:00:00. > :00:00.parts of my constituency but I would be delighted to visit. As wd get
:00:00. > :00:12.towards Christmas, people should try to shop local. Order, order. Will
:00:13. > :00:41.the member wishing to take her seat please come to the table?
:00:42. > :00:52.I swear by Almighty God that I will be faithful and bear true allegiance
:00:53. > :00:59.to Her Majesty Queen Elizabdth, her heirs and successors, according to
:01:00. > :01:22.law, so help me God. You've got me now.
:01:23. > :01:42.Tracey Babin, member for Batley and spend.
:01:43. > :01:49.Order, order. Will the membdr wishing to take his seat pldase come
:01:50. > :02:24.to the table? I swear by Almighty God that I will
:02:25. > :02:28.be faithful and bear true allegiance to Her Majesty Queen Elizabdth, her
:02:29. > :03:00.heirs and successors, according to law, so help me God.
:03:01. > :03:41.Order. We will come to points of order later but in the usual way,
:03:42. > :03:50.and FLV to attend to a point of order later. Statement, the Prime
:03:51. > :03:56.Minister. With permission, H would like to make a statement on my one
:03:57. > :04:01.be in Council last week. I went to this council with a clear mdssage
:04:02. > :04:06.for my 27 European counterp`rts The UK is leaving the EU but not Europe
:04:07. > :04:12.and we are not turning our backs on our friends and allies. For as long
:04:13. > :04:18.as we are members of the EU we will play a full and active role, and
:04:19. > :04:23.after we leave we will be a confident outward looking country,
:04:24. > :04:28.enthusiastic about trading with our European neighbours and cooperating
:04:29. > :04:31.on shared security interests, including law enforcement and
:04:32. > :04:37.counterterrorism. That is the right approach and it was in the spirit we
:04:38. > :04:42.made a significant contribution at this council to ensure a robust
:04:43. > :04:46.European stance in the face of Russian aggression, addresshng the
:04:47. > :04:53.root causes of mass migration and championing free trade around the
:04:54. > :04:57.world. Let me say a word about each. Russia's indiscriminate bombing of
:04:58. > :05:03.civilians in Aleppo and the atrocities we have seen elsdwhere in
:05:04. > :05:07.Syria are horrific. It is vhtal we keep up the pressure on Russia and
:05:08. > :05:11.the Syrian regime to stop its appalling actions and creatd the
:05:12. > :05:18.space for a genuine politic`l transition in Syria. The UK put this
:05:19. > :05:23.issue on the agenda for the council. The Foreign Secretary made the case
:05:24. > :05:28.for a robust response at thd Foreign Affairs Council last Monday and I
:05:29. > :05:33.spoke personally to Chancellor Merkel and President Donald Tusk
:05:34. > :05:37.ahead of the Council last wdek. The council strongly condemned the
:05:38. > :05:41.attacks, called for a cessation of facilities and demand that those
:05:42. > :05:46.responsible for breaches of humanitarian law be held
:05:47. > :05:51.accountable, and we need to go further, which is why we agreed if
:05:52. > :05:56.current atrocities continue, the EU will consider all available options.
:05:57. > :06:02.The agreed everything should be done to bring in humanitarian aid to
:06:03. > :06:07.civilians. On Friday, the UK secured an extraordinary session of the UN
:06:08. > :06:12.human rights Council to press for a ceasefire to enable humanit`rian
:06:13. > :06:18.access to Aleppo. Millions of civilians are trapped there and
:06:19. > :06:22.across Syria in desperate nded of food, shelter and health care. The
:06:23. > :06:29.UK is already the second largest a lot aerial -- bilateral hum`nitarian
:06:30. > :06:35.donor to this crisis and evdry secure access to these areas, we are
:06:36. > :06:39.ready to accelerate over ?23 million of aid to help the most vulnerable
:06:40. > :06:45.in the hardest to reach parts of Syria. Turning to migration, the
:06:46. > :06:50.Home Secretary will give a statement on Calle shortly. At the European
:06:51. > :06:57.Council I confirmed the UK will provide practical support to Europe,
:06:58. > :07:02.including our naval presencd in the Aegean and Mediterranean, and as
:07:03. > :07:08.part of that effort, HMS echo will take over in the Central military
:07:09. > :07:12.knee and early next year. I reiterated that case I made at the
:07:13. > :07:19.UN for a global approach to migration waste on three prhnciples.
:07:20. > :07:25.First, ensuring refugees cl`im asylum in the first save cotntry
:07:26. > :07:30.they reach. Second, improving the way we distinguish between refugees
:07:31. > :07:35.and economic migrants, and third, developing a better overall approach
:07:36. > :07:39.to managing economic migrathon, which recognises that all countries
:07:40. > :07:43.have the right to control their borders and must commit to `ccepting
:07:44. > :07:48.the return of their own nathonals when they have no right to remain
:07:49. > :07:52.elsewhere. This includes working more closely with sauce and transit
:07:53. > :07:56.countries and the council agreed to do more to help these countries
:07:57. > :08:01.prevent illegal migration and return migrants who have no right to stay
:08:02. > :08:07.in EU countries. Turning to trade, I am determined that Britain will be
:08:08. > :08:13.the most passionate, consistent and convincing advocate of free trade
:08:14. > :08:17.anywhere in the world. As wd look beyond our confident, we will seize
:08:18. > :08:23.the opportunities of Brexit to forge an ambitious new role for Britain in
:08:24. > :08:27.the world, and as part of this in the UK is already discussing our
:08:28. > :08:32.future trading relationships with third countries. As I made clear to
:08:33. > :08:38.other member states, this whll not undermine the EU trade agenda, it is
:08:39. > :08:44.not even in competition with it and as long as we remain a membdr of the
:08:45. > :08:49.EU we will continue to back the EU's free trade negotiations. I share
:08:50. > :08:54.everyone's disappointment over the stalled talks between the ET and
:08:55. > :08:58.Canada and we will do what we can to help get these discussions by
:08:59. > :09:03.contract, but to those who suggest these difficulties have a bdaring on
:09:04. > :09:06.our own negotiations, I remhnd them we are not seeking to replicate any
:09:07. > :09:17.existing model another country has in trading with the EU. We will
:09:18. > :09:22.develop our own British moddl. A new relationship for the UK with the EU,
:09:23. > :09:30.to be there for when you're outside the EU, a deal that is ambitious and
:09:31. > :09:34.gold for Britain. I also updated the European Council on Brexit, I said
:09:35. > :09:39.we will invoke Article 50 no later than the end of March next xear and
:09:40. > :09:43.is part of the withdrawal process we will put before Parliament ` great
:09:44. > :09:49.repeal bill which will remove from the statute book once and for all
:09:50. > :09:53.the European Communities Act, so the legislation that gives effect to all
:09:54. > :09:57.EU law in Britain but no longer apply from the data we form`lly
:09:58. > :10:02.leave the EU and the authorhty of EU law in Britain will end. Thd
:10:03. > :10:06.Government will also give the parliament the chance to discuss our
:10:07. > :10:12.approach to leaving the EU, so in addition to regular up dates from my
:10:13. > :10:17.honourable friend, my own statements following council meetings `nd the
:10:18. > :10:23.deliberations of the new select committee on exiting the EU, the
:10:24. > :10:27.Government will take time available for a series of debates on our
:10:28. > :10:31.future relationship with thd EU These will take place beford and
:10:32. > :10:35.after the Christmas recess `nd will include debate on the princhples the
:10:36. > :10:41.Government will pursue in negotiations. Members on all sides
:10:42. > :10:43.will note the Government will not show its hand in detail as we enter
:10:44. > :11:02.into these negotiations. But it is important that melbers
:11:03. > :11:05.have this chance to speak on the issues that matter to their
:11:06. > :11:12.constituents as we prepare to leave the EU. Well we have not yet started
:11:13. > :11:16.the Brexit negotiations, I've made clear last week that my aim is to
:11:17. > :11:23.cement Britain as a close p`rtner of the EU once we have left. I want a
:11:24. > :11:26.deal to reflect the kind of mature, cooperative relationship th`t close
:11:27. > :11:33.friends and allies enjoy, a deal that gives British companies freedom
:11:34. > :11:36.to trade and operate within the European market and allow Etropean
:11:37. > :11:41.businesses to do the same hdre, a deal that delivers the deepdst
:11:42. > :11:47.support cooperation to ensure our national security and that of our
:11:48. > :11:52.allies, a deal that is in Britain's interests and the interests of all
:11:53. > :11:56.our European partners, but ` deal that ensures we are a fully
:11:57. > :12:01.independent sovereign nation, able to do what sovereign nations do
:12:02. > :12:08.Deeside for ourselves how wd control immigration.
:12:09. > :12:14.It will mean our laws will be made here and not in Brussels and the
:12:15. > :12:18.judges interpreting those l`ws will fit not in Luxembourg but hdre in
:12:19. > :12:23.Britain. The negotiations whll take time. There will be different
:12:24. > :12:27.moments ahead and have I have said before it will require patidnce and
:12:28. > :12:31.some give and take. But I fhrmly believe that if we approach this in
:12:32. > :12:34.a constructive spirit, we c`n ensure a smooth departure. We can build a
:12:35. > :12:39.powerful relationship that works both for the UK and the countries of
:12:40. > :12:43.the EU, and we can secure the deal that is right for the British
:12:44. > :12:49.people, whose instruction it is our duty to deliver, and I commdnd this
:12:50. > :12:56.statement to the House. Mr Jeremy Corbyn.
:12:57. > :12:59.Thank you, Mr Speaker. I wotld like to thank the Prime Minister for the
:13:00. > :13:05.advance copy of the statement she has just given us. Funnily dnough I
:13:06. > :13:11.too was in Brussels last Thtrsday, meeting Socialist leaders and their
:13:12. > :13:17.counterparts. I have to say, I was given a little longer to spdak that
:13:18. > :13:23.the five minutes the Prime Linister had at dinner and at a more
:13:24. > :13:26.reasonable time of the day. And indeed, I was listened to vdry
:13:27. > :13:33.carefully by all those around the table. I made it clear, Mr Speaker,
:13:34. > :13:37.to the other leaders, that Britain should continue to be a full and
:13:38. > :13:42.active member of the Europe`n Union until mid-ocean oceans on otr exit
:13:43. > :13:46.are complete. I think the Prime Minister was trying to send the same
:13:47. > :13:52.message, but the manner in which she conveyed it was rather diffdrent.
:13:53. > :13:57.She seemed to be not trying to build a consensus that is necessary, or to
:13:58. > :14:02.shape a future relationship with the European Union that is beneficial to
:14:03. > :14:07.everybody. She had a very dhfferent approach. Mr Speaker, the mdssage
:14:08. > :14:11.that came to me loud and cldar from European leaders last week, was the
:14:12. > :14:15.tone taken by this Tory govdrnment since their Tory party confdrence
:14:16. > :14:21.earlier this month, has dam`ged our global reputation and staff a lot of
:14:22. > :14:25.good will, not just in Europe, but around the world. And althotgh the
:14:26. > :14:29.Prime Minister's words may have appeased the hardline voices behind
:14:30. > :14:32.her, they have only spread `nger and resentment all across Europd by the
:14:33. > :14:37.approach that she and her p`rty have taken. I do not believe we will get
:14:38. > :14:44.the best deal for this country by using threats, hectoring or nectar
:14:45. > :14:47.in of the European Union. For these negotiations to succeed, thd
:14:48. > :14:51.Government frankly needs to adopt a slightly more grown-up approach For
:14:52. > :14:57.negotiations to succeed, Brhtain needs a plan. What is clear to
:14:58. > :15:04.everybody calm from European leaders and business, is quite clearly the
:15:05. > :15:07.Government does not have ond. Can the Prime Minister to the House if
:15:08. > :15:12.any progress has been made since the council meeting last week? Hs she
:15:13. > :15:19.willing to tell us if access to the single market is a red line for her
:15:20. > :15:23.government is or not? The Prime Minister has made it clear wants to
:15:24. > :15:27.end freedom of movement that has not made it clear what will be hn its
:15:28. > :15:30.place, causing uncertainty for business and for the many ET
:15:31. > :15:34.nationals who reside in this country and make such a great contrhbution
:15:35. > :15:38.for our economy. And can shd also tell us that if our governmdnt is
:15:39. > :15:42.supporting moves by senior Conservatives to amend the great
:15:43. > :15:47.repeal bill by adding a sunset clause allowing ministers to strip
:15:48. > :15:53.away EU laws on workers' rights and environmental protection in the
:15:54. > :15:56.years that succeed the exit from the European Union? And also tell us how
:15:57. > :16:01.the Government plan to make up the shortfall of funding to those
:16:02. > :16:06.regions resulting from the loss of structural funding to vital capital
:16:07. > :16:10.programmes all over this cotntry? One week the Secretary of State for
:16:11. > :16:13.Britain exiting the European Union will say one thing, the next the
:16:14. > :16:18.Chancellor will say another. Meanwhile, the Prime Ministdr says
:16:19. > :16:21.very little other than Brexht means Brexit, and we went provide a
:16:22. > :16:27.running commentary. The rest of the world looks on and concludes Britain
:16:28. > :16:31.hasn't got a clue. The truth is this isn't a soft Brexit or even a
:16:32. > :16:38.hard Brexit, it is simply a chaotic Brexit. Because, with all the some
:16:39. > :16:42.certainty, and all these mixed messages, day by day, confidence in
:16:43. > :16:47.this economy falls, and the British people become more worried `bout
:16:48. > :16:51.their future. Two weeks ago, the Treasury said that leaving the
:16:52. > :16:56.single market would lead to a 6 billion loss to the economy. The
:16:57. > :17:03.trade deficit is widening, the value of the pound has already fallen by
:17:04. > :17:07.18%. Industries such as the auto industry and others are del`ying
:17:08. > :17:11.vital investment decisions `nd the Bank of England looking to
:17:12. > :17:15.re-locate. This indecision `nd poor economic management is starting to
:17:16. > :17:19.hit our economy severely, wdakening the hand, as we walk into the most
:17:20. > :17:25.important delegations for generations. We on this sidd of the
:17:26. > :17:29.House respect the referendul result and we accept that Britain lust
:17:30. > :17:33.leave the European Union. Wd also understand that this will bd a money
:17:34. > :17:38.mental exercise, with the ddcisions made now affecting the lives of
:17:39. > :17:43.British people for years to come. The Prime Minister appeared to be
:17:44. > :17:45.making some sort of concesshon about parliamentary scrutiny. I would be
:17:46. > :17:48.grateful if you would explahn exactly what the nature of these
:17:49. > :17:53.debates were going to be each side of the Christmas recess. We as an
:17:54. > :17:59.opposition will not to stand by and let this government choose the terms
:18:00. > :18:02.of Brexit unopposed. It is our duty to scrutinise and our duty to make
:18:03. > :18:07.sure this government does h`ve a Brexit plan for our country. Not
:18:08. > :18:11.just a Brexit plan for the Eurosceptics behind her. And we will
:18:12. > :18:17.continue to push for this p`rliament to have a very full slate in this
:18:18. > :18:21.matter whatever happens in the debates around the Christmas recess.
:18:22. > :18:25.Today, Mr Speaker, the French authorities begin the formal closure
:18:26. > :18:28.of the Calle camp. I would like to take this opportunity to welcome
:18:29. > :18:32.those children who have alrdady arrived in this country, as well as
:18:33. > :18:37.others who have family conndctions. This camp, Mr Speaker, and H have
:18:38. > :18:40.seen it for myself, has become a hellish place where a few of the
:18:41. > :18:47.world's most vulnerable people have come to try and survive and call it
:18:48. > :18:51.their home. Yet it still relains unclear what process and tiletable
:18:52. > :18:56.her government is working under to bring refugee children here who are
:18:57. > :19:02.entitled under international law to refuge in the UK. I read to rate the
:19:03. > :19:07.urgency of the letter I sent to the Prime Minister last week, to
:19:08. > :19:11.personally intervene in our country, and to be open and accommod`ting to
:19:12. > :19:16.those children. I'm grateful to the reply I received an hour ago to my
:19:17. > :19:19.letter but I would be grateful if the Prime Minister could indicate
:19:20. > :19:24.something more precise about the timetable for allowing children and
:19:25. > :19:28.others who have family conndctions to come to this country, and that
:19:29. > :19:31.Britain does not evade its responsibility in helping those who
:19:32. > :19:35.have suffered the biggest global displacement since the end of World
:19:36. > :19:40.War II. This displacement is primarily caused by atrocithes in
:19:41. > :19:45.Syria, and we utterly and totally condemn indiscriminate bombhng. The
:19:46. > :19:48.only solution in Syria is a political one. Mr Speaker, these
:19:49. > :19:53.issues are the one future generations will look back on when
:19:54. > :19:54.it comes to defining this political generation. If we continue to
:19:55. > :20:11.approach the challenges we face in a manner they will only grow
:20:12. > :20:14.larger. We can instead work together in this House with our European
:20:15. > :20:16.partners and the rest of thd world, we may quickly find the large
:20:17. > :20:19.problems we face today appe`r smaller than we first thought, if we
:20:20. > :20:23.work together to help those desperate people all around the
:20:24. > :20:26.globe. Thank you Mr Speaker. The right honourable gentleman said he
:20:27. > :20:30.had been in Brussels last Thursday meeting with various socialhst
:20:31. > :20:33.leaders who were listening to him. I suppose, from his point of view it
:20:34. > :20:40.is good to know that somebody is listening to him! Can I address the
:20:41. > :20:46.last two issues that he refdrred to. He talked about Calais. As H said in
:20:47. > :20:49.my statement, and as he will know, my right honourable friend the Home
:20:50. > :20:54.Secretary will be making a statement on Calais and our response to
:20:55. > :20:58.unaccompanied children and bringing children here into the Unitdd
:20:59. > :21:02.Kingdom, with detail in that. All I will say now is this: we have been
:21:03. > :21:06.working very carefully for ` considerable time now with the
:21:07. > :21:12.French government, both to hmprove matters in relation to Calahs, but
:21:13. > :21:17.also to ensure that we were abiding by our requirements under the Dublin
:21:18. > :21:21.regulations to bring childrdn here who had family links here in the UK.
:21:22. > :21:25.That process speeded up, we have put extra resource in it from the Home
:21:26. > :21:30.Office and we have seen mord children being brought here. We have
:21:31. > :21:34.also adopted a scheme to brhng 000 vulnerable children from thd region,
:21:35. > :21:41.from the Middle East and North Africa, here to the UK, working with
:21:42. > :21:45.UNHCR, and we are putting in place the amendment which the Immhgration
:21:46. > :21:49.Act proposals, which of course required us to first negoti`te,
:21:50. > :21:54.discuss with local authorithes about their ability to receive chhldren
:21:55. > :21:58.here in the UK. Because the overriding aim of everyone of us in
:21:59. > :22:03.this House should be to enstre that it is in the best interests of the
:22:04. > :22:07.children that are being looked at and dealt with, and it is no help
:22:08. > :22:12.for those children if we ard not able properly to provide for them
:22:13. > :22:19.when they come here into thd United Kingdom. He did not talk about the
:22:20. > :22:24.wider migration crisis, excdpt a reference that it was mainlx due to
:22:25. > :22:28.Syrian refugees. Of course what we have seen is large number for people
:22:29. > :22:32.moving not from Syria, but from parts of Africa, which is why the UK
:22:33. > :22:38.has consistently been arguing for more work upstream is to stop the
:22:39. > :22:43.numbers of people coming through and ensure that people have got
:22:44. > :22:46.opportunities in source and transit countries, rather than requhring
:22:47. > :22:50.them to come here to the Unhted Kingdom. In relation to Russia, he
:22:51. > :22:55.made a reference to the indiscriminate bombing in Aleppo.
:22:56. > :23:00.I've see with that that he hs referring to Russian action as well
:23:01. > :23:05.Syrian regime action. It was important that we as the UK put this
:23:06. > :23:09.matter on the table and the agenda of the European Council. Thdy made
:23:10. > :23:14.the agreement that they did. And then if I just come on to the issue
:23:15. > :23:18.about the Brexit arrangements. He referred to the tone that h`s taken
:23:19. > :23:21.place since the Conservativd Party conference. I have to say to the
:23:22. > :23:25.right honourable gentleman that what I found in the European Council last
:23:26. > :23:29.week was a number of Europe`n leaders actually commending the
:23:30. > :23:43.speech I had given at the Conservative Party conference.
:23:44. > :23:47.Including, I have to say, one or two of the socialist leaders who might
:23:48. > :23:56.have been talking to him at the time. He says we don't have a plan.
:23:57. > :24:00.We have a plan, which is not to set out at every stage of these to
:24:01. > :24:03.gauche Asians the detail of these the gauche Asians, because that
:24:04. > :24:09.would be the best way to ensure we did not get the best deal for the
:24:10. > :24:14.UK. He talked about free movement. I noticed that his Shadow Fordign
:24:15. > :24:18.Secretary again refused to say what the Labour Party's statement was and
:24:19. > :24:21.he talked about indecision. I have to say to the Leader of the
:24:22. > :24:25.Opposition he could not guide whether we should be in or out of
:24:26. > :24:29.the European Union, he could not decide when we should be invoking
:24:30. > :24:33.article 50, the only thing he could say is that he would have unfettered
:24:34. > :24:38.immigration into this country, the very thing the British people have
:24:39. > :24:49.told us they don't want. Unlike him, the Conservative Party is lhstening
:24:50. > :24:53.to the British people. Willham Cash. In congratulating my right
:24:54. > :24:57.honourable friend on her prhncipled stand in implementing the vdrdict of
:24:58. > :25:02.the British people, despite the doom and gloom which pours out of parts
:25:03. > :25:06.of the media, is my right honourable friend where that last week, the
:25:07. > :25:10.chairman on the committee for the budgets of the European Parliament,
:25:11. > :25:15.stated the EU was too intrusive it breaks so rules, the member state
:25:16. > :25:19.trust one another and it nedds, as he put it, an electric shock? Does
:25:20. > :25:22.my right honourable friend `gree therefore that the EU itself is
:25:23. > :25:30.trouble. They know it and the British people got it right? Well, I
:25:31. > :25:34.think one of the challenges for the 27 remaining states of the Duropean
:25:35. > :25:38.Union will be for them to ddcide the shape and way in which the Duropean
:25:39. > :25:41.Union acts as it goes forward. I think they will have seen the views
:25:42. > :25:46.of the British people. They will have seen that there were a number
:25:47. > :25:49.of elements that led to the British people deciding to leave thd EU and
:25:50. > :25:53.I think it is for the remaining 27 to think Frei carefully abott how
:25:54. > :26:00.they want to take the EU forward in the future. -- to think verx
:26:01. > :26:05.carefully. I thank the Primd Minister for advance sight of her
:26:06. > :26:11.statement. 52% of voters in Scotland voted to remain in the European
:26:12. > :26:16.Union. Since then, we have heard regularly that apparently Scotland
:26:17. > :26:22.matters to the United Kingdom government. Indeed we hear that
:26:23. > :26:26.Scotland is an equal partner in the United Kingdom. Given that, I
:26:27. > :26:31.imagine the Prime Minister lust have raised this at the European Union
:26:32. > :26:34.Council meeting, but for sole inexplicable reason, she has not
:26:35. > :26:39.made mention of that in her statement today. Can she perhaps
:26:40. > :26:44.tell the House which specifhc issues raised by the Scottish Government
:26:45. > :26:48.she shared at the EU Council meeting? On the meetings shd held
:26:49. > :26:51.today on relation to the cotncil when she met with the governments of
:26:52. > :26:57.Scotland, Wales and Northern Ireland, they have reacted since
:26:58. > :27:01.with frustration. The Welsh First Minister Carwyn Jones has s`id: if
:27:02. > :27:06.the UK Government cannot negotiate an agreed position with a ddvolved
:27:07. > :27:13.administration, then it has little hope of negotiating a good Brexit
:27:14. > :27:16.deal with 27 other EU countries And Scotland's First Minister Nhcola
:27:17. > :27:20.Sturgeon said she had received no more information or detail `bout the
:27:21. > :27:32.UK's negotiating position. Given that the Institute for
:27:33. > :27:37.Government has warned that hmposing a settlement on the regions may
:27:38. > :27:42.provide in a serious breakdown in relations within the UK, thd Prime
:27:43. > :27:46.Minister cannot pretend to take the interests of Scotland, Wales,
:27:47. > :27:52.Northern Ireland and Gibraltar seriously. Either she will rush you
:27:53. > :27:57.will not, and if she will not, Scotland is right to hold an
:27:58. > :28:04.independent referendum and we will protect our place in Europe. He asks
:28:05. > :28:08.me to take seriously the vidws of the Scottish Government and the
:28:09. > :28:14.other devolved administrators, and that was why we were sitting around
:28:15. > :28:20.in the joint Council session this morning, it is quite I have said to
:28:21. > :28:24.the First Minister 's that we will have more of those meetings so we
:28:25. > :28:28.have a greater level of communication with those
:28:29. > :28:34.governments. I want for us hn determining the UK's position,
:28:35. > :28:41.because it will be the UK negotiating with the EU, but we take
:28:42. > :28:45.into full account and understand the impacts and particular issuds that
:28:46. > :28:48.are of concern to the devolved administrations and that is what we
:28:49. > :28:54.discussed today, what we will discuss in detail over the coming
:28:55. > :29:00.weeks and months, and of cotrse there are particular religions, in
:29:01. > :29:04.Northern Ireland the issue of the border is a specific concern we are
:29:05. > :29:09.working on and it is that understanding we want for the
:29:10. > :29:14.future, and I would say when he refers to the possibility of another
:29:15. > :29:19.referendum in relation to Scottish independence, if he wants to ensure
:29:20. > :29:24.that the future prosperity of the Scottish economy, he looks `t the
:29:25. > :29:30.fact that Scotland has more imports and trade arrangements with the rest
:29:31. > :29:37.of the UK then it does with the EU. It is first and foremost desired
:29:38. > :29:42.should be to remain part of the UK. I strongly welcomed the statement.
:29:43. > :29:48.Will she confirm this Parli`ment gave the incision to the Brhtish
:29:49. > :29:54.people on EU membership, so it is now the duty of this Parlialent to
:29:55. > :30:00.implement their wishes? I agree with my right honourable friend, this
:30:01. > :30:06.Parliament voted six to one for the British people to decide whdther we
:30:07. > :30:17.leave or remain in the EU. They gave their verdict, it is now our job to
:30:18. > :30:24.make a success of it. Thank you Mr Speaker. In preparation for the
:30:25. > :30:28.council meeting, did the Prhme Minister commission any English
:30:29. > :30:37.regional impact assessments of Brexit? DBE cargo, whose
:30:38. > :30:47.headquarters are in Dong cursed -- Doncaster, last week announced 93
:30:48. > :30:51.redundancies, saying that the Brexit effect means investment dechsions on
:30:52. > :30:57.major infrastructure projects have been delayed or stopped altogether,
:30:58. > :31:02.and customers have decreased or cancelled orders. Will the Prime
:31:03. > :31:08.Minister undertake to publish Brexit regional impact assessments and how
:31:09. > :31:15.will she insure the voice of the English regions are heard dtring
:31:16. > :31:20.Brexit negotiations? The right honourable lady makes an important
:31:21. > :31:25.point about the impact drags it will have on the economy generally, as we
:31:26. > :31:28.go through these negotiations, and well people often talk about the
:31:29. > :31:33.impact on Scotland, Wales and Northern Ireland, there will be
:31:34. > :31:40.potential impacts on differdnt parts of the UK. The Department for
:31:41. > :31:47.exiting the European Union hs talking to departments throtghout
:31:48. > :31:52.the UK to understand the impact so we negotiate the best possible deal
:31:53. > :31:59.that will be right not just for the poor nations but as a country that
:32:00. > :32:02.works for everyone. May I congratulate my right honourable
:32:03. > :32:07.friend on the positive mess`ge she delivered in Brussels about future
:32:08. > :32:13.cooperation and free trade, and her desire to continue are free trade
:32:14. > :32:18.between ourselves and Europd. Did any of her European colleagtes
:32:19. > :32:25.advocate to her the return of tariffs on trade between us and
:32:26. > :32:31.Europe? I thank him for his question and I know he has long been an
:32:32. > :32:35.advocate of leaving the EU `nd trade possibilities that would be
:32:36. > :32:40.available to was thereafter. We didn't have a detailed disctssion
:32:41. > :32:47.about these matters, precisdly because we haven't yet started the
:32:48. > :32:51.formal negotiations. The Prhme Minister is about to embark on a
:32:52. > :32:56.very complex set of negotiations with her European counterparts, and
:32:57. > :33:02.everyone recognises she will not want to reveal the details of our
:33:03. > :33:05.negotiating hand, but that hs very different from setting out her
:33:06. > :33:12.objectives, which I hope will contain a lot more details than just
:33:13. > :33:17.high-level principles, so c`n I ask the Prime Minister to give the House
:33:18. > :33:22.an undertaking that she will publish her negotiating objectives hn time
:33:23. > :33:28.for the House and the new sdlect them before she presents thdm to the
:33:29. > :33:33.other member states? I have set out the objectives we wish to ahm for in
:33:34. > :33:40.relation to the negotiation we will undertake. Can I congratulate them
:33:41. > :33:43.for having been elected as chairman of the new select committee? His
:33:44. > :33:50.committee will look at issuds to do with Brexit. There are alre`dy over
:33:51. > :33:53.30 different reviews and investigations by Parliament in two
:33:54. > :34:00.different aspects of Brexit, so Parliament can consider the issues
:34:01. > :34:08.involved. Rolls-Royce, a magnificent British country, -- company, employs
:34:09. > :34:13.a number of my constituents, including apprentices. I saw them on
:34:14. > :34:17.Friday and they told me of their concerns, shared through thd
:34:18. > :34:23.aerospace and automotive sectors, about the consequences of otr nation
:34:24. > :34:28.leaving the single market and also the customs union. Could thd Prime
:34:29. > :34:33.Minister assure British bushness that she will listen to thehr needs
:34:34. > :34:39.and concerns as we now move to leaving the European Union? My
:34:40. > :34:44.honourable friend makes an hmportant point about the quality of
:34:45. > :34:49.businesses we have here in the UK. Rolls-Royce is one of those
:34:50. > :34:53.businesses, which is a fine example, including the ways they takd on
:34:54. > :34:59.apprenticeships and contribtte to the growth of our economy. H and all
:35:00. > :35:06.those involved in negotiations will listen to business, that work has
:35:07. > :35:10.already started, the Secret`ry of State for exiting the Europdan Union
:35:11. > :35:13.has been holding those disctssions, I have held round tables with
:35:14. > :35:20.businesses to hear the concdrns The overwhelming view is that h`ving
:35:21. > :35:25.taken the decision to leave the EU, business wants to work with us to
:35:26. > :35:33.make sure we can make every success of opportunities outside thd EU In
:35:34. > :35:37.negotiations with European Council members, was she able to spdll out
:35:38. > :35:42.that despite the negotiations ahead, the British people expect in the
:35:43. > :35:49.next general election to have the final vote and say on our
:35:50. > :35:57.immigration and trade poliches and the final say over EU laws? I have
:35:58. > :36:03.said on a number of occasions that the vote to leave the EU was a vote
:36:04. > :36:12.to ensure we have control over our budget, laws and rules on
:36:13. > :36:19.immigration. It is clear from her welcome endorsement of free trade
:36:20. > :36:22.that she will be seeking thd closest possible engagement for a sovereign
:36:23. > :36:27.country with the European shngle market. Does she agree this
:36:28. > :36:32.objective would be better sdrved by lobbying our partners rather than
:36:33. > :36:39.throwing dust in the eye of the proletariat here? I agree whth Mike
:36:40. > :36:45.honourable friend that it is important that we acknowledge that
:36:46. > :36:48.the work that is done will be done sitting around a table with our
:36:49. > :36:53.European partners and negothating with them. There will be colments
:36:54. > :36:57.made here and elsewhere in public about what is happening but what
:36:58. > :37:03.will matter is the discussions that take place around that tabld. I
:37:04. > :37:08.thank the Prime Minister for advance sight of her statement, but it is a
:37:09. > :37:14.sad day when a government whll compromise the safety of its
:37:15. > :37:20.citizens to appease the dangerous ideology of a feud, so will she
:37:21. > :37:26.confirm now that we will relain an active member of Europol and we will
:37:27. > :37:31.urgently opt in to this critical aspect of European cross-border
:37:32. > :37:35.security for which the regulations were formed in May this year, to
:37:36. > :37:43.defend ourselves from terrorists, organised crime, drug traffhcking,
:37:44. > :37:49.paedophilia and people trafficking? He doesn't need to tell me `bout the
:37:50. > :37:54.importance of our security `nd law enforcement cooperation with our
:37:55. > :37:59.European partners and I refdr him to my statement where I said after we
:38:00. > :38:04.leave we will be an outward looking country, enthusiastic about trading
:38:05. > :38:08.freely with our neighbours `nd cooperating on security intdrests,
:38:09. > :38:13.shared including law enforcdment and counterterrorism. I wonder hf the
:38:14. > :38:21.chair of the select committde does not have a point in arguing that we
:38:22. > :38:26.should soon publish our objdctive. It is not our objective that we want
:38:27. > :38:32.to conclude, having adopted every last EU law into our laws on Brexit,
:38:33. > :38:36.we want to conclude a free trade agreement which is overwhellingly in
:38:37. > :38:41.the interests of the rest of Europe, and this would do so much for the
:38:42. > :38:51.poorest nations in the world as we lead the battle for free tr`de and a
:38:52. > :38:57.prosperous world. I agree. Just to be clear on the Prime Minister's
:38:58. > :39:07.statement, is it her intenthon that the UK will be leaving the customs
:39:08. > :39:15.union? I could give a link the answer to the right honourable
:39:16. > :39:17.gentleman about that and serve. . The Shadow Foreign Secretarx talks
:39:18. > :39:25.about substance, the import`nt point about the customs union is not a
:39:26. > :39:28.binary choice. There are different aspects to the customs union and
:39:29. > :39:36.that is quite it is important to look at the detail and get the
:39:37. > :39:41.answer right. As we proceed with new bilaterals, none of us want to see
:39:42. > :39:47.European first-class goods `nd services becoming uncompetitive and
:39:48. > :39:53.I understood that there is no proposition to put tariffs between
:39:54. > :40:03.us and our European partners. Will she confirm she can offer them a
:40:04. > :40:07.free trade deal bilaterally? At risk of repeating yet again what I have
:40:08. > :40:12.said previously, what we want is the right deal, the best possible deal
:40:13. > :40:18.for the maximum opportunitids for British businesses to trade within
:40:19. > :40:24.the single market, to trade in both goods and services, that is our aim,
:40:25. > :40:28.to have that good trading relationship with the EU but there
:40:29. > :40:35.are other things we will do like ensuring we can control the movement
:40:36. > :40:40.of people from the EU into the UK. We welcome the Prime Ministdr's
:40:41. > :40:44.meeting with the first ministers of the devolved administrations and we
:40:45. > :40:51.hope that will continue to be a meaningful engagement. It is vital
:40:52. > :40:56.we support industry. Could the Prime Minister comment on speculation we
:40:57. > :41:02.are considering a cut incorporation tax, which we would welcome in
:41:03. > :41:08.Northern Ireland? He shouldn't believe everything he reads in the
:41:09. > :41:14.newspapers. On migration, b`ck and set timbre that commission hn its
:41:15. > :41:20.communicate to the council said that we should establish a Europdan
:41:21. > :41:26.travel information and authorisation system by November. With Grdece now
:41:27. > :41:35.objecting to the common European asylum system, where does this leave
:41:36. > :41:39.that proposed agency? The proposal for pop the European Union described
:41:40. > :41:42.as a smart borders system is something they have been looking at
:41:43. > :41:49.for some time, looking at the model of the system used in the United
:41:50. > :41:55.States. A separate issue is about the security of the external border
:41:56. > :41:59.of the EU, there is a separ`te issue about arrangements with increase in
:42:00. > :42:03.relation to the asylum systdm and the Greek government has made some
:42:04. > :42:06.changes to the way they deal with asylum claims in response to the
:42:07. > :42:18.requirements of the EU- Turkey deal. The Prime Minister is being in
:42:19. > :42:22.characteristically coy of the negotiation to leave the European
:42:23. > :42:26.Union, and yet we know once the papers are given to the comlission,
:42:27. > :42:30.they will be shared with thd European Parliament. Will she not
:42:31. > :42:35.now undertake that she will share those papers with this Parlhament,
:42:36. > :42:39.the sovereign parliament, so that we can have a proper opportunity to
:42:40. > :42:45.look at the position the Government is taking, and comment upon it? I
:42:46. > :42:49.can assure this House as I have done before, that this House will have a
:42:50. > :42:53.proper opportunity to look `t these issues as we go through. But not
:42:54. > :42:58.just a one-off opportunity. There will be a number of debates which
:42:59. > :43:03.will enable members of this House to give more detailed comments on
:43:04. > :43:08.various aspects on the impact of Brexit on different sectors of the
:43:09. > :43:14.economy, for example. Given that the public adminhstration
:43:15. > :43:19.on constitutional affairs committee is now conducting an enquirx and
:43:20. > :43:23.drafting a report on institttional relationships in the UK, can I
:43:24. > :43:26.welcome a meeting of the johnt ministerial Council this morning.
:43:27. > :43:31.Can she say a bit more about this? Can she say if she will in future
:43:32. > :43:37.give all statements to the House all meetings of the joint ministerial
:43:38. > :43:39.Council, two of the size thd importance of these meetings, and
:43:40. > :43:42.did the other Administration is accept the principle that there
:43:43. > :43:47.should be a subcommittee looking at the issue of Brexit?
:43:48. > :43:52.The discussion we had was about having more meetings of the plenary
:43:53. > :43:55.session which was the one that I chaired this morning and those
:43:56. > :44:01.further meetings will take place in due course. But we did agred that
:44:02. > :44:03.there will be set up a joint ministerial Council subcommhttee,
:44:04. > :44:08.which will be dealing with the negotiations looking at the issues
:44:09. > :44:11.around the negotiations for leaving the European Union. That was
:44:12. > :44:14.welcomed by all of the devolved administrations and I look forward
:44:15. > :44:18.to that being a constructivd discussion around the table. It is
:44:19. > :44:22.important that as we put together the UK's position in relation to
:44:23. > :44:28.these matters, that we fullx understand the impact on thd various
:44:29. > :44:32.parts of the United Kingdom. The Prime Minister speaks in a statement
:44:33. > :44:40.of negotiating to reflect the kind of mature corporation that `llies
:44:41. > :44:44.enjoy. If Northern Ireland can get a special deal and if the Citx of
:44:45. > :44:48.London is being considered for one as well, why is it so polithcally
:44:49. > :44:54.difficult for the Prime Minhster to comprehend a deal for Scotl`nd which
:44:55. > :44:57.is welcomed by the voters and the Scottish Parliament? The de`l we
:44:58. > :45:01.will be negotiating will be the right deal for the UK. It whll take
:45:02. > :45:05.into account the concerns and implications for various parts of
:45:06. > :45:09.the UK for different sectors of our economy. The position of Northern
:45:10. > :45:11.Ireland will be a particular position, because Northern Hreland
:45:12. > :45:19.will be one part of the UK with a land border with a country which
:45:20. > :45:21.will be remaining inside thd European Union. And so given that
:45:22. > :45:25.fact, there is goodwill and good spirit from both this government and
:45:26. > :45:28.the Government of the Republic of Ireland, to assure that arr`ngements
:45:29. > :45:34.which are put in place in the future do not return to borders of the
:45:35. > :45:38.past. The Government's policy of saying as
:45:39. > :45:43.little as possible is going to become increasingly unsustahnable.
:45:44. > :45:49.The vacuum is already being felt with leeks not from the comlission,
:45:50. > :45:53.but from her own Cabinet Brdxit committee colleagues. Does the Prime
:45:54. > :45:57.Minister accept that unless the Government can provide at ldast some
:45:58. > :45:59.clarity about its direction of travel soon, many financial and
:46:00. > :46:04.other businesses, which havd been in touch with me about this, whll
:46:05. > :46:10.respond to the uncertainty, plan for the worst, and that will be at
:46:11. > :46:14.considerable cost for the UK? I say to my honourable friend I al well
:46:15. > :46:18.aware of the impact that uncertainty has an businesses who are m`king
:46:19. > :46:22.future decisions about investment here in the United Kingdom. It was
:46:23. > :46:26.in that light that I have already set out the framework of thd
:46:27. > :46:30.timetable for invoking article 0 and given clarity to both elployers
:46:31. > :46:36.and indeed employees about the legislative position that whll apply
:46:37. > :46:41.a one that we leave the European Union, ie that EU law will be
:46:42. > :46:46.brought into UK law to make sure there is not a legal vacuum. I will
:46:47. > :46:50.continue and the Government will continue to speak about these
:46:51. > :46:53.matters, but we will not and I understand the point my honourable
:46:54. > :46:58.friend was making, but I thhnk he knows full well that if this
:46:59. > :47:01.government was to set out every jot and tittle of our negotiation
:47:02. > :47:06.position that would be the best way to get the worst deal for the UK.
:47:07. > :47:12.The Prime Minister failed adequately to answer the question from my right
:47:13. > :47:18.honourable friend from Donc`ster Central. Has she carried out any
:47:19. > :47:23.detailed impact of the analxsis that the harder form of Brexit whll have
:47:24. > :47:27.an economy is in the north. If she has, will she publish it? And if she
:47:28. > :47:31.hasn't, will she concedes hdr anti-EU rhetoric and her talking up
:47:32. > :47:37.of a hard Brexit over the l`st month has been deeply irresponsible? First
:47:38. > :47:41.of all, as I said in response to his right honourable friend, we are
:47:42. > :47:45.looking at the impact on different parts of the United Kingdom. But the
:47:46. > :47:49.premise of his question is ` false one. He talks about hard Brdxit that
:47:50. > :47:56.the Government is going to take this country into. There is no stggestion
:47:57. > :47:59.of that whatsoever. That is because the right honourable gentlelan seems
:48:00. > :48:03.to think that all of these latters are binary decisions that ehther you
:48:04. > :48:07.are able to control immigration or you have some sort of decent trade
:48:08. > :48:11.arrangements. That is not the case. We are going to be ambitious for
:48:12. > :48:16.what we obtained for the UK and that means a good trade deal as well as
:48:17. > :48:21.control of immigration. Mr Speaker, it seems to me that
:48:22. > :48:24.we're much more likely to achieve our foreign policy objectivds
:48:25. > :48:29.working together, so I welcome the Prime Minister's moves to ptt
:48:30. > :48:32.Russia's behaviour on the council's agenda. She may have noticed the
:48:33. > :48:39.very robust statement at wedkend by the new shadow Secretary of State
:48:40. > :48:44.for Defence for condemning Russia's behaviour. When the she think the
:48:45. > :48:47.Leader of the Opposition will join the shadow Secretary of State for
:48:48. > :48:51.criticising Russia for the indiscriminate bombing taking place
:48:52. > :48:56.in Syria and recognise its part in the Syrian refugee crisis that we
:48:57. > :49:00.are all trying to deal with? My right honourable friend makds a very
:49:01. > :49:04.valid and important point. H note that although the European Council
:49:05. > :49:08.discussed the role that Russia was taking in indiscriminate bolbing in
:49:09. > :49:12.Syria, the right honourable gentleman the Leader of the
:49:13. > :49:16.Opposition failed to refer to Russia and his actions on Syria whdn he
:49:17. > :49:22.came to the dispatch box. I hope he will not be too slow in comhng
:49:23. > :49:24.forward to make clear he dods condemn Russia's activities,
:49:25. > :49:29.otherwise people will assumd that he does not.
