46. | |
Northern Ireland accepted already have. The Government will propose an | :08:47. | :08:50. | |
amendment to the bill to allow the NHS Wales act so that Welsh | :08:51. | :08:53. | |
ministers can obtain inform`tion from pharmacists and dispensing GPs. | :08:54. | :09:01. | |
In conclusion, Madam Deputy Speaker, medicines are a vital part of the | :09:02. | :09:05. | |
treatment provided by our NHS, robust cost control and information | :09:06. | :09:10. | |
requirements are a key tools to ensure NHS spending on medicines | :09:11. | :09:15. | |
across the UK continues to be affordable whilst delivering better | :09:16. | :09:19. | |
value for taxpayers and freding up resources with support access to | :09:20. | :09:22. | |
services and treatments. Thhs bill will ensure there is a more level | :09:23. | :09:26. | |
playing field between an medicines pricing schemes whilst ensuring that | :09:27. | :09:30. | |
decisions made by the Government are based on a more accurate and robust | :09:31. | :09:36. | |
information about medicine costs. Fear for industry, serif ph`rmacies | :09:37. | :09:41. | |
and affair of the NHS, serif patient and fairer for taxpayers, I commend | :09:42. | :09:46. | |
this bill to the house. Stexn the question is at the bill may be read | :09:47. | :09:52. | |
a second time. Thank you Madam Deputy Speaker. I would likd to | :09:53. | :09:56. | |
thank the Secretary of Statd for outlining the overarching principles | :09:57. | :09:59. | |
of this bill which, seek to allow the NHS to better control the | :10:00. | :10:06. | |
medicine. Subject to blatant abuses in recent years. I would also like | :10:07. | :10:12. | |
to thank the Minister for t`king the time to set out what the Government | :10:13. | :10:16. | |
is seeking to achieve with this bill. I only hope this incrdased | :10:17. | :10:20. | |
appetite for state intervention will spread more widely across | :10:21. | :10:26. | |
Government. As we've heard from the Honourable member for Wolverhampton, | :10:27. | :10:32. | |
south-west, the anti-business interventionism, I would never | :10:33. | :10:35. | |
thought I would say this but I believe the Secretary of St`te is | :10:36. | :10:39. | |
now a fully fledged Corbin Daster having said would he said today In | :10:40. | :10:46. | |
all seriousness, it is clear the market isn't serving patient or the | :10:47. | :10:51. | |
taxpayers. Expenditure on mddicines is a significant and growing | :10:52. | :10:56. | |
proportion of the NHS budget standing at ?15.2 billion in 20 5, | :10:57. | :11:02. | |
2016, an increase of over 20% since 2000 11. If the whole of thd NHS had | :11:03. | :11:08. | |
seen such an increase doing the same period. The incredible advances in | :11:09. | :11:12. | |
science in recent decades often led by companies here in Britain mean | :11:13. | :11:16. | |
that people in this country are in leading longer, healthier lhves than | :11:17. | :11:19. | |
we've ever seen before. While we celebrate this, it is also right | :11:20. | :11:23. | |
that we secure value for money for the NHS to ensure as many p`tients | :11:24. | :11:25. | |
as possible can Can I declare interest as a type two | :11:26. | :11:39. | |
diabetic that 10% of the expenditure of the NHS budget is one di`betes | :11:40. | :11:45. | |
complications therein. Does he agree with me there may well be a desire | :11:46. | :11:51. | |
to prescribe more medicines which will cost more rather than providing | :11:52. | :11:57. | |
diabetics with structured education which, if used, can bring about the | :11:58. | :12:03. | |
cost of diabetes to the NHS. So it is not just about pills. | :12:04. | :12:08. | |
I pay tribute to the great work he does and diabetes and it is a map | :12:09. | :12:14. | |
and he consistently raises `nd is right to do so. There are m`ny ways | :12:15. | :12:19. | |
the diabetes Bill can be tackled and some of the statistics I have seen | :12:20. | :12:23. | |
about the level of take-up of education courses is somethhng we | :12:24. | :12:27. | |
can do much better on. Turnhng back to the bill, we are supporthve of | :12:28. | :12:32. | |
the broad aims of what the Government are trying to achieve but | :12:33. | :12:35. | |
have a number of concerns I hope the Minister will address. Both about | :12:36. | :12:42. | |
what is in the bill and the Government's policies more widely on | :12:43. | :12:46. | |
access to treatment. The technical mechanisms used to control | :12:47. | :12:50. | |
expenditure on medicines have not historically been the subject that | :12:51. | :12:55. | |
has set the public's imagin`tion alight but in June we bar all our to | :12:56. | :12:59. | |
read reports a small number of companies exploited the polls to | :13:00. | :13:05. | |
hike the patient -- hike thd price of medicines. We sold storids of | :13:06. | :13:10. | |
treatment being denied to p`tients on the basis of cost. That we saw | :13:11. | :13:19. | |
stories. There are two currdnt schemes operated the control and | :13:20. | :13:25. | |
pricing, the voluntary PPRS which applies to the vast majoritx and the | :13:26. | :13:31. | |
statutory scheme which in 2014, around 6% branded medicine sales in | :13:32. | :13:37. | |
the UK. The PPRS is based on making payments from companies back to the | :13:38. | :13:42. | |
NHS based on their sales of medicines to the NHS, while the | :13:43. | :13:47. | |
statutory scene operates on a cut to the price of branded medicines. | :13:48. | :13:51. | |
These approaches appear to produce different results. Since 2004 the | :13:52. | :13:55. | |
statutory scheme delivered significantly lower savings than the | :13:56. | :14:02. | |
PPRS as companies are switching into the statutory scheme which hs why we | :14:03. | :14:06. | |
saw a reduction in the level of the rebate. We support the rationale | :14:07. | :14:12. | |
between lining the look-mac aligning the two schemes to deliver ` better | :14:13. | :14:17. | |
level of savings to the taxpayer. As we heard, this bill extends beyond | :14:18. | :14:23. | |
more than that and adds a ndw provision giving the secret`ry of | :14:24. | :14:26. | |
state the power to require `ll medicine manufacturers and suppliers | :14:27. | :14:29. | |
to provide information relating to prices. I certainly will. | :14:30. | :14:35. | |
He will know and we all well there is a difference between the list | :14:36. | :14:40. | |
price that is advertised and the price the NHS actually pays. We must | :14:41. | :14:47. | |
be careful and that is a very important point, it does brhng the | :14:48. | :14:56. | |
cost down for the NHS and those companies may well charge other | :14:57. | :15:00. | |
people higher prices and we must take that into context. | :15:01. | :15:06. | |
He is absolutely right and that is one of the reasons we need to tread | :15:07. | :15:10. | |
carefully and hear what the Government come forward with in | :15:11. | :15:13. | |
terms of regulations they whll be consulting on in due course. Because | :15:14. | :15:19. | |
some of these measures do not form part of the initial consult`tion and | :15:20. | :15:22. | |
there is a feeling some of the things were added at the last minute | :15:23. | :15:26. | |
and giving the cuts to the community pharmacy sector announced l`st week | :15:27. | :15:30. | |
there is anxiety out there `bout what costs could be created by an | :15:31. | :15:39. | |
additional administrative btrden. Does my honourable friend agree | :15:40. | :15:41. | |
pharmacists of them know thdir patients much better than | :15:42. | :15:46. | |
overstretch GPs and can advhse on prescription of appropriate and | :15:47. | :15:49. | |
cheaper drugs and does he also agreed instead of putting more | :15:50. | :15:52. | |
pressure on the pharmacy sector the Minister should support thel to | :15:53. | :15:56. | |
reduce the burden on GPs and help the NHS save money? | :15:57. | :16:03. | |
She is absolutely right, thdre is concern about the announcemdnt last | :16:04. | :16:08. | |
week and we know from survexs taken but approximately one in fotr | :16:09. | :16:12. | |
people, and using pharmacists would go to the GP if they were unable to | :16:13. | :16:16. | |
see pharmacy for advice and we know the pressures surgeries are under so | :16:17. | :16:23. | |
we will have to watch careftlly the impact of those proposals and | :16:24. | :16:27. | |
hopefully they will not be `s serious as a number of membdrs have | :16:28. | :16:33. | |
expressed concern on. The ilpact assessment that talks about these | :16:34. | :16:37. | |
proposals does not offer us too many clues, it says that in terms of the | :16:38. | :16:41. | |
additional cost that could be in card they have not been quantified | :16:42. | :16:46. | |
as their magnitude will not be known until subs regulations. We need to | :16:47. | :16:54. | |
tread carefully on these. -, until subsequent regulations. This is a | :16:55. | :17:03. | |
far from perfect state of affairs and when the bill reaches committee | :17:04. | :17:08. | |
we will get further clarity. He has been fair in his bro`d | :17:09. | :17:13. | |
analysis of the problems we face between the statutory and voluntary | :17:14. | :17:20. | |
schemes and in many ways it is a lesson that is statutory scheme can | :17:21. | :17:26. | |
often be gained by industry. Is it encouraged the Association of | :17:27. | :17:29. | |
pharmaceutical industries are very supportive of what is being proposed | :17:30. | :17:34. | |
and want to work with the sdcretary of state and this is such that we | :17:35. | :17:36. | |
can hopefully get something that will work for the future rather than | :17:37. | :17:41. | |
being a Draconian recommend`tion through from Richmond house? | :17:42. | :17:49. | |
I thank the member and I wotld agree it is important we keep dialogue | :17:50. | :17:54. | |
open with industry because we are proud of the pharmaceutical industry | :17:55. | :17:57. | |
and what they can deliver, ht is a world leader and we do not want to | :17:58. | :18:01. | |
throw the baby out with the bath water. The Government will be aware | :18:02. | :18:05. | |
concern has been expressed by the medical technology sector that | :18:06. | :18:08. | |
medical supplies Artie brought under this regime designed to tackle | :18:09. | :18:14. | |
tackle problems in the pharmaceutical industry and express | :18:15. | :18:18. | |
concerns measures in this bhll will put additional burden on th`t sector | :18:19. | :18:22. | |
and could lead to overall hhgher costs so we welcome assurances from | :18:23. | :18:27. | |
the Secretary of State 99% of businesses that are small or medium | :18:28. | :18:32. | |
will not be unduly troubled by others reporting requirements and we | :18:33. | :18:39. | |
will cope in further detail. -- onerous reporting requirements. It | :18:40. | :18:44. | |
was reportedly estimated income from PPRS and 2016-17 would be ?418 | :18:45. | :18:50. | |
million, in considerable reduction from the and 2015 and win the | :18:51. | :18:54. | |
overall drugs bill is incre`sing its sales of the scheme is not going to | :18:55. | :19:00. | |
plan -- when the overall drtgs bill is increasing. It is said the | :19:01. | :19:03. | |
savings would be about ?90 lillion per year for the NHS. Let us | :19:04. | :19:09. | |
consider whether this bill can address this. One of the benefits we | :19:10. | :19:12. | |
have heard is the bill would close down the football would lead to | :19:13. | :19:17. | |
extortionate prices for a ntmber of drugs. -- closed down the loophole. | :19:18. | :19:27. | |
Small number of companies stch as a drug, remove the brand name, taking | :19:28. | :19:31. | |
them out of the current pricing controls and then pick up the price | :19:32. | :19:37. | |
by many hundreds or even thousands of percent. Some companies lake this | :19:38. | :19:42. | |
strategy a key part of the business model and we have seen in this house | :19:43. | :19:47. | |
exposing some of the worst dxcesses of capitalism, for Mike Ashley and | :19:48. | :19:51. | |
his employment practices to Philip Green. That should be a special | :19:52. | :19:55. | |
category for those who make themselves extremely wealthx by | :19:56. | :19:59. | |
using loopholes in the law to prey on the set of vulnerable and extract | :20:00. | :20:02. | |
obscene profits from the he`lth service. -- on the set and | :20:03. | :20:10. | |
vulnerable. The small number of companies raise the costs of | :20:11. | :20:15. | |
medicines by ?262 million a deal through this practice. When a US | :20:16. | :20:19. | |
pharmaceutical company raisd the price of HIV medication people | :20:20. | :20:23. | |
across the world united in condemnation but it is less well | :20:24. | :20:27. | |
known we have seen the pricd of over 200 medicines more than double in | :20:28. | :20:32. | |
this country with 32 rising by more than 1000% and in one case `n | :20:33. | :20:38. | |
unbelievable increase of 12 and a half thousand percent. -- 12,50 %. | :20:39. | :20:47. | |
We can look at the company website, one of those it was sold to a | :20:48. | :20:51. | |
private equity company for ?367 million on top of commercialising | :20:52. | :20:57. | |
the nation generic medicines. Another of those companies which | :20:58. | :21:04. | |
owns others is open about the fact it, specialises in the acquhsition, | :21:05. | :21:09. | |
licensing and development of oft repeated medicines which max be | :21:10. | :21:13. | |
niche hard to make products. This sounds like a noble pursuit but we | :21:14. | :21:18. | |
know that can't be code for establishing and abusing a dominant | :21:19. | :21:23. | |
market position -- that can decode. I will give way. -- that can be a | :21:24. | :21:27. | |
cold. This bill the powers of the | :21:28. | :21:32. | |
Secretary of State to effectively confiscate profits through that | :21:33. | :21:36. | |
rather than taxation can attempt my honourable friend to a tree might be | :21:37. | :21:40. | |
worth looking at in relation to a company like Google and who has | :21:41. | :21:47. | |
aided by percent of the world Mobile operating systems, that is ` | :21:48. | :21:50. | |
dominant market position whdre there are question marks over thehr | :21:51. | :21:54. | |
taxation and some others profit confiscation could be looked at as | :21:55. | :22:02. | |
well. -- some of the sprockdt. I like them but this is way ottside my | :22:03. | :22:08. | |
brief but I know or health service enters into partnership with Google | :22:09. | :22:13. | |
so I hope ministers ask questions about the taxation arrangemdnts We | :22:14. | :22:17. | |
ignore the vast majority of the generic sector is well controlled by | :22:18. | :22:21. | |
competition and delivers value for money. We welcome the extension of | :22:22. | :22:26. | |
price controls were competition has failed. I would ask the Minhster | :22:27. | :22:31. | |
without he is confident this step alone will be successful, as we have | :22:32. | :22:37. | |
seen how adept International companies can be with moving figures | :22:38. | :22:41. | |
are bound to avoid taxation and we want to avoid this being vulnerable | :22:42. | :22:47. | |
to the gaming we have seen elsewhere. I do not believe, given | :22:48. | :22:52. | |
the vast sums of money at stake these companies will simply stored | :22:53. | :22:57. | |
their shoulders and take thd hit, if the town of order. I was concerned | :22:58. | :23:03. | |
when I read something about this bill which said, in the past the | :23:04. | :23:07. | |
Department of Health would sit informal negotiations with | :23:08. | :23:09. | |
manufacturers were that was pricing issues and we believe this will | :23:10. | :23:13. | |
remain. This notion brings tp uncomfortable memories of the | :23:14. | :23:17. | |
sweetheart deals between multinationals and each MRC and | :23:18. | :23:21. | |
while I am happy fortunes of communication with these colpanies | :23:22. | :23:24. | |
we would like the assurance in all cases prices will be regulated | :23:25. | :23:28. | |
through a transparent and formal process and not behind the scenes | :23:29. | :23:33. | |
talks. If in a feud gives it becomes clear... I certainly will. H want to | :23:34. | :23:41. | |
ask my honourable friend whdre the advertising budgets of | :23:42. | :23:44. | |
pharmaceutical companies dw`rf their research and development budget is | :23:45. | :23:47. | |
that not an argument for thd Government looking again at the tax | :23:48. | :23:51. | |
position of those companies as well as the price position of thd | :23:52. | :23:54. | |
products? I thank my honourable friend for his | :23:55. | :24:02. | |
intervention. I do not like we will get very far with this Government on | :24:03. | :24:07. | |
corporation tax and they have gone in a direction we probably not could | :24:08. | :24:10. | |
them as the opposition and they decide that this is the best way to | :24:11. | :24:14. | |
control prices and see how we get on. I would ask the Minister in the | :24:15. | :24:21. | |
can confirm if it becomes clear in a few years we have open up another | :24:22. | :24:25. | |
set all the polls whether wd can accept the department to be | :24:26. | :24:29. | |
proactive in their investig`tions rather than lying relying on | :24:30. | :24:34. | |
journalists to expose it. -, in another set of loopholes. In | :24:35. | :24:38. | |
Scotland than the big gener`ted was used to create a dedicated fund to | :24:39. | :24:43. | |
get patients access to new ledicines and, as the Minister to invdstigate | :24:44. | :24:47. | |
a similar model and ensure the benefits of the scheme are tsed for | :24:48. | :24:52. | |
improving our poor records `nd allowing patients to benefit from | :24:53. | :24:58. | |
new medicines. We accept thdre will always be challenges in matching | :24:59. | :25:01. | |
funding to new drugs but thdre is at least logic allowing savings to be | :25:02. | :25:09. | |
reinvested. We welcome the report today which sets out an ambhtious | :25:10. | :25:14. | |
plan which could see patients accessing new life-saving treatment | :25:15. | :25:18. | |
up to format years more quickly and I hope the Minister will give | :25:19. | :25:22. | |
financial backing to the review by using future rebates from the | :25:23. | :25:27. | |
pharmaceutical sector to improve access to treatments. I askdd the | :25:28. | :25:30. | |
Government to seriously consider this as a growing concern about | :25:31. | :25:34. | |
access to new treatments and particularly widening gulf between | :25:35. | :25:37. | |
our record of developing new drugs and the ability of the NHS to ensure | :25:38. | :25:43. | |
all patients sufficiently bdnefit. The international comparisons of | :25:44. | :25:45. | |
health technology reports ptblished in August by breast cancer now and | :25:46. | :25:53. | |
Prostate Cancer UK shows thd NHS and cancer patients miss out on | :25:54. | :25:56. | |
innovative treatments incomparable countries of similar wealth and at | :25:57. | :26:01. | |
the same time a number of mddicines have been delisted by the c`ncer | :26:02. | :26:09. | |
drugs and after that overspdnt. There was also another report in | :26:10. | :26:16. | |
July entitled A Pill Too Hard To Swallow, How The Nhs Is Limhting | :26:17. | :26:21. | |
Access To High-priced Drugs. Is sent to similar conclusions about drugs | :26:22. | :26:28. | |
which give possible to elimhnate HIV. | :26:29. | :26:33. | |
We have to be very careful that we don't encourage drug companhes to | :26:34. | :26:39. | |
research into those areas bdcause they would not see that fin`ncial | :26:40. | :26:45. | |
return for them. I thank my honourable friend for the | :26:46. | :26:49. | |
intervention. He is right. We must the very careful with the | :26:50. | :26:54. | |
consequences of this piece of legislation and, again, we know that | :26:55. | :26:57. | |
there will be decisions takdn in terms of investment of -- if the | :26:58. | :27:02. | |
return is not sufficient. Wd have to get the balance right betwedn | :27:03. | :27:05. | |
encouraging investment and getting value for money for the taxpayer. | :27:06. | :27:11. | |
Madam Deputy Speaker, the rdport showed how NHS England have been | :27:12. | :27:16. | |
unable to budget for broad `ccess to drugs. When it failed, rationed | :27:17. | :27:23. | |
access to those drugs. Therd was also widespread controversy over | :27:24. | :27:27. | |
attempts by NHS England to `void funding the anti-HIV by passing on | :27:28. | :27:32. | |
responsibility to local authorities at the same time of cutting the | :27:33. | :27:36. | |
public health budget allocated to councils. If we are to strike - | :27:37. | :27:40. | |
strives to create a level playing field, we should look to thd scene | :27:41. | :27:44. | |
for patients and their abilhty to access treatments. When Labour | :27:45. | :27:53. | |
established... An order was made by Parliament in 2001 to mandate | :27:54. | :27:58. | |
through its technical apprahsal process. They were intended to be | :27:59. | :28:03. | |
available to patients three months after publication of the appraisal | :28:04. | :28:14. | |
full. This has culminated in the. As well as looking at Wingfield fencing | :28:15. | :28:19. | |
the payments, there are also asked to look more widely. Successive | :28:20. | :28:23. | |
studies have demonstrated how there is a relatively low take-up by the | :28:24. | :28:27. | |
UK compared to other high income countries. Not only does th`t let | :28:28. | :28:32. | |
patients down, it can also hmpact on the future of the pharmaceutical | :28:33. | :28:36. | |
industry in the UK, particularly given the concerns for the sector | :28:37. | :28:40. | |
about the relatively small seals converted other countries. H am sure | :28:41. | :28:48. | |
it ministers are aware that the concerns that have been raised in | :28:49. | :28:53. | |
respect of and need to ensure the country can be seen as the leader in | :28:54. | :28:56. | |
the research sector. The Prhme Minister has said it is hard to | :28:57. | :29:00. | |
think of industry of greater strategic importance to Britain as | :29:01. | :29:02. | |
pharmaceutical industry and we would agree with that but we cannot be | :29:03. | :29:06. | |
complacent about the state of UK pharmacy particularly as investment | :29:07. | :29:11. | |
decisions are also made by hearing companies based in other parts of | :29:12. | :29:15. | |
the world. I hope the minister will take seriously the interrel`tionship | :29:16. | :29:18. | |
between decisions about accdss treatments and the future of | :29:19. | :29:21. | |
pharmaceutical research and development in the UK, parthcularly | :29:22. | :29:24. | |
when we know other countries across Europe are using our uncert`inty as | :29:25. | :29:30. | |
a result of Brexit to aye up other opportunities to take on thd march | :29:31. | :29:35. | |
on our own industry. To conclude, the opposition support the broad | :29:36. | :29:38. | |
aims of this bill and what the Government is seeking to achieve in | :29:39. | :29:40. | |
terms of controlling better the cost of medicines. At the committee | :29:41. | :29:45. | |
stage, we will seek to explore the new information powers and the | :29:46. | :29:47. | |
details of the impact of those powers on the supply chain `nd | :29:48. | :29:51. | |
finally we will also continte to hold the Government to accotnt and | :29:52. | :29:54. | |
ensure that patients are able to access the best available treatment | :29:55. | :30:04. | |
without any unnecessary del`y. Thank you, Madam Deputy Speaker. @s any | :30:05. | :30:09. | |
constituency MP bundle, the pressures on the NHS grow ydar in, | :30:10. | :30:16. | |
year out. Partly because of a name -- ageing population, partlx because | :30:17. | :30:21. | |
of developments in medical procedures, advanced drugs that can | :30:22. | :30:28. | |
help to overcome illness or to continue the recovery or | :30:29. | :30:32. | |
stabilisation of a patient's condition. That is why it is always | :30:33. | :30:38. | |
a constant battle for the NHS to root out waste and increase | :30:39. | :30:44. | |
efficiency in the delivery of care without compromising patient care. | :30:45. | :30:54. | |
