24/10/2016 House of Commons


24/10/2016

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parts of my constituency but I would be delighted to visit. As wd get

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towards Christmas, people should try to shop local. Order, order. Will

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the member wishing to take her seat please come to the table?

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I swear by Almighty God that I will be faithful and bear true allegiance

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to Her Majesty Queen Elizabdth, her heirs and successors, according to

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law, so help me God. You've got me now.

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Tracey Babin, member for Batley and spend.

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Order, order. Will the membdr wishing to take his seat pldase come

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to the table? I swear by Almighty God that I will

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be faithful and bear true allegiance to Her Majesty Queen Elizabdth, her

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heirs and successors, according to law, so help me God.

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Order. We will come to points of order later but in the usual way,

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and FLV to attend to a point of order later. Statement, the Prime

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Minister. With permission, H would like to make a statement on my one

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be in Council last week. I went to this council with a clear mdssage

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for my 27 European counterp`rts The UK is leaving the EU but not Europe

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and we are not turning our backs on our friends and allies. For as long

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as we are members of the EU we will play a full and active role, and

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after we leave we will be a confident outward looking country,

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enthusiastic about trading with our European neighbours and cooperating

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on shared security interests, including law enforcement and

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counterterrorism. That is the right approach and it was in the spirit we

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made a significant contribution at this council to ensure a robust

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European stance in the face of Russian aggression, addresshng the

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root causes of mass migration and championing free trade around the

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world. Let me say a word about each. Russia's indiscriminate bombing of

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civilians in Aleppo and the atrocities we have seen elsdwhere in

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Syria are horrific. It is vhtal we keep up the pressure on Russia and

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the Syrian regime to stop its appalling actions and creatd the

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space for a genuine politic`l transition in Syria. The UK put this

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issue on the agenda for the council. The Foreign Secretary made the case

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for a robust response at thd Foreign Affairs Council last Monday and I

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spoke personally to Chancellor Merkel and President Donald Tusk

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ahead of the Council last wdek. The council strongly condemned the

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attacks, called for a cessation of facilities and demand that those

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responsible for breaches of humanitarian law be held

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accountable, and we need to go further, which is why we agreed if

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current atrocities continue, the EU will consider all available options.

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The agreed everything should be done to bring in humanitarian aid to

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civilians. On Friday, the UK secured an extraordinary session of the UN

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human rights Council to press for a ceasefire to enable humanit`rian

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access to Aleppo. Millions of civilians are trapped there and

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across Syria in desperate nded of food, shelter and health care. The

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UK is already the second largest a lot aerial -- bilateral hum`nitarian

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donor to this crisis and evdry secure access to these areas, we are

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ready to accelerate over ?23 million of aid to help the most vulnerable

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in the hardest to reach parts of Syria. Turning to migration, the

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Home Secretary will give a statement on Calle shortly. At the European

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Council I confirmed the UK will provide practical support to Europe,

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including our naval presencd in the Aegean and Mediterranean, and as

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part of that effort, HMS echo will take over in the Central military

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knee and early next year. I reiterated that case I made at the

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UN for a global approach to migration waste on three prhnciples.

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First, ensuring refugees cl`im asylum in the first save cotntry

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they reach. Second, improving the way we distinguish between refugees

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and economic migrants, and third, developing a better overall approach

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to managing economic migrathon, which recognises that all countries

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have the right to control their borders and must commit to `ccepting

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the return of their own nathonals when they have no right to remain

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elsewhere. This includes working more closely with sauce and transit

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countries and the council agreed to do more to help these countries

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prevent illegal migration and return migrants who have no right to stay

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in EU countries. Turning to trade, I am determined that Britain will be

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the most passionate, consistent and convincing advocate of free trade

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anywhere in the world. As wd look beyond our confident, we will seize

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the opportunities of Brexit to forge an ambitious new role for Britain in

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the world, and as part of this in the UK is already discussing our

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future trading relationships with third countries. As I made clear to

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other member states, this whll not undermine the EU trade agenda, it is

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not even in competition with it and as long as we remain a membdr of the

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EU we will continue to back the EU's free trade negotiations. I share

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everyone's disappointment over the stalled talks between the ET and

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Canada and we will do what we can to help get these discussions by

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contract, but to those who suggest these difficulties have a bdaring on

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our own negotiations, I remhnd them we are not seeking to replicate any

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existing model another country has in trading with the EU. We will

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develop our own British moddl. A new relationship for the UK with the EU,

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to be there for when you're outside the EU, a deal that is ambitious and

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gold for Britain. I also updated the European Council on Brexit, I said

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we will invoke Article 50 no later than the end of March next xear and

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is part of the withdrawal process we will put before Parliament ` great

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repeal bill which will remove from the statute book once and for all

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the European Communities Act, so the legislation that gives effect to all

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EU law in Britain but no longer apply from the data we form`lly

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leave the EU and the authorhty of EU law in Britain will end. Thd

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Government will also give the parliament the chance to discuss our

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approach to leaving the EU, so in addition to regular up dates from my

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honourable friend, my own statements following council meetings `nd the

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deliberations of the new select committee on exiting the EU, the

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Government will take time available for a series of debates on our

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future relationship with thd EU These will take place beford and

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after the Christmas recess `nd will include debate on the princhples the

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Government will pursue in negotiations. Members on all sides

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will note the Government will not show its hand in detail as we enter

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into these negotiations. But it is important that melbers

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have this chance to speak on the issues that matter to their

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constituents as we prepare to leave the EU. Well we have not yet started

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the Brexit negotiations, I've made clear last week that my aim is to

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cement Britain as a close p`rtner of the EU once we have left. I want a

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deal to reflect the kind of mature, cooperative relationship th`t close

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friends and allies enjoy, a deal that gives British companies freedom

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to trade and operate within the European market and allow Etropean

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businesses to do the same hdre, a deal that delivers the deepdst

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support cooperation to ensure our national security and that of our

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allies, a deal that is in Britain's interests and the interests of all

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our European partners, but ` deal that ensures we are a fully

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independent sovereign nation, able to do what sovereign nations do

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Deeside for ourselves how wd control immigration.

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It will mean our laws will be made here and not in Brussels and the

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judges interpreting those l`ws will fit not in Luxembourg but hdre in

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Britain. The negotiations whll take time. There will be different

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moments ahead and have I have said before it will require patidnce and

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some give and take. But I fhrmly believe that if we approach this in

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a constructive spirit, we c`n ensure a smooth departure. We can build a

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powerful relationship that works both for the UK and the countries of

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the EU, and we can secure the deal that is right for the British

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people, whose instruction it is our duty to deliver, and I commdnd this

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statement to the House. Mr Jeremy Corbyn.

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Thank you, Mr Speaker. I wotld like to thank the Prime Minister for the

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advance copy of the statement she has just given us. Funnily dnough I

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too was in Brussels last Thtrsday, meeting Socialist leaders and their

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counterparts. I have to say, I was given a little longer to spdak that

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the five minutes the Prime Linister had at dinner and at a more

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reasonable time of the day. And indeed, I was listened to vdry

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carefully by all those around the table. I made it clear, Mr Speaker,

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to the other leaders, that Britain should continue to be a full and

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active member of the Europe`n Union until mid-ocean oceans on otr exit

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are complete. I think the Prime Minister was trying to send the same

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message, but the manner in which she conveyed it was rather diffdrent.

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She seemed to be not trying to build a consensus that is necessary, or to

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shape a future relationship with the European Union that is beneficial to

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everybody. She had a very dhfferent approach. Mr Speaker, the mdssage

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that came to me loud and cldar from European leaders last week, was the

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tone taken by this Tory govdrnment since their Tory party confdrence

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earlier this month, has dam`ged our global reputation and staff a lot of

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good will, not just in Europe, but around the world. And althotgh the

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Prime Minister's words may have appeased the hardline voices behind

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her, they have only spread `nger and resentment all across Europd by the

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approach that she and her p`rty have taken. I do not believe we will get

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the best deal for this country by using threats, hectoring or nectar

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in of the European Union. For these negotiations to succeed, thd

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Government frankly needs to adopt a slightly more grown-up approach For

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negotiations to succeed, Brhtain needs a plan. What is clear to

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everybody calm from European leaders and business, is quite clearly the

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Government does not have ond. Can the Prime Minister to the House if

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any progress has been made since the council meeting last week? Hs she

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willing to tell us if access to the single market is a red line for her

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government is or not? The Prime Minister has made it clear wants to

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end freedom of movement that has not made it clear what will be hn its

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place, causing uncertainty for business and for the many ET

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nationals who reside in this country and make such a great contrhbution

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for our economy. And can shd also tell us that if our governmdnt is

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supporting moves by senior Conservatives to amend the great

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repeal bill by adding a sunset clause allowing ministers to strip

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away EU laws on workers' rights and environmental protection in the

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years that succeed the exit from the European Union? And also tell us how

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the Government plan to make up the shortfall of funding to those

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regions resulting from the loss of structural funding to vital capital

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programmes all over this cotntry? One week the Secretary of State for

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Britain exiting the European Union will say one thing, the next the

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Chancellor will say another. Meanwhile, the Prime Ministdr says

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very little other than Brexht means Brexit, and we went provide a

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running commentary. The rest of the world looks on and concludes Britain

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hasn't got a clue. The truth is this isn't a soft Brexit or even a

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hard Brexit, it is simply a chaotic Brexit. Because, with all the some

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certainty, and all these mixed messages, day by day, confidence in

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this economy falls, and the British people become more worried `bout

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their future. Two weeks ago, the Treasury said that leaving the

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single market would lead to a 6 billion loss to the economy. The

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trade deficit is widening, the value of the pound has already fallen by

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18%. Industries such as the auto industry and others are del`ying

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vital investment decisions `nd the Bank of England looking to

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re-locate. This indecision `nd poor economic management is starting to

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hit our economy severely, wdakening the hand, as we walk into the most

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important delegations for generations. We on this sidd of the

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House respect the referendul result and we accept that Britain lust

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leave the European Union. Wd also understand that this will bd a money

:17:30.:17:33.

mental exercise, with the ddcisions made now affecting the lives of

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British people for years to come. The Prime Minister appeared to be

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making some sort of concesshon about parliamentary scrutiny. I would be

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grateful if you would explahn exactly what the nature of these

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debates were going to be each side of the Christmas recess. We as an

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opposition will not to stand by and let this government choose the terms

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of Brexit unopposed. It is our duty to scrutinise and our duty to make

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sure this government does h`ve a Brexit plan for our country. Not

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just a Brexit plan for the Eurosceptics behind her. And we will

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continue to push for this p`rliament to have a very full slate in this

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matter whatever happens in the debates around the Christmas recess.

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Today, Mr Speaker, the French authorities begin the formal closure

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of the Calle camp. I would like to take this opportunity to welcome

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those children who have alrdady arrived in this country, as well as

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others who have family conndctions. This camp, Mr Speaker, and H have

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seen it for myself, has become a hellish place where a few of the

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world's most vulnerable people have come to try and survive and call it

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their home. Yet it still relains unclear what process and tiletable

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her government is working under to bring refugee children here who are

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entitled under international law to refuge in the UK. I read to rate the

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urgency of the letter I sent to the Prime Minister last week, to

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personally intervene in our country, and to be open and accommod`ting to

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those children. I'm grateful to the reply I received an hour ago to my

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letter but I would be grateful if the Prime Minister could indicate

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something more precise about the timetable for allowing children and

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others who have family conndctions to come to this country, and that

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Britain does not evade its responsibility in helping those who

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have suffered the biggest global displacement since the end of World

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War II. This displacement is primarily caused by atrocithes in

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Syria, and we utterly and totally condemn indiscriminate bombhng. The

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only solution in Syria is a political one. Mr Speaker, these

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issues are the one future generations will look back on when

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it comes to defining this political generation. If we continue to

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approach the challenges we face in a manner they will only grow

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larger. We can instead work together in this House with our European

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partners and the rest of thd world, we may quickly find the large

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problems we face today appe`r smaller than we first thought, if we

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work together to help those desperate people all around the

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globe. Thank you Mr Speaker. The right honourable gentleman said he

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had been in Brussels last Thursday meeting with various socialhst

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leaders who were listening to him. I suppose, from his point of view it

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is good to know that somebody is listening to him! Can I address the

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last two issues that he refdrred to. He talked about Calais. As H said in

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my statement, and as he will know, my right honourable friend the Home

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Secretary will be making a statement on Calais and our response to

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unaccompanied children and bringing children here into the Unitdd

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Kingdom, with detail in that. All I will say now is this: we have been

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working very carefully for ` considerable time now with the

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French government, both to hmprove matters in relation to Calahs, but

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also to ensure that we were abiding by our requirements under the Dublin

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regulations to bring childrdn here who had family links here in the UK.

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That process speeded up, we have put extra resource in it from the Home

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Office and we have seen mord children being brought here. We have

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also adopted a scheme to brhng 000 vulnerable children from thd region,

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from the Middle East and North Africa, here to the UK, working with

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UNHCR, and we are putting in place the amendment which the Immhgration

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Act proposals, which of course required us to first negoti`te,

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discuss with local authorithes about their ability to receive chhldren

:21:50.:21:54.

here in the UK. Because the overriding aim of everyone of us in

:21:55.:21:58.

this House should be to enstre that it is in the best interests of the

:21:59.:22:03.

children that are being looked at and dealt with, and it is no help

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for those children if we ard not able properly to provide for them

:22:08.:22:12.

when they come here into thd United Kingdom. He did not talk about the

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wider migration crisis, excdpt a reference that it was mainlx due to

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Syrian refugees. Of course what we have seen is large number for people

:22:25.:22:28.

moving not from Syria, but from parts of Africa, which is why the UK

:22:29.:22:32.

has consistently been arguing for more work upstream is to stop the

:22:33.:22:38.

numbers of people coming through and ensure that people have got

:22:39.:22:43.

opportunities in source and transit countries, rather than requhring

:22:44.:22:46.

them to come here to the Unhted Kingdom. In relation to Russia, he

:22:47.:22:50.

made a reference to the indiscriminate bombing in Aleppo.

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I've see with that that he hs referring to Russian action as well

:22:56.:23:00.

Syrian regime action. It was important that we as the UK put this

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matter on the table and the agenda of the European Council. Thdy made

:23:06.:23:09.

the agreement that they did. And then if I just come on to the issue

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about the Brexit arrangements. He referred to the tone that h`s taken

:23:15.:23:18.

place since the Conservativd Party conference. I have to say to the

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right honourable gentleman that what I found in the European Council last

:23:22.:23:25.

week was a number of Europe`n leaders actually commending the

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speech I had given at the Conservative Party conference.

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Including, I have to say, one or two of the socialist leaders who might

:23:44.:23:47.

have been talking to him at the time. He says we don't have a plan.

:23:48.:23:56.

We have a plan, which is not to set out at every stage of these to

:23:57.:24:00.

gauche Asians the detail of these the gauche Asians, because that

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would be the best way to ensure we did not get the best deal for the

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UK. He talked about free movement. I noticed that his Shadow Fordign

:24:10.:24:14.

Secretary again refused to say what the Labour Party's statement was and

:24:15.:24:18.

he talked about indecision. I have to say to the Leader of the

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Opposition he could not guide whether we should be in or out of

:24:22.:24:25.

the European Union, he could not decide when we should be invoking

:24:26.:24:29.

article 50, the only thing he could say is that he would have unfettered

:24:30.:24:33.

immigration into this country, the very thing the British people have

:24:34.:24:38.

told us they don't want. Unlike him, the Conservative Party is lhstening

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to the British people. Willham Cash. In congratulating my right

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honourable friend on her prhncipled stand in implementing the vdrdict of

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the British people, despite the doom and gloom which pours out of parts

:24:58.:25:02.

of the media, is my right honourable friend where that last week, the

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chairman on the committee for the budgets of the European Parliament,

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stated the EU was too intrusive it breaks so rules, the member state

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trust one another and it nedds, as he put it, an electric shock? Does

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my right honourable friend `gree therefore that the EU itself is

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trouble. They know it and the British people got it right? Well, I

:25:23.:25:30.

think one of the challenges for the 27 remaining states of the Duropean

:25:31.:25:34.

Union will be for them to ddcide the shape and way in which the Duropean

:25:35.:25:38.

Union acts as it goes forward. I think they will have seen the views

:25:39.:25:41.

of the British people. They will have seen that there were a number

:25:42.:25:46.

of elements that led to the British people deciding to leave thd EU and

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I think it is for the remaining 27 to think Frei carefully abott how

:25:50.:25:53.

they want to take the EU forward in the future. -- to think verx

:25:54.:26:00.

carefully. I thank the Primd Minister for advance sight of her

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statement. 52% of voters in Scotland voted to remain in the European

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Union. Since then, we have heard regularly that apparently Scotland

:26:12.:26:16.

matters to the United Kingdom government. Indeed we hear that

:26:17.:26:22.

Scotland is an equal partner in the United Kingdom. Given that, I

:26:23.:26:26.

imagine the Prime Minister lust have raised this at the European Union

:26:27.:26:31.

Council meeting, but for sole inexplicable reason, she has not

:26:32.:26:34.

made mention of that in her statement today. Can she perhaps

:26:35.:26:39.

tell the House which specifhc issues raised by the Scottish Government

:26:40.:26:44.

she shared at the EU Council meeting? On the meetings shd held

:26:45.:26:48.

today on relation to the cotncil when she met with the governments of

:26:49.:26:51.

Scotland, Wales and Northern Ireland, they have reacted since

:26:52.:26:57.

with frustration. The Welsh First Minister Carwyn Jones has s`id: if

:26:58.:27:01.

the UK Government cannot negotiate an agreed position with a ddvolved

:27:02.:27:06.

administration, then it has little hope of negotiating a good Brexit

:27:07.:27:13.

deal with 27 other EU countries And Scotland's First Minister Nhcola

:27:14.:27:16.

Sturgeon said she had received no more information or detail `bout the

:27:17.:27:20.

UK's negotiating position. Given that the Institute for

:27:21.:27:32.

Government has warned that hmposing a settlement on the regions may

:27:33.:27:37.

provide in a serious breakdown in relations within the UK, thd Prime

:27:38.:27:42.

Minister cannot pretend to take the interests of Scotland, Wales,

:27:43.:27:46.

Northern Ireland and Gibraltar seriously. Either she will rush you

:27:47.:27:52.

will not, and if she will not, Scotland is right to hold an

:27:53.:27:57.

independent referendum and we will protect our place in Europe. He asks

:27:58.:28:04.

me to take seriously the vidws of the Scottish Government and the

:28:05.:28:08.

other devolved administrators, and that was why we were sitting around

:28:09.:28:14.

in the joint Council session this morning, it is quite I have said to

:28:15.:28:20.

the First Minister 's that we will have more of those meetings so we

:28:21.:28:24.

have a greater level of communication with those

:28:25.:28:28.

governments. I want for us hn determining the UK's position,

:28:29.:28:34.

because it will be the UK negotiating with the EU, but we take

:28:35.:28:41.

into full account and understand the impacts and particular issuds that

:28:42.:28:45.

are of concern to the devolved administrations and that is what we

:28:46.:28:48.

discussed today, what we will discuss in detail over the coming

:28:49.:28:54.

weeks and months, and of cotrse there are particular religions, in

:28:55.:29:00.

Northern Ireland the issue of the border is a specific concern we are

:29:01.:29:04.

working on and it is that understanding we want for the

:29:05.:29:09.

future, and I would say when he refers to the possibility of another

:29:10.:29:14.

referendum in relation to Scottish independence, if he wants to ensure

:29:15.:29:19.

that the future prosperity of the Scottish economy, he looks `t the

:29:20.:29:24.

fact that Scotland has more imports and trade arrangements with the rest

:29:25.:29:30.

of the UK then it does with the EU. It is first and foremost desired

:29:31.:29:37.

should be to remain part of the UK. I strongly welcomed the statement.

:29:38.:29:42.

Will she confirm this Parli`ment gave the incision to the Brhtish

:29:43.:29:48.

people on EU membership, so it is now the duty of this Parlialent to

:29:49.:29:54.

implement their wishes? I agree with my right honourable friend, this

:29:55.:30:00.

Parliament voted six to one for the British people to decide whdther we

:30:01.:30:06.

leave or remain in the EU. They gave their verdict, it is now our job to

:30:07.:30:17.

make a success of it. Thank you Mr Speaker. In preparation for the

:30:18.:30:24.

council meeting, did the Prhme Minister commission any English

:30:25.:30:28.

regional impact assessments of Brexit? DBE cargo, whose

:30:29.:30:37.

headquarters are in Dong cursed -- Doncaster, last week announced 93

:30:38.:30:47.

redundancies, saying that the Brexit effect means investment dechsions on

:30:48.:30:51.

major infrastructure projects have been delayed or stopped altogether,

:30:52.:30:57.

and customers have decreased or cancelled orders. Will the Prime

:30:58.:31:02.

Minister undertake to publish Brexit regional impact assessments and how

:31:03.:31:08.

will she insure the voice of the English regions are heard dtring

:31:09.:31:15.

Brexit negotiations? The right honourable lady makes an important

:31:16.:31:20.

point about the impact drags it will have on the economy generally, as we

:31:21.:31:25.

go through these negotiations, and well people often talk about the

:31:26.:31:28.

impact on Scotland, Wales and Northern Ireland, there will be

:31:29.:31:33.

potential impacts on differdnt parts of the UK. The Department for

:31:34.:31:40.

exiting the European Union hs talking to departments throtghout

:31:41.:31:47.

the UK to understand the impact so we negotiate the best possible deal

:31:48.:31:52.

that will be right not just for the poor nations but as a country that

:31:53.:31:59.

works for everyone. May I congratulate my right honourable

:32:00.:32:02.

friend on the positive mess`ge she delivered in Brussels about future

:32:03.:32:07.

cooperation and free trade, and her desire to continue are free trade

:32:08.:32:13.

between ourselves and Europd. Did any of her European colleagtes

:32:14.:32:18.

advocate to her the return of tariffs on trade between us and

:32:19.:32:25.

Europe? I thank him for his question and I know he has long been an

:32:26.:32:31.

advocate of leaving the EU `nd trade possibilities that would be

:32:32.:32:35.

available to was thereafter. We didn't have a detailed disctssion

:32:36.:32:40.

about these matters, precisdly because we haven't yet started the

:32:41.:32:47.

formal negotiations. The Prhme Minister is about to embark on a

:32:48.:32:51.

very complex set of negotiations with her European counterparts, and

:32:52.:32:56.

everyone recognises she will not want to reveal the details of our

:32:57.:33:02.

negotiating hand, but that hs very different from setting out her

:33:03.:33:05.

objectives, which I hope will contain a lot more details than just

:33:06.:33:12.

high-level principles, so c`n I ask the Prime Minister to give the House

:33:13.:33:17.

an undertaking that she will publish her negotiating objectives hn time

:33:18.:33:22.

for the House and the new sdlect them before she presents thdm to the

:33:23.:33:28.

other member states? I have set out the objectives we wish to ahm for in

:33:29.:33:33.

relation to the negotiation we will undertake. Can I congratulate them

:33:34.:33:40.

for having been elected as chairman of the new select committee? His

:33:41.:33:43.

committee will look at issuds to do with Brexit. There are alre`dy over

:33:44.:33:50.

30 different reviews and investigations by Parliament in two

:33:51.:33:53.

different aspects of Brexit, so Parliament can consider the issues

:33:54.:34:00.

involved. Rolls-Royce, a magnificent British country, -- company, employs

:34:01.:34:08.

a number of my constituents, including apprentices. I saw them on

:34:09.:34:13.

Friday and they told me of their concerns, shared through thd

:34:14.:34:17.

aerospace and automotive sectors, about the consequences of otr nation

:34:18.:34:23.

leaving the single market and also the customs union. Could thd Prime

:34:24.:34:28.

Minister assure British bushness that she will listen to thehr needs

:34:29.:34:33.

and concerns as we now move to leaving the European Union? My

:34:34.:34:39.

honourable friend makes an hmportant point about the quality of

:34:40.:34:44.

businesses we have here in the UK. Rolls-Royce is one of those

:34:45.:34:49.

businesses, which is a fine example, including the ways they takd on

:34:50.:34:53.

apprenticeships and contribtte to the growth of our economy. H and all

:34:54.:34:59.

those involved in negotiations will listen to business, that work has

:35:00.:35:06.

already started, the Secret`ry of State for exiting the Europdan Union

:35:07.:35:10.

has been holding those disctssions, I have held round tables with

:35:11.:35:13.

businesses to hear the concdrns The overwhelming view is that h`ving

:35:14.:35:20.

taken the decision to leave the EU, business wants to work with us to

:35:21.:35:25.

make sure we can make every success of opportunities outside thd EU In

:35:26.:35:33.

negotiations with European Council members, was she able to spdll out

:35:34.:35:37.

that despite the negotiations ahead, the British people expect in the

:35:38.:35:42.

next general election to have the final vote and say on our

:35:43.:35:49.

immigration and trade poliches and the final say over EU laws? I have

:35:50.:35:57.

said on a number of occasions that the vote to leave the EU was a vote

:35:58.:36:03.

to ensure we have control over our budget, laws and rules on

:36:04.:36:12.

immigration. It is clear from her welcome endorsement of free trade

:36:13.:36:19.

that she will be seeking thd closest possible engagement for a sovereign

:36:20.:36:22.

country with the European shngle market. Does she agree this

:36:23.:36:27.

objective would be better sdrved by lobbying our partners rather than

:36:28.:36:32.

throwing dust in the eye of the proletariat here? I agree whth Mike

:36:33.:36:39.

honourable friend that it is important that we acknowledge that

:36:40.:36:45.

the work that is done will be done sitting around a table with our

:36:46.:36:48.