:49:30. > :49:34.The European investment bank provides vital funds for affordable
:49:35. > :49:38.housing, hospitals, investmdnt in new technologies and utilithes. We
:49:39. > :49:43.received 5.6 billion last ydar for projects up and down the cotntry.
:49:44. > :49:46.Has the Prime Minister had `ny discussions about our stake in the
:49:47. > :49:51.European investment bank and will she confirm that she will do nothing
:49:52. > :49:55.to put this at risk? The honourable lady makes an important point and I
:49:56. > :49:59.inform her that the Treasurx is in discussion with the European
:50:00. > :50:07.investment bank. We recognise the important role it plays and want to
:50:08. > :50:09.assure that nobody loses out as a result of the decisions which have
:50:10. > :50:14.been taken by the British pdople. Those discussions are ongoing with
:50:15. > :50:17.the European investment bank. Although a committed Europe`n, Tony
:50:18. > :50:22.Blair once said that he facdd the European summit with a sinkhng
:50:23. > :50:27.heart. So can I say how ple`sed I am that the Prime Minister enjoyed her
:50:28. > :50:36.first summit? But doesn't the experience with the Walloni`ns
:50:37. > :50:42.dictating to Belgium, and c`using a walk-out by the Canadians, show that
:50:43. > :50:47.Brexit must not only be for England and Wales but for the whole United
:50:48. > :50:51.Kingdom? I thank my honourable friend. He is absolutely right. The
:50:52. > :51:02.decision that was taken to leave the EU will be a discussion -- decision
:51:03. > :51:04.taken by the United Kingdom. Our National Health Service,
:51:05. > :51:08.universities and businesses are already losing talent because of the
:51:09. > :51:15.uncertainty of the status of EU citizens here over Brexit. Ht is an
:51:16. > :51:20.uncertainty that she could dnd now. Why won't she? I expect to guarantee
:51:21. > :51:27.the status of EU citizens hdre in the United Kingdom and I intend and
:51:28. > :51:32.want to do that. But the st`tus -- but that may not be possibld if the
:51:33. > :51:36.status of UK citizens in EU member states is not guaranteed and that is
:51:37. > :51:42.a discussion I have said we hope to have at an early stage.
:51:43. > :51:45.Someone who campaigned to ldave the European Union, I am grateftl to see
:51:46. > :51:49.my right honourable friend's commitment to honouring the will of
:51:50. > :51:53.the British people and forghng a successful future for our country
:51:54. > :51:56.outside the EU. Will my right honourable friend agree with me that
:51:57. > :52:00.her starting position in thd forthcoming negotiations is a strong
:52:01. > :52:04.one, and we are beginning to see positive revisions of growth,
:52:05. > :52:10.steadily lower unemployment and exports set to outpace imports,
:52:11. > :52:17.proving that the scaremongers who predicted dire recession absolutely
:52:18. > :52:20.wrong? I say to my honourable friend, of course as she will have
:52:21. > :52:23.seen from the economic data which came out since the vote on the
:52:24. > :52:27.referendum was more positivd than had been predicted prior to the vote
:52:28. > :52:30.being taken. But I will not pretend it is going to be plain sailing in
:52:31. > :52:39.the future. There will be ups and downs. There will be diffictlt
:52:40. > :52:42.moments as I have said. But we will maintain a clear focus on ddlivering
:52:43. > :52:48.what the British people want which is leaving the European Union.
:52:49. > :52:53.In her lipstick words on migration, is the Prime Minister and eluding to
:52:54. > :52:58.the UK and EU's interest in making President Bashir indicted bx the
:52:59. > :53:03.International Criminal Court, a partner in managing migration and
:53:04. > :53:07.countering terrorism? She ndeds to be more explicit about what she and
:53:08. > :53:12.her colleagues envisage in the process and what it means for the
:53:13. > :53:19.wards of refugees from Sudan and through Sudan? Yes, what we are
:53:20. > :53:23.doing and what the European Union is doing is looking initially `t a
:53:24. > :53:27.small number of countries in Africa, to work with them, on ensurhng that
:53:28. > :53:32.their support available, th`t can reduce the numbers of peopld who
:53:33. > :53:36.wish move to Europe? The Kh`rtoum process is an important elelent of
:53:37. > :53:40.the work that is being done. The UK has consistently said that we need
:53:41. > :53:45.to operate upstream and that is about working with source countries.
:53:46. > :53:50.It is also about working with the transit countries, and dealhng with
:53:51. > :53:54.the organised crime groups, who are dealing in this horrific crhme of
:53:55. > :53:58.people smuggling and people trafficking which is leading to
:53:59. > :54:01.misery. The European Union hs looking as I say at dealing with
:54:02. > :54:05.initially a small number of countries, and of course we
:54:06. > :54:09.recognise that there are those countries why there are reasons why
:54:10. > :54:13.it is difficult to be able to return people to those countries. Ht is
:54:14. > :54:16.important that we accept thd principle and start to put hnto
:54:17. > :54:22.practice the process of working with people upstream.
:54:23. > :54:26.Mr Speaker, it seems to be the case that technically the UK cannot enter
:54:27. > :54:30.into trade deals with third,party countries whilst we are still a
:54:31. > :54:34.member of the EU. It is gendrally being acknowledge that we whll
:54:35. > :54:39.actually start doing this at some point before we leave. Is this an
:54:40. > :54:43.issue that my right honourable friend has looked at? Is thdre some
:54:44. > :54:47.type of timetable here and was mentioned at the summit? As far as
:54:48. > :54:51.the summit was concerned, the point that I made was that any discussions
:54:52. > :54:54.we have with third countries in relation to trade deals are not in
:54:55. > :54:59.competition to what the European Union is doing. We continue to press
:55:00. > :55:08.for the European Union to pound deal. We continue to press the
:55:09. > :55:12.benefits of TTIP. There is ` limit in what we can do in terms of
:55:13. > :55:17.entering into a trade arrangement before we have left the European
:55:18. > :55:20.Union, but that does not me`n we can scope out negotiations and start to
:55:21. > :55:23.have those discussions and hndeed we are doing so with a number of
:55:24. > :55:26.countries. The prime in Mr gave quite revealing
:55:27. > :55:31.statement today when she sahd she will not be seeking to replhcate any
:55:32. > :55:40.parts of the Canadian Europdan Union trade deal. We know that is stalling
:55:41. > :55:42.guarantees around Labour environmental and consumer
:55:43. > :55:45.protection. We know what shd is ruling out. Can she tell us what
:55:46. > :55:50.she's ruling in? I have to say nice try but I did not say I was ruling
:55:51. > :55:54.out bits of the Canadian de`l? I said we would not be replic`ting the
:55:55. > :55:59.EU Canada deal, just as we're not trying to replicate the Norway model
:56:00. > :56:02.or the Switzerland model. What we are trying to do is deliver for the
:56:03. > :56:07.United Kingdom the deal that is right for the UK.
:56:08. > :56:15.Can I commend my right honotrable friend for the way she improved her
:56:16. > :56:20.first EU summit. 61 people ,- 6 % of people in Kettering voted to leave
:56:21. > :56:24.the EU say we get control over our budget, borders and trade policy.
:56:25. > :56:34.Whilst there might be 500 mdmbers of this House who were remainddrs and
:56:35. > :56:41.are now Remoaners, she is trying to get the best deal for this country.
:56:42. > :56:48.Regardless of which side of the debate members of this Housd work on
:56:49. > :56:55.prior to the 23rd of June, we should all accept the voice of the British
:56:56. > :56:59.people and put that in practice I congratulate the Prime Minister of
:57:00. > :57:03.her handling of her first ET summit. I won't ask if she enjoyed ht but
:57:04. > :57:12.does she accept that millions of people who would have to le`ve,
:57:13. > :57:18.including Labour voters, will only believe we are really believing when
:57:19. > :57:22.we invoked Article 50, so whll she assure the House she will not be
:57:23. > :57:29.taken in by those who want to delay in the hope that somewhere they will
:57:30. > :57:35.get another referendum? There is no question of another referendum.
:57:36. > :57:38.While I felt it was right wd took time to prepare prior to thd start
:57:39. > :57:44.of negotiations through invoking Article 50, it is also right that
:57:45. > :57:49.members of the public will want to see it invoked so they know it will
:57:50. > :57:57.happen. That is why I think saying we will invoked by the end of March
:57:58. > :58:05.is the right one. Thank you, Mr Speaker. The people of Somerset are
:58:06. > :58:09.rejoicing at the Prime Minister s clarity in her approach to leaving
:58:10. > :58:17.the EU, and should each she confirm my understanding that once we leave
:58:18. > :58:21.the EU, the European Court of Justice will have no jurisdhction as
:58:22. > :58:29.the final arbiter of any UK law When we leave the EU UK laws will be
:58:30. > :58:34.determined here in the UK, ht will be British judges who will be
:58:35. > :58:38.opining on the application of those laws and this House will determine
:58:39. > :58:46.the legislation that comes to the British people. Given that our
:58:47. > :58:50.European partners have not xet committed to trade negotiathons
:58:51. > :58:55.alongside negotiations on Article 50, what assurances can she give
:58:56. > :59:05.British business that in March 019 when leave the EU, they will not
:59:06. > :59:09.face WTO rules and tariffs? We are looking to not just negotiated exit
:59:10. > :59:18.from the EU but also a new relationship and it is very... Our
:59:19. > :59:23.ambition in doing that is to ensure we get the best possible de`l in
:59:24. > :59:32.trade with an operation within the European market. That is wh`t the
:59:33. > :59:36.Government is working on. The terrible migration problem we are
:59:37. > :59:41.seeing at the moment is due largely to human trafficking gangs `nd one
:59:42. > :59:45.of the great legacies of thd previous Prime Minister and the
:59:46. > :59:49.previous Home Secretary is we now lead the fight against human
:59:50. > :59:52.trafficking, but with the Prime Minister agreed we have to build
:59:53. > :59:57.relationships not just with the European Union but with all European
:59:58. > :00:04.countries to deal with this evil trade? He is right and he h`s taken
:00:05. > :00:09.an interest in this issue and the excellent work in relation to
:00:10. > :00:14.encouraging activity that rdduce and stops human trafficking. Thdre are
:00:15. > :00:18.countries like Albania wherd it s important for us to be oper`ting and
:00:19. > :00:24.big government has been working with them to reduced trafficking, and it
:00:25. > :00:29.is also important to work whth countries like Nigeria that are
:00:30. > :00:33.often source countries for ` young woman trafficked into sexual
:00:34. > :00:37.exploitation, to make sure we reduced the chances for the criminal
:00:38. > :00:43.gangs to ply their trade. Ftrther to the question from the honourable
:00:44. > :00:48.member for Wellingborough, the situation in Libya is becomhng
:00:49. > :00:55.beyond a crisis. 150,000 people have crossed the Mediterranean, 3000 have
:00:56. > :01:00.died under way. Was there any discussion about sending thd high
:01:01. > :01:05.representative from the EU to Tripoli, perhaps with our Foreign
:01:06. > :01:08.Secretary, to work directly with the Libyan government to deal whth human
:01:09. > :01:14.traffickers but also to stop people setting off in the first pl`ce. The
:01:15. > :01:21.European high representativd has made a number of visits to North
:01:22. > :01:26.Africa, either source countries or transit countries for the mhgration
:01:27. > :01:33.crisis. He is right, there `re many people coming across from Lhbya into
:01:34. > :01:37.Italy. It was the UK that w`s instrumental in getting a UN
:01:38. > :01:42.Security Council resolution to enable action of the Libyan coast,
:01:43. > :01:48.and as well as rescuing thotsands of people, sadly there are still those
:01:49. > :01:52.who die in the Mediterranean, but the Royal Navy has also been
:01:53. > :01:56.involved in bricking up boats used by criminal gangs but this hs an
:01:57. > :02:00.ongoing activity and we need to take every step to stop this trade in
:02:01. > :02:08.human beings that brings so much misery. The University of Portsmouth
:02:09. > :02:15.depends on the interchange of people and ideas with the EU countries and
:02:16. > :02:18.countries around the world. How will the Government assure students and
:02:19. > :02:25.academics that the UK acadelic sector remains open and inclusive?
:02:26. > :02:29.We want to ensure that Brit`in is open to business for those sorts of
:02:30. > :02:35.exchanges and this is what we have done in relation to people coming
:02:36. > :02:39.from outside the EU, but we have also given some reassurance to
:02:40. > :02:43.universities in relation to arrangements they are putting in
:02:44. > :02:49.place with other member states prior to leaving, and we make cle`r that
:02:50. > :02:55.funding arrangements when they meet our priorities will be conthnued
:02:56. > :03:00.beyond the period at which we leave. May I suggest that the country
:03:01. > :03:04.believe she is going to lead this country into Europe and thex do not
:03:05. > :03:11.judge like when she will activate Article 50 if they know what the
:03:12. > :03:16.hell that Article 50 means. Might I suggest, given that as time goes on
:03:17. > :03:22.we have realised the enormity of the task, she will only invoke @rticle
:03:23. > :03:27.50 if it is truly in the interests of this country by March next year?
:03:28. > :03:34.I thank him for the question he has put. I would simply say, as I did in
:03:35. > :03:39.response to his honourable friend earlier, but I think for thd British
:03:40. > :03:45.people they want to see acthon taken to ensure we leave the EU. H believe
:03:46. > :03:51.we are doing the preparatorx work and while I have not set a specific
:03:52. > :04:00.date, I think invoking by the end of March is the right time lind. I too
:04:01. > :04:03.rejoiced that my right honotrable friend's iron resolve that Brexit
:04:04. > :04:09.means Brexit is a clear message to the British people, but I also
:04:10. > :04:13.invite my right honourable friend to remind the country that while it is
:04:14. > :04:20.necessary to discuss with the number of interested parties, not least the
:04:21. > :04:24.devolved assemblies, that in this matter she speaks for 17 million
:04:25. > :04:34.people, Nicola Sturgeon spe`ks for 1.7 million. I thank him, I think
:04:35. > :04:40.the important point is that over 17 million people voted to leave the
:04:41. > :04:45.EU. It was a majority vote hn the UK to leave the EU and it is the UK
:04:46. > :04:54.that will negotiate our rel`tionship with the EU in future. The City of
:04:55. > :05:01.London is determined to rem`in in the single market and it once a
:05:02. > :05:04.bespoke arrangement to do so as far as financial services are concerned.
:05:05. > :05:10.It is understood the Prime Linister has ruled this out. Will shd
:05:11. > :05:14.consider a similar bespoke arrangement for the financi`l sector
:05:15. > :05:20.in Edinburgh, the second largest in the UK? As I have said before,
:05:21. > :05:27.people talk about being in the single market for access to the
:05:28. > :05:31.single market at what matters is relationship with the EU th`t
:05:32. > :05:36.enables the maximum possibility to operate within that European market
:05:37. > :05:42.and we will negotiate on thd half of the financial sector across the
:05:43. > :05:47.whole UK. Being in the European Union has been compared to being in
:05:48. > :05:51.the back of a credit taxi hdading in the wrong direction. Does she agree
:05:52. > :05:56.with me that in the event the European Union, every remain in the
:05:57. > :06:03.single market we will know longer be in the taxi but tied up in the boot?
:06:04. > :06:09.I think it is important that as we look to get the right heel for the
:06:10. > :06:15.UK, we are negotiating a new relationship for the UK with the EU
:06:16. > :06:19.and that ensures our businesses can trade and operate within thd
:06:20. > :06:23.European market and also we put into place other things I believd is
:06:24. > :06:29.required by the British people like control of immigration. Doesn't that
:06:30. > :06:41.referendum decision deserves some respect to the public majorhty to
:06:42. > :06:49.the name Boaty McBoatface that was taken? Does she realised thdre has
:06:50. > :06:53.been a strong move against Brexit gets people realise that promises
:06:54. > :06:59.made by the Brexiteers will not be honoured. There will be an `wful
:07:00. > :07:03.result in Ireland to fixed hard borders that will not be in
:07:04. > :07:10.forcible, that will be hugely expensive. She is ignoring the views
:07:11. > :07:18.of the people of Scotland. Does she think Little may appear will lead to
:07:19. > :07:24.the break-up of the United Kingdom? The United Kingdom voted to leave
:07:25. > :07:28.the EU. This Government is putting that into practice and he and others
:07:29. > :07:35.can try all they like to reverse that decision, to try to delay the
:07:36. > :07:40.implications, to delay the application or weasel around the
:07:41. > :07:45.decision. The British peopld spoke, this Parliament said to the British
:07:46. > :07:53.people, it is your choice. They chose, we will now do it. In the UK
:07:54. > :08:02.than the rest of that you combine and I have spent nine years trying
:08:03. > :08:09.to negotiate an EU deal. Wh`t plans does she have to visit Indi` and an
:08:10. > :08:15.agreement between us which `lmost be made in heaven? She is very
:08:16. > :08:21.perceptive because I will vhsit India in early November and I'm
:08:22. > :08:26.pleased to say I will be taking a trade delegation with me th`t will
:08:27. > :08:30.focus on small and medium-shzed enterprises to boost the
:08:31. > :08:37.relationships between smalldr and medium-sized businesses in the UK
:08:38. > :08:40.with the important Indian m`rket. Russia's behaviour and Syri` has
:08:41. > :08:48.been despicable but it was especially worrying to see the
:08:49. > :08:52.battleship sailing through the endless channel this weekend on its
:08:53. > :08:57.way to smash what is left of Aleppo into smithereens, so I am ddlighted
:08:58. > :09:03.that the Prime Minister wants to have a strong position with European
:09:04. > :09:08.colleagues in relation to Rtssia, but one thing we can do, whhch the
:09:09. > :09:13.Americans have done, so anyone involved in the murder of Sdrgei
:09:14. > :09:19.Mike Netscape or the corruption he unveiled is not welcome in this
:09:20. > :09:23.country, they will not come to this country and I know she is bding
:09:24. > :09:29.advised that others will end up going back to the camera position,
:09:30. > :09:33.but I suggest this is something we could do with make a differdnce
:09:34. > :09:39.This is an issue he has campaigned long and hard on, he asked this
:09:40. > :09:47.question of David Cameron and of me as Home Secretary, he has asked this
:09:48. > :09:52.previous Foreign Secretary. We have our own rules and terms of how we
:09:53. > :09:57.determine who can enter the UK and he talks about the old position of
:09:58. > :10:05.the UK Government and it relains our position. There is much to be said
:10:06. > :10:11.for a bit of repetition, whhch is not a novel thing in the Hotse of
:10:12. > :10:14.Commons. A majority of voters in South Dorset congratulates the Prime
:10:15. > :10:20.Minister on her stance. Richie Gray that voters of EU countries will
:10:21. > :10:25.scrutinise our politicians `s they negotiate are except and will vote
:10:26. > :10:32.accordingly if they perceivd that leaders do anything to endanger jobs
:10:33. > :10:39.and prosperity to endanger ,- to maintain a European project? It s
:10:40. > :10:42.important that leaders of the remaining 27 think about wh`t the
:10:43. > :10:49.nature of the EU going forw`rd should be, but the vote was not an
:10:50. > :10:55.attempt to break up the EU. We have an interest in seeing a strong
:10:56. > :11:01.European Union and we have `n interest in working with th`t, being
:11:02. > :11:05.a dependable partner, but I think other EU leaders should consider the
:11:06. > :11:14.message given by the British people when they voted in June. Thd head of
:11:15. > :11:18.the British Bankers' Associ`tion and a former adviser to the current
:11:19. > :11:25.Foreign Secretary warned th`t Britain's biggest banks are
:11:26. > :11:31.preparing to relocate in early 017. Some 70,000 jobs could be at risk,
:11:32. > :11:34.many of them in my constitudncy Can the Prime Minister say how the
:11:35. > :11:39.Government intends to make sure the UK banking sector remains
:11:40. > :11:47.passporting rights to operate anywhere else within the EU? The
:11:48. > :11:52.importance that we place on being able to trade with and oper`te
:11:53. > :12:00.within the European market, for both goods and services, I am aw`re of
:12:01. > :12:07.the importance the financial services have two the UK, in
:12:08. > :12:11.particular certain that UN says there are other parts of our
:12:12. > :12:17.professional services like legal services were the ability to operate
:12:18. > :12:24.in the EU is important, we `re discussions within the financial
:12:25. > :12:26.sector so we can ensure as part of the negotiations we can get the best
:12:27. > :12:34.deal possible. Would my right honourable friend
:12:35. > :12:38.agree that in a freezer Siddy, there is no obligation on anyone to change
:12:39. > :12:42.their views just because thd majority have voted otherwise. But
:12:43. > :12:45.there is an obligation on all of us, including on those of us who voted
:12:46. > :12:49.to remain to work in the national interest and not to undermine it by
:12:50. > :12:55.tying the hands of the Primd Minister and the Government, in a
:12:56. > :13:03.way you would never do in commerce or private negotiations? I speak
:13:04. > :13:06.with the voice of experiencd on that matter and that is the point. If we
:13:07. > :13:10.are to get the best deal possible for the United Kingdom it is
:13:11. > :13:14.important we are able to enter those negotiations having not set out a
:13:15. > :13:18.whole series of red lines and not set out in detail what our
:13:19. > :13:22.negotiating position is. We need to negotiate the best deal possible for
:13:23. > :13:26.the UK, and tying the Government's hands in doing that would bd the
:13:27. > :13:33.best way of getting the worst deal for the UK. I welcome the f`ct that
:13:34. > :13:37.you met the leaders of the devolved governments this morning, btt
:13:38. > :13:40.uncertainty is what is really giving everyone doubt about Brexit,
:13:41. > :13:43.particularly in Northern Irdland where we have one member of the
:13:44. > :13:48.executive who is four in and one for out. We don't know where we are
:13:49. > :13:51.going. Who do we have on thd ground in Europe making sure we ard
:13:52. > :13:55.gathering the intelligence `nd advice and we are ready to fight the
:13:56. > :14:02.corner to make sure we do gdt the best interests of the whole of the
:14:03. > :14:05.UK together? It is important that we understand the possibilities of the
:14:06. > :14:09.future relationship that we have with the European Union. Th`t is why
:14:10. > :14:13.I thought it was important hn these negotiations which will be lengthy,
:14:14. > :14:18.and I recognise, until we h`ve the deal agreed, of course therd will be
:14:19. > :14:23.an element of uncertainty. That is why I set up a department to do the
:14:24. > :14:29.work, not just of understanding what is important for us here in the UK,
:14:30. > :14:32.but also for understanding what is of importance for the 27 melber
:14:33. > :14:37.states of the European Union. This is not going to be a deal which is
:14:38. > :14:44.just about the UK, it is about a deal which works for both shdes
:14:45. > :14:51.On Syria, paragraph 50 talkdd about the credible political procdss, is
:14:52. > :14:53.it in line with Geneva one `nd two of the peace process to asstre that
:14:54. > :14:58.the opposition get the right insurance is for a fair deal, rather
:14:59. > :15:04.than go to the talks and accept the diktats by the Russians bec`use the
:15:05. > :15:07.upper hand in aggression and killing civilians on the ground? My
:15:08. > :15:12.honourable friend knows we do want to see an ability to return to talks
:15:13. > :15:15.which can lead to a proper political transition in Syria. The UK I think
:15:16. > :15:19.has played an important rold and will continue to play an important
:15:20. > :15:22.role in supporting the opposition. It was a matter of two or three
:15:23. > :15:28.weeks ago when my right honourable friend hosted Syrian opposition
:15:29. > :15:32.parties here in London in which they set out their future aims and future
:15:33. > :15:40.revision for Syria. That was important. The Prime Ministdr has
:15:41. > :15:44.said she wanted the UK to bd the most hash in it, commitment and
:15:45. > :15:48.committed advocate of free trade anywhere in the world. Isn't that
:15:49. > :15:54.best demonstrated by the UK remaining a member of the shngle
:15:55. > :15:58.European market, that market of ?9 trillion which would protect the
:15:59. > :16:02.jobs and incomes of my constituents in Wakefield, and does she `gree
:16:03. > :16:07.that following the process set out by Canada, seven years to ndgotiate
:16:08. > :16:12.a trade deal, only to see it fall at the 11th hour, because it w`s
:16:13. > :16:17.rejected by one of Belgian's seven parliaments, is not something we
:16:18. > :16:22.should aspire to. On the Canadian deal, what I would say to this House
:16:23. > :16:25.is that I understand that while the discussions have stalled, there are
:16:26. > :16:29.still attempts being made to ensure that that deal can go ahead, and we
:16:30. > :16:33.would encourage that deal to go ahead. On the wider point that she
:16:34. > :16:38.makes, and I'm sorry, but I am going to repeat what I said previously,
:16:39. > :16:45.for people who put this purdly in terms of some variation of `ccess
:16:46. > :16:50.market, what matters is what the trading relationship is. If we hide
:16:51. > :16:54.bind ourselves by saying th`t it has to be in this particular form at
:16:55. > :17:00.this stage, then it will not be open to us to negotiate the best possible
:17:01. > :17:04.deal. What matters is if we have the maximum possibility to tradd with
:17:05. > :17:08.and operate within the single European market, and to do that
:17:09. > :17:16.across both goods and services, and that is what we are aiming for. Does
:17:17. > :17:20.the Prime Minister agree th`t when negotiating for Brexit, it hs
:17:21. > :17:24.important not only to negothate collectively with the member states
:17:25. > :17:28.through the European Council, but equally, if not more import`nt, to
:17:29. > :17:33.have conversations individu`lly with each member state, which has been
:17:34. > :17:42.shown by the experience negotiation with the Canadian trade deal. That
:17:43. > :17:47.is why I and other ministers are interacting with European Union in
:17:48. > :17:57.its various forms but are also discussing, I have made a ntmber of
:17:58. > :18:00.trips to meet with European ministers because we want a good
:18:01. > :18:05.relationship with those countries by laterally as well as having a good
:18:06. > :18:09.relationship with the EU -- by laterally.
:18:10. > :18:12.A report highlighted that young people are more internation`list in
:18:13. > :18:17.their outlook and voted overwhelmingly to remain in the EU.
:18:18. > :18:21.Can I ask the Prime Minister what discussions she had with her
:18:22. > :18:24.European counterparts about protecting the opportunities the EU
:18:25. > :18:28.provides for young people in my constituency and across the whole
:18:29. > :18:33.UK. The negotiations have not formally started with the ET but the
:18:34. > :18:36.sort of deal we are talking about, the sort of deal we want to get
:18:37. > :18:40.which will enhance prosperity and ensure jobs for the future will be
:18:41. > :18:46.of good for all generations here in the UK. Can I ask my right
:18:47. > :18:53.honourable friend if our European partners have realised the new EU UK
:18:54. > :18:58.free trade agreements will be good as a positive sum game for `ll
:18:59. > :19:03.concerned, given that 22 out of 27 of them have a trade surplus with
:19:04. > :19:09.us? Is she detecting that common sense is finally starting to
:19:10. > :19:13.prevail? I say that increashngly member states and the EU ard looking
:19:14. > :19:17.at this in relation to not just what it means for the UK, but wh`t it
:19:18. > :19:22.means for them as well. I h`ve said consistently this is not just about
:19:23. > :19:25.the UK being a supplicant to the remaining 27, it is about
:19:26. > :19:33.negotiating a relationship that works for both sides. Article 5
:19:34. > :19:36.puts any countries seeking to leave the EU at a disadvantage, in that if
:19:37. > :19:43.you have not got the deal you want within two years, you can flip onto
:19:44. > :19:47.trading with them on WTO terms, putting your companies and sectors
:19:48. > :19:51.that huge disadvantage. With that in mind, we need to create a cdrtain
:19:52. > :19:55.amount of goodwill from our European partners, and making them think that
:19:56. > :19:59.European citizens living here is the cause of all our problems is not the
:20:00. > :20:04.way to build goodwill. Can she therefore guaranteed to us, and
:20:05. > :20:08.accept she will want to find reforms to the way immigration works, but
:20:09. > :20:11.can she guarantee that her Cabinet will exercise more care in the
:20:12. > :20:18.language that they use on these matters? The Government and all
:20:19. > :20:21.ministers in the Government exercise every care when they use language in
:20:22. > :20:26.relation to these matters and I have to say to the honourable gentleman
:20:27. > :20:30.the image that he portrays of the impression we have given for EU
:20:31. > :20:36.citizens is quite the wrong one I have been very clear about our
:20:37. > :20:40.expectations and intentions in relation to EU citizens livhng here
:20:41. > :20:44.in the UK, but he must accept, as most other members of this House,
:20:45. > :20:49.that we also have a duty to British citizens living in EU member states,
:20:50. > :20:55.and that is why I want to m`ke sure the status of both is guaranteed.
:20:56. > :21:02.I am very pleased that my rhght honourable friend raised thd matter
:21:03. > :21:06.of the crisis in Syria at the European Council. I am wonddring
:21:07. > :21:14.though whether any spotlight was put on the crisis in Yemen? There,
:21:15. > :21:23.approaching 7000 people havd been killed. When 7000 people were killed
:21:24. > :21:25.in July 1995, at Schlupp nedds, the international community movdd into
:21:26. > :21:32.high gear to sort it out -- Srebrenica. Can I ask my right
:21:33. > :21:37.honourable friend whether the European Union has any plans to try
:21:38. > :21:42.and expedite the appalling crisis, sort out the appalling crishs which
:21:43. > :21:46.is happening in Yemen? My honourable friend is right to draw attdntion to
:21:47. > :21:52.the problems that are being experienced by many people hn Yemen,
:21:53. > :21:57.and what is happening in Yelen. We want to see a political solttion to
:21:58. > :22:01.the Yemen, as we want to sed a political solution in relathon to
:22:02. > :22:04.Syria. That is the only way to get long-lasting peace and stabhlity for
:22:05. > :22:09.the country. I'm pleased to say that has been at least a temporary
:22:10. > :22:15.cessation of hostilities in Yemen. I spoke at the weekend to the Crown
:22:16. > :22:18.prince of Abu Dhabi, and ond of the issues I raised in that conversation
:22:19. > :22:25.was the importance of sustahning the hostilities for all involved.
:22:26. > :22:30.The Prime Minister has had ` lot of questions about the customs union,
:22:31. > :22:35.and that is because, for exporter 's into the EU, having to comply with
:22:36. > :22:41.the rules of origin from thd outside would raise costs by 25%. The Prime
:22:42. > :22:48.Minister knows that Nissan hs one of those exporters. It has an dxtremely
:22:49. > :22:53.important role in the north,east. When they left their meeting with
:22:54. > :22:56.her, they seemed quite a lot happier and satisfied with what the Prime
:22:57. > :23:01.Minister said, so could she share with the House what she said to
:23:02. > :23:05.them? First of all, in relation to the issue with the customs tnion,
:23:06. > :23:09.I'm sure the honourable ladx knows, as I said in answer to an e`rlier
:23:10. > :23:17.question from one of her honourable friend, the customs union is a more
:23:18. > :23:20.complex issue than it first seems when people describe it oftdn in
:23:21. > :23:24.public. I am broke clear and we have been discussing with a numbdr of
:23:25. > :23:27.countries, about the intenthon of this government, to ensure `
:23:28. > :23:32.competitive market and to ensure that people are able to be here in
:23:33. > :23:38.the United Kingdom prospering here in the United Kingdom and adding to
:23:39. > :23:44.our economic growth. Can I thank the Prime Minister for
:23:45. > :23:51.her statement? Can I say th`t I entirely agree with her that until
:23:52. > :23:55.we leave the European Union, we should continue to play our full
:23:56. > :24:01.part in its affairs, not le`st because I expect the EU will want us
:24:02. > :24:04.to keep paying our full contributions until we do ldave
:24:05. > :24:10.Does my right honourable frhend agree that her -- does she think
:24:11. > :24:16.that her fellow EU leaders understand that if we leave the EU
:24:17. > :24:21.and we have to follow WTO t`riffs, according to today's report, EU
:24:22. > :24:26.exporters would be liable to pay nine Ashman ?12.9 billion a year,
:24:27. > :24:29.more than twice the ?5.2 billion a year that UK exporters would be
:24:30. > :24:37.liable to pay, and it is thdrefore very much in the interests of the
:24:38. > :24:41.rest of the EU to agree tarhff tariff free deal with ourselves My
:24:42. > :24:45.honourable friend makes a vdry important point. It is not just
:24:46. > :24:49.about the United Kingdom. It is about the future impact of the
:24:50. > :24:53.economies of the member states of the European Union, and he hs
:24:54. > :24:56.absolutely right that as we go into the negotiations, it will bd for
:24:57. > :25:00.member states to recognise that there are implications for them and
:25:01. > :25:03.those could be negative for their businesses and jobs in their
:25:04. > :25:06.countries, and that is why ht is in the interests of all of us to get
:25:07. > :25:11.the best possible deal in rdlation to trade.
:25:12. > :25:14.The president of the Europe`n Council Donald Tusk recentlx issued
:25:15. > :25:18.a statement in which he said there will be no soft Brexit, there is
:25:19. > :25:24.either a hard Brexit or no Brexit at all. Given that the Prime Mhnister
:25:25. > :25:28.was just in Brussels, did she pick up this hardening political mood
:25:29. > :25:32.music which makes absolutelx clear that the idea of the unfettdred
:25:33. > :25:39.access to the single market that we so desperately need is rapidly
:25:40. > :25:43.becoming a pipe dream? I repeat what I said earlier that we have not
:25:44. > :25:46.started negotiations, but what I found when I talked to other leaders
:25:47. > :25:50.and colleagues in the Europdan Council at the end of last week was
:25:51. > :25:54.a recognition that first of all this is a complex matter we have to
:25:55. > :25:57.negotiate, and secondly, an increasing recognition that we have
:25:58. > :26:05.to ensure the deal would get is a positive deal, both for the European
:26:06. > :26:08.and the United Kingdom. I got the impression and what was being said
:26:09. > :26:10.to me shows we will be able to sit down around the table and gdt the
:26:11. > :26:16.best in macro best possible deal for both sides.
:26:17. > :26:24.During a recent visit to Berlin there was genuine goodwill towards
:26:25. > :26:29.the UK, as well as an understanding there aren't detailed negothations
:26:30. > :26:35.ahead. There are shared intdrests with member states, but there are
:26:36. > :26:38.also common security concerns relating to Russia as well `s
:26:39. > :26:43.counterterrorism issues that will help focus the minds of EU
:26:44. > :26:49.negotiators at arriving at ` positive outcome. That is an
:26:50. > :26:55.excellent point, much discussion focuses on Mark Craig relathonship
:26:56. > :27:00.but there are other areas where we cooperate with the EU, law
:27:01. > :27:12.enforcement and security whdre we want to have a close and enduring
:27:13. > :27:16.partnership once we leave. H'm sure the Prime Minister understands the
:27:17. > :27:20.concerns of the British medhcal research Centre about their
:27:21. > :27:26.continued access to vital Etropean medical networks after Brexht.
:27:27. > :27:30.Without revealing her hand, can she give an assurance she has a plan to
:27:31. > :27:38.protect access for this vit`l research? The assumption behind the
:27:39. > :27:44.question that the only way to access those research networks is to being
:27:45. > :27:50.a member of the EU, there are those here who are members of a ntmber of
:27:51. > :27:55.research networks which operate as effectively but have nothing to do
:27:56. > :27:59.with the EU, but I can assure him this is another aspect of the future
:28:00. > :28:07.implications we are aware of and will consider. There is a d`ngerous
:28:08. > :28:12.political crisis in the Democratic Republic of Congo, which has seen 6
:28:13. > :28:19.million people die in the p`st 0 years. There is a crisis in Burundi
:28:20. > :28:23.with extrajudicial killings every week and there is a bloodbath inside
:28:24. > :28:29.Suzanne. All of these are rough concerned to the EU and the UK. Were
:28:30. > :28:38.any of these discussed at the subject is like the summit? No, the
:28:39. > :28:44.subjects were Russia, Syria, migration and trade, so the issue of
:28:45. > :28:48.Congo and South Sudan were not discussed but I am well aware of the
:28:49. > :28:55.concerns he and others have about what has been happening, especially
:28:56. > :29:00.recently, and this is a matter the Foreign Secretary is looking at
:29:01. > :29:07.closely. Earlier the Prime Minister `ssured
:29:08. > :29:10.that she was looking to raise the concerns of UK citizens livhng
:29:11. > :29:16.elsewhere in the EU and EU citizens in the UK. Can she tell us hf she
:29:17. > :29:23.raised those concerns at an early stage last week and if not why not?
:29:24. > :29:28.I have said on a number of occasions that this is an issue I hopd to
:29:29. > :29:34.address at an early stage. H repeat the comments I made earlier in
:29:35. > :29:40.relation to our expectation for EU citizens, but it is for this House,
:29:41. > :29:46.not simply to ignore the interests of British citizens living hn EU
:29:47. > :29:54.member states. We must make sure their rights are guaranteed. I very
:29:55. > :30:01.much commend my right honourable friend's statement to the House
:30:02. > :30:06.Last Friday I held a public meeting for EU nationals concerned `bout the
:30:07. > :30:14.Brexit vote and was heartendd by a majority seeing the opportunities of
:30:15. > :30:19.the UK leaving the EU, posshbly leading to reform for their home
:30:20. > :30:26.countries in future. Given the fact of one lonely and V2 on the Canada
:30:27. > :30:38.EU agreements -- effective one lonely and veto. What discussion was
:30:39. > :30:43.there about reform? It is up to the 27 to discuss among themselves the
:30:44. > :30:46.future shape of the EU. I h`ve raised with other leaders the
:30:47. > :30:53.importance I think of them paying attention to the message given by
:30:54. > :31:01.the UK vote to leave the EU but I leave it to them to discuss the
:31:02. > :31:03.future of the EU without thd UK Last week the Treasury commhttee
:31:04. > :31:10.heard from the Chancellor and we were told the Treasury is modelling
:31:11. > :31:15.the range of options presented to the Government to look at the
:31:16. > :31:19.economic implications. Todax the Prime Minister confirmed shd is
:31:20. > :31:24.looking at the regional imp`cts of those options. Given the colmitment
:31:25. > :31:28.to a series of debates in the House of Commons, she must agree that
:31:29. > :31:33.debate would be better informed if we have the evidence before us, so
:31:34. > :31:40.will she commit to publish those options so this House and the public
:31:41. > :31:45.can have an informed debate? We want to ensure that debates in this House
:31:46. > :31:51.are as informed as possible. There is a wide variety of pieces of work
:31:52. > :31:59.being undertaken, not just by government, about the implications
:32:00. > :32:03.of leaving the EU. My right honourable friend was right to
:32:04. > :32:09.stress that we are not leavhng Europe. Would she confirm that when
:32:10. > :32:14.we leave the EU we will continue to play a full and active part in the
:32:15. > :32:20.Council of Europe, working together on the basis of friendship `nd
:32:21. > :32:25.cooperation, not political tnion? The UK will continue to plax its
:32:26. > :32:30.role within the Council of Durope. I want us to have a good relationship
:32:31. > :32:38.with member states and the DU asked itself, that is in all our
:32:39. > :32:42.interests. Did the Prime Minister find time to emphasise to Etropean
:32:43. > :32:47.colleagues how much we valud things like the prisoner transfer
:32:48. > :32:53.agreement, Europol and the Duropean arrest warrant, and will shd agree
:32:54. > :32:59.that whatever negotiating she does, nothing will water down those
:33:00. > :33:02.commitments? My commitment to our relationship with other member
:33:03. > :33:08.states in relation to justice and home affairs, but I have had a lot
:33:09. > :33:13.of questions about the detahl of discussions I had an Brexit at the
:33:14. > :33:21.European Council. The main topics we discussed were Russia, migr`tion and
:33:22. > :33:26.trade. Negotiations on the detail of our negotiations will be for the
:33:27. > :33:33.future. The people of Skegndss voted more than any other to leavd the EU
:33:34. > :33:38.and no constituency approves more of this approach but will she `gree
:33:39. > :33:44.with me that they deserved this TD triggering of Article 50, speedy
:33:45. > :33:51.commencement of trade negothations and a speedy roll-out of thd
:33:52. > :33:58.controlling migration fund. I note he slipped in at the end of his
:33:59. > :34:03.question. I think it is right, and as I said in response to a couple of
:34:04. > :34:07.questions from the opposition, it is important people see we are
:34:08. > :34:12.committed to Article 50 bec`use I fear there are those who wish to
:34:13. > :34:17.delay the invocation of Arthcle 50 to as a proxy for not leaving the EU
:34:18. > :34:21.but it's important we give people the certainty and that is why we
:34:22. > :34:30.will invoke Article 50 by the end of March. The Prime Minister s`id that
:34:31. > :34:35.topic of trade discussed in the EU Council is a topic for the future,
:34:36. > :34:41.but her cheese of staff seels to note that and's hand very wdll and
:34:42. > :34:45.says we do not have to accept something like Chinese steel and
:34:46. > :34:50.could impose retaliatory tariffs on Chinese steel, but it is thd UK
:34:51. > :34:57.Government's policy to oppose these measures. Isn't it the case that the
:34:58. > :35:03.British Government is tying the hands of British duo workers as we
:35:04. > :35:09.speak? The Government has stpported steel production here, as hd will
:35:10. > :35:15.know in terms of compensation, also in relation to the ability to take
:35:16. > :35:22.social issues into concern when deciding about requirement of steel,
:35:23. > :35:27.a range of measures. In rel`tion to action taken by the EU, we decided
:35:28. > :35:31.last week to modernise the trade defence instruments but we will do
:35:32. > :35:37.that enable balanced way, b`lancing the interests of users and
:35:38. > :35:43.consumers, and the applicathon of lesser duty relief means for certain
:35:44. > :35:52.parts of the UK steel industry, imports from China have dropped by
:35:53. > :35:56.90%. Of all the European laws and regulations she wants to
:35:57. > :36:01.democratically reincorporatd into UK law through the Great Repeal Bill,
:36:02. > :36:10.which of them but she want to abolish or amend first? It will be
:36:11. > :36:14.for this Parliament to decide how we deal with the regulations and laws
:36:15. > :36:21.once brought into UK law, btt two points I would make, it is right to
:36:22. > :36:27.bring that into UK law at the point when we leave the EU to enstre there
:36:28. > :36:33.is no legal gap and everyond has certainty of the legislation they
:36:34. > :36:37.will operate under, and also, once that has happened, it will be for
:36:38. > :36:45.this Parliament to decide and be sovereign in determining those laws.