The Nicholson challenge launched in 2010, sought to save ?20 billion | :30:55. | :31:01. | |
over the last Parliament and as my right honourable friend the | :31:02. | :31:03. | |
Secretary of State, the Minhster of State brother, said, they m`naged to | :31:04. | :31:14. | |
achieve ?19.4 billion. Not by - ?19.4 billion of savings th`t went | :31:15. | :31:19. | |
back to the Treasury, ?19.4 billion that was reinvested in front line | :31:20. | :31:25. | |
services and the NHS. Simil`rly we have great pressure on the dver | :31:26. | :31:34. | |
increasing drugs bill. In England, the drugs bill is a ?15.2 bhllion in | :31:35. | :31:46. | |
the last financial year. 11.2 billion on branded medicines, for | :31:47. | :31:50. | |
billion on an branded generhc medicines. That represents since | :31:51. | :31:59. | |
2010, a 20% increase and a 7% year on year increase. With an ever | :32:00. | :32:04. | |
increasing ageing population, those figures will continue to go up words | :32:05. | :32:12. | |
in future years. What we sed as well is more and more new drugs being | :32:13. | :32:18. | |
developed to combat illness. How many illnesses that the killers even | :32:19. | :32:23. | |
during our lifetimes can now either be cured or stabilised becatse of | :32:24. | :32:30. | |
research in the work of pharmaceutical companies in | :32:31. | :32:33. | |
developing those drugs that can provide those results? Anyone will | :32:34. | :32:41. | |
accept that the research for developing new drugs to tackle | :32:42. | :32:47. | |
illness and disease is phenomenally expensive to the companies `nd also | :32:48. | :32:55. | |
takes sometimes many years hndeed. Therefore, we have to have ` balance | :32:56. | :33:00. | |
between the pharmaceutical companies who have to invest horrendots | :33:01. | :33:07. | |
amounts of money to be able to find a new drug for a new cure or a | :33:08. | :33:14. | |
stabilising medicine for medical conditions that they obviously do | :33:15. | :33:21. | |
you have to benefit from thd horrendously large investments that | :33:22. | :33:27. | |
they make. But that does not mean that that should be a licence for | :33:28. | :33:31. | |
them to be able to simply charge what they like for as long `s they | :33:32. | :33:36. | |
like for the largest profit possible. There is a medium between | :33:37. | :33:43. | |
the two situations and that has been particularly highlighted by the | :33:44. | :33:48. | |
Times report in a few months ago about the investigation in which one | :33:49. | :33:53. | |
saw some of the increases in drugs by pharmaceutical companies that had | :33:54. | :33:58. | |
in effect, a monopoly on th`t drug because there was no compethtion. To | :33:59. | :34:03. | |
give you one or two examples to show the scale of the problem, | :34:04. | :34:12. | |
hydrocortisone tablets rose between 2008 and 2016 on a price per packet | :34:13. | :34:20. | |
from 70p to ?85. That was the ?12,000 increase. Certain | :34:21. | :34:29. | |
anti-depressant tablets, ond sees a 2600% increase of certain t`blets | :34:30. | :34:38. | |
for insomnia, a 3000% incre`se. Frankly, even if it was with a | :34:39. | :34:47. | |
relatively small number of drugs, that is totally unacceptabld and is | :34:48. | :34:54. | |
extremely difficult to justhfy. I accept the cost of drugs to the NHS | :34:55. | :34:59. | |
is extremely complicated. As honourable members will know, | :35:00. | :35:02. | |
branded medicines are currently controlled through the voluntary | :35:03. | :35:07. | |
scheme, the pharmaceutical Price regulatory scheme agreed back in | :35:08. | :35:12. | |
2014 to 2019. For those companies that choose not to join the PPR S, | :35:13. | :35:18. | |
the Government operates a statutory scheme for branded medicines. BPP RS | :35:19. | :35:22. | |
is based on a payment mechanism whereby companies make paymdnts back | :35:23. | :35:26. | |
to the Department of Health based on sales of branded medicines whereas | :35:27. | :35:31. | |
the statutory scheme operatds on the basis of a cut to the published list | :35:32. | :35:38. | |
price of branded medicine. @s a result, the statutory schemd has | :35:39. | :35:42. | |
delivered significantly lowdr savings for the NHS and that is | :35:43. | :35:48. | |
clearly not a satisfactory situation. I welcome the bill as a | :35:49. | :35:53. | |
means for the Government to secure better value for money for both the | :35:54. | :36:00. | |
NHS and for taxpayers. The first important change that this bill will | :36:01. | :36:05. | |
introduce is to clarify the law to allow beyond any doubt the power of | :36:06. | :36:11. | |
the Secretary of State to rdquire a payment mechanism in the st`tutory | :36:12. | :36:15. | |
scheme to limit the cost of medicines. This clarification will | :36:16. | :36:21. | |
enable the Secretary of State to combat the current situation whereby | :36:22. | :36:26. | |
the current arrangements allow manufacturers and suppliers to | :36:27. | :36:31. | |
choose which scheme to be controlled by, which has led to numerots | :36:32. | :36:38. | |
companies to be in the statttory scheme rather than the voluntary | :36:39. | :36:41. | |
scheme because the statutorx scheme is less effective in the level of | :36:42. | :36:49. | |
savings that it makes to thd NHS. Thus, benefits them | :36:50. | :36:52. | |
disproportionately. In effect, what this bill will do when it gdts onto | :36:53. | :36:59. | |
the book, is to allow the Government to require companies to redtce the | :37:00. | :37:03. | |
price of an unbranded generhc drug even if the company is in the | :37:04. | :37:09. | |
voluntary scheme and the Government intend to use this power to limit | :37:10. | :37:15. | |
the price of the unbranded generic medicines for competition in the | :37:16. | :37:20. | |
market fails and companies charge the NHS unreasonably high prices for | :37:21. | :37:27. | |
these projects as highlightdd few moments ago. Through the | :37:28. | :37:30. | |
investigation that the Times carried out. I will give way to the | :37:31. | :37:35. | |
honourable gentleman. The rhght honourable member it may be aware | :37:36. | :37:41. | |
that Concordia International, which has been playing this game, with the | :37:42. | :37:46. | |
drug, that since the public`tion of this bill, it share price h`s gone | :37:47. | :37:53. | |
down 20%. Good news. I am vdry grateful to the honourable gentleman | :37:54. | :37:58. | |
for sharing that information with the house. Equally important the | :37:59. | :38:03. | |
bill will improve and its information collection so that it is | :38:04. | :38:11. | |
better informed on a more consistent basis, which will ensure a better | :38:12. | :38:15. | |
basis for it assessing whether the supply chain as a whole or ` | :38:16. | :38:18. | |
specific sector provide valte for money for the NHS. I don't think it | :38:19. | :38:25. | |
can be underestimated the ilportance of having a more consistent and more | :38:26. | :38:38. | |
viable and a more useful information gathering because information is | :38:39. | :38:44. | |
power insofar as it helps to affect decisions and judgments that if one | :38:45. | :38:49. | |
doesn't have consistent information collection and one does not have | :38:50. | :38:53. | |
sufficient ranges of inform`tion then it does lead to problels in | :38:54. | :39:00. | |
seeking to rectify issues where pharmaceutical companies ard not | :39:01. | :39:08. | |
behaving in the best interests of the NHS but disproportionatdly in | :39:09. | :39:12. | |
their own interests. That is why although in the size it is ` modest | :39:13. | :39:18. | |
piece of legislation, I think that its impact and its importance far, | :39:19. | :39:25. | |
far outstrips the fact that it only has a few clauses in it and I am | :39:26. | :39:33. | |
glad not only goal decided to take this decision but also it would seem | :39:34. | :39:38. | |
that this bill, subject to being looked at by committees, subject to | :39:39. | :39:42. | |
the consultation process on the regulations for the Secretary of | :39:43. | :39:47. | |
State has given assurances to this house about, seems to command | :39:48. | :39:51. | |
widespread support on all shdes of the house and I look forward to it | :39:52. | :39:58. | |
actually reaching the book `nd then as the regulations are developed, | :39:59. | :40:01. | |
the consultation is to ensure that we get it right and we stop some of | :40:02. | :40:07. | |
the abuses that have existed, that have cost the NHS so much, without | :40:08. | :40:15. | |
unfairly penalising the pharmaceutical companies because, as | :40:16. | :40:18. | |
I said earlier, they spent ` considerable amount of time and a | :40:19. | :40:22. | |
massive amount of money in developing drugs that in thd last 30 | :40:23. | :40:28. | |
years have seen considerabld strides for patients with HIV AIDS, they | :40:29. | :40:34. | |
have seen improvements in some of the care for cancer patients and so | :40:35. | :40:42. | |
I welcome this bill. Madam Deputy Speaker, like the previous speaker, | :40:43. | :40:47. | |
I do pay tribute to some of the research and development th`t has | :40:48. | :40:50. | |
been done by the pharmaceuthcal industry. Europe has become the | :40:51. | :40:55. | |
biggest research network in the world and the biggest benefhciary of | :40:56. | :41:00. | |
that has been the United Kingdom. Through Horizon 2020 funding in | :41:01. | :41:04. | |
collaboration with the European medicines agency and as was said by | :41:05. | :41:08. | |
our speakers, both of these are going to change and the | :41:09. | :41:10. | |
pharmaceutical industry within this country will be rather nervous and | :41:11. | :41:15. | |
rather anxious about exactlx what their future is. Every new job they | :41:16. | :41:21. | |
discover it creates an additional cost pressures are the NHS. Hence, | :41:22. | :41:27. | |
the reason for the PPR S. Its existence of the 50s but thd one | :41:28. | :41:32. | |
we're in at the moment is, since 2014, has brought the -- significant | :41:33. | :41:38. | |
benefits as was mentioned bx the Shadow Minister for health. In | :41:39. | :41:42. | |
Scotland, that directly fund a new medicines and rare diseases fund. | :41:43. | :41:46. | |
Ours is not a cancer drug ftnd and therefore that gives us gre`ter | :41:47. | :41:50. | |
flexibility. The patient or a condition does not need to beat | :41:51. | :41:57. | |
cancer. Hence, we are giving this drug for hepatitis C, we ard giving | :41:58. | :42:03. | |
another dog for... It does `ctually give us more flexibility for these | :42:04. | :42:04. | |
very rare diseases. It to give sum of management and | :42:05. | :42:16. | |
cost pressure and soak the Scottish Government and my colleagues will | :42:17. | :42:21. | |
complete trading up this bill leads to end closing some loopholds the | :42:22. | :42:27. | |
NHS faces, particularly we heard about those with a monopoly on | :42:28. | :42:33. | |
generic medicines, that can often be companies in the PPRS schemd and | :42:34. | :42:37. | |
therefore are able to chargd what they like for their generics so | :42:38. | :42:41. | |
there must be greater alignlent and it must apply to all drugs, not just | :42:42. | :42:48. | |
all companies. The third part mentioned by the Secretary of State | :42:49. | :42:52. | |
is the collection of data and this is something, as someone who has | :42:53. | :42:58. | |
worked in the NHS, the NHS has struggled with before and I do have | :42:59. | :43:04. | |
a few concerns about how thhs will work across the entire NHS `nd the | :43:05. | :43:09. | |
whole pharmaceutical industry and now also medal coal technology and | :43:10. | :43:14. | |
supplies. We need to make stre the data collection is a relatively | :43:15. | :43:19. | |
simple and straightforward `nd hopefully using a data that is | :43:20. | :43:25. | |
already collected and bringhng that data together. As someone | :43:26. | :43:29. | |
representing one of the devolved nations the importance for ts would | :43:30. | :43:35. | |
be our Government can access it easily and it says clearly hn the | :43:36. | :43:39. | |
bill data gathered would be shared with Scottish ministers but on what | :43:40. | :43:43. | |
basis? Will it be down to Scottish and Welsh ministers requestdd that | :43:44. | :43:48. | |
when they want it as opposed to perhaps waiting for an annu`l return | :43:49. | :43:53. | |
which might not happen to bd at the point they want? I also would hope | :43:54. | :43:59. | |
there has been, obviously the Secretary of State mention they have | :44:00. | :44:03. | |
been consultation, but the consultation going forward because | :44:04. | :44:07. | |
very much this bill will be the Devil and the detail in the | :44:08. | :44:12. | |
extension to all medical supplies. Scotland already uses the lot of | :44:13. | :44:15. | |
central procurement to keep costs down and it would be import`nt to us | :44:16. | :44:19. | |
that enable back and did not interfere with it. | :44:20. | :44:24. | |
She is making a powerful spdech as ever. If I can pick her medhcal | :44:25. | :44:30. | |
brains of medical supplies because medical supplies are defined in the | :44:31. | :44:35. | |
2006 act as covering surgic`l, dental and optical materials and | :44:36. | :44:42. | |
equipment. As a clinician, would she include something like a cat scan or | :44:43. | :44:48. | |
MRI scanner as a piece of strgical equipment, certainly not dental or | :44:49. | :44:53. | |
optical. It seems to me it hs not actually surgical equipment, it is | :44:54. | :44:58. | |
investigative equipment and MRI scanners start at around ?2 million. | :44:59. | :45:07. | |
This is one of the areas to look at. I do not like having an narrow | :45:08. | :45:11. | |
definition but only means of blades and the like and does not t`ke an | :45:12. | :45:17. | |
hour hugely expensive infrastructure would make sense. When buying these | :45:18. | :45:22. | |
kinds of machines in Scotland we tend to look at central procurement | :45:23. | :45:26. | |
and assessment and that opens up the potential for massive savings so | :45:27. | :45:32. | |
there is going to be a lot lore work in committee and then in regulation | :45:33. | :45:37. | |
to make this function in thd way everyone wants it to function. One | :45:38. | :45:42. | |
of the things, and it may not be in this bill but an aspiration for | :45:43. | :45:48. | |
something later, is I think we need something much more radical. It is | :45:49. | :45:54. | |
the case it is about five ydars delay for patients in the UK | :45:55. | :45:59. | |
accessing new medicines. Whdn you look at comparisons of cancdr | :46:00. | :46:04. | |
survival, when you look at patients with early disease often we are | :46:05. | :46:10. | |
ahead, and breast cancer we were one of the earliest nations doing | :46:11. | :46:13. | |
population screening but whdn you look at people with more advanced or | :46:14. | :46:18. | |
aggressive disease is where we fall behind. This is where our food | :46:19. | :46:27. | |
outcomes and survival in colparison to European countries comes from -- | :46:28. | :46:30. | |
Pooler survival and outcomes. Part of that is sometimes the eyd | :46:31. | :46:37. | |
watering initial prices of new drugs. Yes, we can set methods to | :46:38. | :46:41. | |
try and control that but a lot of these drugs do not get throtgh the | :46:42. | :46:46. | |
system because they are so expensive. In my interactions with | :46:47. | :46:50. | |
some of the major pharmaceutical companies sent in this placd I think | :46:51. | :46:55. | |
there is an appetite for a different way of doing it. Perhaps it would be | :46:56. | :47:02. | |
if prices were much lower btt they have a guaranteed number of patients | :47:03. | :47:07. | |
before a drug became generic, it might be just a totally different | :47:08. | :47:11. | |
way and might put at risk sharing because at the beginning we often do | :47:12. | :47:15. | |
not know if that drug is re`lly going to be as good as it is cracked | :47:16. | :47:21. | |
up to be and if it starts at ?100,000 we will struggle to get it | :47:22. | :47:25. | |
through any of our pricing systems. I think one of the other onds coming | :47:26. | :47:30. | |
up is how we expect pharmacdutical companies to make a profit on drugs | :47:31. | :47:39. | |
we never intend to use? We know we need new antibiotics, we know any | :47:40. | :47:42. | |
brand-new class of antibiothc and we have not had a new class of 30 | :47:43. | :47:47. | |
years, what have they been left on the shelf so the system we have will | :47:48. | :47:52. | |
simply not fund research for that kind of drug. While this tidies up | :47:53. | :47:57. | |
some of the issues we have now, we need is much more blue sky thinking | :47:58. | :48:02. | |
going forward and that would be with the equipment, was on drugs, with | :48:03. | :48:07. | |
how we develop different thhngs because otherwise we will go on | :48:08. | :48:12. | |
having the interminable deb`tes I have taken part in Westminster Hall | :48:13. | :48:16. | |
will be one debate saying wd want more research such as an br`in | :48:17. | :48:20. | |
tumours and the next week wd have the debate on not being abld to | :48:21. | :48:25. | |
access a brand-new drug that is being developed within the | :48:26. | :48:30. | |
pharmaceutical industry. I'l happy to give way. | :48:31. | :48:38. | |
I thank the honourable lady for giving such uninformed speech but | :48:39. | :48:41. | |
would she also agree we're dntering a new landscape and -- giving such | :48:42. | :48:51. | |
an informed speech. Some trdatments will be used across various cancers | :48:52. | :48:56. | |
or diseases and when that comes into the picture we will need an even | :48:57. | :49:01. | |
more flexible approach to how we will benefit from those thugs and | :49:02. | :49:07. | |
how to optimise patient outcomes. -- benefit from those on drugs. | :49:08. | :49:15. | |
We are entering the realms `nd have entered the realms of using immune | :49:16. | :49:22. | |
therapies such as the drug look mac -- that was a drunk people went to | :49:23. | :49:27. | |
court to try to access yet behalf the risks of a certain dise`se. And | :49:28. | :49:35. | |
then you end up spending much more. The reason we use the serpent god | :49:36. | :49:40. | |
for hepatitis C in Scotland if it is almost sure to and thereford we | :49:41. | :49:47. | |
produce fewer patients. -- the reason we provide a certain drug for | :49:48. | :49:52. | |
hepatitis C. The genetic drtgs that we are likely to be using in the | :49:53. | :49:56. | |
future will be even more eyd watering the expensive but then | :49:57. | :50:01. | |
again may have bigger impact. While this is tidying up, my concdrns are | :50:02. | :50:08. | |
the involvement of the devolved administrations, both in design and | :50:09. | :50:14. | |
access to data, ensuring funding for PPRS which we use for our ndw drugs | :50:15. | :50:19. | |
fund, is maintained. There hs a call for us to do something much bigger | :50:20. | :50:23. | |
and much more blue sky in the future. | :50:24. | :50:30. | |
It is a pleasure to follow the extremely well informed spedch of | :50:31. | :50:34. | |
the honourable lady. I hope ministers on the front bench will | :50:35. | :50:38. | |
continue to study what happdns in Scotland as they do elsewhere so we | :50:39. | :50:43. | |
can share information and copy best practice, whether from Scotland or | :50:44. | :50:48. | |
elsewhere in the world and H am aware of the fine medical tradition | :50:49. | :50:55. | |
Scotland has. I would like to start by paying credit to the Timds | :50:56. | :51:01. | |
newspaper for their investigation starting on June the 3rd. Often we | :51:02. | :51:05. | |
have cause to complain about the press in this place and we `re often | :51:06. | :51:09. | |
the subject of the enquiries which we sometimes find unwelcome and the | :51:10. | :51:15. | |
press are from time to time irresponsible and should be more | :51:16. | :51:18. | |
responsible but in this casd I think we can all thank the Claims for | :51:19. | :51:24. | |
sharing a spotlight on what is quite frankly some unacceptable practice | :51:25. | :51:30. | |
within the pharmaceutical industry. -- flank the Times. It has huge | :51:31. | :51:37. | |
implications for the NHS. I will indeed. | :51:38. | :51:44. | |
She is exploring the work the Times bed in June and can I remind him in | :51:45. | :51:49. | |
that context when discussing the early adoption of drugs which we | :51:50. | :51:53. | |
talk about today we should bear in mind the work the Times dead in the | :51:54. | :51:59. | |
1960s to uncover thalidomidd as a terrible drug and one which was | :52:00. | :52:04. | |
never licensed in the USA bdcause of their concerns the testing was not | :52:05. | :52:10. | |
adequate. Yes, we want things, it's a market where possible but we must | :52:11. | :52:16. | |
be very careful. -- we want things earlier to market. I believd it was | :52:17. | :52:22. | |
actually Sunday Times investigative team that focused on that issue We | :52:23. | :52:28. | |
should pause and reflect and be thankful for the tremendous | :52:29. | :52:31. | |
tradition operatives investhgative journalism that does help and is an | :52:32. | :52:36. | |
ally to us in this place and it is important to put that on thd record. | :52:37. | :52:41. | |
Part of what the Times did contributed to the secretarx of | :52:42. | :52:46. | |
state launching the CMA enqtiry and it was quite right the compdtition | :52:47. | :52:51. | |
and market authority enquirx and I am pleased that was put on the way. | :52:52. | :52:56. | |
A number of speakers this evening have made the completely valid point | :52:57. | :53:02. | |
which I agree with that it hs of vital we continue to have a strong | :53:03. | :53:08. | |
pharmaceutical industry in the UK. In the month in which she w`s | :53:09. | :53:15. | |
appointed, the Prime Ministdr said, "It is hard to think of an hndustry | :53:16. | :53:20. | |
or greater strategic import`nce to Britain than our pharmaceuthcal | :53:21. | :53:24. | |
industry." And she was absolutely right to say so. I have bridf | :53:25. | :53:30. | |
comments that says the outptt of the pharmaceutical industry in the UK in | :53:31. | :53:39. | |
2015 was ?12.7 billion, 8% of the UK's and tyre manufacturing output. | :53:40. | :53:44. | |
If we look at one or two of the larger players, one company, for | :53:45. | :53:51. | |
example, is active in over 050 markets around the world, 100,0 0 | :53:52. | :53:58. | |
employees globally, a seat manufacturing site and the largest | :53:59. | :54:03. | |
vaccine business in the world. Of particular significance is ht | :54:04. | :54:08. | |
conducts all research into research hops, one in Philadelphia, the other | :54:09. | :54:14. | |
in Stevenage and a number of my constituents are proud to work at | :54:15. | :54:20. | |
that site. If we look at a second company, another large | :54:21. | :54:26. | |
pharmaceutical company in the UK, it has 6700 UK employees, support a | :54:27. | :54:31. | |
further 35,000 jobs here and operates across seven different | :54:32. | :54:35. | |
sites, one of which is in Ltton close to my constituency whdre again | :54:36. | :54:40. | |
in number of my constituents are proud to work and be a right to be | :54:41. | :54:47. | |
proud to work there. As the Secretary of State said earlier the | :54:48. | :54:53. | |
medicines Bill for NHS Engl`nd's at ?15.2 billion in 2015 - 16 hs the | :54:54. | :55:02. | |
second largest cost to NHS `ngered after hot on staff so it is of vital | :55:03. | :55:09. | |
-- after costs on staff. It is vital we secure value for money. Ht is of | :55:10. | :55:16. | |
concern competition and market authority has spoken of, "Excessive | :55:17. | :55:23. | |
and unfair prices." And also referred to companies which have, | :55:24. | :55:29. | |
"Abused a dominant position." There has been incidents where thdre has | :55:30. | :55:35. | |
been no competition or insufficient competition and so it is absolutely | :55:36. | :55:41. | |
right the Government has in to deal with this issue. This touchds on a | :55:42. | :55:46. | |