European partners and negothating with them. There will be colments

:36:49.:36:53.

made here and elsewhere in public about what is happening but what

:36:54.:36:57.

will matter is the discussions that take place around that tabld. I

:36:58.:37:03.

thank the Prime Minister for advance sight of her statement, but it is a

:37:04.:37:08.

sad day when a government whll compromise the safety of its

:37:09.:37:14.

citizens to appease the dangerous ideology of a feud, so will she

:37:15.:37:20.

confirm now that we will relain an active member of Europol and we will

:37:21.:37:26.

urgently opt in to this critical aspect of European cross-border

:37:27.:37:31.

security for which the regulations were formed in May this year, to

:37:32.:37:35.

defend ourselves from terrorists, organised crime, drug traffhcking,

:37:36.:37:43.

paedophilia and people trafficking? He doesn't need to tell me `bout the

:37:44.:37:49.

importance of our security `nd law enforcement cooperation with our

:37:50.:37:54.

European partners and I refdr him to my statement where I said after we

:37:55.:37:59.

leave we will be an outward looking country, enthusiastic about trading

:38:00.:38:04.

freely with our neighbours `nd cooperating on security intdrests,

:38:05.:38:08.

shared including law enforcdment and counterterrorism. I wonder hf the

:38:09.:38:13.

chair of the select committde does not have a point in arguing that we

:38:14.:38:21.

should soon publish our objdctive. It is not our objective that we want

:38:22.:38:26.

to conclude, having adopted every last EU law into our laws on Brexit,

:38:27.:38:32.

we want to conclude a free trade agreement which is overwhellingly in

:38:33.:38:36.

the interests of the rest of Europe, and this would do so much for the

:38:37.:38:41.

poorest nations in the world as we lead the battle for free tr`de and a

:38:42.:38:51.

prosperous world. I agree. Just to be clear on the Prime Minister's

:38:52.:38:57.

statement, is it her intenthon that the UK will be leaving the customs

:38:58.:39:07.

union? I could give a link the answer to the right honourable

:39:08.:39:15.

gentleman about that and serve. . The Shadow Foreign Secretarx talks

:39:16.:39:17.

about substance, the import`nt point about the customs union is not a

:39:18.:39:25.

binary choice. There are different aspects to the customs union and

:39:26.:39:28.

that is quite it is important to look at the detail and get the

:39:29.:39:36.

answer right. As we proceed with new bilaterals, none of us want to see

:39:37.:39:41.

European first-class goods `nd services becoming uncompetitive and

:39:42.:39:47.

I understood that there is no proposition to put tariffs between

:39:48.:39:53.

us and our European partners. Will she confirm she can offer them a

:39:54.:40:03.

free trade deal bilaterally? At risk of repeating yet again what I have

:40:04.:40:07.

said previously, what we want is the right deal, the best possible deal

:40:08.:40:12.

for the maximum opportunitids for British businesses to trade within

:40:13.:40:18.

the single market, to trade in both goods and services, that is our aim,

:40:19.:40:24.

to have that good trading relationship with the EU but there

:40:25.:40:28.

are other things we will do like ensuring we can control the movement

:40:29.:40:35.

of people from the EU into the UK. We welcome the Prime Ministdr's

:40:36.:40:40.

meeting with the first ministers of the devolved administrations and we

:40:41.:40:44.

hope that will continue to be a meaningful engagement. It is vital

:40:45.:40:51.

we support industry. Could the Prime Minister comment on speculation we

:40:52.:40:56.

are considering a cut incorporation tax, which we would welcome in

:40:57.:41:02.

Northern Ireland? He shouldn't believe everything he reads in the

:41:03.:41:08.

newspapers. On migration, b`ck and set timbre that commission hn its

:41:09.:41:14.

communicate to the council said that we should establish a Europdan

:41:15.:41:20.

travel information and authorisation system by November. With Grdece now

:41:21.:41:26.

objecting to the common European asylum system, where does this leave

:41:27.:41:35.

that proposed agency? The proposal for pop the European Union described

:41:36.:41:39.

as a smart borders system is something they have been looking at

:41:40.:41:42.

for some time, looking at the model of the system used in the United

:41:43.:41:49.

States. A separate issue is about the security of the external border

:41:50.:41:55.

of the EU, there is a separ`te issue about arrangements with increase in

:41:56.:41:59.

relation to the asylum systdm and the Greek government has made some

:42:00.:42:03.

changes to the way they deal with asylum claims in response to the

:42:04.:42:06.

requirements of the EU- Turkey deal. The Prime Minister is being in

:42:07.:42:18.

characteristically coy of the negotiation to leave the European

:42:19.:42:22.

Union, and yet we know once the papers are given to the comlission,

:42:23.:42:26.

they will be shared with thd European Parliament. Will she not

:42:27.:42:30.

now undertake that she will share those papers with this Parlhament,

:42:31.:42:35.

the sovereign parliament, so that we can have a proper opportunity to

:42:36.:42:39.

look at the position the Government is taking, and comment upon it? I

:42:40.:42:45.

can assure this House as I have done before, that this House will have a

:42:46.:42:49.

proper opportunity to look `t these issues as we go through. But not

:42:50.:42:53.

just a one-off opportunity. There will be a number of debates which

:42:54.:42:58.

will enable members of this House to give more detailed comments on

:42:59.:43:03.

various aspects on the impact of Brexit on different sectors of the

:43:04.:43:08.

economy, for example. Given that the public adminhstration

:43:09.:43:14.

on constitutional affairs committee is now conducting an enquirx and

:43:15.:43:19.

drafting a report on institttional relationships in the UK, can I

:43:20.:43:23.

welcome a meeting of the johnt ministerial Council this morning.

:43:24.:43:26.

Can she say a bit more about this? Can she say if she will in future

:43:27.:43:31.

give all statements to the House all meetings of the joint ministerial

:43:32.:43:37.

Council, two of the size thd importance of these meetings, and

:43:38.:43:39.

did the other Administration is accept the principle that there

:43:40.:43:42.

should be a subcommittee looking at the issue of Brexit?

:43:43.:43:47.

The discussion we had was about having more meetings of the plenary

:43:48.:43:52.

session which was the one that I chaired this morning and those

:43:53.:43:55.

further meetings will take place in due course. But we did agred that

:43:56.:44:01.

there will be set up a joint ministerial Council subcommhttee,

:44:02.:44:03.

which will be dealing with the negotiations looking at the issues

:44:04.:44:08.

around the negotiations for leaving the European Union. That was

:44:09.:44:11.

welcomed by all of the devolved administrations and I look forward

:44:12.:44:14.

to that being a constructivd discussion around the table. It is

:44:15.:44:18.

important that as we put together the UK's position in relation to

:44:19.:44:22.

these matters, that we fullx understand the impact on thd various

:44:23.:44:28.

parts of the United Kingdom. The Prime Minister speaks in a statement

:44:29.:44:32.

of negotiating to reflect the kind of mature corporation that `llies

:44:33.:44:40.

enjoy. If Northern Ireland can get a special deal and if the Citx of

:44:41.:44:44.

London is being considered for one as well, why is it so polithcally

:44:45.:44:48.

difficult for the Prime Minhster to comprehend a deal for Scotl`nd which

:44:49.:44:54.

is welcomed by the voters and the Scottish Parliament? The de`l we

:44:55.:44:57.

will be negotiating will be the right deal for the UK. It whll take

:44:58.:45:01.

into account the concerns and implications for various parts of

:45:02.:45:05.

the UK for different sectors of our economy. The position of Northern

:45:06.:45:09.

Ireland will be a particular position, because Northern Hreland

:45:10.:45:11.

will be one part of the UK with a land border with a country which

:45:12.:45:19.

will be remaining inside thd European Union. And so given that

:45:20.:45:21.

fact, there is goodwill and good spirit from both this government and

:45:22.:45:25.

the Government of the Republic of Ireland, to assure that arr`ngements

:45:26.:45:28.

which are put in place in the future do not return to borders of the

:45:29.:45:34.

past. The Government's policy of saying as

:45:35.:45:38.

little as possible is going to become increasingly unsustahnable.

:45:39.:45:43.

The vacuum is already being felt with leeks not from the comlission,

:45:44.:45:49.

but from her own Cabinet Brdxit committee colleagues. Does the Prime

:45:50.:45:53.

Minister accept that unless the Government can provide at ldast some

:45:54.:45:57.

clarity about its direction of travel soon, many financial and

:45:58.:45:59.

other businesses, which havd been in touch with me about this, whll

:46:00.:46:04.

respond to the uncertainty, plan for the worst, and that will be at

:46:05.:46:10.

considerable cost for the UK? I say to my honourable friend I al well

:46:11.:46:14.

aware of the impact that uncertainty has an businesses who are m`king

:46:15.:46:18.

future decisions about investment here in the United Kingdom. It was

:46:19.:46:22.

in that light that I have already set out the framework of thd

:46:23.:46:26.

timetable for invoking article 0 and given clarity to both elployers

:46:27.:46:30.

and indeed employees about the legislative position that whll apply

:46:31.:46:36.

a one that we leave the European Union, ie that EU law will be

:46:37.:46:41.

brought into UK law to make sure there is not a legal vacuum. I will

:46:42.:46:46.

continue and the Government will continue to speak about these

:46:47.:46:50.

matters, but we will not and I understand the point my honourable

:46:51.:46:53.

friend was making, but I thhnk he knows full well that if this

:46:54.:46:58.

government was to set out every jot and tittle of our negotiation

:46:59.:47:01.

position that would be the best way to get the worst deal for the UK.

:47:02.:47:06.

The Prime Minister failed adequately to answer the question from my right

:47:07.:47:12.

honourable friend from Donc`ster Central. Has she carried out any

:47:13.:47:18.

detailed impact of the analxsis that the harder form of Brexit whll have

:47:19.:47:23.

an economy is in the north. If she has, will she publish it? And if she

:47:24.:47:27.

hasn't, will she concedes hdr anti-EU rhetoric and her talking up

:47:28.:47:31.

of a hard Brexit over the l`st month has been deeply irresponsible? First

:47:32.:47:37.

of all, as I said in response to his right honourable friend, we are

:47:38.:47:41.

looking at the impact on different parts of the United Kingdom. But the

:47:42.:47:45.

premise of his question is ` false one. He talks about hard Brdxit that

:47:46.:47:49.

the Government is going to take this country into. There is no stggestion

:47:50.:47:56.

of that whatsoever. That is because the right honourable gentlelan seems

:47:57.:47:59.

to think that all of these latters are binary decisions that ehther you

:48:00.:48:03.

are able to control immigration or you have some sort of decent trade

:48:04.:48:07.

arrangements. That is not the case. We are going to be ambitious for

:48:08.:48:11.

what we obtained for the UK and that means a good trade deal as well as

:48:12.:48:16.

control of immigration. Mr Speaker, it seems to me that

:48:17.:48:21.

we're much more likely to achieve our foreign policy objectivds

:48:22.:48:24.

working together, so I welcome the Prime Minister's moves to ptt

:48:25.:48:29.

Russia's behaviour on the council's agenda. She may have noticed the

:48:30.:48:32.

very robust statement at wedkend by the new shadow Secretary of State

:48:33.:48:39.

for Defence for condemning Russia's behaviour. When the she think the

:48:40.:48:44.

Leader of the Opposition will join the shadow Secretary of State for

:48:45.:48:47.

criticising Russia for the indiscriminate bombing taking place

:48:48.:48:51.

in Syria and recognise its part in the Syrian refugee crisis that we

:48:52.:48:56.

are all trying to deal with? My right honourable friend makds a very

:48:57.:49:00.

valid and important point. H note that although the European Council

:49:01.:49:04.

discussed the role that Russia was taking in indiscriminate bolbing in

:49:05.:49:08.

Syria, the right honourable gentleman the Leader of the

:49:09.:49:12.

Opposition failed to refer to Russia and his actions on Syria whdn he

:49:13.:49:16.

came to the dispatch box. I hope he will not be too slow in comhng

:49:17.:49:22.

forward to make clear he dods condemn Russia's activities,

:49:23.:49:24.

otherwise people will assumd that he does not.

:49:25.:49:29.

The European investment bank provides vital funds for affordable

:49:30.:49:34.

housing, hospitals, investmdnt in new technologies and utilithes. We

:49:35.:49:38.

received 5.6 billion last ydar for projects up and down the cotntry.

:49:39.:49:43.

Has the Prime Minister had `ny discussions about our stake in the

:49:44.:49:46.

European investment bank and will she confirm that she will do nothing

:49:47.:49:51.

to put this at risk? The honourable lady makes an important point and I

:49:52.:49:55.

inform her that the Treasurx is in discussion with the European

:49:56.:49:59.

investment bank. We recognise the important role it plays and want to

:50:00.:50:07.

assure that nobody loses out as a result of the decisions which have

:50:08.:50:09.

been taken by the British pdople. Those discussions are ongoing with

:50:10.:50:14.

the European investment bank. Although a committed Europe`n, Tony

:50:15.:50:17.

Blair once said that he facdd the European summit with a sinkhng

:50:18.:50:22.

heart. So can I say how ple`sed I am that the Prime Minister enjoyed her

:50:23.:50:27.

first summit? But doesn't the experience with the Walloni`ns

:50:28.:50:36.

dictating to Belgium, and c`using a walk-out by the Canadians, show that

:50:37.:50:42.

Brexit must not only be for England and Wales but for the whole United

:50:43.:50:47.

Kingdom? I thank my honourable friend. He is absolutely right. The

:50:48.:50:51.

decision that was taken to leave the EU will be a discussion -- decision

:50:52.:51:02.

taken by the United Kingdom. Our National Health Service,

:51:03.:51:04.

universities and businesses are already losing talent because of the

:51:05.:51:08.

uncertainty of the status of EU citizens here over Brexit. Ht is an

:51:09.:51:15.

uncertainty that she could dnd now. Why won't she? I expect to guarantee

:51:16.:51:20.

the status of EU citizens hdre in the United Kingdom and I intend and

:51:21.:51:27.

want to do that. But the st`tus -- but that may not be possibld if the

:51:28.:51:32.

status of UK citizens in EU member states is not guaranteed and that is

:51:33.:51:36.

a discussion I have said we hope to have at an early stage.

:51:37.:51:42.

Someone who campaigned to ldave the European Union, I am grateftl to see

:51:43.:51:45.

my right honourable friend's commitment to honouring the will of

:51:46.:51:49.

the British people and forghng a successful future for our country

:51:50.:51:53.

outside the EU. Will my right honourable friend agree with me that

:51:54.:51:56.

her starting position in thd forthcoming negotiations is a strong

:51:57.:52:00.

one, and we are beginning to see positive revisions of growth,

:52:01.:52:04.

steadily lower unemployment and exports set to outpace imports,

:52:05.:52:10.

proving that the scaremongers who predicted dire recession absolutely

:52:11.:52:17.

wrong? I say to my honourable friend, of course as she will have

:52:18.:52:20.

seen from the economic data which came out since the vote on the

:52:21.:52:23.

referendum was more positivd than had been predicted prior to the vote

:52:24.:52:27.

being taken. But I will not pretend it is going to be plain sailing in

:52:28.:52:30.

the future. There will be ups and downs. There will be diffictlt

:52:31.:52:39.

moments as I have said. But we will maintain a clear focus on ddlivering

:52:40.:52:42.

what the British people want which is leaving the European Union.

:52:43.:52:48.

In her lipstick words on migration, is the Prime Minister and eluding to

:52:49.:52:53.

the UK and EU's interest in making President Bashir indicted bx the

:52:54.:52:58.

International Criminal Court, a partner in managing migration and

:52:59.:53:03.

countering terrorism? She ndeds to be more explicit about what she and

:53:04.:53:07.

her colleagues envisage in the process and what it means for the

:53:08.:53:12.

wards of refugees from Sudan and through Sudan? Yes, what we are

:53:13.:53:19.

doing and what the European Union is doing is looking initially `t a

:53:20.:53:23.

small number of countries in Africa, to work with them, on ensurhng that

:53:24.:53:27.

their support available, th`t can reduce the numbers of peopld who

:53:28.:53:32.

wish move to Europe? The Kh`rtoum process is an important elelent of

:53:33.:53:36.

the work that is being done. The UK has consistently said that we need

:53:37.:53:40.

to operate upstream and that is about working with source countries.

:53:41.:53:45.

It is also about working with the transit countries, and dealhng with

:53:46.:53:50.

the organised crime groups, who are dealing in this horrific crhme of

:53:51.:53:54.

people smuggling and people trafficking which is leading to

:53:55.:53:58.

misery. The European Union hs looking as I say at dealing with

:53:59.:54:01.

initially a small number of countries, and of course we

:54:02.:54:05.

recognise that there are those countries why there are reasons why

:54:06.:54:09.

it is difficult to be able to return people to those countries. Ht is

:54:10.:54:13.

important that we accept thd principle and start to put hnto

:54:14.:54:16.

practice the process of working with people upstream.

:54:17.:54:22.

Mr Speaker, it seems to be the case that technically the UK cannot enter

:54:23.:54:26.

into trade deals with third,party countries whilst we are still a

:54:27.:54:30.

member of the EU. It is gendrally being acknowledge that we whll

:54:31.:54:34.

actually start doing this at some point before we leave. Is this an

:54:35.:54:39.

issue that my right honourable friend has looked at? Is thdre some

:54:40.:54:43.

type of timetable here and was mentioned at the summit? As far as

:54:44.:54:47.

the summit was concerned, the point that I made was that any discussions

:54:48.:54:51.

we have with third countries in relation to trade deals are not in

:54:52.:54:54.

competition to what the European Union is doing. We continue to press

:54:55.:54:59.

for the European Union to pound deal. We continue to press the

:55:00.:55:08.

benefits of TTIP. There is ` limit in what we can do in terms of

:55:09.:55:12.

entering into a trade arrangement before we have left the European

:55:13.:55:17.

Union, but that does not me`n we can scope out negotiations and start to

:55:18.:55:20.

have those discussions and hndeed we are doing so with a number of

:55:21.:55:23.

countries. The prime in Mr gave quite revealing

:55:24.:55:26.

statement today when she sahd she will not be seeking to replhcate any

:55:27.:55:31.

parts of the Canadian Europdan Union trade deal. We know that is stalling

:55:32.:55:40.

guarantees around Labour environmental and consumer

:55:41.:55:42.

protection. We know what shd is ruling out. Can she tell us what

:55:43.:55:45.

she's ruling in? I have to say nice try but I did not say I was ruling

:55:46.:55:50.

out bits of the Canadian de`l? I said we would not be replic`ting the

:55:51.:55:54.

EU Canada deal, just as we're not trying to replicate the Norway model

:55:55.:55:59.

or the Switzerland model. What we are trying to do is deliver for the

:56:00.:56:02.

United Kingdom the deal that is right for the UK.

:56:03.:56:07.

Can I commend my right honotrable friend for the way she improved her

:56:08.:56:15.

first EU summit. 61 people ,- 6 % of people in Kettering voted to leave

:56:16.:56:20.

the EU say we get control over our budget, borders and trade policy.

:56:21.:56:24.

Whilst there might be 500 mdmbers of this House who were remainddrs and

:56:25.:56:34.

are now Remoaners, she is trying to get the best deal for this country.

:56:35.:56:41.

Regardless of which side of the debate members of this Housd work on

:56:42.:56:48.

prior to the 23rd of June, we should all accept the voice of the British

:56:49.:56:55.

people and put that in practice I congratulate the Prime Minister of

:56:56.:56:59.

her handling of her first ET summit. I won't ask if she enjoyed ht but

:57:00.:57:03.

does she accept that millions of people who would have to le`ve,

:57:04.:57:12.

including Labour voters, will only believe we are really believing when

:57:13.:57:18.

we invoked Article 50, so whll she assure the House she will not be

:57:19.:57:22.

taken in by those who want to delay in the hope that somewhere they will

:57:23.:57:29.

get another referendum? There is no question of another referendum.

:57:30.:57:35.

While I felt it was right wd took time to prepare prior to thd start

:57:36.:57:38.

of negotiations through invoking Article 50, it is also right that

:57:39.:57:44.

members of the public will want to see it invoked so they know it will

:57:45.:57:49.

happen. That is why I think saying we will invoked by the end of March

:57:50.:57:57.

is the right one. Thank you, Mr Speaker. The people of Somerset are

:57:58.:58:05.

rejoicing at the Prime Minister s clarity in her approach to leaving

:58:06.:58:09.

the EU, and should each she confirm my understanding that once we leave

:58:10.:58:17.

the EU, the European Court of Justice will have no jurisdhction as

:58:18.:58:21.

the final arbiter of any UK law When we leave the EU UK laws will be

:58:22.:58:29.

determined here in the UK, ht will be British judges who will be

:58:30.:58:34.

opining on the application of those laws and this House will determine

:58:35.:58:38.

the legislation that comes to the British people. Given that our

:58:39.:58:46.

European partners have not xet committed to trade negotiathons

:58:47.:58:50.

alongside negotiations on Article 50, what assurances can she give

:58:51.:58:55.

British business that in March 019 when leave the EU, they will not

:58:56.:59:05.

face WTO rules and tariffs? We are looking to not just negotiated exit

:59:06.:59:09.

from the EU but also a new relationship and it is very... Our

:59:10.:59:18.

ambition in doing that is to ensure we get the best possible de`l in

:59:19.:59:23.

trade with an operation within the European market. That is wh`t the

:59:24.:59:32.

Government is working on. The terrible migration problem we are

:59:33.:59:36.

seeing at the moment is due largely to human trafficking gangs `nd one

:59:37.:59:41.

of the great legacies of thd previous Prime Minister and the

:59:42.:59:45.

previous Home Secretary is we now lead the fight against human

:59:46.:59:49.

trafficking, but with the Prime Minister agreed we have to build

:59:50.:59:52.

relationships not just with the European Union but with all European

:59:53.:59:57.

countries to deal with this evil trade? He is right and he h`s taken

:59:58.:00:04.

an interest in this issue and the excellent work in relation to

:00:05.:00:09.

encouraging activity that rdduce and stops human trafficking. Thdre are

:00:10.:00:14.

countries like Albania wherd it s important for us to be oper`ting and

:00:15.:00:18.

big government has been working with them to reduced trafficking, and it

:00:19.:00:24.

is also important to work whth countries like Nigeria that are

:00:25.:00:29.

often source countries for ` young woman trafficked into sexual

:00:30.:00:33.

exploitation, to make sure we reduced the chances for the criminal

:00:34.:00:37.

gangs to ply their trade. Ftrther to the question from the honourable

:00:38.:00:43.

member for Wellingborough, the situation in Libya is becomhng

:00:44.:00:48.

beyond a crisis. 150,000 people have crossed the Mediterranean, 3000 have

:00:49.:00:55.

died under way. Was there any discussion about sending thd high

:00:56.:01:00.

representative from the EU to Tripoli, perhaps with our Foreign

:01:01.:01:05.

Secretary, to work directly with the Libyan government to deal whth human

:01:06.:01:08.

traffickers but also to stop people setting off in the first pl`ce. The

:01:09.:01:14.

European high representativd has made a number of visits to North

:01:15.:01:21.

Africa, either source countries or transit countries for the mhgration

:01:22.:01:26.

crisis. He is right, there `re many people coming across from Lhbya into

:01:27.:01:33.

Italy. It was the UK that w`s instrumental in getting a UN

:01:34.:01:37.

Security Council resolution to enable action of the Libyan coast,

:01:38.:01:42.

and as well as rescuing thotsands of people, sadly there are still those

:01:43.:01:48.

who die in the Mediterranean, but the Royal Navy has also been

:01:49.:01:52.

involved in bricking up boats used by criminal gangs but this hs an

:01:53.:01:56.

ongoing activity and we need to take every step to stop this trade in

:01:57.:02:00.

human beings that brings so much misery. The University of Portsmouth

:02:01.:02:08.

depends on the interchange of people and ideas with the EU countries and

:02:09.:02:15.

countries around the world. How will the Government assure students and

:02:16.:02:18.

academics that the UK acadelic sector remains open and inclusive?

:02:19.:02:25.

We want to ensure that Brit`in is open to business for those sorts of

:02:26.:02:29.

exchanges and this is what we have done in relation to people coming

:02:30.:02:35.

from outside the EU, but we have also given some reassurance to

:02:36.:02:39.

universities in relation to arrangements they are putting in

:02:40.:02:43.

place with other member states prior to leaving, and we make cle`r that

:02:44.:02:49.

funding arrangements when they meet our priorities will be conthnued

:02:50.:02:55.

beyond the period at which we leave. May I suggest that the country

:02:56.:03:00.

believe she is going to lead this country into Europe and thex do not

:03:01.:03:04.

judge like when she will activate Article 50 if they know what the

:03:05.:03:11.

hell that Article 50 means. Might I suggest, given that as time goes on

:03:12.:03:16.

we have realised the enormity of the task, she will only invoke @rticle

:03:17.:03:22.

50 if it is truly in the interests of this country by March next year?

:03:23.:03:27.

I thank him for the question he has put. I would simply say, as I did in

:03:28.:03:34.

response to his honourable friend earlier, but I think for thd British

:03:35.:03:39.

people they want to see acthon taken to ensure we leave the EU. H believe

:03:40.:03:45.

we are doing the preparatorx work and while I have not set a specific

:03:46.:03:51.

date, I think invoking by the end of March is the right time lind. I too

:03:52.:04:00.

rejoiced that my right honotrable friend's iron resolve that Brexit

:04:01.:04:03.

means Brexit is a clear message to the British people, but I also

:04:04.:04:09.

invite my right honourable friend to remind the country that while it is

:04:10.:04:13.

necessary to discuss with the number of interested parties, not least the

:04:14.:04:20.

devolved assemblies, that in this matter she speaks for 17 million

:04:21.:04:24.

people, Nicola Sturgeon spe`ks for 1.7 million. I thank him, I think

:04:25.:04:34.

the important point is that over 17 million people voted to leave the

:04:35.:04:40.

EU. It was a majority vote hn the UK to leave the EU and it is the UK

:04:41.:04:45.

that will negotiate our rel`tionship with the EU in future. The City of

:04:46.:04:54.

London is determined to rem`in in the single market and it once a

:04:55.:05:01.

bespoke arrangement to do so as far as financial services are concerned.

:05:02.:05:04.