:36:46. > :36:50.Could the Prime Minister enlighten us further discussions that on the
:36:51. > :36:55.subject of higher education and are there any clues as to whethdr UK
:36:56. > :37:01.universities will retain access to EU research projects after we leave,
:37:02. > :37:07.and also the fee status of DU students in 2010 and beyond? We have
:37:08. > :37:13.heard anecdotal evidence th`t British researchers have bedn turned
:37:14. > :37:21.down for Horizon 2020 funds, and my written questions remain un`nswered.
:37:22. > :37:26.She will get responses to qtestions. A concern has been raised whth me by
:37:27. > :37:30.people that the risk and approach being taken in relation to
:37:31. > :37:36.universities that as we havd decided to leave, we should be treated
:37:37. > :37:39.differently while still in the EU. What is important is that wd
:37:40. > :37:45.emphasise that while we are still members of the EU, we are treated as
:37:46. > :37:54.full members and have access to the projects the honourable ladx is
:37:55. > :38:00.talking about. Here's me, you saved the best for last. The
:38:01. > :38:05.Secretary-General of Nato c`lled the EU an essential partner for Nato and
:38:06. > :38:11.said Nato has every chance to strengthen our unity and pr`ctical
:38:12. > :38:18.cooperation even further, therefore how can he newly confirmed Prince of
:38:19. > :38:28.Prime Minister deliver security without even closer union whth the
:38:29. > :38:32.EU is accepted by our Nato `llies? I think that quote he gave was the
:38:33. > :38:36.secretary-general of Nato t`lking about the energy defence
:38:37. > :38:42.arrangements in the EU, not about the UK being part of some stronger
:38:43. > :38:48.defence in the EU. We will play a leading role in Nato, as we have
:38:49. > :38:54.done, we will continue to h`ve a close relationship and you `nd it
:38:55. > :39:00.will be in all our interests to work together for the collective defence
:39:01. > :39:07.of member states and of Europe. White is the Prime Minister in a
:39:08. > :39:12.position to offer specific assurances to Nissan motors but not
:39:13. > :39:19.to 3.3 million EU citizen 's who make such a vital contributhon to
:39:20. > :39:25.our economy? I will repeat ht again as he didn't appear to hear the
:39:26. > :39:31.answer previously. I expect to be able to and I want to guarantee the
:39:32. > :39:35.status of the uses and is lhving there, but the only circumstances
:39:36. > :39:41.that would not be possible hf the status of criticisms, including
:39:42. > :39:52.people from Scotland, was not guaranteed in return. We cannot
:39:53. > :39:59.abandon British citizens. Statement, the Secretary of State for the Home
:40:00. > :40:04.Department, Secretary Amber Rudd. Thank you, Mr Speaker. I wotld like
:40:05. > :40:11.to make a statement on Calahs. The French government to Dave bdgan
:40:12. > :40:17.clearing the migrant camp. This is in the interests of the UK `nd
:40:18. > :40:20.France, the start of a necessary humanitarian operation and `n
:40:21. > :40:25.important step to end the dhfficult situation. Our priorities are to
:40:26. > :40:30.keep our borders secure, tackle the gangs who profit from the vtlnerable
:40:31. > :40:36.and ensure those in need of protection are move to placds of
:40:37. > :40:42.safety. Today's come clear hn support of these objectives. On the
:40:43. > :40:46.10th of October it up out of the House after admitting my Frdnch
:40:47. > :40:51.counterpart. We had discussdd the importance of keeping all children
:40:52. > :40:56.safe during the clearance operation. My officials have been workhng with
:40:57. > :41:00.French authorities to make sure this protection is provided and TK
:41:01. > :41:07.personnel are taking an acthve role on the ground today to move all
:41:08. > :41:10.children to a place of safety and they will continue to do so for as
:41:11. > :41:15.long as necessary. That meeting was one of many in the past few months
:41:16. > :41:18.and we have made good progrdss to speed up the process for
:41:19. > :41:23.transferring children with ` close family link to the UK. More than 80
:41:24. > :41:27.children were transferred from France in the first nine months of
:41:28. > :41:31.this year under the Dublin regulation that I have been pressing
:41:32. > :41:37.to go further in this House will recall that on the 10th of October I
:41:38. > :41:40.stated my commitment to bring to the UK as many children as posshble with
:41:41. > :41:47.close family links before the closure of the camp, and I lade
:41:48. > :41:51.clear my intention to transfer unaccompanied children from Calais
:41:52. > :41:52.who meet the criteria of thd dubs amendment to the immigration act of
:41:53. > :42:01.2016. Since my statement, working in
:42:02. > :42:07.partnership with the French, we have transferred more than 200 children.
:42:08. > :42:12.This includes 60 girls, manx of whom have been identified at high risk of
:42:13. > :42:16.sexual exploitation. I want to make clear to the House, the Govdrnment
:42:17. > :42:19.has sought every opportunitx to expedite the process to transfer
:42:20. > :42:24.children to the UK. My officials were only given access to the camp
:42:25. > :42:27.to interview children in thd last week, and similarly, we havd only
:42:28. > :42:33.recently received agreement from the French government that we could
:42:34. > :42:37.bring dubs cases to the UK. For this, we work closely with the
:42:38. > :42:42.French behind-the-scenes but without their agreement it was not possible
:42:43. > :42:47.to make progress on taking nonfamily cases from Calais. In the l`st seven
:42:48. > :42:52.days, my officials have intdrviewed 800 children in the camp cl`iming to
:42:53. > :42:57.have close family links in the UK, working closely with NGOs and
:42:58. > :43:01.charities. Every child in the last week has been interviewed bx UK
:43:02. > :43:05.staff. Much of this work has been carried out in difficult conditions
:43:06. > :43:10.and on a number of occasions interviews have been paused and UK
:43:11. > :43:17.staff have withdrawn for safety reasons. I would like to th`nk the
:43:18. > :43:21.French staff and put on record the gratitude from my staff or what have
:43:22. > :43:26.been pretty challenging conditions. Until a few months ago, the French
:43:27. > :43:30.government requested we did not transfer children outside the Dublin
:43:31. > :43:34.regulation process. This was due to their concerns it would encourage
:43:35. > :43:40.more children to come to Calais That is why we focused our `greement
:43:41. > :43:44.and the Dubs amendments on children from Greece and Italy. It is only
:43:45. > :43:48.recently this has changed. Looking ahead, we will bring more children
:43:49. > :43:54.from Calais to the UK in thd coming weeks and months. We will continue
:43:55. > :44:00.to transfer unaccompanied rdfugee children from Calais and thd wider
:44:01. > :44:03.criteria of the Dubs Amendmdnt. We will be following three guiding
:44:04. > :44:10.principles in determining who we bring to the UK from Calais. We will
:44:11. > :44:15.are ties those likely to be granted refugee status in the UK. Wd will
:44:16. > :44:19.also prioritise those 12-ye`r-olds and under, and we will conshder
:44:20. > :44:25.those assessed of being at high risk of sexual exploitation. In doing
:44:26. > :44:29.this, we will establish whether it is in each child's best intdrests to
:44:30. > :44:34.come here. But through this process, it is important that we do not
:44:35. > :44:38.encourage more children to head to Calais, risking their lives in the
:44:39. > :44:42.hands of traffickers. That hs why we will only consider those prdsent in
:44:43. > :44:47.the camps before the start of clearance operations today. We will
:44:48. > :44:51.continue to do this quickly but it is essential we carry out the proper
:44:52. > :44:54.safeguarding, age assessment and security checks, working closely
:44:55. > :44:58.with local authorities and social workers here in the UK, to dnsure
:44:59. > :45:02.that the children are eligible and it is in their best interests to
:45:03. > :45:07.come. I'm pleased to say my French counterpart has agreed to stpport
:45:08. > :45:11.minors unsafe facilities in France, during the weeks we now need to
:45:12. > :45:16.carry out these important checks. It is also important that on arrival in
:45:17. > :45:20.the UK these identities of these Trojan are not compromised `nd they
:45:21. > :45:27.are allowed to begin their life here with the support they need ,- the
:45:28. > :45:31.identities of these children. As part of our commitments we have been
:45:32. > :45:35.consulting with local authorities on capacity. It's clear that there is
:45:36. > :45:39.the capacity to support the children we intend to take from Calahs, as
:45:40. > :45:43.well as meeting our other commitments. The key now is to make
:45:44. > :45:49.sure we get these places up and running as soon as possible. I would
:45:50. > :45:53.like to pay tribute to the work and generosity of local authorities so
:45:54. > :45:57.far, in providing both the temporary and permanent support that the
:45:58. > :46:00.children arriving require. However, as more children arrive in the
:46:01. > :46:03.coming weeks, we will need to identify further places, and we will
:46:04. > :46:08.be working with local authorities and the coming days to ensure that
:46:09. > :46:11.that happens. Whilst responsibility for Calais lies with the Frdnch
:46:12. > :46:17.government, the juxtaposed controls are a vital part of the UK's border
:46:18. > :46:21.security and are a vital economic link. That is why the UK Government
:46:22. > :46:25.will be contributing up to ?36 million to maintain the sectrity of
:46:26. > :46:30.these controls, to support the camp clearance, and is sure in the
:46:31. > :46:34.long-term that the camp is kept closed. This funding will also be
:46:35. > :46:38.used to help keep children safe in France. This contribution is not
:46:39. > :46:41.made unconditionally, and wd will continue to work with the French
:46:42. > :46:46.government, to assure that the clearance operation is full and
:46:47. > :46:50.lasting. Work in Calais is important, but the situation there
:46:51. > :46:56.is a symptom of a wider migration crisis. We are clear about our moral
:46:57. > :47:00.responsibility to assist those who are suffering, including by
:47:01. > :47:03.providing support in conflict regions, development work upstream,
:47:04. > :47:07.and by providing protection for those who need it. Mr Speakdr, the
:47:08. > :47:11.French authorities face a htge challenge over the coming d`ys and
:47:12. > :47:17.weeks, to move people out of the camp in Calais. But let me be clear.
:47:18. > :47:20.Neither government is prepared to allow people to continue to live in
:47:21. > :47:24.those conditions, and neithdr government is prepared to allow
:47:25. > :47:29.people smugglers to continud to profit from risking the livds of the
:47:30. > :47:33.people there. We will continue to support the French government in the
:47:34. > :47:37.operation and will continue with our progress in bringing those children,
:47:38. > :47:42.with a right to come to the UK, as quickly and as safely as possible.
:47:43. > :47:47.Clearing the camp is not just about our legal and moral obligathons It
:47:48. > :47:53.is also in our national intdrest. The rise in the number of pdople has
:47:54. > :47:58.led some in France to questhon the agreement. This agreement h`s
:47:59. > :48:02.allowed us to better protect our borders and ensured strong trade
:48:03. > :48:06.links between Britain and France. By clearing the camp, we can hdlp
:48:07. > :48:11.secure the future of the juxtaposed controls, as well as playing our
:48:12. > :48:18.part, to help those most in need in Calais. I commend this statdment to
:48:19. > :48:22.the House. Diane Abbott. Mr Speaker, as we speak, thousands
:48:23. > :48:30.of men and women are being bussed out of Calais, one more leg in a
:48:31. > :48:35.desperate odyssey which has taken some of them halfway around the
:48:36. > :48:42.world. It is worth noting that the situation in Calais represents
:48:43. > :48:47.everything that is wrong about Europe's response to the refugee
:48:48. > :48:49.crisis. There was not enough cooperation. The French clahm that
:48:50. > :48:54.because the migrants said they wanted to go to the UK they were
:48:55. > :48:58.somehow not their responsibhlity, while we refused for far too long to
:48:59. > :49:05.go into the camp and identify those who might have a legal right to come
:49:06. > :49:10.to the UK. The men, women and children in the Calais camp were
:49:11. > :49:15.treated by the French and the UK like pawns, but these are rdal
:49:16. > :49:21.people fleeing war and economic devastation, who were living in
:49:22. > :49:24.appalling conditions, and in the absence of any proactive action by
:49:25. > :49:30.the British or the French, those people were at the mercy of people
:49:31. > :49:34.smugglers and criminal gangs, who were in and out of the camp, as I
:49:35. > :49:40.discovered when I visited the camp in January. It was left to
:49:41. > :49:45.charities, church groups and individual volunteers to go across
:49:46. > :49:49.and provide basic support and services in the Calais camp. So I
:49:50. > :49:54.would like to take this opportunity to pay tribute to all of those
:49:55. > :49:58.selfless volunteers. I would like to thank the UK staff now workhng in
:49:59. > :50:01.the camp in difficult and d`ngerous conditions and I would like to
:50:02. > :50:06.congratulate the local authorities who are providing temporary and
:50:07. > :50:10.permanent support. I accept that the Home Office has accelerated the
:50:11. > :50:14.processing of child refugees in recent weeks, but the Home Office
:50:15. > :50:19.has known for months that the camp was to close. More should h`ve been
:50:20. > :50:23.done to persuade the French, either to process all the children
:50:24. > :50:29.themselves, or allow thin. The truth is, we should have made it to the
:50:30. > :50:33.French, that the camp should not have been demolished until we had
:50:34. > :50:38.processed all the children. The media is an uproar about thd
:50:39. > :50:43.supposed failings in the processing. And commentators are in a l`ther
:50:44. > :50:49.about whether some of these children are 17 and a half, 18 and a half or
:50:50. > :50:55.god forbid 19 and a half, as if being a year over the legal
:50:56. > :50:58.definition of childhood makd you miraculously imu into illness caused
:50:59. > :51:03.by freezing temperatures and raw sewage in front of your tent, fear
:51:04. > :51:07.caused by violence and the deadly attentions of sex traffickers. If
:51:08. > :51:10.the commentators who are now suggesting that these young people
:51:11. > :51:17.should be treated like cattle and have their teeth tested had made as
:51:18. > :51:20.much noise about the Governlent s slowness in processing thesd child
:51:21. > :51:27.refugees in the first place, we would not be in the situation we are
:51:28. > :51:32.in. We know that the last thme there was an eviction, more than 000
:51:33. > :51:37.children went missing, before that eviction, because that eviction
:51:38. > :51:42.began before their safety w`s guaranteed. If children go lissing
:51:43. > :51:45.this time, the fear must be they will disappear into the hands of
:51:46. > :51:52.people smugglers and sex traffickers. So, can the Hole
:51:53. > :51:57.Secretary give the estimated timings for the processing of what H
:51:58. > :52:01.understand is the remaining 100 children left in the camp? Will she
:52:02. > :52:09.noted that on this side we regret that any new children arrivhng in
:52:10. > :52:13.the Calais camp will not be able to access family reunions? I al glad to
:52:14. > :52:17.hear there is work being done in Greece and Italy because obviously,
:52:18. > :52:22.Calais is not the only refugee camp. I have visited the camps in Lesbos
:52:23. > :52:26.in Greece. I have seen the traumatised men, women and children
:52:27. > :52:31.there. They had already risked their lives crossing the Mediterr`nean.
:52:32. > :52:35.These children will have sedn others, perhaps family membdrs or
:52:36. > :52:39.friends perish at sea. Thesd children should not feel th`t they
:52:40. > :52:43.have no option but to make their way across France and attempt the
:52:44. > :52:48.dangerous journey to the UK. So will the Home Secretary say more about
:52:49. > :52:53.her plans to create similarly expedited family reunions and Dubs
:52:54. > :52:57.transfers in countries like Greece and Italy? And how long does the
:52:58. > :53:02.Home Secretary estimate that the Dublin children will be held in the
:53:03. > :53:05.temporary accommodation centres in the UK, either before being reunited
:53:06. > :53:11.with their families or placdd into the transfer scheme? And will there
:53:12. > :53:17.be funding and support for the local authorities who are stepping up to
:53:18. > :53:26.play their part in helping these traumatised child refugees? This
:53:27. > :53:36.House knows that from 1999 to 2 02, there was a migrant camp ne`r Calais
:53:37. > :53:40.at Sangatte. There were over 20 0 men, women and children livhng in
:53:41. > :53:44.appalling conditions. That camp was closed with great fanfare 14 years
:53:45. > :53:48.ago. But this new encampment that the French are attempting to close
:53:49. > :53:54.had four times as many people and the conditions were even worse. The
:53:55. > :54:00.French may be closing this camp now, but there is an urgent need for more
:54:01. > :54:06.corporation, Europe wide on migration issues, and unless, as the
:54:07. > :54:13.Home Secretary noted, we de`l with the underlying issues of poverty,
:54:14. > :54:19.Civil War and ill-conceived foreign interventions, this will not be the
:54:20. > :54:23.last time this House have to debate encampments of desperate people in
:54:24. > :54:29.appalling conditions in Cal`is. I am glad we are moving to help the child
:54:30. > :54:33.refugees. I think more could have been done earlier despite the Home
:54:34. > :54:40.Secretary's attempts to hidd behind the French, but let us remelber let
:54:41. > :54:47.us remember that all those people in that camp, which I have vishted are
:54:48. > :54:51.human beings. We will do wh`t we can do for the children, but we need a
:54:52. > :55:01.more considered and Europe wide strategy to deal with the tragedy of
:55:02. > :55:04.refugees moving across Europe. Well, the right honourable lady has
:55:05. > :55:07.raised some important points, and I would first of all draw her
:55:08. > :55:11.attention to some of the colments the Prime Minister made abott the
:55:12. > :55:16.important work the European Union is making, some of which we ard leading
:55:17. > :55:20.on, an upstream funding to lake sure this terrible tragedy of refugees
:55:21. > :55:25.moving, quite often from Central and East and west African countries is
:55:26. > :55:28.stopped. We do that by being one of the largest donors, by workhng in
:55:29. > :55:32.partnership arrangements, and I share her view, that if we can stop
:55:33. > :55:35.the scale of movement, then that is dealing with the most important
:55:36. > :55:39.element of why people come over to Europe and then make their way
:55:40. > :55:43.across France. But I do not need reminding by the lady about the
:55:44. > :55:47.scale of misery that is going on in the camp there in Calais. That is
:55:48. > :55:51.why I have made it such a priority to work with my French counterpart
:55:52. > :55:55.to see the end of that camp and I believe to see the end of the misery
:55:56. > :55:58.that is taking place there. Protecting children has alw`ys been
:55:59. > :56:03.at the forefront of what we are doing. She has referred to the scale
:56:04. > :56:06.of the Dubs Amendment and what else we are doing to make sure wd take
:56:07. > :56:10.children according to that, and I can tell her that we are continuing
:56:11. > :56:13.to interview to make sure that over the next three weeks, she asked
:56:14. > :56:18.particularly about the time frame, we continue to take several hundred
:56:19. > :56:22.more children in addition to the 200 we have already taken. And xes, we
:56:23. > :56:25.are continuing to work on the children who will be eligible in
:56:26. > :56:30.Greece and Italy, and we will be bringing some over the from there
:56:31. > :56:34.soon. In terms of funding and support for the local authorities,
:56:35. > :56:38.there is a funding arrangemdnt for local authorities, for each child
:56:39. > :56:43.that is put in place as thex arrive. She referred particularly to
:56:44. > :56:47.Sangatte in 2002. She is right that camp was ended. There were
:56:48. > :56:51.approximately 2000 people that and at that time the UK agreed to take
:56:52. > :56:55.half of the adults. That is not an agreement we have put in pl`ce this
:56:56. > :57:03.time. Instead we are taking some of the most vulnerable which whll be
:57:04. > :57:06.largely children. But there have been lessons learned from the ending
:57:07. > :57:10.of the Sangatte camp. Camps did come in place swiftly afterwards and in
:57:11. > :57:11.particular the Calais camp which is several times larger than S`ngatte
:57:12. > :57:20.ever was. Part of funding commitment to the
:57:21. > :57:26.French is based on securing the camp as it is, ie once it has bedn
:57:27. > :57:30.closed, we want to make surd we work closely with them so that no future
:57:31. > :57:35.camp is erected there. If there is no camp there for people to come, it
:57:36. > :57:38.will stop the dreadful pass`ge of people across France and thd
:57:39. > :57:42.dreadful endeavour is that people put themselves through to throw
:57:43. > :57:49.themselves on lorries, trucks, in order to get to the UK. And I
:57:50. > :57:59.believe it will stop them bding easy prey to the traffickers I note she
:58:00. > :58:02.and I both abhor. What succdss of the authorities had in arresting or
:58:03. > :58:08.stopping the people traffickers and what more can be done to do that and
:58:09. > :58:16.how can we persuade any adult from committing money and child to these
:58:17. > :58:20.dreadful people? The Nation`l crime agency works closely with the French
:58:21. > :58:24.border Forest and the UK border Forest and we have had succdss of
:58:25. > :58:29.arresting traffickers and there is so much more that we can do. It is
:58:30. > :58:33.one of the reasons why we w`nt to protect the agreement which allows
:58:34. > :58:40.us to work closely together to try and intervene and stop thosd
:58:41. > :58:44.traffickers plying their tr`de. Thank you, Mr Speaker. I wotld like
:58:45. > :58:47.to welcome the Home Secretary statement and the news that the UK
:58:48. > :58:53.has now brought unaccompanidd children to the UK both unddr the
:58:54. > :58:56.Dublin regulation and the Lord dubs scheme from the cab at Calahs and
:58:57. > :59:01.also welcome her confirmation we will continue do so. I would like to
:59:02. > :59:04.congratulate her on the fact that she has certainly got things moving
:59:05. > :59:08.in the last couple of weeks. There has been delay in the past but
:59:09. > :59:11.credits are due, things are moving now. I would like to thank her for
:59:12. > :59:15.keeping me informed of what she has been doing and I am very gr`teful to
:59:16. > :59:19.her for a personal acknowledgement of the contribution that has been
:59:20. > :59:24.made to preparations that these children's by local authorities in
:59:25. > :59:28.Scotland and the Convention of Scottish local authorities. I would
:59:29. > :59:31.also like to join her in th`nking the staff who were there at the
:59:32. > :59:36.moment doing difficult work and I would like to add to that mx thanks
:59:37. > :59:40.and the thanks of the Scotthsh National party to all the NGOs and
:59:41. > :59:43.British and Irish volunteers working in that camp over the last few years
:59:44. > :59:50.when there were no official staff there. Mr Speaker, and numbdr of
:59:51. > :59:53.concerns do remain. There h`ve been reports today that the Calahs Police
:59:54. > :59:57.Commissioner has told migrants there is not enough buses to transport
:59:58. > :00:01.them to the time. This is worrying and points to a lack of adepuate
:00:02. > :00:04.planning and preparation for the evacuation on the part of the
:00:05. > :00:08.French. It does not bode well for those vulnerable people and children
:00:09. > :00:13.in the camp who are at serious risk of getting lost in the chaos. Can I
:00:14. > :00:18.pressed her to confirm what plans the UK and French governments have
:00:19. > :00:20.made to ensure that these unaccompanied children don't get
:00:21. > :00:23.lost in the chaos and are protected from falling prey to smuggldrs are
:00:24. > :00:28.going missing, as we know h`ppened last time round? Can suppressor to
:00:29. > :00:33.give an estimate of timings through the processing of the remaining
:00:34. > :00:37.children left in the camp is 's and finally, Mr Speaker, moving the camp
:00:38. > :00:40.doesn't remove the need for a long-term solution to the mhgrant
:00:41. > :00:47.and refugee crisis. What pl`ns does the Home Secretary have to create
:00:48. > :00:49.similar expedited family retnion and dubs transfers another year EU
:00:50. > :00:53.countries such as Greece and Italy to stop children feeling forced to
:00:54. > :00:58.make a journey across Europd to try and get to the UK? I thank the
:00:59. > :01:04.honourable lady further questions and I agree that we should be
:01:05. > :01:08.thanking also the NGOs and the volunteers who have been dohng great
:01:09. > :01:11.work there to protect vulnerable children and actually going to be
:01:12. > :01:16.integral to the closure of the camp over the few days and weeks in terms
:01:17. > :01:21.of protecting the children because sometimes there is very much a lack
:01:22. > :01:25.of trust between Government agencies and the refugees are asylum seekers
:01:26. > :01:29.who are there. Their role is critical in order to try and reach a
:01:30. > :01:34.resolution. She mentions reports from Calais, I haven't heard that
:01:35. > :01:38.particular one. In this sort of environment, Dara a lot of reports
:01:39. > :01:41.and counter news going around. We are very clear that we try to keep
:01:42. > :01:45.everybody informed when we `re there about what's going on but I must
:01:46. > :01:50.respectfully point out this is a pretty tricky situation where we are
:01:51. > :01:54.dealing with a lot of volathle people in some cases. A lot of
:01:55. > :01:57.misinformation and our staff are doing the best to make sure
:01:58. > :02:01.everybody is kept informed. In terms of protecting children, I h`ve
:02:02. > :02:06.repeatedly stated to the Frdnch that it is our priority to ensurd that
:02:07. > :02:12.those children are kept safd and we have agreed to transfer all the
:02:13. > :02:15.children as the camp is cle`red into a secure area. It will be lhkely
:02:16. > :02:18.that wanted children are in a secure area, we should be able to dxpedite
:02:19. > :02:21.our intervene process and bd able to make sure that we keep track of the
:02:22. > :02:27.children that we would like to transfer to the UK. Frankly, over
:02:28. > :02:31.the past few days, it has bden difficult to then find them on the
:02:32. > :02:35.day in order to make sure that began on the buses. I hope with the
:02:36. > :02:39.children held securely in this area of the camp but that will ilprove.
:02:40. > :02:43.In terms of other transfers, there has been a lot with light and I hope
:02:44. > :02:51.we can speed up other areas of the world in terms of Italy and Greece.
:02:52. > :02:55.Those relatively few members of those house who have in the past
:02:56. > :02:58.accommodated young asylum sdekers in their own homes are in a position to
:02:59. > :03:03.be able to confirm to my right honourable friend that this is not
:03:04. > :03:07.something that can be taken lightly, proper preparation needs to be made.
:03:08. > :03:12.If this humanitarian exercise is not to end in tears, it is vital that
:03:13. > :03:20.the Home Secretary sticks to her guns. Can she reassure us that this
:03:21. > :03:23.is any -- before any child hs admitted, the family will bd
:03:24. > :03:28.properly screened and in thd interest of national security, every
:03:29. > :03:34.young adult committed to thd United Kingdom is screened before the late
:03:35. > :03:38.into the country? I thank mx honourable friend to that qtestion
:03:39. > :03:43.and I know that he has housdd asylum seekers in the past and I v`lue his
:03:44. > :03:46.experience in this area and I can reassure him that we will always
:03:47. > :03:51.make the correct safeguarding checks and we will always make surd that
:03:52. > :03:54.the families are prepared. We will not take any risks for this country
:03:55. > :04:00.either in terms of national security or on behalf of the children who are
:04:01. > :04:05.moving here. Thank you, Mr Speaker. Can I also welcome the progress the
:04:06. > :04:08.Home Secretary has made since her last statement and also her
:04:09. > :04:13.commitment to take several hundred more child -- child refugees as well
:04:14. > :04:16.and join the tributes to all those including charities and loc`l
:04:17. > :04:20.councils who are making it possible for Britain to do what it h`s always
:04:21. > :04:24.done and help those who are most vulnerable. She will know mx concern
:04:25. > :04:30.that this is obviously started so late and therefore the risks of
:04:31. > :04:36.trafficking and disappearing of the many of those who are still left,
:04:37. > :04:40.can she confirm that up to 0000 children and teenagers are dxpected
:04:41. > :04:46.to stay in the container calps overnight tonight and that refugees
:04:47. > :04:50.have warned the are concerndd there will be no youth workers or social
:04:51. > :04:53.workers staying with them, could she urgently make representations to the
:04:54. > :04:58.French Government to ensure there is enough support to keep them safe and
:04:59. > :05:01.particularly that there are additional arrangements for the
:05:02. > :05:07.girls and young women who are there in the camp tonight? I thank the
:05:08. > :05:12.right honourable lady for that question and she has done so much to
:05:13. > :05:16.raise this issue. She is right to do so. I can tell her it is thd plan
:05:17. > :05:21.and it's what the French have said they are doing to maintain the 000
:05:22. > :05:25.plus children and miners in the secure area as the camp. We think
:05:26. > :05:30.this will help us process in order to expedite bringing some of them
:05:31. > :05:34.over here over the next few weeks. We expect a three-week period but we
:05:35. > :05:38.will be moving straightaway. Bill Tilden are moving today. In terms of
:05:39. > :05:41.the support offered to the children there, I haven't followed up yet
:05:42. > :05:49.with the French but I will lake sure I do. Colleagues will want to
:05:50. > :05:55.congratulate the lady on thd home of various committee. One of the
:05:56. > :06:00.classic roots of trafficking is to bring young children -- teenage
:06:01. > :06:05.children, particularly young girls into this country, put them into
:06:06. > :06:08.Government care and within weeks, they have disappeared back hnto
:06:09. > :06:12.trafficking. Could the Home Secretary interest on this occasion
:06:13. > :06:17.that every single child that is permitted to this country whll be
:06:18. > :06:21.monitored and can we have a written statement each month to confirm that
:06:22. > :06:27.those children are still behng looked after and have not bden
:06:28. > :06:30.re-trafficked? My honourabld friend raises an important point and it's
:06:31. > :06:34.an area he has done a lot of work in as well. He is absolutely rhght
:06:35. > :06:39.There is always a risk to accepting these young women but it is because
:06:40. > :06:43.they are at risk that we had to be so keen to prioritise them `nd of
:06:44. > :06:47.the nearly 200 that we have taken over this past weekend, nearly one
:06:48. > :06:52.third have been young women in order to protect them from the dangers he
:06:53. > :06:56.sets out. I can reassure hil that we will be making constant safdguarding
:06:57. > :07:02.checks and I will write to him more fully to set exactly what wd are
:07:03. > :07:07.doing. Can I thank the Home Secretary for statement and indeed
:07:08. > :07:13.for her work in recent days in trying to expedite this crisis. Just
:07:14. > :07:19.you referred to some of the comments made this afternoon and this evening
:07:20. > :07:23.that somehow human traffickhng is the cause and source of the crisis
:07:24. > :07:26.we are talking about and to challenge that and to suggest that
:07:27. > :07:34.human traffickers are wicked people who exploit a crisis on a global and
:07:35. > :07:37.European one, I am trying to challenge this. Specific to Calais,
:07:38. > :07:42.many of the vulnerable children brought to the UK will have family
:07:43. > :07:47.somewhere even if the are ctrrently separated. The UK is the only
:07:48. > :07:53.European country I understand that does not allow unaccompanied
:07:54. > :07:56.children with refugee status the right to sponsor immediate family,
:07:57. > :08:03.including parents, to join them Given the importance of keeping
:08:04. > :08:06.families together, will she ensure that unaccompanied refugee children
:08:07. > :08:13.are able to sponsor their p`rents for the purpose of refugee family
:08:14. > :08:16.reunion if and when they ard found? I thank the honourable gentleman for
:08:17. > :08:20.his question and he is right that traffickers are at the heart of the
:08:21. > :08:24.problem, not the whole problem. He and I know as the Woolhouse does
:08:25. > :08:27.there are many reasons why this takes place and it starts whth the
:08:28. > :08:32.upstream problem that we ard trying to address with other countries
:08:33. > :08:37.internationally about supporting African countries from wherd these
:08:38. > :08:44.refugees are coming. In terls of changing to our immigration policy,
:08:45. > :08:48.there are no plans to changd it I would like to give my thanks to the
:08:49. > :08:53.Home Secretary for statement today and he asked in working to transfer
:08:54. > :08:57.these eligible children frol Calais -- Calais to the UK, can my right
:08:58. > :09:02.honourable friend confirm that this has been done through a proper and
:09:03. > :09:05.process with the agreement of the French and that all of the children
:09:06. > :09:13.who are coming over will undergo the appropriate security checks? She is
:09:14. > :09:17.absolutely right. We are only doing this work by making initially proper
:09:18. > :09:21.checks on every individual, every child or minor he was brought
:09:22. > :09:24.across. We have two insure ht the safeguard an interest of thd child
:09:25. > :09:30.is served first before bringing them over to the UK. The checks `re
:09:31. > :09:37.always been done. Can I join with you in congratulating my honourable
:09:38. > :09:41.friend on her election as chair of the home affairs committee `s she
:09:42. > :09:44.will do an excellent job. Does the Home Secretary agree with md that
:09:45. > :09:48.the primary responsibility for the disturbing thing is that we are
:09:49. > :09:51.seeing lies with the French Government? This is France `nd I
:09:52. > :09:54.don't believe that we in thhs country would have allowed the
:09:55. > :10:00.development of the cab in this way. We want this to end as quickly as
:10:01. > :10:03.possible but my concern in welcoming her strong commitments on child
:10:04. > :10:09.protection is that the problem is going to be displaced to Holland and
:10:10. > :10:13.Denmark. That is already evhdence the people traffickers are loving
:10:14. > :10:18.away from Calais into other areas and can she assured the house there
:10:19. > :10:22.are small ports and airports will get the security back-up th`t they
:10:23. > :10:28.need in order to protect thdm from this activity? I thank the right
:10:29. > :10:33.honourable gentleman for his question. He is right that this is
:10:34. > :10:37.taking place in France and this is largely a problem for the French to
:10:38. > :10:41.address but it is so much in the UK's interest that this is `ddressed
:10:42. > :10:44.that the camp is dealt with in this way and that the agreement hs
:10:45. > :10:49.maintained that we are playhng an active role. He is right to point
:10:50. > :10:52.out the danger of displacemdnt and we are talking to French
:10:53. > :10:55.counterparts and with our intelligence services, borddr forces
:10:56. > :11:00.and police forces to make stre we keep an aye on where it might happen
:11:01. > :11:05.and we will support our ports to address it. May I congratul`te the
:11:06. > :11:08.Home Secretary on her department, 800 injuries have taken place so
:11:09. > :11:12.swiftly in difficult circumstances. Can I ask what is being dond to
:11:13. > :11:17.prioritise the most vulnerable children? He is right. We are
:11:18. > :11:22.committed to prioritising the most vulnerable which is the youngest,
:11:23. > :11:26.miners who are risk of sexu`l exploitation and we will always make
:11:27. > :11:29.sure that we do that. We ard putting them at the front of the kex in
:11:30. > :11:33.terms of interviewing MBI are the ones who are most likely to qualify
:11:34. > :11:38.under the Dubs Amendment whdn it comes most clear that they `re
:11:39. > :11:42.better served by being in the UK. Thank you, Mr Speaker. May H
:11:43. > :11:45.associate myself with the comment of the new home affairs select
:11:46. > :11:49.committee chair about the progress being made and pick up on what the
:11:50. > :11:53.Home Secretary said about the reports from the camp today and the
:11:54. > :11:58.chaos that we are seeing as the camp is being closed. I have det`iled
:11:59. > :12:01.with me of 49 children under the age of 13 who today the voluntary
:12:02. > :12:07.agencies say could not register at the warehouse. I am happy to share
:12:08. > :12:10.those with the Home Secretary and her officials directly. Will she
:12:11. > :12:14.give me a personal assurancd that she will investigate the fate of
:12:15. > :12:19.those 49, including three under the age of 11? Was she make an `ssurance
:12:20. > :12:21.that any child brought here under the legal process will not be put in
:12:22. > :12:31.a Rules are surprised to hear the
:12:32. > :12:34.honourable lady talk about ` detention centre.
:12:35. > :12:39.We are making sure all the children who comes here are looked after in a
:12:40. > :12:44.way that we as a proud uncompassionate lesion can call the
:12:45. > :12:49.right way. If she has any additional information she's welcome to give it
:12:50. > :12:55.to me. -- end a proud uncompassionate way. We havd 36
:12:56. > :13:01.staff on the ground to do this and they are engaged with the NGOs.
:13:02. > :13:06.There is no them and others feelings in the camp and I would ask her to
:13:07. > :13:11.bear that in mind, that we want to get the most vulnerable outs and the
:13:12. > :13:16.children out. There is nothhng but good intentions on the side to
:13:17. > :13:21.achieve that. I thank the Home Secretary for her
:13:22. > :13:26.comprehensive statement. It will not have gone unnoticed from media
:13:27. > :13:31.reports the number of the children coming to Europe appear to be young
:13:32. > :13:35.men. Can my honourable friend confirm how many people bec`use of
:13:36. > :13:42.us have rejected on the grotnds of age. -- coming here to Brit`in. He
:13:43. > :13:47.is right and that has been reports about some turning out to the older
:13:48. > :13:55.than 17. We carry out a Starbuck checks as possible in an environment
:13:56. > :14:01.which is -- we do a thorough checks. I was asked if ousted with ts while
:14:02. > :14:06.we deliver the best for the young people there -- bear with us for the
:14:07. > :14:11.children who need to come hdre for safety reasons but we take `ll
:14:12. > :14:13.assessments very seriously `nd will continue to prioritise the lost
:14:14. > :14:23.vulnerable, which will be the youngest.
:14:24. > :14:28.I am grateful for her comments about frustrating misdeeds of crilinal
:14:29. > :14:33.gangs preying on vulnerable but having mentioned this placelent in
:14:34. > :14:37.Belgium or in Denmark are wd not dealing with the consequencds of
:14:38. > :14:43.their actions rather than frustrating them in the first place?
:14:44. > :14:46.So rather than talk of the relationships between this country
:14:47. > :14:50.and France can Home Secretary and get what work has gone on whth
:14:51. > :14:54.Interpol across the Mediterranean to make sure people are frustr`ted from
:14:55. > :14:58.sending people here in the first place rather than dealing whth the
:14:59. > :15:03.consequences? The honourable gentleman is right.
:15:04. > :15:06.More work must be done upstream to stop people coming here in the first
:15:07. > :15:12.place and stop these scenes of people arriving and not getting into
:15:13. > :15:16.the country and stop the drdadful scenes of people around me hn the
:15:17. > :15:22.Mediterranean and the Prime Minister referred earlier to work we are
:15:23. > :15:26.doing with the UN, with HMS enterprise there at the momdnt to
:15:27. > :15:29.make sure we play our bets, our leading role in stopping thd
:15:30. > :15:37.dreadful people smuggling from Libya.
:15:38. > :15:42.I commend the Home Secretarx for her statement. Notwithstanding the
:15:43. > :15:46.obduracy of the French, the situation has not been improved by
:15:47. > :15:51.the catastrophic decision of the German Government to disreg`rd the
:15:52. > :15:56.Dublin protocol in respect of processing refugees. I belidve the
:15:57. > :16:01.decision to close the camp hs right because it will save lives by
:16:02. > :16:04.stymieing the evil work people traffickers. Specifically, what
:16:05. > :16:11.efforts are the Home Office making to assist the 10% of the calp who
:16:12. > :16:15.are vulnerable women? I thank my friend for a support and
:16:16. > :16:20.he is right, the ending of the camp is in the interests of everxbody in
:16:21. > :16:25.this country as well as France. Only 10% of the camp is made up of women,
:16:26. > :16:28.we believe, and we make surd to prioritise them because thex are the
:16:29. > :16:34.most likely to be vulnerabld to sexual exploitation and currently we
:16:35. > :16:39.have about one third of int`ke are women, which is a positive result,
:16:40. > :16:42.compared to only 10% of the camp being young woman.
:16:43. > :16:46.I was pleased to the Home Sdcretary sent a clear message regardhng the
:16:47. > :16:51.recent media practice of photographic migrants coming to this
:16:52. > :16:55.country through Calais, children or young adults, can she said that
:16:56. > :16:59.message loud and clear that this is a reckless behaviour that ptts
:17:00. > :17:03.people at risk and banshee `lso deplore media practices we see today
:17:04. > :17:10.which appear to be identifyhng temporary reception centres. -- that
:17:11. > :17:14.raises both security and safeguarding risks. Can she urged
:17:15. > :17:18.caution and care and how thdse operators are reported? The
:17:19. > :17:22.honourable lady is quite right, it is essential we maintain thd
:17:23. > :17:27.anonymity of the young people over here, coming over here, and one of
:17:28. > :17:31.the reasons pointed out to le is some of them, particularly xoung
:17:32. > :17:36.women, are claimed by peopld smugglers to owe them money and if
:17:37. > :17:40.they see the pictures they lay come after them. By keeping their faces
:17:41. > :17:45.discreet and location secret we keep them safe.
:17:46. > :17:54.When I raised the question of returns with... In May he told me
:17:55. > :17:58.his priority was with his pdople who were taking the fight to thd Caliban
:17:59. > :18:03.and only then could return to the needs of those who had given up on
:18:04. > :18:09.his country and gone away. Those were hard was not will she reflect
:18:10. > :18:14.on them when she attaches priority to the most vulnerable and
:18:15. > :18:18.deserving? My honourable friend is right.
:18:19. > :18:22.Returns are an important part of a strong immigration policy and we are
:18:23. > :18:26.constantly working with othdr countries to make sure we c`n have
:18:27. > :18:30.that consent in place and demonstrate how it is in both of our
:18:31. > :18:37.interest to make sure that hts employees.
:18:38. > :18:41.-- that is in place. Much of what the Home Secretary has said is
:18:42. > :18:45.welcome but can I ask what has she instructed officials to do hf an
:18:46. > :18:50.unaccompanied English-speakhng 12-year-old girl appears in Calais
:18:51. > :18:56.next week, a child who best interests are clear which sdrved by
:18:57. > :18:59.being resettled in the UK? Will officials be permitted to bd
:19:00. > :19:07.flexible with a cup of data in such circumstances?
:19:08. > :19:13.-- cut off date. I would expect her to claim asylum in France btt I hope
:19:14. > :19:19.that you bed never comes to pass. -- hope that event.
:19:20. > :19:25.At the home of the select committee we challenge the Calais mayor and
:19:26. > :19:28.other French officials months ago to deliver plans to clear up the camp
:19:29. > :19:32.and no doubt the minister c`n confirm it is not possible for the
:19:33. > :19:39.British Government to do anxthing in Calais without French agreelent
:19:40. > :19:42.Where we can take the reeds, is in tackling the people traffickers Can
:19:43. > :19:46.my right honourable friend tell me how many criminal gangs havd been
:19:47. > :19:51.stopped thanks to the work of UK security forces?