broader philosophical point and we have a brief exchange on thhs | :55:47. | :55:51. | |
earlier, but in response to me on the morality of business behaviour | :55:52. | :55:55. | |
the Prime Minister wrote to me a couple of days ago and she said "We | :55:56. | :56:04. | |
need to ensure the free market has an ethical basis." I absolutely | :56:05. | :56:07. | |
agree with that. The House of agree with that. The House of | :56:08. | :56:12. | |
Commons brief for this debate looks at the top you live in medicine | :56:13. | :56:16. | |
where there has been these huge price increases, ranging from one | :56:17. | :56:24. | |
would the eye watering Baha'i 1 12% price rise right up to another drug | :56:25. | :56:28. | |
which had a 5281% price risd. There maybe some reasons in some | :56:29. | :56:39. | |
cases if some of the ingredhents, the raw material a particul`r drug | :56:40. | :56:45. | |
are suddenly in very short supply, why a price increase like that would | :56:46. | :56:50. | |
be justified by the departmdnt knows that in the majority of casds, there | :56:51. | :56:55. | |
is no valid reason for thosd huge increases and that is why the | :56:56. | :57:01. | |
Government has quite properly acted. I welcome the powers in the bill to | :57:02. | :57:07. | |
reduce prices and to impose price controls and very importantly has | :57:08. | :57:11. | |
been referred to earlier to gather information. I do have a cotple of | :57:12. | :57:16. | |
questions for the Minister when he replies about the gathering of | :57:17. | :57:23. | |
information. Getting inform`tion is absolutely vital and I am pleased | :57:24. | :57:26. | |
that the Government has got measures in this bill to get completd | :57:27. | :57:30. | |
information but my question to my honourable friend on the front bench | :57:31. | :57:33. | |
is whether he is satisfied that there is sufficient analytical | :57:34. | :57:40. | |
really know what is going on? The really know what is going on? The | :57:41. | :57:44. | |
reason I ask that is that I've had a huge privilege to work with members | :57:45. | :57:49. | |
of the senior civil service in a different department of the last two | :57:50. | :57:53. | |
years but sometimes I think we expect civil servants to have a | :57:54. | :57:57. | |
range of skills that it is not fair for us to expect them to have. My | :57:58. | :58:03. | |
question again to the Minister is that the necessary commerci`l | :58:04. | :58:06. | |
expertise within his departlent to really work out what is going on | :58:07. | :58:10. | |
he and his officials will h`ve at he and his officials will h`ve at | :58:11. | :58:17. | |
their fingertips, is there ht is scheme between pharmaceutic`l | :58:18. | :58:21. | |
businesses and the Department of Health? So his officials re`lly know | :58:22. | :58:25. | |
how the market works in any particular gains that might be being | :58:26. | :58:31. | |
played. And this is something that I think is really important, H'm aware | :58:32. | :58:34. | |
there is one permanent secrdtary post at the moment who had ` | :58:35. | :58:39. | |
secondment earlier in his chvil service career with d'Anjou. I think | :58:40. | :58:45. | |
it is a really important pohnt for both ministers and the perm`nent | :58:46. | :58:48. | |
Secretary to make sure that is lacking ability within the | :58:49. | :58:51. | |
Department and if it's not there, I hope the key and the ministdrial | :58:52. | :58:55. | |
team will take steps to makd sure that it is. I say that becatse if | :58:56. | :59:00. | |
you look at some of the e-m`ils which came into the public domain as | :59:01. | :59:06. | |
some of them were brought to light some of them were brought to light | :59:07. | :59:10. | |
through Freedom of informathon requests, it would seem to le there | :59:11. | :59:14. | |
was not quite the level of serious analysis and probing and enpuiry | :59:15. | :59:17. | |
that we all really would have liked to have seen and I'm sure mx | :59:18. | :59:20. | |
honourable friend would've liked to have seen. In conclusion, M`dam | :59:21. | :59:24. | |
Deputy Speaker, the Governmdnt are bringing forward this bill because | :59:25. | :59:29. | |
the care passionately about the future of our National Health | :59:30. | :59:33. | |
Service and they will do evdrything necessary to protect it and that | :59:34. | :59:36. | |
very much includes getting value for money from the drugs that the NHS | :59:37. | :59:41. | |
pays for. But it's also bec`use on the side of the house, we v`lue and | :59:42. | :59:45. | |
care about the role of the free market. We know the greatest | :59:46. | :59:48. | |
economic mechanism in the hhstory of economic mechanism in the hhstory of | :59:49. | :59:52. | |
mankind for creating wealth and relieving poverty and is because we | :59:53. | :59:57. | |
care about it that we will `ct to reform it square that is necessary, | :59:58. | :00:00. | |
whether it's in the interests of the NHS are every -- any other part of | :00:01. | :00:11. | |
our country. This is an uncontroversial set of meastres and | :00:12. | :00:15. | |
I confirm my support for thd bill as it stands. Madam Deputy Spe`ker the | :00:16. | :00:20. | |
great strides in medical schence of the last decade and further back | :00:21. | :00:27. | |
robustly to be celebrated whth cutting-edge new treatments for life | :00:28. | :00:30. | |
threatening and life shortening conditions, including a number of | :00:31. | :00:33. | |
rare diseases and cancers, offering many people the hope of improved | :00:34. | :00:37. | |
health, longer life and quality-of-life that in the past | :00:38. | :00:41. | |
would just not have been possible. As well as the enormous bendfits it | :00:42. | :00:46. | |
brings to patients, the indtstry it also makes an incredibly valuable | :00:47. | :00:50. | |
contribution to the UK and ht's only right that we acknowledge that here | :00:51. | :00:56. | |
today. But there is an inevhtable cost attached to the triumph of | :00:57. | :01:00. | |
modern medicine and the challenge is to ensure patient access to new | :01:01. | :01:03. | |
treatments as quickly as possible whilst ensuring value for money for | :01:04. | :01:08. | |
the NHS. The bill seeks to `ddress some of the shortcomings and | :01:09. | :01:11. | |
addresses clear abuses of the current system and I think will | :01:12. | :01:17. | |
bring greater consistency to the existing arrangements for | :01:18. | :01:20. | |
controlling the cost of medhcines, new and old and I find myself, as I | :01:21. | :01:24. | |
have said in agreement with the proposals. It's good that so many | :01:25. | :01:29. | |
companies recognise their responsibility for keeping the | :01:30. | :01:32. | |
branded medicines bill in check by signing up to the pharmaceutical | :01:33. | :01:37. | |
price regulation scheme. Under the terms of the scheme, manufacturers | :01:38. | :01:38. | |
pay a rebate to the Departmdnt of pay a rebate to the Departmdnt of | :01:39. | :01:42. | |
Health to cover expenditure on branded medicines above agrded | :01:43. | :01:45. | |
limits. It's a responsible `pproach, helping to insure that patidnts can | :01:46. | :01:49. | |
benefit from access to novel drugs anyway which is sustainable to the | :01:50. | :01:54. | |
taxpayer. I would agree with the Secretary of State and the need to | :01:55. | :02:00. | |
address the current disparity for by the statutory medicines pricing | :02:01. | :02:03. | |
scheme delivers lower savings than the voluntary scheme. These | :02:04. | :02:07. | |
differences are expected to widen, which is clearly not in keeping with | :02:08. | :02:11. | |
the spirit of either arrangdment. So it makes sense that should be more | :02:12. | :02:16. | |
closely aligned and, as the Secretary of State says, we have to | :02:17. | :02:19. | |
remove the incentive to shift from one scheme to the other. I | :02:20. | :02:24. | |
particularly welcome the proposals to strengthen the authority of the | :02:25. | :02:28. | |
Secretary of State to intervene when on branded medicines are prhced | :02:29. | :02:33. | |
excessively. The NHS and patients benefit immensely from medicines | :02:34. | :02:39. | |
which where one is availabld only at high public expense becoming | :02:40. | :02:43. | |
available farmer cheaply after the page and expires and generic | :02:44. | :02:47. | |
products come into the markdt. We should recognise the great value | :02:48. | :02:51. | |
that this competitive market brings, saving the NHS more than ?13 billion | :02:52. | :02:57. | |
every year, according to thd British generic manufacturing assochation. | :02:58. | :03:02. | |
We also know that the overall cost of generic items is increashng at a | :03:03. | :03:06. | |
faster rate than branded itdms and have been -- there have been some | :03:07. | :03:11. | |
outrageous increases which other honourable members have refdrred to | :03:12. | :03:15. | |
in the price of some individual generic drugs in recent years where | :03:16. | :03:18. | |
there is only a single comp`ny producing that drug. It looks like a | :03:19. | :03:26. | |
clear case of profiteering for the NHS is being ripped off. Let's just | :03:27. | :03:30. | |
of this is when a particular company of this is when a particular company | :03:31. | :03:34. | |
takes an excessive profit from takes an excessive profit from | :03:35. | :03:37. | |
increasing the price of the drug in increasing the price of the drug in | :03:38. | :03:40. | |
this way. It means that othdr patients of the NHS, partictlarly | :03:41. | :03:46. | |
those in the more marginal `reas which don't get the attention that | :03:47. | :03:51. | |
they deserve, they lose out because there is less money to spend, less | :03:52. | :03:56. | |
money for example on teenagdrs with mental health problems, learning | :03:57. | :04:01. | |
disabilities, there is the cost and the price to be paid for thhs | :04:02. | :04:09. | |
excessive profiteering and ht is utterly unethical behaviour. I hope | :04:10. | :04:13. | |
very much that the competithon and market authority can find a way to | :04:14. | :04:17. | |
take action against these companies, who appear to have constructed a | :04:18. | :04:23. | |
business model to exploit this particular loophole. In number of | :04:24. | :04:27. | |
generic medicines increased as other honourable members have said in | :04:28. | :04:32. | |
price by more than 2000% in the last decade. The most horrific example | :04:33. | :04:37. | |
that I came across was a medicine increasing from ?13 and 90p in 005 | :04:38. | :04:48. | |
two ?632 in 2015. A rise of more than ?600 per item dispensed. That | :04:49. | :04:55. | |
is utterly despicable for any private company to think th`t they | :04:56. | :04:58. | |
can do that and the Governmdnt is absolutely right to take action to | :04:59. | :05:04. | |
end this outrageous practicd. Generic account for three qtarters | :05:05. | :05:09. | |
of prescription items dispensed in the community, so in those cases | :05:10. | :05:13. | |
where competition fails to deliver value for money, it is important | :05:14. | :05:17. | |
that there are measures at our disposable -- disposal to control | :05:18. | :05:23. | |
these prices and abuses which place intolerable pressure on NHS budgets. | :05:24. | :05:27. | |
It makes little sense that generic medicines can be controlled the | :05:28. | :05:30. | |
statutory scheme but that the Government is currently prevented | :05:31. | :05:34. | |
from stepping in for companhes branded products are regulated to | :05:35. | :05:39. | |
BPP RS. It seems clear we should remove this anomaly. I would add | :05:40. | :05:43. | |
that in using these powers to introduce price controls, the | :05:44. | :05:48. | |
Government should of course exercise caution and guard against any | :05:49. | :05:52. | |
unintended consequences that may impact on the viability of smaller | :05:53. | :05:55. | |
companies and I am sure that the Government will be alert to that. | :05:56. | :06:02. | |
The aims and provisions of the bill are admirable but it is onlx part of | :06:03. | :06:07. | |
a much wider debate about how we can sustain access to a ground-breaking | :06:08. | :06:11. | |
new treatments for the NHS hs in the middle of the longest financial | :06:12. | :06:15. | |
squeeze in its history. There was one intervention on the Govdrnment | :06:16. | :06:19. | |
side to Secretary of State which drew attention to the fact that the | :06:20. | :06:24. | |
total Belfour drugs is rising at an unsustainable rate. The Right | :06:25. | :06:29. | |
honourable member four at Chelmsford also raises questions and wd have to | :06:30. | :06:34. | |
address this. The NHS will not be sustainable at the current rate of | :06:35. | :06:39. | |
of drugs that we are witnessing at the moment. It is no secret the NHS | :06:40. | :06:47. | |
has struggled to adapt to ndw modern medicines, particularly those that | :06:48. | :06:52. | |
carry a large budget impact, both any case have had great difficulty | :06:53. | :06:57. | |
in figuring out which medichnes to approve and how those medichnes are | :06:58. | :07:02. | |
to be afforded and brought to patients. Recently, NHS England has | :07:03. | :07:05. | |
delayed funding for the new hepatitis C treatments that I was | :07:06. | :07:10. | |
interested in the points made by the SNP wrappers and to live a little | :07:11. | :07:16. | |
earlier. Despite being recolmended for use in the NHS, we also have the | :07:17. | :07:21. | |
ongoing and deeply unsavourx case of the prep treatment. Not onlx is NHS | :07:22. | :07:27. | |
England taking its legal ch`llenge to the bitter end to avoid having to | :07:28. | :07:31. | |
pay for the drug, there havd also been reports of it hitting patient | :07:32. | :07:35. | |
groups against each other bx saying that patients could miss out on | :07:36. | :07:41. | |
vital treatments for cancer, rare diseases for children, should prep | :07:42. | :07:45. | |
be funded. We don't want to get into this debate of comparing thd rights | :07:46. | :07:49. | |
and interests of one group of patients against another in this | :07:50. | :07:53. | |
way. Earlier this month, NHS England launched a consultation on proposals | :07:54. | :07:59. | |
to change the way some drugs are funded for there is a high costs | :08:00. | :08:05. | |
involved. Currently, NHS England are at legally required to fund drugs | :08:06. | :08:11. | |
recommended as being clinic`lly and cost effective, normally within | :08:12. | :08:15. | |
three months of guidance behng issued barring unique circulstances. | :08:16. | :08:20. | |
Under the new proposals, if it is recommended a drug will bring a | :08:21. | :08:24. | |
wreck -- estimated cost of the NHS wreck -- estimated cost of the NHS | :08:25. | :08:29. | |
above is certain eight, ?20 million of the suggested figure, NHS England | :08:30. | :08:34. | |
can go back and ask for longer to rule out the medicine if it's unable | :08:35. | :08:37. | |
to agree a lower price with the manufacturer. Surely this is | :08:38. | :08:41. | |
precisely the opposite of what we ought to be trying to achieve in | :08:42. | :08:45. | |
terms of speedier access to new drugs that are coming on stream | :08:46. | :08:50. | |
Ignoring questions about how that somewhat arbitrary cost of the 20 | :08:51. | :08:56. | |
million figure I referred to was arrived at, there is a concdrn that | :08:57. | :09:01. | |
this is the creeping step towards the rationing of approved treatments | :09:02. | :09:07. | |
in the NHS. It seems to me to be an admission in effect that thd NHS | :09:08. | :09:11. | |
cannot afford to pay even for the drugs which are found to be | :09:12. | :09:15. | |
have been raised by Nicholas have been raised by Nicholas | :09:16. | :09:21. | |
Timmins, the highly respectdd observer who was a senior fdllow at | :09:22. | :09:26. | |
the Kings fund. The great worry is that opening up the debate on how or | :09:27. | :09:32. | |
slowly approved treatments can be adopted will put us on a slhppery | :09:33. | :09:36. | |
slope to a new discussion on whether approved treatments should be | :09:37. | :09:41. | |
adopted at all and, at the very least, UK patients will be further | :09:42. | :09:45. | |
disadvantaged and the SNP spokesperson has already made the | :09:46. | :09:49. | |
point that we compare very badly with many other countries whth more | :09:50. | :09:53. | |
delays in getting access to new cost-effective treatments. H wonder | :09:54. | :09:59. | |
if he recognises the fact that Western the other countries, we are | :10:00. | :10:03. | |
one of the tiny handful that have allowed that opening price to be | :10:04. | :10:07. | |
completely set by the pharm`ceutical industry as high as they like. I | :10:08. | :10:13. | |
absolutely know at that point. I suppose the overall point I'm making | :10:14. | :10:18. | |
is that given the unsustain`ble increase of the total drugs bill, | :10:19. | :10:24. | |
given the actions that NHS Dngland are now taking, it appears `s if we | :10:25. | :10:28. | |
are going to be any more difficult position in terms of getting speedy | :10:29. | :10:32. | |
access to new drugs, which can be life-saving, and I think thd | :10:33. | :10:38. | |
Government needs to reflect on this. The SNP spokesperson made this point | :10:39. | :10:41. | |
in her speech, that this Bill tidies up things that have to be thdied up. | :10:42. | :10:46. | |
There is a much bigger debate about how unearthed the NHS is able to | :10:47. | :10:54. | |
afford vital treatments, whhch in other countries patients ard getting | :10:55. | :10:59. | |
access to much sooner. It strikes me that if we are approaching ` | :11:00. | :11:04. | |
situation where we are unable to cope with new treatments th`t have | :11:05. | :11:09. | |
been judged by an arms length expert body to be clinically effective for | :11:10. | :11:13. | |
patients and cost-effective for the NHS then it is yet more evidence | :11:14. | :11:20. | |
that the NHS needs more resources and I just repeat again to the | :11:21. | :11:25. | |
Minister, he will be very shck of hearing me say it, but at some | :11:26. | :11:29. | |
point, the Government has to recognise that we are simplx | :11:30. | :11:33. | |
drifting towards a crash with the NHS. We face, and existenti`l talent | :11:34. | :11:40. | |
which this debate this evenhng have highlighted. It has to be confronted | :11:41. | :11:46. | |
at some point. I urge the Government again to consider a cross-p`rty | :11:47. | :11:52. | |
approach so that we can achheve ultimately, any discussion with the | :11:53. | :11:55. | |
public a long-term sustainable settlement for the NHS which | :11:56. | :12:00. | |
recognises this dramatic increase in the cost of drugs but recognises | :12:01. | :12:05. | |
also that all of our loved ones want to get access to those | :12:06. | :12:10. | |
We should also be mindful of the potential impact of Brexit on the | :12:11. | :12:17. | |
life sciences industry and the additional challenges we face in | :12:18. | :12:23. | |
keeping the NHS medicines Bhll under control if trade between thd UK and | :12:24. | :12:28. | |
the EU becomes subject to ctstoms duties, import VAT and borddr | :12:29. | :12:33. | |
controls, thereby increasing costs to the life sciences industry and in | :12:34. | :12:37. | |
turn potentially drive up the costs of new medicines to the NHS and | :12:38. | :12:43. | |
impact access on UK patients to the most innovative treatments. Finally, | :12:44. | :12:52. | |
we also need to make sure evaluation process and methodology are fit for | :12:53. | :12:56. | |
purpose. Traditional appraisal methods and the notions of cost | :12:57. | :13:01. | |
effectiveness are unsuitabld for many modern medicines, especially | :13:02. | :13:05. | |
drugs of immense scientific innovation that target just a small | :13:06. | :13:10. | |
number of patients but the NHS has been slow to respond. The C`ncer | :13:11. | :13:16. | |
Drugs Fund is the case in point established as a sticking plaster | :13:17. | :13:20. | |
after a cost of promising drugs were judged to be not cost-effective | :13:21. | :13:24. | |
While it is almost certainlx the case many of these treatments came | :13:25. | :13:30. | |
with too high a price to be routinely funded, few would deny | :13:31. | :13:35. | |
they were being evaluated under outdated processes that could not | :13:36. | :13:39. | |
for the capture of their value, many rare disease treatment suffdr from | :13:40. | :13:43. | |
the same problem. Companies have a duty to ensure their medicines are | :13:44. | :13:51. | |
priced but NHS England and Knives have a duty to make sure thdir | :13:52. | :13:55. | |
evaluation processes and decision-making criteria ard fit for | :13:56. | :13:57. | |
purpose sought new medicines are given a fair hearing what ott some | :13:58. | :14:02. | |
of the excessive delays we have seen recently. We owe it to patidnts to | :14:03. | :14:08. | |
make sure it happens. To conclude, I support this tidying up measure and | :14:09. | :14:13. | |
I support in particular endhng the outrageous practice of a nulber of | :14:14. | :14:18. | |
companies in profiteering at the expense of NHS patients. Thhs debate | :14:19. | :14:23. | |
has also raised it much bigger issue about how we afford in this country | :14:24. | :14:28. | |
ground-breaking treatments which keep our loved ones alive. | :14:29. | :14:36. | |
It is a pleasure to speak in support of the medical supplies costs bill | :14:37. | :14:42. | |
which affects my constituents in North Wales as it applies UK wide. | :14:43. | :14:47. | |
It is an example of the Govdrnment responding reasonably quickly to | :14:48. | :14:51. | |
issues brought to its attention and it deserves credit that. My | :14:52. | :14:56. | |
principal reason for supporting this bill relates to the vast increase in | :14:57. | :15:02. | |
cost of certain of patented drugs. As we heard, and also the ilpact of | :15:03. | :15:08. | |
those. I first had contacts from constituents in June about ` | :15:09. | :15:14. | |
loophole in existing regulations leading to some generic drugs being | :15:15. | :15:20. | |
high price up to 12,000%. This fall on from the Times investigation 50 | :15:21. | :15:28. | |
drugs were identified, costhng 262 million a year for the NHS. That | :15:29. | :15:32. | |
practice followed on. The epuivalent of 7000 junior doctors. There has | :15:33. | :15:39. | |
not been similar price incrdases are coming in mainland Europe or I do | :15:40. | :15:43. | |
not believe there has been, which tends to suggest we have sole | :15:44. | :15:49. | |
fielders in our own regulathons We also discussed this matter hn the | :15:50. | :15:54. | |
select committee and saw evhdence of correspondence which highlighted it | :15:55. | :15:59. | |
for at least one year. We should not just refer to costs, there `re also | :16:00. | :16:05. | |
real big impact on patients themselves when they have the drugs | :16:06. | :16:11. | |
withdrawn from them. The issue hits home particularly for me whdn I make | :16:12. | :16:15. | |
a constituents at the surgery of mine in the summer and she has given | :16:16. | :16:21. | |
me permission to talk about her story. She was diagnosed with | :16:22. | :16:27. | |
hypothyroidism, and underactive thyroid, in 2006 and had typical | :16:28. | :16:32. | |
symptoms of weight gain, here are stunning, brittle nails, tiredness, | :16:33. | :16:37. | |
peeing all over and a low moods and was prescribed the usual trdatment | :16:38. | :16:43. | |
in such circumstances. She was also given a cocktail of other drugs | :16:44. | :16:49. | |
because the other drug did not work so she was on quite strong | :16:50. | :16:53. | |
medication for an extended period of time. She saw her endocrinologist | :16:54. | :17:02. | |
and 2014 and he started a dhfferent drug which she described as an | :17:03. | :17:07. | |
absolute revelation and she said she was so much better than four years | :17:08. | :17:11. | |
and brain fog lifted at energy levels soared. When she tridd to | :17:12. | :17:15. | |
reduce the dose of the drug she found her symptoms began to return | :17:16. | :17:20. | |
and had to have some time off work. She is now a teaching and c`retaker. | :17:21. | :17:28. | |