It is understood the Prime Linister has ruled this out. Will shd

:05:05.:05:10.

consider a similar bespoke arrangement for the financi`l sector

:05:11.:05:14.

in Edinburgh, the second largest in the UK? As I have said before,

:05:15.:05:20.

people talk about being in the single market for access to the

:05:21.:05:27.

single market at what matters is relationship with the EU th`t

:05:28.:05:31.

enables the maximum possibility to operate within that European market

:05:32.:05:36.

and we will negotiate on thd half of the financial sector across the

:05:37.:05:42.

whole UK. Being in the European Union has been compared to being in

:05:43.:05:47.

the back of a credit taxi hdading in the wrong direction. Does she agree

:05:48.:05:51.

with me that in the event the European Union, every remain in the

:05:52.:05:56.

single market we will know longer be in the taxi but tied up in the boot?

:05:57.:06:03.

I think it is important that as we look to get the right heel for the

:06:04.:06:09.

UK, we are negotiating a new relationship for the UK with the EU

:06:10.:06:15.

and that ensures our businesses can trade and operate within thd

:06:16.:06:19.

European market and also we put into place other things I believd is

:06:20.:06:23.

required by the British people like control of immigration. Doesn't that

:06:24.:06:29.

referendum decision deserves some respect to the public majorhty to

:06:30.:06:41.

the name Boaty McBoatface that was taken? Does she realised thdre has

:06:42.:06:49.

been a strong move against Brexit gets people realise that promises

:06:50.:06:53.

made by the Brexiteers will not be honoured. There will be an `wful

:06:54.:06:59.

result in Ireland to fixed hard borders that will not be in

:07:00.:07:03.

forcible, that will be hugely expensive. She is ignoring the views

:07:04.:07:10.

of the people of Scotland. Does she think Little may appear will lead to

:07:11.:07:18.

the break-up of the United Kingdom? The United Kingdom voted to leave

:07:19.:07:24.

the EU. This Government is putting that into practice and he and others

:07:25.:07:28.

can try all they like to reverse that decision, to try to delay the

:07:29.:07:35.

implications, to delay the application or weasel around the

:07:36.:07:40.

decision. The British peopld spoke, this Parliament said to the British

:07:41.:07:45.

people, it is your choice. They chose, we will now do it. In the UK

:07:46.:07:53.

than the rest of that you combine and I have spent nine years trying

:07:54.:08:02.

to negotiate an EU deal. Wh`t plans does she have to visit Indi` and an

:08:03.:08:09.

agreement between us which `lmost be made in heaven? She is very

:08:10.:08:15.

perceptive because I will vhsit India in early November and I'm

:08:16.:08:21.

pleased to say I will be taking a trade delegation with me th`t will

:08:22.:08:26.

focus on small and medium-shzed enterprises to boost the

:08:27.:08:30.

relationships between smalldr and medium-sized businesses in the UK

:08:31.:08:37.

with the important Indian m`rket. Russia's behaviour and Syri` has

:08:38.:08:40.

been despicable but it was especially worrying to see the

:08:41.:08:48.

battleship sailing through the endless channel this weekend on its

:08:49.:08:52.

way to smash what is left of Aleppo into smithereens, so I am ddlighted

:08:53.:08:57.

that the Prime Minister wants to have a strong position with European

:08:58.:09:03.

colleagues in relation to Rtssia, but one thing we can do, whhch the

:09:04.:09:08.

Americans have done, so anyone involved in the murder of Sdrgei

:09:09.:09:13.

Mike Netscape or the corruption he unveiled is not welcome in this

:09:14.:09:19.

country, they will not come to this country and I know she is bding

:09:20.:09:23.

advised that others will end up going back to the camera position,

:09:24.:09:29.

but I suggest this is something we could do with make a differdnce

:09:30.:09:33.

This is an issue he has campaigned long and hard on, he asked this

:09:34.:09:39.

question of David Cameron and of me as Home Secretary, he has asked this

:09:40.:09:47.

previous Foreign Secretary. We have our own rules and terms of how we

:09:48.:09:52.

determine who can enter the UK and he talks about the old position of

:09:53.:09:57.

the UK Government and it relains our position. There is much to be said

:09:58.:10:05.

for a bit of repetition, whhch is not a novel thing in the Hotse of

:10:06.:10:11.

Commons. A majority of voters in South Dorset congratulates the Prime

:10:12.:10:14.

Minister on her stance. Richie Gray that voters of EU countries will

:10:15.:10:20.

scrutinise our politicians `s they negotiate are except and will vote

:10:21.:10:25.

accordingly if they perceivd that leaders do anything to endanger jobs

:10:26.:10:32.

and prosperity to endanger ,- to maintain a European project? It s

:10:33.:10:39.

important that leaders of the remaining 27 think about wh`t the

:10:40.:10:42.

nature of the EU going forw`rd should be, but the vote was not an

:10:43.:10:49.

attempt to break up the EU. We have an interest in seeing a strong

:10:50.:10:55.

European Union and we have `n interest in working with th`t, being

:10:56.:11:01.

a dependable partner, but I think other EU leaders should consider the

:11:02.:11:05.

message given by the British people when they voted in June. Thd head of

:11:06.:11:14.

the British Bankers' Associ`tion and a former adviser to the current

:11:15.:11:18.

Foreign Secretary warned th`t Britain's biggest banks are

:11:19.:11:25.

preparing to relocate in early 017. Some 70,000 jobs could be at risk,

:11:26.:11:31.

many of them in my constitudncy Can the Prime Minister say how the

:11:32.:11:34.

Government intends to make sure the UK banking sector remains

:11:35.:11:39.

passporting rights to operate anywhere else within the EU? The

:11:40.:11:47.

importance that we place on being able to trade with and oper`te

:11:48.:11:52.

within the European market, for both goods and services, I am aw`re of

:11:53.:12:00.

the importance the financial services have two the UK, in

:12:01.:12:07.

particular certain that UN says there are other parts of our

:12:08.:12:11.

professional services like legal services were the ability to operate

:12:12.:12:17.

in the EU is important, we `re discussions within the financial

:12:18.:12:24.

sector so we can ensure as part of the negotiations we can get the best

:12:25.:12:26.

deal possible. Would my right honourable friend

:12:27.:12:34.

agree that in a freezer Siddy, there is no obligation on anyone to change

:12:35.:12:38.

their views just because thd majority have voted otherwise. But

:12:39.:12:42.

there is an obligation on all of us, including on those of us who voted

:12:43.:12:45.

to remain to work in the national interest and not to undermine it by

:12:46.:12:49.

tying the hands of the Primd Minister and the Government, in a

:12:50.:12:55.

way you would never do in commerce or private negotiations? I speak

:12:56.:13:03.

with the voice of experiencd on that matter and that is the point. If we

:13:04.:13:06.

are to get the best deal possible for the United Kingdom it is

:13:07.:13:10.

important we are able to enter those negotiations having not set out a

:13:11.:13:14.

whole series of red lines and not set out in detail what our

:13:15.:13:18.

negotiating position is. We need to negotiate the best deal possible for

:13:19.:13:22.

the UK, and tying the Government's hands in doing that would bd the

:13:23.:13:26.

best way of getting the worst deal for the UK. I welcome the f`ct that

:13:27.:13:33.

you met the leaders of the devolved governments this morning, btt

:13:34.:13:37.

uncertainty is what is really giving everyone doubt about Brexit,

:13:38.:13:40.

particularly in Northern Irdland where we have one member of the

:13:41.:13:43.

executive who is four in and one for out. We don't know where we are

:13:44.:13:48.

going. Who do we have on thd ground in Europe making sure we ard

:13:49.:13:51.

gathering the intelligence `nd advice and we are ready to fight the

:13:52.:13:55.

corner to make sure we do gdt the best interests of the whole of the

:13:56.:14:02.

UK together? It is important that we understand the possibilities of the

:14:03.:14:05.

future relationship that we have with the European Union. Th`t is why

:14:06.:14:09.

I thought it was important hn these negotiations which will be lengthy,

:14:10.:14:13.

and I recognise, until we h`ve the deal agreed, of course therd will be

:14:14.:14:18.

an element of uncertainty. That is why I set up a department to do the

:14:19.:14:23.

work, not just of understanding what is important for us here in the UK,

:14:24.:14:29.

but also for understanding what is of importance for the 27 melber

:14:30.:14:32.

states of the European Union. This is not going to be a deal which is

:14:33.:14:37.

just about the UK, it is about a deal which works for both shdes

:14:38.:14:44.

On Syria, paragraph 50 talkdd about the credible political procdss, is

:14:45.:14:51.

it in line with Geneva one `nd two of the peace process to asstre that

:14:52.:14:53.

the opposition get the right insurance is for a fair deal, rather

:14:54.:14:58.

than go to the talks and accept the diktats by the Russians bec`use the

:14:59.:15:04.

upper hand in aggression and killing civilians on the ground? My

:15:05.:15:07.

honourable friend knows we do want to see an ability to return to talks

:15:08.:15:12.

which can lead to a proper political transition in Syria. The UK I think

:15:13.:15:15.

has played an important rold and will continue to play an important

:15:16.:15:19.

role in supporting the opposition. It was a matter of two or three

:15:20.:15:22.

weeks ago when my right honourable friend hosted Syrian opposition

:15:23.:15:28.

parties here in London in which they set out their future aims and future

:15:29.:15:32.

revision for Syria. That was important. The Prime Ministdr has

:15:33.:15:40.

said she wanted the UK to bd the most hash in it, commitment and

:15:41.:15:44.

committed advocate of free trade anywhere in the world. Isn't that

:15:45.:15:48.

best demonstrated by the UK remaining a member of the shngle

:15:49.:15:54.

European market, that market of ?9 trillion which would protect the

:15:55.:15:58.

jobs and incomes of my constituents in Wakefield, and does she `gree

:15:59.:16:02.

that following the process set out by Canada, seven years to ndgotiate

:16:03.:16:07.

a trade deal, only to see it fall at the 11th hour, because it w`s

:16:08.:16:12.

rejected by one of Belgian's seven parliaments, is not something we

:16:13.:16:17.

should aspire to. On the Canadian deal, what I would say to this House

:16:18.:16:22.

is that I understand that while the discussions have stalled, there are

:16:23.:16:25.

still attempts being made to ensure that that deal can go ahead, and we

:16:26.:16:29.

would encourage that deal to go ahead. On the wider point that she

:16:30.:16:33.

makes, and I'm sorry, but I am going to repeat what I said previously,

:16:34.:16:38.

for people who put this purdly in terms of some variation of `ccess

:16:39.:16:45.

market, what matters is what the trading relationship is. If we hide

:16:46.:16:50.

bind ourselves by saying th`t it has to be in this particular form at

:16:51.:16:54.

this stage, then it will not be open to us to negotiate the best possible

:16:55.:17:00.

deal. What matters is if we have the maximum possibility to tradd with

:17:01.:17:04.

and operate within the single European market, and to do that

:17:05.:17:08.

across both goods and services, and that is what we are aiming for. Does

:17:09.:17:16.

the Prime Minister agree th`t when negotiating for Brexit, it hs

:17:17.:17:20.

important not only to negothate collectively with the member states

:17:21.:17:24.

through the European Council, but equally, if not more import`nt, to

:17:25.:17:28.

have conversations individu`lly with each member state, which has been

:17:29.:17:33.

shown by the experience negotiation with the Canadian trade deal. That

:17:34.:17:42.

is why I and other ministers are interacting with European Union in

:17:43.:17:47.

its various forms but are also discussing, I have made a ntmber of

:17:48.:17:57.

trips to meet with European ministers because we want a good

:17:58.:18:00.

relationship with those countries by laterally as well as having a good

:18:01.:18:05.

relationship with the EU -- by laterally.

:18:06.:18:09.

A report highlighted that young people are more internation`list in

:18:10.:18:12.

their outlook and voted overwhelmingly to remain in the EU.

:18:13.:18:17.

Can I ask the Prime Minister what discussions she had with her

:18:18.:18:21.

European counterparts about protecting the opportunities the EU

:18:22.:18:24.

provides for young people in my constituency and across the whole

:18:25.:18:28.

UK. The negotiations have not formally started with the ET but the

:18:29.:18:33.

sort of deal we are talking about, the sort of deal we want to get

:18:34.:18:36.

which will enhance prosperity and ensure jobs for the future will be

:18:37.:18:40.

of good for all generations here in the UK. Can I ask my right

:18:41.:18:46.

honourable friend if our European partners have realised the new EU UK

:18:47.:18:53.

free trade agreements will be good as a positive sum game for `ll

:18:54.:18:58.

concerned, given that 22 out of 27 of them have a trade surplus with

:18:59.:19:03.

us? Is she detecting that common sense is finally starting to

:19:04.:19:09.

prevail? I say that increashngly member states and the EU ard looking

:19:10.:19:13.

at this in relation to not just what it means for the UK, but wh`t it

:19:14.:19:17.

means for them as well. I h`ve said consistently this is not just about

:19:18.:19:22.

the UK being a supplicant to the remaining 27, it is about

:19:23.:19:25.

negotiating a relationship that works for both sides. Article 5

:19:26.:19:33.

puts any countries seeking to leave the EU at a disadvantage, in that if

:19:34.:19:36.

you have not got the deal you want within two years, you can flip onto

:19:37.:19:43.

trading with them on WTO terms, putting your companies and sectors

:19:44.:19:47.

that huge disadvantage. With that in mind, we need to create a cdrtain

:19:48.:19:51.

amount of goodwill from our European partners, and making them think that

:19:52.:19:55.

European citizens living here is the cause of all our problems is not the

:19:56.:19:59.

way to build goodwill. Can she therefore guaranteed to us, and

:20:00.:20:04.

accept she will want to find reforms to the way immigration works, but

:20:05.:20:08.

can she guarantee that her Cabinet will exercise more care in the

:20:09.:20:11.

language that they use on these matters? The Government and all

:20:12.:20:18.

ministers in the Government exercise every care when they use language in

:20:19.:20:21.

relation to these matters and I have to say to the honourable gentleman

:20:22.:20:26.

the image that he portrays of the impression we have given for EU

:20:27.:20:30.

citizens is quite the wrong one I have been very clear about our

:20:31.:20:36.

expectations and intentions in relation to EU citizens livhng here

:20:37.:20:40.

in the UK, but he must accept, as most other members of this House,

:20:41.:20:44.

that we also have a duty to British citizens living in EU member states,

:20:45.:20:49.

and that is why I want to m`ke sure the status of both is guaranteed.

:20:50.:20:55.

I am very pleased that my rhght honourable friend raised thd matter

:20:56.:21:02.

of the crisis in Syria at the European Council. I am wonddring

:21:03.:21:06.

though whether any spotlight was put on the crisis in Yemen? There,

:21:07.:21:14.

approaching 7000 people havd been killed. When 7000 people were killed

:21:15.:21:23.

in July 1995, at Schlupp nedds, the international community movdd into

:21:24.:21:25.

high gear to sort it out -- Srebrenica. Can I ask my right

:21:26.:21:32.

honourable friend whether the European Union has any plans to try

:21:33.:21:37.

and expedite the appalling crisis, sort out the appalling crishs which

:21:38.:21:42.

is happening in Yemen? My honourable friend is right to draw attdntion to

:21:43.:21:46.

the problems that are being experienced by many people hn Yemen,

:21:47.:21:52.

and what is happening in Yelen. We want to see a political solttion to

:21:53.:21:57.

the Yemen, as we want to sed a political solution in relathon to

:21:58.:22:01.

Syria. That is the only way to get long-lasting peace and stabhlity for

:22:02.:22:04.

the country. I'm pleased to say that has been at least a temporary

:22:05.:22:09.

cessation of hostilities in Yemen. I spoke at the weekend to the Crown

:22:10.:22:15.

prince of Abu Dhabi, and ond of the issues I raised in that conversation

:22:16.:22:18.

was the importance of sustahning the hostilities for all involved.

:22:19.:22:25.

The Prime Minister has had ` lot of questions about the customs union,

:22:26.:22:30.

and that is because, for exporter 's into the EU, having to comply with

:22:31.:22:35.

the rules of origin from thd outside would raise costs by 25%. The Prime

:22:36.:22:41.

Minister knows that Nissan hs one of those exporters. It has an dxtremely

:22:42.:22:48.

important role in the north,east. When they left their meeting with

:22:49.:22:53.

her, they seemed quite a lot happier and satisfied with what the Prime

:22:54.:22:56.

Minister said, so could she share with the House what she said to

:22:57.:23:01.

them? First of all, in relation to the issue with the customs tnion,

:23:02.:23:05.

I'm sure the honourable ladx knows, as I said in answer to an e`rlier

:23:06.:23:09.

question from one of her honourable friend, the customs union is a more

:23:10.:23:17.

complex issue than it first seems when people describe it oftdn in

:23:18.:23:20.

public. I am broke clear and we have been discussing with a numbdr of

:23:21.:23:24.

countries, about the intenthon of this government, to ensure `

:23:25.:23:27.

competitive market and to ensure that people are able to be here in

:23:28.:23:32.

the United Kingdom prospering here in the United Kingdom and adding to

:23:33.:23:38.

our economic growth. Can I thank the Prime Minister for

:23:39.:23:44.

her statement? Can I say th`t I entirely agree with her that until

:23:45.:23:51.

we leave the European Union, we should continue to play our full

:23:52.:23:55.

part in its affairs, not le`st because I expect the EU will want us

:23:56.:24:01.

to keep paying our full contributions until we do ldave

:24:02.:24:04.

Does my right honourable frhend agree that her -- does she think

:24:05.:24:10.

that her fellow EU leaders understand that if we leave the EU

:24:11.:24:16.

and we have to follow WTO t`riffs, according to today's report, EU

:24:17.:24:21.

exporters would be liable to pay nine Ashman ?12.9 billion a year,

:24:22.:24:26.

more than twice the ?5.2 billion a year that UK exporters would be

:24:27.:24:29.

liable to pay, and it is thdrefore very much in the interests of the

:24:30.:24:37.

rest of the EU to agree tarhff tariff free deal with ourselves My

:24:38.:24:41.

honourable friend makes a vdry important point. It is not just

:24:42.:24:45.

about the United Kingdom. It is about the future impact of the

:24:46.:24:49.

economies of the member states of the European Union, and he hs

:24:50.:24:53.

absolutely right that as we go into the negotiations, it will bd for

:24:54.:24:56.

member states to recognise that there are implications for them and

:24:57.:25:00.

those could be negative for their businesses and jobs in their

:25:01.:25:03.

countries, and that is why ht is in the interests of all of us to get

:25:04.:25:06.

the best possible deal in rdlation to trade.

:25:07.:25:11.

The president of the Europe`n Council Donald Tusk recentlx issued

:25:12.:25:14.

a statement in which he said there will be no soft Brexit, there is

:25:15.:25:18.

either a hard Brexit or no Brexit at all. Given that the Prime Mhnister

:25:19.:25:24.

was just in Brussels, did she pick up this hardening political mood

:25:25.:25:28.

music which makes absolutelx clear that the idea of the unfettdred

:25:29.:25:32.

access to the single market that we so desperately need is rapidly

:25:33.:25:39.

becoming a pipe dream? I repeat what I said earlier that we have not

:25:40.:25:43.

started negotiations, but what I found when I talked to other leaders

:25:44.:25:46.

and colleagues in the Europdan Council at the end of last week was

:25:47.:25:50.

a recognition that first of all this is a complex matter we have to

:25:51.:25:54.

negotiate, and secondly, an increasing recognition that we have

:25:55.:25:57.

to ensure the deal would get is a positive deal, both for the European

:25:58.:26:05.

and the United Kingdom. I got the impression and what was being said

:26:06.:26:08.

to me shows we will be able to sit down around the table and gdt the

:26:09.:26:10.

best in macro best possible deal for both sides.

:26:11.:26:16.

During a recent visit to Berlin there was genuine goodwill towards

:26:17.:26:24.

the UK, as well as an understanding there aren't detailed negothations

:26:25.:26:29.

ahead. There are shared intdrests with member states, but there are

:26:30.:26:35.

also common security concerns relating to Russia as well `s

:26:36.:26:38.

counterterrorism issues that will help focus the minds of EU

:26:39.:26:43.

negotiators at arriving at ` positive outcome. That is an

:26:44.:26:49.

excellent point, much discussion focuses on Mark Craig relathonship

:26:50.:26:55.

but there are other areas where we cooperate with the EU, law

:26:56.:27:00.

enforcement and security whdre we want to have a close and enduring

:27:01.:27:12.

partnership once we leave. H'm sure the Prime Minister understands the

:27:13.:27:16.

concerns of the British medhcal research Centre about their

:27:17.:27:20.

continued access to vital Etropean medical networks after Brexht.

:27:21.:27:26.

Without revealing her hand, can she give an assurance she has a plan to

:27:27.:27:30.

protect access for this vit`l research? The assumption behind the

:27:31.:27:38.

question that the only way to access those research networks is to being

:27:39.:27:44.

a member of the EU, there are those here who are members of a ntmber of

:27:45.:27:50.

research networks which operate as effectively but have nothing to do

:27:51.:27:55.

with the EU, but I can assure him this is another aspect of the future

:27:56.:27:59.

implications we are aware of and will consider. There is a d`ngerous

:28:00.:28:07.

political crisis in the Democratic Republic of Congo, which has seen 6

:28:08.:28:12.

million people die in the p`st 0 years. There is a crisis in Burundi

:28:13.:28:19.

with extrajudicial killings every week and there is a bloodbath inside

:28:20.:28:23.

Suzanne. All of these are rough concerned to the EU and the UK. Were

:28:24.:28:29.

any of these discussed at the subject is like the summit? No, the

:28:30.:28:38.

subjects were Russia, Syria, migration and trade, so the issue of

:28:39.:28:44.

Congo and South Sudan were not discussed but I am well aware of the

:28:45.:28:48.

concerns he and others have about what has been happening, especially

:28:49.:28:55.

recently, and this is a matter the Foreign Secretary is looking at

:28:56.:29:00.

closely. Earlier the Prime Minister `ssured

:29:01.:29:07.

that she was looking to raise the concerns of UK citizens livhng

:29:08.:29:10.

elsewhere in the EU and EU citizens in the UK. Can she tell us hf she

:29:11.:29:16.

raised those concerns at an early stage last week and if not why not?

:29:17.:29:23.

I have said on a number of occasions that this is an issue I hopd to

:29:24.:29:28.

address at an early stage. H repeat the comments I made earlier in

:29:29.:29:34.

relation to our expectation for EU citizens, but it is for this House,

:29:35.:29:40.

not simply to ignore the interests of British citizens living hn EU

:29:41.:29:46.

member states. We must make sure their rights are guaranteed. I very

:29:47.:29:54.

much commend my right honourable friend's statement to the House

:29:55.:30:01.

Last Friday I held a public meeting for EU nationals concerned `bout the

:30:02.:30:06.

Brexit vote and was heartendd by a majority seeing the opportunities of

:30:07.:30:14.

the UK leaving the EU, posshbly leading to reform for their home

:30:15.:30:19.

countries in future. Given the fact of one lonely and V2 on the Canada

:30:20.:30:26.

EU agreements -- effective one lonely and veto. What discussion was

:30:27.:30:38.

there about reform? It is up to the 27 to discuss among themselves the

:30:39.:30:43.

future shape of the EU. I h`ve raised with other leaders the

:30:44.:30:46.

importance I think of them paying attention to the message given by

:30:47.:30:53.

the UK vote to leave the EU but I leave it to them to discuss the

:30:54.:31:01.

future of the EU without thd UK Last week the Treasury commhttee

:31:02.:31:03.

heard from the Chancellor and we were told the Treasury is modelling

:31:04.:31:10.

the range of options presented to the Government to look at the

:31:11.:31:15.

economic implications. Todax the Prime Minister confirmed shd is

:31:16.:31:19.

looking at the regional imp`cts of those options. Given the colmitment

:31:20.:31:24.

to a series of debates in the House of Commons, she must agree that

:31:25.:31:28.

debate would be better informed if we have the evidence before us, so

:31:29.:31:33.

will she commit to publish those options so this House and the public

:31:34.:31:40.

can have an informed debate? We want to ensure that debates in this House

:31:41.:31:45.

are as informed as possible. There is a wide variety of pieces of work

:31:46.:31:51.

being undertaken, not just by government, about the implications

:31:52.:31:59.

of leaving the EU. My right honourable friend was right to

:32:00.:32:03.

stress that we are not leavhng Europe. Would she confirm that when

:32:04.:32:09.

we leave the EU we will continue to play a full and active part in the

:32:10.:32:14.

Council of Europe, working together on the basis of friendship `nd

:32:15.:32:20.

cooperation, not political tnion? The UK will continue to plax its

:32:21.:32:25.

role within the Council of Durope. I want us to have a good relationship

:32:26.:32:30.

with member states and the DU asked itself, that is in all our

:32:31.:32:38.

interests. Did the Prime Minister find time to emphasise to Etropean

:32:39.:32:42.

colleagues how much we valud things like the prisoner transfer

:32:43.:32:47.

agreement, Europol and the Duropean arrest warrant, and will shd agree

:32:48.:32:53.

that whatever negotiating she does, nothing will water down those

:32:54.:32:59.

commitments? My commitment to our relationship with other member

:33:00.:33:02.

states in relation to justice and home affairs, but I have had a lot

:33:03.:33:08.

of questions about the detahl of discussions I had an Brexit at the

:33:09.:33:13.

European Council. The main topics we discussed were Russia, migr`tion and

:33:14.:33:21.

trade. Negotiations on the detail of our negotiations will be for the

:33:22.:33:26.

future. The people of Skegndss voted more than any other to leavd the EU

:33:27.:33:33.

and no constituency approves more of this approach but will she `gree

:33:34.:33:38.

with me that they deserved this TD triggering of Article 50, speedy

:33:39.:33:44.

commencement of trade negothations and a speedy roll-out of thd

:33:45.:33:51.

controlling migration fund. I note he slipped in at the end of his

:33:52.:33:58.

question. I think it is right, and as I said in response to a couple of

:33:59.:34:03.

questions from the opposition, it is important people see we are

:34:04.:34:07.

committed to Article 50 bec`use I fear there are those who wish to

:34:08.:34:12.

delay the invocation of Arthcle 50 to as a proxy for not leaving the EU

:34:13.:34:17.

but it's important we give people the certainty and that is why we

:34:18.:34:21.

will invoke Article 50 by the end of March. The Prime Minister s`id that

:34:22.:34:30.

topic of trade discussed in the EU Council is a topic for the future,

:34:31.:34:35.

but her cheese of staff seels to note that and's hand very wdll and

:34:36.:34:41.

says we do not have to accept something like Chinese steel and

:34:42.:34:45.

could impose retaliatory tariffs on Chinese steel, but it is thd UK

:34:46.:34:50.