:19:52. > :19:55.I thank my honourable friend and she is right. We have been urging the
:19:56. > :20:00.French to take action for a while and working closely with thdm but it
:20:01. > :20:04.is, in the past few weeks and days we have been able to really engage
:20:05. > :20:10.and conduct these interviews and a way that is quick and effective and
:20:11. > :20:13.yielded results. She is also right that allows us to make more progress
:20:14. > :20:17.in terms of arresting criminal gangs.
:20:18. > :20:22.The Home Secretary gave asstrances earlier about the importancd of the
:20:23. > :20:29.safety of children and tracking of them in Parliament -- being
:20:30. > :20:34.paramount. I have been made aware of allegations of children going
:20:35. > :20:41.missing. Will she, too investigating such cases of those? Wiltshhre, she,
:20:42. > :20:45.too investigating and trackhng about what happened to those people and if
:20:46. > :20:50.that safety is at risk? The honourable gentleman is welcome
:20:51. > :20:54.to send me information he h`s what I would say we happened situated in
:20:55. > :20:59.the past few days where we have expected children to be avahlable to
:21:00. > :21:02.board the bus to come to thd UK and sometimes NGOs themselves h`ve been
:21:03. > :21:06.surprised that could not find the children. It is not as
:21:07. > :21:10.straightforward as we wished it could be but I cope what thdse
:21:11. > :21:16.changes we will have the chhldren all in one secure area it whll be
:21:17. > :21:21.more straightforward to bring a child to the UK that we havd
:21:22. > :21:25.committed to. Can I thank the Home Secret`ry for
:21:26. > :21:30.her statement and can my right honourable friend tell the house how
:21:31. > :21:38.much the Government has invdsted in reinforcing the border at C`lais?
:21:39. > :21:43.The total package is ?36 million, of which 40 million is for sectrity.
:21:44. > :21:48.That security being in placd in Calais is in our interest to make
:21:49. > :21:51.sure we can predict tourists, truckers, the economy and going
:21:52. > :21:59.about their normal course of business which I hope will be much
:22:00. > :22:03.improved once the camp is cleared. Can the Home Secretary reassure us
:22:04. > :22:09.local authorities will be adequately funded and see how they will be
:22:10. > :22:14.compensated and more import`ntly that adequate accommodation is
:22:15. > :22:17.provided for these children and not institutionalised.
:22:18. > :22:20.The honourable gentleman max be aware the Dubbs Ammendment can only
:22:21. > :22:27.be implemented if local authorities, for what volunteered to takd those
:22:28. > :22:32.children. Subversion local authorities have come forward but we
:22:33. > :22:39.will need more over -- suffhcient local authorities have come forward
:22:40. > :22:46.but we need father places. ,- further places. They are aw`re of
:22:47. > :22:52.the rate weepy and I hope they will consider that adequate compdnsation.
:22:53. > :22:56.-- the rate we pay. I welcome comments on my right
:22:57. > :23:01.honourable friend has made `bout the robustness of the checking process
:23:02. > :23:06.of those eligible to be relocated to the UK because there are legitimate
:23:07. > :23:12.concerns about that. One of the reception centres is in West Sussex
:23:13. > :23:16.and can I have assurances the county council there will indeed gdt back
:23:17. > :23:23.on going support because thdre are already pressures on their budget to
:23:24. > :23:26.ensure this will not, this will be beneficial to those children and not
:23:27. > :23:31.detrimental to others in thd West Sussex.
:23:32. > :23:35.We are always grateful for the generous way in which local
:23:36. > :23:38.authorities come forward and have positively responded to the call we
:23:39. > :23:43.put out. I would particularly like to say thank you to West Sussex
:23:44. > :23:47.fought the good work they h`ve been doing and hosting one of thd
:23:48. > :23:53.dispersal centres and we will work closely with them to ensure that
:23:54. > :23:59.good relationship continues. I have listened closely to the Home
:24:00. > :24:03.Secretary and answers about safeguarding and I ask this question
:24:04. > :24:08.because a social worker got in touch with me to say for the children who
:24:09. > :24:12.have started to enter the country it has been a bureaucratic shalbles.
:24:13. > :24:17.She said social services have been given wrong addresses, wrong,
:24:18. > :24:20.contacts and I would like to ask the Home Secretary how she and her
:24:21. > :24:25.department will urgently ensure the correct provisions are in place to
:24:26. > :24:31.support social services to lake sure that once children are here they do
:24:32. > :24:36.not fall through the cracks. I would just say to her somdtimes we
:24:37. > :24:41.do not have all the information we need. One of the reasons whx the
:24:42. > :24:45.full cohort of nearly 200 Dtblin children has not yet been brought
:24:46. > :24:51.over this because we have not been able to establish where thehr close
:24:52. > :24:55.family members are so it max be on the issue she is drawing attention
:24:56. > :25:01.to the close family members who have been claimed and contacted `re not
:25:02. > :25:08.longer quite as contactable once the local authority is addressing it. I
:25:09. > :25:12.would say to her, this can be a complicated process, it is not
:25:13. > :25:17.always the case the contacts we are given straightforward to follow up
:25:18. > :25:19.on what if she wants to send me a particular example I of course we'll
:25:20. > :25:27.look at that. I thank the Home Secretary `nd the
:25:28. > :25:31.talk of the humanitarian opdration because when I was there in February
:25:32. > :25:37.it was far from humanitarian. Can she confirm again the sheltdr will
:25:38. > :25:46.be sufficient to accommodatd all child refugees if not withott the
:25:47. > :25:49.French authorities accepting... Can the secretary of state trulx
:25:50. > :25:53.safeguard the fact children dispersed across centres across the
:25:54. > :25:55.front they will be accommod`ted and those with whom we have a ldgal duty
:25:56. > :26:04.under Dubbs Ammendment? The only reassurance I can give him
:26:05. > :26:08.is what I've been given by the French. We have asked them that the
:26:09. > :26:14.children are kept in a secure area. It was our request that it should be
:26:15. > :26:19.outside the camp, the tools to do it inside reassuring as they could keep
:26:20. > :26:21.the child and secure. We ard in close contact and we have a large
:26:22. > :26:26.number of Home Office representative there as well as the hundreds of
:26:27. > :26:29.border for staff in the are`. We are hopeful we will be able to lake sure
:26:30. > :26:33.we work closely with them to keep them safe but this is a French
:26:34. > :26:40.responsibility although we `re giving them all the support we can.
:26:41. > :26:43.I welcome very much what thd Home Secretary said today about children
:26:44. > :26:47.but we should remind ourselves it is not only children who require
:26:48. > :26:52.international protection. When I visited Calais at Easter, wd met
:26:53. > :26:57.Afghans and we met Kurds who had been previously granted asylum in
:26:58. > :27:01.the UK before returning homd about to flee a second time and h`d ended
:27:02. > :27:07.up at Calais. While the Homd Office would get that set of keys hn terms
:27:08. > :27:12.of who is appropriate for the UK to take responsibility for? In this
:27:13. > :27:15.case, while the camps are bding demolished, we have made a
:27:16. > :27:19.commitment to take the most vulnerable children and within that
:27:20. > :27:23.cohort of children, the ones who are the youngest and the ones who are
:27:24. > :27:28.vulnerable to sexual exploitation. In terms of other people who may be
:27:29. > :27:31.vulnerable, there may be ond or two who qualify under the Dubs
:27:32. > :27:35.Amendment, but otherwise thdy will need to apply for asylum as a normal
:27:36. > :27:41.case in France. We must stick to the general accepted principle that the
:27:42. > :27:45.apply for asylum in the first country of safety. A number of my
:27:46. > :27:49.constituents have got in totch to express compassion for thosd in the
:27:50. > :27:52.Jungle camp but a number of other people are also worried abott the
:27:53. > :27:56.age of those we are being sden to take. Can the Home Secretarx talk a
:27:57. > :28:00.little bit zero -- more abott the numbers we are projecting on the
:28:01. > :28:05.grounds of age but the comprehensive security package around who we take
:28:06. > :28:10.in the first place? I would like to reassure my honourable friend the
:28:11. > :28:13.best way to assess age is bx using experienced social workers. That is
:28:14. > :28:18.what we are doing in terms of assessing the age on the ground
:28:19. > :28:21.Most of the young people we are talking to, children, miners,
:28:22. > :28:28.whatever you call them, are teenagers. Most of them are
:28:29. > :28:32.teenagers and most of them `re young boys. I still think it's thd right
:28:33. > :28:36.thing to do but I would ask him to be sure his constituents th`t we
:28:37. > :28:41.will always do the proper safeguarding checks to insure they
:28:42. > :28:45.are indeed what they say thdy are. Can I commend the Home Secrdtary and
:28:46. > :28:50.her staff are the efforts she has made in accelerating the process of
:28:51. > :28:53.bringing unaccompanied minors to this country. Can I press on the
:28:54. > :28:59.challenges the local authorhties are pressing? My understanding hs that
:29:00. > :29:03.they... The calling the samd number of limited in time and agencies
:29:04. > :29:08.Does she see a more central role for Government in coordinating the
:29:09. > :29:11.availability of places in the independent sector? He raisds an
:29:12. > :29:15.important point and if that were the case, that would not be a stccessful
:29:16. > :29:18.outcome. A lot of the local authorities are choosing to work
:29:19. > :29:21.together and we have got good examples of good practice where five
:29:22. > :29:27.local authorities are getting together, not competing and making a
:29:28. > :29:31.joint offer. I welcome the Home Secretary's statement. Prior to my
:29:32. > :29:35.election to this place, I rdgularly defended the Home Office in many
:29:36. > :29:39.immigration and asylum cases. It is widely accepted by judges and
:29:40. > :29:42.practitioners that aid assessment of undocumented children is notoriously
:29:43. > :29:45.difficult and not an exact science. The rise in cases in the
:29:46. > :29:50.administrative Court reflect this fact. Will my right honourable
:29:51. > :29:55.friend confirms that dental checks are not the appropriate method for
:29:56. > :30:00.an age assessment and guidance exists in the case law and that the
:30:01. > :30:03.practices of the London boroughs of Croydon which have adopted
:30:04. > :30:09.throughout the country which suggest that listing to the history,
:30:10. > :30:14.observers of behaviour and children getting evidence is a much better
:30:15. > :30:17.indicator rather than physical maturity? I thank my honour`ble
:30:18. > :30:20.friend to that question and I know she has substantial experienced in
:30:21. > :30:24.this field having acted as `n immigration officer are comhng into
:30:25. > :30:29.Parliament. The best way to assess age is by using experienced
:30:30. > :30:33.assessors and we will continue to do that. The British dental Association
:30:34. > :30:38.has said that is not the right way to go, it is not effective,
:30:39. > :30:44.reliable. The best way is to use the type of assessment we are which is
:30:45. > :30:49.based on experience. Wouldn't it be in the best interests of thd asylum
:30:50. > :30:54.seekers and local authoritids if the asylum seekers, especially the
:30:55. > :30:59.children, were located my evenly throughout the country. My local
:31:00. > :31:02.authority copes with 500 each year, the constituencies of the present
:31:03. > :31:07.Prime Minister, the previous Bedminster and the previous
:31:08. > :31:13.Chancellor of the Exchequer take none at all. Obviously, while my
:31:14. > :31:17.local authority is doing very well with this, there are strains on the
:31:18. > :31:24.local services, including the schools and the health servhce. As
:31:25. > :31:29.the new comers and the asyltm seekers will be especially
:31:30. > :31:32.vulnerable and many of them without -- with rice health problems than it
:31:33. > :31:35.can she make sure the money given to local authorities is adequate for
:31:36. > :31:40.the long years for which it will be required? There is a nation`l
:31:41. > :31:43.transfer scheme in order to make sure unaccompanied children are
:31:44. > :31:47.fairly shared around the cotntry. We are urging local authorities to step
:31:48. > :31:51.up and I can say to him that we are getting a very strong response from
:31:52. > :31:55.local authorities. This has gone to the heart of people in the country
:31:56. > :31:58.and local authorities who w`nt to participate and want to help and who
:31:59. > :32:03.believe in this as an endeavour to try and address but we will always
:32:04. > :32:08.need more I will in urge ag`in anyone who think their local
:32:09. > :32:12.authorities can help to urgd them to step forward to do so. The situation
:32:13. > :32:14.is fast-moving but the Home Secretary has said her officials
:32:15. > :32:19.have been hard at work in the last week and have conducted 800
:32:20. > :32:24.interviews. 200 children have been admitted to the UK. For my first
:32:25. > :32:29.question, how many more intdrviews on how many more applications does
:32:30. > :32:33.she expect her staff to process how far through this are away and my
:32:34. > :32:38.second question is, is that ratio of one acceptance to for applications a
:32:39. > :32:47.ratio that we are likely to see continuing? It takes less thme to
:32:48. > :32:53.ask two questions than it took a lot of people to ask one question. I say
:32:54. > :32:58.to my honourable friend that is not quite how it's working out. The 200
:32:59. > :33:02.are largely made up of the Dubs Amendment children for which they
:33:03. > :33:05.have a strong family tie in the UK. About one quarter are made tp of
:33:06. > :33:09.dogs and the balance of the additional children that we will
:33:10. > :33:13.take will be Dubs Amendment children. The 800 who have been
:33:14. > :33:17.interviewed, the not coming to the UK. We are just processing their
:33:18. > :33:21.claims. There will be anothdr 2 0 300 interviews and we hope to beat a
:33:22. > :33:25.figure of a few hundred mord over the next two to three weeks while
:33:26. > :33:28.the camp is being cleared and then we will have done our commitment to
:33:29. > :33:37.the French which we hope will be approximately half the children who
:33:38. > :33:41.were there. A point of order I raised with the greatest reluctance
:33:42. > :33:46.but it is a matter for you Lr Speaker and a matter of somd
:33:47. > :33:52.urgency. You will recall in November 20 15th the Conservative delegates
:33:53. > :33:55.were queried and there was ` debate in this house when this report was
:33:56. > :34:01.made about the selection of delegates. At the time, you rightly
:34:02. > :34:06.said it wasn't your job to hnterfere with the decisions of partids in the
:34:07. > :34:11.whose delegates they say. I believe there is a decision to be m`de a few
:34:12. > :34:14.errors ago and is not only hmproper but possibly illegal. Until the
:34:15. > :34:20.matter can be resolved, I h`ve to send you an e-mail and a letter
:34:21. > :34:23.about what happened. I'm sure it might be a misunderstanding but can
:34:24. > :34:28.I ask you in the meantime to repeat what you did with the Conservative
:34:29. > :34:32.-- Conservative delegates and declined to send the chosen delegate
:34:33. > :34:37.by the Labour Party to the Council of Europe into the matter h`s been
:34:38. > :34:42.resolved? Can I say to the honourable gentleman, I thank him
:34:43. > :34:45.for his point of order. He did come to the chair earlier and sax to me
:34:46. > :34:48.about this matter and I don't dispute that one moment but I have
:34:49. > :34:55.to say to him that I have not yet seen his e-mail and I think it would
:34:56. > :35:00.be prudent for me to study that and to reflect carefully upon the matter
:35:01. > :35:02.and to take advice before pronouncing of course I will
:35:03. > :35:07.remember the sequence of evdnts to which the honourable gentlelan
:35:08. > :35:11.referred if memory serves md, that is principally concerned melbers
:35:12. > :35:15.from the governing party. In this instance, I think the honourable
:35:16. > :35:18.gentleman is concerned about his own party's delegation. I don't
:35:19. > :35:23.interfere in the choice of lembers of the delegation, that is not a
:35:24. > :35:29.matter for me. I do have a responsibility to notify thd
:35:30. > :35:37.Parliamentary assembly of the decision made here. Of course, I
:35:38. > :35:41.wouldn't wish to do anything that was procedurally improper. H will
:35:42. > :35:47.have to satisfy myself that whatever I am being asked or instructed to do
:35:48. > :35:53.is procedurally proper. I whll not be sending any letter until I have
:35:54. > :35:56.so satisfied myself. I hope that is helpful and admitted that dtty, I
:35:57. > :36:01.will study the letter from the honourable gentleman. If thdre are
:36:02. > :36:07.no further point of order, we proceed now to the main bushness,
:36:08. > :36:18.the orders of the day. Health service medical supplies, sdcond
:36:19. > :36:24.reading. I call the Secretary of State for Health, secretary Jeremy
:36:25. > :36:28.Hunt. I beg to move that thd bill is ready second time. This is ` short
:36:29. > :36:34.and focused bill which is vhtally important not only for the NHS but
:36:35. > :36:40.also for patients. NHS spending on medicines is second only to staffing
:36:41. > :36:50.costs. The health and social care information estimated the NHS
:36:51. > :36:55.England spent over... A risd of nearly 20% since 2010. With advances
:36:56. > :36:59.in science and our ageing population, these costs can only
:37:00. > :37:03.continue to grow. Medicines are a vital part of patient care hn the
:37:04. > :37:07.NHS, both in hospitals and community. Thanks to research and
:37:08. > :37:13.development effort of the science industry which can be checkdd -
:37:14. > :37:17.contributes ?56 million to the UK economy every year our understanding
:37:18. > :37:21.diseases and the best way to treat them has improved dramatically over
:37:22. > :37:28.the last 20 years. Who would have thought that UK work pioneering
:37:29. > :37:31.superconducting magnets would result -- result in MRI scanners which
:37:32. > :37:36.would save hundreds of lives each year through the early detection of
:37:37. > :37:39.breast cancer or that the rdmarkable research by our national Institute
:37:40. > :37:43.for health research into translational medicine would lead to
:37:44. > :37:46.scientific breakthroughs in areas such as gene therapy being taken
:37:47. > :37:54.from the lab to the clinic? Any six-year period, this has ldd to
:37:55. > :38:00.340... Generating ?380 millhon. This Government is committed to dnsuring
:38:01. > :38:02.that patients get access to innovative and cost effective
:38:03. > :38:06.medicines as quickly as possible. I want to pay tribute to the work
:38:07. > :38:11.carried out by my honourabld friend, the member from Norfolk, who worked
:38:12. > :38:17.tirelessly to promote this hndustry and to established the access review
:38:18. > :38:21.to provide clear recommendations on how the Government, NHS and industry
:38:22. > :38:25.can work together to ensure patients benefit from transformative new
:38:26. > :38:29.products much more quickly. That review was published today `nd is an
:38:30. > :38:34.excellent document which ch`llenges everyone in the medicine system to
:38:35. > :38:41.up their game. Eric mission is to continue our progress in ensuring
:38:42. > :38:46.patients get rapid... Howevdr, we also need to ensure we are getting
:38:47. > :38:49.the best value for the NHS which is why we bought this -- brought this
:38:50. > :38:55.bill before the house. The purpose of the bill is to clarify modernise
:38:56. > :39:06.provisions to control the cost of health. These provisions will align
:39:07. > :39:09.its statutory and cost control mechanisms currently in existence,
:39:10. > :39:13.although the Government to control the cost of excessively priced on
:39:14. > :39:18.branded generic medicines and ensure we have compared the data whth which
:39:19. > :39:22.to reimburse people who dispense medicines. Taken together, they will
:39:23. > :39:31.enable us to secure better value for money for the NHS and its spend on
:39:32. > :39:37.medicines. I congratulate hhm on this effort. I received a written
:39:38. > :39:43.answer that last year GPs spent ?85 million prescribing paracet`mol 500
:39:44. > :39:46.million grams of personal costs ?19 and asked. I just wonder whdther
:39:47. > :39:52.this bill will enable us to look at those sort of costs and whether that
:39:53. > :39:56.is appropriate? I am very grateful to him of reading that issud because
:39:57. > :39:59.what he is doing, although the measures that he's actually talking
:40:00. > :40:03.about are not directly covered in this bill, he's reminding md how is
:40:04. > :40:08.that the business of getting value for money from our drugs business is
:40:09. > :40:13.everyone's business throughout the NHS. We do know that there hs a huge
:40:14. > :40:17.amount of prescribing of medicines which isn't strictly necess`ry and
:40:18. > :40:23.we had further evidence frol the Cabinet of Royal colleges this
:40:24. > :40:27.morning about that. He makes an extremely important point. This bill
:40:28. > :40:33.is part of the effort to get better value for money from our budget The
:40:34. > :40:39.initiative he talks about are equally important. Further to that
:40:40. > :40:44.question, I can see how the bill will deal with the issue of the
:40:45. > :40:48.branding and that's very welcome but I understand there are thred other
:40:49. > :40:53.areas of concern. The questhon of price delay which I think the
:40:54. > :40:58.competition in markets authority have been looking at and thdn
:40:59. > :41:03.there's this problem of so-called loyalty schemes, all of which are
:41:04. > :41:06.used to artificially inflatd the cost of medicines to the NHS. Will
:41:07. > :41:15.we also deal with those are`s? It will deal with some of the
:41:16. > :41:20.concerns of the honourable gentleman and we will listen to all concerns
:41:21. > :41:27.are raised by members during the progress of the Bill but thd
:41:28. > :41:31.particular issue he raises with Competition and Markets Authority
:41:32. > :41:36.are already doing an investhgation as to the behaviour of
:41:37. > :41:42.pharmaceutical companies in certain situations but what has become clear
:41:43. > :41:47.is that there is a particul`rly unethical and unacceptable practice
:41:48. > :41:54.with respect to drugs companies getting control of generic drugs in
:41:55. > :42:01.which they and a monopoly and raising the prices. There w`s one
:42:02. > :42:06.product whose price increasd 12 000% between two and -- 2008 and 201 and
:42:07. > :42:13.if the price had stayed unchanged the NHS would have spent ?58 million
:42:14. > :42:17.less and the Government's concluded the simplest and quickest w`y to
:42:18. > :42:22.sort this is through legisl`tion. I will happily take as other hssues he
:42:23. > :42:29.raised and look into them. I will happily give way. I welcome
:42:30. > :42:33.the provisions of this bill in terms of closing loopholes and de`ling
:42:34. > :42:38.with these terrible examples were the NHS is essentially being
:42:39. > :42:44.exploited. Could he point to the future with the suggestion that the
:42:45. > :42:47.drugs bill will increase to 20 billion by 2020, a much mord
:42:48. > :42:53.significant increase than projected can afford. What better measures
:42:54. > :42:56.must take place for us to substantively deal with this bigger
:42:57. > :43:06.problem? She is right. We see demand for
:43:07. > :43:10.services including treatments and drugs and that will increasd by a
:43:11. > :43:14.total of around 30 billion over the next five-year period which is a
:43:15. > :43:19.huge amount and more than wd can afford as a country without changing
:43:20. > :43:23.practice and that is why ard implementing a very challenging
:43:24. > :43:29.series of efficiency reforms designed to make sure we can afford
:43:30. > :43:32.to continue current levels of NHS service on its ?10 billion hncrease
:43:33. > :43:38.the Government is putting an end. Part of that is managers like those
:43:39. > :43:44.in this bill to control the drugs bill. -- part of that is me`sures
:43:45. > :43:48.like this. With them that the next 25 years what we are seeing is a
:43:49. > :43:54.bigger issue of the pace of innovation in science acceldrating
:43:55. > :43:57.and that provides great opportunities for the NHS btt
:43:58. > :44:01.potentially great pressures on the budget and we will continue to
:44:02. > :44:09.discuss those issues extenshvely in this house. I will happily give way.
:44:10. > :44:13.What assessment has been made of the impact this bill might have on the
:44:14. > :44:17.parallel trade and pharmacetticals which he will now has both costs and
:44:18. > :44:23.benefits for the NHS and for patient care?
:44:24. > :44:29.I think my honourable friend who obviously knows about these matters
:44:30. > :44:38.in a great deal of detail, should be reassured this bill will stop people
:44:39. > :44:42.who are part of a voluntary scheme parallel importing through Duropean
:44:43. > :44:46.subsidiaries which currentlx under the single market rules we `re not
:44:47. > :44:55.able to stop. That football will be closed. The first element of the
:44:56. > :44:59.bill. -- that loophole. The first element relates to court br`nded
:45:00. > :45:03.medicines. We have had both stature and voluntary with the
:45:04. > :45:11.pharmaceutical companies to limit the cost. Companies can join either
:45:12. > :45:15.scheme. Each voluntary schele lasts around five years before a new
:45:16. > :45:19.scheme is negotiated, the ctrrent voluntary scheme is the 2014
:45:20. > :45:25.pharmaceutical price regulation scheme will stop the objecthves of
:45:26. > :45:29.that agreement include keephng the branded health service medicine bill
:45:30. > :45:34.with an affordable limits while supporting the availability of
:45:35. > :45:40.innovative medicines. For industry this provides companies with the
:45:41. > :45:46.certainty and backing to flourish in the UK and abroad. I will ghve way
:45:47. > :45:50.in the second. The current PPRS operates by requiring participating
:45:51. > :45:54.companies to make a payment to the Department of Health of a pdrcentage
:45:55. > :46:00.of the NHS still be the new web portal sales exceed a certahn amount
:46:01. > :46:03.and that has resulted in 1.2 four billion and payments, all of which
:46:04. > :46:10.has been reinvested for the benefit of patients.
:46:11. > :46:13.The early part of the bill `ppears incredibly torturous becausd it is
:46:14. > :46:21.whether something is under the violent bully a statutory scheme and
:46:22. > :46:25.switching back and forth. -, seems is that because the scheme runs
:46:26. > :46:30.until 2019 and the Government would intent not to renew the schdme then?
:46:31. > :46:35.If the Government looks to consider renewal then why are we havhng these
:46:36. > :46:40.two parallel scheme to complicate the situation?
:46:41. > :46:44.I think the honourable gentleman makes an important point and it will
:46:45. > :46:51.be for this house and the Government to reflect on prior to 2019 whether
:46:52. > :46:55.it is worth carrying on with two separate schemes. This has been the
:46:56. > :47:00.arrangement -- arrangement for many years and essential that wh`t has
:47:01. > :47:05.happened over successive PPRS voluntary agreements is the
:47:06. > :47:10.agreement has, the vast majority of NHS sales and the statutory scheme
:47:11. > :47:12.has been a back-up for people who do not want to participate in the
:47:13. > :47:16.voluntary scheme but what wd have seen recently is an elegant of
:47:17. > :47:21.gaming the system whereby more and more people move away from the
:47:22. > :47:28.voluntary scheme so what thhs bill is doing is removing the incentives
:47:29. > :47:32.for people to switch between one scheme and the other and making the
:47:33. > :47:39.benefits to the NHS essenti`lly the same whichever scheme peopld choose.
:47:40. > :47:43.It will be for this house to reflect and the Government to consider if
:47:44. > :47:49.that dual structure is right. I will happily give way.
:47:50. > :47:52.He tells us the 1.24 billion has come in after the rebate and many
:47:53. > :48:00.are puzzled as to where that has been. Good the Secretary of State
:48:01. > :48:05.tell us? -- could he tell us? It comes back to the Department of
:48:06. > :48:10.Health and is invested throtgh that in the NHS. It would be wonderful if
:48:11. > :48:14.it was more than 1.24 billion because there is a lot of nded in
:48:15. > :48:21.the NHS right now but it is much needed funds but our concern is
:48:22. > :48:24.companies have been exploithng the fact there are differences between
:48:25. > :48:32.the voluntary and statutory schemes and indeed is exploiting a perpetual
:48:33. > :48:38.loop all this bill seeks to close, which is if they have drugs in both
:48:39. > :48:42.schemes we are unable to regulate at all the prices of schemes, of the
:48:43. > :48:46.drugs that would ordinarily fall under the statutory scheme `nd that
:48:47. > :48:51.is why this bill is so important. I will give way.
:48:52. > :48:56.Notwithstanding the object of the bill which I can see are adlirable
:48:57. > :49:01.can he accept hundreds of mhllions of pounds could be saved on the
:49:02. > :49:04.drugs budget if that was better analysis of prescription patterns. I
:49:05. > :49:11.pulled before the apartment analytical pharmacist to look at the
:49:12. > :49:16.balance between efficiency `nd cost and increase the use of bio some of
:49:17. > :49:21.us were hundreds of millions could be saved, perhaps some of that .24
:49:22. > :49:26.billion could be invested in that gritter analysis. Indeed. I think
:49:27. > :49:31.honourable gentleman makes `n important point -- in that gritter
:49:32. > :49:35.and I was. The third part of this bill will mean we have greater data
:49:36. > :49:39.collection to allow those analytics to take place but we also sdek to
:49:40. > :49:45.break down barriers between the pharmacy sector and general practice
:49:46. > :49:49.so we built finance 2000 ph`rmacists additionally to work in gendral
:49:50. > :49:56.practice so we can learn ex`ctly the lessons he talks about. Indded, then
:49:57. > :50:00.I will make some progress. Further to that point about bio some
:50:01. > :50:07.others and welcoming this legislation and the opportunity to
:50:08. > :50:12.create savings -- bio simil`r. Would you use it as an opportunitx to
:50:13. > :50:18.address the issues alone is... He will know the member for Mid Norfolk
:50:19. > :50:21.has already updated the house to set out there are barriers and both
:50:22. > :50:29.domestic and European legislation that prevents the use of thhs drug
:50:30. > :50:33.because it is not licensed but the scale of savings could be so vast I
:50:34. > :50:37.feel there is a case for introducing measures in this bill to allow this
:50:38. > :50:44.issue to be addressed. I am happy to look into that, I
:50:45. > :50:50.believe my own constituents have been affected by that very hssue. I
:50:51. > :50:55.am not aware currently therd would be in the bill for putting hnto that
:50:56. > :50:58.important point but this is a moment when we should reflect on whether we
:50:59. > :51:04.can do everything possible to deal with some of the anomalies hn the
:51:05. > :51:11.drug licensing regime but whth two these unintended consequencds she
:51:12. > :51:15.mentions. -- that lead to the unintended consequences. For those
:51:16. > :51:19.not in the PPRS we have a statutory scheme based boycott the list price
:51:20. > :51:23.of products rather than a p`yment mechanism on company sales. Since
:51:24. > :51:27.the introduction of the reb`te mechanism and the second back the
:51:28. > :51:31.volume of drugs going through it has been lower estimated and thd
:51:32. > :51:36.statutory scheme has delivered more savings than projected and the
:51:37. > :51:41.inequity between the two has led to some companies by vesting product
:51:42. > :51:48.from the PPRS into the statttory scheme, further reducing savings for
:51:49. > :51:50.the NHS. We consulted on iddas to reform the statutory scheme to
:51:51. > :51:57.introduce a payment mechanism similar to that currently placed in
:51:58. > :52:01.the PPRS. Our intentions were to put in place both voluntary and
:52:02. > :52:05.statutory scheme broadly colparable in the savings achieved and
:52:06. > :52:09.companies have the freedom to decide which one to join a move from one to
:52:10. > :52:13.the other depending on the other benefits they offer but it hs our
:52:14. > :52:20.position the savings to the NHS of heart by both schemes should be
:52:21. > :52:24.broadly similar. In responsd to the consultation while NHS respondents
:52:25. > :52:28.supported this the pharmacettical industry queried if the Govdrnment
:52:29. > :52:32.have powers to introduce thd statutory payment system so
:52:33. > :52:36.following a legislative revhew an amendment should be made to clarify
:52:37. > :52:40.existing powers to make cle`r the Government does have the power to
:52:41. > :52:44.introduce a payment mechanism in the statutory scheme. The bill does this
:52:45. > :52:50.by clarifying existing provhsions in the NHS act 2006 to put beyond doubt
:52:51. > :52:55.we can introduce a payment lechanism in statutory scheme. Also alends the
:52:56. > :53:00.NHS act 2006 so it contains essential provisions for enforcement
:53:01. > :53:04.action, payment due under ehther a future voluntary scheme will be
:53:05. > :53:07.recoverable through the courts if necessary and this would include
:53:08. > :53:12.power to recover payments dte from any company that leaves one scheme
:53:13. > :53:15.to join the other. The powers to control the cost of medicind
:53:16. > :53:20.proposed in this bill adding modest addition to the powers alre`dy
:53:21. > :53:23.provided for in the 2006 act to control the price of profit
:53:24. > :53:27.associated with medicines used by the health service. However, they
:53:28. > :53:31.are necessary to ensure the Government have the scope and
:53:32. > :53:34.flexibility to respond to changes in the commercial environment. The
:53:35. > :53:38.intended application of the powers will be set out in regulations and I
:53:39. > :53:42.can assure the house we will provide a list of the regulations to
:53:43. > :53:48.reassure the house we will be fair and proportionate in exercising the
:53:49. > :53:54.powers. I am happy to give way. I voted for the build ten ydars ago
:53:55. > :53:56.but I have to say to the Secretary of State, particularly for `
:53:57. > :54:02.Conservative Government, proper controls is pretty Draconian and
:54:03. > :54:08.this -- proper controls and less Government appears to be extending
:54:09. > :54:13.buzz whereas historically the way we have dealt with this is through
:54:14. > :54:19.taxation, such as the windf`ll tax on backpacks and so on. But the
:54:20. > :54:23.Secretary of State is now proposing something which would be loved by
:54:24. > :54:30.the Leader of the Opposition, to extend profit controls to a big part
:54:31. > :54:37.of the economy. Two is soci`list like me it seems a bit
:54:38. > :54:44.counterintuitive for a Consdrvative to do this. A rock march into the
:54:45. > :54:48.centre ground continues. -- a rock march into the centre ground. Can I
:54:49. > :54:53.reassure the honourable gentleman for his interesting points but we
:54:54. > :54:58.will be very fair and proportionate in our approach. It is not `bout
:54:59. > :55:01.bringing in widespread profht controls and it is important to see
:55:02. > :55:08.we recognise the incredibly important role of the pharm`ceutical
:55:09. > :55:14.industry in medical advance and we want Britain to be the European
:55:15. > :55:18.Central of operations post-Brexit and many people in this house have
:55:19. > :55:23.campaigned on an issue of ddmentia and we are hopeful of a curd,
:55:24. > :55:30.possible in this country. Wd recognise profits are what defines
:55:31. > :55:36.the research to make these remarkable change is possible. I
:55:37. > :55:41.will conclude this point. However, it is important for us to bd able to
:55:42. > :55:49.see what profits are being generated by the company's choice as to
:55:50. > :55:54.whether they use the PPRS scheme of the statutory scheme, as a clue as
:55:55. > :55:59.to whether they are being f`ir in their approach with respect to the
:56:00. > :56:05.NHS and that is why the measures in this bill strike the right balance.
:56:06. > :56:14.I hope there is a reassuring underside of the house is not rather
:56:15. > :56:21.than does the other side. Would he take this opportunity to st`te even
:56:22. > :56:24.further the great contributhon the pharmaceutical industry makds not
:56:25. > :56:28.just in this country that as a global player and as he rightly says
:56:29. > :56:33.that the profit motive -- motive is an important part in ensuring the
:56:34. > :56:37.competition will also mean that we can have this sort of reforls and
:56:38. > :56:40.the sort of new drugs that will transform the lives of us btt also
:56:41. > :56:47.future generations in the ydars to come? I am very happy to give that
:56:48. > :56:51.reassurance. As I said earlher, this is an industry that contribttes ?56
:56:52. > :56:57.billion to the UK economy, tens of thousands of jobs. When the Prime
:56:58. > :57:02.Minister is talking about where she she sees our competitive advantage,
:57:03. > :57:06.she talks about financial sdrvices and the very next industry she talks
:57:07. > :57:10.about is the sciences industry. I completely agree with my honourable
:57:11. > :57:13.friend about its incredible importance, not just to this country
:57:14. > :57:19.but to the future of humanity. That is why I am sitting in this Bill to
:57:20. > :57:24.establish a fair relationshhp between the NHS, which we h`d to
:57:25. > :57:27.represent as we are finding it to the tax system and the
:57:28. > :57:32.pharmaceutical industry, I think it is also fair to say that thdre have
:57:33. > :57:36.been times when some practices by some pharmaceutical companids have
:57:37. > :57:40.been disappointing and is bdcause we want to make sure that doesn't
:57:41. > :57:45.happen and that we can conthnue with harmonious relationships th`t we are
:57:46. > :57:50.proposing this bill to the house. I will give way and then I will make a
:57:51. > :57:53.little bit of progress. I thank the Secretary of State for giving way,
:57:54. > :57:57.he has been very generous whth his time. This isn't about profhts
:57:58. > :58:01.control, it's about having ` fair return for investment. This is about
:58:02. > :58:07.a business model that is emdrging that could be seen as profiteering.
:58:08. > :58:12.Yes, he's right. Effectivelx, denies with betting is that we are closing
:58:13. > :58:16.a loophole. If one was being less polite, one might say there is a
:58:17. > :58:21.shame having to do that. I think it is nonetheless important to do what
:58:22. > :58:25.we are proposing to the house. We do recognise that has been somdtime
:58:26. > :58:29.since consulted on the options and I would like to reassure honotrable
:58:30. > :58:35.members and those companies in the statue test team that we will
:58:36. > :58:43.confirm the implementation of a mechanism... We estimate th`t 1
:58:44. > :58:48.companies would be affected by the instruction of the payment lechanism
:58:49. > :58:51.with a companies who are melbers of the PPR is not affected. Our
:58:52. > :58:57.proposals would save the he`lth service across the UK an estimated
:58:58. > :59:03.?90 million a year. I now ttrn to the second key element of this bill
:59:04. > :59:06.which amends the NHS 2006 to strengthen the Government's power to
:59:07. > :59:10.set prices of medicines where companies charge unreasonably high
:59:11. > :59:14.prices for unbranded generic medicines. We rely on competition in
:59:15. > :59:22.the market to keep the prizd of these drugs down. This generally
:59:23. > :59:25.works well and has in combination of lead to significant savings. We are
:59:26. > :59:29.aware in some instances where there is no competition to keep rhses down
:59:30. > :59:31.and companies have raised their prices to what looks like an
:59:32. > :59:36.unreasonable and unjustifiable level. As highlighted by thd Times
:59:37. > :59:40.investigation earlier this xear there are companies who appdar to
:59:41. > :59:45.have made it in their busindss model to purchase medicines for which
:59:46. > :59:50.there are no competitive products. They then exploit a monopolx
:59:51. > :59:53.position to raise prices. Wd cannot allow this practice to conthnue
:59:54. > :59:58.unchallenged. My department has been working closely with the colpetition
:59:59. > :00:02.markets authority to alert them to any cases where there may bd market
:00:03. > :00:06.abuse and provide evidence to support this. We also need to tackle
:00:07. > :00:12.this with an error-free micro-and the costs of medicines and close the
:00:13. > :00:16.loophole of the branding medicines. While the Government's existing
:00:17. > :00:18.powers allow to control the price of any health service medicine, the
:00:19. > :00:22.current terrorist to not allow controls to be placed on unbranded
:00:23. > :00:28.generic medicines where companies are members of the voluntarx PPI ice
:00:29. > :00:36.cream. Most companies have ` mixed portfolio of branded and unbranded
:00:37. > :00:41.generic medicines. For this reason, they are able to use the pe`k PRS
:00:42. > :00:45.membership to avoid Governmdnt control of their prices. It should
:00:46. > :00:49.be said this practice is not widespread. However, there `ppears
:00:50. > :00:52.to be a handful of companies who are exploiting our freedom of pricing
:00:53. > :00:56.for unbranded generic medichnes where there is no competition in the
:00:57. > :00:59.market, leading NHS no choice but to purchase the medicine at grossly
:01:00. > :01:06.inflated prices or to transfer patients to other medicines which
:01:07. > :01:09.are not always suitable. Many in the industry would also like to see this
:01:10. > :01:14.inappropriate behaviour stalped out. I give way to my right honotrable
:01:15. > :01:17.friend. I very much agree whth the point is just made. He talks about
:01:18. > :01:21.collaboration with the compdtition markets authority and can hd give
:01:22. > :01:25.any indication as to whether he expects any action to be taken in
:01:26. > :01:27.terms of abuse in the marketplace, given that there is a small memory
:01:28. > :01:35.of companies who have behavdd appallingly? I can't give you that
:01:36. > :01:39.indication as he will know that they operate completely independdntly. I
:01:40. > :01:44.don't know what their findings are going to be. I would support any
:01:45. > :01:48.action that the recommended. I do think this bill can be therd's some
:01:49. > :01:52.security in the house that hf they are unable to find evidence and in
:01:53. > :01:56.specific cases that they got in front of them, we will be able to
:01:57. > :02:01.take action as the Government providing the house is willhng to
:02:02. > :02:11.support this bill. My right honourable friend.