The daughter she is taking now was acquired from a company in 0992 and | :17:29. | :17:39. | |
to put the costs into perspdctive, a packet of this drug in 2011 was ?34 | :17:40. | :17:47. | |
65 and this year it is ?250 20. A 645% increase which is a relatively | :17:48. | :17:54. | |
insignificant compared to some of the other examples but is still an | :17:55. | :18:02. | |
example of a really quite significant increase nevertheless. I | :18:03. | :18:06. | |
understand drugs that work costing ?3.4 million a year in 2010 now cost | :18:07. | :18:11. | |
the NHS over 20 million. My local health board is on .gov -- | :18:12. | :18:18. | |
understandably concerned as other elements of the NHS also ard and is | :18:19. | :18:25. | |
looking into withdrawing thhs drug. For my constituents that makes | :18:26. | :18:28. | |
anxious and she is worried `bout the impact on her colleagues if she | :18:29. | :18:34. | |
cannot work and her pupils `nd she has two children of her own as well. | :18:35. | :18:41. | |
The Department of Health as the competition and market authority to | :18:42. | :18:43. | |
investigate this issue which may or may not result in a good outcome but | :18:44. | :18:48. | |
it is not a sustainable way forward. It will much about the loophole or | :18:49. | :18:51. | |
stop the same thing happening again which is why we need this | :18:52. | :18:59. | |
legislation. The generic market is generally competitive with fair | :19:00. | :19:03. | |
prices for all and I believd it comprises of ?4 billion of the 15.2 | :19:04. | :19:09. | |
billion spent by the NHS on drugs per annum or ?4 billion is ` 20 | :19:10. | :19:14. | |
rise over the past five years. There is a statutory system which can in | :19:15. | :19:19. | |
theory control prices of both branded and non-branded drugs | :19:20. | :19:23. | |
however there is the loophole is discussed. The loophole involves all | :19:24. | :19:29. | |
generics are available usually via one manufacturer or supplier which | :19:30. | :19:35. | |
also market branded drugs and is a member of the voluntary regtlation | :19:36. | :19:40. | |
scheme, PPRS, in relation to these. Their membership of the PPRS means | :19:41. | :19:44. | |
under existing legislation they cannot currently be subject to the | :19:45. | :19:49. | |
statutory scheme, even for the generic drugs. There are concerned | :19:50. | :19:54. | |
this loophole has been exported by some and, indeed, it has potentially | :19:55. | :20:01. | |
been a delivers business model to purchase off patented medichnes for | :20:02. | :20:05. | |
which there are no competithve manufacturers, in other words, where | :20:06. | :20:10. | |
there is no competition. Yot might ask why with other drug companies | :20:11. | :20:15. | |
not seek to manufacture these drugs if they are being sold for such | :20:16. | :20:20. | |
large quantities. Introducing new competition is not always fdasible | :20:21. | :20:26. | |
due to the time taken to obtain and licensing due to often small size of | :20:27. | :20:31. | |
the market once they are produced and also of due to a diffictlt | :20:32. | :20:36. | |
manufacturing process. I support change in primary road legislation | :20:37. | :20:42. | |
to the 2006 act which would allow Government to consult and bring | :20:43. | :20:45. | |
forward enforcement of statttory controls on all generic drugs to | :20:46. | :20:50. | |
require, if necessary, comp`nies to reduce the price of drugs or for | :20:51. | :20:52. | |
other controls to be imposed. This other controls to be imposed. This | :20:53. | :20:57. | |
amounts to an extension of dxisting deterrent power was the secretary of | :20:58. | :21:01. | |
state has not yet used to dhrect the prices of drugs which already fall | :21:02. | :21:07. | |
under the statutory scheme. Assuming Royal assent of this bill in early | :21:08. | :21:12. | |
2017 we would then need investigations and discussions with | :21:13. | :21:14. | |
the companies concerned where that have been issues raised and it is | :21:15. | :21:19. | |
important we are fair not only to the taxpayer but also to thd | :21:20. | :21:23. | |
companies. If not, the ultilate risk remains the product should be taken | :21:24. | :21:29. | |
off the market. For my constituents, where is she left? She is hoping | :21:30. | :21:34. | |
this bill goes through, she will also be looking to BCMA to come | :21:35. | :21:40. | |
forward with some good news. -- the CMA. She may be tempted to purchase | :21:41. | :21:48. | |
the drug from abroad or onlhne. I think interim agreements allow | :21:49. | :21:54. | |
patients like her to continte to receive her prescription nedds to be | :21:55. | :21:59. | |
considered and if the Government does feel that the drugs can be | :22:00. | :22:04. | |
acquired from abroad at a mtch better rate than people likd her | :22:05. | :22:08. | |
would appreciate if that cotld be assisted. I think for all, ` routine | :22:09. | :22:12. | |
and systematic monitoring of drug costs is good to be important. There | :22:13. | :22:17. | |
are two other principal elelents of the bill which I will briefly | :22:18. | :22:22. | |
referred to. Secondly, therd are changes to the statutory scheme | :22:23. | :22:27. | |
proposed and in autumn 2015 the secretary of state consultant on | :22:28. | :22:31. | |
strengthening the statutory scheme. This bill proposes to bring | :22:32. | :22:36. | |
statutory scheme in line with the voluntary 2014 PPRS for all those | :22:37. | :22:41. | |
manufacturers or supplier is not PPRS members. There are 166 | :22:42. | :22:47. | |
within the PPRS and ?8 billhon and within the PPRS and ?8 billhon and | :22:48. | :22:55. | |
is currently sped through a mechanism and ?647 million `rt | :22:56. | :22:57. | |
brought back to the taxpayer each year when the agreed cap has been | :22:58. | :23:03. | |
exceeded. There are just 17 companies within the statutory | :23:04. | :23:07. | |
scheme through which ?1 billion is spent. There is evidence of | :23:08. | :23:11. | |
companies switching from thd voluntary to the statutory scheme | :23:12. | :23:17. | |
for financial reasons, meanhng an annual ?88 million annual loss to | :23:18. | :23:22. | |
the taxpayer. These companids should be. -- are mostly small and non UK | :23:23. | :23:27. | |
based. Changes to the schemd will require companies to make p`yments | :23:28. | :23:30. | |
back to the Department of Hdalth based on level of sales to the NHS. | :23:31. | :23:34. | |
This can be in addition to other mechanisms. Whereas the existing | :23:35. | :23:41. | |
statutory scheme operates vha a cut to the public, splice currently set | :23:42. | :23:47. | |
at 15% so the existing schele and brings in less money but also result | :23:48. | :23:53. | |
in an equity to companies, risk to supply and uncertainty of fhnancial | :23:54. | :23:57. | |
outcomes for complex reasons that I will not go into. But, so the bill | :23:58. | :24:05. | |
proposes new penalties for noncompliance and recovery of | :24:06. | :24:09. | |
payments owed to the courts. Ultimately, this bill creatds a more | :24:10. | :24:12. | |
level playing field between companies in the two schemes and it | :24:13. | :24:16. | |
merely extends what is in place for the vast majority of companhes so I | :24:17. | :24:21. | |
do not see it as being in any way unreasonable and I do not bdlieve | :24:22. | :24:24. | |
there should be major concerns regarding the impact on resdarch and | :24:25. | :24:28. | |
investment. The third part of the bill refers to inflammation powers | :24:29. | :24:32. | |
and that brings together thd information requirements for NHS | :24:33. | :24:37. | |
medicines and other supplies in the NHS act. It enables the Govdrnment | :24:38. | :24:42. | |
regulations to obtain inforlation on the sales and purchases of ledicines | :24:43. | :24:46. | |
and other supplies from all parts of the supply chain, manufacturing and | :24:47. | :24:51. | |
distribution, pharmacy to ddfine purposes. This will improve the data | :24:52. | :24:55. | |
which informs reimbursement arrangements for the communhty | :24:56. | :24:58. | |
pharmacy and GP practices. Ht will also help to ensure value for money. | :24:59. | :25:05. | |
These are positive proposals but it is important they are not over | :25:06. | :25:08. | |
bearing on the companies concerned. In particular, I want to make the | :25:09. | :25:13. | |
case for medical technology and devices businesses as they have not | :25:14. | :25:17. | |
been subject to such data collection in the past the secretary of state | :25:18. | :25:20. | |
has given us some reassurance about that today but we need to rdcognise | :25:21. | :25:24. | |
a large proportion of these businesses, maintaining percent our | :25:25. | :25:29. | |
SMEs supplement to work with industry to develop approprhate | :25:30. | :25:35. | |
regulations. We need to avohd onerous and routine data collection | :25:36. | :25:40. | |
is going beyond existing data required by future Massey. H support | :25:41. | :25:45. | |
the principles of this bill and the Association of British | :25:46. | :25:47. | |
pharmaceutical industry largely support it also but the det`il will | :25:48. | :25:50. | |
be subject to consultation during be subject to consultation during | :25:51. | :25:53. | |
2017 and I look forward to scrutinising progress over the | :25:54. | :25:58. | |
coming months. It is a pleasure to form up my | :25:59. | :26:04. | |
honourable friend. And if you're much of the points he has m`de. One | :26:05. | :26:10. | |
point he bit was about how 252 million being spent by the NHS and | :26:11. | :26:18. | |
50 drugs. It is actually 262 million extra backs to the increase in | :26:19. | :26:24. | |
prices. That really brings home the problem this is causing and why we | :26:25. | :26:30. | |
need to look at this bill again Devon the many members have already | :26:31. | :26:33. | |
focused on a range of areas I wanted to focus on the issue of generic | :26:34. | :26:39. | |
drugs and some of the huge price increases we have seen. It hs right | :26:40. | :26:44. | |
to say and I've audit following the intervention of the member from | :26:45. | :26:50. | |
Wolverhampton South West, actually, it is not unreasonable for ` | :26:51. | :26:53. | |
pharmaceutical company to m`ke a profit in exchange for investment it | :26:54. | :26:58. | |
has made to develop a new drug and bringing to market. That is what | :26:59. | :27:02. | |
operating system is therefore. The paper is there to protect for a | :27:03. | :27:05. | |
period of time the ability for the company to charge a reasonable price | :27:06. | :27:09. | |
to reflect the risk and invdstment. The keyboards at about the struggles | :27:10. | :27:14. | |
of the out of the pit. They are drugs no longer patented. The | :27:15. | :27:19. | |
company had a reasonable period of time to make investment bank and | :27:20. | :27:23. | |
there is a limited supply and therefore it is on the road we go in | :27:24. | :27:28. | |
and deal with what is an emdrging business. There is 02 bits `bout | :27:29. | :27:35. | |
that. Some of the names the list -- there are no two ways about that. | :27:36. | :27:39. | |
Some of the companies are consistently having unusually high | :27:40. | :27:44. | |
increases in prices and it hs clearly business model is ddveloping | :27:45. | :27:47. | |
to take advantage of the loophole and at the end of the day not to | :27:48. | :27:52. | |
make a profit but to property and to property of the energy -- of the NHS | :27:53. | :28:00. | |
-- to property of the NHS. We can all think of instances were drug | :28:01. | :28:04. | |
company lobbying points the patient is unable to get treatment `nd this | :28:05. | :28:08. | |
is the sort of thing that mdans people cannot get treatment. Here we | :28:09. | :28:18. | |
are as Conservatives are dohng prose controls but it is clear thhs is not | :28:19. | :28:23. | |
about intervening in a markdt, it is about market failure. Where the | :28:24. | :28:26. | |
normal procedures of compethtion are not producing fair or reasonable | :28:27. | :28:33. | |
outcomes either for the NHS patient we are providing products on behalf | :28:34. | :28:39. | |
of all. I saw the amazing work done on brain tumour research at Plymouth | :28:40. | :28:44. | |
University recently and saw some of the skills and ground-breakhng | :28:45. | :28:49. | |
research they use that bring real benefits but that is not thd | :28:50. | :28:52. | |
business model of these particular companies, the model is to look for | :28:53. | :28:57. | |
a drug that is to be prescrhbed and has one supply, buy it, get hold of | :28:58. | :29:01. | |
the supply and increase price. That is nothing to do with delivdring new | :29:02. | :29:07. | |
and products. For me this bhll is very welcome and its propos`ls to... | :29:08. | :29:20. | |
And if you are putting to look up your product 12,000%, you whll not | :29:21. | :29:29. | |
be co-operative into an enqtiry The Secretary of State will havd powers | :29:30. | :29:31. | |
to require more information to be supplied. I give way. I am grateful | :29:32. | :29:38. | |
to my new friend, another socialist, for giving way. Can I suggest other | :29:39. | :29:44. | |
areas of the economy where his Christian Democrat fellows would be | :29:45. | :29:52. | |
prepared to address profitedring? Well, I thank him, he tempts me but | :29:53. | :29:58. | |
seeing Mr Deputy Speaker is in the chair, it is tough on relathve | :29:59. | :30:02. | |
points going off the subject and I could be dangerous territorx. We | :30:03. | :30:10. | |
have seen work government h`s done in other sectors, the energx sector | :30:11. | :30:17. | |
but this is a unique practice where there is only one customer, the NHS | :30:18. | :30:21. | |
in large part, and where thdre is only one supplier. I'm struggling to | :30:22. | :30:26. | |
think of other industries that replicate that but that is why these | :30:27. | :30:32. | |
price rises are disgraceful and this industry is about profiteerhng of | :30:33. | :30:36. | |
illness and pain. I briefly give way. Can I suggest another hndustry | :30:37. | :30:43. | |
where it is worth looking at, the defence Supply industry. Parts of | :30:44. | :30:48. | |
it. I thank him for the intervention. I have spent plenty of | :30:49. | :30:54. | |
time looking through examplds of defence procurement that have gone | :30:55. | :31:00. | |
wrong although to be fair to the minister, he may be new to the | :31:01. | :31:03. | |
health department but not the issues of tackling in defence proctrement. | :31:04. | :31:09. | |
It is noticeable that most of the issues making their way for the | :31:10. | :31:13. | |
review of what went wrong otr legacy issues that were still -- wd are | :31:14. | :31:19. | |
still dealing with rather than the modern procurement. I'm conscious we | :31:20. | :31:24. | |
do have the Deputy speaker hn the chair and I need to get back to the | :31:25. | :31:30. | |
price of drugs. It is clear from looking to the evidence that the | :31:31. | :31:34. | |
current system of regulation is not effective given that you can put | :31:35. | :31:38. | |
branded projects into the voluntary scheme and use that to jack up costs | :31:39. | :31:43. | |
for your generic products. @nd that is not right. As other membdrs said, | :31:44. | :31:50. | |
we are all facing demands on the NHS and I have no problem with companies | :31:51. | :31:54. | |
who give good service charghng a fair price and making a fair return. | :31:55. | :31:59. | |
But that is clearly not what is going on with this business model | :32:00. | :32:04. | |
and we can see numerous exalples, especially the chart in the library | :32:05. | :32:08. | |
showing thousands of percents across a number of products. It is | :32:09. | :32:12. | |
impossible to believe the thousands of % increases are going on in any | :32:13. | :32:19. | |
of the input materials to this products. This is vagrant | :32:20. | :32:23. | |
racketeering and profiteering going on at the expense of patients and | :32:24. | :32:29. | |
people in pain. Even if the drug is still provided, it is money and | :32:30. | :32:31. | |
resources that should have been spent elsewhere. That is whx pleased | :32:32. | :32:38. | |
to see the unanimity breaking out in the house this evening around these | :32:39. | :32:41. | |
proposals although there is a need to discuss them in more det`ils in | :32:42. | :32:47. | |
committee but this bill is the right time, it is not about tacklhng | :32:48. | :32:50. | |
legitimate profits, it is about getting rid of profiteering and it | :32:51. | :32:57. | |
has my full support. It is ` pleasure to be called to spdak in | :32:58. | :33:02. | |
this debate today and to follow my honourable friend from Torb`y. From | :33:03. | :33:06. | |
what I understand, it will close the loopholes and gaps that exist in the | :33:07. | :33:12. | |
current powers given to the Secretary of State and my friends | :33:13. | :33:17. | |
before me have highlighted the loopholes and gaps. Overall the | :33:18. | :33:23. | |
measures are important to ensure we have value for the taxpayer across | :33:24. | :33:29. | |
the medicines budget. But where I take issue with the proposals is the | :33:30. | :33:35. | |
inclusion of medical supplids, other related products. As part of the | :33:36. | :33:42. | |
third element of the bill. This element introduces a new information | :33:43. | :33:46. | |
power for the Secretary of State and while I welcome this in principle, | :33:47. | :33:52. | |
it may be own arrest for sm`ll enterprises that supplied to this | :33:53. | :34:00. | |
side of the business. I am sure much of the required information has been | :34:01. | :34:07. | |
collated by each company but it s important it can be transmitted in | :34:08. | :34:13. | |
an easy and timely fashion. I was listening carefully to the Secretary | :34:14. | :34:16. | |
of State and he implied he does not want the measures he suggests to be | :34:17. | :34:22. | |
burdensome but I seek the mhnisters assurance on this issue. Dods my | :34:23. | :34:32. | |
honourable friend, it is thd ability to use the data effectively that is | :34:33. | :34:37. | |
important, there is no point in collecting data and not being able | :34:38. | :34:45. | |
to use it. I give way. Coupling those two together, does shd agree I | :34:46. | :34:50. | |
be advisable for the governlent to look at a threshold, a turnover | :34:51. | :34:53. | |
threshold below which this information were not have to be | :34:54. | :34:59. | |
supplied or might be supplidd to a lesser extent and quantity | :35:00. | :35:02. | |
addressing the issue of how homeless this might be but could address | :35:03. | :35:07. | |
issues of whether the government has the capacity to crunch the figures. | :35:08. | :35:14. | |
He makes a good point, therd is a cut off for some of the dat` | :35:15. | :35:19. | |
collection or different parts in existence and it might be ?4 million | :35:20. | :35:25. | |
turnover but we can get clarification on that. What concerns | :35:26. | :35:28. | |
me more is who will define what is classified as a medical supply and | :35:29. | :35:39. | |
other related products? As we heard, in an intervention, really ht is how | :35:40. | :35:45. | |
long is that piece of string? Section 264 supplements and it | :35:46. | :35:54. | |
requires the Secretary of State to consult anybody like the Association | :35:55. | :36:00. | |
of the pharmaceutical industry which appears to represent manufacturers | :36:01. | :36:04. | |
and distributors and supplidrs of health service medicines, mddical | :36:05. | :36:06. | |
supplies or related products acquired for the purposes of the | :36:07. | :36:11. | |
health service in England or the UK before making any regulations under | :36:12. | :36:19. | |
section 264 a or B. But, if the definition of supplies is unclear, | :36:20. | :36:22. | |
how would the Secretary of State know who to consult with? Hd | :36:23. | :36:27. | |
indicated he has had discussions with medicine and medical ddvice | :36:28. | :36:32. | |
suppliers but I fear there lay be more product areas out therd that | :36:33. | :36:36. | |
have been missed out of the initial discussions. I ask the Secrdtary of | :36:37. | :36:42. | |
State to provide guidance on what he understands as medical supplies and | :36:43. | :36:48. | |
other related products. For example, does it include in vitro di`gnostic | :36:49. | :36:59. | |
products or IVDs? So, if it includes IVDs, does he agree to constlt with | :37:00. | :37:05. | |
the Association, the trade association which represents this | :37:06. | :37:11. | |
industry across the UK? This is an important area for the life sciences | :37:12. | :37:15. | |
industry with nearly 900 million pathology tests performed every | :37:16. | :37:20. | |
year. And with 70% of every clinical decision being made using some form | :37:21. | :37:26. | |
of IVD. If they are included, we need to be around the table to | :37:27. | :37:33. | |
participate. I wish to conclude by saying in general terms I al in | :37:34. | :37:37. | |
favour of this bill as it is ensuring good value for mondy for | :37:38. | :37:40. | |
taxpayers and ultimately for patients. That is what we nded to be | :37:41. | :37:46. | |
thinking about, the patient. However, there does need to be some | :37:47. | :37:50. | |
clarification throughout thd bill which will be sought out at | :37:51. | :37:55. | |
committee stage and I support the bill tonight. Thank you. It is a | :37:56. | :38:02. | |
pleasure to follow my honourable friend. We know old ground, the | :38:03. | :38:13. | |
ageing population, the costs bearing down which other members alluded to | :38:14. | :38:19. | |
earlier. We know the advancds in science are going quicker than we | :38:20. | :38:26. | |
can make the legislation. One of my local CCGs suffered an exorbitant | :38:27. | :38:32. | |
increase in capsules having to find another 600,006 months. Needing to | :38:33. | :38:39. | |
look at drugs more widely, the honourable member from South Suffolk | :38:40. | :38:43. | |
mentioned if paracetamol was not prescribed in that CCG it would save | :38:44. | :38:48. | |
?1 million a year. The meastres in the bill aimed to manage thd cost of | :38:49. | :38:53. | |
drugs. The measure to make dfficient data correction is also most welcome | :38:54. | :39:00. | |
so that we start to have a decision-making based on evhdence. | :39:01. | :39:05. | |
Last autumn the Secretary of State consulted publicly on how to address | :39:06. | :39:09. | |
the problem of excessively priced unbranded medicines and the industry | :39:10. | :39:14. | |
fed back. They were glad of the dialogue. Drug costs are | :39:15. | :39:19. | |
unsustainable. A saving of 80 million per health area was | :39:20. | :39:26. | |
identified, my only CCG could save ?1 million per annum from an repeat | :39:27. | :39:30. | |
prescriptions. Nationally, ht would mean more than 12,000 more community | :39:31. | :39:35. | |
nurses could actually be employed. We need to start making these | :39:36. | :39:39. | |
decisions where we want to be spending the money. The pressure on | :39:40. | :39:45. | |
social care, as was alluded to, I decisions we are going to h`ve to | :39:46. | :39:49. | |
make as a government, and as patients. The current systel allows | :39:50. | :39:54. | |
for some to be in and others to be outside the system and it lhmits the | :39:55. | :39:59. | |
robustness and I support it wholeheartedly. Does not target | :40:00. | :40:02. | |
those who do not play fair `nd we need to stamp down on it. It is | :40:03. | :40:07. | |
those better patient outcomds that I'm passionate about. We all play a | :40:08. | :40:12. | |
part including the pharmacist industry because of the unipue | :40:13. | :40:15. | |
industry in this country. The industry is important to us as the | :40:16. | :40:23. | |
member for Chelmsford and South West Bedfordshire and the Cities of | :40:24. | :40:26. | |
London and Westminster have alluded to, we need to be supportivd of the | :40:27. | :40:31. | |
companies that work positivdly for patients and engage in trying to | :40:32. | :40:37. | |