Government's policy to oppose these measures. Isn't it the case that the

:34:51.:34:57.

British Government is tying the hands of British duo workers as we

:34:58.:35:03.

speak? The Government has stpported steel production here, as hd will

:35:04.:35:09.

know in terms of compensation, also in relation to the ability to take

:35:10.:35:15.

social issues into concern when deciding about requirement of steel,

:35:16.:35:22.

a range of measures. In rel`tion to action taken by the EU, we decided

:35:23.:35:27.

last week to modernise the trade defence instruments but we will do

:35:28.:35:31.

that enable balanced way, b`lancing the interests of users and

:35:32.:35:37.

consumers, and the applicathon of lesser duty relief means for certain

:35:38.:35:43.

parts of the UK steel industry, imports from China have dropped by

:35:44.:35:52.

90%. Of all the European laws and regulations she wants to

:35:53.:35:56.

democratically reincorporatd into UK law through the Great Repeal Bill,

:35:57.:36:01.

which of them but she want to abolish or amend first? It will be

:36:02.:36:10.

for this Parliament to decide how we deal with the regulations and laws

:36:11.:36:14.

once brought into UK law, btt two points I would make, it is right to

:36:15.:36:21.

bring that into UK law at the point when we leave the EU to enstre there

:36:22.:36:27.

is no legal gap and everyond has certainty of the legislation they

:36:28.:36:33.

will operate under, and also, once that has happened, it will be for

:36:34.:36:37.

this Parliament to decide and be sovereign in determining those laws.

:36:38.:36:45.

Could the Prime Minister enlighten us further discussions that on the

:36:46.:36:50.

subject of higher education and are there any clues as to whethdr UK

:36:51.:36:55.

universities will retain access to EU research projects after we leave,

:36:56.:37:01.

and also the fee status of DU students in 2010 and beyond? We have

:37:02.:37:07.

heard anecdotal evidence th`t British researchers have bedn turned

:37:08.:37:13.

down for Horizon 2020 funds, and my written questions remain un`nswered.

:37:14.:37:21.

She will get responses to qtestions. A concern has been raised whth me by

:37:22.:37:26.

people that the risk and approach being taken in relation to

:37:27.:37:30.

universities that as we havd decided to leave, we should be treated

:37:31.:37:36.

differently while still in the EU. What is important is that wd

:37:37.:37:39.

emphasise that while we are still members of the EU, we are treated as

:37:40.:37:45.

full members and have access to the projects the honourable ladx is

:37:46.:37:54.

talking about. Here's me, you saved the best for last. The

:37:55.:38:00.

Secretary-General of Nato c`lled the EU an essential partner for Nato and

:38:01.:38:05.

said Nato has every chance to strengthen our unity and pr`ctical

:38:06.:38:11.

cooperation even further, therefore how can he newly confirmed Prince of

:38:12.:38:18.

Prime Minister deliver security without even closer union whth the

:38:19.:38:28.

EU is accepted by our Nato `llies? I think that quote he gave was the

:38:29.:38:32.

secretary-general of Nato t`lking about the energy defence

:38:33.:38:36.

arrangements in the EU, not about the UK being part of some stronger

:38:37.:38:42.

defence in the EU. We will play a leading role in Nato, as we have

:38:43.:38:48.

done, we will continue to h`ve a close relationship and you `nd it

:38:49.:38:54.

will be in all our interests to work together for the collective defence

:38:55.:39:00.

of member states and of Europe. White is the Prime Minister in a

:39:01.:39:07.

position to offer specific assurances to Nissan motors but not

:39:08.:39:12.

to 3.3 million EU citizen 's who make such a vital contributhon to

:39:13.:39:19.

our economy? I will repeat ht again as he didn't appear to hear the

:39:20.:39:25.

answer previously. I expect to be able to and I want to guarantee the

:39:26.:39:31.

status of the uses and is lhving there, but the only circumstances

:39:32.:39:35.

that would not be possible hf the status of criticisms, including

:39:36.:39:41.

people from Scotland, was not guaranteed in return. We cannot

:39:42.:39:52.

abandon British citizens. Statement, the Secretary of State for the Home

:39:53.:39:59.

Department, Secretary Amber Rudd. Thank you, Mr Speaker. I wotld like

:40:00.:40:04.

to make a statement on Calahs. The French government to Dave bdgan

:40:05.:40:11.

clearing the migrant camp. This is in the interests of the UK `nd

:40:12.:40:17.

France, the start of a necessary humanitarian operation and `n

:40:18.:40:20.

important step to end the dhfficult situation. Our priorities are to

:40:21.:40:25.

keep our borders secure, tackle the gangs who profit from the vtlnerable

:40:26.:40:30.

and ensure those in need of protection are move to placds of

:40:31.:40:36.

safety. Today's come clear hn support of these objectives. On the

:40:37.:40:42.

10th of October it up out of the House after admitting my Frdnch

:40:43.:40:46.

counterpart. We had discussdd the importance of keeping all children

:40:47.:40:51.

safe during the clearance operation. My officials have been workhng with

:40:52.:40:56.

French authorities to make sure this protection is provided and TK

:40:57.:41:00.

personnel are taking an acthve role on the ground today to move all

:41:01.:41:07.

children to a place of safety and they will continue to do so for as

:41:08.:41:10.

long as necessary. That meeting was one of many in the past few months

:41:11.:41:15.

and we have made good progrdss to speed up the process for

:41:16.:41:18.

transferring children with ` close family link to the UK. More than 80

:41:19.:41:23.

children were transferred from France in the first nine months of

:41:24.:41:27.

this year under the Dublin regulation that I have been pressing

:41:28.:41:31.

to go further in this House will recall that on the 10th of October I

:41:32.:41:37.

stated my commitment to bring to the UK as many children as posshble with

:41:38.:41:40.

close family links before the closure of the camp, and I lade

:41:41.:41:47.

clear my intention to transfer unaccompanied children from Calais

:41:48.:41:51.

who meet the criteria of thd dubs amendment to the immigration act of

:41:52.:41:52.

2016. Since my statement, working in

:41:53.:42:01.

partnership with the French, we have transferred more than 200 children.

:42:02.:42:07.

This includes 60 girls, manx of whom have been identified at high risk of

:42:08.:42:12.

sexual exploitation. I want to make clear to the House, the Govdrnment

:42:13.:42:16.

has sought every opportunitx to expedite the process to transfer

:42:17.:42:19.

children to the UK. My officials were only given access to the camp

:42:20.:42:24.

to interview children in thd last week, and similarly, we havd only

:42:25.:42:27.

recently received agreement from the French government that we could

:42:28.:42:33.

bring dubs cases to the UK. For this, we work closely with the

:42:34.:42:37.

French behind-the-scenes but without their agreement it was not possible

:42:38.:42:42.

to make progress on taking nonfamily cases from Calais. In the l`st seven

:42:43.:42:47.

days, my officials have intdrviewed 800 children in the camp cl`iming to

:42:48.:42:52.

have close family links in the UK, working closely with NGOs and

:42:53.:42:57.

charities. Every child in the last week has been interviewed bx UK

:42:58.:43:01.

staff. Much of this work has been carried out in difficult conditions

:43:02.:43:05.

and on a number of occasions interviews have been paused and UK

:43:06.:43:10.

staff have withdrawn for safety reasons. I would like to th`nk the

:43:11.:43:17.

French staff and put on record the gratitude from my staff or what have

:43:18.:43:21.

been pretty challenging conditions. Until a few months ago, the French

:43:22.:43:26.

government requested we did not transfer children outside the Dublin

:43:27.:43:30.

regulation process. This was due to their concerns it would encourage

:43:31.:43:34.

more children to come to Calais That is why we focused our `greement

:43:35.:43:40.

and the Dubs amendments on children from Greece and Italy. It is only

:43:41.:43:44.

recently this has changed. Looking ahead, we will bring more children

:43:45.:43:48.

from Calais to the UK in thd coming weeks and months. We will continue

:43:49.:43:54.

to transfer unaccompanied rdfugee children from Calais and thd wider

:43:55.:44:00.

criteria of the Dubs Amendmdnt. We will be following three guiding

:44:01.:44:03.

principles in determining who we bring to the UK from Calais. We will

:44:04.:44:10.

are ties those likely to be granted refugee status in the UK. Wd will

:44:11.:44:15.

also prioritise those 12-ye`r-olds and under, and we will conshder

:44:16.:44:19.

those assessed of being at high risk of sexual exploitation. In doing

:44:20.:44:25.

this, we will establish whether it is in each child's best intdrests to

:44:26.:44:29.

come here. But through this process, it is important that we do not

:44:30.:44:34.

encourage more children to head to Calais, risking their lives in the

:44:35.:44:38.

hands of traffickers. That hs why we will only consider those prdsent in

:44:39.:44:42.

the camps before the start of clearance operations today. We will

:44:43.:44:47.

continue to do this quickly but it is essential we carry out the proper

:44:48.:44:51.

safeguarding, age assessment and security checks, working closely

:44:52.:44:54.

with local authorities and social workers here in the UK, to dnsure

:44:55.:44:58.

that the children are eligible and it is in their best interests to

:44:59.:45:02.

come. I'm pleased to say my French counterpart has agreed to stpport

:45:03.:45:07.

minors unsafe facilities in France, during the weeks we now need to

:45:08.:45:11.

carry out these important checks. It is also important that on arrival in

:45:12.:45:16.

the UK these identities of these Trojan are not compromised `nd they

:45:17.:45:20.

are allowed to begin their life here with the support they need ,- the

:45:21.:45:27.

identities of these children. As part of our commitments we have been

:45:28.:45:31.

consulting with local authorities on capacity. It's clear that there is

:45:32.:45:35.

the capacity to support the children we intend to take from Calahs, as

:45:36.:45:39.

well as meeting our other commitments. The key now is to make

:45:40.:45:43.

sure we get these places up and running as soon as possible. I would

:45:44.:45:49.

like to pay tribute to the work and generosity of local authorities so

:45:50.:45:53.

far, in providing both the temporary and permanent support that the

:45:54.:45:57.

children arriving require. However, as more children arrive in the

:45:58.:46:00.

coming weeks, we will need to identify further places, and we will

:46:01.:46:03.

be working with local authorities and the coming days to ensure that

:46:04.:46:08.

that happens. Whilst responsibility for Calais lies with the Frdnch

:46:09.:46:11.

government, the juxtaposed controls are a vital part of the UK's border

:46:12.:46:17.

security and are a vital economic link. That is why the UK Government

:46:18.:46:21.

will be contributing up to ?36 million to maintain the sectrity of

:46:22.:46:25.

these controls, to support the camp clearance, and is sure in the

:46:26.:46:30.

long-term that the camp is kept closed. This funding will also be

:46:31.:46:34.

used to help keep children safe in France. This contribution is not

:46:35.:46:38.

made unconditionally, and wd will continue to work with the French

:46:39.:46:41.

government, to assure that the clearance operation is full and

:46:42.:46:46.

lasting. Work in Calais is important, but the situation there

:46:47.:46:50.

is a symptom of a wider migration crisis. We are clear about our moral

:46:51.:46:56.

responsibility to assist those who are suffering, including by

:46:57.:47:00.

providing support in conflict regions, development work upstream,

:47:01.:47:03.

and by providing protection for those who need it. Mr Speakdr, the

:47:04.:47:07.

French authorities face a htge challenge over the coming d`ys and

:47:08.:47:11.

weeks, to move people out of the camp in Calais. But let me be clear.

:47:12.:47:17.

Neither government is prepared to allow people to continue to live in

:47:18.:47:20.

those conditions, and neithdr government is prepared to allow

:47:21.:47:24.

people smugglers to continud to profit from risking the livds of the

:47:25.:47:29.

people there. We will continue to support the French government in the

:47:30.:47:33.

operation and will continue with our progress in bringing those children,

:47:34.:47:37.

with a right to come to the UK, as quickly and as safely as possible.

:47:38.:47:42.

Clearing the camp is not just about our legal and moral obligathons It

:47:43.:47:47.

is also in our national intdrest. The rise in the number of pdople has

:47:48.:47:53.

led some in France to questhon the agreement. This agreement h`s

:47:54.:47:58.

allowed us to better protect our borders and ensured strong trade

:47:59.:48:02.

links between Britain and France. By clearing the camp, we can hdlp

:48:03.:48:06.

secure the future of the juxtaposed controls, as well as playing our

:48:07.:48:11.

part, to help those most in need in Calais. I commend this statdment to

:48:12.:48:18.

the House. Diane Abbott. Mr Speaker, as we speak, thousands

:48:19.:48:22.

of men and women are being bussed out of Calais, one more leg in a

:48:23.:48:30.

desperate odyssey which has taken some of them halfway around the

:48:31.:48:35.

world. It is worth noting that the situation in Calais represents

:48:36.:48:42.

everything that is wrong about Europe's response to the refugee

:48:43.:48:47.

crisis. There was not enough cooperation. The French clahm that

:48:48.:48:49.

because the migrants said they wanted to go to the UK they were

:48:50.:48:54.

somehow not their responsibhlity, while we refused for far too long to

:48:55.:48:58.

go into the camp and identify those who might have a legal right to come

:48:59.:49:05.

to the UK. The men, women and children in the Calais camp were

:49:06.:49:10.

treated by the French and the UK like pawns, but these are rdal

:49:11.:49:15.

people fleeing war and economic devastation, who were living in

:49:16.:49:21.

appalling conditions, and in the absence of any proactive action by

:49:22.:49:24.

the British or the French, those people were at the mercy of people

:49:25.:49:30.

smugglers and criminal gangs, who were in and out of the camp, as I

:49:31.:49:34.

discovered when I visited the camp in January. It was left to

:49:35.:49:40.

charities, church groups and individual volunteers to go across

:49:41.:49:45.

and provide basic support and services in the Calais camp. So I

:49:46.:49:49.

would like to take this opportunity to pay tribute to all of those

:49:50.:49:54.

selfless volunteers. I would like to thank the UK staff now workhng in

:49:55.:49:58.

the camp in difficult and d`ngerous conditions and I would like to

:49:59.:50:01.

congratulate the local authorities who are providing temporary and

:50:02.:50:06.

permanent support. I accept that the Home Office has accelerated the

:50:07.:50:10.

processing of child refugees in recent weeks, but the Home Office

:50:11.:50:14.

has known for months that the camp was to close. More should h`ve been

:50:15.:50:19.

done to persuade the French, either to process all the children

:50:20.:50:23.

themselves, or allow thin. The truth is, we should have made it to the

:50:24.:50:29.

French, that the camp should not have been demolished until we had

:50:30.:50:33.

processed all the children. The media is an uproar about thd

:50:34.:50:38.

supposed failings in the processing. And commentators are in a l`ther

:50:39.:50:43.

about whether some of these children are 17 and a half, 18 and a half or

:50:44.:50:49.

god forbid 19 and a half, as if being a year over the legal

:50:50.:50:55.

definition of childhood makd you miraculously imu into illness caused

:50:56.:50:58.

by freezing temperatures and raw sewage in front of your tent, fear

:50:59.:51:03.

caused by violence and the deadly attentions of sex traffickers. If

:51:04.:51:07.

the commentators who are now suggesting that these young people

:51:08.:51:10.

should be treated like cattle and have their teeth tested had made as

:51:11.:51:17.

much noise about the Governlent s slowness in processing thesd child

:51:18.:51:20.

refugees in the first place, we would not be in the situation we are

:51:21.:51:27.

in. We know that the last thme there was an eviction, more than 000

:51:28.:51:32.

children went missing, before that eviction, because that eviction

:51:33.:51:37.

began before their safety w`s guaranteed. If children go lissing

:51:38.:51:42.

this time, the fear must be they will disappear into the hands of

:51:43.:51:45.

people smugglers and sex traffickers. So, can the Hole

:51:46.:51:52.

Secretary give the estimated timings for the processing of what H

:51:53.:51:57.

understand is the remaining 100 children left in the camp? Will she

:51:58.:52:01.

noted that on this side we regret that any new children arrivhng in

:52:02.:52:09.

the Calais camp will not be able to access family reunions? I al glad to

:52:10.:52:13.

hear there is work being done in Greece and Italy because obviously,

:52:14.:52:17.

Calais is not the only refugee camp. I have visited the camps in Lesbos

:52:18.:52:22.

in Greece. I have seen the traumatised men, women and children

:52:23.:52:26.

there. They had already risked their lives crossing the Mediterr`nean.

:52:27.:52:31.

These children will have sedn others, perhaps family membdrs or

:52:32.:52:35.

friends perish at sea. Thesd children should not feel th`t they

:52:36.:52:39.

have no option but to make their way across France and attempt the

:52:40.:52:43.

dangerous journey to the UK. So will the Home Secretary say more about

:52:44.:52:48.

her plans to create similarly expedited family reunions and Dubs

:52:49.:52:53.

transfers in countries like Greece and Italy? And how long does the

:52:54.:52:57.

Home Secretary estimate that the Dublin children will be held in the

:52:58.:53:02.

temporary accommodation centres in the UK, either before being reunited

:53:03.:53:05.

with their families or placdd into the transfer scheme? And will there

:53:06.:53:11.

be funding and support for the local authorities who are stepping up to

:53:12.:53:17.

play their part in helping these traumatised child refugees? This

:53:18.:53:26.

House knows that from 1999 to 2 02, there was a migrant camp ne`r Calais

:53:27.:53:36.

at Sangatte. There were over 20 0 men, women and children livhng in

:53:37.:53:40.

appalling conditions. That camp was closed with great fanfare 14 years

:53:41.:53:44.

ago. But this new encampment that the French are attempting to close

:53:45.:53:48.

had four times as many people and the conditions were even worse. The

:53:49.:53:54.

French may be closing this camp now, but there is an urgent need for more

:53:55.:54:00.

corporation, Europe wide on migration issues, and unless, as the

:54:01.:54:06.

Home Secretary noted, we de`l with the underlying issues of poverty,

:54:07.:54:13.

Civil War and ill-conceived foreign interventions, this will not be the

:54:14.:54:19.

last time this House have to debate encampments of desperate people in

:54:20.:54:23.

appalling conditions in Cal`is. I am glad we are moving to help the child

:54:24.:54:29.

refugees. I think more could have been done earlier despite the Home

:54:30.:54:33.

Secretary's attempts to hidd behind the French, but let us remelber let

:54:34.:54:40.

us remember that all those people in that camp, which I have vishted are

:54:41.:54:47.

human beings. We will do wh`t we can do for the children, but we need a

:54:48.:54:51.

more considered and Europe wide strategy to deal with the tragedy of

:54:52.:55:01.

refugees moving across Europe. Well, the right honourable lady has

:55:02.:55:04.

raised some important points, and I would first of all draw her

:55:05.:55:07.

attention to some of the colments the Prime Minister made abott the

:55:08.:55:11.

important work the European Union is making, some of which we ard leading

:55:12.:55:16.

on, an upstream funding to lake sure this terrible tragedy of refugees

:55:17.:55:20.

moving, quite often from Central and East and west African countries is

:55:21.:55:25.

stopped. We do that by being one of the largest donors, by workhng in

:55:26.:55:28.

partnership arrangements, and I share her view, that if we can stop

:55:29.:55:32.

the scale of movement, then that is dealing with the most important

:55:33.:55:35.

element of why people come over to Europe and then make their way

:55:36.:55:39.

across France. But I do not need reminding by the lady about the

:55:40.:55:43.

scale of misery that is going on in the camp there in Calais. That is

:55:44.:55:47.

why I have made it such a priority to work with my French counterpart

:55:48.:55:51.

to see the end of that camp and I believe to see the end of the misery

:55:52.:55:55.

that is taking place there. Protecting children has alw`ys been

:55:56.:55:58.

at the forefront of what we are doing. She has referred to the scale

:55:59.:56:03.

of the Dubs Amendment and what else we are doing to make sure wd take

:56:04.:56:06.

children according to that, and I can tell her that we are continuing

:56:07.:56:10.

to interview to make sure that over the next three weeks, she asked

:56:11.:56:13.

particularly about the time frame, we continue to take several hundred

:56:14.:56:18.

more children in addition to the 200 we have already taken. And xes, we

:56:19.:56:22.

are continuing to work on the children who will be eligible in

:56:23.:56:25.

Greece and Italy, and we will be bringing some over the from there

:56:26.:56:30.

soon. In terms of funding and support for the local authorities,

:56:31.:56:34.

there is a funding arrangemdnt for local authorities, for each child

:56:35.:56:38.

that is put in place as thex arrive. She referred particularly to

:56:39.:56:43.

Sangatte in 2002. She is right that camp was ended. There were

:56:44.:56:47.

approximately 2000 people that and at that time the UK agreed to take

:56:48.:56:51.

half of the adults. That is not an agreement we have put in pl`ce this

:56:52.:56:55.

time. Instead we are taking some of the most vulnerable which whll be

:56:56.:57:03.

largely children. But there have been lessons learned from the ending

:57:04.:57:06.

of the Sangatte camp. Camps did come in place swiftly afterwards and in

:57:07.:57:10.

particular the Calais camp which is several times larger than S`ngatte

:57:11.:57:11.

ever was. Part of funding commitment to the

:57:12.:57:20.

French is based on securing the camp as it is, ie once it has bedn

:57:21.:57:26.

closed, we want to make surd we work closely with them so that no future

:57:27.:57:30.

camp is erected there. If there is no camp there for people to come, it

:57:31.:57:35.

will stop the dreadful pass`ge of people across France and thd

:57:36.:57:38.

dreadful endeavour is that people put themselves through to throw

:57:39.:57:42.

themselves on lorries, trucks, in order to get to the UK. And I

:57:43.:57:49.

believe it will stop them bding easy prey to the traffickers I note she

:57:50.:57:59.

and I both abhor. What succdss of the authorities had in arresting or

:58:00.:58:02.

stopping the people traffickers and what more can be done to do that and

:58:03.:58:08.

how can we persuade any adult from committing money and child to these

:58:09.:58:16.

dreadful people? The Nation`l crime agency works closely with the French

:58:17.:58:20.

border Forest and the UK border Forest and we have had succdss of

:58:21.:58:24.

arresting traffickers and there is so much more that we can do. It is

:58:25.:58:29.

one of the reasons why we w`nt to protect the agreement which allows

:58:30.:58:33.

us to work closely together to try and intervene and stop thosd

:58:34.:58:40.

traffickers plying their tr`de. Thank you, Mr Speaker. I wotld like

:58:41.:58:44.

to welcome the Home Secretary statement and the news that the UK

:58:45.:58:47.

has now brought unaccompanidd children to the UK both unddr the

:58:48.:58:53.

Dublin regulation and the Lord dubs scheme from the cab at Calahs and

:58:54.:58:56.

also welcome her confirmation we will continue do so. I would like to

:58:57.:59:01.

congratulate her on the fact that she has certainly got things moving

:59:02.:59:04.

in the last couple of weeks. There has been delay in the past but

:59:05.:59:08.

credits are due, things are moving now. I would like to thank her for

:59:09.:59:11.

keeping me informed of what she has been doing and I am very gr`teful to

:59:12.:59:15.

her for a personal acknowledgement of the contribution that has been

:59:16.:59:19.

made to preparations that these children's by local authorities in

:59:20.:59:24.

Scotland and the Convention of Scottish local authorities. I would

:59:25.:59:28.

also like to join her in th`nking the staff who were there at the

:59:29.:59:31.

moment doing difficult work and I would like to add to that mx thanks

:59:32.:59:36.

and the thanks of the Scotthsh National party to all the NGOs and

:59:37.:59:40.

British and Irish volunteers working in that camp over the last few years

:59:41.:59:43.

when there were no official staff there. Mr Speaker, and numbdr of

:59:44.:59:50.

concerns do remain. There h`ve been reports today that the Calahs Police

:59:51.:59:53.

Commissioner has told migrants there is not enough buses to transport

:59:54.:59:57.

them to the time. This is worrying and points to a lack of adepuate

:59:58.:00:01.

planning and preparation for the evacuation on the part of the

:00:02.:00:04.

French. It does not bode well for those vulnerable people and children

:00:05.:00:08.

in the camp who are at serious risk of getting lost in the chaos. Can I

:00:09.:00:13.

pressed her to confirm what plans the UK and French governments have

:00:14.:00:18.

made to ensure that these unaccompanied children don't get

:00:19.:00:20.

lost in the chaos and are protected from falling prey to smuggldrs are

:00:21.:00:23.

going missing, as we know h`ppened last time round? Can suppressor to

:00:24.:00:28.

give an estimate of timings through the processing of the remaining

:00:29.:00:33.

children left in the camp is 's and finally, Mr Speaker, moving the camp

:00:34.:00:37.

doesn't remove the need for a long-term solution to the mhgrant

:00:38.:00:40.

and refugee crisis. What pl`ns does the Home Secretary have to create

:00:41.:00:47.

similar expedited family retnion and dubs transfers another year EU

:00:48.:00:49.

countries such as Greece and Italy to stop children feeling forced to

:00:50.:00:53.

make a journey across Europd to try and get to the UK? I thank the

:00:54.:00:58.

honourable lady further questions and I agree that we should be

:00:59.:01:04.

thanking also the NGOs and the volunteers who have been dohng great

:01:05.:01:08.

work there to protect vulnerable children and actually going to be

:01:09.:01:11.

integral to the closure of the camp over the few days and weeks in terms

:01:12.:01:16.

of protecting the children because sometimes there is very much a lack

:01:17.:01:21.

of trust between Government agencies and the refugees are asylum seekers

:01:22.:01:25.

who are there. Their role is critical in order to try and reach a

:01:26.:01:29.

resolution. She mentions reports from Calais, I haven't heard that

:01:30.:01:34.

particular one. In this sort of environment, Dara a lot of reports

:01:35.:01:38.

and counter news going around. We are very clear that we try to keep

:01:39.:01:41.

everybody informed when we `re there about what's going on but I must

:01:42.:01:45.

respectfully point out this is a pretty tricky situation where we are

:01:46.:01:50.

dealing with a lot of volathle people in some cases. A lot of

:01:51.:01:54.

misinformation and our staff are doing the best to make sure

:01:55.:01:57.

everybody is kept informed. In terms of protecting children, I h`ve

:01:58.:02:01.

repeatedly stated to the Frdnch that it is our priority to ensurd that

:02:02.:02:06.

those children are kept safd and we have agreed to transfer all the

:02:07.:02:12.

children as the camp is cle`red into a secure area. It will be lhkely

:02:13.:02:15.

that wanted children are in a secure area, we should be able to dxpedite

:02:16.:02:18.

our intervene process and bd able to make sure that we keep track of the

:02:19.:02:21.

children that we would like to transfer to the UK. Frankly, over

:02:22.:02:27.

the past few days, it has bden difficult to then find them on the

:02:28.:02:31.

day in order to make sure that began on the buses. I hope with the

:02:32.:02:35.

children held securely in this area of the camp but that will ilprove.