:02:12. > :02:17.How does it compare to thosd in other health services by other
:02:18. > :02:27.health providers in western European countries? We have made somd
:02:28. > :02:34.assessment of those. Essenthally, our concern is that even without
:02:35. > :02:39.comparison to what's happenhng in other countries, this is
:02:40. > :02:41.unreasonable behaviour. I mdntioned one example to the honourable
:02:42. > :02:46.gentleman other side of the house earlier, there is another one I can
:02:47. > :02:53.give him which is that the price has increased between 2011 and 2016 by
:02:54. > :02:58.3000 600%. I just don't think we can justify that. Given that we want to
:02:59. > :03:01.have strong harmonious positive relationships between the NHS and
:03:02. > :03:05.pharmaceutical industry, we just need to eliminate the possibility of
:03:06. > :03:10.that kind of behaviour happdning going forward. This bill amdnds the
:03:11. > :03:12.NHS act 2006 to allow the Government to control the prices of thdse
:03:13. > :03:21.medicines even when the manufacturers members part of this
:03:22. > :03:26.voluntary scheme. We only whll use this power when charging at an
:03:27. > :03:31.unreasonably high price. Thd representative body are also keen to
:03:32. > :03:35.look at how we exercise this power. I now turn to the final elelent of
:03:36. > :03:39.the bill which will strengthen the Government's powers to gathdr
:03:40. > :03:43.information on the costs of medical supplies and other related products
:03:44. > :03:47.across the supply chain frol factories to those who supply
:03:48. > :03:50.medicines to patients. We ctrrently collect information on the cell and
:03:51. > :03:55.purchase of medicines from various parts of the supply chain under
:03:56. > :03:59.various arrangements and very range of specific purposes. Some of these
:04:00. > :04:02.arrangements are voluntary while others are statutory. The bhll will
:04:03. > :04:06.streamline the existing information requirements in the energy `ct 006
:04:07. > :04:11.relating to controlling the cost of health care products. It will enable
:04:12. > :04:15.the Government to make regulations for all those involved in the
:04:16. > :04:21.manufacturing distribution of health service medicines, medicine lies or
:04:22. > :04:28.other related products to rdcord and provide information on sales and
:04:29. > :04:32.purchase. The reimbursement of community pharmacies and GPs,
:04:33. > :04:35.determining the value for money supply chain of products and
:04:36. > :04:40.controlling the cost of medhcines. This will enable the Governlent to
:04:41. > :04:43.pick the current voluntary arrangement with manufacturdrs and
:04:44. > :04:48.wholesalers and unbranded J`ck medicines are manufactured specials
:04:49. > :04:50.on the statutory footing. As the arrangements are voluntary, they
:04:51. > :04:57.don't cover all products and companies which limits the
:04:58. > :04:59.robustness of the reimburselent A fitting for data collection is
:05:00. > :05:06.important to the Government can run a request... I know some colleagues
:05:07. > :05:09.have raised concerns about the implications of funding dechsions to
:05:10. > :05:12.community pharmacies and I want to reassure the house that this bill
:05:13. > :05:16.does not impact on those decisions, nor does it remove the requhrement
:05:17. > :05:19.for consultation with the representative body of pharlacy
:05:20. > :05:23.contractors on their funding arrangement in the future. However,
:05:24. > :05:28.the information will give slall data on which to base those disctssions
:05:29. > :05:30.and decisions rather than rdlying on data only available to us under
:05:31. > :05:34.voluntary schemes and arrangements. The information would also dnable
:05:35. > :05:39.the Government to obtain information from across the supply chain to
:05:40. > :05:43.assure itself the supply ch`in or parts of it is delivering v`lue for
:05:44. > :05:46.money for any cheese patients and the taxpayer, something we cannot do
:05:47. > :05:54.with our existing fragmented detail. I am happy to give way. Would buy
:05:55. > :05:58.right honourable friend be giving consideration to asking pharmacists
:05:59. > :06:02.who can prepare their own mddicines which would save the NHS trdmendous
:06:03. > :06:06.amounts of money will you bd considering that in the overall
:06:07. > :06:13.scheme of getting some information on the medicines that you are
:06:14. > :06:17.providing? It may be the case that the information that we collect
:06:18. > :06:22.makes it possible for us to do more robust analysis on issues lhke the
:06:23. > :06:26.one that she rightly brings to the attention of the house. Even if it
:06:27. > :06:29.doesn't, I think this is an issue we should consider and I'm verx happy
:06:30. > :06:33.to write back to her to see whether we can make more progress in that
:06:34. > :06:38.area. I would also like to reassure the house of the application of this
:06:39. > :06:42.information power to the medical technology industry. Over 98% of the
:06:43. > :06:47.company's supplying technology medicines. Their products m`y be
:06:48. > :06:51.less high profile at the latest cancer medicines but no less
:06:52. > :06:54.innovative are vital for patients. We have no interest in plachng
:06:55. > :06:59.additional burdens on these companies. The 2006 act alrdady
:07:00. > :07:03.provides power for the Government to require suppliers of medical
:07:04. > :07:07.technologies to keep and provide information on almost any aspect of
:07:08. > :07:10.their business. This bill whll clarify and modernisers powdrs and I
:07:11. > :07:15.am committed to exercising them in a way which is fair and proportionate
:07:16. > :07:18.to companies to the NHS and to the taxpayer who rightly demand value
:07:19. > :07:23.for money from the supply chain Companies are currently reqtired to
:07:24. > :07:26.hold information on income sales for six years for tax purposes. We work
:07:27. > :07:30.closely with the industry to ensure the requirement to keep and record
:07:31. > :07:37.data does not militantly increase this burden. My officials h`ve
:07:38. > :07:40.already been in discussion for both medicines and medical devicds about
:07:41. > :07:46.these powers to ensure their implementation is robust and
:07:47. > :07:52.proportionate and will provhde us to debate on these provisions. I want
:07:53. > :07:55.to reassure colleagues that a consultation will take placd on the
:07:56. > :08:01.regulations specify the information requirements. I would also like to
:08:02. > :08:03.thank ministers and evolve administrations further constructive
:08:04. > :08:06.input and engagement with mx department with respect to the Bill
:08:07. > :08:10.provisions. Whilst many of the provisions in the Bill are reserved
:08:11. > :08:12.in relation to Scotland and Wales, there are some information
:08:13. > :08:17.requirements which currentlx apply to England only but could also apply
:08:18. > :08:21.in the territories of the ddvolved illustrations. We intend to propose
:08:22. > :08:24.amendments to the builder of the agreement between the Government and
:08:25. > :08:27.evolve demonstrations to th`t information from wholesalers and
:08:28. > :08:31.manufacturers can be collected by the Government for the whold of the
:08:32. > :08:36.UK and shared with the devolved administrations. This avoids the
:08:37. > :08:39.burden created by each country creating the same information. The
:08:40. > :08:44.Welsh Government has also asked me to enable them to maintain
:08:45. > :08:46.information from dispensing GPs a power the Scottish Government and
:08:47. > :08:50.Northern Ireland accepted already have. The Government will propose an
:08:51. > :08:53.amendment to the bill to allow the NHS Wales act so that Welsh
:08:54. > :09:01.ministers can obtain inform`tion from pharmacists and dispensing GPs.
:09:02. > :09:05.In conclusion, Madam Deputy Speaker, medicines are a vital part of the
:09:06. > :09:10.treatment provided by our NHS, robust cost control and information
:09:11. > :09:15.requirements are a key tools to ensure NHS spending on medicines
:09:16. > :09:19.across the UK continues to be affordable whilst delivering better
:09:20. > :09:22.value for taxpayers and freding up resources with support access to
:09:23. > :09:26.services and treatments. Thhs bill will ensure there is a more level
:09:27. > :09:30.playing field between an medicines pricing schemes whilst ensuring that
:09:31. > :09:36.decisions made by the Government are based on a more accurate and robust
:09:37. > :09:41.information about medicine costs. Fear for industry, serif ph`rmacies
:09:42. > :09:46.and affair of the NHS, serif patient and fairer for taxpayers, I commend
:09:47. > :09:52.this bill to the house. Stexn the question is at the bill may be read
:09:53. > :09:56.a second time. Thank you Madam Deputy Speaker. I would likd to
:09:57. > :09:59.thank the Secretary of Statd for outlining the overarching principles
:10:00. > :10:06.of this bill which, seek to allow the NHS to better control the
:10:07. > :10:12.medicine. Subject to blatant abuses in recent years. I would also like
:10:13. > :10:16.to thank the Minister for t`king the time to set out what the Government
:10:17. > :10:20.is seeking to achieve with this bill. I only hope this incrdased
:10:21. > :10:26.appetite for state intervention will spread more widely across
:10:27. > :10:32.Government. As we've heard from the Honourable member for Wolverhampton,
:10:33. > :10:35.south-west, the anti-business interventionism, I would never
:10:36. > :10:39.thought I would say this but I believe the Secretary of St`te is
:10:40. > :10:46.now a fully fledged Corbin Daster having said would he said today In
:10:47. > :10:51.all seriousness, it is clear the market isn't serving patient or the
:10:52. > :10:56.taxpayers. Expenditure on mddicines is a significant and growing
:10:57. > :11:02.proportion of the NHS budget standing at ?15.2 billion in 20 5,
:11:03. > :11:08.2016, an increase of over 20% since 2000 11. If the whole of thd NHS had
:11:09. > :11:12.seen such an increase doing the same period. The incredible advances in
:11:13. > :11:16.science in recent decades often led by companies here in Britain mean
:11:17. > :11:19.that people in this country are in leading longer, healthier lhves than
:11:20. > :11:23.we've ever seen before. While we celebrate this, it is also right
:11:24. > :11:25.that we secure value for money for the NHS to ensure as many p`tients
:11:26. > :11:39.as possible can Can I declare interest as a type two
:11:40. > :11:45.diabetic that 10% of the expenditure of the NHS budget is one di`betes
:11:46. > :11:51.complications therein. Does he agree with me there may well be a desire
:11:52. > :11:57.to prescribe more medicines which will cost more rather than providing
:11:58. > :12:03.diabetics with structured education which, if used, can bring about the
:12:04. > :12:08.cost of diabetes to the NHS. So it is not just about pills.
:12:09. > :12:14.I pay tribute to the great work he does and diabetes and it is a map
:12:15. > :12:19.and he consistently raises `nd is right to do so. There are m`ny ways
:12:20. > :12:23.the diabetes Bill can be tackled and some of the statistics I have seen
:12:24. > :12:27.about the level of take-up of education courses is somethhng we
:12:28. > :12:32.can do much better on. Turnhng back to the bill, we are supporthve of
:12:33. > :12:35.the broad aims of what the Government are trying to achieve but
:12:36. > :12:42.have a number of concerns I hope the Minister will address. Both about
:12:43. > :12:46.what is in the bill and the Government's policies more widely on
:12:47. > :12:50.access to treatment. The technical mechanisms used to control
:12:51. > :12:55.expenditure on medicines have not historically been the subject that
:12:56. > :12:59.has set the public's imagin`tion alight but in June we bar all our to
:13:00. > :13:05.read reports a small number of companies exploited the polls to
:13:06. > :13:10.hike the patient -- hike thd price of medicines. We sold storids of
:13:11. > :13:19.treatment being denied to p`tients on the basis of cost. That we saw
:13:20. > :13:25.stories. There are two currdnt schemes operated the control and
:13:26. > :13:31.pricing, the voluntary PPRS which applies to the vast majoritx and the
:13:32. > :13:37.statutory scheme which in 2014, around 6% branded medicine sales in
:13:38. > :13:42.the UK. The PPRS is based on making payments from companies back to the
:13:43. > :13:47.NHS based on their sales of medicines to the NHS, while the
:13:48. > :13:51.statutory scene operates on a cut to the price of branded medicines.
:13:52. > :13:55.These approaches appear to produce different results. Since 2004 the
:13:56. > :14:02.statutory scheme delivered significantly lower savings than the
:14:03. > :14:06.PPRS as companies are switching into the statutory scheme which hs why we
:14:07. > :14:12.saw a reduction in the level of the rebate. We support the rationale
:14:13. > :14:17.between lining the look-mac aligning the two schemes to deliver ` better
:14:18. > :14:23.level of savings to the taxpayer. As we heard, this bill extends beyond
:14:24. > :14:26.more than that and adds a ndw provision giving the secret`ry of
:14:27. > :14:29.state the power to require `ll medicine manufacturers and suppliers
:14:30. > :14:35.to provide information relating to prices. I certainly will.
:14:36. > :14:40.He will know and we all well there is a difference between the list
:14:41. > :14:47.price that is advertised and the price the NHS actually pays. We must
:14:48. > :14:56.be careful and that is a very important point, it does brhng the
:14:57. > :15:00.cost down for the NHS and those companies may well charge other
:15:01. > :15:06.people higher prices and we must take that into context.
:15:07. > :15:10.He is absolutely right and that is one of the reasons we need to tread
:15:11. > :15:13.carefully and hear what the Government come forward with in
:15:14. > :15:19.terms of regulations they whll be consulting on in due course. Because
:15:20. > :15:22.some of these measures do not form part of the initial consult`tion and
:15:23. > :15:26.there is a feeling some of the things were added at the last minute
:15:27. > :15:30.and giving the cuts to the community pharmacy sector announced l`st week
:15:31. > :15:39.there is anxiety out there `bout what costs could be created by an
:15:40. > :15:41.additional administrative btrden. Does my honourable friend agree
:15:42. > :15:46.pharmacists of them know thdir patients much better than
:15:47. > :15:49.overstretch GPs and can advhse on prescription of appropriate and
:15:50. > :15:52.cheaper drugs and does he also agreed instead of putting more
:15:53. > :15:56.pressure on the pharmacy sector the Minister should support thel to
:15:57. > :16:03.reduce the burden on GPs and help the NHS save money?
:16:04. > :16:08.She is absolutely right, thdre is concern about the announcemdnt last
:16:09. > :16:12.week and we know from survexs taken but approximately one in fotr
:16:13. > :16:16.people, and using pharmacists would go to the GP if they were unable to
:16:17. > :16:23.see pharmacy for advice and we know the pressures surgeries are under so
:16:24. > :16:27.we will have to watch careftlly the impact of those proposals and
:16:28. > :16:33.hopefully they will not be `s serious as a number of membdrs have
:16:34. > :16:37.expressed concern on. The ilpact assessment that talks about these
:16:38. > :16:41.proposals does not offer us too many clues, it says that in terms of the
:16:42. > :16:46.additional cost that could be in card they have not been quantified
:16:47. > :16:54.as their magnitude will not be known until subs regulations. We need to
:16:55. > :17:03.tread carefully on these. -, until subsequent regulations. This is a
:17:04. > :17:08.far from perfect state of affairs and when the bill reaches committee
:17:09. > :17:13.we will get further clarity. He has been fair in his bro`d
:17:14. > :17:20.analysis of the problems we face between the statutory and voluntary
:17:21. > :17:26.schemes and in many ways it is a lesson that is statutory scheme can
:17:27. > :17:29.often be gained by industry. Is it encouraged the Association of
:17:30. > :17:34.pharmaceutical industries are very supportive of what is being proposed
:17:35. > :17:36.and want to work with the sdcretary of state and this is such that we
:17:37. > :17:41.can hopefully get something that will work for the future rather than
:17:42. > :17:49.being a Draconian recommend`tion through from Richmond house?
:17:50. > :17:54.I thank the member and I wotld agree it is important we keep dialogue
:17:55. > :17:57.open with industry because we are proud of the pharmaceutical industry
:17:58. > :18:01.and what they can deliver, ht is a world leader and we do not want to
:18:02. > :18:05.throw the baby out with the bath water. The Government will be aware
:18:06. > :18:08.concern has been expressed by the medical technology sector that
:18:09. > :18:14.medical supplies Artie brought under this regime designed to tackle
:18:15. > :18:18.tackle problems in the pharmaceutical industry and express
:18:19. > :18:22.concerns measures in this bhll will put additional burden on th`t sector
:18:23. > :18:27.and could lead to overall hhgher costs so we welcome assurances from
:18:28. > :18:32.the Secretary of State 99% of businesses that are small or medium
:18:33. > :18:39.will not be unduly troubled by others reporting requirements and we
:18:40. > :18:44.will cope in further detail. -- onerous reporting requirements. It
:18:45. > :18:50.was reportedly estimated income from PPRS and 2016-17 would be ?418
:18:51. > :18:54.million, in considerable reduction from the and 2015 and win the
:18:55. > :19:00.overall drugs bill is incre`sing its sales of the scheme is not going to
:19:01. > :19:03.plan -- when the overall drtgs bill is increasing. It is said the
:19:04. > :19:09.savings would be about ?90 lillion per year for the NHS. Let us
:19:10. > :19:12.consider whether this bill can address this. One of the benefits we
:19:13. > :19:17.have heard is the bill would close down the football would lead to
:19:18. > :19:27.extortionate prices for a ntmber of drugs. -- closed down the loophole.
:19:28. > :19:31.Small number of companies stch as a drug, remove the brand name, taking
:19:32. > :19:37.them out of the current pricing controls and then pick up the price
:19:38. > :19:42.by many hundreds or even thousands of percent. Some companies lake this
:19:43. > :19:47.strategy a key part of the business model and we have seen in this house
:19:48. > :19:51.exposing some of the worst dxcesses of capitalism, for Mike Ashley and
:19:52. > :19:55.his employment practices to Philip Green. That should be a special
:19:56. > :19:59.category for those who make themselves extremely wealthx by
:20:00. > :20:02.using loopholes in the law to prey on the set of vulnerable and extract
:20:03. > :20:10.obscene profits from the he`lth service. -- on the set and
:20:11. > :20:15.vulnerable. The small number of companies raise the costs of
:20:16. > :20:19.medicines by ?262 million a deal through this practice. When a US
:20:20. > :20:23.pharmaceutical company raisd the price of HIV medication people
:20:24. > :20:27.across the world united in condemnation but it is less well
:20:28. > :20:32.known we have seen the pricd of over 200 medicines more than double in
:20:33. > :20:38.this country with 32 rising by more than 1000% and in one case `n
:20:39. > :20:47.unbelievable increase of 12 and a half thousand percent. -- 12,50 %.
:20:48. > :20:51.We can look at the company website, one of those it was sold to a
:20:52. > :20:57.private equity company for ?367 million on top of commercialising
:20:58. > :21:04.the nation generic medicines. Another of those companies which
:21:05. > :21:09.owns others is open about the fact it, specialises in the acquhsition,
:21:10. > :21:13.licensing and development of oft repeated medicines which max be
:21:14. > :21:18.niche hard to make products. This sounds like a noble pursuit but we
:21:19. > :21:23.know that can't be code for establishing and abusing a dominant
:21:24. > :21:27.market position -- that can decode. I will give way. -- that can be a
:21:28. > :21:32.cold. This bill the powers of the
:21:33. > :21:36.Secretary of State to effectively confiscate profits through that
:21:37. > :21:40.rather than taxation can attempt my honourable friend to a tree might be
:21:41. > :21:47.worth looking at in relation to a company like Google and who has
:21:48. > :21:50.aided by percent of the world Mobile operating systems, that is `
:21:51. > :21:54.dominant market position whdre there are question marks over thehr
:21:55. > :22:02.taxation and some others profit confiscation could be looked at as
:22:03. > :22:08.well. -- some of the sprockdt. I like them but this is way ottside my
:22:09. > :22:13.brief but I know or health service enters into partnership with Google
:22:14. > :22:17.so I hope ministers ask questions about the taxation arrangemdnts We
:22:18. > :22:21.ignore the vast majority of the generic sector is well controlled by
:22:22. > :22:26.competition and delivers value for money. We welcome the extension of
:22:27. > :22:31.price controls were competition has failed. I would ask the Minhster
:22:32. > :22:37.without he is confident this step alone will be successful, as we have
:22:38. > :22:41.seen how adept International companies can be with moving figures
:22:42. > :22:47.are bound to avoid taxation and we want to avoid this being vulnerable
:22:48. > :22:52.to the gaming we have seen elsewhere. I do not believe, given
:22:53. > :22:57.the vast sums of money at stake these companies will simply stored
:22:58. > :23:03.their shoulders and take thd hit, if the town of order. I was concerned
:23:04. > :23:07.when I read something about this bill which said, in the past the
:23:08. > :23:09.Department of Health would sit informal negotiations with
:23:10. > :23:13.manufacturers were that was pricing issues and we believe this will
:23:14. > :23:17.remain. This notion brings tp uncomfortable memories of the
:23:18. > :23:21.sweetheart deals between multinationals and each MRC and
:23:22. > :23:24.while I am happy fortunes of communication with these colpanies
:23:25. > :23:28.we would like the assurance in all cases prices will be regulated
:23:29. > :23:33.through a transparent and formal process and not behind the scenes
:23:34. > :23:41.talks. If in a feud gives it becomes clear... I certainly will. H want to
:23:42. > :23:44.ask my honourable friend whdre the advertising budgets of
:23:45. > :23:47.pharmaceutical companies dw`rf their research and development budget is
:23:48. > :23:51.that not an argument for thd Government looking again at the tax
:23:52. > :23:54.position of those companies as well as the price position of thd
:23:55. > :24:02.products? I thank my honourable friend for his
:24:03. > :24:07.intervention. I do not like we will get very far with this Government on
:24:08. > :24:10.corporation tax and they have gone in a direction we probably not could
:24:11. > :24:14.them as the opposition and they decide that this is the best way to
:24:15. > :24:21.control prices and see how we get on. I would ask the Minister in the
:24:22. > :24:25.can confirm if it becomes clear in a few years we have open up another
:24:26. > :24:29.set all the polls whether wd can accept the department to be
:24:30. > :24:34.proactive in their investig`tions rather than lying relying on
:24:35. > :24:38.journalists to expose it. -, in another set of loopholes. In
:24:39. > :24:43.Scotland than the big gener`ted was used to create a dedicated fund to
:24:44. > :24:47.get patients access to new ledicines and, as the Minister to invdstigate
:24:48. > :24:52.a similar model and ensure the benefits of the scheme are tsed for
:24:53. > :24:58.improving our poor records `nd allowing patients to benefit from
:24:59. > :25:01.new medicines. We accept thdre will always be challenges in matching
:25:02. > :25:09.funding to new drugs but thdre is at least logic allowing savings to be
:25:10. > :25:14.reinvested. We welcome the report today which sets out an ambhtious
:25:15. > :25:18.plan which could see patients accessing new life-saving treatment
:25:19. > :25:22.up to format years more quickly and I hope the Minister will give
:25:23. > :25:27.financial backing to the review by using future rebates from the
:25:28. > :25:30.pharmaceutical sector to improve access to treatments. I askdd the
:25:31. > :25:34.Government to seriously consider this as a growing concern about
:25:35. > :25:37.access to new treatments and particularly widening gulf between
:25:38. > :25:43.our record of developing new drugs and the ability of the NHS to ensure
:25:44. > :25:45.all patients sufficiently bdnefit. The international comparisons of
:25:46. > :25:53.health technology reports ptblished in August by breast cancer now and
:25:54. > :25:56.Prostate Cancer UK shows thd NHS and cancer patients miss out on
:25:57. > :26:01.innovative treatments incomparable countries of similar wealth and at
:26:02. > :26:09.the same time a number of mddicines have been delisted by the c`ncer
:26:10. > :26:16.drugs and after that overspdnt. There was also another report in
:26:17. > :26:21.July entitled A Pill Too Hard To Swallow, How The Nhs Is Limhting
:26:22. > :26:28.Access To High-priced Drugs. Is sent to similar conclusions about drugs
:26:29. > :26:33.which give possible to elimhnate HIV.
:26:34. > :26:39.We have to be very careful that we don't encourage drug companhes to
:26:40. > :26:45.research into those areas bdcause they would not see that fin`ncial
:26:46. > :26:49.return for them. I thank my honourable friend for the
:26:50. > :26:54.intervention. He is right. We must the very careful with the
:26:55. > :26:57.consequences of this piece of legislation and, again, we know that
:26:58. > :27:02.there will be decisions takdn in terms of investment of -- if the
:27:03. > :27:05.return is not sufficient. Wd have to get the balance right betwedn
:27:06. > :27:11.encouraging investment and getting value for money for the taxpayer.
:27:12. > :27:16.Madam Deputy Speaker, the rdport showed how NHS England have been
:27:17. > :27:23.unable to budget for broad `ccess to drugs. When it failed, rationed
:27:24. > :27:27.access to those drugs. Therd was also widespread controversy over
:27:28. > :27:32.attempts by NHS England to `void funding the anti-HIV by passing on
:27:33. > :27:36.responsibility to local authorities at the same time of cutting the
:27:37. > :27:40.public health budget allocated to councils. If we are to strike -
:27:41. > :27:44.strives to create a level playing field, we should look to thd scene
:27:45. > :27:53.for patients and their abilhty to access treatments. When Labour
:27:54. > :27:58.established... An order was made by Parliament in 2001 to mandate
:27:59. > :28:03.through its technical apprahsal process. They were intended to be
:28:04. > :28:14.available to patients three months after publication of the appraisal
:28:15. > :28:19.full. This has culminated in the. As well as looking at Wingfield fencing
:28:20. > :28:23.the payments, there are also asked to look more widely. Successive
:28:24. > :28:27.studies have demonstrated how there is a relatively low take-up by the
:28:28. > :28:32.UK compared to other high income countries. Not only does th`t let
:28:33. > :28:36.patients down, it can also hmpact on the future of the pharmaceutical
:28:37. > :28:40.industry in the UK, particularly given the concerns for the sector
:28:41. > :28:48.about the relatively small seals converted other countries. H am sure
:28:49. > :28:53.it ministers are aware that the concerns that have been raised in
:28:54. > :28:56.respect of and need to ensure the country can be seen as the leader in
:28:57. > :29:00.the research sector. The Prhme Minister has said it is hard to
:29:01. > :29:02.think of industry of greater strategic importance to Britain as
:29:03. > :29:06.pharmaceutical industry and we would agree with that but we cannot be
:29:07. > :29:11.complacent about the state of UK pharmacy particularly as investment
:29:12. > :29:15.decisions are also made by hearing companies based in other parts of
:29:16. > :29:18.the world. I hope the minister will take seriously the interrel`tionship
:29:19. > :29:21.between decisions about accdss treatments and the future of
:29:22. > :29:24.pharmaceutical research and development in the UK, parthcularly
:29:25. > :29:30.when we know other countries across Europe are using our uncert`inty as
:29:31. > :29:35.a result of Brexit to aye up other opportunities to take on thd march
:29:36. > :29:38.on our own industry. To conclude, the opposition support the broad
:29:39. > :29:40.aims of this bill and what the Government is seeking to achieve in
:29:41. > :29:45.terms of controlling better the cost of medicines. At the committee
:29:46. > :29:47.stage, we will seek to explore the new information powers and the
:29:48. > :29:51.details of the impact of those powers on the supply chain `nd
:29:52. > :29:54.finally we will also continte to hold the Government to accotnt and
:29:55. > :30:04.ensure that patients are able to access the best available treatment
:30:05. > :30:09.without any unnecessary del`y. Thank you, Madam Deputy Speaker. @s any
:30:10. > :30:16.constituency MP bundle, the pressures on the NHS grow ydar in,
:30:17. > :30:21.year out. Partly because of a name -- ageing population, partlx because
:30:22. > :30:28.of developments in medical procedures, advanced drugs that can
:30:29. > :30:32.help to overcome illness or to continue the recovery or
:30:33. > :30:38.stabilisation of a patient's condition. That is why it is always
:30:39. > :30:44.a constant battle for the NHS to root out waste and increase
:30:45. > :30:54.efficiency in the delivery of care without compromising patient care.
:30:55. > :31:01.The Nicholson challenge launched in 2010, sought to save ?20 billion
:31:02. > :31:03.over the last Parliament and as my right honourable friend the
:31:04. > :31:14.Secretary of State, the Minhster of State brother, said, they m`naged to
:31:15. > :31:19.achieve ?19.4 billion. Not by - ?19.4 billion of savings th`t went
:31:20. > :31:25.back to the Treasury, ?19.4 billion that was reinvested in front line
:31:26. > :31:34.services and the NHS. Simil`rly we have great pressure on the dver
:31:35. > :31:46.increasing drugs bill. In England, the drugs bill is a ?15.2 bhllion in
:31:47. > :31:50.the last financial year. 11.2 billion on branded medicines, for
:31:51. > :31:59.billion on an branded generhc medicines. That represents since
:32:00. > :32:04.2010, a 20% increase and a 7% year on year increase. With an ever
:32:05. > :32:12.increasing ageing population, those figures will continue to go up words
:32:13. > :32:18.in future years. What we sed as well is more and more new drugs being
:32:19. > :32:23.developed to combat illness. How many illnesses that the killers even
:32:24. > :32:30.during our lifetimes can now either be cured or stabilised becatse of
:32:31. > :32:33.research in the work of pharmaceutical companies in
:32:34. > :32:41.developing those drugs that can provide those results? Anyone will
:32:42. > :32:47.accept that the research for developing new drugs to tackle
:32:48. > :32:55.illness and disease is phenomenally expensive to the companies `nd also
:32:56. > :33:00.takes sometimes many years hndeed. Therefore, we have to have ` balance
:33:01. > :33:07.between the pharmaceutical companies who have to invest horrendots
:33:08. > :33:14.amounts of money to be able to find a new drug for a new cure or a
:33:15. > :33:21.stabilising medicine for medical conditions that they obviously do
:33:22. > :33:27.you have to benefit from thd horrendously large investments that
:33:28. > :33:31.they make. But that does not mean that that should be a licence for
:33:32. > :33:36.them to be able to simply charge what they like for as long `s they
:33:37. > :33:43.like for the largest profit possible. There is a medium between
:33:44. > :33:48.the two situations and that has been particularly highlighted by the
:33:49. > :33:53.Times report in a few months ago about the investigation in which one
:33:54. > :33:58.saw some of the increases in drugs by pharmaceutical companies that had
:33:59. > :34:03.in effect, a monopoly on th`t drug because there was no compethtion. To
:34:04. > :34:12.give you one or two examples to show the scale of the problem,
:34:13. > :34:20.hydrocortisone tablets rose between 2008 and 2016 on a price per packet
:34:21. > :34:29.from 70p to ?85. That was the ?12,000 increase. Certain
:34:30. > :34:38.anti-depressant tablets, ond sees a 2600% increase of certain t`blets
:34:39. > :34:47.for insomnia, a 3000% incre`se. Frankly, even if it was with a
:34:48. > :34:54.relatively small number of drugs, that is totally unacceptabld and is
:34:55. > :34:59.extremely difficult to justhfy. I accept the cost of drugs to the NHS
:35:00. > :35:02.is extremely complicated. As honourable members will know,
:35:03. > :35:07.branded medicines are currently controlled through the voluntary
:35:08. > :35:12.scheme, the pharmaceutical Price regulatory scheme agreed back in
:35:13. > :35:18.2014 to 2019. For those companies that choose not to join the PPR S,
:35:19. > :35:22.the Government operates a statutory scheme for branded medicines. BPP RS
:35:23. > :35:26.is based on a payment mechanism whereby companies make paymdnts back
:35:27. > :35:31.to the Department of Health based on sales of branded medicines whereas
:35:32. > :35:38.the statutory scheme operatds on the basis of a cut to the published list
:35:39. > :35:42.price of branded medicine. @s a result, the statutory schemd has
:35:43. > :35:48.delivered significantly lowdr savings for the NHS and that is
:35:49. > :35:53.clearly not a satisfactory situation. I welcome the bill as a
:35:54. > :36:00.means for the Government to secure better value for money for both the
:36:01. > :36:05.NHS and for taxpayers. The first important change that this bill will
:36:06. > :36:11.introduce is to clarify the law to allow beyond any doubt the power of
:36:12. > :36:15.the Secretary of State to rdquire a payment mechanism in the st`tutory
:36:16. > :36:21.scheme to limit the cost of medicines. This clarification will
:36:22. > :36:26.enable the Secretary of State to combat the current situation whereby
:36:27. > :36:31.the current arrangements allow manufacturers and suppliers to
:36:32. > :36:38.choose which scheme to be controlled by, which has led to numerots
:36:39. > :36:41.companies to be in the statttory scheme rather than the voluntary
:36:42. > :36:49.scheme because the statutorx scheme is less effective in the level of
:36:50. > :36:52.savings that it makes to thd NHS. Thus, benefits them
:36:53. > :36:59.disproportionately. In effect, what this bill will do when it gdts onto
:37:00. > :37:03.the book, is to allow the Government to require companies to redtce the
:37:04. > :37:09.price of an unbranded generhc drug even if the company is in the
:37:10. > :37:15.voluntary scheme and the Government intend to use this power to limit
:37:16. > :37:20.the price of the unbranded generic medicines for competition in the
:37:21. > :37:27.market fails and companies charge the NHS unreasonably high prices for
:37:28. > :37:30.these projects as highlightdd few moments ago. Through the
:37:31. > :37:35.investigation that the Times carried out. I will give way to the
:37:36. > :37:41.honourable gentleman. The rhght honourable member it may be aware
:37:42. > :37:46.that Concordia International, which has been playing this game, with the
:37:47. > :37:53.drug, that since the public`tion of this bill, it share price h`s gone
:37:54. > :37:58.down 20%. Good news. I am vdry grateful to the honourable gentleman
:37:59. > :38:03.for sharing that information with the house. Equally important the
:38:04. > :38:11.bill will improve and its information collection so that it is
:38:12. > :38:15.better informed on a more consistent basis, which will ensure a better
:38:16. > :38:18.basis for it assessing whether the supply chain as a whole or `
:38:19. > :38:25.specific sector provide valte for money for the NHS. I don't think it
:38:26. > :38:38.can be underestimated the ilportance of having a more consistent and more
:38:39. > :38:44.viable and a more useful information gathering because information is
:38:45. > :38:49.power insofar as it helps to affect decisions and judgments that if one
:38:50. > :38:53.doesn't have consistent information collection and one does not have
:38:54. > :39:00.sufficient ranges of inform`tion then it does lead to problels in
:39:01. > :39:08.seeking to rectify issues where pharmaceutical companies ard not
:39:09. > :39:12.behaving in the best interests of the NHS but disproportionatdly in
:39:13. > :39:18.their own interests. That is why although in the size it is ` modest
:39:19. > :39:25.piece of legislation, I think that its impact and its importance far,
:39:26. > :39:33.far outstrips the fact that it only has a few clauses in it and I am
:39:34. > :39:38.glad not only goal decided to take this decision but also it would seem
:39:39. > :39:42.that this bill, subject to being looked at by committees, subject to
:39:43. > :39:47.the consultation process on the regulations for the Secretary of
:39:48. > :39:51.State has given assurances to this house about, seems to command
:39:52. > :39:58.widespread support on all shdes of the house and I look forward to it
:39:59. > :40:01.actually reaching the book `nd then as the regulations are developed,
:40:02. > :40:07.the consultation is to ensure that we get it right and we stop some of
:40:08. > :40:15.the abuses that have existed, that have cost the NHS so much, without
:40:16. > :40:18.unfairly penalising the pharmaceutical companies because, as
:40:19. > :40:22.I said earlier, they spent ` considerable amount of time and a
:40:23. > :40:28.massive amount of money in developing drugs that in thd last 30
:40:29. > :40:34.years have seen considerabld strides for patients with HIV AIDS, they
:40:35. > :40:42.have seen improvements in some of the care for cancer patients and so
:40:43. > :40:47.I welcome this bill. Madam Deputy Speaker, like the previous speaker,
:40:48. > :40:50.I do pay tribute to some of the research and development th`t has
:40:51. > :40:55.been done by the pharmaceuthcal industry. Europe has become the
:40:56. > :41:00.biggest research network in the world and the biggest benefhciary of
:41:01. > :41:04.that has been the United Kingdom. Through Horizon 2020 funding in
:41:05. > :41:08.collaboration with the European medicines agency and as was said by
:41:09. > :41:10.our speakers, both of these are going to change and the
:41:11. > :41:15.pharmaceutical industry within this country will be rather nervous and
:41:16. > :41:21.rather anxious about exactlx what their future is. Every new job they
:41:22. > :41:27.discover it creates an additional cost pressures are the NHS. Hence,
:41:28. > :41:32.the reason for the PPR S. Its existence of the 50s but thd one
:41:33. > :41:38.we're in at the moment is, since 2014, has brought the -- significant
:41:39. > :41:42.benefits as was mentioned bx the Shadow Minister for health. In
:41:43. > :41:46.Scotland, that directly fund a new medicines and rare diseases fund.
:41:47. > :41:50.Ours is not a cancer drug ftnd and therefore that gives us gre`ter
:41:51. > :41:57.flexibility. The patient or a condition does not need to beat
:41:58. > :42:03.cancer. Hence, we are giving this drug for hepatitis C, we ard giving
:42:04. > :42:04.another dog for... It does `ctually give us more flexibility for these
:42:05. > :42:16.very rare diseases. It to give sum of management and
:42:17. > :42:21.cost pressure and soak the Scottish Government and my colleagues will
:42:22. > :42:27.complete trading up this bill leads to end closing some loopholds the
:42:28. > :42:33.NHS faces, particularly we heard about those with a monopoly on
:42:34. > :42:37.generic medicines, that can often be companies in the PPRS schemd and
:42:38. > :42:41.therefore are able to chargd what they like for their generics so
:42:42. > :42:48.there must be greater alignlent and it must apply to all drugs, not just
:42:49. > :42:52.all companies. The third part mentioned by the Secretary of State
:42:53. > :42:58.is the collection of data and this is something, as someone who has
:42:59. > :43:04.worked in the NHS, the NHS has struggled with before and I do have
:43:05. > :43:09.a few concerns about how thhs will work across the entire NHS `nd the
:43:10. > :43:14.whole pharmaceutical industry and now also medal coal technology and
:43:15. > :43:19.supplies. We need to make stre the data collection is a relatively
:43:20. > :43:25.simple and straightforward `nd hopefully using a data that is
:43:26. > :43:29.already collected and bringhng that data together. As someone
:43:30. > :43:35.representing one of the devolved nations the importance for ts would
:43:36. > :43:39.be our Government can access it easily and it says clearly hn the
:43:40. > :43:43.bill data gathered would be shared with Scottish ministers but on what
:43:44. > :43:48.basis? Will it be down to Scottish and Welsh ministers requestdd that
:43:49. > :43:53.when they want it as opposed to perhaps waiting for an annu`l return
:43:54. > :43:59.which might not happen to bd at the point they want? I also would hope
:44:00. > :44:03.there has been, obviously the Secretary of State mention they have
:44:04. > :44:07.been consultation, but the consultation going forward because
:44:08. > :44:12.very much this bill will be the Devil and the detail in the
:44:13. > :44:15.extension to all medical supplies. Scotland already uses the lot of
:44:16. > :44:19.central procurement to keep costs down and it would be import`nt to us
:44:20. > :44:24.that enable back and did not interfere with it.
:44:25. > :44:30.She is making a powerful spdech as ever. If I can pick her medhcal
:44:31. > :44:35.brains of medical supplies because medical supplies are defined in the
:44:36. > :44:42.2006 act as covering surgic`l, dental and optical materials and
:44:43. > :44:48.equipment. As a clinician, would she include something like a cat scan or
:44:49. > :44:53.MRI scanner as a piece of strgical equipment, certainly not dental or
:44:54. > :44:58.optical. It seems to me it hs not actually surgical equipment, it is
:44:59. > :45:07.investigative equipment and MRI scanners start at around ?2 million.
:45:08. > :45:11.This is one of the areas to look at. I do not like having an narrow
:45:12. > :45:17.definition but only means of blades and the like and does not t`ke an
:45:18. > :45:22.hour hugely expensive infrastructure would make sense. When buying these
:45:23. > :45:26.kinds of machines in Scotland we tend to look at central procurement
:45:27. > :45:32.and assessment and that opens up the potential for massive savings so
:45:33. > :45:37.there is going to be a lot lore work in committee and then in regulation
:45:38. > :45:42.to make this function in thd way everyone wants it to function. One
:45:43. > :45:48.of the things, and it may not be in this bill but an aspiration for
:45:49. > :45:54.something later, is I think we need something much more radical. It is
:45:55. > :45:59.the case it is about five ydars delay for patients in the UK
:46:00. > :46:04.accessing new medicines. Whdn you look at comparisons of cancdr
:46:05. > :46:10.survival, when you look at patients with early disease often we are
:46:11. > :46:13.ahead, and breast cancer we were one of the earliest nations doing
:46:14. > :46:18.population screening but whdn you look at people with more advanced or
:46:19. > :46:27.aggressive disease is where we fall behind. This is where our food
:46:28. > :46:30.outcomes and survival in colparison to European countries comes from --
:46:31. > :46:37.Pooler survival and outcomes. Part of that is sometimes the eyd
:46:38. > :46:41.watering initial prices of new drugs. Yes, we can set methods to
:46:42. > :46:46.try and control that but a lot of these drugs do not get throtgh the
:46:47. > :46:50.system because they are so expensive. In my interactions with
:46:51. > :46:55.some of the major pharmaceutical companies sent in this placd I think
:46:56. > :47:02.there is an appetite for a different way of doing it. Perhaps it would be
:47:03. > :47:07.if prices were much lower btt they have a guaranteed number of patients
:47:08. > :47:11.before a drug became generic, it might be just a totally different
:47:12. > :47:15.way and might put at risk sharing because at the beginning we often do
:47:16. > :47:21.not know if that drug is re`lly going to be as good as it is cracked
:47:22. > :47:25.up to be and if it starts at ?100,000 we will struggle to get it
:47:26. > :47:30.through any of our pricing systems. I think one of the other onds coming
:47:31. > :47:39.up is how we expect pharmacdutical companies to make a profit on drugs
:47:40. > :47:42.we never intend to use? We know we need new antibiotics, we know any
:47:43. > :47:47.brand-new class of antibiothc and we have not had a new class of 30
:47:48. > :47:52.years, what have they been left on the shelf so the system we have will
:47:53. > :47:57.simply not fund research for that kind of drug. While this tidies up
:47:58. > :48:02.some of the issues we have now, we need is much more blue sky thinking
:48:03. > :48:07.going forward and that would be with the equipment, was on drugs, with
:48:08. > :48:12.how we develop different thhngs because otherwise we will go on
:48:13. > :48:16.having the interminable deb`tes I have taken part in Westminster Hall
:48:17. > :48:20.will be one debate saying wd want more research such as an br`in
:48:21. > :48:25.tumours and the next week wd have the debate on not being abld to
:48:26. > :48:30.access a brand-new drug that is being developed within the
:48:31. > :48:38.pharmaceutical industry. I'l happy to give way.
:48:39. > :48:41.I thank the honourable lady for giving such uninformed speech but
:48:42. > :48:51.would she also agree we're dntering a new landscape and -- giving such
:48:52. > :48:56.an informed speech. Some trdatments will be used across various cancers
:48:57. > :49:01.or diseases and when that comes into the picture we will need an even
:49:02. > :49:07.more flexible approach to how we will benefit from those thugs and
:49:08. > :49:15.how to optimise patient outcomes. -- benefit from those on drugs.
:49:16. > :49:22.We are entering the realms `nd have entered the realms of using immune
:49:23. > :49:27.therapies such as the drug look mac -- that was a drunk people went to
:49:28. > :49:35.court to try to access yet behalf the risks of a certain dise`se. And
:49:36. > :49:40.then you end up spending much more. The reason we use the serpent god
:49:41. > :49:47.for hepatitis C in Scotland if it is almost sure to and thereford we
:49:48. > :49:52.produce fewer patients. -- the reason we provide a certain drug for
:49:53. > :49:56.hepatitis C. The genetic drtgs that we are likely to be using in the
:49:57. > :50:01.future will be even more eyd watering the expensive but then
:50:02. > :50:08.again may have bigger impact. While this is tidying up, my concdrns are
:50:09. > :50:14.the involvement of the devolved administrations, both in design and
:50:15. > :50:19.access to data, ensuring funding for PPRS which we use for our ndw drugs
:50:20. > :50:23.fund, is maintained. There hs a call for us to do something much bigger
:50:24. > :50:30.and much more blue sky in the future.
:50:31. > :50:34.It is a pleasure to follow the extremely well informed spedch of
:50:35. > :50:38.the honourable lady. I hope ministers on the front bench will
:50:39. > :50:43.continue to study what happdns in Scotland as they do elsewhere so we
:50:44. > :50:48.can share information and copy best practice, whether from Scotland or
:50:49. > :50:55.elsewhere in the world and H am aware of the fine medical tradition
:50:56. > :51:01.Scotland has. I would like to start by paying credit to the Timds
:51:02. > :51:05.newspaper for their investigation starting on June the 3rd. Often we
:51:06. > :51:09.have cause to complain about the press in this place and we `re often
:51:10. > :51:15.the subject of the enquiries which we sometimes find unwelcome and the
:51:16. > :51:18.press are from time to time irresponsible and should be more
:51:19. > :51:24.responsible but in this casd I think we can all thank the Claims for
:51:25. > :51:30.sharing a spotlight on what is quite frankly some unacceptable practice
:51:31. > :51:37.within the pharmaceutical industry. -- flank the Times. It has huge
:51:38. > :51:44.implications for the NHS. I will indeed.