find solutions. The Association of British pharmaceutical industry | :40:38. | :40:39. | |
supports the government in increasing powers where market | :40:40. | :40:43. | |
failure has occurred. There is a balance between ensuring new drugs | :40:44. | :40:48. | |
are developed which brings le to off label drugs, those that havd another | :40:49. | :40:52. | |
use the which they were originally formulated. | :40:53. | :41:03. | |
Many drugs originally developed for morning sickness but have bden found | :41:04. | :41:09. | |
latterly to be very benefichal for the treatment of some cancers and | :41:10. | :41:14. | |
skin conditions. We need to understand these new uses for | :41:15. | :41:19. | |
approved drugs for the speediest of transitions from bench to bddside. | :41:20. | :41:23. | |
As they have not been through trials yet, we also need to be mindful this | :41:24. | :41:28. | |
is not a new drug, and just because the target... Drug should bd costed. | :41:29. | :41:40. | |
Does she remember the time that was spent last November debating the | :41:41. | :41:47. | |
offer patented drugs bill and when I flagged up the concern that for a | :41:48. | :41:52. | |
doctor prescribing a drug whth a license for use takes precedence | :41:53. | :41:55. | |
over and off Peyton drug whhch may do the same and with this g`ming we | :41:56. | :42:01. | |
have seen, there is a concern that the drug companies will twe`k a drug | :42:02. | :42:05. | |
in a slight manner and sell it to the NHS at hundreds of thousands | :42:06. | :42:11. | |
when an offer patented drugs would do the same and that has not been | :42:12. | :42:12. | |
dealt with. I thank her after making thd point | :42:13. | :42:21. | |
so succinctly. I am also gr`teful for the Secretary of State for the | :42:22. | :42:25. | |
clarification and the honourable member comments around the | :42:26. | :42:28. | |
technology industry which I do believe need looking at. I would be | :42:29. | :42:34. | |
grateful to know that the s`vings made are likely to be reinvdsted | :42:35. | :42:39. | |
into patients particularly given my position as chair of the APG on | :42:40. | :42:42. | |
personalised medicine into the latest medicines and treatmdnt. This | :42:43. | :42:47. | |
Bill is designed to stop individuals making vast sums of money and taking | :42:48. | :42:51. | |
advantage of a loophole and I backed the Government's aim of valte for | :42:52. | :42:56. | |
money and fair prices for optimum patient outcomes. I am heartened to | :42:57. | :43:00. | |
see the cross-party support for this Bill and look forward to seding it | :43:01. | :43:09. | |
to make positive progress. Thank you, Mr Deputy Speaker. I would like | :43:10. | :43:13. | |
to thank those members who lade contributions to the debate today. | :43:14. | :43:17. | |
We find ourselves in a situ`tion where we have some time avahlable | :43:18. | :43:22. | |
which is amazing. What we rdfer to the interventions that we hdard in | :43:23. | :43:26. | |
the early part of the debatd because I think there have been a r`nge of | :43:27. | :43:29. | |
interesting points. The honourable member for Totnes rage the view that | :43:30. | :43:36. | |
it gives the opportunity to that that drugs that have not bedn | :43:37. | :43:44. | |
licensed, but so needed eye that group of people. And I was pleased | :43:45. | :43:48. | |
to hear the Secretary of St`te say that he would look at that. My | :43:49. | :43:55. | |
friend Wilbur Hampton Southwest -- Wolverhampton South West. In a | :43:56. | :43:59. | |
number of quite a music interventions has talked about a | :44:00. | :44:04. | |
policy on profit control of the farm sector and said that the party of | :44:05. | :44:07. | |
Sid is marching on to the cdntre ground and perhaps gone past the | :44:08. | :44:16. | |
march of dissent. -- opposite. The member for Leicester East | :44:17. | :44:18. | |
particularly talked about the proportion of the NHS budget spent | :44:19. | :44:23. | |
on diabetes, he was concerndd about the increase in the drugs Bhll and | :44:24. | :44:27. | |
suggested the use of structtred interventions, not just for drugs | :44:28. | :44:29. | |
for those people because it is such a large proportion of the NHS Bill | :44:30. | :44:37. | |
that is spent on diabetes. Honourable friend for Alan `nd | :44:38. | :44:40. | |
Deeside made the point that we need to make sure that measures of this | :44:41. | :44:43. | |
Bill do not act as a disincdntive for Pharma companies to makd | :44:44. | :44:50. | |
contributions to companies. I think many of the members contribtting to | :44:51. | :44:53. | |
make know we are walking thd line here in terms of making savhngs but | :44:54. | :44:57. | |
making sure there aren't disincentives. The red honotrable | :44:58. | :45:00. | |
member for Chelmsford welcoled the Bill. He talked about our ageing | :45:01. | :45:04. | |
conch dashed back on probathon and we talked about that. The ilportance | :45:05. | :45:10. | |
of new drugs but they need to deal with unacceptable profiteerhng and a | :45:11. | :45:14. | |
number of members of refer to that. The honourable lady for Central | :45:15. | :45:17. | |
Ayrshire talked about having the biggest research network in the | :45:18. | :45:20. | |
world but topped about change and talked that the Pharma comp`nies | :45:21. | :45:26. | |
would be anxious and... She welcomed the tidying up aspect of thd Bill | :45:27. | :45:29. | |
and I think that was a general view that members on all sides of the | :45:30. | :45:33. | |
housework not. She talked and the number of members have done in this | :45:34. | :45:38. | |
debate about not just in a building the management of cost pressures but | :45:39. | :45:41. | |
doing something more radical and I think that has been a real flavour | :45:42. | :45:46. | |
of this debate. Using this `s an opportunity to do something | :45:47. | :45:50. | |
different, I agree with her concerns about the data collection aspects of | :45:51. | :45:53. | |
the Bill and I will say mord about that. But I also agree that we need | :45:54. | :45:57. | |
to do something more radical and for instance she talked about t`ckling | :45:58. | :46:01. | |
the five-year delay to access new medicines and rightly points out | :46:02. | :46:04. | |
that that is probably where or poorest survival rates are coming | :46:05. | :46:08. | |
from. The honourable member for Southwest at Fisher commenddd the | :46:09. | :46:13. | |
Times for investigating this issue we are talking about that tonight. | :46:14. | :46:15. | |
Also talked about the inforlation powers. He talked about was of the | :46:16. | :46:19. | |
Department for health at thd analytical ability to use the data | :46:20. | :46:23. | |
being gathered and that is `n important question. If new data is | :46:24. | :46:26. | |
being required to be gatherdd what are we going to do with the? The red | :46:27. | :46:31. | |
honourable member per in West Norfolk acknowledge the valte of the | :46:32. | :46:34. | |
competitive market but also talked about the sometimes outrageous | :46:35. | :46:37. | |
increases in the price of gdneric drugs and we have heard somd | :46:38. | :46:40. | |
staggering examples today including the example of a rise of ?600 per | :46:41. | :46:45. | |
item dispensed in one particular case. He hoped as other members have | :46:46. | :46:50. | |
that the Competition and Markets Authority would take action and I | :46:51. | :46:53. | |
think that has been a key theme tonight. He talked also abott not | :46:54. | :46:57. | |
wanting to fit the needs and interests of some patients were | :46:58. | :47:00. | |
needing drugs like prep versus other needed drugs and I agree. I don t | :47:01. | :47:05. | |
think we want to go there. He also talked about the fact that this is a | :47:06. | :47:09. | |
slippery slope when we get hnto debating whether to delay adopting | :47:10. | :47:14. | |
even approved treatments. In his view that is more evidence that the | :47:15. | :47:17. | |
NHS needs more resources. The honourable member Clwyd talked about | :47:18. | :47:23. | |
the impact on his constituent of a drug prescribed to her which helps | :47:24. | :47:25. | |
her work and increases energy levels but the cost of which has increased | :47:26. | :47:31. | |
by 645% and we must keep focus on the impact of individuals of the | :47:32. | :47:34. | |
decisions that we make becatse having found a drug that suhts her | :47:35. | :47:37. | |
it would be dreadful that w`s withdrawn. He also talked about the | :47:38. | :47:43. | |
difficulties of increasing new competition into the market. His | :47:44. | :47:46. | |
constituent is hoping the Bhll goes through as are many tonight and for | :47:47. | :47:50. | |
action on competition and m`rkets and let's all hope that goes | :47:51. | :47:54. | |
through. The honourable member for Torbay talked about intervening to | :47:55. | :47:57. | |
deal with market failure and his view was that we need to separate | :47:58. | :48:03. | |
out the companies that are doing good research, brain tumour research | :48:04. | :48:06. | |
that he has seen recently, `nd those that are having nothing to do with | :48:07. | :48:08. | |
producing new and innovativd products but are just making money. | :48:09. | :48:15. | |
Will my friend give way? Can I cite her and he has the library brief | :48:16. | :48:18. | |
because it isn't exactly as cut and dry as the honourable member for | :48:19. | :48:22. | |
Torbay may have been thinking. The library brief tells us that the | :48:23. | :48:27. | |
competitions and market authority took action against pharmacdutical | :48:28. | :48:30. | |
companies with regards to gdneric pricing. Glaxo Smith Kline `nd a | :48:31. | :48:35. | |
number of other companies wdre fined 45 million when it was found that | :48:36. | :48:38. | |
payments had been made in order to prevent the added. The situ`tion | :48:39. | :48:43. | |
being offered on the market. So SmithKline is a great Pharm` company | :48:44. | :48:48. | |
incomes are turning up of ndw drugs that crossed the line in thhs case | :48:49. | :48:51. | |
according to the library brhefs with is not either or. No, but I think | :48:52. | :48:57. | |
the honourable member for Torbay was talking about companies that are not | :48:58. | :49:01. | |
even doing research, just btying up generic drugs and profiteerhng. I | :49:02. | :49:04. | |
think generally that has bedn a condemnation on all sides of that. I | :49:05. | :49:10. | |
thank the Shadow Minister forgiving way. To be clear I think shd | :49:11. | :49:14. | |
probably agreed that it is names that keep on popping up particularly | :49:15. | :49:18. | |
in the Times investigation of companies who seem to be quhte | :49:19. | :49:23. | |
regularly revolve in the most eye watering price increases and this is | :49:24. | :49:26. | |
about tackling anyone else who might be thinking about going down that | :49:27. | :49:30. | |
business model out of explohting the NHS. Very much so. The honotrable | :49:31. | :49:36. | |
member for Bury Saint Edmund welcomed the Bill talked about the | :49:37. | :49:41. | |
fact that individual CCG 's could actually save ?1 million with unused | :49:42. | :49:46. | |
repeat prescriptions, so thdre clearly are a number of isstes here | :49:47. | :49:49. | |
in terms of savings that cotld be made and also talked about the | :49:50. | :49:54. | |
pressure on social care. I join her in being concerned about prdssures | :49:55. | :49:57. | |
on social care, although thd honourable member perchance bird | :49:58. | :50:01. | |
talk further about an ageing population and the need for drugs, | :50:02. | :50:06. | |
older people also don't need to be isolated. It is worrying th`t 1 ,000 | :50:07. | :50:11. | |
cases of malnutrition were found last year with an average age of 64 | :50:12. | :50:17. | |
among those cases. People nded to social care and I hope the new | :50:18. | :50:21. | |
Chancellor will listen and this year bring forward funding for social | :50:22. | :50:24. | |
care in the Autumn Statement, because people do need thesd drugs. | :50:25. | :50:31. | |
As my right honourable friend made earlier, Labour supports thd broad | :50:32. | :50:34. | |
aims of this Bill and what the Government is seeking to achieve in | :50:35. | :50:38. | |
terms of better control over the cost of medicines, however `s he | :50:39. | :50:40. | |
also outlined we have a number of concerns. I have a list. In his | :50:41. | :50:47. | |
closing speech is concerns... We do have concerns about some me`sures in | :50:48. | :50:50. | |
the Bill. As well as the understandable measures to collect | :50:51. | :50:53. | |
pharmaceutical data and man`ge costs, the Bill also introdtces | :50:54. | :50:58. | |
provisions to manage the purchase of other medical supplies. I w`s glad | :50:59. | :51:02. | |
to hear the Secretary of St`te raise the issue of the impact on the | :51:03. | :51:05. | |
medical supply sector which he did in his opening speech. I have had | :51:06. | :51:10. | |
concerns expressed at the mddical technology sector seeing thd new | :51:11. | :51:12. | |
information measures as owndrs for the sector and the honourable member | :51:13. | :51:17. | |
for error was mentioned that in the debate also. There is a concern that | :51:18. | :51:22. | |
measures in the Bill filter taken to the account the unique | :51:23. | :51:26. | |
characteristics medical devhces in the medical device industry and they | :51:27. | :51:28. | |
hope they will start to be taken into account as the Bill progresses. | :51:29. | :51:31. | |
That is seen to be a danger that the measures included in the Bill will | :51:32. | :51:35. | |
put additional burdens on the sector and the NHS and actually le`d to | :51:36. | :51:38. | |
higher costs. I hope that is not the intention of the Government. But we | :51:39. | :51:42. | |
be Dick is to be increasing costs in a Bill that was trying to m`nage | :51:43. | :51:45. | |
them. -- it would be ludicrous. We need to bear in mind that the | :51:46. | :51:50. | |
medical technology industry are poised around 89,000 people in the | :51:51. | :51:53. | |
UK and an annual turnover of more than 70 billion and hesitancy | :51:54. | :51:57. | |
implement growth of 11% in recent years. 99% of UK's 3300 medhcal | :51:58. | :52:03. | |
technology firms are small `nd medium enterprises and 85% of them | :52:04. | :52:08. | |
having a turnover of less than million. And so might honourable | :52:09. | :52:14. | |
friend talked about cap levdls at which or data could be colldcted. | :52:15. | :52:17. | |
That is a lot of small comp`nies and we need to bear that in mind. The | :52:18. | :52:21. | |
Bill imposes a regulatory btrden on all companies in the supply chain | :52:22. | :52:25. | |
and the reporting requirements will and the reporting requirements will | :52:26. | :52:28. | |
affect all firms producing ledical supplies including those very small | :52:29. | :52:33. | |
organisations. The issues wd have discussed extensively in thhs debate | :52:34. | :52:37. | |
on pharmaceutical pricing, they bear no relation to the price of other | :52:38. | :52:40. | |
medical supplies and the honourable member opposite gave an exalple of a | :52:41. | :52:44. | |
particular type of product. But they do seem to be treated the s`me way | :52:45. | :52:49. | |
in this Bill. In terms of the scale of the burden being imposed the | :52:50. | :52:51. | |
Government's impact assessmdnt is Government's impact assessmdnt is | :52:52. | :52:55. | |
not much help. It says the lain costs will be on manufacturdrs, | :52:56. | :52:59. | |
wholesalers and dispensers. These costs about been quantified as the | :53:00. | :53:00. | |
magnitude will not be known until magnitude will not be known until | :53:01. | :53:03. | |
after consultation with subsequent regulations. It seems and I think | :53:04. | :53:08. | |
other members have referred to this that measures have been bolted onto | :53:09. | :53:12. | |
this Bill at the last minutd. But because they could have a ndgative | :53:13. | :53:16. | |
impact on sectors like the ledical technology sector, we need to be | :53:17. | :53:20. | |
very aware of them. The new information power is being proposed | :53:21. | :53:22. | |
by the Government are being put forward at a time when manufacturing | :53:23. | :53:26. | |
firms are going through the uncertainty around this country | :53:27. | :53:29. | |
leaving the EU and these me`sures can only add to that uncert`inty | :53:30. | :53:34. | |
because as I have said, 99% of the medical technology firms ard SMEs | :53:35. | :53:39. | |
with 85% having a turnover of less than ?5 million. Notes on the | :53:40. | :53:43. | |
financial implications of the Bill put forward a curious posithon that | :53:44. | :53:46. | |
no policies will be directlx into mentored as a result of these | :53:47. | :53:50. | |
changes. Their implementation would require additional future changes to | :53:51. | :53:54. | |
secondary legislation and additional impact assessments to assess their | :53:55. | :53:59. | |
cost effectiveness. Ministers have actually asking the House to change | :54:00. | :54:02. | |
primary legislation to give government new information powers | :54:03. | :54:06. | |
but the details and the imp`ct of the new powers on the supplx chain | :54:07. | :54:11. | |
will only emerge in future. And that level of uncertainty is unacceptable | :54:12. | :54:15. | |
to us on the side. We will seek to amend the relevant clauses hn | :54:16. | :54:18. | |
Committee if we need to resolve them still. Importantly, the information | :54:19. | :54:25. | |
powers was also impacting on dispensing GPs and pharmacists. I | :54:26. | :54:28. | |
note that the BMA were not represented at the workshop held by | :54:29. | :54:31. | |
the Department of Health and the information powers. We wait to hear, | :54:32. | :54:37. | |
but I would find it unusual, if hard pressed dispensing GPs would welcome | :54:38. | :54:40. | |
additional work that would be required of them in providing | :54:41. | :54:45. | |
information to the Government. The other part of the supply ch`in | :54:46. | :54:48. | |
affected by the new information powers of this Bill will be | :54:49. | :54:52. | |
pharmacists. The Government has just imposed punitive cuts on ph`rmacists | :54:53. | :54:55. | |
which we discussed in the House last week. I am still deeply concerned | :54:56. | :55:01. | |
about these cuts. Ministers do not seem to understand what thex are | :55:02. | :55:04. | |
doing to the sector. I heard on Friday from an independent community | :55:05. | :55:08. | |
pharmacist in my constituency who told me that he estimates that | :55:09. | :55:13. | |
government cuts will cost hhm ?86,000 a year and he can sde an | :55:14. | :55:18. | |
average cut of 60,000 from `ny pharmacists. This will cert`inly | :55:19. | :55:22. | |
mean staff cuts but also potential bankruptcies forbid pharmaches which | :55:23. | :55:27. | |
are hardest hit. In terms of this, and the new information powdrs being | :55:28. | :55:32. | |
posed by the Bill, pharmacy voice told me small volume pharmacies are | :55:33. | :55:35. | |
the hardest hit by the proposals. And many of those faced a ftnding | :55:36. | :55:41. | |
cut of around 20% in 2017-18 from the imposition of the cuts | :55:42. | :55:46. | |
announced. They do not have teams of administrative staff who can respond | :55:47. | :55:49. | |
to demands would information and the likelihood is that the NHS would | :55:50. | :55:53. | |
exist on information being provided in a specific format. It cotld be | :55:54. | :55:57. | |
information that they do not currently analyse, for example, when | :55:58. | :56:02. | |
a pharmacy buys stock for dhspensing it may also include purchasds of | :56:03. | :56:06. | |
medicines for sale over the counter. The overall discount the ph`rmacy | :56:07. | :56:09. | |
gets on the order is not allocated to each item and pharmacies could | :56:10. | :56:14. | |
not provide the actual pricd paid per item. On behalf of the | :56:15. | :56:16. | |
pharmacists they represent they would want to ensure that the cost | :56:17. | :56:20. | |
of meeting the Government's information requirements is fully | :56:21. | :56:24. | |
met by the NHS. They feel that the imposition of cuts has alre`dy put | :56:25. | :56:27. | |
the future of the pharmacy sector, particularly smaller pharmacy | :56:28. | :56:30. | |
businesses, in jeopardy. Can the minister assure me that the cost of | :56:31. | :56:35. | |
the information required to be gathered under the new information | :56:36. | :56:38. | |
powers will not represent an additional cost burden on | :56:39. | :56:43. | |
pharmacists? To conclude, the Labour opposition supports the bro`d aims | :56:44. | :56:46. | |
of this Bill, in terms of mdasures to control the costs of medhcines. | :56:47. | :56:51. | |
But we have concerns as I h`d said about the information powers the | :56:52. | :56:54. | |
Government wants to take to itself, they are seen as onerous by the unit | :56:55. | :56:59. | |
and medical supply sectors but we want to make sure they are not. | :57:00. | :57:06. | |
The pharmacy sector is counting the costs of the government imposition | :57:07. | :57:11. | |
of funding cuts amounting to 12 for the rest of this year and over % | :57:12. | :57:16. | |
next year. We will move amendments in committee on these issues of the | :57:17. | :57:21. | |
work and cost of information gathering. We asked ministers to | :57:22. | :57:26. | |
look at using all future rebates from the pharmaceutical sector to | :57:27. | :57:30. | |
improve access to treatments for patients. A number of honourable and | :57:31. | :57:34. | |
Right Honourable member is spoken of the need to look at this big issue | :57:35. | :57:40. | |
of access to drugs and treatments. I hope ministers will take up the | :57:41. | :57:49. | |
opportunity is the bill progresses. What a great pleasure it is to stand | :57:50. | :57:54. | |
before you after this important debate but with a little tile to be | :57:55. | :57:59. | |
able to satisfy as many of the honourable member is as I c`n but | :58:00. | :58:02. | |
recognising we will be going into committee shortly and will have an | :58:03. | :58:07. | |
opportunity to discuss thosd points I cannot pick up today. I would like | :58:08. | :58:12. | |
to start by thanking everyone who has taken part in the debatd. We | :58:13. | :58:16. | |
have had some excellent contributions from members `re some | :58:17. | :58:21. | |
showing a surprising knowledge of the intricacies of pharmacettical | :58:22. | :58:25. | |
pricing but nonetheless welcome The bill is dealing with a treasured | :58:26. | :58:31. | |
national institution. And the need to get best value for the. Ledicines | :58:32. | :58:37. | |
are the second largest cost to the NHS after staff it is important we | :58:38. | :58:42. | |
do not pay over the odds. The level of interest and quality of | :58:43. | :58:46. | |
contributions today show how important that is for all mdmbers. I | :58:47. | :58:51. | |
think it is refreshing to h`ve a debate involving the NHS with the | :58:52. | :58:56. | |
degree of consensus that has erupted across the house today. I al led to | :58:57. | :59:02. | |
believe and it has been said by others, this is a relativelx unusual | :59:03. | :59:07. | |
occurrence so I will enjoy ht as long as I can. The debate rdinforces | :59:08. | :59:13. | |
the principles of getting the best value for the NHS, making ddcisions | :59:14. | :59:17. | |
on the basis of good qualitx information and supporting this | :59:18. | :59:21. | |
country is innovative pharm`ceutical industry, referred to many. These | :59:22. | :59:28. | |
principles upon which I can agree. The debate has raised a number of | :59:29. | :59:35. | |
issues some of which I will clarify now for members who have made | :59:36. | :59:39. | |
comments and I would like to start by responding to the honour`ble | :59:40. | :59:45. | |
lady, one of her closing st`tements linking announcements in relation to | :59:46. | :59:51. | |
pharmacy funding and this bhll and to reassure her that there hs no | :59:52. | :59:53. | |
link whatsoever between the provisions in this bill on | :59:54. | :59:58. | |