:02:36.:02:39.

In terms of other transfers, there has been a lot with light and I hope

:02:40.:02:43.

we can speed up other areas of the world in terms of Italy and Greece.

:02:44.:02:51.

Those relatively few members of those house who have in the past

:02:52.:02:55.

accommodated young asylum sdekers in their own homes are in a position to

:02:56.:02:58.

be able to confirm to my right honourable friend that this is not

:02:59.:03:03.

something that can be taken lightly, proper preparation needs to be made.

:03:04.:03:07.

If this humanitarian exercise is not to end in tears, it is vital that

:03:08.:03:12.

the Home Secretary sticks to her guns. Can she reassure us that this

:03:13.:03:20.

is any -- before any child hs admitted, the family will bd

:03:21.:03:23.

properly screened and in thd interest of national security, every

:03:24.:03:28.

young adult committed to thd United Kingdom is screened before the late

:03:29.:03:34.

into the country? I thank mx honourable friend to that qtestion

:03:35.:03:38.

and I know that he has housdd asylum seekers in the past and I v`lue his

:03:39.:03:43.

experience in this area and I can reassure him that we will always

:03:44.:03:46.

make the correct safeguarding checks and we will always make surd that

:03:47.:03:51.

the families are prepared. We will not take any risks for this country

:03:52.:03:54.

either in terms of national security or on behalf of the children who are

:03:55.:04:00.

moving here. Thank you, Mr Speaker. Can I also welcome the progress the

:04:01.:04:05.

Home Secretary has made since her last statement and also her

:04:06.:04:08.

commitment to take several hundred more child -- child refugees as well

:04:09.:04:13.

and join the tributes to all those including charities and loc`l

:04:14.:04:16.

councils who are making it possible for Britain to do what it h`s always

:04:17.:04:20.

done and help those who are most vulnerable. She will know mx concern

:04:21.:04:24.

that this is obviously started so late and therefore the risks of

:04:25.:04:30.

trafficking and disappearing of the many of those who are still left,

:04:31.:04:36.

can she confirm that up to 0000 children and teenagers are dxpected

:04:37.:04:40.

to stay in the container calps overnight tonight and that refugees

:04:41.:04:46.

have warned the are concerndd there will be no youth workers or social

:04:47.:04:50.

workers staying with them, could she urgently make representations to the

:04:51.:04:53.

French Government to ensure there is enough support to keep them safe and

:04:54.:04:58.

particularly that there are additional arrangements for the

:04:59.:05:01.

girls and young women who are there in the camp tonight? I thank the

:05:02.:05:07.

right honourable lady for that question and she has done so much to

:05:08.:05:12.

raise this issue. She is right to do so. I can tell her it is thd plan

:05:13.:05:16.

and it's what the French have said they are doing to maintain the 000

:05:17.:05:21.

plus children and miners in the secure area as the camp. We think

:05:22.:05:25.

this will help us process in order to expedite bringing some of them

:05:26.:05:30.

over here over the next few weeks. We expect a three-week period but we

:05:31.:05:34.

will be moving straightaway. Bill Tilden are moving today. In terms of

:05:35.:05:38.

the support offered to the children there, I haven't followed up yet

:05:39.:05:41.

with the French but I will lake sure I do. Colleagues will want to

:05:42.:05:49.

congratulate the lady on thd home of various committee. One of the

:05:50.:05:55.

classic roots of trafficking is to bring young children -- teenage

:05:56.:06:00.

children, particularly young girls into this country, put them into

:06:01.:06:05.

Government care and within weeks, they have disappeared back hnto

:06:06.:06:08.

trafficking. Could the Home Secretary interest on this occasion

:06:09.:06:12.

that every single child that is permitted to this country whll be

:06:13.:06:17.

monitored and can we have a written statement each month to confirm that

:06:18.:06:21.

those children are still behng looked after and have not bden

:06:22.:06:27.

re-trafficked? My honourabld friend raises an important point and it's

:06:28.:06:30.

an area he has done a lot of work in as well. He is absolutely rhght

:06:31.:06:34.

There is always a risk to accepting these young women but it is because

:06:35.:06:39.

they are at risk that we had to be so keen to prioritise them `nd of

:06:40.:06:43.

the nearly 200 that we have taken over this past weekend, nearly one

:06:44.:06:47.

third have been young women in order to protect them from the dangers he

:06:48.:06:52.

sets out. I can reassure hil that we will be making constant safdguarding

:06:53.:06:56.

checks and I will write to him more fully to set exactly what wd are

:06:57.:07:02.

doing. Can I thank the Home Secretary for statement and indeed

:07:03.:07:07.

for her work in recent days in trying to expedite this crisis. Just

:07:08.:07:13.

you referred to some of the comments made this afternoon and this evening

:07:14.:07:19.

that somehow human traffickhng is the cause and source of the crisis

:07:20.:07:23.

we are talking about and to challenge that and to suggest that

:07:24.:07:26.

human traffickers are wicked people who exploit a crisis on a global and

:07:27.:07:34.

European one, I am trying to challenge this. Specific to Calais,

:07:35.:07:37.

many of the vulnerable children brought to the UK will have family

:07:38.:07:42.

somewhere even if the are ctrrently separated. The UK is the only

:07:43.:07:47.

European country I understand that does not allow unaccompanied

:07:48.:07:53.

children with refugee status the right to sponsor immediate family,

:07:54.:07:56.

including parents, to join them Given the importance of keeping

:07:57.:08:03.

families together, will she ensure that unaccompanied refugee children

:08:04.:08:06.

are able to sponsor their p`rents for the purpose of refugee family

:08:07.:08:13.

reunion if and when they ard found? I thank the honourable gentleman for

:08:14.:08:16.

his question and he is right that traffickers are at the heart of the

:08:17.:08:20.

problem, not the whole problem. He and I know as the Woolhouse does

:08:21.:08:24.

there are many reasons why this takes place and it starts whth the

:08:25.:08:27.

upstream problem that we ard trying to address with other countries

:08:28.:08:32.

internationally about supporting African countries from wherd these

:08:33.:08:37.

refugees are coming. In terls of changing to our immigration policy,

:08:38.:08:44.

there are no plans to changd it I would like to give my thanks to the

:08:45.:08:48.

Home Secretary for statement today and he asked in working to transfer

:08:49.:08:53.

these eligible children frol Calais -- Calais to the UK, can my right

:08:54.:08:57.

honourable friend confirm that this has been done through a proper and

:08:58.:09:02.

process with the agreement of the French and that all of the children

:09:03.:09:05.

who are coming over will undergo the appropriate security checks? She is

:09:06.:09:13.

absolutely right. We are only doing this work by making initially proper

:09:14.:09:17.

checks on every individual, every child or minor he was brought

:09:18.:09:21.

across. We have two insure ht the safeguard an interest of thd child

:09:22.:09:24.

is served first before bringing them over to the UK. The checks `re

:09:25.:09:30.

always been done. Can I join with you in congratulating my honourable

:09:31.:09:37.

friend on her election as chair of the home affairs committee `s she

:09:38.:09:41.

will do an excellent job. Does the Home Secretary agree with md that

:09:42.:09:44.

the primary responsibility for the disturbing thing is that we are

:09:45.:09:48.

seeing lies with the French Government? This is France `nd I

:09:49.:09:51.

don't believe that we in thhs country would have allowed the

:09:52.:09:54.

development of the cab in this way. We want this to end as quickly as

:09:55.:10:00.

possible but my concern in welcoming her strong commitments on child

:10:01.:10:03.

protection is that the problem is going to be displaced to Holland and

:10:04.:10:09.

Denmark. That is already evhdence the people traffickers are loving

:10:10.:10:13.

away from Calais into other areas and can she assured the house there

:10:14.:10:18.

are small ports and airports will get the security back-up th`t they

:10:19.:10:22.

need in order to protect thdm from this activity? I thank the right

:10:23.:10:28.

honourable gentleman for his question. He is right that this is

:10:29.:10:33.

taking place in France and this is largely a problem for the French to

:10:34.:10:37.

address but it is so much in the UK's interest that this is `ddressed

:10:38.:10:41.

that the camp is dealt with in this way and that the agreement hs

:10:42.:10:44.

maintained that we are playhng an active role. He is right to point

:10:45.:10:49.

out the danger of displacemdnt and we are talking to French

:10:50.:10:52.

counterparts and with our intelligence services, borddr forces

:10:53.:10:55.

and police forces to make stre we keep an aye on where it might happen

:10:56.:11:00.

and we will support our ports to address it. May I congratul`te the

:11:01.:11:05.

Home Secretary on her department, 800 injuries have taken place so

:11:06.:11:08.

swiftly in difficult circumstances. Can I ask what is being dond to

:11:09.:11:12.

prioritise the most vulnerable children? He is right. We are

:11:13.:11:17.

committed to prioritising the most vulnerable which is the youngest,

:11:18.:11:22.

miners who are risk of sexu`l exploitation and we will always make

:11:23.:11:26.

sure that we do that. We ard putting them at the front of the kex in

:11:27.:11:29.

terms of interviewing MBI are the ones who are most likely to qualify

:11:30.:11:33.

under the Dubs Amendment whdn it comes most clear that they `re

:11:34.:11:38.

better served by being in the UK. Thank you, Mr Speaker. May H

:11:39.:11:42.

associate myself with the comment of the new home affairs select

:11:43.:11:45.

committee chair about the progress being made and pick up on what the

:11:46.:11:49.

Home Secretary said about the reports from the camp today and the

:11:50.:11:53.

chaos that we are seeing as the camp is being closed. I have det`iled

:11:54.:11:58.

with me of 49 children under the age of 13 who today the voluntary

:11:59.:12:01.

agencies say could not register at the warehouse. I am happy to share

:12:02.:12:07.

those with the Home Secretary and her officials directly. Will she

:12:08.:12:10.

give me a personal assurancd that she will investigate the fate of

:12:11.:12:14.

those 49, including three under the age of 11? Was she make an `ssurance

:12:15.:12:19.

that any child brought here under the legal process will not be put in

:12:20.:12:21.

a Rules are surprised to hear the

:12:22.:12:31.

honourable lady talk about ` detention centre.

:12:32.:12:34.

We are making sure all the children who comes here are looked after in a

:12:35.:12:39.

way that we as a proud uncompassionate lesion can call the

:12:40.:12:44.

right way. If she has any additional information she's welcome to give it

:12:45.:12:49.

to me. -- end a proud uncompassionate way. We havd 36

:12:50.:12:55.

staff on the ground to do this and they are engaged with the NGOs.

:12:56.:13:01.

There is no them and others feelings in the camp and I would ask her to

:13:02.:13:06.

bear that in mind, that we want to get the most vulnerable outs and the

:13:07.:13:11.

children out. There is nothhng but good intentions on the side to

:13:12.:13:16.

achieve that. I thank the Home Secretary for her

:13:17.:13:21.

comprehensive statement. It will not have gone unnoticed from media

:13:22.:13:26.

reports the number of the children coming to Europe appear to be young

:13:27.:13:31.

men. Can my honourable friend confirm how many people bec`use of

:13:32.:13:35.

us have rejected on the grotnds of age. -- coming here to Brit`in. He

:13:36.:13:42.

is right and that has been reports about some turning out to the older

:13:43.:13:47.

than 17. We carry out a Starbuck checks as possible in an environment

:13:48.:13:55.

which is -- we do a thorough checks. I was asked if ousted with ts while

:13:56.:14:01.

we deliver the best for the young people there -- bear with us for the

:14:02.:14:06.

children who need to come hdre for safety reasons but we take `ll

:14:07.:14:11.

assessments very seriously `nd will continue to prioritise the lost

:14:12.:14:13.

vulnerable, which will be the youngest.

:14:14.:14:23.

I am grateful for her comments about frustrating misdeeds of crilinal

:14:24.:14:28.

gangs preying on vulnerable but having mentioned this placelent in

:14:29.:14:33.

Belgium or in Denmark are wd not dealing with the consequencds of

:14:34.:14:37.

their actions rather than frustrating them in the first place?

:14:38.:14:43.

So rather than talk of the relationships between this country

:14:44.:14:46.

and France can Home Secretary and get what work has gone on whth

:14:47.:14:50.

Interpol across the Mediterranean to make sure people are frustr`ted from

:14:51.:14:54.

sending people here in the first place rather than dealing whth the

:14:55.:14:58.

consequences? The honourable gentleman is right.

:14:59.:15:03.

More work must be done upstream to stop people coming here in the first

:15:04.:15:06.

place and stop these scenes of people arriving and not getting into

:15:07.:15:12.

the country and stop the drdadful scenes of people around me hn the

:15:13.:15:16.

Mediterranean and the Prime Minister referred earlier to work we are

:15:17.:15:22.

doing with the UN, with HMS enterprise there at the momdnt to

:15:23.:15:26.

make sure we play our bets, our leading role in stopping thd

:15:27.:15:29.

dreadful people smuggling from Libya.

:15:30.:15:37.

I commend the Home Secretarx for her statement. Notwithstanding the

:15:38.:15:42.

obduracy of the French, the situation has not been improved by

:15:43.:15:46.

the catastrophic decision of the German Government to disreg`rd the

:15:47.:15:51.

Dublin protocol in respect of processing refugees. I belidve the

:15:52.:15:56.

decision to close the camp hs right because it will save lives by

:15:57.:16:01.

stymieing the evil work people traffickers. Specifically, what

:16:02.:16:04.

efforts are the Home Office making to assist the 10% of the calp who

:16:05.:16:11.

are vulnerable women? I thank my friend for a support and

:16:12.:16:15.

he is right, the ending of the camp is in the interests of everxbody in

:16:16.:16:20.

this country as well as France. Only 10% of the camp is made up of women,

:16:21.:16:25.

we believe, and we make surd to prioritise them because thex are the

:16:26.:16:28.

most likely to be vulnerabld to sexual exploitation and currently we

:16:29.:16:34.

have about one third of int`ke are women, which is a positive result,

:16:35.:16:39.

compared to only 10% of the camp being young woman.

:16:40.:16:42.

I was pleased to the Home Sdcretary sent a clear message regardhng the

:16:43.:16:46.

recent media practice of photographic migrants coming to this

:16:47.:16:51.

country through Calais, children or young adults, can she said that

:16:52.:16:55.

message loud and clear that this is a reckless behaviour that ptts

:16:56.:16:59.

people at risk and banshee `lso deplore media practices we see today

:17:00.:17:03.

which appear to be identifyhng temporary reception centres. -- that

:17:04.:17:10.

raises both security and safeguarding risks. Can she urged

:17:11.:17:14.

caution and care and how thdse operators are reported? The

:17:15.:17:18.

honourable lady is quite right, it is essential we maintain thd

:17:19.:17:22.

anonymity of the young people over here, coming over here, and one of

:17:23.:17:27.

the reasons pointed out to le is some of them, particularly xoung

:17:28.:17:31.

women, are claimed by peopld smugglers to owe them money and if

:17:32.:17:36.

they see the pictures they lay come after them. By keeping their faces

:17:37.:17:40.

discreet and location secret we keep them safe.

:17:41.:17:45.

When I raised the question of returns with... In May he told me

:17:46.:17:54.

his priority was with his pdople who were taking the fight to thd Caliban

:17:55.:17:58.

and only then could return to the needs of those who had given up on

:17:59.:18:03.

his country and gone away. Those were hard was not will she reflect

:18:04.:18:09.

on them when she attaches priority to the most vulnerable and

:18:10.:18:14.

deserving? My honourable friend is right.

:18:15.:18:18.

Returns are an important part of a strong immigration policy and we are

:18:19.:18:22.

constantly working with othdr countries to make sure we c`n have

:18:23.:18:26.

that consent in place and demonstrate how it is in both of our

:18:27.:18:30.

interest to make sure that hts employees.

:18:31.:18:37.

-- that is in place. Much of what the Home Secretary has said is

:18:38.:18:41.

welcome but can I ask what has she instructed officials to do hf an

:18:42.:18:45.

unaccompanied English-speakhng 12-year-old girl appears in Calais

:18:46.:18:50.

next week, a child who best interests are clear which sdrved by

:18:51.:18:56.

being resettled in the UK? Will officials be permitted to bd

:18:57.:18:59.

flexible with a cup of data in such circumstances?

:19:00.:19:07.

-- cut off date. I would expect her to claim asylum in France btt I hope

:19:08.:19:13.

that you bed never comes to pass. -- hope that event.

:19:14.:19:19.

At the home of the select committee we challenge the Calais mayor and

:19:20.:19:25.

other French officials months ago to deliver plans to clear up the camp

:19:26.:19:28.

and no doubt the minister c`n confirm it is not possible for the

:19:29.:19:32.

British Government to do anxthing in Calais without French agreelent

:19:33.:19:39.

Where we can take the reeds, is in tackling the people traffickers Can

:19:40.:19:42.

my right honourable friend tell me how many criminal gangs havd been

:19:43.:19:46.

stopped thanks to the work of UK security forces?

:19:47.:19:51.

I thank my honourable friend and she is right. We have been urging the

:19:52.:19:55.

French to take action for a while and working closely with thdm but it

:19:56.:20:00.

is, in the past few weeks and days we have been able to really engage

:20:01.:20:04.

and conduct these interviews and a way that is quick and effective and

:20:05.:20:10.

yielded results. She is also right that allows us to make more progress

:20:11.:20:13.

in terms of arresting criminal gangs.

:20:14.:20:17.

The Home Secretary gave asstrances earlier about the importancd of the

:20:18.:20:22.

safety of children and tracking of them in Parliament -- being

:20:23.:20:29.

paramount. I have been made aware of allegations of children going

:20:30.:20:34.

missing. Will she, too investigating such cases of those? Wiltshhre, she,

:20:35.:20:41.

too investigating and trackhng about what happened to those people and if

:20:42.:20:45.

that safety is at risk? The honourable gentleman is welcome

:20:46.:20:50.

to send me information he h`s what I would say we happened situated in

:20:51.:20:54.

the past few days where we have expected children to be avahlable to

:20:55.:20:59.

board the bus to come to thd UK and sometimes NGOs themselves h`ve been

:21:00.:21:02.

surprised that could not find the children. It is not as

:21:03.:21:06.

straightforward as we wished it could be but I cope what thdse

:21:07.:21:10.

changes we will have the chhldren all in one secure area it whll be

:21:11.:21:16.

more straightforward to bring a child to the UK that we havd

:21:17.:21:21.

committed to. Can I thank the Home Secret`ry for

:21:22.:21:25.

her statement and can my right honourable friend tell the house how

:21:26.:21:30.

much the Government has invdsted in reinforcing the border at C`lais?

:21:31.:21:38.

The total package is ?36 million, of which 40 million is for sectrity.

:21:39.:21:43.

That security being in placd in Calais is in our interest to make

:21:44.:21:48.

sure we can predict tourists, truckers, the economy and going

:21:49.:21:51.

about their normal course of business which I hope will be much

:21:52.:21:59.

improved once the camp is cleared. Can the Home Secretary reassure us

:22:00.:22:03.

local authorities will be adequately funded and see how they will be

:22:04.:22:09.

compensated and more import`ntly that adequate accommodation is

:22:10.:22:14.

provided for these children and not institutionalised.

:22:15.:22:17.

The honourable gentleman max be aware the Dubbs Ammendment can only

:22:18.:22:20.

be implemented if local authorities, for what volunteered to takd those

:22:21.:22:27.

children. Subversion local authorities have come forward but we

:22:28.:22:32.

will need more over -- suffhcient local authorities have come forward

:22:33.:22:39.

but we need father places. ,- further places. They are aw`re of

:22:40.:22:46.

the rate weepy and I hope they will consider that adequate compdnsation.

:22:47.:22:52.

-- the rate we pay. I welcome comments on my right

:22:53.:22:56.

honourable friend has made `bout the robustness of the checking process

:22:57.:23:01.

of those eligible to be relocated to the UK because there are legitimate

:23:02.:23:06.

concerns about that. One of the reception centres is in West Sussex

:23:07.:23:12.

and can I have assurances the county council there will indeed gdt back

:23:13.:23:16.

on going support because thdre are already pressures on their budget to

:23:17.:23:23.

ensure this will not, this will be beneficial to those children and not

:23:24.:23:26.

detrimental to others in thd West Sussex.

:23:27.:23:31.

We are always grateful for the generous way in which local

:23:32.:23:35.

authorities come forward and have positively responded to the call we

:23:36.:23:38.

put out. I would particularly like to say thank you to West Sussex

:23:39.:23:43.

fought the good work they h`ve been doing and hosting one of thd

:23:44.:23:47.

dispersal centres and we will work closely with them to ensure that

:23:48.:23:53.

good relationship continues. I have listened closely to the Home

:23:54.:23:59.

Secretary and answers about safeguarding and I ask this question

:24:00.:24:03.

because a social worker got in touch with me to say for the children who

:24:04.:24:08.

have started to enter the country it has been a bureaucratic shalbles.

:24:09.:24:12.

She said social services have been given wrong addresses, wrong,

:24:13.:24:17.

contacts and I would like to ask the Home Secretary how she and her

:24:18.:24:20.

department will urgently ensure the correct provisions are in place to

:24:21.:24:25.

support social services to lake sure that once children are here they do

:24:26.:24:31.

not fall through the cracks. I would just say to her somdtimes we

:24:32.:24:36.

do not have all the information we need. One of the reasons whx the

:24:37.:24:41.

full cohort of nearly 200 Dtblin children has not yet been brought

:24:42.:24:45.

over this because we have not been able to establish where thehr close

:24:46.:24:51.

family members are so it max be on the issue she is drawing attention

:24:52.:24:55.

to the close family members who have been claimed and contacted `re not

:24:56.:25:01.

longer quite as contactable once the local authority is addressing it. I

:25:02.:25:08.

would say to her, this can be a complicated process, it is not

:25:09.:25:12.

always the case the contacts we are given straightforward to follow up

:25:13.:25:17.

on what if she wants to send me a particular example I of course we'll

:25:18.:25:19.

look at that. I thank the Home Secretary `nd the

:25:20.:25:27.

talk of the humanitarian opdration because when I was there in February

:25:28.:25:31.

it was far from humanitarian. Can she confirm again the sheltdr will

:25:32.:25:37.

be sufficient to accommodatd all child refugees if not withott the

:25:38.:25:46.

French authorities accepting... Can the secretary of state trulx

:25:47.:25:49.

safeguard the fact children dispersed across centres across the

:25:50.:25:53.

front they will be accommod`ted and those with whom we have a ldgal duty

:25:54.:25:55.

under Dubbs Ammendment? The only reassurance I can give him

:25:56.:26:04.

is what I've been given by the French. We have asked them that the

:26:05.:26:08.

children are kept in a secure area. It was our request that it should be

:26:09.:26:14.

outside the camp, the tools to do it inside reassuring as they could keep

:26:15.:26:19.

the child and secure. We ard in close contact and we have a large

:26:20.:26:21.

number of Home Office representative there as well as the hundreds of

:26:22.:26:26.

border for staff in the are`. We are hopeful we will be able to lake sure

:26:27.:26:29.

we work closely with them to keep them safe but this is a French

:26:30.:26:33.

responsibility although we `re giving them all the support we can.

:26:34.:26:40.

I welcome very much what thd Home Secretary said today about children

:26:41.:26:43.

but we should remind ourselves it is not only children who require

:26:44.:26:47.

international protection. When I visited Calais at Easter, wd met

:26:48.:26:52.

Afghans and we met Kurds who had been previously granted asylum in

:26:53.:26:57.

the UK before returning homd about to flee a second time and h`d ended

:26:58.:27:01.

up at Calais. While the Homd Office would get that set of keys hn terms

:27:02.:27:07.

of who is appropriate for the UK to take responsibility for? In this

:27:08.:27:12.

case, while the camps are bding demolished, we have made a

:27:13.:27:15.

commitment to take the most vulnerable children and within that

:27:16.:27:19.

cohort of children, the ones who are the youngest and the ones who are

:27:20.:27:23.

vulnerable to sexual exploitation. In terms of other people who may be

:27:24.:27:28.

vulnerable, there may be ond or two who qualify under the Dubs

:27:29.:27:31.

Amendment, but otherwise thdy will need to apply for asylum as a normal

:27:32.:27:35.

case in France. We must stick to the general accepted principle that the

:27:36.:27:41.

apply for asylum in the first country of safety. A number of my

:27:42.:27:45.

constituents have got in totch to express compassion for thosd in the

:27:46.:27:49.

Jungle camp but a number of other people are also worried abott the

:27:50.:27:52.

age of those we are being sden to take. Can the Home Secretarx talk a

:27:53.:27:56.

little bit zero -- more abott the numbers we are projecting on the

:27:57.:28:00.

grounds of age but the comprehensive security package around who we take

:28:01.:28:05.

in the first place? I would like to reassure my honourable friend the

:28:06.:28:10.

best way to assess age is bx using experienced social workers. That is

:28:11.:28:13.

what we are doing in terms of assessing the age on the ground

:28:14.:28:18.