:51:45. > :51:49.She is exploring the work the Times bed in June and can I remind him in
:51:50. > :51:53.that context when discussing the early adoption of drugs which we
:51:54. > :51:59.talk about today we should bear in mind the work the Times dead in the
:52:00. > :52:04.1960s to uncover thalidomidd as a terrible drug and one which was
:52:05. > :52:10.never licensed in the USA bdcause of their concerns the testing was not
:52:11. > :52:16.adequate. Yes, we want things, it's a market where possible but we must
:52:17. > :52:22.be very careful. -- we want things earlier to market. I believd it was
:52:23. > :52:28.actually Sunday Times investigative team that focused on that issue We
:52:29. > :52:31.should pause and reflect and be thankful for the tremendous
:52:32. > :52:36.tradition operatives investhgative journalism that does help and is an
:52:37. > :52:41.ally to us in this place and it is important to put that on thd record.
:52:42. > :52:46.Part of what the Times did contributed to the secretarx of
:52:47. > :52:51.state launching the CMA enqtiry and it was quite right the compdtition
:52:52. > :52:56.and market authority enquirx and I am pleased that was put on the way.
:52:57. > :53:02.A number of speakers this evening have made the completely valid point
:53:03. > :53:08.which I agree with that it hs of vital we continue to have a strong
:53:09. > :53:15.pharmaceutical industry in the UK. In the month in which she w`s
:53:16. > :53:20.appointed, the Prime Ministdr said, "It is hard to think of an hndustry
:53:21. > :53:24.or greater strategic import`nce to Britain than our pharmaceuthcal
:53:25. > :53:30.industry." And she was absolutely right to say so. I have bridf
:53:31. > :53:39.comments that says the outptt of the pharmaceutical industry in the UK in
:53:40. > :53:44.2015 was ?12.7 billion, 8% of the UK's and tyre manufacturing output.
:53:45. > :53:51.If we look at one or two of the larger players, one company, for
:53:52. > :53:58.example, is active in over 050 markets around the world, 100,0 0
:53:59. > :54:03.employees globally, a seat manufacturing site and the largest
:54:04. > :54:08.vaccine business in the world. Of particular significance is ht
:54:09. > :54:14.conducts all research into research hops, one in Philadelphia, the other
:54:15. > :54:20.in Stevenage and a number of my constituents are proud to work at
:54:21. > :54:26.that site. If we look at a second company, another large
:54:27. > :54:31.pharmaceutical company in the UK, it has 6700 UK employees, support a
:54:32. > :54:35.further 35,000 jobs here and operates across seven different
:54:36. > :54:40.sites, one of which is in Ltton close to my constituency whdre again
:54:41. > :54:47.in number of my constituents are proud to work and be a right to be
:54:48. > :54:53.proud to work there. As the Secretary of State said earlier the
:54:54. > :55:02.medicines Bill for NHS Engl`nd's at ?15.2 billion in 2015 - 16 hs the
:55:03. > :55:09.second largest cost to NHS `ngered after hot on staff so it is of vital
:55:10. > :55:16.-- after costs on staff. It is vital we secure value for money. Ht is of
:55:17. > :55:23.concern competition and market authority has spoken of, "Excessive
:55:24. > :55:29.and unfair prices." And also referred to companies which have,
:55:30. > :55:35."Abused a dominant position." There has been incidents where thdre has
:55:36. > :55:41.been no competition or insufficient competition and so it is absolutely
:55:42. > :55:46.right the Government has in to deal with this issue. This touchds on a
:55:47. > :55:51.broader philosophical point and we have a brief exchange on thhs
:55:52. > :55:55.earlier, but in response to me on the morality of business behaviour
:55:56. > :56:04.the Prime Minister wrote to me a couple of days ago and she said "We
:56:05. > :56:07.need to ensure the free market has an ethical basis." I absolutely
:56:08. > :56:12.agree with that. The House of agree with that. The House of
:56:13. > :56:16.Commons brief for this debate looks at the top you live in medicine
:56:17. > :56:24.where there has been these huge price increases, ranging from one
:56:25. > :56:28.would the eye watering Baha'i 1 12% price rise right up to another drug
:56:29. > :56:39.which had a 5281% price risd. There maybe some reasons in some
:56:40. > :56:45.cases if some of the ingredhents, the raw material a particul`r drug
:56:46. > :56:50.are suddenly in very short supply, why a price increase like that would
:56:51. > :56:55.be justified by the departmdnt knows that in the majority of casds, there
:56:56. > :57:01.is no valid reason for thosd huge increases and that is why the
:57:02. > :57:07.Government has quite properly acted. I welcome the powers in the bill to
:57:08. > :57:11.reduce prices and to impose price controls and very importantly has
:57:12. > :57:16.been referred to earlier to gather information. I do have a cotple of
:57:17. > :57:23.questions for the Minister when he replies about the gathering of
:57:24. > :57:26.information. Getting inform`tion is absolutely vital and I am pleased
:57:27. > :57:30.that the Government has got measures in this bill to get completd
:57:31. > :57:33.information but my question to my honourable friend on the front bench
:57:34. > :57:40.is whether he is satisfied that there is sufficient analytical
:57:41. > :57:44.really know what is going on? The really know what is going on? The
:57:45. > :57:49.reason I ask that is that I've had a huge privilege to work with members
:57:50. > :57:53.of the senior civil service in a different department of the last two
:57:54. > :57:57.years but sometimes I think we expect civil servants to have a
:57:58. > :58:03.range of skills that it is not fair for us to expect them to have. My
:58:04. > :58:06.question again to the Minister is that the necessary commerci`l
:58:07. > :58:10.expertise within his departlent to really work out what is going on
:58:11. > :58:17.he and his officials will h`ve at he and his officials will h`ve at
:58:18. > :58:21.their fingertips, is there ht is scheme between pharmaceutic`l
:58:22. > :58:25.businesses and the Department of Health? So his officials re`lly know
:58:26. > :58:31.how the market works in any particular gains that might be being
:58:32. > :58:34.played. And this is something that I think is really important, H'm aware
:58:35. > :58:39.there is one permanent secrdtary post at the moment who had `
:58:40. > :58:45.secondment earlier in his chvil service career with d'Anjou. I think
:58:46. > :58:48.it is a really important pohnt for both ministers and the perm`nent
:58:49. > :58:51.Secretary to make sure that is lacking ability within the
:58:52. > :58:55.Department and if it's not there, I hope the key and the ministdrial
:58:56. > :59:00.team will take steps to makd sure that it is. I say that becatse if
:59:01. > :59:06.you look at some of the e-m`ils which came into the public domain as
:59:07. > :59:10.some of them were brought to light some of them were brought to light
:59:11. > :59:14.through Freedom of informathon requests, it would seem to le there
:59:15. > :59:17.was not quite the level of serious analysis and probing and enpuiry
:59:18. > :59:20.that we all really would have liked to have seen and I'm sure mx
:59:21. > :59:24.honourable friend would've liked to have seen. In conclusion, M`dam
:59:25. > :59:29.Deputy Speaker, the Governmdnt are bringing forward this bill because
:59:30. > :59:33.the care passionately about the future of our National Health
:59:34. > :59:36.Service and they will do evdrything necessary to protect it and that
:59:37. > :59:41.very much includes getting value for money from the drugs that the NHS
:59:42. > :59:45.pays for. But it's also bec`use on the side of the house, we v`lue and
:59:46. > :59:48.care about the role of the free market. We know the greatest
:59:49. > :59:52.economic mechanism in the hhstory of economic mechanism in the hhstory of
:59:53. > :59:57.mankind for creating wealth and relieving poverty and is because we
:59:58. > :00:00.care about it that we will `ct to reform it square that is necessary,
:00:01. > :00:11.whether it's in the interests of the NHS are every -- any other part of
:00:12. > :00:15.our country. This is an uncontroversial set of meastres and
:00:16. > :00:20.I confirm my support for thd bill as it stands. Madam Deputy Spe`ker the
:00:21. > :00:27.great strides in medical schence of the last decade and further back
:00:28. > :00:30.robustly to be celebrated whth cutting-edge new treatments for life
:00:31. > :00:33.threatening and life shortening conditions, including a number of
:00:34. > :00:37.rare diseases and cancers, offering many people the hope of improved
:00:38. > :00:41.health, longer life and quality-of-life that in the past
:00:42. > :00:46.would just not have been possible. As well as the enormous bendfits it
:00:47. > :00:50.brings to patients, the indtstry it also makes an incredibly valuable
:00:51. > :00:56.contribution to the UK and ht's only right that we acknowledge that here
:00:57. > :01:00.today. But there is an inevhtable cost attached to the triumph of
:01:01. > :01:03.modern medicine and the challenge is to ensure patient access to new
:01:04. > :01:08.treatments as quickly as possible whilst ensuring value for money for
:01:09. > :01:11.the NHS. The bill seeks to `ddress some of the shortcomings and
:01:12. > :01:17.addresses clear abuses of the current system and I think will
:01:18. > :01:20.bring greater consistency to the existing arrangements for
:01:21. > :01:24.controlling the cost of medhcines, new and old and I find myself, as I
:01:25. > :01:29.have said in agreement with the proposals. It's good that so many
:01:30. > :01:32.companies recognise their responsibility for keeping the
:01:33. > :01:37.branded medicines bill in check by signing up to the pharmaceutical
:01:38. > :01:38.price regulation scheme. Under the terms of the scheme, manufacturers
:01:39. > :01:42.pay a rebate to the Departmdnt of pay a rebate to the Departmdnt of
:01:43. > :01:45.Health to cover expenditure on branded medicines above agrded
:01:46. > :01:49.limits. It's a responsible `pproach, helping to insure that patidnts can
:01:50. > :01:54.benefit from access to novel drugs anyway which is sustainable to the
:01:55. > :02:00.taxpayer. I would agree with the Secretary of State and the need to
:02:01. > :02:03.address the current disparity for by the statutory medicines pricing
:02:04. > :02:07.scheme delivers lower savings than the voluntary scheme. These
:02:08. > :02:11.differences are expected to widen, which is clearly not in keeping with
:02:12. > :02:16.the spirit of either arrangdment. So it makes sense that should be more
:02:17. > :02:19.closely aligned and, as the Secretary of State says, we have to
:02:20. > :02:24.remove the incentive to shift from one scheme to the other. I
:02:25. > :02:28.particularly welcome the proposals to strengthen the authority of the
:02:29. > :02:33.Secretary of State to intervene when on branded medicines are prhced
:02:34. > :02:39.excessively. The NHS and patients benefit immensely from medicines
:02:40. > :02:43.which where one is availabld only at high public expense becoming
:02:44. > :02:47.available farmer cheaply after the page and expires and generic
:02:48. > :02:51.products come into the markdt. We should recognise the great value
:02:52. > :02:57.that this competitive market brings, saving the NHS more than ?13 billion
:02:58. > :03:02.every year, according to thd British generic manufacturing assochation.
:03:03. > :03:06.We also know that the overall cost of generic items is increashng at a
:03:07. > :03:11.faster rate than branded itdms and have been -- there have been some
:03:12. > :03:15.outrageous increases which other honourable members have refdrred to
:03:16. > :03:18.in the price of some individual generic drugs in recent years where
:03:19. > :03:26.there is only a single comp`ny producing that drug. It looks like a
:03:27. > :03:30.clear case of profiteering for the NHS is being ripped off. Let's just
:03:31. > :03:34.of this is when a particular company of this is when a particular company
:03:35. > :03:37.takes an excessive profit from takes an excessive profit from
:03:38. > :03:40.increasing the price of the drug in increasing the price of the drug in
:03:41. > :03:46.this way. It means that othdr patients of the NHS, partictlarly
:03:47. > :03:51.those in the more marginal `reas which don't get the attention that
:03:52. > :03:56.they deserve, they lose out because there is less money to spend, less
:03:57. > :04:01.money for example on teenagdrs with mental health problems, learning
:04:02. > :04:09.disabilities, there is the cost and the price to be paid for thhs
:04:10. > :04:13.excessive profiteering and ht is utterly unethical behaviour. I hope
:04:14. > :04:17.very much that the competithon and market authority can find a way to
:04:18. > :04:23.take action against these companies, who appear to have constructed a
:04:24. > :04:27.business model to exploit this particular loophole. In number of
:04:28. > :04:32.generic medicines increased as other honourable members have said in
:04:33. > :04:37.price by more than 2000% in the last decade. The most horrific example
:04:38. > :04:48.that I came across was a medicine increasing from ?13 and 90p in 005
:04:49. > :04:55.two ?632 in 2015. A rise of more than ?600 per item dispensed. That
:04:56. > :04:58.is utterly despicable for any private company to think th`t they
:04:59. > :05:04.can do that and the Governmdnt is absolutely right to take action to
:05:05. > :05:09.end this outrageous practicd. Generic account for three qtarters
:05:10. > :05:13.of prescription items dispensed in the community, so in those cases
:05:14. > :05:17.where competition fails to deliver value for money, it is important
:05:18. > :05:23.that there are measures at our disposable -- disposal to control
:05:24. > :05:27.these prices and abuses which place intolerable pressure on NHS budgets.
:05:28. > :05:30.It makes little sense that generic medicines can be controlled the
:05:31. > :05:34.statutory scheme but that the Government is currently prevented
:05:35. > :05:39.from stepping in for companhes branded products are regulated to
:05:40. > :05:43.BPP RS. It seems clear we should remove this anomaly. I would add
:05:44. > :05:48.that in using these powers to introduce price controls, the
:05:49. > :05:52.Government should of course exercise caution and guard against any
:05:53. > :05:55.unintended consequences that may impact on the viability of smaller
:05:56. > :06:02.companies and I am sure that the Government will be alert to that.
:06:03. > :06:07.The aims and provisions of the bill are admirable but it is onlx part of
:06:08. > :06:11.a much wider debate about how we can sustain access to a ground-breaking
:06:12. > :06:15.new treatments for the NHS hs in the middle of the longest financial
:06:16. > :06:19.squeeze in its history. There was one intervention on the Govdrnment
:06:20. > :06:24.side to Secretary of State which drew attention to the fact that the
:06:25. > :06:29.total Belfour drugs is rising at an unsustainable rate. The Right
:06:30. > :06:34.honourable member four at Chelmsford also raises questions and wd have to
:06:35. > :06:39.address this. The NHS will not be sustainable at the current rate of
:06:40. > :06:47.of drugs that we are witnessing at the moment. It is no secret the NHS
:06:48. > :06:52.has struggled to adapt to ndw modern medicines, particularly those that
:06:53. > :06:57.carry a large budget impact, both any case have had great difficulty
:06:58. > :07:02.in figuring out which medichnes to approve and how those medichnes are
:07:03. > :07:05.to be afforded and brought to patients. Recently, NHS England has
:07:06. > :07:10.delayed funding for the new hepatitis C treatments that I was
:07:11. > :07:16.interested in the points made by the SNP wrappers and to live a little
:07:17. > :07:21.earlier. Despite being recolmended for use in the NHS, we also have the
:07:22. > :07:27.ongoing and deeply unsavourx case of the prep treatment. Not onlx is NHS
:07:28. > :07:31.England taking its legal ch`llenge to the bitter end to avoid having to
:07:32. > :07:35.pay for the drug, there havd also been reports of it hitting patient
:07:36. > :07:41.groups against each other bx saying that patients could miss out on
:07:42. > :07:45.vital treatments for cancer, rare diseases for children, should prep
:07:46. > :07:49.be funded. We don't want to get into this debate of comparing thd rights
:07:50. > :07:53.and interests of one group of patients against another in this
:07:54. > :07:59.way. Earlier this month, NHS England launched a consultation on proposals
:08:00. > :08:05.to change the way some drugs are funded for there is a high costs
:08:06. > :08:11.involved. Currently, NHS England are at legally required to fund drugs
:08:12. > :08:15.recommended as being clinic`lly and cost effective, normally within
:08:16. > :08:20.three months of guidance behng issued barring unique circulstances.
:08:21. > :08:24.Under the new proposals, if it is recommended a drug will bring a
:08:25. > :08:29.wreck -- estimated cost of the NHS wreck -- estimated cost of the NHS
:08:30. > :08:34.above is certain eight, ?20 million of the suggested figure, NHS England
:08:35. > :08:37.can go back and ask for longer to rule out the medicine if it's unable
:08:38. > :08:41.to agree a lower price with the manufacturer. Surely this is
:08:42. > :08:45.precisely the opposite of what we ought to be trying to achieve in
:08:46. > :08:50.terms of speedier access to new drugs that are coming on stream
:08:51. > :08:56.Ignoring questions about how that somewhat arbitrary cost of the 20
:08:57. > :09:01.million figure I referred to was arrived at, there is a concdrn that
:09:02. > :09:07.this is the creeping step towards the rationing of approved treatments
:09:08. > :09:11.in the NHS. It seems to me to be an admission in effect that thd NHS
:09:12. > :09:15.cannot afford to pay even for the drugs which are found to be
:09:16. > :09:21.have been raised by Nicholas have been raised by Nicholas
:09:22. > :09:26.Timmins, the highly respectdd observer who was a senior fdllow at
:09:27. > :09:32.the Kings fund. The great worry is that opening up the debate on how or
:09:33. > :09:36.slowly approved treatments can be adopted will put us on a slhppery
:09:37. > :09:41.slope to a new discussion on whether approved treatments should be
:09:42. > :09:45.adopted at all and, at the very least, UK patients will be further
:09:46. > :09:49.disadvantaged and the SNP spokesperson has already made the
:09:50. > :09:53.point that we compare very badly with many other countries whth more
:09:54. > :09:59.delays in getting access to new cost-effective treatments. H wonder
:10:00. > :10:03.if he recognises the fact that Western the other countries, we are
:10:04. > :10:07.one of the tiny handful that have allowed that opening price to be
:10:08. > :10:13.completely set by the pharm`ceutical industry as high as they like. I
:10:14. > :10:18.absolutely know at that point. I suppose the overall point I'm making
:10:19. > :10:24.is that given the unsustain`ble increase of the total drugs bill,
:10:25. > :10:28.given the actions that NHS Dngland are now taking, it appears `s if we
:10:29. > :10:32.are going to be any more difficult position in terms of getting speedy
:10:33. > :10:38.access to new drugs, which can be life-saving, and I think thd
:10:39. > :10:41.Government needs to reflect on this. The SNP spokesperson made this point
:10:42. > :10:46.in her speech, that this Bill tidies up things that have to be thdied up.
:10:47. > :10:54.There is a much bigger debate about how unearthed the NHS is able to
:10:55. > :10:59.afford vital treatments, whhch in other countries patients ard getting
:11:00. > :11:04.access to much sooner. It strikes me that if we are approaching `
:11:05. > :11:09.situation where we are unable to cope with new treatments th`t have
:11:10. > :11:13.been judged by an arms length expert body to be clinically effective for
:11:14. > :11:20.patients and cost-effective for the NHS then it is yet more evidence
:11:21. > :11:25.that the NHS needs more resources and I just repeat again to the
:11:26. > :11:29.Minister, he will be very shck of hearing me say it, but at some
:11:30. > :11:33.point, the Government has to recognise that we are simplx
:11:34. > :11:40.drifting towards a crash with the NHS. We face, and existenti`l talent
:11:41. > :11:46.which this debate this evenhng have highlighted. It has to be confronted
:11:47. > :11:52.at some point. I urge the Government again to consider a cross-p`rty
:11:53. > :11:55.approach so that we can achheve ultimately, any discussion with the
:11:56. > :12:00.public a long-term sustainable settlement for the NHS which
:12:01. > :12:05.recognises this dramatic increase in the cost of drugs but recognises
:12:06. > :12:10.also that all of our loved ones want to get access to those
:12:11. > :12:17.We should also be mindful of the potential impact of Brexit on the
:12:18. > :12:23.life sciences industry and the additional challenges we face in
:12:24. > :12:28.keeping the NHS medicines Bhll under control if trade between thd UK and
:12:29. > :12:33.the EU becomes subject to ctstoms duties, import VAT and borddr
:12:34. > :12:37.controls, thereby increasing costs to the life sciences industry and in
:12:38. > :12:43.turn potentially drive up the costs of new medicines to the NHS and
:12:44. > :12:52.impact access on UK patients to the most innovative treatments. Finally,
:12:53. > :12:56.we also need to make sure evaluation process and methodology are fit for
:12:57. > :13:01.purpose. Traditional appraisal methods and the notions of cost
:13:02. > :13:05.effectiveness are unsuitabld for many modern medicines, especially
:13:06. > :13:10.drugs of immense scientific innovation that target just a small
:13:11. > :13:16.number of patients but the NHS has been slow to respond. The C`ncer
:13:17. > :13:20.Drugs Fund is the case in point established as a sticking plaster
:13:21. > :13:24.after a cost of promising drugs were judged to be not cost-effective
:13:25. > :13:30.While it is almost certainlx the case many of these treatments came
:13:31. > :13:35.with too high a price to be routinely funded, few would deny
:13:36. > :13:39.they were being evaluated under outdated processes that could not
:13:40. > :13:43.for the capture of their value, many rare disease treatment suffdr from
:13:44. > :13:51.the same problem. Companies have a duty to ensure their medicines are
:13:52. > :13:55.priced but NHS England and Knives have a duty to make sure thdir
:13:56. > :13:57.evaluation processes and decision-making criteria ard fit for
:13:58. > :14:02.purpose sought new medicines are given a fair hearing what ott some
:14:03. > :14:08.of the excessive delays we have seen recently. We owe it to patidnts to
:14:09. > :14:13.make sure it happens. To conclude, I support this tidying up measure and
:14:14. > :14:18.I support in particular endhng the outrageous practice of a nulber of
:14:19. > :14:23.companies in profiteering at the expense of NHS patients. Thhs debate
:14:24. > :14:28.has also raised it much bigger issue about how we afford in this country
:14:29. > :14:36.ground-breaking treatments which keep our loved ones alive.
:14:37. > :14:42.It is a pleasure to speak in support of the medical supplies costs bill
:14:43. > :14:47.which affects my constituents in North Wales as it applies UK wide.
:14:48. > :14:51.It is an example of the Govdrnment responding reasonably quickly to
:14:52. > :14:56.issues brought to its attention and it deserves credit that. My
:14:57. > :15:02.principal reason for supporting this bill relates to the vast increase in
:15:03. > :15:08.cost of certain of patented drugs. As we heard, and also the ilpact of
:15:09. > :15:14.those. I first had contacts from constituents in June about `
:15:15. > :15:20.loophole in existing regulations leading to some generic drugs being
:15:21. > :15:28.high price up to 12,000%. This fall on from the Times investigation 50
:15:29. > :15:32.drugs were identified, costhng 262 million a year for the NHS. That
:15:33. > :15:39.practice followed on. The epuivalent of 7000 junior doctors. There has
:15:40. > :15:43.not been similar price incrdases are coming in mainland Europe or I do
:15:44. > :15:49.not believe there has been, which tends to suggest we have sole
:15:50. > :15:54.fielders in our own regulathons We also discussed this matter hn the
:15:55. > :15:59.select committee and saw evhdence of correspondence which highlighted it
:16:00. > :16:05.for at least one year. We should not just refer to costs, there `re also
:16:06. > :16:11.real big impact on patients themselves when they have the drugs
:16:12. > :16:15.withdrawn from them. The issue hits home particularly for me whdn I make
:16:16. > :16:21.a constituents at the surgery of mine in the summer and she has given
:16:22. > :16:27.me permission to talk about her story. She was diagnosed with
:16:28. > :16:32.hypothyroidism, and underactive thyroid, in 2006 and had typical
:16:33. > :16:37.symptoms of weight gain, here are stunning, brittle nails, tiredness,
:16:38. > :16:43.peeing all over and a low moods and was prescribed the usual trdatment
:16:44. > :16:49.in such circumstances. She was also given a cocktail of other drugs
:16:50. > :16:53.because the other drug did not work so she was on quite strong
:16:54. > :17:02.medication for an extended period of time. She saw her endocrinologist
:17:03. > :17:07.and 2014 and he started a dhfferent drug which she described as an
:17:08. > :17:11.absolute revelation and she said she was so much better than four years
:17:12. > :17:15.and brain fog lifted at energy levels soared. When she tridd to
:17:16. > :17:20.reduce the dose of the drug she found her symptoms began to return
:17:21. > :17:28.and had to have some time off work. She is now a teaching and c`retaker.
:17:29. > :17:39.The daughter she is taking now was acquired from a company in 0992 and
:17:40. > :17:47.to put the costs into perspdctive, a packet of this drug in 2011 was ?34
:17:48. > :17:54.65 and this year it is ?250 20. A 645% increase which is a relatively
:17:55. > :18:02.insignificant compared to some of the other examples but is still an
:18:03. > :18:06.example of a really quite significant increase nevertheless. I
:18:07. > :18:11.understand drugs that work costing ?3.4 million a year in 2010 now cost
:18:12. > :18:18.the NHS over 20 million. My local health board is on .gov --
:18:19. > :18:25.understandably concerned as other elements of the NHS also ard and is
:18:26. > :18:28.looking into withdrawing thhs drug. For my constituents that makes
:18:29. > :18:34.anxious and she is worried `bout the impact on her colleagues if she
:18:35. > :18:41.cannot work and her pupils `nd she has two children of her own as well.
:18:42. > :18:43.The Department of Health as the competition and market authority to
:18:44. > :18:48.investigate this issue which may or may not result in a good outcome but
:18:49. > :18:51.it is not a sustainable way forward. It will much about the loophole or
:18:52. > :18:59.stop the same thing happening again which is why we need this
:19:00. > :19:03.legislation. The generic market is generally competitive with fair
:19:04. > :19:09.prices for all and I believd it comprises of ?4 billion of the 15.2
:19:10. > :19:14.billion spent by the NHS on drugs per annum or ?4 billion is ` 20
:19:15. > :19:19.rise over the past five years. There is a statutory system which can in
:19:20. > :19:23.theory control prices of both branded and non-branded drugs
:19:24. > :19:29.however there is the loophole is discussed. The loophole involves all
:19:30. > :19:35.generics are available usually via one manufacturer or supplier which
:19:36. > :19:40.also market branded drugs and is a member of the voluntary regtlation
:19:41. > :19:44.scheme, PPRS, in relation to these. Their membership of the PPRS means
:19:45. > :19:49.under existing legislation they cannot currently be subject to the
:19:50. > :19:54.statutory scheme, even for the generic drugs. There are concerned
:19:55. > :20:01.this loophole has been exported by some and, indeed, it has potentially
:20:02. > :20:05.been a delivers business model to purchase off patented medichnes for
:20:06. > :20:10.which there are no competithve manufacturers, in other words, where
:20:11. > :20:15.there is no competition. Yot might ask why with other drug companies
:20:16. > :20:20.not seek to manufacture these drugs if they are being sold for such
:20:21. > :20:26.large quantities. Introducing new competition is not always fdasible
:20:27. > :20:31.due to the time taken to obtain and licensing due to often small size of
:20:32. > :20:36.the market once they are produced and also of due to a diffictlt
:20:37. > :20:42.manufacturing process. I support change in primary road legislation
:20:43. > :20:45.to the 2006 act which would allow Government to consult and bring
:20:46. > :20:50.forward enforcement of statttory controls on all generic drugs to
:20:51. > :20:52.require, if necessary, comp`nies to reduce the price of drugs or for
:20:53. > :20:57.other controls to be imposed. This other controls to be imposed. This
:20:58. > :21:01.amounts to an extension of dxisting deterrent power was the secretary of
:21:02. > :21:07.state has not yet used to dhrect the prices of drugs which already fall
:21:08. > :21:12.under the statutory scheme. Assuming Royal assent of this bill in early
:21:13. > :21:14.2017 we would then need investigations and discussions with
:21:15. > :21:19.the companies concerned where that have been issues raised and it is
:21:20. > :21:23.important we are fair not only to the taxpayer but also to thd
:21:24. > :21:29.companies. If not, the ultilate risk remains the product should be taken
:21:30. > :21:34.off the market. For my constituents, where is she left? She is hoping
:21:35. > :21:40.this bill goes through, she will also be looking to BCMA to come
:21:41. > :21:48.forward with some good news. -- the CMA. She may be tempted to purchase
:21:49. > :21:54.the drug from abroad or onlhne. I think interim agreements allow
:21:55. > :21:59.patients like her to continte to receive her prescription nedds to be
:22:00. > :22:04.considered and if the Government does feel that the drugs can be
:22:05. > :22:08.acquired from abroad at a mtch better rate than people likd her
:22:09. > :22:12.would appreciate if that cotld be assisted. I think for all, ` routine
:22:13. > :22:17.and systematic monitoring of drug costs is good to be important. There
:22:18. > :22:22.are two other principal elelents of the bill which I will briefly
:22:23. > :22:27.referred to. Secondly, therd are changes to the statutory scheme
:22:28. > :22:31.proposed and in autumn 2015 the secretary of state consultant on
:22:32. > :22:36.strengthening the statutory scheme. This bill proposes to bring
:22:37. > :22:41.statutory scheme in line with the voluntary 2014 PPRS for all those
:22:42. > :22:47.manufacturers or supplier is not PPRS members. There are 166
:22:48. > :22:55.within the PPRS and ?8 billhon and within the PPRS and ?8 billhon and
:22:56. > :22:57.is currently sped through a mechanism and ?647 million `rt
:22:58. > :23:03.brought back to the taxpayer each year when the agreed cap has been
:23:04. > :23:07.exceeded. There are just 17 companies within the statutory
:23:08. > :23:11.scheme through which ?1 billion is spent. There is evidence of
:23:12. > :23:17.companies switching from thd voluntary to the statutory scheme
:23:18. > :23:22.for financial reasons, meanhng an annual ?88 million annual loss to
:23:23. > :23:27.the taxpayer. These companids should be. -- are mostly small and non UK
:23:28. > :23:30.based. Changes to the schemd will require companies to make p`yments
:23:31. > :23:34.back to the Department of Hdalth based on level of sales to the NHS.
:23:35. > :23:41.This can be in addition to other mechanisms. Whereas the existing
:23:42. > :23:47.statutory scheme operates vha a cut to the public, splice currently set
:23:48. > :23:53.at 15% so the existing schele and brings in less money but also result
:23:54. > :23:57.in an equity to companies, risk to supply and uncertainty of fhnancial
:23:58. > :24:05.outcomes for complex reasons that I will not go into. But, so the bill
:24:06. > :24:09.proposes new penalties for noncompliance and recovery of
:24:10. > :24:12.payments owed to the courts. Ultimately, this bill creatds a more
:24:13. > :24:16.level playing field between companies in the two schemes and it
:24:17. > :24:21.merely extends what is in place for the vast majority of companhes so I
:24:22. > :24:24.do not see it as being in any way unreasonable and I do not bdlieve
:24:25. > :24:28.there should be major concerns regarding the impact on resdarch and
:24:29. > :24:32.investment. The third part of the bill refers to inflammation powers
:24:33. > :24:37.and that brings together thd information requirements for NHS
:24:38. > :24:42.medicines and other supplies in the NHS act. It enables the Govdrnment
:24:43. > :24:46.regulations to obtain inforlation on the sales and purchases of ledicines
:24:47. > :24:51.and other supplies from all parts of the supply chain, manufacturing and
:24:52. > :24:55.distribution, pharmacy to ddfine purposes. This will improve the data
:24:56. > :24:58.which informs reimbursement arrangements for the communhty
:24:59. > :25:05.pharmacy and GP practices. Ht will also help to ensure value for money.
:25:06. > :25:08.These are positive proposals but it is important they are not over
:25:09. > :25:13.bearing on the companies concerned. In particular, I want to make the
:25:14. > :25:17.case for medical technology and devices businesses as they have not
:25:18. > :25:20.been subject to such data collection in the past the secretary of state
:25:21. > :25:24.has given us some reassurance about that today but we need to rdcognise
:25:25. > :25:29.a large proportion of these businesses, maintaining percent our
:25:30. > :25:35.SMEs supplement to work with industry to develop approprhate
:25:36. > :25:40.regulations. We need to avohd onerous and routine data collection
:25:41. > :25:45.is going beyond existing data required by future Massey. H support
:25:46. > :25:47.the principles of this bill and the Association of British
:25:48. > :25:50.pharmaceutical industry largely support it also but the det`il will
:25:51. > :25:53.be subject to consultation during be subject to consultation during
:25:54. > :25:58.2017 and I look forward to scrutinising progress over the
:25:59. > :26:04.coming months. It is a pleasure to form up my
:26:05. > :26:10.honourable friend. And if you're much of the points he has m`de. One
:26:11. > :26:18.point he bit was about how 252 million being spent by the NHS and
:26:19. > :26:24.50 drugs. It is actually 262 million extra backs to the increase in
:26:25. > :26:30.prices. That really brings home the problem this is causing and why we
:26:31. > :26:33.need to look at this bill again Devon the many members have already
:26:34. > :26:39.focused on a range of areas I wanted to focus on the issue of generic
:26:40. > :26:44.drugs and some of the huge price increases we have seen. It hs right
:26:45. > :26:50.to say and I've audit following the intervention of the member from
:26:51. > :26:53.Wolverhampton South West, actually, it is not unreasonable for `
:26:54. > :26:58.pharmaceutical company to m`ke a profit in exchange for investment it
:26:59. > :27:02.has made to develop a new drug and bringing to market. That is what
:27:03. > :27:05.operating system is therefore. The paper is there to protect for a
:27:06. > :27:09.period of time the ability for the company to charge a reasonable price
:27:10. > :27:14.to reflect the risk and invdstment. The keyboards at about the struggles
:27:15. > :27:19.of the out of the pit. They are drugs no longer patented. The
:27:20. > :27:23.company had a reasonable period of time to make investment bank and
:27:24. > :27:28.there is a limited supply and therefore it is on the road we go in
:27:29. > :27:35.and deal with what is an emdrging business. There is 02 bits `bout
:27:36. > :27:39.that. Some of the names the list -- there are no two ways about that.
:27:40. > :27:44.Some of the companies are consistently having unusually high
:27:45. > :27:47.increases in prices and it hs clearly business model is ddveloping
:27:48. > :27:52.to take advantage of the loophole and at the end of the day not to
:27:53. > :28:00.make a profit but to property and to property of the energy -- of the NHS
:28:01. > :28:04.-- to property of the NHS. We can all think of instances were drug
:28:05. > :28:08.company lobbying points the patient is unable to get treatment `nd this
:28:09. > :28:18.is the sort of thing that mdans people cannot get treatment. Here we
:28:19. > :28:23.are as Conservatives are dohng prose controls but it is clear thhs is not
:28:24. > :28:26.about intervening in a markdt, it is about market failure. Where the
:28:27. > :28:33.normal procedures of compethtion are not producing fair or reasonable
:28:34. > :28:39.outcomes either for the NHS patient we are providing products on behalf
:28:40. > :28:44.of all. I saw the amazing work done on brain tumour research at Plymouth
:28:45. > :28:49.University recently and saw some of the skills and ground-breakhng
:28:50. > :28:52.research they use that bring real benefits but that is not thd
:28:53. > :28:57.business model of these particular companies, the model is to look for
:28:58. > :29:01.a drug that is to be prescrhbed and has one supply, buy it, get hold of
:29:02. > :29:07.the supply and increase price. That is nothing to do with delivdring new
:29:08. > :29:20.and products. For me this bhll is very welcome and its propos`ls to...
:29:21. > :29:29.And if you are putting to look up your product 12,000%, you whll not
:29:30. > :29:31.be co-operative into an enqtiry The Secretary of State will havd powers
:29:32. > :29:38.to require more information to be supplied. I give way. I am grateful
:29:39. > :29:44.to my new friend, another socialist, for giving way. Can I suggest other
:29:45. > :29:52.areas of the economy where his Christian Democrat fellows would be
:29:53. > :29:58.prepared to address profitedring? Well, I thank him, he tempts me but
:29:59. > :30:02.seeing Mr Deputy Speaker is in the chair, it is tough on relathve
:30:03. > :30:10.points going off the subject and I could be dangerous territorx. We
:30:11. > :30:17.have seen work government h`s done in other sectors, the energx sector
:30:18. > :30:21.but this is a unique practice where there is only one customer, the NHS
:30:22. > :30:26.in large part, and where thdre is only one supplier. I'm struggling to
:30:27. > :30:32.think of other industries that replicate that but that is why these
:30:33. > :30:36.price rises are disgraceful and this industry is about profiteerhng of
:30:37. > :30:43.illness and pain. I briefly give way. Can I suggest another hndustry
:30:44. > :30:48.where it is worth looking at, the defence Supply industry. Parts of
:30:49. > :30:54.it. I thank him for the intervention. I have spent plenty of
:30:55. > :31:00.time looking through examplds of defence procurement that have gone
:31:01. > :31:03.wrong although to be fair to the minister, he may be new to the
:31:04. > :31:09.health department but not the issues of tackling in defence proctrement.
:31:10. > :31:13.It is noticeable that most of the issues making their way for the
:31:14. > :31:19.review of what went wrong otr legacy issues that were still -- wd are
:31:20. > :31:24.still dealing with rather than the modern procurement. I'm conscious we
:31:25. > :31:30.do have the Deputy speaker hn the chair and I need to get back to the
:31:31. > :31:34.price of drugs. It is clear from looking to the evidence that the
:31:35. > :31:38.current system of regulation is not effective given that you can put
:31:39. > :31:43.branded projects into the voluntary scheme and use that to jack up costs
:31:44. > :31:50.for your generic products. @nd that is not right. As other membdrs said,
:31:51. > :31:54.we are all facing demands on the NHS and I have no problem with companies
:31:55. > :31:59.who give good service charghng a fair price and making a fair return.
:32:00. > :32:04.But that is clearly not what is going on with this business model
:32:05. > :32:08.and we can see numerous exalples, especially the chart in the library
:32:09. > :32:12.showing thousands of percents across a number of products. It is
:32:13. > :32:19.impossible to believe the thousands of % increases are going on in any
:32:20. > :32:23.of the input materials to this products. This is vagrant
:32:24. > :32:29.racketeering and profiteering going on at the expense of patients and
:32:30. > :32:31.people in pain. Even if the drug is still provided, it is money and
:32:32. > :32:38.resources that should have been spent elsewhere. That is whx pleased
:32:39. > :32:41.to see the unanimity breaking out in the house this evening around these
:32:42. > :32:47.proposals although there is a need to discuss them in more det`ils in
:32:48. > :32:50.committee but this bill is the right time, it is not about tacklhng
:32:51. > :32:57.legitimate profits, it is about getting rid of profiteering and it
:32:58. > :33:02.has my full support. It is ` pleasure to be called to spdak in
:33:03. > :33:06.this debate today and to follow my honourable friend from Torb`y. From
:33:07. > :33:12.what I understand, it will close the loopholes and gaps that exist in the
:33:13. > :33:17.current powers given to the Secretary of State and my friends
:33:18. > :33:23.before me have highlighted the loopholes and gaps. Overall the
:33:24. > :33:29.measures are important to ensure we have value for the taxpayer across
:33:30. > :33:35.the medicines budget. But where I take issue with the proposals is the
:33:36. > :33:42.inclusion of medical supplids, other related products. As part of the
:33:43. > :33:46.third element of the bill. This element introduces a new information
:33:47. > :33:52.power for the Secretary of State and while I welcome this in principle,
:33:53. > :34:00.it may be own arrest for sm`ll enterprises that supplied to this
:34:01. > :34:07.side of the business. I am sure much of the required information has been
:34:08. > :34:13.collated by each company but it s important it can be transmitted in
:34:14. > :34:16.an easy and timely fashion. I was listening carefully to the Secretary
:34:17. > :34:22.of State and he implied he does not want the measures he suggests to be
:34:23. > :34:32.burdensome but I seek the mhnisters assurance on this issue. Dods my
:34:33. > :34:37.honourable friend, it is thd ability to use the data effectively that is
:34:38. > :34:45.important, there is no point in collecting data and not being able
:34:46. > :34:50.to use it. I give way. Coupling those two together, does shd agree I
:34:51. > :34:53.be advisable for the governlent to look at a threshold, a turnover
:34:54. > :34:59.threshold below which this information were not have to be
:35:00. > :35:02.supplied or might be supplidd to a lesser extent and quantity
:35:03. > :35:07.addressing the issue of how homeless this might be but could address
:35:08. > :35:14.issues of whether the government has the capacity to crunch the figures.
:35:15. > :35:19.He makes a good point, therd is a cut off for some of the dat`
:35:20. > :35:25.collection or different parts in existence and it might be ?4 million
:35:26. > :35:28.turnover but we can get clarification on that. What concerns
:35:29. > :35:39.me more is who will define what is classified as a medical supply and
:35:40. > :35:45.other related products? As we heard, in an intervention, really ht is how
:35:46. > :35:54.long is that piece of string? Section 264 supplements and it
:35:55. > :36:00.requires the Secretary of State to consult anybody like the Association
:36:01. > :36:04.of the pharmaceutical industry which appears to represent manufacturers
:36:05. > :36:06.and distributors and supplidrs of health service medicines, mddical
:36:07. > :36:11.supplies or related products acquired for the purposes of the
:36:12. > :36:19.health service in England or the UK before making any regulations under
:36:20. > :36:22.section 264 a or B. But, if the definition of supplies is unclear,
:36:23. > :36:27.how would the Secretary of State know who to consult with? Hd
:36:28. > :36:32.indicated he has had discussions with medicine and medical ddvice
:36:33. > :36:36.suppliers but I fear there lay be more product areas out therd that
:36:37. > :36:42.have been missed out of the initial discussions. I ask the Secrdtary of
:36:43. > :36:48.State to provide guidance on what he understands as medical supplies and
:36:49. > :36:59.other related products. For example, does it include in vitro di`gnostic
:37:00. > :37:05.products or IVDs? So, if it includes IVDs, does he agree to constlt with
:37:06. > :37:11.the Association, the trade association which represents this
:37:12. > :37:15.industry across the UK? This is an important area for the life sciences
:37:16. > :37:20.industry with nearly 900 million pathology tests performed every
:37:21. > :37:26.year. And with 70% of every clinical decision being made using some form
:37:27. > :37:33.of IVD. If they are included, we need to be around the table to
:37:34. > :37:37.participate. I wish to conclude by saying in general terms I al in
:37:38. > :37:40.favour of this bill as it is ensuring good value for mondy for
:37:41. > :37:46.taxpayers and ultimately for patients. That is what we nded to be
:37:47. > :37:50.thinking about, the patient. However, there does need to be some
:37:51. > :37:55.clarification throughout thd bill which will be sought out at
:37:56. > :38:02.committee stage and I support the bill tonight. Thank you. It is a
:38:03. > :38:13.pleasure to follow my honourable friend. We know old ground, the
:38:14. > :38:19.ageing population, the costs bearing down which other members alluded to
:38:20. > :38:26.earlier. We know the advancds in science are going quicker than we
:38:27. > :38:32.can make the legislation. One of my local CCGs suffered an exorbitant
:38:33. > :38:39.increase in capsules having to find another 600,006 months. Needing to
:38:40. > :38:43.look at drugs more widely, the honourable member from South Suffolk
:38:44. > :38:48.mentioned if paracetamol was not prescribed in that CCG it would save
:38:49. > :38:53.?1 million a year. The meastres in the bill aimed to manage thd cost of
:38:54. > :39:00.drugs. The measure to make dfficient data correction is also most welcome
:39:01. > :39:05.so that we start to have a decision-making based on evhdence.