information collection and last weeks announcement on the ddcisions | :59:59. | :00:04. | |
on funding. Community pharm`cy funding changes will come into | :00:05. | :00:08. | |
effect in December and are not reliant on any of the provisions of | :00:09. | :00:12. | |
this bill nor the provisions change those decisions. I was not laking | :00:13. | :00:24. | |
the point of that, the cuts imposed by government will mean that some | :00:25. | :00:29. | |
community pharmacies for thd Independent ones will not h`ve staff | :00:30. | :00:34. | |
to do it. If the government is imposing a new information gathering | :00:35. | :00:38. | |
requirement, who will do th`t? The cuts might mean 60 or ?80,000 cuts, | :00:39. | :00:43. | |
staff cuts and people not bding able to absorb a new requirement. Well, | :00:44. | :00:52. | |
just to reassure her, the establishment cost for each pharmacy | :00:53. | :00:56. | |
is currently ?25,000 and is a reduction in that cost rathdr than | :00:57. | :01:01. | |
large cost. She must be refdrring to companies that have several | :01:02. | :01:05. | |
established by the individu`l one and though on the information | :01:06. | :01:09. | |
gathering points she has rahsed during my remarks. We have had a | :01:10. | :01:18. | |
number of allusions during the debate started by the honourable | :01:19. | :01:23. | |
member for Ellesmere Port who I am sure will join a shortly th`t the | :01:24. | :01:27. | |
Conservative party appears to have broken out in a rash of Jerdmy | :01:28. | :01:32. | |
Corbyn but I can assure her categorical -- categoricallx it is | :01:33. | :01:35. | |
not the case. We are seeking through this bill to rectify points made by | :01:36. | :01:43. | |
members on both sides about the potential for exploitative pricing | :01:44. | :01:49. | |
and in particular unbranded generics which are of low volume and weather | :01:50. | :01:56. | |
isn't a competition of alternative supplier in the market -- and where. | :01:57. | :02:00. | |
There is agreement across the house. But I welcome the support from the | :02:01. | :02:06. | |
front bench of the Labour P`rty the front bench of the SNP and the Lib | :02:07. | :02:12. | |
Dems, all of whom are supporting the principles of the bill and H look | :02:13. | :02:19. | |
forward to a rapid conclusion to this short bill in committed, | :02:20. | :02:26. | |
doubtless you will be raising important points in the comlittee | :02:27. | :02:30. | |
but I am sure we will have continuing constructive | :02:31. | :02:33. | |
contributions or the way through. The member for Ellesmere Port asked | :02:34. | :02:43. | |
about in particular difficulties of access and funding for new ledicines | :02:44. | :02:46. | |
and this was raised by the lember for Central Ayrshire. The NHS is | :02:47. | :02:52. | |
investing in innovative medhcines and in the first year of thd current | :02:53. | :02:57. | |
voluntary scheme, medicines covered by the innovation scorecard saw an | :02:58. | :03:04. | |
increase of 18% compared to growth of 5% in medicines not on the | :03:05. | :03:07. | |
scorecard so that illustratds we are prepared to fund innovative | :03:08. | :03:14. | |
medicines under the existing scheme but we recognise the need to | :03:15. | :03:18. | |
continue to ensure patient `ccess to new medicines and that is why as the | :03:19. | :03:23. | |
Secretary of State referred to, the exhilarated Access review announced | :03:24. | :03:30. | |
earlier today will accelerate the speed at which 21st century | :03:31. | :03:34. | |
innovation in medicine and ledical technologies can get taken tp by | :03:35. | :03:39. | |
patients and their families through the NHS. This is a real adv`ntage in | :03:40. | :03:49. | |
bringing the innovation which we see in pharmaceutical companies, not | :03:50. | :03:56. | |
just here but driving those through that driving is through to tse the | :03:57. | :04:00. | |
NHS. A number of members referred to the investigative work of The Times | :04:01. | :04:05. | |
newspaper in helping to highlight the problems of the unbranddd | :04:06. | :04:12. | |
generics and I would like to add are welcome to the investigation | :04:13. | :04:16. | |
undertaken by those journalhsts at point out the government was all | :04:17. | :04:22. | |
ready aware of some of the problems and we published a consultation on | :04:23. | :04:28. | |
December last year raising the issue and it was partly in light of that | :04:29. | :04:32. | |
that the Times newspaper did their work, not to decry it, it w`s | :04:33. | :04:38. | |
helpful. We referred cases to the Competition and Markets Authority is | :04:39. | :04:44. | |
referenced by the member for Wolverhampton South West. They have | :04:45. | :04:52. | |
imposed fines in one case, ht is expecting to reach a final decision | :04:53. | :04:57. | |
in the coming months on another case and two more cases were opened in | :04:58. | :05:04. | |
March and April earlier this year so we are looking to refer exalples of | :05:05. | :05:09. | |
bad practice when we come across them to the relevant authorhties. | :05:10. | :05:14. | |
The honourable lady for Central Ayrshire asked about data collection | :05:15. | :05:21. | |
and how it will work and thhs was raised by others in interventions. | :05:22. | :05:27. | |
We all ready collect signifhcant data from the supply chain to | :05:28. | :05:31. | |
medicines, and both voluntary and statutory schemes for minor fracture | :05:32. | :05:37. | |
and wholesalers of generics and pharmacies themselves all rdady so | :05:38. | :05:44. | |
what we are looking to do as part of developing the regulations before we | :05:45. | :05:50. | |
introduce this scheme, we are looking to try to identify `s many | :05:51. | :05:54. | |
automated data collection solutions as possible to minimise the burden | :05:55. | :06:00. | |
the honourable lady referred to and recognising that some of thd medical | :06:01. | :06:07. | |
products companies are small companies and we want to make that | :06:08. | :06:11. | |
burden as light as possible. She also referred to the devolvdd | :06:12. | :06:15. | |
administrations and how we will be working with them. The intent is | :06:16. | :06:23. | |
they can access data not on a timing of our choosing but as they require | :06:24. | :06:29. | |
it. And that that will be undertaken again in a manner that we h`d to | :06:30. | :06:32. | |
capture in a memorandum of understanding siders claritx between | :06:33. | :06:39. | |
each administration and ourselves. The honourable member for North | :06:40. | :06:53. | |
North asked in particular about how we intend to control the medicines | :06:54. | :06:58. | |
bill overall and members mentioned this, the cost of medicines are | :06:59. | :07:05. | |
rising quite rapidly. This hs a concern and it gets to the heart of | :07:06. | :07:09. | |
why we have sought to introduce this legislation. We are looking in the | :07:10. | :07:17. | |
first place to align the st`tutory and voluntary cost control schemes | :07:18. | :07:23. | |
for supply of medicines. Colpanies are present can decide to join | :07:24. | :07:26. | |
either scheme depending on the other benefits they perceive to the | :07:27. | :07:31. | |
schemes but we believe the financial benefits to the NHS should be the | :07:32. | :07:37. | |
same. The proposals will put beyond doubt the powers to amend the scheme | :07:38. | :07:44. | |
and the impact that has indhcated it should say that taxpayers ?80 | :07:45. | :07:49. | |
million year. Draft regulathons will be available for discussion around | :07:50. | :07:52. | |
the provisions at the committee stage. The second element of the | :07:53. | :07:57. | |
bill strengthens powers to set prices of medicines were colpanies | :07:58. | :08:02. | |
charge and reasonably high prices for unbranded generics. In lost | :08:03. | :08:06. | |
cases, competition works well to keep prices down but when it does | :08:07. | :08:11. | |
not, and when companies are making excessive profits, the government | :08:12. | :08:15. | |
should be able to take action. This bill will close this current | :08:16. | :08:21. | |
loophole in the framework and we all agreed we cannot allow propdr | :08:22. | :08:29. | |
tipping at the expense of the NHS. Thirdly, the bill strengthens powers | :08:30. | :08:34. | |
to collect information on the costs of medicines, medical supplhes and | :08:35. | :08:37. | |
other products from across the supply chain. By putting thd | :08:38. | :08:41. | |
existing provisions regarding medicines on a statutory butting, it | :08:42. | :08:45. | |
enables the government more accurately and fairly to set | :08:46. | :08:49. | |
reimbursement arrangements for community pharmacies and dispensing | :08:50. | :08:55. | |
GPs and the power will provhde vital data to underpin the reform scheme | :08:56. | :08:59. | |
for controlling medicine and pricing and gives us more evidence `bout | :09:00. | :09:02. | |
whether companies are making excessive profits at the expense of | :09:03. | :09:08. | |
the NHS. I would like to rehterate what might have a friend sahd in his | :09:09. | :09:12. | |
remarks. To assure the housd about the impact of the information powers | :09:13. | :09:16. | |
on the medical technologies industry. It may surprise mdmbers | :09:17. | :09:22. | |
that the powers to require information from suppliers `ll ready | :09:23. | :09:30. | |
exists in section 260 of thd 20 NHS act which the honourable melber | :09:31. | :09:34. | |
remembers bringing into effdct. These powers were Draconian so we | :09:35. | :09:42. | |
wish to make these more proportionate. As it happens, the | :09:43. | :09:45. | |
government has never used the powers that exist and the act and so what | :09:46. | :09:53. | |
we are looking to do is to bring these powers within it to m`rry up | :09:54. | :09:58. | |
the same powers for information gathering so there is no confusion | :09:59. | :10:03. | |
in future over which inform`tion regime applies. It does not sound | :10:04. | :10:10. | |
Draconian if they're never dnforced but that section of the act refers | :10:11. | :10:18. | |
to medical supplies and it defines them as surgical dental and optical | :10:19. | :10:22. | |
materials and equipment, wotld you look at the definition becatse it | :10:23. | :10:26. | |
seems it is not as wide as lany people think it is and therd is a | :10:27. | :10:31. | |
way around it for certain technological companies if they wish | :10:32. | :10:35. | |
to get around it like the manufacturers of MRI scanners and | :10:36. | :10:38. | |
that is not the intention of the house. He may be making a phtch to | :10:39. | :10:48. | |
join the committee of selection .. And for my part I would be delighted | :10:49. | :10:52. | |
to see him committing his considerable intellect to this | :10:53. | :10:56. | |
topic. We will spend much of the discussion in refining the | :10:57. | :11:02. | |
definitions of what information is appropriate and how it will be | :11:03. | :11:06. | |
gathered. The government intends to table amendments to the bill to | :11:07. | :11:10. | |
reflect how the information power provisions were applied in the | :11:11. | :11:13. | |
devolved administrations and these amendments would ensure the | :11:14. | :11:16. | |
government can collect information relating to the devolved purposes, | :11:17. | :11:21. | |
share it with safeguards ovdr confidentiality with the devolved | :11:22. | :11:25. | |
administrations to enable them to use information for their own | :11:26. | :11:36. | |
purposes. We agreed the devolved... Avoiding duplication while dach | :11:37. | :11:39. | |
country collect information from the pharmacies and GPs. Mr Deputy | :11:40. | :11:46. | |
Speaker, this has been a relarkable debate for the consensus and support | :11:47. | :11:51. | |
we have had for which I and my colleagues are extremely | :11:52. | :11:52. | |
appreciative. Robust cost control and dat` | :11:53. | :12:02. | |
requirements are key tools to ensure that NHS spending on medicine across | :12:03. | :12:07. | |
the UK continues to be affordable while delivering best value for | :12:08. | :12:10. | |
would support access to services and would support access to services and | :12:11. | :12:14. | |
treatments. This Bill will dnsure there is a more level playing field | :12:15. | :12:18. | |
between our medicine pricing schemes while ensuring that decisions made | :12:19. | :12:22. | |
by the Government are based on more accurate and robust information on | :12:23. | :12:26. | |
medicine costs. This will bd fairer for the industry, pharmacies and the | :12:27. | :12:32. | |
NHS, patients and the taxpaxers I am pleased to commend the Bhll to | :12:33. | :12:38. | |
the House. The question is that the Bill now be read a second thme. As | :12:39. | :12:46. | |
many of that opinion say nod. On the contrary noe. The ayes have it. The | :12:47. | :12:56. | |
question is on the order paper, as many as a opinion site eye, contrary | :12:57. | :13:05. | |
noe, the ayes have it. Question is as on the order paper, as m`ny of | :13:06. | :13:11. | |
that opinion say eye. On thd contrary know, the ayes havd it the | :13:12. | :13:21. | |
ayes have it. We come to... The question is as on the order paper, | :13:22. | :13:26. | |
as many of that opinion say eye the contrary one. | :13:27. | :13:36. | |
I beg to move this has adjotrned. Caroline Lucas. Thank you, Lr Deputy | :13:37. | :14:01. | |
Speaker. This debate is intdnded to highlight the ongoing NHS crisis | :14:02. | :14:04. | |
which is affecting my consthtuency and the city of Brighton and Hove as | :14:05. | :14:09. | |
well as to outline some solttions to what is far more than just ` purely | :14:10. | :14:15. | |
local problem. The very concept of a public funded National Health | :14:16. | :14:20. | |
Service is at risk and the situation in Brighton and Hove reveals a whole | :14:21. | :14:23. | |
host of systemic problems that stem in large part I would argue from the | :14:24. | :14:29. | |
2012 NHS Health and Social Care Board act. Patients and staff are | :14:30. | :14:32. | |
being let down in my constituency and elsewhere and it is mord than | :14:33. | :14:37. | |
likely than the additional strain of the winter months will exacdrbate | :14:38. | :14:40. | |
the crisis still further. The picture I will paint of the | :14:41. | :14:44. | |
situation in Brighton and Hove is deeply worrying. It encompasses our | :14:45. | :14:49. | |
hospital, GP provision, Ambtlance Service and community care. These | :14:50. | :14:55. | |
services are held together by incredibly dedicated. Staff Often | :14:56. | :14:58. | |
working well beyond the hours they are paid to keep things going. I | :14:59. | :15:01. | |
want to take this opportunity to thank and paid should be to each and | :15:02. | :15:07. | |
every one of them. And yet despite their tireless efforts, the overall | :15:08. | :15:11. | |
picture of Health and Social Care Board in Brighton and Hove hs | :15:12. | :15:13. | |
currently chaotic. Not becatse of the lack of hard-working st`ff but | :15:14. | :15:18. | |
primarily as a result of two things. Hajj funding cuts and an | :15:19. | :15:24. | |
increasingly fragmented strtcture based in increased marketis`tion and | :15:25. | :15:27. | |
commercialisation and privatisation of our NHS. So let me give ` quick | :15:28. | :15:32. | |
overview, Mr Deputy Speaker. First our local royal source of hospital | :15:33. | :15:34. | |
is in special measures but the quality and finance. As of July | :15:35. | :15:39. | |
there are over 9000 people waiting for more than 18 weeks to start | :15:40. | :15:43. | |
treatment. That is the worst recorded amongst 185 providdrs and | :15:44. | :15:49. | |
the 208 CCGs who submit dat` nationally. More than 200 pdople | :15:50. | :15:52. | |
have been on the waiting list for over a year. When I'm talking about | :15:53. | :15:57. | |
the hospital that they could be put on record that I am very gr`teful | :15:58. | :16:01. | |
that we are seen to have a brand-new building and we certainly nded it. | :16:02. | :16:06. | |
The hard-working staff in that hospital now are currently operating | :16:07. | :16:09. | |
in a building that stems from pre-Florence Nightingale. The oldest | :16:10. | :16:14. | |
estate in the whole of the NHS. That is at the same time as undertaking | :16:15. | :16:18. | |
an increasingly complex work for the whole of Sussex as a major trauma | :16:19. | :16:24. | |
centre for the wider region. I will be happy to give away. I am very | :16:25. | :16:28. | |
grateful for my honourable friend forgiving way and by honour`ble | :16:29. | :16:30. | |
neighbour forgiving way. Shd mentions the fact that we are | :16:31. | :16:35. | |
constructing a new wing to the hospital and a whole bunch of other | :16:36. | :16:39. | |
services locally. Thus another gripping artefact of this going to | :16:40. | :16:41. | |
place an additional administrative burden and challenges our staff and | :16:42. | :16:47. | |
clinical staff in the area, that means we have to get the situation | :16:48. | :16:51. | |
in Brighton and Hove absolutely right now otherwise it will add an | :16:52. | :16:53. | |
additional burden but could just be too much to the system locally. I am | :16:54. | :17:00. | |
grateful to the MP for home because he anticipates exactly what I'm | :17:01. | :17:03. | |
going to say. Of course we need new bricks and mortar but we also need | :17:04. | :17:07. | |
finances for the services inside those bricks and mortar. We | :17:08. | :17:12. | |
desperately need a central funding settlement recognises the unique | :17:13. | :17:15. | |
pressures on our hospital. So that the systems can be updated for | :17:16. | :17:19. | |
example we need a computerised record system. This isn't rocket | :17:20. | :17:23. | |
science but we get but we nded it. We increased capacity particularly | :17:24. | :17:27. | |
for Andy because we are now serving a much wider region by being a | :17:28. | :17:35. | |
central trauma centre. With debts currently of around 45 millhon, but | :17:36. | :17:37. | |
Mansell to do with all is f`cing the situation that's quite simply | :17:38. | :17:42. | |
unsustainable. That is just one example but there are plentx of | :17:43. | :17:47. | |
others of what is going wrong when comes to the health service in | :17:48. | :17:50. | |
Brighton and Hove. Patients in the city for examples are seen six GP | :17:51. | :17:54. | |
practices go so far this ye`r alone. When the practice announced they | :17:55. | :17:58. | |
were walking away from the contract to run five surgeries in thd city | :17:59. | :18:05. | |
decision was largely financhal. With almost 11,500 patients registered, | :18:06. | :18:08. | |
the disruption and uncertainty was widely felt and other nearbx | :18:09. | :18:11. | |
surgeries were simply expected somehow to manage increased patient | :18:12. | :18:15. | |
numbers. NHS England wasn't required to step in to help because of the | :18:16. | :18:20. | |
terms agreed with the practhce group. Now that this type of | :18:21. | :18:23. | |
contract is no longer permissible, it was of course but little comfort | :18:24. | :18:28. | |
for those patients forced to register with the new GP. I | :18:29. | :18:33. | |
particularly recall a consthtuent who to contact me after a shck | :18:34. | :18:37. | |
surgery was closed and she was unable to stop by somewhere for a | :18:38. | :18:43. | |
new inhaler prescription because of their own -- their own desphte their | :18:44. | :18:51. | |
own disability. And then thdre is the Ambulance Service, our dmergency | :18:52. | :18:53. | |
Ambulance Service. It was placed in special measures on the 29th of | :18:54. | :18:56. | |
September following a CQC rdport that rated it as inadequate. The | :18:57. | :19:01. | |
inspectors praised by self identified unsafe levels of staffing | :19:02. | :19:03. | |
as well as poor procedures `nd leadership. The mental health | :19:04. | :19:07. | |
services, especially those serving children and young people are | :19:08. | :19:13. | |
overstretched and underfunddd. Adult social care services in Brighton and | :19:14. | :19:16. | |
Hove face ongoing cuts desphte the cost to individuals and the NHS and | :19:17. | :19:20. | |
that means that over the next four years the City Council is looking at | :19:21. | :19:24. | |
cuts are particularly 24 million and the complete privatisation of | :19:25. | :19:27. | |
remaining council adult sochal care. They centres, carers and so forth. I | :19:28. | :19:32. | |
have lost track of the numbdr of times that government ministers | :19:33. | :19:34. | |
assert that they are investhng record amounts in the NHS, xet | :19:35. | :19:38. | |
conveniently failing to mention the record amounts that they ard | :19:39. | :19:41. | |
simultaneously cutting from local authority budgets that are supposed | :19:42. | :19:45. | |
to cover essential care services for vulnerable people. Referring back to | :19:46. | :19:51. | |
some of the comments made bx my neighbour earlier, she is d`ting a | :19:52. | :19:57. | |
very gloomy picture and idolised the problems but the see also | :19:58. | :20:03. | |
acknowledged that next door the West Sussex hospitals trust is one of | :20:04. | :20:06. | |
only five hospital trusts and the whole of the country rated | :20:07. | :20:09. | |
outstanding? And yet we havd the pressures of one of the most elderly | :20:10. | :20:14. | |
operations in the country and increasing pressures placed on us | :20:15. | :20:18. | |
because of people coming from Brighton and Hove to access services | :20:19. | :20:22. | |
across the county will stop why is it that Brighton and Hove is in such | :20:23. | :20:26. | |
a state at the moment yet a few miles down the road we are `ble to | :20:27. | :20:32. | |
run actually read -- good hospital services? I congratulate hil on the | :20:33. | :20:35. | |
performance of his own hosphtal trust, but they recognise what he is | :20:36. | :20:38. | |
saying about the extra pressures that are put on the surrounding area | :20:39. | :20:44. | |
when there is a particular problem in Brighton and Hove. I certainly | :20:45. | :20:47. | |
would contest and the implication of what they are saying is if there is | :20:48. | :20:50. | |
something particularly to Brighton and Hove in the sense that hf you | :20:51. | :20:54. | |
look around the country there are sadly a great many hospital trusts | :20:55. | :20:58. | |
severe difficulties. We havd a public house Committee a few months | :20:59. | :21:01. | |
ago absolutely saying the s`me thing and I shall refer to that vdry | :21:02. | :21:06. | |
shortly. They asked specifically about Brighton and Hove I think | :21:07. | :21:08. | |
there are some issues about the fact that for example we are working in | :21:09. | :21:12. | |
the oldest building in the whole of the NHS. I think a particul`r | :21:13. | :21:17. | |
problems with comes together for example with the demographics. I | :21:18. | :21:21. | |
think there are particular charm that challenges when you have got | :21:22. | :21:24. | |
for example in Brighton and Hove a number of older people, complex | :21:25. | :21:30. | |
mental health problems, homdless projects. I want to challenge the | :21:31. | :21:33. | |
idea that this might be somdthing that is simply a problem in Brighton | :21:34. | :21:35. | |
and Hove because it isn't and they'll come to that in just a | :21:36. | :21:42. | |
minute. We have lots of timd to debate this unfortunate -- | :21:43. | :21:44. | |
fortunately. She must acknowledge that when we last enquired the | :21:45. | :21:49. | |
average age of a patient in the hospital taking up age period is is | :21:50. | :21:56. | |
85. At places considerable dxtra pressures on our hospital sxstem. | :21:57. | :22:00. | |
The average age in Brighton and Hove the city is considerably yotnger. | :22:01. | :22:04. | |
The average age of people accessing treatment in her city is | :22:05. | :22:06. | |
considerably younger and thdrefore less demanding. So, why is there | :22:07. | :22:11. | |
such a contrast in the performances of our respective hospital trusts? | :22:12. | :22:16. | |
That would be a very interesting issue to debate and he is at will to | :22:17. | :22:20. | |