Most of the young people we are talking to, children, miners,

:28:19.:28:21.

whatever you call them, are teenagers. Most of them are

:28:22.:28:28.

teenagers and most of them `re young boys. I still think it's thd right

:28:29.:28:32.

thing to do but I would ask him to be sure his constituents th`t we

:28:33.:28:36.

will always do the proper safeguarding checks to insure they

:28:37.:28:41.

are indeed what they say thdy are. Can I commend the Home Secrdtary and

:28:42.:28:45.

her staff are the efforts she has made in accelerating the process of

:28:46.:28:50.

bringing unaccompanied minors to this country. Can I press on the

:28:51.:28:53.

challenges the local authorhties are pressing? My understanding hs that

:28:54.:28:59.

they... The calling the samd number of limited in time and agencies

:29:00.:29:03.

Does she see a more central role for Government in coordinating the

:29:04.:29:08.

availability of places in the independent sector? He raisds an

:29:09.:29:11.

important point and if that were the case, that would not be a stccessful

:29:12.:29:15.

outcome. A lot of the local authorities are choosing to work

:29:16.:29:18.

together and we have got good examples of good practice where five

:29:19.:29:21.

local authorities are getting together, not competing and making a

:29:22.:29:27.

joint offer. I welcome the Home Secretary's statement. Prior to my

:29:28.:29:31.

election to this place, I rdgularly defended the Home Office in many

:29:32.:29:35.

immigration and asylum cases. It is widely accepted by judges and

:29:36.:29:39.

practitioners that aid assessment of undocumented children is notoriously

:29:40.:29:42.

difficult and not an exact science. The rise in cases in the

:29:43.:29:45.

administrative Court reflect this fact. Will my right honourable

:29:46.:29:50.

friend confirms that dental checks are not the appropriate method for

:29:51.:29:55.

an age assessment and guidance exists in the case law and that the

:29:56.:30:00.

practices of the London boroughs of Croydon which have adopted

:30:01.:30:03.

throughout the country which suggest that listing to the history,

:30:04.:30:09.

observers of behaviour and children getting evidence is a much better

:30:10.:30:14.

indicator rather than physical maturity? I thank my honour`ble

:30:15.:30:17.

friend to that question and I know she has substantial experienced in

:30:18.:30:20.

this field having acted as `n immigration officer are comhng into

:30:21.:30:24.

Parliament. The best way to assess age is by using experienced

:30:25.:30:29.

assessors and we will continue to do that. The British dental Association

:30:30.:30:33.

has said that is not the right way to go, it is not effective,

:30:34.:30:38.

reliable. The best way is to use the type of assessment we are which is

:30:39.:30:44.

based on experience. Wouldn't it be in the best interests of thd asylum

:30:45.:30:49.

seekers and local authoritids if the asylum seekers, especially the

:30:50.:30:54.

children, were located my evenly throughout the country. My local

:30:55.:30:59.

authority copes with 500 each year, the constituencies of the present

:31:00.:31:02.

Prime Minister, the previous Bedminster and the previous

:31:03.:31:07.

Chancellor of the Exchequer take none at all. Obviously, while my

:31:08.:31:13.

local authority is doing very well with this, there are strains on the

:31:14.:31:17.

local services, including the schools and the health servhce. As

:31:18.:31:24.

the new comers and the asyltm seekers will be especially

:31:25.:31:29.

vulnerable and many of them without -- with rice health problems than it

:31:30.:31:32.

can she make sure the money given to local authorities is adequate for

:31:33.:31:35.

the long years for which it will be required? There is a nation`l

:31:36.:31:40.

transfer scheme in order to make sure unaccompanied children are

:31:41.:31:43.

fairly shared around the cotntry. We are urging local authorities to step

:31:44.:31:47.

up and I can say to him that we are getting a very strong response from

:31:48.:31:51.

local authorities. This has gone to the heart of people in the country

:31:52.:31:55.

and local authorities who w`nt to participate and want to help and who

:31:56.:31:58.

believe in this as an endeavour to try and address but we will always

:31:59.:32:03.

need more I will in urge ag`in anyone who think their local

:32:04.:32:08.

authorities can help to urgd them to step forward to do so. The situation

:32:09.:32:12.

is fast-moving but the Home Secretary has said her officials

:32:13.:32:14.

have been hard at work in the last week and have conducted 800

:32:15.:32:19.

interviews. 200 children have been admitted to the UK. For my first

:32:20.:32:24.

question, how many more intdrviews on how many more applications does

:32:25.:32:29.

she expect her staff to process how far through this are away and my

:32:30.:32:33.

second question is, is that ratio of one acceptance to for applications a

:32:34.:32:38.

ratio that we are likely to see continuing? It takes less thme to

:32:39.:32:47.

ask two questions than it took a lot of people to ask one question. I say

:32:48.:32:53.

to my honourable friend that is not quite how it's working out. The 200

:32:54.:32:58.

are largely made up of the Dubs Amendment children for which they

:32:59.:33:02.

have a strong family tie in the UK. About one quarter are made tp of

:33:03.:33:05.

dogs and the balance of the additional children that we will

:33:06.:33:09.

take will be Dubs Amendment children. The 800 who have been

:33:10.:33:13.

interviewed, the not coming to the UK. We are just processing their

:33:14.:33:17.

claims. There will be anothdr 2 0 300 interviews and we hope to beat a

:33:18.:33:21.

figure of a few hundred mord over the next two to three weeks while

:33:22.:33:25.

the camp is being cleared and then we will have done our commitment to

:33:26.:33:28.

the French which we hope will be approximately half the children who

:33:29.:33:37.

were there. A point of order I raised with the greatest reluctance

:33:38.:33:41.

but it is a matter for you Lr Speaker and a matter of somd

:33:42.:33:46.

urgency. You will recall in November 20 15th the Conservative delegates

:33:47.:33:52.

were queried and there was ` debate in this house when this report was

:33:53.:33:55.

made about the selection of delegates. At the time, you rightly

:33:56.:34:01.

said it wasn't your job to hnterfere with the decisions of partids in the

:34:02.:34:06.

whose delegates they say. I believe there is a decision to be m`de a few

:34:07.:34:11.

errors ago and is not only hmproper but possibly illegal. Until the

:34:12.:34:14.

matter can be resolved, I h`ve to send you an e-mail and a letter

:34:15.:34:20.

about what happened. I'm sure it might be a misunderstanding but can

:34:21.:34:23.

I ask you in the meantime to repeat what you did with the Conservative

:34:24.:34:28.

-- Conservative delegates and declined to send the chosen delegate

:34:29.:34:32.

by the Labour Party to the Council of Europe into the matter h`s been

:34:33.:34:37.

resolved? Can I say to the honourable gentleman, I thank him

:34:38.:34:42.

for his point of order. He did come to the chair earlier and sax to me

:34:43.:34:45.

about this matter and I don't dispute that one moment but I have

:34:46.:34:48.

to say to him that I have not yet seen his e-mail and I think it would

:34:49.:34:55.

be prudent for me to study that and to reflect carefully upon the matter

:34:56.:35:00.

and to take advice before pronouncing of course I will

:35:01.:35:02.

remember the sequence of evdnts to which the honourable gentlelan

:35:03.:35:07.

referred if memory serves md, that is principally concerned melbers

:35:08.:35:11.

from the governing party. In this instance, I think the honourable

:35:12.:35:15.

gentleman is concerned about his own party's delegation. I don't

:35:16.:35:18.

interfere in the choice of lembers of the delegation, that is not a

:35:19.:35:23.

matter for me. I do have a responsibility to notify thd

:35:24.:35:29.

Parliamentary assembly of the decision made here. Of course, I

:35:30.:35:37.

wouldn't wish to do anything that was procedurally improper. H will

:35:38.:35:41.

have to satisfy myself that whatever I am being asked or instructed to do

:35:42.:35:47.

is procedurally proper. I whll not be sending any letter until I have

:35:48.:35:53.

so satisfied myself. I hope that is helpful and admitted that dtty, I

:35:54.:35:56.

will study the letter from the honourable gentleman. If thdre are

:35:57.:36:01.

no further point of order, we proceed now to the main bushness,

:36:02.:36:07.

the orders of the day. Health service medical supplies, sdcond

:36:08.:36:18.

reading. I call the Secretary of State for Health, secretary Jeremy

:36:19.:36:24.

Hunt. I beg to move that thd bill is ready second time. This is ` short

:36:25.:36:28.

and focused bill which is vhtally important not only for the NHS but

:36:29.:36:34.

also for patients. NHS spending on medicines is second only to staffing

:36:35.:36:40.

costs. The health and social care information estimated the NHS

:36:41.:36:50.

England spent over... A risd of nearly 20% since 2010. With advances

:36:51.:36:55.

in science and our ageing population, these costs can only

:36:56.:36:59.

continue to grow. Medicines are a vital part of patient care hn the

:37:00.:37:03.

NHS, both in hospitals and community. Thanks to research and

:37:04.:37:07.

development effort of the science industry which can be checkdd -

:37:08.:37:13.

contributes ?56 million to the UK economy every year our understanding

:37:14.:37:17.

diseases and the best way to treat them has improved dramatically over

:37:18.:37:21.

the last 20 years. Who would have thought that UK work pioneering

:37:22.:37:28.

superconducting magnets would result -- result in MRI scanners which

:37:29.:37:31.

would save hundreds of lives each year through the early detection of

:37:32.:37:36.

breast cancer or that the rdmarkable research by our national Institute

:37:37.:37:39.

for health research into translational medicine would lead to

:37:40.:37:43.

scientific breakthroughs in areas such as gene therapy being taken

:37:44.:37:46.

from the lab to the clinic? Any six-year period, this has ldd to

:37:47.:37:54.

340... Generating ?380 millhon. This Government is committed to dnsuring

:37:55.:38:00.

that patients get access to innovative and cost effective

:38:01.:38:02.

medicines as quickly as possible. I want to pay tribute to the work

:38:03.:38:06.

carried out by my honourabld friend, the member from Norfolk, who worked

:38:07.:38:11.

tirelessly to promote this hndustry and to established the access review

:38:12.:38:17.

to provide clear recommendations on how the Government, NHS and industry

:38:18.:38:21.

can work together to ensure patients benefit from transformative new

:38:22.:38:25.

products much more quickly. That review was published today `nd is an

:38:26.:38:29.

excellent document which ch`llenges everyone in the medicine system to

:38:30.:38:34.

up their game. Eric mission is to continue our progress in ensuring

:38:35.:38:41.

patients get rapid... Howevdr, we also need to ensure we are getting

:38:42.:38:46.

the best value for the NHS which is why we bought this -- brought this

:38:47.:38:49.

bill before the house. The purpose of the bill is to clarify modernise

:38:50.:38:55.

provisions to control the cost of health. These provisions will align

:38:56.:39:06.

its statutory and cost control mechanisms currently in existence,

:39:07.:39:09.

although the Government to control the cost of excessively priced on

:39:10.:39:13.

branded generic medicines and ensure we have compared the data whth which

:39:14.:39:18.

to reimburse people who dispense medicines. Taken together, they will

:39:19.:39:22.

enable us to secure better value for money for the NHS and its spend on

:39:23.:39:31.

medicines. I congratulate hhm on this effort. I received a written

:39:32.:39:37.

answer that last year GPs spent ?85 million prescribing paracet`mol 500

:39:38.:39:43.

million grams of personal costs ?19 and asked. I just wonder whdther

:39:44.:39:46.

this bill will enable us to look at those sort of costs and whether that

:39:47.:39:52.

is appropriate? I am very grateful to him of reading that issud because

:39:53.:39:56.

what he is doing, although the measures that he's actually talking

:39:57.:39:59.

about are not directly covered in this bill, he's reminding md how is

:40:00.:40:03.

that the business of getting value for money from our drugs business is

:40:04.:40:08.

everyone's business throughout the NHS. We do know that there hs a huge

:40:09.:40:13.

amount of prescribing of medicines which isn't strictly necess`ry and

:40:14.:40:17.

we had further evidence frol the Cabinet of Royal colleges this

:40:18.:40:23.

morning about that. He makes an extremely important point. This bill

:40:24.:40:27.

is part of the effort to get better value for money from our budget The

:40:28.:40:33.

initiative he talks about are equally important. Further to that

:40:34.:40:39.

question, I can see how the bill will deal with the issue of the

:40:40.:40:44.

branding and that's very welcome but I understand there are thred other

:40:45.:40:48.

areas of concern. The questhon of price delay which I think the

:40:49.:40:53.

competition in markets authority have been looking at and thdn

:40:54.:40:58.

there's this problem of so-called loyalty schemes, all of which are

:40:59.:41:03.

used to artificially inflatd the cost of medicines to the NHS. Will

:41:04.:41:06.

we also deal with those are`s? It will deal with some of the

:41:07.:41:15.

concerns of the honourable gentleman and we will listen to all concerns

:41:16.:41:20.

are raised by members during the progress of the Bill but thd

:41:21.:41:27.

particular issue he raises with Competition and Markets Authority

:41:28.:41:31.

are already doing an investhgation as to the behaviour of

:41:32.:41:36.

pharmaceutical companies in certain situations but what has become clear

:41:37.:41:42.

is that there is a particul`rly unethical and unacceptable practice

:41:43.:41:47.

with respect to drugs companies getting control of generic drugs in

:41:48.:41:54.

which they and a monopoly and raising the prices. There w`s one

:41:55.:42:01.

product whose price increasd 12 000% between two and -- 2008 and 201 and

:42:02.:42:06.

if the price had stayed unchanged the NHS would have spent ?58 million

:42:07.:42:13.

less and the Government's concluded the simplest and quickest w`y to

:42:14.:42:17.

sort this is through legisl`tion. I will happily take as other hssues he

:42:18.:42:22.

raised and look into them. I will happily give way. I welcome

:42:23.:42:29.

the provisions of this bill in terms of closing loopholes and de`ling

:42:30.:42:33.

with these terrible examples were the NHS is essentially being

:42:34.:42:38.

exploited. Could he point to the future with the suggestion that the

:42:39.:42:44.

drugs bill will increase to 20 billion by 2020, a much mord

:42:45.:42:47.

significant increase than projected can afford. What better measures

:42:48.:42:53.

must take place for us to substantively deal with this bigger

:42:54.:42:56.

problem? She is right. We see demand for

:42:57.:43:06.

services including treatments and drugs and that will increasd by a

:43:07.:43:10.

total of around 30 billion over the next five-year period which is a

:43:11.:43:14.

huge amount and more than wd can afford as a country without changing

:43:15.:43:19.

practice and that is why ard implementing a very challenging

:43:20.:43:23.

series of efficiency reforms designed to make sure we can afford

:43:24.:43:29.

to continue current levels of NHS service on its ?10 billion hncrease

:43:30.:43:32.

the Government is putting an end. Part of that is managers like those

:43:33.:43:38.

in this bill to control the drugs bill. -- part of that is me`sures

:43:39.:43:44.

like this. With them that the next 25 years what we are seeing is a

:43:45.:43:48.

bigger issue of the pace of innovation in science acceldrating

:43:49.:43:54.

and that provides great opportunities for the NHS btt

:43:55.:43:57.

potentially great pressures on the budget and we will continue to

:43:58.:44:01.

discuss those issues extenshvely in this house. I will happily give way.

:44:02.:44:09.

What assessment has been made of the impact this bill might have on the

:44:10.:44:13.

parallel trade and pharmacetticals which he will now has both costs and

:44:14.:44:17.

benefits for the NHS and for patient care?

:44:18.:44:23.

I think my honourable friend who obviously knows about these matters

:44:24.:44:29.

in a great deal of detail, should be reassured this bill will stop people

:44:30.:44:38.

who are part of a voluntary scheme parallel importing through Duropean

:44:39.:44:42.

subsidiaries which currentlx under the single market rules we `re not

:44:43.:44:46.

able to stop. That football will be closed. The first element of the

:44:47.:44:55.

bill. -- that loophole. The first element relates to court br`nded

:44:56.:44:59.

medicines. We have had both stature and voluntary with the

:45:00.:45:03.

pharmaceutical companies to limit the cost. Companies can join either

:45:04.:45:11.

scheme. Each voluntary schele lasts around five years before a new

:45:12.:45:15.

scheme is negotiated, the ctrrent voluntary scheme is the 2014

:45:16.:45:19.

pharmaceutical price regulation scheme will stop the objecthves of

:45:20.:45:25.

that agreement include keephng the branded health service medicine bill

:45:26.:45:29.

with an affordable limits while supporting the availability of

:45:30.:45:34.

innovative medicines. For industry this provides companies with the

:45:35.:45:40.

certainty and backing to flourish in the UK and abroad. I will ghve way

:45:41.:45:46.

in the second. The current PPRS operates by requiring participating

:45:47.:45:50.

companies to make a payment to the Department of Health of a pdrcentage

:45:51.:45:54.

of the NHS still be the new web portal sales exceed a certahn amount

:45:55.:46:00.

and that has resulted in 1.2 four billion and payments, all of which

:46:01.:46:03.

has been reinvested for the benefit of patients.

:46:04.:46:10.

The early part of the bill `ppears incredibly torturous becausd it is

:46:11.:46:13.

whether something is under the violent bully a statutory scheme and

:46:14.:46:21.

switching back and forth. -, seems is that because the scheme runs

:46:22.:46:25.

until 2019 and the Government would intent not to renew the schdme then?

:46:26.:46:30.

If the Government looks to consider renewal then why are we havhng these

:46:31.:46:35.

two parallel scheme to complicate the situation?

:46:36.:46:40.

I think the honourable gentleman makes an important point and it will

:46:41.:46:44.

be for this house and the Government to reflect on prior to 2019 whether

:46:45.:46:51.

it is worth carrying on with two separate schemes. This has been the

:46:52.:46:55.

arrangement -- arrangement for many years and essential that wh`t has

:46:56.:47:00.

happened over successive PPRS voluntary agreements is the

:47:01.:47:05.

agreement has, the vast majority of NHS sales and the statutory scheme

:47:06.:47:10.

has been a back-up for people who do not want to participate in the

:47:11.:47:12.

voluntary scheme but what wd have seen recently is an elegant of

:47:13.:47:16.

gaming the system whereby more and more people move away from the

:47:17.:47:21.

voluntary scheme so what thhs bill is doing is removing the incentives

:47:22.:47:28.

for people to switch between one scheme and the other and making the

:47:29.:47:32.

benefits to the NHS essenti`lly the same whichever scheme peopld choose.

:47:33.:47:39.

It will be for this house to reflect and the Government to consider if

:47:40.:47:43.

that dual structure is right. I will happily give way.

:47:44.:47:49.

He tells us the 1.24 billion has come in after the rebate and many

:47:50.:47:52.

are puzzled as to where that has been. Good the Secretary of State

:47:53.:48:00.

tell us? -- could he tell us? It comes back to the Department of

:48:01.:48:05.

Health and is invested throtgh that in the NHS. It would be wonderful if

:48:06.:48:10.

it was more than 1.24 billion because there is a lot of nded in

:48:11.:48:14.

the NHS right now but it is much needed funds but our concern is

:48:15.:48:21.

companies have been exploithng the fact there are differences between

:48:22.:48:24.

the voluntary and statutory schemes and indeed is exploiting a perpetual

:48:25.:48:32.

loop all this bill seeks to close, which is if they have drugs in both

:48:33.:48:38.

schemes we are unable to regulate at all the prices of schemes, of the

:48:39.:48:42.

drugs that would ordinarily fall under the statutory scheme `nd that

:48:43.:48:46.

is why this bill is so important. I will give way.

:48:47.:48:51.

Notwithstanding the object of the bill which I can see are adlirable

:48:52.:48:56.

can he accept hundreds of mhllions of pounds could be saved on the

:48:57.:49:01.

drugs budget if that was better analysis of prescription patterns. I

:49:02.:49:04.

pulled before the apartment analytical pharmacist to look at the

:49:05.:49:11.

balance between efficiency `nd cost and increase the use of bio some of

:49:12.:49:16.

us were hundreds of millions could be saved, perhaps some of that .24

:49:17.:49:21.

billion could be invested in that gritter analysis. Indeed. I think

:49:22.:49:26.

honourable gentleman makes `n important point -- in that gritter

:49:27.:49:31.

and I was. The third part of this bill will mean we have greater data

:49:32.:49:35.

collection to allow those analytics to take place but we also sdek to

:49:36.:49:39.

break down barriers between the pharmacy sector and general practice

:49:40.:49:45.

so we built finance 2000 ph`rmacists additionally to work in gendral

:49:46.:49:49.

practice so we can learn ex`ctly the lessons he talks about. Indded, then

:49:50.:49:56.

I will make some progress. Further to that point about bio some

:49:57.:50:00.

others and welcoming this legislation and the opportunity to

:50:01.:50:07.

create savings -- bio simil`r. Would you use it as an opportunitx to

:50:08.:50:12.

address the issues alone is... He will know the member for Mid Norfolk

:50:13.:50:18.

has already updated the house to set out there are barriers and both

:50:19.:50:21.

domestic and European legislation that prevents the use of thhs drug

:50:22.:50:29.

because it is not licensed but the scale of savings could be so vast I

:50:30.:50:33.

feel there is a case for introducing measures in this bill to allow this

:50:34.:50:37.

issue to be addressed. I am happy to look into that, I

:50:38.:50:44.

believe my own constituents have been affected by that very hssue. I

:50:45.:50:50.

am not aware currently therd would be in the bill for putting hnto that

:50:51.:50:55.

important point but this is a moment when we should reflect on whether we

:50:56.:50:58.

can do everything possible to deal with some of the anomalies hn the

:50:59.:51:04.

drug licensing regime but whth two these unintended consequencds she

:51:05.:51:11.

mentions. -- that lead to the unintended consequences. For those

:51:12.:51:15.

not in the PPRS we have a statutory scheme based boycott the list price

:51:16.:51:19.

of products rather than a p`yment mechanism on company sales. Since

:51:20.:51:23.

the introduction of the reb`te mechanism and the second back the

:51:24.:51:27.

volume of drugs going through it has been lower estimated and thd

:51:28.:51:31.

statutory scheme has delivered more savings than projected and the

:51:32.:51:36.

inequity between the two has led to some companies by vesting product

:51:37.:51:41.

from the PPRS into the statttory scheme, further reducing savings for

:51:42.:51:48.

the NHS. We consulted on iddas to reform the statutory scheme to

:51:49.:51:50.

introduce a payment mechanism similar to that currently placed in

:51:51.:51:57.

the PPRS. Our intentions were to put in place both voluntary and

:51:58.:52:01.

statutory scheme broadly colparable in the savings achieved and

:52:02.:52:05.

companies have the freedom to decide which one to join a move from one to

:52:06.:52:09.

the other depending on the other benefits they offer but it hs our

:52:10.:52:13.

position the savings to the NHS of heart by both schemes should be

:52:14.:52:20.

broadly similar. In responsd to the consultation while NHS respondents

:52:21.:52:24.

supported this the pharmacettical industry queried if the Govdrnment

:52:25.:52:28.

have powers to introduce thd statutory payment system so

:52:29.:52:32.

following a legislative revhew an amendment should be made to clarify

:52:33.:52:36.

existing powers to make cle`r the Government does have the power to

:52:37.:52:40.

introduce a payment mechanism in the statutory scheme. The bill does this

:52:41.:52:44.

by clarifying existing provhsions in the NHS act 2006 to put beyond doubt

:52:45.:52:50.

we can introduce a payment lechanism in statutory scheme. Also alends the

:52:51.:52:55.

NHS act 2006 so it contains essential provisions for enforcement

:52:56.:53:00.

action, payment due under ehther a future voluntary scheme will be

:53:01.:53:04.

recoverable through the courts if necessary and this would include

:53:05.:53:07.

power to recover payments dte from any company that leaves one scheme

:53:08.:53:12.

to join the other. The powers to control the cost of medicind

:53:13.:53:15.

proposed in this bill adding modest addition to the powers alre`dy

:53:16.:53:20.

provided for in the 2006 act to control the price of profit

:53:21.:53:23.

associated with medicines used by the health service. However, they

:53:24.:53:27.

are necessary to ensure the Government have the scope and

:53:28.:53:31.

flexibility to respond to changes in the commercial environment. The

:53:32.:53:34.

intended application of the powers will be set out in regulations and I

:53:35.:53:38.

can assure the house we will provide a list of the regulations to

:53:39.:53:42.

reassure the house we will be fair and proportionate in exercising the

:53:43.:53:48.

powers. I am happy to give way. I voted for the build ten ydars ago

:53:49.:53:54.

but I have to say to the Secretary of State, particularly for `

:53:55.:53:56.

Conservative Government, proper controls is pretty Draconian and

:53:57.:54:02.

this -- proper controls and less Government appears to be extending

:54:03.:54:08.

buzz whereas historically the way we have dealt with this is through

:54:09.:54:13.

taxation, such as the windf`ll tax on backpacks and so on. But the

:54:14.:54:19.

Secretary of State is now proposing something which would be loved by

:54:20.:54:23.

the Leader of the Opposition, to extend profit controls to a big part

:54:24.:54:30.

of the economy. Two is soci`list like me it seems a bit

:54:31.:54:37.

counterintuitive for a Consdrvative to do this. A rock march into the

:54:38.:54:44.

centre ground continues. -- a rock march into the centre ground. Can I

:54:45.:54:48.

reassure the honourable gentleman for his interesting points but we

:54:49.:54:53.

will be very fair and proportionate in our approach. It is not `bout

:54:54.:54:58.

bringing in widespread profht controls and it is important to see

:54:59.:55:01.

we recognise the incredibly important role of the pharm`ceutical

:55:02.:55:08.

industry in medical advance and we want Britain to be the European

:55:09.:55:14.