:39:06. > :39:09.Last autumn the Secretary of State consulted publicly on how to address
:39:10. > :39:14.the problem of excessively priced unbranded medicines and the industry
:39:15. > :39:19.fed back. They were glad of the dialogue. Drug costs are
:39:20. > :39:26.unsustainable. A saving of 80 million per health area was
:39:27. > :39:30.identified, my only CCG could save ?1 million per annum from an repeat
:39:31. > :39:35.prescriptions. Nationally, ht would mean more than 12,000 more community
:39:36. > :39:39.nurses could actually be employed. We need to start making these
:39:40. > :39:45.decisions where we want to be spending the money. The pressure on
:39:46. > :39:49.social care, as was alluded to, I decisions we are going to h`ve to
:39:50. > :39:54.make as a government, and as patients. The current systel allows
:39:55. > :39:59.for some to be in and others to be outside the system and it lhmits the
:40:00. > :40:02.robustness and I support it wholeheartedly. Does not target
:40:03. > :40:07.those who do not play fair `nd we need to stamp down on it. It is
:40:08. > :40:12.those better patient outcomds that I'm passionate about. We all play a
:40:13. > :40:15.part including the pharmacist industry because of the unipue
:40:16. > :40:23.industry in this country. The industry is important to us as the
:40:24. > :40:26.member for Chelmsford and South West Bedfordshire and the Cities of
:40:27. > :40:31.London and Westminster have alluded to, we need to be supportivd of the
:40:32. > :40:37.companies that work positivdly for patients and engage in trying to
:40:38. > :40:39.find solutions. The Association of British pharmaceutical industry
:40:40. > :40:43.supports the government in increasing powers where market
:40:44. > :40:48.failure has occurred. There is a balance between ensuring new drugs
:40:49. > :40:52.are developed which brings le to off label drugs, those that havd another
:40:53. > :41:03.use the which they were originally formulated.
:41:04. > :41:09.Many drugs originally developed for morning sickness but have bden found
:41:10. > :41:14.latterly to be very benefichal for the treatment of some cancers and
:41:15. > :41:19.skin conditions. We need to understand these new uses for
:41:20. > :41:23.approved drugs for the speediest of transitions from bench to bddside.
:41:24. > :41:28.As they have not been through trials yet, we also need to be mindful this
:41:29. > :41:40.is not a new drug, and just because the target... Drug should bd costed.
:41:41. > :41:47.Does she remember the time that was spent last November debating the
:41:48. > :41:52.offer patented drugs bill and when I flagged up the concern that for a
:41:53. > :41:55.doctor prescribing a drug whth a license for use takes precedence
:41:56. > :42:01.over and off Peyton drug whhch may do the same and with this g`ming we
:42:02. > :42:05.have seen, there is a concern that the drug companies will twe`k a drug
:42:06. > :42:11.in a slight manner and sell it to the NHS at hundreds of thousands
:42:12. > :42:12.when an offer patented drugs would do the same and that has not been
:42:13. > :42:21.dealt with. I thank her after making thd point
:42:22. > :42:25.so succinctly. I am also gr`teful for the Secretary of State for the
:42:26. > :42:28.clarification and the honourable member comments around the
:42:29. > :42:34.technology industry which I do believe need looking at. I would be
:42:35. > :42:39.grateful to know that the s`vings made are likely to be reinvdsted
:42:40. > :42:42.into patients particularly given my position as chair of the APG on
:42:43. > :42:47.personalised medicine into the latest medicines and treatmdnt. This
:42:48. > :42:51.Bill is designed to stop individuals making vast sums of money and taking
:42:52. > :42:56.advantage of a loophole and I backed the Government's aim of valte for
:42:57. > :43:00.money and fair prices for optimum patient outcomes. I am heartened to
:43:01. > :43:09.see the cross-party support for this Bill and look forward to seding it
:43:10. > :43:13.to make positive progress. Thank you, Mr Deputy Speaker. I would like
:43:14. > :43:17.to thank those members who lade contributions to the debate today.
:43:18. > :43:22.We find ourselves in a situ`tion where we have some time avahlable
:43:23. > :43:26.which is amazing. What we rdfer to the interventions that we hdard in
:43:27. > :43:29.the early part of the debatd because I think there have been a r`nge of
:43:30. > :43:36.interesting points. The honourable member for Totnes rage the view that
:43:37. > :43:44.it gives the opportunity to that that drugs that have not bedn
:43:45. > :43:48.licensed, but so needed eye that group of people. And I was pleased
:43:49. > :43:55.to hear the Secretary of St`te say that he would look at that. My
:43:56. > :43:59.friend Wilbur Hampton Southwest -- Wolverhampton South West. In a
:44:00. > :44:04.number of quite a music interventions has talked about a
:44:05. > :44:07.policy on profit control of the farm sector and said that the party of
:44:08. > :44:16.Sid is marching on to the cdntre ground and perhaps gone past the
:44:17. > :44:18.march of dissent. -- opposite. The member for Leicester East
:44:19. > :44:23.particularly talked about the proportion of the NHS budget spent
:44:24. > :44:27.on diabetes, he was concerndd about the increase in the drugs Bhll and
:44:28. > :44:29.suggested the use of structtred interventions, not just for drugs
:44:30. > :44:37.for those people because it is such a large proportion of the NHS Bill
:44:38. > :44:40.that is spent on diabetes. Honourable friend for Alan `nd
:44:41. > :44:43.Deeside made the point that we need to make sure that measures of this
:44:44. > :44:50.Bill do not act as a disincdntive for Pharma companies to makd
:44:51. > :44:53.contributions to companies. I think many of the members contribtting to
:44:54. > :44:57.make know we are walking thd line here in terms of making savhngs but
:44:58. > :45:00.making sure there aren't disincentives. The red honotrable
:45:01. > :45:04.member for Chelmsford welcoled the Bill. He talked about our ageing
:45:05. > :45:10.conch dashed back on probathon and we talked about that. The ilportance
:45:11. > :45:14.of new drugs but they need to deal with unacceptable profiteerhng and a
:45:15. > :45:17.number of members of refer to that. The honourable lady for Central
:45:18. > :45:20.Ayrshire talked about having the biggest research network in the
:45:21. > :45:26.world but topped about change and talked that the Pharma comp`nies
:45:27. > :45:29.would be anxious and... She welcomed the tidying up aspect of thd Bill
:45:30. > :45:33.and I think that was a general view that members on all sides of the
:45:34. > :45:38.housework not. She talked and the number of members have done in this
:45:39. > :45:41.debate about not just in a building the management of cost pressures but
:45:42. > :45:46.doing something more radical and I think that has been a real flavour
:45:47. > :45:50.of this debate. Using this `s an opportunity to do something
:45:51. > :45:53.different, I agree with her concerns about the data collection aspects of
:45:54. > :45:57.the Bill and I will say mord about that. But I also agree that we need
:45:58. > :46:01.to do something more radical and for instance she talked about t`ckling
:46:02. > :46:04.the five-year delay to access new medicines and rightly points out
:46:05. > :46:08.that that is probably where or poorest survival rates are coming
:46:09. > :46:13.from. The honourable member for Southwest at Fisher commenddd the
:46:14. > :46:15.Times for investigating this issue we are talking about that tonight.
:46:16. > :46:19.Also talked about the inforlation powers. He talked about was of the
:46:20. > :46:23.Department for health at thd analytical ability to use the data
:46:24. > :46:26.being gathered and that is `n important question. If new data is
:46:27. > :46:31.being required to be gatherdd what are we going to do with the? The red
:46:32. > :46:34.honourable member per in West Norfolk acknowledge the valte of the
:46:35. > :46:37.competitive market but also talked about the sometimes outrageous
:46:38. > :46:40.increases in the price of gdneric drugs and we have heard somd
:46:41. > :46:45.staggering examples today including the example of a rise of ?600 per
:46:46. > :46:50.item dispensed in one particular case. He hoped as other members have
:46:51. > :46:53.that the Competition and Markets Authority would take action and I
:46:54. > :46:57.think that has been a key theme tonight. He talked also abott not
:46:58. > :47:00.wanting to fit the needs and interests of some patients were
:47:01. > :47:05.needing drugs like prep versus other needed drugs and I agree. I don t
:47:06. > :47:09.think we want to go there. He also talked about the fact that this is a
:47:10. > :47:14.slippery slope when we get hnto debating whether to delay adopting
:47:15. > :47:17.even approved treatments. In his view that is more evidence that the
:47:18. > :47:23.NHS needs more resources. The honourable member Clwyd talked about
:47:24. > :47:25.the impact on his constituent of a drug prescribed to her which helps
:47:26. > :47:31.her work and increases energy levels but the cost of which has increased
:47:32. > :47:34.by 645% and we must keep focus on the impact of individuals of the
:47:35. > :47:37.decisions that we make becatse having found a drug that suhts her
:47:38. > :47:43.it would be dreadful that w`s withdrawn. He also talked about the
:47:44. > :47:46.difficulties of increasing new competition into the market. His
:47:47. > :47:50.constituent is hoping the Bhll goes through as are many tonight and for
:47:51. > :47:54.action on competition and m`rkets and let's all hope that goes
:47:55. > :47:57.through. The honourable member for Torbay talked about intervening to
:47:58. > :48:03.deal with market failure and his view was that we need to separate
:48:04. > :48:06.out the companies that are doing good research, brain tumour research
:48:07. > :48:08.that he has seen recently, `nd those that are having nothing to do with
:48:09. > :48:15.producing new and innovativd products but are just making money.
:48:16. > :48:18.Will my friend give way? Can I cite her and he has the library brief
:48:19. > :48:22.because it isn't exactly as cut and dry as the honourable member for
:48:23. > :48:27.Torbay may have been thinking. The library brief tells us that the
:48:28. > :48:30.competitions and market authority took action against pharmacdutical
:48:31. > :48:35.companies with regards to gdneric pricing. Glaxo Smith Kline `nd a
:48:36. > :48:38.number of other companies wdre fined 45 million when it was found that
:48:39. > :48:43.payments had been made in order to prevent the added. The situ`tion
:48:44. > :48:48.being offered on the market. So SmithKline is a great Pharm` company
:48:49. > :48:51.incomes are turning up of ndw drugs that crossed the line in thhs case
:48:52. > :48:57.according to the library brhefs with is not either or. No, but I think
:48:58. > :49:01.the honourable member for Torbay was talking about companies that are not
:49:02. > :49:04.even doing research, just btying up generic drugs and profiteerhng. I
:49:05. > :49:10.think generally that has bedn a condemnation on all sides of that. I
:49:11. > :49:14.thank the Shadow Minister forgiving way. To be clear I think shd
:49:15. > :49:18.probably agreed that it is names that keep on popping up particularly
:49:19. > :49:23.in the Times investigation of companies who seem to be quhte
:49:24. > :49:26.regularly revolve in the most eye watering price increases and this is
:49:27. > :49:30.about tackling anyone else who might be thinking about going down that
:49:31. > :49:36.business model out of explohting the NHS. Very much so. The honotrable
:49:37. > :49:41.member for Bury Saint Edmund welcomed the Bill talked about the
:49:42. > :49:46.fact that individual CCG 's could actually save ?1 million with unused
:49:47. > :49:49.repeat prescriptions, so thdre clearly are a number of isstes here
:49:50. > :49:54.in terms of savings that cotld be made and also talked about the
:49:55. > :49:57.pressure on social care. I join her in being concerned about prdssures
:49:58. > :50:01.on social care, although thd honourable member perchance bird
:50:02. > :50:06.talk further about an ageing population and the need for drugs,
:50:07. > :50:11.older people also don't need to be isolated. It is worrying th`t 1 ,000
:50:12. > :50:17.cases of malnutrition were found last year with an average age of 64
:50:18. > :50:21.among those cases. People nded to social care and I hope the new
:50:22. > :50:24.Chancellor will listen and this year bring forward funding for social
:50:25. > :50:31.care in the Autumn Statement, because people do need thesd drugs.
:50:32. > :50:34.As my right honourable friend made earlier, Labour supports thd broad
:50:35. > :50:38.aims of this Bill and what the Government is seeking to achieve in
:50:39. > :50:40.terms of better control over the cost of medicines, however `s he
:50:41. > :50:47.also outlined we have a number of concerns. I have a list. In his
:50:48. > :50:50.closing speech is concerns... We do have concerns about some me`sures in
:50:51. > :50:53.the Bill. As well as the understandable measures to collect
:50:54. > :50:58.pharmaceutical data and man`ge costs, the Bill also introdtces
:50:59. > :51:02.provisions to manage the purchase of other medical supplies. I w`s glad
:51:03. > :51:05.to hear the Secretary of St`te raise the issue of the impact on the
:51:06. > :51:10.medical supply sector which he did in his opening speech. I have had
:51:11. > :51:12.concerns expressed at the mddical technology sector seeing thd new
:51:13. > :51:17.information measures as owndrs for the sector and the honourable member
:51:18. > :51:22.for error was mentioned that in the debate also. There is a concern that
:51:23. > :51:26.measures in the Bill filter taken to the account the unique
:51:27. > :51:28.characteristics medical devhces in the medical device industry and they
:51:29. > :51:31.hope they will start to be taken into account as the Bill progresses.
:51:32. > :51:35.That is seen to be a danger that the measures included in the Bill will
:51:36. > :51:38.put additional burdens on the sector and the NHS and actually le`d to
:51:39. > :51:42.higher costs. I hope that is not the intention of the Government. But we
:51:43. > :51:45.be Dick is to be increasing costs in a Bill that was trying to m`nage
:51:46. > :51:50.them. -- it would be ludicrous. We need to bear in mind that the
:51:51. > :51:53.medical technology industry are poised around 89,000 people in the
:51:54. > :51:57.UK and an annual turnover of more than 70 billion and hesitancy
:51:58. > :52:03.implement growth of 11% in recent years. 99% of UK's 3300 medhcal
:52:04. > :52:08.technology firms are small `nd medium enterprises and 85% of them
:52:09. > :52:14.having a turnover of less than million. And so might honourable
:52:15. > :52:17.friend talked about cap levdls at which or data could be colldcted.
:52:18. > :52:21.That is a lot of small comp`nies and we need to bear that in mind. The
:52:22. > :52:25.Bill imposes a regulatory btrden on all companies in the supply chain
:52:26. > :52:28.and the reporting requirements will and the reporting requirements will
:52:29. > :52:33.affect all firms producing ledical supplies including those very small
:52:34. > :52:37.organisations. The issues wd have discussed extensively in thhs debate
:52:38. > :52:40.on pharmaceutical pricing, they bear no relation to the price of other
:52:41. > :52:44.medical supplies and the honourable member opposite gave an exalple of a
:52:45. > :52:49.particular type of product. But they do seem to be treated the s`me way
:52:50. > :52:51.in this Bill. In terms of the scale of the burden being imposed the
:52:52. > :52:55.Government's impact assessmdnt is Government's impact assessmdnt is
:52:56. > :52:59.not much help. It says the lain costs will be on manufacturdrs,
:53:00. > :53:00.wholesalers and dispensers. These costs about been quantified as the
:53:01. > :53:03.magnitude will not be known until magnitude will not be known until
:53:04. > :53:08.after consultation with subsequent regulations. It seems and I think
:53:09. > :53:12.other members have referred to this that measures have been bolted onto
:53:13. > :53:16.this Bill at the last minutd. But because they could have a ndgative
:53:17. > :53:20.impact on sectors like the ledical technology sector, we need to be
:53:21. > :53:22.very aware of them. The new information power is being proposed
:53:23. > :53:26.by the Government are being put forward at a time when manufacturing
:53:27. > :53:29.firms are going through the uncertainty around this country
:53:30. > :53:34.leaving the EU and these me`sures can only add to that uncert`inty
:53:35. > :53:39.because as I have said, 99% of the medical technology firms ard SMEs
:53:40. > :53:43.with 85% having a turnover of less than ?5 million. Notes on the
:53:44. > :53:46.financial implications of the Bill put forward a curious posithon that
:53:47. > :53:50.no policies will be directlx into mentored as a result of these
:53:51. > :53:54.changes. Their implementation would require additional future changes to
:53:55. > :53:59.secondary legislation and additional impact assessments to assess their
:54:00. > :54:02.cost effectiveness. Ministers have actually asking the House to change
:54:03. > :54:06.primary legislation to give government new information powers
:54:07. > :54:11.but the details and the imp`ct of the new powers on the supplx chain
:54:12. > :54:15.will only emerge in future. And that level of uncertainty is unacceptable
:54:16. > :54:18.to us on the side. We will seek to amend the relevant clauses hn
:54:19. > :54:25.Committee if we need to resolve them still. Importantly, the information
:54:26. > :54:28.powers was also impacting on dispensing GPs and pharmacists. I
:54:29. > :54:31.note that the BMA were not represented at the workshop held by
:54:32. > :54:37.the Department of Health and the information powers. We wait to hear,
:54:38. > :54:40.but I would find it unusual, if hard pressed dispensing GPs would welcome
:54:41. > :54:45.additional work that would be required of them in providing
:54:46. > :54:48.information to the Government. The other part of the supply ch`in
:54:49. > :54:52.affected by the new information powers of this Bill will be
:54:53. > :54:55.pharmacists. The Government has just imposed punitive cuts on ph`rmacists
:54:56. > :55:01.which we discussed in the House last week. I am still deeply concerned
:55:02. > :55:04.about these cuts. Ministers do not seem to understand what thex are
:55:05. > :55:08.doing to the sector. I heard on Friday from an independent community
:55:09. > :55:13.pharmacist in my constituency who told me that he estimates that
:55:14. > :55:18.government cuts will cost hhm ?86,000 a year and he can sde an
:55:19. > :55:22.average cut of 60,000 from `ny pharmacists. This will cert`inly
:55:23. > :55:27.mean staff cuts but also potential bankruptcies forbid pharmaches which
:55:28. > :55:32.are hardest hit. In terms of this, and the new information powdrs being
:55:33. > :55:35.posed by the Bill, pharmacy voice told me small volume pharmacies are
:55:36. > :55:41.the hardest hit by the proposals. And many of those faced a ftnding
:55:42. > :55:46.cut of around 20% in 2017-18 from the imposition of the cuts
:55:47. > :55:49.announced. They do not have teams of administrative staff who can respond
:55:50. > :55:53.to demands would information and the likelihood is that the NHS would
:55:54. > :55:57.exist on information being provided in a specific format. It cotld be
:55:58. > :56:02.information that they do not currently analyse, for example, when
:56:03. > :56:06.a pharmacy buys stock for dhspensing it may also include purchasds of
:56:07. > :56:09.medicines for sale over the counter. The overall discount the ph`rmacy
:56:10. > :56:14.gets on the order is not allocated to each item and pharmacies could
:56:15. > :56:16.not provide the actual pricd paid per item. On behalf of the
:56:17. > :56:20.pharmacists they represent they would want to ensure that the cost
:56:21. > :56:24.of meeting the Government's information requirements is fully
:56:25. > :56:27.met by the NHS. They feel that the imposition of cuts has alre`dy put
:56:28. > :56:30.the future of the pharmacy sector, particularly smaller pharmacy
:56:31. > :56:35.businesses, in jeopardy. Can the minister assure me that the cost of
:56:36. > :56:38.the information required to be gathered under the new information
:56:39. > :56:43.powers will not represent an additional cost burden on
:56:44. > :56:46.pharmacists? To conclude, the Labour opposition supports the bro`d aims
:56:47. > :56:51.of this Bill, in terms of mdasures to control the costs of medhcines.
:56:52. > :56:54.But we have concerns as I h`d said about the information powers the
:56:55. > :56:59.Government wants to take to itself, they are seen as onerous by the unit
:57:00. > :57:06.and medical supply sectors but we want to make sure they are not.
:57:07. > :57:11.The pharmacy sector is counting the costs of the government imposition
:57:12. > :57:16.of funding cuts amounting to 12 for the rest of this year and over %
:57:17. > :57:21.next year. We will move amendments in committee on these issues of the
:57:22. > :57:26.work and cost of information gathering. We asked ministers to
:57:27. > :57:30.look at using all future rebates from the pharmaceutical sector to
:57:31. > :57:34.improve access to treatments for patients. A number of honourable and
:57:35. > :57:40.Right Honourable member is spoken of the need to look at this big issue
:57:41. > :57:49.of access to drugs and treatments. I hope ministers will take up the
:57:50. > :57:54.opportunity is the bill progresses. What a great pleasure it is to stand
:57:55. > :57:59.before you after this important debate but with a little tile to be
:58:00. > :58:02.able to satisfy as many of the honourable member is as I c`n but
:58:03. > :58:07.recognising we will be going into committee shortly and will have an
:58:08. > :58:12.opportunity to discuss thosd points I cannot pick up today. I would like
:58:13. > :58:16.to start by thanking everyone who has taken part in the debatd. We
:58:17. > :58:21.have had some excellent contributions from members `re some
:58:22. > :58:25.showing a surprising knowledge of the intricacies of pharmacettical
:58:26. > :58:31.pricing but nonetheless welcome The bill is dealing with a treasured
:58:32. > :58:37.national institution. And the need to get best value for the. Ledicines
:58:38. > :58:42.are the second largest cost to the NHS after staff it is important we
:58:43. > :58:46.do not pay over the odds. The level of interest and quality of
:58:47. > :58:51.contributions today show how important that is for all mdmbers. I
:58:52. > :58:56.think it is refreshing to h`ve a debate involving the NHS with the
:58:57. > :59:02.degree of consensus that has erupted across the house today. I al led to
:59:03. > :59:07.believe and it has been said by others, this is a relativelx unusual
:59:08. > :59:13.occurrence so I will enjoy ht as long as I can. The debate rdinforces
:59:14. > :59:17.the principles of getting the best value for the NHS, making ddcisions
:59:18. > :59:21.on the basis of good qualitx information and supporting this
:59:22. > :59:28.country is innovative pharm`ceutical industry, referred to many. These
:59:29. > :59:35.principles upon which I can agree. The debate has raised a number of
:59:36. > :59:39.issues some of which I will clarify now for members who have made
:59:40. > :59:45.comments and I would like to start by responding to the honour`ble
:59:46. > :59:51.lady, one of her closing st`tements linking announcements in relation to
:59:52. > :59:53.pharmacy funding and this bhll and to reassure her that there hs no
:59:54. > :59:58.link whatsoever between the provisions in this bill on
:59:59. > :00:04.information collection and last weeks announcement on the ddcisions
:00:05. > :00:08.on funding. Community pharm`cy funding changes will come into
:00:09. > :00:12.effect in December and are not reliant on any of the provisions of
:00:13. > :00:24.this bill nor the provisions change those decisions. I was not laking
:00:25. > :00:29.the point of that, the cuts imposed by government will mean that some
:00:30. > :00:34.community pharmacies for thd Independent ones will not h`ve staff
:00:35. > :00:38.to do it. If the government is imposing a new information gathering
:00:39. > :00:43.requirement, who will do th`t? The cuts might mean 60 or ?80,000 cuts,
:00:44. > :00:52.staff cuts and people not bding able to absorb a new requirement. Well,
:00:53. > :00:56.just to reassure her, the establishment cost for each pharmacy
:00:57. > :01:01.is currently ?25,000 and is a reduction in that cost rathdr than
:01:02. > :01:05.large cost. She must be refdrring to companies that have several
:01:06. > :01:09.established by the individu`l one and though on the information
:01:10. > :01:18.gathering points she has rahsed during my remarks. We have had a
:01:19. > :01:23.number of allusions during the debate started by the honourable
:01:24. > :01:27.member for Ellesmere Port who I am sure will join a shortly th`t the
:01:28. > :01:32.Conservative party appears to have broken out in a rash of Jerdmy
:01:33. > :01:35.Corbyn but I can assure her categorical -- categoricallx it is
:01:36. > :01:43.not the case. We are seeking through this bill to rectify points made by
:01:44. > :01:49.members on both sides about the potential for exploitative pricing
:01:50. > :01:56.and in particular unbranded generics which are of low volume and weather
:01:57. > :02:00.isn't a competition of alternative supplier in the market -- and where.
:02:01. > :02:06.There is agreement across the house. But I welcome the support from the
:02:07. > :02:12.front bench of the Labour P`rty the front bench of the SNP and the Lib
:02:13. > :02:19.Dems, all of whom are supporting the principles of the bill and H look
:02:20. > :02:26.forward to a rapid conclusion to this short bill in committed,
:02:27. > :02:30.doubtless you will be raising important points in the comlittee
:02:31. > :02:33.but I am sure we will have continuing constructive
:02:34. > :02:43.contributions or the way through. The member for Ellesmere Port asked
:02:44. > :02:46.about in particular difficulties of access and funding for new ledicines
:02:47. > :02:52.and this was raised by the lember for Central Ayrshire. The NHS is
:02:53. > :02:57.investing in innovative medhcines and in the first year of thd current
:02:58. > :03:04.voluntary scheme, medicines covered by the innovation scorecard saw an
:03:05. > :03:07.increase of 18% compared to growth of 5% in medicines not on the
:03:08. > :03:14.scorecard so that illustratds we are prepared to fund innovative
:03:15. > :03:18.medicines under the existing scheme but we recognise the need to
:03:19. > :03:23.continue to ensure patient `ccess to new medicines and that is why as the
:03:24. > :03:30.Secretary of State referred to, the exhilarated Access review announced
:03:31. > :03:34.earlier today will accelerate the speed at which 21st century
:03:35. > :03:39.innovation in medicine and ledical technologies can get taken tp by
:03:40. > :03:49.patients and their families through the NHS. This is a real adv`ntage in
:03:50. > :03:56.bringing the innovation which we see in pharmaceutical companies, not
:03:57. > :04:00.just here but driving those through that driving is through to tse the
:04:01. > :04:05.NHS. A number of members referred to the investigative work of The Times
:04:06. > :04:12.newspaper in helping to highlight the problems of the unbranddd
:04:13. > :04:16.generics and I would like to add are welcome to the investigation
:04:17. > :04:22.undertaken by those journalhsts at point out the government was all
:04:23. > :04:28.ready aware of some of the problems and we published a consultation on
:04:29. > :04:32.December last year raising the issue and it was partly in light of that
:04:33. > :04:38.that the Times newspaper did their work, not to decry it, it w`s
:04:39. > :04:44.helpful. We referred cases to the Competition and Markets Authority is
:04:45. > :04:52.referenced by the member for Wolverhampton South West. They have
:04:53. > :04:57.imposed fines in one case, ht is expecting to reach a final decision
:04:58. > :05:04.in the coming months on another case and two more cases were opened in
:05:05. > :05:09.March and April earlier this year so we are looking to refer exalples of
:05:10. > :05:14.bad practice when we come across them to the relevant authorhties.
:05:15. > :05:21.The honourable lady for Central Ayrshire asked about data collection
:05:22. > :05:27.and how it will work and thhs was raised by others in interventions.
:05:28. > :05:31.We all ready collect signifhcant data from the supply chain to
:05:32. > :05:37.medicines, and both voluntary and statutory schemes for minor fracture
:05:38. > :05:44.and wholesalers of generics and pharmacies themselves all rdady so
:05:45. > :05:50.what we are looking to do as part of developing the regulations before we
:05:51. > :05:54.introduce this scheme, we are looking to try to identify `s many
:05:55. > :06:00.automated data collection solutions as possible to minimise the burden
:06:01. > :06:07.the honourable lady referred to and recognising that some of thd medical
:06:08. > :06:11.products companies are small companies and we want to make that
:06:12. > :06:15.burden as light as possible. She also referred to the devolvdd
:06:16. > :06:23.administrations and how we will be working with them. The intent is
:06:24. > :06:29.they can access data not on a timing of our choosing but as they require
:06:30. > :06:32.it. And that that will be undertaken again in a manner that we h`d to
:06:33. > :06:39.capture in a memorandum of understanding siders claritx between
:06:40. > :06:53.each administration and ourselves. The honourable member for North
:06:54. > :06:58.North asked in particular about how we intend to control the medicines
:06:59. > :07:05.bill overall and members mentioned this, the cost of medicines are
:07:06. > :07:09.rising quite rapidly. This hs a concern and it gets to the heart of
:07:10. > :07:17.why we have sought to introduce this legislation. We are looking in the
:07:18. > :07:23.first place to align the st`tutory and voluntary cost control schemes
:07:24. > :07:26.for supply of medicines. Colpanies are present can decide to join
:07:27. > :07:31.either scheme depending on the other benefits they perceive to the
:07:32. > :07:37.schemes but we believe the financial benefits to the NHS should be the
:07:38. > :07:44.same. The proposals will put beyond doubt the powers to amend the scheme
:07:45. > :07:49.and the impact that has indhcated it should say that taxpayers ?80
:07:50. > :07:52.million year. Draft regulathons will be available for discussion around
:07:53. > :07:57.the provisions at the committee stage. The second element of the
:07:58. > :08:02.bill strengthens powers to set prices of medicines were colpanies
:08:03. > :08:06.charge and reasonably high prices for unbranded generics. In lost
:08:07. > :08:11.cases, competition works well to keep prices down but when it does
:08:12. > :08:15.not, and when companies are making excessive profits, the government
:08:16. > :08:21.should be able to take action. This bill will close this current
:08:22. > :08:29.loophole in the framework and we all agreed we cannot allow propdr
:08:30. > :08:34.tipping at the expense of the NHS. Thirdly, the bill strengthens powers
:08:35. > :08:37.to collect information on the costs of medicines, medical supplhes and
:08:38. > :08:41.other products from across the supply chain. By putting thd
:08:42. > :08:45.existing provisions regarding medicines on a statutory butting, it
:08:46. > :08:49.enables the government more accurately and fairly to set
:08:50. > :08:55.reimbursement arrangements for community pharmacies and dispensing
:08:56. > :08:59.GPs and the power will provhde vital data to underpin the reform scheme
:09:00. > :09:02.for controlling medicine and pricing and gives us more evidence `bout
:09:03. > :09:08.whether companies are making excessive profits at the expense of
:09:09. > :09:12.the NHS. I would like to rehterate what might have a friend sahd in his
:09:13. > :09:16.remarks. To assure the housd about the impact of the information powers
:09:17. > :09:22.on the medical technologies industry. It may surprise mdmbers
:09:23. > :09:30.that the powers to require information from suppliers `ll ready
:09:31. > :09:34.exists in section 260 of thd 20 NHS act which the honourable melber
:09:35. > :09:42.remembers bringing into effdct. These powers were Draconian so we
:09:43. > :09:45.wish to make these more proportionate. As it happens, the
:09:46. > :09:53.government has never used the powers that exist and the act and so what
:09:54. > :09:58.we are looking to do is to bring these powers within it to m`rry up
:09:59. > :10:03.the same powers for information gathering so there is no confusion
:10:04. > :10:10.in future over which inform`tion regime applies. It does not sound
:10:11. > :10:18.Draconian if they're never dnforced but that section of the act refers
:10:19. > :10:22.to medical supplies and it defines them as surgical dental and optical
:10:23. > :10:26.materials and equipment, wotld you look at the definition becatse it
:10:27. > :10:31.seems it is not as wide as lany people think it is and therd is a
:10:32. > :10:35.way around it for certain technological companies if they wish
:10:36. > :10:38.to get around it like the manufacturers of MRI scanners and
:10:39. > :10:48.that is not the intention of the house. He may be making a phtch to
:10:49. > :10:52.join the committee of selection .. And for my part I would be delighted
:10:53. > :10:56.to see him committing his considerable intellect to this
:10:57. > :11:02.topic. We will spend much of the discussion in refining the
:11:03. > :11:06.definitions of what information is appropriate and how it will be
:11:07. > :11:10.gathered. The government intends to table amendments to the bill to
:11:11. > :11:13.reflect how the information power provisions were applied in the
:11:14. > :11:16.devolved administrations and these amendments would ensure the
:11:17. > :11:21.government can collect information relating to the devolved purposes,
:11:22. > :11:25.share it with safeguards ovdr confidentiality with the devolved
:11:26. > :11:36.administrations to enable them to use information for their own
:11:37. > :11:39.purposes. We agreed the devolved... Avoiding duplication while dach
:11:40. > :11:46.country collect information from the pharmacies and GPs. Mr Deputy
:11:47. > :11:51.Speaker, this has been a relarkable debate for the consensus and support
:11:52. > :11:52.we have had for which I and my colleagues are extremely
:11:53. > :12:02.appreciative. Robust cost control and dat`
:12:03. > :12:07.requirements are key tools to ensure that NHS spending on medicine across
:12:08. > :12:10.the UK continues to be affordable while delivering best value for
:12:11. > :12:14.would support access to services and would support access to services and
:12:15. > :12:18.treatments. This Bill will dnsure there is a more level playing field
:12:19. > :12:22.between our medicine pricing schemes while ensuring that decisions made
:12:23. > :12:26.by the Government are based on more accurate and robust information on
:12:27. > :12:32.medicine costs. This will bd fairer for the industry, pharmacies and the
:12:33. > :12:38.NHS, patients and the taxpaxers I am pleased to commend the Bhll to
:12:39. > :12:46.the House. The question is that the Bill now be read a second thme. As
:12:47. > :12:56.many of that opinion say nod. On the contrary noe. The ayes have it. The
:12:57. > :13:05.question is on the order paper, as many as a opinion site eye, contrary
:13:06. > :13:11.noe, the ayes have it. Question is as on the order paper, as m`ny of
:13:12. > :13:21.that opinion say eye. On thd contrary know, the ayes havd it the
:13:22. > :13:26.ayes have it. We come to... The question is as on the order paper,
:13:27. > :13:36.as many of that opinion say eye the contrary one.
:13:37. > :14:01.I beg to move this has adjotrned. Caroline Lucas. Thank you, Lr Deputy
:14:02. > :14:04.Speaker. This debate is intdnded to highlight the ongoing NHS crisis
:14:05. > :14:09.which is affecting my consthtuency and the city of Brighton and Hove as
:14:10. > :14:15.well as to outline some solttions to what is far more than just ` purely
:14:16. > :14:20.local problem. The very concept of a public funded National Health
:14:21. > :14:23.Service is at risk and the situation in Brighton and Hove reveals a whole
:14:24. > :14:29.host of systemic problems that stem in large part I would argue from the
:14:30. > :14:32.2012 NHS Health and Social Care Board act. Patients and staff are
:14:33. > :14:37.being let down in my constituency and elsewhere and it is mord than
:14:38. > :14:40.likely than the additional strain of the winter months will exacdrbate
:14:41. > :14:44.the crisis still further. The picture I will paint of the
:14:45. > :14:49.situation in Brighton and Hove is deeply worrying. It encompasses our
:14:50. > :14:55.hospital, GP provision, Ambtlance Service and community care. These
:14:56. > :14:58.services are held together by incredibly dedicated. Staff Often
:14:59. > :15:01.working well beyond the hours they are paid to keep things going. I
:15:02. > :15:07.want to take this opportunity to thank and paid should be to each and
:15:08. > :15:11.every one of them. And yet despite their tireless efforts, the overall
:15:12. > :15:13.picture of Health and Social Care Board in Brighton and Hove hs
:15:14. > :15:18.currently chaotic. Not becatse of the lack of hard-working st`ff but
:15:19. > :15:24.primarily as a result of two things. Hajj funding cuts and an
:15:25. > :15:27.increasingly fragmented strtcture based in increased marketis`tion and
:15:28. > :15:32.commercialisation and privatisation of our NHS. So let me give ` quick
:15:33. > :15:34.overview, Mr Deputy Speaker. First our local royal source of hospital
:15:35. > :15:39.is in special measures but the quality and finance. As of July
:15:40. > :15:43.there are over 9000 people waiting for more than 18 weeks to start
:15:44. > :15:49.treatment. That is the worst recorded amongst 185 providdrs and
:15:50. > :15:52.the 208 CCGs who submit dat` nationally. More than 200 pdople
:15:53. > :15:57.have been on the waiting list for over a year. When I'm talking about
:15:58. > :16:01.the hospital that they could be put on record that I am very gr`teful
:16:02. > :16:06.that we are seen to have a brand-new building and we certainly nded it.
:16:07. > :16:09.The hard-working staff in that hospital now are currently operating
:16:10. > :16:14.in a building that stems from pre-Florence Nightingale. The oldest
:16:15. > :16:18.estate in the whole of the NHS. That is at the same time as undertaking
:16:19. > :16:24.an increasingly complex work for the whole of Sussex as a major trauma
:16:25. > :16:28.centre for the wider region. I will be happy to give away. I am very
:16:29. > :16:30.grateful for my honourable friend forgiving way and by honour`ble
:16:31. > :16:35.neighbour forgiving way. Shd mentions the fact that we are
:16:36. > :16:39.constructing a new wing to the hospital and a whole bunch of other
:16:40. > :16:41.services locally. Thus another gripping artefact of this going to
:16:42. > :16:47.place an additional administrative burden and challenges our staff and
:16:48. > :16:51.clinical staff in the area, that means we have to get the situation
:16:52. > :16:53.in Brighton and Hove absolutely right now otherwise it will add an
:16:54. > :17:00.additional burden but could just be too much to the system locally. I am
:17:01. > :17:03.grateful to the MP for home because he anticipates exactly what I'm
:17:04. > :17:07.going to say. Of course we need new bricks and mortar but we also need
:17:08. > :17:12.finances for the services inside those bricks and mortar. We
:17:13. > :17:15.desperately need a central funding settlement recognises the unique
:17:16. > :17:19.pressures on our hospital. So that the systems can be updated for
:17:20. > :17:23.example we need a computerised record system. This isn't rocket
:17:24. > :17:27.science but we get but we nded it. We increased capacity particularly
:17:28. > :17:35.for Andy because we are now serving a much wider region by being a
:17:36. > :17:37.central trauma centre. With debts currently of around 45 millhon, but
:17:38. > :17:42.Mansell to do with all is f`cing the situation that's quite simply
:17:43. > :17:47.unsustainable. That is just one example but there are plentx of
:17:48. > :17:50.others of what is going wrong when comes to the health service in
:17:51. > :17:54.Brighton and Hove. Patients in the city for examples are seen six GP
:17:55. > :17:58.practices go so far this ye`r alone. When the practice announced they
:17:59. > :18:05.were walking away from the contract to run five surgeries in thd city
:18:06. > :18:08.decision was largely financhal. With almost 11,500 patients registered,
:18:09. > :18:11.the disruption and uncertainty was widely felt and other nearbx
:18:12. > :18:15.surgeries were simply expected somehow to manage increased patient
:18:16. > :18:20.numbers. NHS England wasn't required to step in to help because of the
:18:21. > :18:23.terms agreed with the practhce group. Now that this type of
:18:24. > :18:28.contract is no longer permissible, it was of course but little comfort
:18:29. > :18:33.for those patients forced to register with the new GP. I
:18:34. > :18:37.particularly recall a consthtuent who to contact me after a shck
:18:38. > :18:43.surgery was closed and she was unable to stop by somewhere for a
:18:44. > :18:51.new inhaler prescription because of their own -- their own desphte their
:18:52. > :18:53.own disability. And then thdre is the Ambulance Service, our dmergency
:18:54. > :18:56.Ambulance Service. It was placed in special measures on the 29th of
:18:57. > :19:01.September following a CQC rdport that rated it as inadequate. The
:19:02. > :19:03.inspectors praised by self identified unsafe levels of staffing
:19:04. > :19:07.as well as poor procedures `nd leadership. The mental health
:19:08. > :19:13.services, especially those serving children and young people are
:19:14. > :19:16.overstretched and underfunddd. Adult social care services in Brighton and
:19:17. > :19:20.Hove face ongoing cuts desphte the cost to individuals and the NHS and
:19:21. > :19:24.that means that over the next four years the City Council is looking at
:19:25. > :19:27.cuts are particularly 24 million and the complete privatisation of
:19:28. > :19:32.remaining council adult sochal care. They centres, carers and so forth. I
:19:33. > :19:34.have lost track of the numbdr of times that government ministers
:19:35. > :19:38.assert that they are investhng record amounts in the NHS, xet
:19:39. > :19:41.conveniently failing to mention the record amounts that they ard
:19:42. > :19:45.simultaneously cutting from local authority budgets that are supposed
:19:46. > :19:51.to cover essential care services for vulnerable people. Referring back to
:19:52. > :19:57.some of the comments made bx my neighbour earlier, she is d`ting a
:19:58. > :20:03.very gloomy picture and idolised the problems but the see also
:20:04. > :20:06.acknowledged that next door the West Sussex hospitals trust is one of
:20:07. > :20:09.only five hospital trusts and the whole of the country rated
:20:10. > :20:14.outstanding? And yet we havd the pressures of one of the most elderly
:20:15. > :20:18.operations in the country and increasing pressures placed on us
:20:19. > :20:22.because of people coming from Brighton and Hove to access services
:20:23. > :20:26.across the county will stop why is it that Brighton and Hove is in such
:20:27. > :20:32.a state at the moment yet a few miles down the road we are `ble to
:20:33. > :20:35.run actually read -- good hospital services? I congratulate hil on the
:20:36. > :20:38.performance of his own hosphtal trust, but they recognise what he is
:20:39. > :20:44.saying about the extra pressures that are put on the surrounding area
:20:45. > :20:47.when there is a particular problem in Brighton and Hove. I certainly
:20:48. > :20:50.would contest and the implication of what they are saying is if there is
:20:51. > :20:54.something particularly to Brighton and Hove in the sense that hf you
:20:55. > :20:58.look around the country there are sadly a great many hospital trusts
:20:59. > :21:01.severe difficulties. We havd a public house Committee a few months
:21:02. > :21:06.ago absolutely saying the s`me thing and I shall refer to that vdry
:21:07. > :21:08.shortly. They asked specifically about Brighton and Hove I think
:21:09. > :21:12.there are some issues about the fact that for example we are working in
:21:13. > :21:17.the oldest building in the whole of the NHS. I think a particul`r
:21:18. > :21:21.problems with comes together for example with the demographics. I
:21:22. > :21:24.think there are particular charm that challenges when you have got
:21:25. > :21:30.for example in Brighton and Hove a number of older people, complex
:21:31. > :21:33.mental health problems, homdless projects. I want to challenge the
:21:34. > :21:35.idea that this might be somdthing that is simply a problem in Brighton
:21:36. > :21:42.and Hove because it isn't and they'll come to that in just a
:21:43. > :21:44.minute. We have lots of timd to debate this unfortunate --
:21:45. > :21:49.fortunately. She must acknowledge that when we last enquired the
:21:50. > :21:56.average age of a patient in the hospital taking up age period is is
:21:57. > :22:00.85. At places considerable dxtra pressures on our hospital sxstem.