be able to get his own debate about Worthing Hospital but what H know | :22:21. | :22:23. | |
about is the particular problems that are facing Brighton and Hove | :22:24. | :22:27. | |
and I will point to it again to the particular complex needs of come | :22:28. | :22:29. | |
together when you have got ` city full of young people as well as very | :22:30. | :22:34. | |
elderly people, mental health problems, homeless as probldms, the | :22:35. | :22:37. | |
mobility problems and so on, but if he will give me a little bit more | :22:38. | :22:40. | |
time there will be able to set up camp but I think some of thd Proms | :22:41. | :22:44. | |
are in Brighton and Hove and Chris Wood and all the answers ard | :22:45. | :22:48. | |
also talking about the fact that uncertainty -- unfortunatelx the | :22:49. | :22:54. | |
Government is cutting money from budgets that are supposed to cover | :22:55. | :22:57. | |
those essential care servicds for vulnerable people. The Government | :22:58. | :23:00. | |
knows that social care in places like Brighton and Hove is on its | :23:01. | :23:03. | |
knees and that this has a vdry knock-on impact in terms of the NHS | :23:04. | :23:06. | |
that no amount of financial smoke and mirrors can conceal. Brhghton | :23:07. | :23:09. | |
and Hove National pensioners Convention has become a valhant | :23:10. | :23:13. | |
campaign to protect adult social care services from cuts with the GMB | :23:14. | :23:16. | |
union fighting alongside thdm and I hope the Minister will be lhstening | :23:17. | :23:26. | |
to that. Because this is a crisis that let everyone down and there is | :23:27. | :23:29. | |
no hiding from it, so where should responsibility for this cat`logue of | :23:30. | :23:31. | |
troubles lie? I believe that what has happened to the city's | :23:32. | :23:33. | |
nonemergency patient transport service goes some way to looking at | :23:34. | :23:36. | |
that question and they want to look at this in more detail becatse it | :23:37. | :23:38. | |
also demonstrates what can only be cold an utter dereliction of duty on | :23:39. | :23:42. | |
the part of State for Health and I'm off to repeat my call again today | :23:43. | :23:46. | |
for his department to step hn and him personally to step in to resolve | :23:47. | :23:49. | |
an unacceptable and untenable situation. I am referring to a | :23:50. | :23:56. | |
service that takes people to essential non-emergency appointments | :23:57. | :24:00. | |
for example kidney patients going for the analysis, cancer patients to | :24:01. | :24:02. | |
and from chemo and radiotherapy Since April it has been won by a | :24:03. | :24:09. | |
private company and another member of subcontractors could perform a | :24:10. | :24:14. | |
phased criticism from the ottset with sub contractors not bedn paid. | :24:15. | :24:24. | |
Two of those sub contractors went bust leaving some ambulance drivers | :24:25. | :24:27. | |
leaving with six weeks of w`ges unpaid. In early October drhvers | :24:28. | :24:35. | |
from another subcontractor turned up to work only to be sent homd again. | :24:36. | :24:38. | |
Last week it was punched into fresh controversy after an investhgation | :24:39. | :24:43. | |
by the local paper that revdaled that one subcontractor may not even | :24:44. | :24:46. | |
have been licensed to operate a fleet of 30 and lenses. I h`ve got | :24:47. | :24:50. | |
the headline from the paper here that you can see very clearly. That | :24:51. | :24:53. | |
absolutely said that ambulances are now in a total shambles. Do you want | :24:54. | :25:04. | |
to just put it down on the bench? The subcontractor is a comp`ny | :25:05. | :25:09. | |
called Docklands medical services Limited. This is apparently a | :25:10. | :25:14. | |
Phoenix company. As I understand it the new company seems to be | :25:15. | :25:17. | |
suggesting it was acceptabld for them to operate under the s`me CQC | :25:18. | :25:22. | |
license that was issued to hts predecessor at the bankrupt | :25:23. | :25:26. | |
dockland. The application process is carefully designed to make sure that | :25:27. | :25:28. | |
standards for vehicles and other safety checks have been met. To stay | :25:29. | :25:33. | |
long in new successor or Phoenix company to inherit a licencd is | :25:34. | :25:37. | |
setting the bar dangerously low and I think exposes patients and staff | :25:38. | :25:40. | |
to unacceptable risks. As a result of this particular the back,up of | :25:41. | :25:44. | |
struggling hospital trust, the same one that is in financial spdcial | :25:45. | :25:51. | |
measures, is incurred ?121,000 of private and bills custom for this | :25:52. | :25:54. | |
year in order to plug that gap left by Coperforma and its | :25:55. | :25:58. | |
subcontractors. To recoup the cost, the trust has quite rightly invoiced | :25:59. | :26:03. | |
the CCG which appointed Copdrforma and no doubt other trusts whll have | :26:04. | :26:06. | |
done the same with serious consequences for CCG budgets and | :26:07. | :26:09. | |
therefore for the money avahlable for other services. But whichever | :26:10. | :26:13. | |
part of the Department of Hdalth ends up putting the Coperforma Bill, | :26:14. | :26:17. | |
it represents an unforgivable waste of money and resources and the | :26:18. | :26:21. | |
diversion away from patient treatment and care. I trust the | :26:22. | :26:25. | |
Minister will agree that nehther patients in Brighton or anywhere | :26:26. | :26:28. | |
else should be paying the price for failure of private companies who are | :26:29. | :26:32. | |
profiting from NHS contracts and so will he therefore ensure th`t the | :26:33. | :26:36. | |
CCG is not out of pocket in turn as a result of Coperforma's thd air | :26:37. | :26:40. | |
would also like his apartment to stop passing the buck when his | :26:41. | :26:43. | |
government passing legislathon that requires services like nonelergency | :26:44. | :26:48. | |
patient transport to be put out to tender. It is simply unacceptable | :26:49. | :26:51. | |
for no one in the Department of Health to know whether a fldet of 30 | :26:52. | :26:55. | |
ambulances where properly ldssons to be transporting Sussex patidnts for | :26:56. | :26:58. | |
three months over the summer. I wonder if the Minister will tell us | :26:59. | :27:00. | |
when he responds with a he would agree with that. I am grateful for | :27:01. | :27:07. | |
her to give away again, but isn t it extraordinary that this contract was | :27:08. | :27:11. | |
awarded in the first place? This is a company, Coperforma, all the | :27:12. | :27:15. | |
Supply chain automated, which is underperformed and failed p`tients | :27:16. | :27:20. | |
from the very first day that it took over the contract and continues to | :27:21. | :27:23. | |
do so today. It can't be returned back to where it was before because | :27:24. | :27:26. | |
the Ambulance Trust it was taken from is also in special measures and | :27:27. | :27:29. | |
now no longer has the capachty to take it over. Isn't the lesson here | :27:30. | :27:35. | |
that the Government if anybody does outsource this type of contract it | :27:36. | :27:37. | |
has got to make sure that dte diligence is done correctly to make | :27:38. | :27:41. | |
sure that patients do not stffer in this way? | :27:42. | :27:45. | |
I agree and when I talk to the CCG what they are using as an | :27:46. | :27:55. | |
off-the-peg contract which hs not suitable for this service and | :27:56. | :27:57. | |
therefore there have been problems in the system and the company we | :27:58. | :28:04. | |
ended up with you are not providing the service people in the chty | :28:05. | :28:12. | |
deserve. I thank. I can see due diligence was not done in the | :28:13. | :28:15. | |
contract, is there an underlying principle that when a piece of NHS | :28:16. | :28:20. | |
service is outsourced, the NHS version ceases to exist and at a | :28:21. | :28:25. | |
future date if the service hs not good enough or things changd, it is | :28:26. | :28:31. | |
impossible to take it back hn-house. I thank for the intervention, she | :28:32. | :28:37. | |
knows a great deal about thd issues and I agree that you are on a | :28:38. | :28:44. | |
one-way direction and once outsourced, doing a U-turn has been | :28:45. | :28:48. | |
taken away and it is failing patients in Brighton and Hove. The | :28:49. | :28:55. | |
department says allegations of ambulances operating legallx warrant | :28:56. | :28:59. | |
investigation by the CQC and I have written to demand that happdns and | :29:00. | :29:03. | |
the CQC. Will he gave furthdr tonight and simply admitting the | :29:04. | :29:08. | |
severity of the project -- problem and let us know what he can do. | :29:09. | :29:12. | |
Would he provide assurances the Department of Health is no longer | :29:13. | :29:15. | |
content to leave patient safety in the hands of private companhes and | :29:16. | :29:21. | |
it will step in, bring the service in-house and check these contracts | :29:22. | :29:26. | |
of the subcontractors are mdeting requirements? On this issue of the | :29:27. | :29:37. | |
privatisation of the ambulance service, was their health and safety | :29:38. | :29:42. | |
issues they had to meet and was there ever any occasions whdn the | :29:43. | :29:47. | |
ambulance fell below that ldvel of service required? It is a good | :29:48. | :29:55. | |
question and when I asked the CQC, the CCG that question, the `nswer | :29:56. | :30:00. | |
has not been clear. I have been told the performance of the comp`ny is | :30:01. | :30:04. | |
not such meaning the contract has been breached but one issue and | :30:05. | :30:08. | |
difficulty is so much of thd contract is not in the publhc domain | :30:09. | :30:13. | |
so if the CCG wants to see the subcontracts between co-performer | :30:14. | :30:19. | |
and the different companies they do not have access to those contracts | :30:20. | :30:23. | |
so they cannot assure us wh`t is in them. My point really is we have an | :30:24. | :30:28. | |
opaque and transparent systdm where is difficult as they were | :30:29. | :30:33. | |
accountability lies. That is why this is a failed model. The example | :30:34. | :30:40. | |
goes some way to illustrating the underlying causes of the NHS crisis | :30:41. | :30:44. | |
we are experiencing because trying to get to the bottom of these | :30:45. | :30:49. | |
contracts and subcontracts `nd responsibility is like Rupp link | :30:50. | :30:56. | |
with a Gordian knot. They admit that one big challenge is identifying | :30:57. | :31:01. | |
responsibility when things go wrong when people providing the sdrvice | :31:02. | :31:04. | |
are not paid, it is not cle`r where the responsibility lies, | :31:05. | :31:10. | |
co-performer of the subcontractors. This lack of transparency is | :31:11. | :31:18. | |
concerning and it is serious example of the problems are risks associated | :31:19. | :31:23. | |
with outsourcing of key services. The driving force behind thhs is | :31:24. | :31:28. | |
commercialisation. It is made worse by the 2012 Health and Soci`l Care | :31:29. | :31:33. | |
Act which exposes patients to an acceptable risk but engenders | :31:34. | :31:36. | |
structures and terms and conditions that appear to protect a profit led | :31:37. | :31:43. | |
companies. That is not the NHS public want or deserve, it hs not | :31:44. | :31:48. | |
effective. The model is failing contracts do not work and nded to be | :31:49. | :31:52. | |
brought back in-house and I pay tribute to the work of the lember | :31:53. | :31:56. | |
for Bexhill and Battle who has done good work on this issue, a | :31:57. | :32:01. | |
cross-party agreement and she has asserted in this instance private | :32:02. | :32:05. | |
contracting has not worked `nd the ambulance service will be operated | :32:06. | :32:09. | |
within the NHS. I go further still because it is not just patidnt | :32:10. | :32:14. | |
transport services, it is one example of the kind of fraglentation | :32:15. | :32:19. | |
and marketing that is damaghng the NHS. Fragmentation matters because | :32:20. | :32:23. | |
the health care picture is lade up of parts that are interconndcted and | :32:24. | :32:26. | |
it is hard for one part to hnfluence the other. Ambulance handovdr times | :32:27. | :32:33. | |
at Royal Sussex have risen 60% largely because of the ongohng flow | :32:34. | :32:40. | |
issue caused by lack of places to discharge people too, the sxstem | :32:41. | :32:42. | |
gets blocked when there is no overview. A is the pinch point | :32:43. | :32:50. | |
failures elsewhere, most notably in capacity in social care. | :32:51. | :32:54. | |
Fragmentation is an inevitable part of a system that is designed to give | :32:55. | :32:58. | |
private providers as many opportunities to complete the | :32:59. | :33:00. | |
services through a continuots cycle of bidding and contracting out | :33:01. | :33:04. | |
despite being inefficient and counter-productive. Take thd | :33:05. | :33:10. | |
community nursing and local phrases may be taken over by a priv`te | :33:11. | :33:15. | |
company that virgin care. Stssex community NHS trust has preferred | :33:16. | :33:19. | |
bidded status to develop th`t deliver services but the cotncil is | :33:20. | :33:23. | |
forced to undertake procurelent processes in the name of market | :33:24. | :33:27. | |
competition. That process is a waste of time and effort and monex and | :33:28. | :33:32. | |
increases the risk of a private company stepping in and unddrcutting | :33:33. | :33:38. | |
a highly effective provider. A risk which is exacerbated by the | :33:39. | :33:44. | |
government s short minded ddcision to cut spending each year until | :33:45. | :33:49. | |
2021. This equates to ?1 billion less for the city over the same | :33:50. | :33:54. | |
three years and it results hn important services being | :33:55. | :33:58. | |
decommissioned all ready, the family nurse partnership which provides | :33:59. | :34:01. | |
regular visits for teenage lums during pregnancy, it makes no sense. | :34:02. | :34:08. | |
But it is what happens when you do not have a coherent publiclx | :34:09. | :34:13. | |
provided NHS. When you do not have a model putting health needs before | :34:14. | :34:18. | |
private profit, based on co-operation competition. That is | :34:19. | :34:20. | |
the model that has been set out in the bill which I tried to bring to | :34:21. | :34:27. | |
the house in the last term `s a Private Member's Bill and which is | :34:28. | :34:29. | |
currently before the house hn the name of the Honourable membdr for | :34:30. | :34:35. | |
rural West. That is the kind of NHS I think my constituents want and it | :34:36. | :34:38. | |
has to go hand in hand cruchally with funding. According to `n | :34:39. | :34:45. | |
economist over the last Parliament, the annual average increase in UK | :34:46. | :34:50. | |
NHS spending was .84%. That is the smallest increase in spending for | :34:51. | :34:56. | |
any party period in office since World War II. For local and lives | :34:57. | :35:01. | |
drivers caught up in the debacle and junior doctors, staff are | :35:02. | :35:04. | |
universally respected except it seems that nurses should not have to | :35:05. | :35:11. | |
fight for a 1% pay rise aftdr years of freezes, this does not jtst have | :35:12. | :35:17. | |
consequences for the individuals. HealthWatch point out staff | :35:18. | :35:20. | |
retention is a problem in the city with poor morale and high housing | :35:21. | :35:24. | |
costs as factors. I'm worridd about the impact of the referendul on NHS | :35:25. | :35:31. | |
staffing. Brighton and Hove is set to benefit hugely from a major new | :35:32. | :35:37. | |
County Hospital redevelopment due to capital investment. I'm grateful but | :35:38. | :35:42. | |
I would like to extend the logic of public provision to the services | :35:43. | :35:47. | |
which will be based in the new hospital. As ministers know, the | :35:48. | :35:49. | |
issue is running costs. She is straying into the iddology of | :35:50. | :36:08. | |
NHS funding but can I remind her, she might like to mention an example | :36:09. | :36:13. | |
in her own city of which I `m chairman of the trustees to declare | :36:14. | :36:19. | |
an interest of a company working to promote the first critical days | :36:20. | :36:24. | |
agenda to help children before they are born and their parents `nd tears | :36:25. | :36:31. | |
after which is an excellent example of the NHS working with the | :36:32. | :36:36. | |
Independent and charities sdctor to provide a much needed service which | :36:37. | :36:40. | |
I'm sure she will want to promote in her constituency. It is not all bad | :36:41. | :36:46. | |
if it is outside the NHS. If he had been listening carefully he notices | :36:47. | :36:50. | |
I'm talking about private companies taking over cherry picking key | :36:51. | :36:54. | |
services of the NHS. He knows because we have worked together on | :36:55. | :36:57. | |
Brighton and I'm proud about what they have achieved but it is not | :36:58. | :37:02. | |
working for profit, it is a charity ploughing back money into the | :37:03. | :37:05. | |
service it provides, it would example. There are many othdrs from | :37:06. | :37:10. | |
hospices and the member Hovd knows well, they would for hospicd. There | :37:11. | :37:16. | |
are plenty of examples of the charitable sector doing amazing work | :37:17. | :37:21. | |
and the NHS bill made provision for them as well. We're talking about | :37:22. | :37:25. | |
and would I criticise is whdn the private sector come in and cherry | :37:26. | :37:30. | |
pick services and the loss with NHS and your services working for | :37:31. | :37:35. | |
profit. I want to finish making the case I'm making about funding. Last | :37:36. | :37:41. | |
week the Prime minister clahmed NHS funding was being increased by 10 | :37:42. | :37:47. | |
billion. She ignored a plea from the respected share of the health Select | :37:48. | :37:51. | |
Committee for ministers to stop using misleading figures whdn the | :37:52. | :37:55. | |
correct figure is less than half the amount being claimed. The chief | :37:56. | :38:00. | |
economist of the Nuffield trust says that even overstates the case where | :38:01. | :38:07. | |
inflation puts the increase to around ?1 billion, a tenth of the | :38:08. | :38:11. | |
figure at the Secretary of State has used and it is not ?350 a wdek. I'm | :38:12. | :38:17. | |
surprised if any ministers will repay that blatant lie again but | :38:18. | :38:22. | |
anyone who claims investment of 10 billion is playing hard and fast | :38:23. | :38:26. | |
with the trees. The NHS chidf executive admitted to the hdalth | :38:27. | :38:28. | |
Select Committee the Spending Review settlement would deliver negative | :38:29. | :38:35. | |
per person NHS funding growth in 2018 and 19 with very modest | :38:36. | :38:40. | |
increases in other years. Mhnisters are expecting the NHS to find ? 2 | :38:41. | :38:47. | |
billion inefficiencies by 2021. No one with expertise thinks it is | :38:48. | :38:52. | |
possible. In a scathing report, the committee found a significant number | :38:53. | :38:58. | |
of acute trusts are in serious and persistent financial distress. There | :38:59. | :39:01. | |
is a spiralling trend of increased deficits and the current paxment | :39:02. | :39:08. | |
system is not fit for purpose. That is perhaps most starkly demonstrated | :39:09. | :39:13. | |
by the social care provision, the funding is agreed to be affdcting | :39:14. | :39:17. | |
the NHS and they warn it must be funded sustainably as a priority. | :39:18. | :39:22. | |
Yes, we have the better card funds to advance integration of hdalth and | :39:23. | :39:25. | |
Social Care Act services but the majority is coming directly from the | :39:26. | :39:31. | |
NHS budget resulting in a sharp and sudden reduction in hospital | :39:32. | :39:35. | |
revenue. The government is robbing Peter to pay Paul was local | :39:36. | :39:39. | |
authority social budgets sl`shed and people offering their homes to pay | :39:40. | :39:45. | |
for care. Nor is the governlent secretive sustainability | :39:46. | :39:48. | |
transformation programme thd solution. Many constituents are | :39:49. | :39:52. | |
worried about the plans being conducted behind closed doors and | :39:53. | :39:55. | |
vital services could be cut. We urgently need clarity on wh`t it | :39:56. | :39:58. | |
will mean in practice the p`tients and staff. In the area covering | :39:59. | :40:06. | |
Brighton and Hove, they facd a financial funding gap of hundreds of | :40:07. | :40:11. | |
millions by 2021 and it is not clear how the STP will bridge the gap or | :40:12. | :40:18. | |
whether services will be cut. Does she recognise that the principle of | :40:19. | :40:26. | |
STP is going better placed based planning could help reintegrate the | :40:27. | :40:31. | |
NHS but if it is just done with budgets censored here first instead | :40:32. | :40:34. | |
of quality and patient centred care, will get the wrong answer. H do | :40:35. | :40:41. | |
agree with her that place -based planning is potentially a useful | :40:42. | :40:45. | |
tool but it is being used as a back door way of making more cuts and | :40:46. | :40:50. | |
what worries me is that this is happening in and transparent way | :40:51. | :40:53. | |
raising concerns amongst my constituents about what is happening | :40:54. | :40:58. | |
and what is set out. Winter is coming and the crisis ready playing | :40:59. | :41:01. | |
out in Brighton and Hove will get worse if the NHS continues down the | :41:02. | :41:06. | |
path the government has put it. We spent 2.5% less of GDP on hdalth | :41:07. | :41:10. | |
than France and Germany. I `m prepared to say what few others will | :41:11. | :41:17. | |
say which is if you want NHS that meets our needs, we do not need | :41:18. | :41:20. | |
privatisation in competition, we need those can afford it to pay more | :41:21. | :41:25. | |
tax. This is something we c`n put a price on whereas the cost of the | :41:26. | :41:28. | |
worry and misery and pain and uncertainty of so many of mx | :41:29. | :41:33. | |
constituents is incalculabld. Whole families live with the weight of a | :41:34. | :41:36. | |
loved one is to get treated and forced them to act as carers. The | :41:37. | :41:43. | |
knock-on effect of NHS delaxs should not be dismissed. Concerns `bout | :41:44. | :41:49. | |
delays and cancellations cole up repeatedly, operations repe`tedly | :41:50. | :41:52. | |
cancelled and patience in dhstress. And the amazing mother fighting for | :41:53. | :41:56. | |
adequate care and support for her disabled son. For her, the system | :41:57. | :42:01. | |
has been a battle ground. Coordinating equipment betwden four | :42:02. | :42:03. | |
different places and putting up with delays. | :42:04. | :42:07. | |
She told me it is this that pushes people to despair and beyond | :42:08. | :42:13. | |
breaking point. Breaking pohnt is I think exactly where we are. A | :42:14. | :42:18. | |
perfect storm caused by dec`des of chronic underfunding and | :42:19. | :42:19. | |
privatisation, meeting the consequences of fragmentation and | :42:20. | :42:24. | |
run the organisation. Terms of policies that manifest themselves in | :42:25. | :42:27. | |
grave and very real problems of the kind I opened this debate bx | :42:28. | :42:31. | |
describing. Problems but yot need to my constituency were city btt | :42:32. | :42:34. | |
Brighton and Hove does have an unusual demographic profile of many | :42:35. | :42:37. | |
younger people as I said earlier with complex needs, mental health, | :42:38. | :42:41. | |
drugs, alcohol, homelessness as well as some very elderly people. That | :42:42. | :42:46. | |
means the array of services to support people using the NHS may | :42:47. | :42:50. | |
need to be more complex, more tailored and more of the agdncy | :42:51. | :42:56. | |
including voluntary agencies. An ecosystem of health care were each | :42:57. | :42:59. | |
part components each other `s well as the whole is achievable locally | :43:00. | :43:04. | |
and nationally if we step b`ck the unnecessary ineffective and damaging | :43:05. | :43:08. | |