Central of operations post-Brexit and many people in this house have

:55:15.:55:18.

campaigned on an issue of ddmentia and we are hopeful of a curd,

:55:19.:55:23.

possible in this country. Wd recognise profits are what defines

:55:24.:55:30.

the research to make these remarkable change is possible. I

:55:31.:55:36.

will conclude this point. However, it is important for us to bd able to

:55:37.:55:41.

see what profits are being generated by the company's choice as to

:55:42.:55:49.

whether they use the PPRS scheme of the statutory scheme, as a clue as

:55:50.:55:54.

to whether they are being f`ir in their approach with respect to the

:55:55.:55:59.

NHS and that is why the measures in this bill strike the right balance.

:56:00.:56:05.

I hope there is a reassuring underside of the house is not rather

:56:06.:56:14.

than does the other side. Would he take this opportunity to st`te even

:56:15.:56:21.

further the great contributhon the pharmaceutical industry makds not

:56:22.:56:24.

just in this country that as a global player and as he rightly says

:56:25.:56:28.

that the profit motive -- motive is an important part in ensuring the

:56:29.:56:33.

competition will also mean that we can have this sort of reforls and

:56:34.:56:37.

the sort of new drugs that will transform the lives of us btt also

:56:38.:56:40.

future generations in the ydars to come? I am very happy to give that

:56:41.:56:47.

reassurance. As I said earlher, this is an industry that contribttes ?56

:56:48.:56:51.

billion to the UK economy, tens of thousands of jobs. When the Prime

:56:52.:56:57.

Minister is talking about where she she sees our competitive advantage,

:56:58.:57:02.

she talks about financial sdrvices and the very next industry she talks

:57:03.:57:06.

about is the sciences industry. I completely agree with my honourable

:57:07.:57:10.

friend about its incredible importance, not just to this country

:57:11.:57:13.

but to the future of humanity. That is why I am sitting in this Bill to

:57:14.:57:19.

establish a fair relationshhp between the NHS, which we h`d to

:57:20.:57:24.

represent as we are finding it to the tax system and the

:57:25.:57:27.

pharmaceutical industry, I think it is also fair to say that thdre have

:57:28.:57:32.

been times when some practices by some pharmaceutical companids have

:57:33.:57:36.

been disappointing and is bdcause we want to make sure that doesn't

:57:37.:57:40.

happen and that we can conthnue with harmonious relationships th`t we are

:57:41.:57:45.

proposing this bill to the house. I will give way and then I will make a

:57:46.:57:50.

little bit of progress. I thank the Secretary of State for giving way,

:57:51.:57:53.

he has been very generous whth his time. This isn't about profhts

:57:54.:57:57.

control, it's about having ` fair return for investment. This is about

:57:58.:58:01.

a business model that is emdrging that could be seen as profiteering.

:58:02.:58:07.

Yes, he's right. Effectivelx, denies with betting is that we are closing

:58:08.:58:12.

a loophole. If one was being less polite, one might say there is a

:58:13.:58:16.

shame having to do that. I think it is nonetheless important to do what

:58:17.:58:21.

we are proposing to the house. We do recognise that has been somdtime

:58:22.:58:25.

since consulted on the options and I would like to reassure honotrable

:58:26.:58:29.

members and those companies in the statue test team that we will

:58:30.:58:35.

confirm the implementation of a mechanism... We estimate th`t 1

:58:36.:58:43.

companies would be affected by the instruction of the payment lechanism

:58:44.:58:48.

with a companies who are melbers of the PPR is not affected. Our

:58:49.:58:51.

proposals would save the he`lth service across the UK an estimated

:58:52.:58:57.

?90 million a year. I now ttrn to the second key element of this bill

:58:58.:59:03.

which amends the NHS 2006 to strengthen the Government's power to

:59:04.:59:06.

set prices of medicines where companies charge unreasonably high

:59:07.:59:10.

prices for unbranded generic medicines. We rely on competition in

:59:11.:59:14.

the market to keep the prizd of these drugs down. This generally

:59:15.:59:22.

works well and has in combination of lead to significant savings. We are

:59:23.:59:25.

aware in some instances where there is no competition to keep rhses down

:59:26.:59:29.

and companies have raised their prices to what looks like an

:59:30.:59:31.

unreasonable and unjustifiable level. As highlighted by thd Times

:59:32.:59:36.

investigation earlier this xear there are companies who appdar to

:59:37.:59:40.

have made it in their busindss model to purchase medicines for which

:59:41.:59:45.

there are no competitive products. They then exploit a monopolx

:59:46.:59:50.

position to raise prices. Wd cannot allow this practice to conthnue

:59:51.:59:53.

unchallenged. My department has been working closely with the colpetition

:59:54.:59:58.

markets authority to alert them to any cases where there may bd market

:59:59.:00:02.

abuse and provide evidence to support this. We also need to tackle

:00:03.:00:06.

this with an error-free micro-and the costs of medicines and close the

:00:07.:00:12.

loophole of the branding medicines. While the Government's existing

:00:13.:00:16.

powers allow to control the price of any health service medicine, the

:00:17.:00:18.

current terrorist to not allow controls to be placed on unbranded

:00:19.:00:22.

generic medicines where companies are members of the voluntarx PPI ice

:00:23.:00:28.

cream. Most companies have ` mixed portfolio of branded and unbranded

:00:29.:00:36.

generic medicines. For this reason, they are able to use the pe`k PRS

:00:37.:00:41.

membership to avoid Governmdnt control of their prices. It should

:00:42.:00:45.

be said this practice is not widespread. However, there `ppears

:00:46.:00:49.

to be a handful of companies who are exploiting our freedom of pricing

:00:50.:00:52.

for unbranded generic medichnes where there is no competition in the

:00:53.:00:56.

market, leading NHS no choice but to purchase the medicine at grossly

:00:57.:00:59.

inflated prices or to transfer patients to other medicines which

:01:00.:01:06.

are not always suitable. Many in the industry would also like to see this

:01:07.:01:09.

inappropriate behaviour stalped out. I give way to my right honotrable

:01:10.:01:14.

friend. I very much agree whth the point is just made. He talks about

:01:15.:01:17.

collaboration with the compdtition markets authority and can hd give

:01:18.:01:21.

any indication as to whether he expects any action to be taken in

:01:22.:01:25.

terms of abuse in the marketplace, given that there is a small memory

:01:26.:01:27.

of companies who have behavdd appallingly? I can't give you that

:01:28.:01:35.

indication as he will know that they operate completely independdntly. I

:01:36.:01:39.

don't know what their findings are going to be. I would support any

:01:40.:01:44.

action that the recommended. I do think this bill can be therd's some

:01:45.:01:48.

security in the house that hf they are unable to find evidence and in

:01:49.:01:52.

specific cases that they got in front of them, we will be able to

:01:53.:01:56.

take action as the Government providing the house is willhng to

:01:57.:02:01.

support this bill. My right honourable friend.

:02:02.:02:11.

How does it compare to thosd in other health services by other

:02:12.:02:17.

health providers in western European countries? We have made somd

:02:18.:02:27.

assessment of those. Essenthally, our concern is that even without

:02:28.:02:34.

comparison to what's happenhng in other countries, this is

:02:35.:02:39.

unreasonable behaviour. I mdntioned one example to the honourable

:02:40.:02:41.

gentleman other side of the house earlier, there is another one I can

:02:42.:02:46.

give him which is that the price has increased between 2011 and 2016 by

:02:47.:02:53.

3000 600%. I just don't think we can justify that. Given that we want to

:02:54.:02:58.

have strong harmonious positive relationships between the NHS and

:02:59.:03:01.

pharmaceutical industry, we just need to eliminate the possibility of

:03:02.:03:05.

that kind of behaviour happdning going forward. This bill amdnds the

:03:06.:03:10.

NHS act 2006 to allow the Government to control the prices of thdse

:03:11.:03:12.

medicines even when the manufacturers members part of this

:03:13.:03:21.

voluntary scheme. We only whll use this power when charging at an

:03:22.:03:26.

unreasonably high price. Thd representative body are also keen to

:03:27.:03:31.

look at how we exercise this power. I now turn to the final elelent of

:03:32.:03:35.

the bill which will strengthen the Government's powers to gathdr

:03:36.:03:39.

information on the costs of medical supplies and other related products

:03:40.:03:43.

across the supply chain frol factories to those who supply

:03:44.:03:47.

medicines to patients. We ctrrently collect information on the cell and

:03:48.:03:50.

purchase of medicines from various parts of the supply chain under

:03:51.:03:55.

various arrangements and very range of specific purposes. Some of these

:03:56.:03:59.

arrangements are voluntary while others are statutory. The bhll will

:04:00.:04:02.

streamline the existing information requirements in the energy `ct 006

:04:03.:04:06.

relating to controlling the cost of health care products. It will enable

:04:07.:04:11.

the Government to make regulations for all those involved in the

:04:12.:04:15.

manufacturing distribution of health service medicines, medicine lies or

:04:16.:04:21.

other related products to rdcord and provide information on sales and

:04:22.:04:28.

purchase. The reimbursement of community pharmacies and GPs,

:04:29.:04:32.

determining the value for money supply chain of products and

:04:33.:04:35.

controlling the cost of medhcines. This will enable the Governlent to

:04:36.:04:40.

pick the current voluntary arrangement with manufacturdrs and

:04:41.:04:43.

wholesalers and unbranded J`ck medicines are manufactured specials

:04:44.:04:48.

on the statutory footing. As the arrangements are voluntary, they

:04:49.:04:50.

don't cover all products and companies which limits the

:04:51.:04:57.

robustness of the reimburselent A fitting for data collection is

:04:58.:04:59.

important to the Government can run a request... I know some colleagues

:05:00.:05:06.

have raised concerns about the implications of funding dechsions to

:05:07.:05:09.

community pharmacies and I want to reassure the house that this bill

:05:10.:05:12.

does not impact on those decisions, nor does it remove the requhrement

:05:13.:05:16.

for consultation with the representative body of pharlacy

:05:17.:05:19.

contractors on their funding arrangement in the future. However,

:05:20.:05:23.

the information will give slall data on which to base those disctssions

:05:24.:05:28.

and decisions rather than rdlying on data only available to us under

:05:29.:05:30.

voluntary schemes and arrangements. The information would also dnable

:05:31.:05:34.

the Government to obtain information from across the supply chain to

:05:35.:05:39.

assure itself the supply ch`in or parts of it is delivering v`lue for

:05:40.:05:43.

money for any cheese patients and the taxpayer, something we cannot do

:05:44.:05:46.

with our existing fragmented detail. I am happy to give way. Would buy

:05:47.:05:54.

right honourable friend be giving consideration to asking pharmacists

:05:55.:05:58.

who can prepare their own mddicines which would save the NHS trdmendous

:05:59.:06:02.

amounts of money will you bd considering that in the overall

:06:03.:06:06.

scheme of getting some information on the medicines that you are

:06:07.:06:13.

providing? It may be the case that the information that we collect

:06:14.:06:17.

makes it possible for us to do more robust analysis on issues lhke the

:06:18.:06:22.

one that she rightly brings to the attention of the house. Even if it

:06:23.:06:26.

doesn't, I think this is an issue we should consider and I'm verx happy

:06:27.:06:29.

to write back to her to see whether we can make more progress in that

:06:30.:06:33.

area. I would also like to reassure the house of the application of this

:06:34.:06:38.

information power to the medical technology industry. Over 98% of the

:06:39.:06:42.

company's supplying technology medicines. Their products m`y be

:06:43.:06:47.

less high profile at the latest cancer medicines but no less

:06:48.:06:51.

innovative are vital for patients. We have no interest in plachng

:06:52.:06:54.

additional burdens on these companies. The 2006 act alrdady

:06:55.:06:59.

provides power for the Government to require suppliers of medical

:07:00.:07:03.

technologies to keep and provide information on almost any aspect of

:07:04.:07:07.

their business. This bill whll clarify and modernisers powdrs and I

:07:08.:07:10.

am committed to exercising them in a way which is fair and proportionate

:07:11.:07:15.

to companies to the NHS and to the taxpayer who rightly demand value

:07:16.:07:18.

for money from the supply chain Companies are currently reqtired to

:07:19.:07:23.

hold information on income sales for six years for tax purposes. We work

:07:24.:07:26.

closely with the industry to ensure the requirement to keep and record

:07:27.:07:30.

data does not militantly increase this burden. My officials h`ve

:07:31.:07:37.

already been in discussion for both medicines and medical devicds about

:07:38.:07:40.

these powers to ensure their implementation is robust and

:07:41.:07:46.

proportionate and will provhde us to debate on these provisions. I want

:07:47.:07:52.

to reassure colleagues that a consultation will take placd on the

:07:53.:07:55.

regulations specify the information requirements. I would also like to

:07:56.:08:01.

thank ministers and evolve administrations further constructive

:08:02.:08:03.

input and engagement with mx department with respect to the Bill

:08:04.:08:06.

provisions. Whilst many of the provisions in the Bill are reserved

:08:07.:08:10.

in relation to Scotland and Wales, there are some information

:08:11.:08:12.

requirements which currentlx apply to England only but could also apply

:08:13.:08:17.

in the territories of the ddvolved illustrations. We intend to propose

:08:18.:08:21.

amendments to the builder of the agreement between the Government and

:08:22.:08:24.

evolve demonstrations to th`t information from wholesalers and

:08:25.:08:27.

manufacturers can be collected by the Government for the whold of the

:08:28.:08:31.

UK and shared with the devolved administrations. This avoids the

:08:32.:08:36.

burden created by each country creating the same information. The

:08:37.:08:39.

Welsh Government has also asked me to enable them to maintain

:08:40.:08:44.

information from dispensing GPs a power the Scottish Government and

:08:45.:08:46.

Northern Ireland accepted already have. The Government will propose an

:08:47.:08:50.

amendment to the bill to allow the NHS Wales act so that Welsh

:08:51.:08:53.

ministers can obtain inform`tion from pharmacists and dispensing GPs.

:08:54.:09:01.

In conclusion, Madam Deputy Speaker, medicines are a vital part of the

:09:02.:09:05.

treatment provided by our NHS, robust cost control and information

:09:06.:09:10.

requirements are a key tools to ensure NHS spending on medicines

:09:11.:09:15.

across the UK continues to be affordable whilst delivering better

:09:16.:09:19.

value for taxpayers and freding up resources with support access to

:09:20.:09:22.

services and treatments. Thhs bill will ensure there is a more level

:09:23.:09:26.

playing field between an medicines pricing schemes whilst ensuring that

:09:27.:09:30.

decisions made by the Government are based on a more accurate and robust

:09:31.:09:36.

information about medicine costs. Fear for industry, serif ph`rmacies

:09:37.:09:41.

and affair of the NHS, serif patient and fairer for taxpayers, I commend

:09:42.:09:46.

this bill to the house. Stexn the question is at the bill may be read

:09:47.:09:52.

a second time. Thank you Madam Deputy Speaker. I would likd to

:09:53.:09:56.

thank the Secretary of Statd for outlining the overarching principles

:09:57.:09:59.

of this bill which, seek to allow the NHS to better control the

:10:00.:10:06.

medicine. Subject to blatant abuses in recent years. I would also like

:10:07.:10:12.

to thank the Minister for t`king the time to set out what the Government

:10:13.:10:16.

is seeking to achieve with this bill. I only hope this incrdased

:10:17.:10:20.

appetite for state intervention will spread more widely across

:10:21.:10:26.

Government. As we've heard from the Honourable member for Wolverhampton,

:10:27.:10:32.

south-west, the anti-business interventionism, I would never

:10:33.:10:35.

thought I would say this but I believe the Secretary of St`te is

:10:36.:10:39.

now a fully fledged Corbin Daster having said would he said today In

:10:40.:10:46.

all seriousness, it is clear the market isn't serving patient or the

:10:47.:10:51.

taxpayers. Expenditure on mddicines is a significant and growing

:10:52.:10:56.

proportion of the NHS budget standing at ?15.2 billion in 20 5,

:10:57.:11:02.

2016, an increase of over 20% since 2000 11. If the whole of thd NHS had

:11:03.:11:08.

seen such an increase doing the same period. The incredible advances in

:11:09.:11:12.

science in recent decades often led by companies here in Britain mean

:11:13.:11:16.

that people in this country are in leading longer, healthier lhves than

:11:17.:11:19.

we've ever seen before. While we celebrate this, it is also right

:11:20.:11:23.

that we secure value for money for the NHS to ensure as many p`tients

:11:24.:11:25.

as possible can Can I declare interest as a type two

:11:26.:11:39.

diabetic that 10% of the expenditure of the NHS budget is one di`betes

:11:40.:11:45.

complications therein. Does he agree with me there may well be a desire

:11:46.:11:51.

to prescribe more medicines which will cost more rather than providing

:11:52.:11:57.

diabetics with structured education which, if used, can bring about the

:11:58.:12:03.

cost of diabetes to the NHS. So it is not just about pills.

:12:04.:12:08.

I pay tribute to the great work he does and diabetes and it is a map

:12:09.:12:14.

and he consistently raises `nd is right to do so. There are m`ny ways

:12:15.:12:19.

the diabetes Bill can be tackled and some of the statistics I have seen

:12:20.:12:23.

about the level of take-up of education courses is somethhng we

:12:24.:12:27.

can do much better on. Turnhng back to the bill, we are supporthve of

:12:28.:12:32.

the broad aims of what the Government are trying to achieve but

:12:33.:12:35.

have a number of concerns I hope the Minister will address. Both about

:12:36.:12:42.

what is in the bill and the Government's policies more widely on

:12:43.:12:46.

access to treatment. The technical mechanisms used to control

:12:47.:12:50.

expenditure on medicines have not historically been the subject that

:12:51.:12:55.

has set the public's imagin`tion alight but in June we bar all our to

:12:56.:12:59.

read reports a small number of companies exploited the polls to

:13:00.:13:05.

hike the patient -- hike thd price of medicines. We sold storids of

:13:06.:13:10.

treatment being denied to p`tients on the basis of cost. That we saw

:13:11.:13:19.

stories. There are two currdnt schemes operated the control and

:13:20.:13:25.

pricing, the voluntary PPRS which applies to the vast majoritx and the

:13:26.:13:31.

statutory scheme which in 2014, around 6% branded medicine sales in

:13:32.:13:37.

the UK. The PPRS is based on making payments from companies back to the

:13:38.:13:42.

NHS based on their sales of medicines to the NHS, while the

:13:43.:13:47.

statutory scene operates on a cut to the price of branded medicines.

:13:48.:13:51.

These approaches appear to produce different results. Since 2004 the

:13:52.:13:55.

statutory scheme delivered significantly lower savings than the

:13:56.:14:02.

PPRS as companies are switching into the statutory scheme which hs why we

:14:03.:14:06.

saw a reduction in the level of the rebate. We support the rationale

:14:07.:14:12.

between lining the look-mac aligning the two schemes to deliver ` better

:14:13.:14:17.

level of savings to the taxpayer. As we heard, this bill extends beyond

:14:18.:14:23.

more than that and adds a ndw provision giving the secret`ry of

:14:24.:14:26.

state the power to require `ll medicine manufacturers and suppliers

:14:27.:14:29.

to provide information relating to prices. I certainly will.

:14:30.:14:35.

He will know and we all well there is a difference between the list

:14:36.:14:40.

price that is advertised and the price the NHS actually pays. We must

:14:41.:14:47.

be careful and that is a very important point, it does brhng the

:14:48.:14:56.

cost down for the NHS and those companies may well charge other

:14:57.:15:00.

people higher prices and we must take that into context.

:15:01.:15:06.

He is absolutely right and that is one of the reasons we need to tread

:15:07.:15:10.

carefully and hear what the Government come forward with in

:15:11.:15:13.

terms of regulations they whll be consulting on in due course. Because

:15:14.:15:19.

some of these measures do not form part of the initial consult`tion and

:15:20.:15:22.

there is a feeling some of the things were added at the last minute

:15:23.:15:26.

and giving the cuts to the community pharmacy sector announced l`st week

:15:27.:15:30.

there is anxiety out there `bout what costs could be created by an

:15:31.:15:39.

additional administrative btrden. Does my honourable friend agree

:15:40.:15:41.

pharmacists of them know thdir patients much better than

:15:42.:15:46.

overstretch GPs and can advhse on prescription of appropriate and

:15:47.:15:49.

cheaper drugs and does he also agreed instead of putting more

:15:50.:15:52.

pressure on the pharmacy sector the Minister should support thel to

:15:53.:15:56.

reduce the burden on GPs and help the NHS save money?

:15:57.:16:03.

She is absolutely right, thdre is concern about the announcemdnt last

:16:04.:16:08.

week and we know from survexs taken but approximately one in fotr

:16:09.:16:12.

people, and using pharmacists would go to the GP if they were unable to

:16:13.:16:16.

see pharmacy for advice and we know the pressures surgeries are under so

:16:17.:16:23.

we will have to watch careftlly the impact of those proposals and

:16:24.:16:27.

hopefully they will not be `s serious as a number of membdrs have

:16:28.:16:33.

expressed concern on. The ilpact assessment that talks about these

:16:34.:16:37.

proposals does not offer us too many clues, it says that in terms of the

:16:38.:16:41.

additional cost that could be in card they have not been quantified

:16:42.:16:46.

as their magnitude will not be known until subs regulations. We need to

:16:47.:16:54.

tread carefully on these. -, until subsequent regulations. This is a

:16:55.:17:03.

far from perfect state of affairs and when the bill reaches committee

:17:04.:17:08.

we will get further clarity. He has been fair in his bro`d

:17:09.:17:13.

analysis of the problems we face between the statutory and voluntary

:17:14.:17:20.

schemes and in many ways it is a lesson that is statutory scheme can

:17:21.:17:26.

often be gained by industry. Is it encouraged the Association of

:17:27.:17:29.

pharmaceutical industries are very supportive of what is being proposed

:17:30.:17:34.

and want to work with the sdcretary of state and this is such that we

:17:35.:17:36.

can hopefully get something that will work for the future rather than

:17:37.:17:41.

being a Draconian recommend`tion through from Richmond house?

:17:42.:17:49.

I thank the member and I wotld agree it is important we keep dialogue

:17:50.:17:54.

open with industry because we are proud of the pharmaceutical industry

:17:55.:17:57.

and what they can deliver, ht is a world leader and we do not want to

:17:58.:18:01.

throw the baby out with the bath water. The Government will be aware

:18:02.:18:05.

concern has been expressed by the medical technology sector that

:18:06.:18:08.

medical supplies Artie brought under this regime designed to tackle

:18:09.:18:14.

tackle problems in the pharmaceutical industry and express

:18:15.:18:18.

concerns measures in this bhll will put additional burden on th`t sector

:18:19.:18:22.

and could lead to overall hhgher costs so we welcome assurances from

:18:23.:18:27.

the Secretary of State 99% of businesses that are small or medium

:18:28.:18:32.

will not be unduly troubled by others reporting requirements and we

:18:33.:18:39.

will cope in further detail. -- onerous reporting requirements. It

:18:40.:18:44.

was reportedly estimated income from PPRS and 2016-17 would be ?418

:18:45.:18:50.

million, in considerable reduction from the and 2015 and win the

:18:51.:18:54.

overall drugs bill is incre`sing its sales of the scheme is not going to

:18:55.:19:00.

plan -- when the overall drtgs bill is increasing. It is said the

:19:01.:19:03.

savings would be about ?90 lillion per year for the NHS. Let us

:19:04.:19:09.

consider whether this bill can address this. One of the benefits we

:19:10.:19:12.

have heard is the bill would close down the football would lead to

:19:13.:19:17.

extortionate prices for a ntmber of drugs. -- closed down the loophole.

:19:18.:19:27.

Small number of companies stch as a drug, remove the brand name, taking

:19:28.:19:31.

them out of the current pricing controls and then pick up the price

:19:32.:19:37.

by many hundreds or even thousands of percent. Some companies lake this

:19:38.:19:42.

strategy a key part of the business model and we have seen in this house

:19:43.:19:47.

exposing some of the worst dxcesses of capitalism, for Mike Ashley and

:19:48.:19:51.

his employment practices to Philip Green. That should be a special

:19:52.:19:55.

category for those who make themselves extremely wealthx by

:19:56.:19:59.

using loopholes in the law to prey on the set of vulnerable and extract

:20:00.:20:02.

obscene profits from the he`lth service. -- on the set and

:20:03.:20:10.

vulnerable. The small number of companies raise the costs of

:20:11.:20:15.

medicines by ?262 million a deal through this practice. When a US

:20:16.:20:19.

pharmaceutical company raisd the price of HIV medication people

:20:20.:20:23.

across the world united in condemnation but it is less well

:20:24.:20:27.

known we have seen the pricd of over 200 medicines more than double in

:20:28.:20:32.

this country with 32 rising by more than 1000% and in one case `n

:20:33.:20:38.

unbelievable increase of 12 and a half thousand percent. -- 12,50 %.

:20:39.:20:47.

We can look at the company website, one of those it was sold to a

:20:48.:20:51.

private equity company for ?367 million on top of commercialising

:20:52.:20:57.

the nation generic medicines. Another of those companies which

:20:58.:21:04.

owns others is open about the fact it, specialises in the acquhsition,

:21:05.:21:09.

licensing and development of oft repeated medicines which max be

:21:10.:21:13.

niche hard to make products. This sounds like a noble pursuit but we

:21:14.:21:18.

know that can't be code for establishing and abusing a dominant

:21:19.:21:23.

market position -- that can decode. I will give way. -- that can be a

:21:24.:21:27.

cold. This bill the powers of the

:21:28.:21:32.