:22:01. > :22:04.The average age in Brighton and Hove the city is considerably yotnger.
:22:05. > :22:06.The average age of people accessing treatment in her city is
:22:07. > :22:11.considerably younger and thdrefore less demanding. So, why is there
:22:12. > :22:16.such a contrast in the performances of our respective hospital trusts?
:22:17. > :22:20.That would be a very interesting issue to debate and he is at will to
:22:21. > :22:23.be able to get his own debate about Worthing Hospital but what H know
:22:24. > :22:27.about is the particular problems that are facing Brighton and Hove
:22:28. > :22:29.and I will point to it again to the particular complex needs of come
:22:30. > :22:34.together when you have got ` city full of young people as well as very
:22:35. > :22:37.elderly people, mental health problems, homeless as probldms, the
:22:38. > :22:40.mobility problems and so on, but if he will give me a little bit more
:22:41. > :22:44.time there will be able to set up camp but I think some of thd Proms
:22:45. > :22:48.are in Brighton and Hove and Chris Wood and all the answers ard
:22:49. > :22:54.also talking about the fact that uncertainty -- unfortunatelx the
:22:55. > :22:57.Government is cutting money from budgets that are supposed to cover
:22:58. > :23:00.those essential care servicds for vulnerable people. The Government
:23:01. > :23:03.knows that social care in places like Brighton and Hove is on its
:23:04. > :23:06.knees and that this has a vdry knock-on impact in terms of the NHS
:23:07. > :23:09.that no amount of financial smoke and mirrors can conceal. Brhghton
:23:10. > :23:13.and Hove National pensioners Convention has become a valhant
:23:14. > :23:16.campaign to protect adult social care services from cuts with the GMB
:23:17. > :23:26.union fighting alongside thdm and I hope the Minister will be lhstening
:23:27. > :23:29.to that. Because this is a crisis that let everyone down and there is
:23:30. > :23:31.no hiding from it, so where should responsibility for this cat`logue of
:23:32. > :23:33.troubles lie? I believe that what has happened to the city's
:23:34. > :23:36.nonemergency patient transport service goes some way to looking at
:23:37. > :23:38.that question and they want to look at this in more detail becatse it
:23:39. > :23:42.also demonstrates what can only be cold an utter dereliction of duty on
:23:43. > :23:46.the part of State for Health and I'm off to repeat my call again today
:23:47. > :23:49.for his department to step hn and him personally to step in to resolve
:23:50. > :23:56.an unacceptable and untenable situation. I am referring to a
:23:57. > :24:00.service that takes people to essential non-emergency appointments
:24:01. > :24:02.for example kidney patients going for the analysis, cancer patients to
:24:03. > :24:09.and from chemo and radiotherapy Since April it has been won by a
:24:10. > :24:14.private company and another member of subcontractors could perform a
:24:15. > :24:24.phased criticism from the ottset with sub contractors not bedn paid.
:24:25. > :24:27.Two of those sub contractors went bust leaving some ambulance drivers
:24:28. > :24:35.leaving with six weeks of w`ges unpaid. In early October drhvers
:24:36. > :24:38.from another subcontractor turned up to work only to be sent homd again.
:24:39. > :24:43.Last week it was punched into fresh controversy after an investhgation
:24:44. > :24:46.by the local paper that revdaled that one subcontractor may not even
:24:47. > :24:50.have been licensed to operate a fleet of 30 and lenses. I h`ve got
:24:51. > :24:53.the headline from the paper here that you can see very clearly. That
:24:54. > :25:04.absolutely said that ambulances are now in a total shambles. Do you want
:25:05. > :25:09.to just put it down on the bench? The subcontractor is a comp`ny
:25:10. > :25:14.called Docklands medical services Limited. This is apparently a
:25:15. > :25:17.Phoenix company. As I understand it the new company seems to be
:25:18. > :25:22.suggesting it was acceptabld for them to operate under the s`me CQC
:25:23. > :25:26.license that was issued to hts predecessor at the bankrupt
:25:27. > :25:28.dockland. The application process is carefully designed to make sure that
:25:29. > :25:33.standards for vehicles and other safety checks have been met. To stay
:25:34. > :25:37.long in new successor or Phoenix company to inherit a licencd is
:25:38. > :25:40.setting the bar dangerously low and I think exposes patients and staff
:25:41. > :25:44.to unacceptable risks. As a result of this particular the back,up of
:25:45. > :25:51.struggling hospital trust, the same one that is in financial spdcial
:25:52. > :25:54.measures, is incurred ?121,000 of private and bills custom for this
:25:55. > :25:58.year in order to plug that gap left by Coperforma and its
:25:59. > :26:03.subcontractors. To recoup the cost, the trust has quite rightly invoiced
:26:04. > :26:06.the CCG which appointed Copdrforma and no doubt other trusts whll have
:26:07. > :26:09.done the same with serious consequences for CCG budgets and
:26:10. > :26:13.therefore for the money avahlable for other services. But whichever
:26:14. > :26:17.part of the Department of Hdalth ends up putting the Coperforma Bill,
:26:18. > :26:21.it represents an unforgivable waste of money and resources and the
:26:22. > :26:25.diversion away from patient treatment and care. I trust the
:26:26. > :26:28.Minister will agree that nehther patients in Brighton or anywhere
:26:29. > :26:32.else should be paying the price for failure of private companies who are
:26:33. > :26:36.profiting from NHS contracts and so will he therefore ensure th`t the
:26:37. > :26:40.CCG is not out of pocket in turn as a result of Coperforma's thd air
:26:41. > :26:43.would also like his apartment to stop passing the buck when his
:26:44. > :26:48.government passing legislathon that requires services like nonelergency
:26:49. > :26:51.patient transport to be put out to tender. It is simply unacceptable
:26:52. > :26:55.for no one in the Department of Health to know whether a fldet of 30
:26:56. > :26:58.ambulances where properly ldssons to be transporting Sussex patidnts for
:26:59. > :27:00.three months over the summer. I wonder if the Minister will tell us
:27:01. > :27:07.when he responds with a he would agree with that. I am grateful for
:27:08. > :27:11.her to give away again, but isn t it extraordinary that this contract was
:27:12. > :27:15.awarded in the first place? This is a company, Coperforma, all the
:27:16. > :27:20.Supply chain automated, which is underperformed and failed p`tients
:27:21. > :27:23.from the very first day that it took over the contract and continues to
:27:24. > :27:26.do so today. It can't be returned back to where it was before because
:27:27. > :27:29.the Ambulance Trust it was taken from is also in special measures and
:27:30. > :27:35.now no longer has the capachty to take it over. Isn't the lesson here
:27:36. > :27:37.that the Government if anybody does outsource this type of contract it
:27:38. > :27:41.has got to make sure that dte diligence is done correctly to make
:27:42. > :27:45.sure that patients do not stffer in this way?
:27:46. > :27:55.I agree and when I talk to the CCG what they are using as an
:27:56. > :27:57.off-the-peg contract which hs not suitable for this service and
:27:58. > :28:04.therefore there have been problems in the system and the company we
:28:05. > :28:12.ended up with you are not providing the service people in the chty
:28:13. > :28:15.deserve. I thank. I can see due diligence was not done in the
:28:16. > :28:20.contract, is there an underlying principle that when a piece of NHS
:28:21. > :28:25.service is outsourced, the NHS version ceases to exist and at a
:28:26. > :28:31.future date if the service hs not good enough or things changd, it is
:28:32. > :28:37.impossible to take it back hn-house. I thank for the intervention, she
:28:38. > :28:44.knows a great deal about thd issues and I agree that you are on a
:28:45. > :28:48.one-way direction and once outsourced, doing a U-turn has been
:28:49. > :28:55.taken away and it is failing patients in Brighton and Hove. The
:28:56. > :28:59.department says allegations of ambulances operating legallx warrant
:29:00. > :29:03.investigation by the CQC and I have written to demand that happdns and
:29:04. > :29:08.the CQC. Will he gave furthdr tonight and simply admitting the
:29:09. > :29:12.severity of the project -- problem and let us know what he can do.
:29:13. > :29:15.Would he provide assurances the Department of Health is no longer
:29:16. > :29:21.content to leave patient safety in the hands of private companhes and
:29:22. > :29:26.it will step in, bring the service in-house and check these contracts
:29:27. > :29:37.of the subcontractors are mdeting requirements? On this issue of the
:29:38. > :29:42.privatisation of the ambulance service, was their health and safety
:29:43. > :29:47.issues they had to meet and was there ever any occasions whdn the
:29:48. > :29:55.ambulance fell below that ldvel of service required? It is a good
:29:56. > :30:00.question and when I asked the CQC, the CCG that question, the `nswer
:30:01. > :30:04.has not been clear. I have been told the performance of the comp`ny is
:30:05. > :30:08.not such meaning the contract has been breached but one issue and
:30:09. > :30:13.difficulty is so much of thd contract is not in the publhc domain
:30:14. > :30:19.so if the CCG wants to see the subcontracts between co-performer
:30:20. > :30:23.and the different companies they do not have access to those contracts
:30:24. > :30:28.so they cannot assure us wh`t is in them. My point really is we have an
:30:29. > :30:33.opaque and transparent systdm where is difficult as they were
:30:34. > :30:40.accountability lies. That is why this is a failed model. The example
:30:41. > :30:44.goes some way to illustrating the underlying causes of the NHS crisis
:30:45. > :30:49.we are experiencing because trying to get to the bottom of these
:30:50. > :30:56.contracts and subcontracts `nd responsibility is like Rupp link
:30:57. > :31:01.with a Gordian knot. They admit that one big challenge is identifying
:31:02. > :31:04.responsibility when things go wrong when people providing the sdrvice
:31:05. > :31:10.are not paid, it is not cle`r where the responsibility lies,
:31:11. > :31:18.co-performer of the subcontractors. This lack of transparency is
:31:19. > :31:23.concerning and it is serious example of the problems are risks associated
:31:24. > :31:28.with outsourcing of key services. The driving force behind thhs is
:31:29. > :31:33.commercialisation. It is made worse by the 2012 Health and Soci`l Care
:31:34. > :31:36.Act which exposes patients to an acceptable risk but engenders
:31:37. > :31:43.structures and terms and conditions that appear to protect a profit led
:31:44. > :31:48.companies. That is not the NHS public want or deserve, it hs not
:31:49. > :31:52.effective. The model is failing contracts do not work and nded to be
:31:53. > :31:56.brought back in-house and I pay tribute to the work of the lember
:31:57. > :32:01.for Bexhill and Battle who has done good work on this issue, a
:32:02. > :32:05.cross-party agreement and she has asserted in this instance private
:32:06. > :32:09.contracting has not worked `nd the ambulance service will be operated
:32:10. > :32:14.within the NHS. I go further still because it is not just patidnt
:32:15. > :32:19.transport services, it is one example of the kind of fraglentation
:32:20. > :32:23.and marketing that is damaghng the NHS. Fragmentation matters because
:32:24. > :32:26.the health care picture is lade up of parts that are interconndcted and
:32:27. > :32:33.it is hard for one part to hnfluence the other. Ambulance handovdr times
:32:34. > :32:40.at Royal Sussex have risen 60% largely because of the ongohng flow
:32:41. > :32:42.issue caused by lack of places to discharge people too, the sxstem
:32:43. > :32:50.gets blocked when there is no overview. A is the pinch point
:32:51. > :32:54.failures elsewhere, most notably in capacity in social care.
:32:55. > :32:58.Fragmentation is an inevitable part of a system that is designed to give
:32:59. > :33:00.private providers as many opportunities to complete the
:33:01. > :33:04.services through a continuots cycle of bidding and contracting out
:33:05. > :33:10.despite being inefficient and counter-productive. Take thd
:33:11. > :33:15.community nursing and local phrases may be taken over by a priv`te
:33:16. > :33:19.company that virgin care. Stssex community NHS trust has preferred
:33:20. > :33:23.bidded status to develop th`t deliver services but the cotncil is
:33:24. > :33:27.forced to undertake procurelent processes in the name of market
:33:28. > :33:32.competition. That process is a waste of time and effort and monex and
:33:33. > :33:38.increases the risk of a private company stepping in and unddrcutting
:33:39. > :33:44.a highly effective provider. A risk which is exacerbated by the
:33:45. > :33:49.government s short minded ddcision to cut spending each year until
:33:50. > :33:54.2021. This equates to ?1 billion less for the city over the same
:33:55. > :33:58.three years and it results hn important services being
:33:59. > :34:01.decommissioned all ready, the family nurse partnership which provides
:34:02. > :34:08.regular visits for teenage lums during pregnancy, it makes no sense.
:34:09. > :34:13.But it is what happens when you do not have a coherent publiclx
:34:14. > :34:18.provided NHS. When you do not have a model putting health needs before
:34:19. > :34:20.private profit, based on co-operation competition. That is
:34:21. > :34:27.the model that has been set out in the bill which I tried to bring to
:34:28. > :34:29.the house in the last term `s a Private Member's Bill and which is
:34:30. > :34:35.currently before the house hn the name of the Honourable membdr for
:34:36. > :34:38.rural West. That is the kind of NHS I think my constituents want and it
:34:39. > :34:45.has to go hand in hand cruchally with funding. According to `n
:34:46. > :34:50.economist over the last Parliament, the annual average increase in UK
:34:51. > :34:56.NHS spending was .84%. That is the smallest increase in spending for
:34:57. > :35:01.any party period in office since World War II. For local and lives
:35:02. > :35:04.drivers caught up in the debacle and junior doctors, staff are
:35:05. > :35:11.universally respected except it seems that nurses should not have to
:35:12. > :35:17.fight for a 1% pay rise aftdr years of freezes, this does not jtst have
:35:18. > :35:20.consequences for the individuals. HealthWatch point out staff
:35:21. > :35:24.retention is a problem in the city with poor morale and high housing
:35:25. > :35:31.costs as factors. I'm worridd about the impact of the referendul on NHS
:35:32. > :35:37.staffing. Brighton and Hove is set to benefit hugely from a major new
:35:38. > :35:42.County Hospital redevelopment due to capital investment. I'm grateful but
:35:43. > :35:47.I would like to extend the logic of public provision to the services
:35:48. > :35:49.which will be based in the new hospital. As ministers know, the
:35:50. > :36:08.issue is running costs. She is straying into the iddology of
:36:09. > :36:13.NHS funding but can I remind her, she might like to mention an example
:36:14. > :36:19.in her own city of which I `m chairman of the trustees to declare
:36:20. > :36:24.an interest of a company working to promote the first critical days
:36:25. > :36:31.agenda to help children before they are born and their parents `nd tears
:36:32. > :36:36.after which is an excellent example of the NHS working with the
:36:37. > :36:40.Independent and charities sdctor to provide a much needed service which
:36:41. > :36:46.I'm sure she will want to promote in her constituency. It is not all bad
:36:47. > :36:50.if it is outside the NHS. If he had been listening carefully he notices
:36:51. > :36:54.I'm talking about private companies taking over cherry picking key
:36:55. > :36:57.services of the NHS. He knows because we have worked together on
:36:58. > :37:02.Brighton and I'm proud about what they have achieved but it is not
:37:03. > :37:05.working for profit, it is a charity ploughing back money into the
:37:06. > :37:10.service it provides, it would example. There are many othdrs from
:37:11. > :37:16.hospices and the member Hovd knows well, they would for hospicd. There
:37:17. > :37:21.are plenty of examples of the charitable sector doing amazing work
:37:22. > :37:25.and the NHS bill made provision for them as well. We're talking about
:37:26. > :37:30.and would I criticise is whdn the private sector come in and cherry
:37:31. > :37:35.pick services and the loss with NHS and your services working for
:37:36. > :37:41.profit. I want to finish making the case I'm making about funding. Last
:37:42. > :37:47.week the Prime minister clahmed NHS funding was being increased by 10
:37:48. > :37:51.billion. She ignored a plea from the respected share of the health Select
:37:52. > :37:55.Committee for ministers to stop using misleading figures whdn the
:37:56. > :38:00.correct figure is less than half the amount being claimed. The chief
:38:01. > :38:07.economist of the Nuffield trust says that even overstates the case where
:38:08. > :38:11.inflation puts the increase to around ?1 billion, a tenth of the
:38:12. > :38:17.figure at the Secretary of State has used and it is not ?350 a wdek. I'm
:38:18. > :38:22.surprised if any ministers will repay that blatant lie again but
:38:23. > :38:26.anyone who claims investment of 10 billion is playing hard and fast
:38:27. > :38:28.with the trees. The NHS chidf executive admitted to the hdalth
:38:29. > :38:35.Select Committee the Spending Review settlement would deliver negative
:38:36. > :38:40.per person NHS funding growth in 2018 and 19 with very modest
:38:41. > :38:47.increases in other years. Mhnisters are expecting the NHS to find ? 2
:38:48. > :38:52.billion inefficiencies by 2021. No one with expertise thinks it is
:38:53. > :38:58.possible. In a scathing report, the committee found a significant number
:38:59. > :39:01.of acute trusts are in serious and persistent financial distress. There
:39:02. > :39:08.is a spiralling trend of increased deficits and the current paxment
:39:09. > :39:13.system is not fit for purpose. That is perhaps most starkly demonstrated
:39:14. > :39:17.by the social care provision, the funding is agreed to be affdcting
:39:18. > :39:22.the NHS and they warn it must be funded sustainably as a priority.
:39:23. > :39:25.Yes, we have the better card funds to advance integration of hdalth and
:39:26. > :39:31.Social Care Act services but the majority is coming directly from the
:39:32. > :39:35.NHS budget resulting in a sharp and sudden reduction in hospital
:39:36. > :39:39.revenue. The government is robbing Peter to pay Paul was local
:39:40. > :39:45.authority social budgets sl`shed and people offering their homes to pay
:39:46. > :39:48.for care. Nor is the governlent secretive sustainability
:39:49. > :39:52.transformation programme thd solution. Many constituents are
:39:53. > :39:55.worried about the plans being conducted behind closed doors and
:39:56. > :39:58.vital services could be cut. We urgently need clarity on wh`t it
:39:59. > :40:06.will mean in practice the p`tients and staff. In the area covering
:40:07. > :40:11.Brighton and Hove, they facd a financial funding gap of hundreds of
:40:12. > :40:18.millions by 2021 and it is not clear how the STP will bridge the gap or
:40:19. > :40:26.whether services will be cut. Does she recognise that the principle of
:40:27. > :40:31.STP is going better placed based planning could help reintegrate the
:40:32. > :40:34.NHS but if it is just done with budgets censored here first instead
:40:35. > :40:41.of quality and patient centred care, will get the wrong answer. H do
:40:42. > :40:45.agree with her that place -based planning is potentially a useful
:40:46. > :40:50.tool but it is being used as a back door way of making more cuts and
:40:51. > :40:53.what worries me is that this is happening in and transparent way
:40:54. > :40:58.raising concerns amongst my constituents about what is happening
:40:59. > :41:01.and what is set out. Winter is coming and the crisis ready playing
:41:02. > :41:06.out in Brighton and Hove will get worse if the NHS continues down the
:41:07. > :41:10.path the government has put it. We spent 2.5% less of GDP on hdalth
:41:11. > :41:17.than France and Germany. I `m prepared to say what few others will
:41:18. > :41:20.say which is if you want NHS that meets our needs, we do not need
:41:21. > :41:25.privatisation in competition, we need those can afford it to pay more
:41:26. > :41:28.tax. This is something we c`n put a price on whereas the cost of the
:41:29. > :41:33.worry and misery and pain and uncertainty of so many of mx
:41:34. > :41:36.constituents is incalculabld. Whole families live with the weight of a
:41:37. > :41:43.loved one is to get treated and forced them to act as carers. The
:41:44. > :41:49.knock-on effect of NHS delaxs should not be dismissed. Concerns `bout
:41:50. > :41:52.delays and cancellations cole up repeatedly, operations repe`tedly
:41:53. > :41:56.cancelled and patience in dhstress. And the amazing mother fighting for
:41:57. > :42:01.adequate care and support for her disabled son. For her, the system
:42:02. > :42:03.has been a battle ground. Coordinating equipment betwden four
:42:04. > :42:07.different places and putting up with delays.
:42:08. > :42:13.She told me it is this that pushes people to despair and beyond
:42:14. > :42:18.breaking point. Breaking pohnt is I think exactly where we are. A
:42:19. > :42:19.perfect storm caused by dec`des of chronic underfunding and
:42:20. > :42:24.privatisation, meeting the consequences of fragmentation and
:42:25. > :42:27.run the organisation. Terms of policies that manifest themselves in
:42:28. > :42:31.grave and very real problems of the kind I opened this debate bx
:42:32. > :42:34.describing. Problems but yot need to my constituency were city btt
:42:35. > :42:37.Brighton and Hove does have an unusual demographic profile of many
:42:38. > :42:41.younger people as I said earlier with complex needs, mental health,
:42:42. > :42:46.drugs, alcohol, homelessness as well as some very elderly people. That
:42:47. > :42:50.means the array of services to support people using the NHS may
:42:51. > :42:56.need to be more complex, more tailored and more of the agdncy
:42:57. > :42:59.including voluntary agencies. An ecosystem of health care were each
:43:00. > :43:04.part components each other `s well as the whole is achievable locally
:43:05. > :43:08.and nationally if we step b`ck the unnecessary ineffective and damaging
:43:09. > :43:12.complexity that currently infects the NHS. If we reinstate th`t basic
:43:13. > :43:17.principle of a publicly funded and provided National Health Service
:43:18. > :43:20.that is free at the point of access. If we give patients, staff `nd the
:43:21. > :43:23.public a voice from the outside with matters as part of a box ticking
:43:24. > :43:28.exercise I believe that is how to bring us back from the brink. So
:43:29. > :43:31.finally, let me just acknowledge I have raised a number of questions
:43:32. > :43:35.throughout this debate and H will distribute them now for Minhster 's
:43:36. > :43:38.sake before I give up the thought his response. Lead from the felt
:43:39. > :43:41.step in to bring back accountability and stability to the nonemergency
:43:42. > :43:44.transport system in Brighton and Hove, bring the service back into
:43:45. > :43:49.the public sector as a mattdr of urgency and up the Bill could sack
:43:50. > :43:53.and he promised us that the plans will not mean that the servhces and
:43:54. > :43:56.closures? Will our possible trusts and mental Health Trust get the
:43:57. > :44:01.money they desperately need to trace the cuts -- without having to stress
:44:02. > :44:06.that this efficiency savings? Will he and other governors to stop using
:44:07. > :44:09.inaccurate figures and use the Autumn Statement to announcd a
:44:10. > :44:12.genuine step change when it comes to funding social care via loc`l
:44:13. > :44:18.authorities and NHS services in the round ticking for the habit of any
:44:19. > :44:22.test specific inflation covdr or he petitioned Home Secretary community
:44:23. > :44:25.guaranty EU workers to remahn and prevent the NHS from further
:44:26. > :44:29.instability and uncertainty and will he finally take a really honest look
:44:30. > :44:31.of the knock-on effects and inefficiencies of health care model
:44:32. > :44:41.that is jeopardising accountability, transparency standards and patient
:44:42. > :44:43.care? I would like to start by congratulating the honourable lady
:44:44. > :44:47.and not just in securing thhs debate but securing it on a day in which
:44:48. > :44:52.she was able to get through her entire speech and take into mention
:44:53. > :44:57.from the honourable gentlem`n for home and by honourable friend from
:44:58. > :45:02.East Worthing and Shoreham? A considerable achievement. Wd know
:45:03. > :45:07.that she has a long standing interest in the health outcomes for
:45:08. > :45:12.her constituents, as do all of us in this House. I would like to join her
:45:13. > :45:15.at the start of my remarks by highlighting the excellent work
:45:16. > :45:20.carried out every day by all those who work in the NHS, not just in her
:45:21. > :45:25.constituency but equally in my home and across the country. Before
:45:26. > :45:29.addressing the honourable l`dy's specific points I would likd to give
:45:30. > :45:34.the House and overall view of the NHS in her constituency. Brhghton
:45:35. > :45:38.and Hove CCG has a geographhcal area of approximately 34 square liles and
:45:39. > :45:45.covers a patient population of some 300,000. Commissions a wide range of
:45:46. > :45:48.health care services includhng from the main local acute trust, Brighton
:45:49. > :45:53.and Sussex University Hospitals NHS Trust. The regional teaching
:45:54. > :45:56.hospital working across two sites in Brighton and Hove. I understand that
:45:57. > :46:00.the trees that a recruit trtst treats over three quarters of a
:46:01. > :46:04.million patients every year and it recognises its growing role as a
:46:05. > :46:08.developing academic centre. The honourable lady has asked not for
:46:09. > :46:12.the first time for more funding to improve services and facilities in
:46:13. > :46:17.Brighton and I am pleased that she recognised in her speech thd over
:46:18. > :46:22.half ?1 billion capital invdstment under way at the Royal Sussdx County
:46:23. > :46:26.Hospital replacing some verx old buildings as she said and stpporting
:46:27. > :46:29.the service quality improvelents planned by the trust. I was a little
:46:30. > :46:33.bit disappointed that the honourable gentleman in his intervention which
:46:34. > :46:37.came just around the time that she was referring to this capit`l
:46:38. > :46:41.investments didn't also acknowledge that this is a significant
:46:42. > :46:47.investment in the facilities at the heart of health provision in
:46:48. > :46:51.Brighton. But this government has created the Care Quality Colmission
:46:52. > :46:55.to shine a light on good and bad health care quality up and down the
:46:56. > :46:59.country and their independent inspection teams provide a vital
:47:00. > :47:04.function on behalf of patients and everyone in England in challenging
:47:05. > :47:06.health hospitals, GP surgerhes, care homes and all other health care
:47:07. > :47:13.providers are delivering to the standards we should all expdct. CQC
:47:14. > :47:17.have identified that local NHS in the honourable lady's consthtuency
:47:18. > :47:23.faces some challenges and I would acknowledge that the confludnce of
:47:24. > :47:27.inspection reports coming ott around the same time as several of the
:47:28. > :47:37.different providers and commissioners in her area is an
:47:38. > :47:42.unusual challenge to correct. This does come in stark contrast as was
:47:43. > :47:51.pointed out by my honourabld friend for East Worthing and Shoreham that
:47:52. > :47:53.next door there is an outst`nding rated Western Sussex Hospit`l NHS
:47:54. > :48:06.Foundation Trust which also serves residents of West Sussex. While
:48:07. > :48:10.next-door, as was clearly indicated by an honourable lady, Brighton and
:48:11. > :48:14.is six NHS Trust was rated inadequate earlier this year by the
:48:15. > :48:21.CQC Andrew support their recovery, NHS improvement has placed distrust
:48:22. > :48:24.into special measures. I am extremely grateful for him giving
:48:25. > :48:27.way soberly in his speech. He mentions there is an unusual
:48:28. > :48:30.confluence of reports coming in I would suggest that actually the
:48:31. > :48:35.unusual thing is that each of these reports are indicating such extreme
:48:36. > :48:40.failure in many different p`rts of our health system in Brighton and
:48:41. > :48:43.Hove. From the Ambulance Trtst to six GP surgeries brilliantlx
:48:44. > :48:45.outlined by the member for Brighton Pavilion right through to the
:48:46. > :48:49.hospital trust all in speci`l measures and the hospital in
:48:50. > :48:53.financial measures. That is the unusual thing. I would suggdst that
:48:54. > :48:58.the economy from Brighton and Hove is no bankrupt. Could I suggest the
:48:59. > :49:02.Minister that he doesn't do his thinking on his feet now but would
:49:03. > :49:06.he just consider that if his department would appoint solebody to
:49:07. > :49:10.our city who can take an ovdrview of what is right and wrong in our city,
:49:11. > :49:13.the funding and the relationship between the different health bodies
:49:14. > :49:17.and the local authority and that does bring together all of the
:49:18. > :49:20.health systems, figure out what is wrong and figure out how we can
:49:21. > :49:26.bring together to solve all these problems together because the
:49:27. > :49:30.fractures have got much. I will take up his invitation to think ly feet,
:49:31. > :49:34.but they will be preferring in remarks later to some the
:49:35. > :49:38.sustainability and transforlation plan the honourable lady referred to
:49:39. > :49:43.which is providing a forum for much closer collaboration across the NHS
:49:44. > :49:47.within an area. Clearly it hs a much larger area than Brighton itself.
:49:48. > :49:51.But it is I think going somd way towards meeting the kind of analysis
:49:52. > :49:55.the honourable gentleman is looking for and I will also look at some of
:49:56. > :50:02.the individual trust support that they are getting on a wider NHS
:50:03. > :50:06.group to provide additional qualified medical and managdrial
:50:07. > :50:13.support to help solve these problems. I simply want to put on
:50:14. > :50:16.record that again he referenced the fact that at the rotor is a more
:50:17. > :50:20.successful trust and I would just point that not only are we operating
:50:21. > :50:24.in a very old building but we are also trying to do that at the time
:50:25. > :50:28.when the hospital has becomhng this major trauma centre and that is a
:50:29. > :50:30.massive change to what is h`ppening in Brighton and Hove. So I would
:50:31. > :50:36.simply reemphasise the points that make honourable colleague from Hove
:50:37. > :50:39.made that what we need here is need -- real finance and I don't think it
:50:40. > :50:48.is good to do it, it need some money. Thank you. I think,
:50:49. > :50:54.acknowledging the point she has made, I hope in part the STP will
:50:55. > :50:57.focus the attention of the wider area to support the new tratma
:50:58. > :51:03.centre that is being establhshed, because that is part of the purpose
:51:04. > :51:08.of the STP although of course I have yet to see the full details. I think
:51:09. > :51:12.we all recognise that patients deserve the highest quality care. We
:51:13. > :51:18.expect the trust to take action to ensure that the root causes of the
:51:19. > :51:22.CQC concerns are addressed. NHS improvement has confirmed that the
:51:23. > :51:27.trust has developed a recovdry plan and as part of a package of support
:51:28. > :51:30.for the trust from being in special measures NHS improvement has
:51:31. > :51:39.appointed an improvement director and a board adviser. I think we
:51:40. > :51:42.should also acknowledge that in addition to the trust challdnges,
:51:43. > :51:48.there are some other good things going on in Brighton, I think we
:51:49. > :51:51.should praise the team that delivers services for children at thd Royal
:51:52. > :51:57.Alexandra Children's Hospit`l in Brighton, as the CQC has iddntified
:51:58. > :52:03.them as rated outstanding for being innovative and well fed. Emdrgency
:52:04. > :52:08.care services at the trust `re not as we would expect as she h`d
:52:09. > :52:11.identified. Support the nathonal emergency care improvement
:52:12. > :52:16.programme, a clinically led initiative that offers intensive
:52:17. > :52:19.practical help to trusts looking to improve their emergency services,
:52:20. > :52:25.NHS improvement is also working closely with local clinicians to
:52:26. > :52:28.make a difference for peopld Brighton and Hove seeking elergency
:52:29. > :52:31.care. The trust is also devdloping plans to create capacities to
:52:32. > :52:37.support delivery of the planned care standards. As the honourabld lady
:52:38. > :52:40.said on Monday last week NHS improvement announced that the trust
:52:41. > :52:44.had entered financial speci`l measures. A prop -- programle launch
:52:45. > :52:49.by the regulator that provides a rapid turnaround passage for trusts
:52:50. > :52:52.that have either not agreed savings targets with local commissioners or
:52:53. > :52:55.had planned to make savings but would you taking significantly from
:52:56. > :53:00.this plan in third quarterlx returns. As part of financi`l
:53:01. > :53:04.special measures the trust will agree a recovery plan with NHS
:53:05. > :53:09.improvement within a certain period of time. But trust will also get
:53:10. > :53:13.support from and is held accountable by a financial improvement director,
:53:14. > :53:18.being appointed to the trust. The honourable lady has also referred to
:53:19. > :53:25.the challenges faced by the Ambulance Services in her
:53:26. > :53:27.constituency and in the are` and in addition, South East Coast @mbulance
:53:28. > :53:31.Service was recommended for special measures by the CQC in its
:53:32. > :53:38.inspection report published last month. NHS improvement acknowledges
:53:39. > :53:42.that there are wide-ranging problems in the trust including Governor
:53:43. > :53:47.structures and processes, ctlture and performances and emerging
:53:48. > :53:50.issues. It has agreed a support package for the crossed that I could
:53:51. > :53:55.trust, formalised on August nine this year and this includes a formal
:53:56. > :53:59.peer support relationship whth a neighbouring Ambulance Trust that is
:54:00. > :54:05.rated good by the CQC. As p`rt of the support package, NHS Improvement
:54:06. > :54:13.has also appointed an interhm chair and is appointing an improvdment
:54:14. > :54:15.director in due course. For the second time, I am extreme are
:54:16. > :54:20.grateful for him giving way. We focus on the onus for improvement on
:54:21. > :54:25.the delivery bodies within the Brighton and Hove area NHS
:54:26. > :54:28.Improvement and CQC have bedn outlining plans and their
:54:29. > :54:36.responsibilities to instigate this improvement, does he accept also
:54:37. > :54:38.that NHS Improvement is also being scrutinised and is under scrutiny in
:54:39. > :54:43.the way that they unfold thhs improvement programme and if
:54:44. > :54:46.improvements don't happen f`st enough, they will also be ctlpable,
:54:47. > :54:50.because some of the dates that have already been outlined for
:54:51. > :54:58.improvement have passed without the improvements being met. I think the
:54:59. > :55:02.honourable gentleman will rdcognise that NHS Improvement only c`me
:55:03. > :55:07.together with effect from April this year as the two previous regulators
:55:08. > :55:13.were combined. It is to a ddgree finding its feet in working out how
:55:14. > :55:17.best to assist trusts that get into difficulty. It has introducdd a
:55:18. > :55:23.number of different schemes from different types of challengd and we
:55:24. > :55:29.touched on the care challenge and the financial special measures
:55:30. > :55:32.challenge. Also undertaking a 5-point A improvement plan to
:55:33. > :55:38.focus particularly on challdnges within emergency care. So, H think
:55:39. > :55:44.it is fair to say that it is early days to see how NHS Improvelent
:55:45. > :55:52.undertakes its functions, btt we have every confidence in NHS
:55:53. > :55:57.Improvement to be able to assist trusts in dealing with thesd
:55:58. > :56:05.challenges. Finally, in rel`tion to the south-east Ambulance Service,
:56:06. > :56:09.NHS Improvement is also unddrtaking a capability and capacity rdview and
:56:10. > :56:15.will provide the trust support with its finances. The honourabld lady
:56:16. > :56:18.has also touched on the problems with the non-urgent patient
:56:19. > :56:21.transport service provider `nd this has clearly been a very difficult
:56:22. > :56:30.time for its staff and for some patients. My understanding hs that
:56:31. > :56:34.high reverse haven CCG has overseen the implementation plans ensuring
:56:35. > :56:37.continuity of service, and has recently appointed a specialist
:56:38. > :56:40.transport adviser to look into the resilience of the contract `nd
:56:41. > :56:43.explore options to strengthdn this further. The provision of these
:56:44. > :56:48.services is quite rightly a matter for the local NHS and she asked who
:56:49. > :56:53.is responsible for monitoring contracts and the reality is that it
:56:54. > :56:56.is the CCG which is the statutory NHS body with responsibilitx for the
:56:57. > :57:01.integrity of the procurement as well as managing the contract. It has
:57:02. > :57:06.powers within the stand -- standard NHS contract to intervene where a
:57:07. > :57:13.contract performance. What hs expected. I am grateful to him. He
:57:14. > :57:18.is saying the CCG has that power but they told me they could not see the
:57:19. > :57:20.contract that was between co-performer and there
:57:21. > :57:25.subcontractors because that was not to see they cannot have that degree
:57:26. > :57:28.of oversight and if this is the last time he is going to give wax, could
:57:29. > :57:34.he say whether he is going to step in on the issue of whether or not
:57:35. > :57:37.Docklands Phoenix company actually is properly licensed to be providing
:57:38. > :57:40.be served at it is providing because right now we don't know and that
:57:41. > :57:44.could be putting our patients at risk.
:57:45. > :57:51.It is down to the CCG to undertake a contract giving it visibility
:57:52. > :57:56.through sub contracts. If that is a failing subsequent contracts, they
:57:57. > :58:01.need to get to and they will learn from that message. As to thd
:58:02. > :58:07.regulation of the provider, that is a matter for the CQC to look at and
:58:08. > :58:17.I will undertake to enquire of them what status the provider has to
:58:18. > :58:24.ensure that is properly regtlated. She spent much of her remarks
:58:25. > :58:28.talking about, in familiar terms about her understanding of the
:58:29. > :58:33.impact of her so-called privatisation of the NHS. I gently
:58:34. > :58:38.remind her the Health and Social Care Act 2012 did not introduce
:58:39. > :58:41.competition to the NHS. Previous governments have used patient choice
:58:42. > :58:46.and competition as part of their reform programme and independent
:58:47. > :58:52.sector providers have been providing care and services to NHS patients
:58:53. > :58:56.under successive governments since the NHS was founded. And in
:58:57. > :58:58.particular in the area of nonemergency patient transport, this
:58:59. > :59:07.has been happening across m`ny areas of the country. In the last year for
:59:08. > :59:11.which data is available, NHS commissioners purchased sevdn points
:59:12. > :59:18.6% of total health care frol the independent sector and in 2010, this
:59:19. > :59:21.was around 5%, the rate of growth of the use of private providers is
:59:22. > :59:36.lower under this government and labour. -- van labour. We h`ve about
:59:37. > :59:42.an hour left to carry on thd debate. That is only if the minister wishes
:59:43. > :59:50.to speak for an hour. Indulge me on this intervention. Whilst I have no
:59:51. > :59:54.problem with the principle of outsourcing and she is right, the
:59:55. > :00:00.level of outsourcing may go up and may give down because it should be
:00:01. > :00:03.based on the quality of altdrnative providers providing quality services
:00:04. > :00:12.and is the best place at thd time but will he acknowledge on this code
:00:13. > :00:17.performer company, where people are vulnerable people relying on regular
:00:18. > :00:21.treatment have been left at home or dumped elsewhere and have not
:00:22. > :00:28.accessed this. This has been going on for so long. But warmly put the
:00:29. > :00:32.contract to organisations lhke this, much better due diligence ndeds to
:00:33. > :00:35.be done and there needs to be a fallback plan because when the
:00:36. > :00:39.ambulance service, who declhne to take on this contract in thd first
:00:40. > :00:43.place are now not in a position to take it on anyway, there is little
:00:44. > :00:48.option for somebody else to come in and take on the service urgdntly and
:00:49. > :00:57.provide level of care consthtuents need and it has not happened. Well,
:00:58. > :01:04.he makes a powerful case and as I have undertaken to the membdr of
:01:05. > :01:10.Brighton Pavilion, I will bd looking and taking up this issue with CQC to
:01:11. > :01:18.ask them to give me some re`ssurance as to both the regulation and how
:01:19. > :01:21.the procurement... Is relev`nt to them, we should look at Chew
:01:22. > :01:28.diligence for this activity. I accept that. I will close whthout
:01:29. > :01:33.taking further interventions. A brief word more as I promisdd on the
:01:34. > :01:41.sustainability and transforlation plans. These are, were submhtted to
:01:42. > :01:51.NHS England by 44 regions dtring the course of last week and as H said,
:01:52. > :01:54.the intent of these plans is to build on the work ready unddrtaken
:01:55. > :02:01.to strengthen care and help deliver the NHS plans for the futurd set out
:02:02. > :02:04.in the five-year forward by encouraging providers and
:02:05. > :02:13.commissioners within an are` to work more collaboratively without the
:02:14. > :02:18.barriers of stove piping whhch have led to conflict between to
:02:19. > :02:24.incorporate to come up with the best plan for patients and taking into
:02:25. > :02:29.account as mentioned increasing integration with social card
:02:30. > :02:37.providers in the area. And so local authorities are an integral part to
:02:38. > :02:42.these plans. I cannot give way. We are expecting most areas will
:02:43. > :02:46.undertake public engagement from now until the end of the year and build
:02:47. > :02:51.on the engagement they have done to shape thinking but we are clear we
:02:52. > :02:58.do not expect changes to thd services people currently rdceive
:02:59. > :03:01.without proper local engagelent and public consultation. There `re
:03:02. > :03:05.long-standing processes in place to make sure this happens so in
:03:06. > :03:13.closing, I have been generots and I have spoken for substantially longer
:03:14. > :03:17.than I normally would in wide gap and debate. It is the responsibility
:03:18. > :03:21.of local NHS organisations to determine how local services are
:03:22. > :03:24.delivered. They are best pl`ced to understand the needs of the people
:03:25. > :03:31.they serve and we must ensure changes led locally. In somd cases
:03:32. > :03:35.with improved local managemdnt where there has been shortcomings and the
:03:36. > :03:39.need to be focused on the ndeds of local populations and not cdntral
:03:40. > :03:42.government driven. This govdrnment recognises the importance of
:03:43. > :03:47.ensuring the NHS is held to standards of care in her
:03:48. > :03:51.constituency and across the UK and we continue to work to ensure
:03:52. > :04:00.services of high-quality, s`fe and appropriate affordable. The question
:04:01. > :05:01.is that we do now adjourned. The ayes have it. Order, order!
:05:02. > :05:07.No one can deny politicians are pretty important people, as I am
:05:08. > :05:11.sure they are the first to remind us. After all, it is up to them to
:05:12. > :05:15.make the laws which govern the lives. You and I might call them
:05:16. > :05:20.bigwigs and the origin of this word can be found in Parliament s
:05:21. > :05:23.judicial heritage. Westminster Hall and the Houses of Parliament was the
:05:24. > :05:25.meeting point for the law courts for seven