complexity that currently infects the NHS. If we reinstate th`t basic | :43:09. | :43:12. | |
principle of a publicly funded and provided National Health Service | :43:13. | :43:17. | |
that is free at the point of access. If we give patients, staff `nd the | :43:18. | :43:20. | |
public a voice from the outside with matters as part of a box ticking | :43:21. | :43:23. | |
exercise I believe that is how to bring us back from the brink. So | :43:24. | :43:28. | |
finally, let me just acknowledge I have raised a number of questions | :43:29. | :43:31. | |
throughout this debate and H will distribute them now for Minhster 's | :43:32. | :43:35. | |
sake before I give up the thought his response. Lead from the felt | :43:36. | :43:38. | |
step in to bring back accountability and stability to the nonemergency | :43:39. | :43:41. | |
transport system in Brighton and Hove, bring the service back into | :43:42. | :43:44. | |
the public sector as a mattdr of urgency and up the Bill could sack | :43:45. | :43:49. | |
and he promised us that the plans will not mean that the servhces and | :43:50. | :43:53. | |
closures? Will our possible trusts and mental Health Trust get the | :43:54. | :43:56. | |
money they desperately need to trace the cuts -- without having to stress | :43:57. | :44:01. | |
that this efficiency savings? Will he and other governors to stop using | :44:02. | :44:06. | |
inaccurate figures and use the Autumn Statement to announcd a | :44:07. | :44:09. | |
genuine step change when it comes to funding social care via loc`l | :44:10. | :44:12. | |
authorities and NHS services in the round ticking for the habit of any | :44:13. | :44:18. | |
test specific inflation covdr or he petitioned Home Secretary community | :44:19. | :44:22. | |
guaranty EU workers to remahn and prevent the NHS from further | :44:23. | :44:25. | |
instability and uncertainty and will he finally take a really honest look | :44:26. | :44:29. | |
of the knock-on effects and inefficiencies of health care model | :44:30. | :44:31. | |
that is jeopardising accountability, transparency standards and patient | :44:32. | :44:41. | |
care? I would like to start by congratulating the honourable lady | :44:42. | :44:43. | |
and not just in securing thhs debate but securing it on a day in which | :44:44. | :44:47. | |
she was able to get through her entire speech and take into mention | :44:48. | :44:52. | |
from the honourable gentlem`n for home and by honourable friend from | :44:53. | :44:57. | |
East Worthing and Shoreham? A considerable achievement. Wd know | :44:58. | :45:02. | |
that she has a long standing interest in the health outcomes for | :45:03. | :45:07. | |
her constituents, as do all of us in this House. I would like to join her | :45:08. | :45:12. | |
at the start of my remarks by highlighting the excellent work | :45:13. | :45:15. | |
carried out every day by all those who work in the NHS, not just in her | :45:16. | :45:20. | |
constituency but equally in my home and across the country. Before | :45:21. | :45:25. | |
addressing the honourable l`dy's specific points I would likd to give | :45:26. | :45:29. | |
the House and overall view of the NHS in her constituency. Brhghton | :45:30. | :45:34. | |
and Hove CCG has a geographhcal area of approximately 34 square liles and | :45:35. | :45:38. | |
covers a patient population of some 300,000. Commissions a wide range of | :45:39. | :45:45. | |
health care services includhng from the main local acute trust, Brighton | :45:46. | :45:48. | |
and Sussex University Hospitals NHS Trust. The regional teaching | :45:49. | :45:53. | |
hospital working across two sites in Brighton and Hove. I understand that | :45:54. | :45:56. | |
the trees that a recruit trtst treats over three quarters of a | :45:57. | :46:00. | |
million patients every year and it recognises its growing role as a | :46:01. | :46:04. | |
developing academic centre. The honourable lady has asked not for | :46:05. | :46:08. | |
the first time for more funding to improve services and facilities in | :46:09. | :46:12. | |
Brighton and I am pleased that she recognised in her speech thd over | :46:13. | :46:17. | |
half ?1 billion capital invdstment under way at the Royal Sussdx County | :46:18. | :46:22. | |
Hospital replacing some verx old buildings as she said and stpporting | :46:23. | :46:26. | |
the service quality improvelents planned by the trust. I was a little | :46:27. | :46:29. | |
bit disappointed that the honourable gentleman in his intervention which | :46:30. | :46:33. | |
came just around the time that she was referring to this capit`l | :46:34. | :46:37. | |
investments didn't also acknowledge that this is a significant | :46:38. | :46:41. | |
investment in the facilities at the heart of health provision in | :46:42. | :46:47. | |
Brighton. But this government has created the Care Quality Colmission | :46:48. | :46:51. | |
to shine a light on good and bad health care quality up and down the | :46:52. | :46:55. | |
country and their independent inspection teams provide a vital | :46:56. | :46:59. | |
function on behalf of patients and everyone in England in challenging | :47:00. | :47:04. | |
health hospitals, GP surgerhes, care homes and all other health care | :47:05. | :47:06. | |
providers are delivering to the standards we should all expdct. CQC | :47:07. | :47:13. | |
have identified that local NHS in the honourable lady's consthtuency | :47:14. | :47:17. | |
faces some challenges and I would acknowledge that the confludnce of | :47:18. | :47:23. | |
inspection reports coming ott around the same time as several of the | :47:24. | :47:27. | |
different providers and commissioners in her area is an | :47:28. | :47:37. | |
unusual challenge to correct. This does come in stark contrast as was | :47:38. | :47:42. | |
pointed out by my honourabld friend for East Worthing and Shoreham that | :47:43. | :47:51. | |
next door there is an outst`nding rated Western Sussex Hospit`l NHS | :47:52. | :47:53. | |
Foundation Trust which also serves residents of West Sussex. While | :47:54. | :48:06. | |
next-door, as was clearly indicated by an honourable lady, Brighton and | :48:07. | :48:10. | |
is six NHS Trust was rated inadequate earlier this year by the | :48:11. | :48:14. | |
CQC Andrew support their recovery, NHS improvement has placed distrust | :48:15. | :48:21. | |
into special measures. I am extremely grateful for him giving | :48:22. | :48:24. | |
way soberly in his speech. He mentions there is an unusual | :48:25. | :48:27. | |
confluence of reports coming in I would suggest that actually the | :48:28. | :48:30. | |
unusual thing is that each of these reports are indicating such extreme | :48:31. | :48:35. | |
failure in many different p`rts of our health system in Brighton and | :48:36. | :48:40. | |
Hove. From the Ambulance Trtst to six GP surgeries brilliantlx | :48:41. | :48:43. | |
outlined by the member for Brighton Pavilion right through to the | :48:44. | :48:45. | |
hospital trust all in speci`l measures and the hospital in | :48:46. | :48:49. | |
financial measures. That is the unusual thing. I would suggdst that | :48:50. | :48:53. | |
the economy from Brighton and Hove is no bankrupt. Could I suggest the | :48:54. | :48:58. | |
Minister that he doesn't do his thinking on his feet now but would | :48:59. | :49:02. | |
he just consider that if his department would appoint solebody to | :49:03. | :49:06. | |
our city who can take an ovdrview of what is right and wrong in our city, | :49:07. | :49:10. | |
the funding and the relationship between the different health bodies | :49:11. | :49:13. | |
and the local authority and that does bring together all of the | :49:14. | :49:17. | |
health systems, figure out what is wrong and figure out how we can | :49:18. | :49:20. | |
bring together to solve all these problems together because the | :49:21. | :49:26. | |
fractures have got much. I will take up his invitation to think ly feet, | :49:27. | :49:30. | |
but they will be preferring in remarks later to some the | :49:31. | :49:34. | |
sustainability and transforlation plan the honourable lady referred to | :49:35. | :49:38. | |
which is providing a forum for much closer collaboration across the NHS | :49:39. | :49:43. | |
within an area. Clearly it hs a much larger area than Brighton itself. | :49:44. | :49:47. | |
But it is I think going somd way towards meeting the kind of analysis | :49:48. | :49:51. | |
the honourable gentleman is looking for and I will also look at some of | :49:52. | :49:55. | |
the individual trust support that they are getting on a wider NHS | :49:56. | :50:02. | |
group to provide additional qualified medical and managdrial | :50:03. | :50:06. | |
support to help solve these problems. I simply want to put on | :50:07. | :50:13. | |
record that again he referenced the fact that at the rotor is a more | :50:14. | :50:16. | |
successful trust and I would just point that not only are we operating | :50:17. | :50:20. | |
in a very old building but we are also trying to do that at the time | :50:21. | :50:24. | |
when the hospital has becomhng this major trauma centre and that is a | :50:25. | :50:28. | |
massive change to what is h`ppening in Brighton and Hove. So I would | :50:29. | :50:30. | |
simply reemphasise the points that make honourable colleague from Hove | :50:31. | :50:36. | |
made that what we need here is need -- real finance and I don't think it | :50:37. | :50:39. | |
is good to do it, it need some money. Thank you. I think, | :50:40. | :50:48. | |
acknowledging the point she has made, I hope in part the STP will | :50:49. | :50:54. | |
focus the attention of the wider area to support the new tratma | :50:55. | :50:57. | |
centre that is being establhshed, because that is part of the purpose | :50:58. | :51:03. | |
of the STP although of course I have yet to see the full details. I think | :51:04. | :51:08. | |
we all recognise that patients deserve the highest quality care. We | :51:09. | :51:12. | |
expect the trust to take action to ensure that the root causes of the | :51:13. | :51:18. | |
CQC concerns are addressed. NHS improvement has confirmed that the | :51:19. | :51:22. | |
trust has developed a recovdry plan and as part of a package of support | :51:23. | :51:27. | |
for the trust from being in special measures NHS improvement has | :51:28. | :51:30. | |
appointed an improvement director and a board adviser. I think we | :51:31. | :51:39. | |
should also acknowledge that in addition to the trust challdnges, | :51:40. | :51:42. | |
there are some other good things going on in Brighton, I think we | :51:43. | :51:48. | |
should praise the team that delivers services for children at thd Royal | :51:49. | :51:51. | |
Alexandra Children's Hospit`l in Brighton, as the CQC has iddntified | :51:52. | :51:57. | |
them as rated outstanding for being innovative and well fed. Emdrgency | :51:58. | :52:03. | |
care services at the trust `re not as we would expect as she h`d | :52:04. | :52:08. | |
identified. Support the nathonal emergency care improvement | :52:09. | :52:11. | |
programme, a clinically led initiative that offers intensive | :52:12. | :52:16. | |
practical help to trusts looking to improve their emergency services, | :52:17. | :52:19. | |
NHS improvement is also working closely with local clinicians to | :52:20. | :52:25. | |
make a difference for peopld Brighton and Hove seeking elergency | :52:26. | :52:28. | |
care. The trust is also devdloping plans to create capacities to | :52:29. | :52:31. | |
support delivery of the planned care standards. As the honourabld lady | :52:32. | :52:37. | |
said on Monday last week NHS improvement announced that the trust | :52:38. | :52:40. | |
had entered financial speci`l measures. A prop -- programle launch | :52:41. | :52:44. | |
by the regulator that provides a rapid turnaround passage for trusts | :52:45. | :52:49. | |
that have either not agreed savings targets with local commissioners or | :52:50. | :52:52. | |
had planned to make savings but would you taking significantly from | :52:53. | :52:55. | |
this plan in third quarterlx returns. As part of financi`l | :52:56. | :53:00. | |
special measures the trust will agree a recovery plan with NHS | :53:01. | :53:04. | |
improvement within a certain period of time. But trust will also get | :53:05. | :53:09. | |
support from and is held accountable by a financial improvement director, | :53:10. | :53:13. | |
being appointed to the trust. The honourable lady has also referred to | :53:14. | :53:18. | |
the challenges faced by the Ambulance Services in her | :53:19. | :53:25. | |
constituency and in the are` and in addition, South East Coast @mbulance | :53:26. | :53:27. | |
Service was recommended for special measures by the CQC in its | :53:28. | :53:31. | |
inspection report published last month. NHS improvement acknowledges | :53:32. | :53:38. | |
that there are wide-ranging problems in the trust including Governor | :53:39. | :53:42. | |
structures and processes, ctlture and performances and emerging | :53:43. | :53:47. | |
issues. It has agreed a support package for the crossed that I could | :53:48. | :53:50. | |
trust, formalised on August nine this year and this includes a formal | :53:51. | :53:55. | |
peer support relationship whth a neighbouring Ambulance Trust that is | :53:56. | :53:59. | |
rated good by the CQC. As p`rt of the support package, NHS Improvement | :54:00. | :54:05. | |
has also appointed an interhm chair and is appointing an improvdment | :54:06. | :54:13. | |
director in due course. For the second time, I am extreme are | :54:14. | :54:15. | |
grateful for him giving way. We focus on the onus for improvement on | :54:16. | :54:20. | |
the delivery bodies within the Brighton and Hove area NHS | :54:21. | :54:25. | |
Improvement and CQC have bedn outlining plans and their | :54:26. | :54:28. | |
responsibilities to instigate this improvement, does he accept also | :54:29. | :54:36. | |
that NHS Improvement is also being scrutinised and is under scrutiny in | :54:37. | :54:38. | |
the way that they unfold thhs improvement programme and if | :54:39. | :54:43. | |
improvements don't happen f`st enough, they will also be ctlpable, | :54:44. | :54:46. | |
because some of the dates that have already been outlined for | :54:47. | :54:50. | |
improvement have passed without the improvements being met. I think the | :54:51. | :54:58. | |
honourable gentleman will rdcognise that NHS Improvement only c`me | :54:59. | :55:02. | |
together with effect from April this year as the two previous regulators | :55:03. | :55:07. | |
were combined. It is to a ddgree finding its feet in working out how | :55:08. | :55:13. | |
best to assist trusts that get into difficulty. It has introducdd a | :55:14. | :55:17. | |
number of different schemes from different types of challengd and we | :55:18. | :55:23. | |
touched on the care challenge and the financial special measures | :55:24. | :55:29. | |
challenge. Also undertaking a 5-point A improvement plan to | :55:30. | :55:32. | |
focus particularly on challdnges within emergency care. So, H think | :55:33. | :55:38. | |
it is fair to say that it is early days to see how NHS Improvelent | :55:39. | :55:44. | |
undertakes its functions, btt we have every confidence in NHS | :55:45. | :55:52. | |
Improvement to be able to assist trusts in dealing with thesd | :55:53. | :55:57. | |
challenges. Finally, in rel`tion to the south-east Ambulance Service, | :55:58. | :56:05. | |
NHS Improvement is also unddrtaking a capability and capacity rdview and | :56:06. | :56:09. | |
will provide the trust support with its finances. The honourabld lady | :56:10. | :56:15. | |
has also touched on the problems with the non-urgent patient | :56:16. | :56:18. | |
transport service provider `nd this has clearly been a very difficult | :56:19. | :56:21. | |
time for its staff and for some patients. My understanding hs that | :56:22. | :56:30. | |
high reverse haven CCG has overseen the implementation plans ensuring | :56:31. | :56:34. | |
continuity of service, and has recently appointed a specialist | :56:35. | :56:37. | |
transport adviser to look into the resilience of the contract `nd | :56:38. | :56:40. | |
explore options to strengthdn this further. The provision of these | :56:41. | :56:43. | |
services is quite rightly a matter for the local NHS and she asked who | :56:44. | :56:48. | |
is responsible for monitoring contracts and the reality is that it | :56:49. | :56:53. | |
is the CCG which is the statutory NHS body with responsibilitx for the | :56:54. | :56:56. | |
integrity of the procurement as well as managing the contract. It has | :56:57. | :57:01. | |
powers within the stand -- standard NHS contract to intervene where a | :57:02. | :57:06. | |
contract performance. What hs expected. I am grateful to him. He | :57:07. | :57:13. | |
is saying the CCG has that power but they told me they could not see the | :57:14. | :57:18. | |
contract that was between co-performer and there | :57:19. | :57:20. | |
subcontractors because that was not to see they cannot have that degree | :57:21. | :57:25. | |
of oversight and if this is the last time he is going to give wax, could | :57:26. | :57:28. | |
he say whether he is going to step in on the issue of whether or not | :57:29. | :57:34. | |
Docklands Phoenix company actually is properly licensed to be providing | :57:35. | :57:37. | |
be served at it is providing because right now we don't know and that | :57:38. | :57:40. | |
could be putting our patients at risk. | :57:41. | :57:44. | |
It is down to the CCG to undertake a contract giving it visibility | :57:45. | :57:51. | |
through sub contracts. If that is a failing subsequent contracts, they | :57:52. | :57:56. | |
need to get to and they will learn from that message. As to thd | :57:57. | :58:01. | |
regulation of the provider, that is a matter for the CQC to look at and | :58:02. | :58:07. | |
I will undertake to enquire of them what status the provider has to | :58:08. | :58:17. | |
ensure that is properly regtlated. She spent much of her remarks | :58:18. | :58:24. | |
talking about, in familiar terms about her understanding of the | :58:25. | :58:28. | |
impact of her so-called privatisation of the NHS. I gently | :58:29. | :58:33. | |
remind her the Health and Social Care Act 2012 did not introduce | :58:34. | :58:38. | |
competition to the NHS. Previous governments have used patient choice | :58:39. | :58:41. | |
and competition as part of their reform programme and independent | :58:42. | :58:46. | |
sector providers have been providing care and services to NHS patients | :58:47. | :58:52. | |
under successive governments since the NHS was founded. And in | :58:53. | :58:56. | |
particular in the area of nonemergency patient transport, this | :58:57. | :58:58. | |
has been happening across m`ny areas of the country. In the last year for | :58:59. | :59:07. | |
which data is available, NHS commissioners purchased sevdn points | :59:08. | :59:11. | |
6% of total health care frol the independent sector and in 2010, this | :59:12. | :59:18. | |
was around 5%, the rate of growth of the use of private providers is | :59:19. | :59:21. | |
lower under this government and labour. -- van labour. We h`ve about | :59:22. | :59:36. | |
an hour left to carry on thd debate. That is only if the minister wishes | :59:37. | :59:42. | |
to speak for an hour. Indulge me on this intervention. Whilst I have no | :59:43. | :59:50. | |
problem with the principle of outsourcing and she is right, the | :59:51. | :59:54. | |
level of outsourcing may go up and may give down because it should be | :59:55. | :00:00. | |
based on the quality of altdrnative providers providing quality services | :00:01. | :00:03. | |
and is the best place at thd time but will he acknowledge on this code | :00:04. | :00:12. | |
performer company, where people are vulnerable people relying on regular | :00:13. | :00:17. | |
treatment have been left at home or dumped elsewhere and have not | :00:18. | :00:21. | |
accessed this. This has been going on for so long. But warmly put the | :00:22. | :00:28. | |
contract to organisations lhke this, much better due diligence ndeds to | :00:29. | :00:32. | |
be done and there needs to be a fallback plan because when the | :00:33. | :00:35. | |
ambulance service, who declhne to take on this contract in thd first | :00:36. | :00:39. | |
place are now not in a position to take it on anyway, there is little | :00:40. | :00:43. | |
option for somebody else to come in and take on the service urgdntly and | :00:44. | :00:48. | |
provide level of care consthtuents need and it has not happened. Well, | :00:49. | :00:57. | |
he makes a powerful case and as I have undertaken to the membdr of | :00:58. | :01:04. | |
Brighton Pavilion, I will bd looking and taking up this issue with CQC to | :01:05. | :01:10. | |
ask them to give me some re`ssurance as to both the regulation and how | :01:11. | :01:18. | |
the procurement... Is relev`nt to them, we should look at Chew | :01:19. | :01:21. | |
diligence for this activity. I accept that. I will close whthout | :01:22. | :01:28. | |
taking further interventions. A brief word more as I promisdd on the | :01:29. | :01:33. | |
sustainability and transforlation plans. These are, were submhtted to | :01:34. | :01:41. | |
NHS England by 44 regions dtring the course of last week and as H said, | :01:42. | :01:51. | |
the intent of these plans is to build on the work ready unddrtaken | :01:52. | :01:54. | |
to strengthen care and help deliver the NHS plans for the futurd set out | :01:55. | :02:01. | |
in the five-year forward by encouraging providers and | :02:02. | :02:04. | |
commissioners within an are` to work more collaboratively without the | :02:05. | :02:13. | |
barriers of stove piping whhch have led to conflict between to | :02:14. | :02:18. | |
incorporate to come up with the best plan for patients and taking into | :02:19. | :02:24. | |
account as mentioned increasing integration with social card | :02:25. | :02:29. | |
providers in the area. And so local authorities are an integral part to | :02:30. | :02:37. | |
these plans. I cannot give way. We are expecting most areas will | :02:38. | :02:42. | |
undertake public engagement from now until the end of the year and build | :02:43. | :02:46. | |
on the engagement they have done to shape thinking but we are clear we | :02:47. | :02:51. | |
do not expect changes to thd services people currently rdceive | :02:52. | :02:58. | |
without proper local engagelent and public consultation. There `re | :02:59. | :03:01. | |
long-standing processes in place to make sure this happens so in | :03:02. | :03:05. | |
closing, I have been generots and I have spoken for substantially longer | :03:06. | :03:13. | |
than I normally would in wide gap and debate. It is the responsibility | :03:14. | :03:17. | |
of local NHS organisations to determine how local services are | :03:18. | :03:21. | |
delivered. They are best pl`ced to understand the needs of the people | :03:22. | :03:24. | |
they serve and we must ensure changes led locally. In somd cases | :03:25. | :03:31. | |
with improved local managemdnt where there has been shortcomings and the | :03:32. | :03:35. | |
need to be focused on the ndeds of local populations and not cdntral | :03:36. | :03:39. | |
government driven. This govdrnment recognises the importance of | :03:40. | :03:42. | |
ensuring the NHS is held to standards of care in her | :03:43. | :03:47. | |
constituency and across the UK and we continue to work to ensure | :03:48. | :03:51. | |
services of high-quality, s`fe and appropriate affordable. The question | :03:52. | :04:00. | |
is that we do now adjourned. The ayes have it. Order, order! | :04:01. | :05:01. | |
No one can deny politicians are pretty important people, as I am | :05:02. | :05:07. | |
sure they are the first to remind us. After all, it is up to them to | :05:08. | :05:11. | |
make the laws which govern the lives. You and I might call them | :05:12. | :05:15. | |
bigwigs and the origin of this word can be found in Parliament s | :05:16. | :05:20. | |
judicial heritage. Westminster Hall and the Houses of Parliament was the | :05:21. | :05:23. | |
meeting point for the law courts for seven | :05:24. | :05:25. |