Secretary of State to effectively confiscate profits through that

:21:33.:21:36.

rather than taxation can attempt my honourable friend to a tree might be

:21:37.:21:40.

worth looking at in relation to a company like Google and who has

:21:41.:21:47.

aided by percent of the world Mobile operating systems, that is `

:21:48.:21:50.

dominant market position whdre there are question marks over thehr

:21:51.:21:54.

taxation and some others profit confiscation could be looked at as

:21:55.:22:02.

well. -- some of the sprockdt. I like them but this is way ottside my

:22:03.:22:08.

brief but I know or health service enters into partnership with Google

:22:09.:22:13.

so I hope ministers ask questions about the taxation arrangemdnts We

:22:14.:22:17.

ignore the vast majority of the generic sector is well controlled by

:22:18.:22:21.

competition and delivers value for money. We welcome the extension of

:22:22.:22:26.

price controls were competition has failed. I would ask the Minhster

:22:27.:22:31.

without he is confident this step alone will be successful, as we have

:22:32.:22:37.

seen how adept International companies can be with moving figures

:22:38.:22:41.

are bound to avoid taxation and we want to avoid this being vulnerable

:22:42.:22:47.

to the gaming we have seen elsewhere. I do not believe, given

:22:48.:22:52.

the vast sums of money at stake these companies will simply stored

:22:53.:22:57.

their shoulders and take thd hit, if the town of order. I was concerned

:22:58.:23:03.

when I read something about this bill which said, in the past the

:23:04.:23:07.

Department of Health would sit informal negotiations with

:23:08.:23:09.

manufacturers were that was pricing issues and we believe this will

:23:10.:23:13.

remain. This notion brings tp uncomfortable memories of the

:23:14.:23:17.

sweetheart deals between multinationals and each MRC and

:23:18.:23:21.

while I am happy fortunes of communication with these colpanies

:23:22.:23:24.

we would like the assurance in all cases prices will be regulated

:23:25.:23:28.

through a transparent and formal process and not behind the scenes

:23:29.:23:33.

talks. If in a feud gives it becomes clear... I certainly will. H want to

:23:34.:23:41.

ask my honourable friend whdre the advertising budgets of

:23:42.:23:44.

pharmaceutical companies dw`rf their research and development budget is

:23:45.:23:47.

that not an argument for thd Government looking again at the tax

:23:48.:23:51.

position of those companies as well as the price position of thd

:23:52.:23:54.

products? I thank my honourable friend for his

:23:55.:24:02.

intervention. I do not like we will get very far with this Government on

:24:03.:24:07.

corporation tax and they have gone in a direction we probably not could

:24:08.:24:10.

them as the opposition and they decide that this is the best way to

:24:11.:24:14.

control prices and see how we get on. I would ask the Minister in the

:24:15.:24:21.

can confirm if it becomes clear in a few years we have open up another

:24:22.:24:25.

set all the polls whether wd can accept the department to be

:24:26.:24:29.

proactive in their investig`tions rather than lying relying on

:24:30.:24:34.

journalists to expose it. -, in another set of loopholes. In

:24:35.:24:38.

Scotland than the big gener`ted was used to create a dedicated fund to

:24:39.:24:43.

get patients access to new ledicines and, as the Minister to invdstigate

:24:44.:24:47.

a similar model and ensure the benefits of the scheme are tsed for

:24:48.:24:52.

improving our poor records `nd allowing patients to benefit from

:24:53.:24:58.

new medicines. We accept thdre will always be challenges in matching

:24:59.:25:01.

funding to new drugs but thdre is at least logic allowing savings to be

:25:02.:25:09.

reinvested. We welcome the report today which sets out an ambhtious

:25:10.:25:14.

plan which could see patients accessing new life-saving treatment

:25:15.:25:18.

up to format years more quickly and I hope the Minister will give

:25:19.:25:22.

financial backing to the review by using future rebates from the

:25:23.:25:27.

pharmaceutical sector to improve access to treatments. I askdd the

:25:28.:25:30.

Government to seriously consider this as a growing concern about

:25:31.:25:34.

access to new treatments and particularly widening gulf between

:25:35.:25:37.

our record of developing new drugs and the ability of the NHS to ensure

:25:38.:25:43.

all patients sufficiently bdnefit. The international comparisons of

:25:44.:25:45.

health technology reports ptblished in August by breast cancer now and

:25:46.:25:53.

Prostate Cancer UK shows thd NHS and cancer patients miss out on

:25:54.:25:56.

innovative treatments incomparable countries of similar wealth and at

:25:57.:26:01.

the same time a number of mddicines have been delisted by the c`ncer

:26:02.:26:09.

drugs and after that overspdnt. There was also another report in

:26:10.:26:16.

July entitled A Pill Too Hard To Swallow, How The Nhs Is Limhting

:26:17.:26:21.

Access To High-priced Drugs. Is sent to similar conclusions about drugs

:26:22.:26:28.

which give possible to elimhnate HIV.

:26:29.:26:33.

We have to be very careful that we don't encourage drug companhes to

:26:34.:26:39.

research into those areas bdcause they would not see that fin`ncial

:26:40.:26:45.

return for them. I thank my honourable friend for the

:26:46.:26:49.

intervention. He is right. We must the very careful with the

:26:50.:26:54.

consequences of this piece of legislation and, again, we know that

:26:55.:26:57.

there will be decisions takdn in terms of investment of -- if the

:26:58.:27:02.

return is not sufficient. Wd have to get the balance right betwedn

:27:03.:27:05.

encouraging investment and getting value for money for the taxpayer.

:27:06.:27:11.

Madam Deputy Speaker, the rdport showed how NHS England have been

:27:12.:27:16.

unable to budget for broad `ccess to drugs. When it failed, rationed

:27:17.:27:23.

access to those drugs. Therd was also widespread controversy over

:27:24.:27:27.

attempts by NHS England to `void funding the anti-HIV by passing on

:27:28.:27:32.

responsibility to local authorities at the same time of cutting the

:27:33.:27:36.

public health budget allocated to councils. If we are to strike -

:27:37.:27:40.

strives to create a level playing field, we should look to thd scene

:27:41.:27:44.

for patients and their abilhty to access treatments. When Labour

:27:45.:27:53.

established... An order was made by Parliament in 2001 to mandate

:27:54.:27:58.

through its technical apprahsal process. They were intended to be

:27:59.:28:03.

available to patients three months after publication of the appraisal

:28:04.:28:14.

full. This has culminated in the. As well as looking at Wingfield fencing

:28:15.:28:19.

the payments, there are also asked to look more widely. Successive

:28:20.:28:23.

studies have demonstrated how there is a relatively low take-up by the

:28:24.:28:27.

UK compared to other high income countries. Not only does th`t let

:28:28.:28:32.

patients down, it can also hmpact on the future of the pharmaceutical

:28:33.:28:36.

industry in the UK, particularly given the concerns for the sector

:28:37.:28:40.

about the relatively small seals converted other countries. H am sure

:28:41.:28:48.

it ministers are aware that the concerns that have been raised in

:28:49.:28:53.

respect of and need to ensure the country can be seen as the leader in

:28:54.:28:56.

the research sector. The Prhme Minister has said it is hard to

:28:57.:29:00.

think of industry of greater strategic importance to Britain as

:29:01.:29:02.

pharmaceutical industry and we would agree with that but we cannot be

:29:03.:29:06.

complacent about the state of UK pharmacy particularly as investment

:29:07.:29:11.

decisions are also made by hearing companies based in other parts of

:29:12.:29:15.

the world. I hope the minister will take seriously the interrel`tionship

:29:16.:29:18.

between decisions about accdss treatments and the future of

:29:19.:29:21.

pharmaceutical research and development in the UK, parthcularly

:29:22.:29:24.

when we know other countries across Europe are using our uncert`inty as

:29:25.:29:30.

a result of Brexit to aye up other opportunities to take on thd march

:29:31.:29:35.

on our own industry. To conclude, the opposition support the broad

:29:36.:29:38.

aims of this bill and what the Government is seeking to achieve in

:29:39.:29:40.

terms of controlling better the cost of medicines. At the committee

:29:41.:29:45.

stage, we will seek to explore the new information powers and the

:29:46.:29:47.

details of the impact of those powers on the supply chain `nd

:29:48.:29:51.

finally we will also continte to hold the Government to accotnt and

:29:52.:29:54.

ensure that patients are able to access the best available treatment

:29:55.:30:04.

without any unnecessary del`y. Thank you, Madam Deputy Speaker. @s any

:30:05.:30:09.

constituency MP bundle, the pressures on the NHS grow ydar in,

:30:10.:30:16.

year out. Partly because of a name -- ageing population, partlx because

:30:17.:30:21.

of developments in medical procedures, advanced drugs that can

:30:22.:30:28.

help to overcome illness or to continue the recovery or

:30:29.:30:32.

stabilisation of a patient's condition. That is why it is always

:30:33.:30:38.

a constant battle for the NHS to root out waste and increase

:30:39.:30:44.

efficiency in the delivery of care without compromising patient care.

:30:45.:30:54.

The Nicholson challenge launched in 2010, sought to save ?20 billion

:30:55.:31:01.

over the last Parliament and as my right honourable friend the

:31:02.:31:03.

Secretary of State, the Minhster of State brother, said, they m`naged to

:31:04.:31:14.

achieve ?19.4 billion. Not by - ?19.4 billion of savings th`t went

:31:15.:31:19.

back to the Treasury, ?19.4 billion that was reinvested in front line

:31:20.:31:25.

services and the NHS. Simil`rly we have great pressure on the dver

:31:26.:31:34.

increasing drugs bill. In England, the drugs bill is a ?15.2 bhllion in

:31:35.:31:46.

the last financial year. 11.2 billion on branded medicines, for

:31:47.:31:50.

billion on an branded generhc medicines. That represents since

:31:51.:31:59.

2010, a 20% increase and a 7% year on year increase. With an ever

:32:00.:32:04.

increasing ageing population, those figures will continue to go up words

:32:05.:32:12.

in future years. What we sed as well is more and more new drugs being

:32:13.:32:18.

developed to combat illness. How many illnesses that the killers even

:32:19.:32:23.

during our lifetimes can now either be cured or stabilised becatse of

:32:24.:32:30.

research in the work of pharmaceutical companies in

:32:31.:32:33.

developing those drugs that can provide those results? Anyone will

:32:34.:32:41.

accept that the research for developing new drugs to tackle

:32:42.:32:47.

illness and disease is phenomenally expensive to the companies `nd also

:32:48.:32:55.

takes sometimes many years hndeed. Therefore, we have to have ` balance

:32:56.:33:00.

between the pharmaceutical companies who have to invest horrendots

:33:01.:33:07.

amounts of money to be able to find a new drug for a new cure or a

:33:08.:33:14.

stabilising medicine for medical conditions that they obviously do

:33:15.:33:21.

you have to benefit from thd horrendously large investments that

:33:22.:33:27.

they make. But that does not mean that that should be a licence for

:33:28.:33:31.

them to be able to simply charge what they like for as long `s they

:33:32.:33:36.

like for the largest profit possible. There is a medium between

:33:37.:33:43.

the two situations and that has been particularly highlighted by the

:33:44.:33:48.

Times report in a few months ago about the investigation in which one

:33:49.:33:53.

saw some of the increases in drugs by pharmaceutical companies that had

:33:54.:33:58.

in effect, a monopoly on th`t drug because there was no compethtion. To

:33:59.:34:03.

give you one or two examples to show the scale of the problem,

:34:04.:34:12.

hydrocortisone tablets rose between 2008 and 2016 on a price per packet

:34:13.:34:20.

from 70p to ?85. That was the ?12,000 increase. Certain

:34:21.:34:29.

anti-depressant tablets, ond sees a 2600% increase of certain t`blets

:34:30.:34:38.

for insomnia, a 3000% incre`se. Frankly, even if it was with a

:34:39.:34:47.

relatively small number of drugs, that is totally unacceptabld and is

:34:48.:34:54.

extremely difficult to justhfy. I accept the cost of drugs to the NHS

:34:55.:34:59.

is extremely complicated. As honourable members will know,

:35:00.:35:02.

branded medicines are currently controlled through the voluntary

:35:03.:35:07.

scheme, the pharmaceutical Price regulatory scheme agreed back in

:35:08.:35:12.

2014 to 2019. For those companies that choose not to join the PPR S,

:35:13.:35:18.

the Government operates a statutory scheme for branded medicines. BPP RS

:35:19.:35:22.

is based on a payment mechanism whereby companies make paymdnts back

:35:23.:35:26.

to the Department of Health based on sales of branded medicines whereas

:35:27.:35:31.

the statutory scheme operatds on the basis of a cut to the published list

:35:32.:35:38.

price of branded medicine. @s a result, the statutory schemd has

:35:39.:35:42.

delivered significantly lowdr savings for the NHS and that is

:35:43.:35:48.

clearly not a satisfactory situation. I welcome the bill as a

:35:49.:35:53.

means for the Government to secure better value for money for both the

:35:54.:36:00.

NHS and for taxpayers. The first important change that this bill will

:36:01.:36:05.

introduce is to clarify the law to allow beyond any doubt the power of

:36:06.:36:11.

the Secretary of State to rdquire a payment mechanism in the st`tutory

:36:12.:36:15.

scheme to limit the cost of medicines. This clarification will

:36:16.:36:21.

enable the Secretary of State to combat the current situation whereby

:36:22.:36:26.

the current arrangements allow manufacturers and suppliers to

:36:27.:36:31.

choose which scheme to be controlled by, which has led to numerots

:36:32.:36:38.

companies to be in the statttory scheme rather than the voluntary

:36:39.:36:41.

scheme because the statutorx scheme is less effective in the level of

:36:42.:36:49.

savings that it makes to thd NHS. Thus, benefits them

:36:50.:36:52.

disproportionately. In effect, what this bill will do when it gdts onto

:36:53.:36:59.

the book, is to allow the Government to require companies to redtce the

:37:00.:37:03.

price of an unbranded generhc drug even if the company is in the

:37:04.:37:09.

voluntary scheme and the Government intend to use this power to limit

:37:10.:37:15.

the price of the unbranded generic medicines for competition in the

:37:16.:37:20.

market fails and companies charge the NHS unreasonably high prices for

:37:21.:37:27.

these projects as highlightdd few moments ago. Through the

:37:28.:37:30.

investigation that the Times carried out. I will give way to the

:37:31.:37:35.

honourable gentleman. The rhght honourable member it may be aware

:37:36.:37:41.

that Concordia International, which has been playing this game, with the

:37:42.:37:46.

drug, that since the public`tion of this bill, it share price h`s gone

:37:47.:37:53.

down 20%. Good news. I am vdry grateful to the honourable gentleman

:37:54.:37:58.

for sharing that information with the house. Equally important the

:37:59.:38:03.

bill will improve and its information collection so that it is

:38:04.:38:11.

better informed on a more consistent basis, which will ensure a better

:38:12.:38:15.

basis for it assessing whether the supply chain as a whole or `

:38:16.:38:18.

specific sector provide valte for money for the NHS. I don't think it

:38:19.:38:25.

can be underestimated the ilportance of having a more consistent and more

:38:26.:38:38.

viable and a more useful information gathering because information is

:38:39.:38:44.

power insofar as it helps to affect decisions and judgments that if one

:38:45.:38:49.

doesn't have consistent information collection and one does not have

:38:50.:38:53.

sufficient ranges of inform`tion then it does lead to problels in

:38:54.:39:00.

seeking to rectify issues where pharmaceutical companies ard not

:39:01.:39:08.

behaving in the best interests of the NHS but disproportionatdly in

:39:09.:39:12.

their own interests. That is why although in the size it is ` modest

:39:13.:39:18.

piece of legislation, I think that its impact and its importance far,

:39:19.:39:25.

far outstrips the fact that it only has a few clauses in it and I am

:39:26.:39:33.

glad not only goal decided to take this decision but also it would seem

:39:34.:39:38.

that this bill, subject to being looked at by committees, subject to

:39:39.:39:42.

the consultation process on the regulations for the Secretary of

:39:43.:39:47.

State has given assurances to this house about, seems to command

:39:48.:39:51.

widespread support on all shdes of the house and I look forward to it

:39:52.:39:58.

actually reaching the book `nd then as the regulations are developed,

:39:59.:40:01.

the consultation is to ensure that we get it right and we stop some of

:40:02.:40:07.

the abuses that have existed, that have cost the NHS so much, without

:40:08.:40:15.

unfairly penalising the pharmaceutical companies because, as

:40:16.:40:18.

I said earlier, they spent ` considerable amount of time and a

:40:19.:40:22.

massive amount of money in developing drugs that in thd last 30

:40:23.:40:28.

years have seen considerabld strides for patients with HIV AIDS, they

:40:29.:40:34.

have seen improvements in some of the care for cancer patients and so

:40:35.:40:42.

I welcome this bill. Madam Deputy Speaker, like the previous speaker,

:40:43.:40:47.

I do pay tribute to some of the research and development th`t has

:40:48.:40:50.

been done by the pharmaceuthcal industry. Europe has become the

:40:51.:40:55.

biggest research network in the world and the biggest benefhciary of

:40:56.:41:00.

that has been the United Kingdom. Through Horizon 2020 funding in

:41:01.:41:04.

collaboration with the European medicines agency and as was said by

:41:05.:41:08.

our speakers, both of these are going to change and the

:41:09.:41:10.

pharmaceutical industry within this country will be rather nervous and

:41:11.:41:15.

rather anxious about exactlx what their future is. Every new job they

:41:16.:41:21.

discover it creates an additional cost pressures are the NHS. Hence,

:41:22.:41:27.

the reason for the PPR S. Its existence of the 50s but thd one

:41:28.:41:32.

we're in at the moment is, since 2014, has brought the -- significant

:41:33.:41:38.

benefits as was mentioned bx the Shadow Minister for health. In

:41:39.:41:42.

Scotland, that directly fund a new medicines and rare diseases fund.

:41:43.:41:46.

Ours is not a cancer drug ftnd and therefore that gives us gre`ter

:41:47.:41:50.

flexibility. The patient or a condition does not need to beat

:41:51.:41:57.

cancer. Hence, we are giving this drug for hepatitis C, we ard giving

:41:58.:42:03.

another dog for... It does `ctually give us more flexibility for these

:42:04.:42:04.

very rare diseases. It to give sum of management and

:42:05.:42:16.

cost pressure and soak the Scottish Government and my colleagues will

:42:17.:42:21.

complete trading up this bill leads to end closing some loopholds the

:42:22.:42:27.

NHS faces, particularly we heard about those with a monopoly on

:42:28.:42:33.

generic medicines, that can often be companies in the PPRS schemd and

:42:34.:42:37.

therefore are able to chargd what they like for their generics so

:42:38.:42:41.

there must be greater alignlent and it must apply to all drugs, not just

:42:42.:42:48.

all companies. The third part mentioned by the Secretary of State

:42:49.:42:52.

is the collection of data and this is something, as someone who has

:42:53.:42:58.

worked in the NHS, the NHS has struggled with before and I do have

:42:59.:43:04.

a few concerns about how thhs will work across the entire NHS `nd the

:43:05.:43:09.

whole pharmaceutical industry and now also medal coal technology and

:43:10.:43:14.

supplies. We need to make stre the data collection is a relatively

:43:15.:43:19.

simple and straightforward `nd hopefully using a data that is

:43:20.:43:25.

already collected and bringhng that data together. As someone

:43:26.:43:29.

representing one of the devolved nations the importance for ts would

:43:30.:43:35.

be our Government can access it easily and it says clearly hn the

:43:36.:43:39.

bill data gathered would be shared with Scottish ministers but on what

:43:40.:43:43.

basis? Will it be down to Scottish and Welsh ministers requestdd that

:43:44.:43:48.

when they want it as opposed to perhaps waiting for an annu`l return

:43:49.:43:53.

which might not happen to bd at the point they want? I also would hope

:43:54.:43:59.

there has been, obviously the Secretary of State mention they have

:44:00.:44:03.

been consultation, but the consultation going forward because

:44:04.:44:07.

very much this bill will be the Devil and the detail in the

:44:08.:44:12.

extension to all medical supplies. Scotland already uses the lot of

:44:13.:44:15.

central procurement to keep costs down and it would be import`nt to us

:44:16.:44:19.

that enable back and did not interfere with it.

:44:20.:44:24.

She is making a powerful spdech as ever. If I can pick her medhcal

:44:25.:44:30.

brains of medical supplies because medical supplies are defined in the

:44:31.:44:35.

2006 act as covering surgic`l, dental and optical materials and

:44:36.:44:42.

equipment. As a clinician, would she include something like a cat scan or

:44:43.:44:48.

MRI scanner as a piece of strgical equipment, certainly not dental or

:44:49.:44:53.

optical. It seems to me it hs not actually surgical equipment, it is

:44:54.:44:58.

investigative equipment and MRI scanners start at around ?2 million.

:44:59.:45:07.

This is one of the areas to look at. I do not like having an narrow

:45:08.:45:11.

definition but only means of blades and the like and does not t`ke an

:45:12.:45:17.

hour hugely expensive infrastructure would make sense. When buying these

:45:18.:45:22.

kinds of machines in Scotland we tend to look at central procurement

:45:23.:45:26.

and assessment and that opens up the potential for massive savings so

:45:27.:45:32.

there is going to be a lot lore work in committee and then in regulation

:45:33.:45:37.

to make this function in thd way everyone wants it to function. One

:45:38.:45:42.

of the things, and it may not be in this bill but an aspiration for

:45:43.:45:48.

something later, is I think we need something much more radical. It is

:45:49.:45:54.

the case it is about five ydars delay for patients in the UK

:45:55.:45:59.

accessing new medicines. Whdn you look at comparisons of cancdr

:46:00.:46:04.

survival, when you look at patients with early disease often we are

:46:05.:46:10.

ahead, and breast cancer we were one of the earliest nations doing

:46:11.:46:13.

population screening but whdn you look at people with more advanced or

:46:14.:46:18.

aggressive disease is where we fall behind. This is where our food

:46:19.:46:27.

outcomes and survival in colparison to European countries comes from --

:46:28.:46:30.

Pooler survival and outcomes. Part of that is sometimes the eyd

:46:31.:46:37.

watering initial prices of new drugs. Yes, we can set methods to

:46:38.:46:41.

try and control that but a lot of these drugs do not get throtgh the

:46:42.:46:46.

system because they are so expensive. In my interactions with

:46:47.:46:50.

some of the major pharmaceutical companies sent in this placd I think

:46:51.:46:55.

there is an appetite for a different way of doing it. Perhaps it would be

:46:56.:47:02.

if prices were much lower btt they have a guaranteed number of patients

:47:03.:47:07.

before a drug became generic, it might be just a totally different

:47:08.:47:11.

way and might put at risk sharing because at the beginning we often do

:47:12.:47:15.

not know if that drug is re`lly going to be as good as it is cracked

:47:16.:47:21.

up to be and if it starts at ?100,000 we will struggle to get it

:47:22.:47:25.

through any of our pricing systems. I think one of the other onds coming

:47:26.:47:30.

up is how we expect pharmacdutical companies to make a profit on drugs

:47:31.:47:39.

we never intend to use? We know we need new antibiotics, we know any

:47:40.:47:42.

brand-new class of antibiothc and we have not had a new class of 30

:47:43.:47:47.

years, what have they been left on the shelf so the system we have will

:47:48.:47:52.

simply not fund research for that kind of drug. While this tidies up

:47:53.:47:57.

some of the issues we have now, we need is much more blue sky thinking

:47:58.:48:02.

going forward and that would be with the equipment, was on drugs, with

:48:03.:48:07.

how we develop different thhngs because otherwise we will go on

:48:08.:48:12.

having the interminable deb`tes I have taken part in Westminster Hall

:48:13.:48:16.

will be one debate saying wd want more research such as an br`in

:48:17.:48:20.

tumours and the next week wd have the debate on not being abld to

:48:21.:48:25.

access a brand-new drug that is being developed within the

:48:26.:48:30.

pharmaceutical industry. I'l happy to give way.

:48:31.:48:38.

I thank the honourable lady for giving such uninformed speech but

:48:39.:48:41.

would she also agree we're dntering a new landscape and -- giving such

:48:42.:48:51.

an informed speech. Some trdatments will be used across various cancers

:48:52.:48:56.

or diseases and when that comes into the picture we will need an even

:48:57.:49:01.

more flexible approach to how we will benefit from those thugs and

:49:02.:49:07.

how to optimise patient outcomes. -- benefit from those on drugs.

:49:08.:49:15.

We are entering the realms `nd have entered the realms of using immune

:49:16.:49:22.

therapies such as the drug look mac -- that was a drunk people went to

:49:23.:49:27.

court to try to access yet behalf the risks of a certain dise`se. And

:49:28.:49:35.

then you end up spending much more. The reason we use the serpent god

:49:36.:49:40.

for hepatitis C in Scotland if it is almost sure to and thereford we

:49:41.:49:47.

produce fewer patients. -- the reason we provide a certain drug for

:49:48.:49:52.

hepatitis C. The genetic drtgs that we are likely to be using in the

:49:53.:49:56.

future will be even more eyd watering the expensive but then

:49:57.:50:01.

again may have bigger impact. While this is tidying up, my concdrns are

:50:02.:50:08.

the involvement of the devolved administrations, both in design and

:50:09.:50:14.

access to data, ensuring funding for PPRS which we use for our ndw drugs

:50:15.:50:19.

fund, is maintained. There hs a call for us to do something much bigger

:50:20.:50:23.

and much more blue sky in the future.

:50:24.:50:30.

It is a pleasure to follow the extremely well informed spedch of

:50:31.:50:34.

the honourable lady. I hope ministers on the front bench will

:50:35.:50:38.

continue to study what happdns in Scotland as they do elsewhere so we

:50:39.:50:43.

can share information and copy best practice, whether from Scotland or

:50:44.:50:48.

elsewhere in the world and H am aware of the fine medical tradition

:50:49.:50:55.

Scotland has. I would like to start by paying credit to the Timds

:50:56.:51:01.

newspaper for their investigation starting on June the 3rd. Often we

:51:02.:51:05.

have cause to complain about the press in this place and we `re often

:51:06.:51:09.

the subject of the enquiries which we sometimes find unwelcome and the

:51:10.:51:15.

press are from time to time irresponsible and should be more

:51:16.:51:18.

responsible but in this casd I think we can all thank the Claims for

:51:19.:51:24.

sharing a spotlight on what is quite frankly some unacceptable practice

:51:25.:51:30.

within the pharmaceutical industry. -- flank the Times. It has huge

:51:31.:51:37.

implications for the NHS. I will indeed.

:51:38.:51:44.

She is exploring the work the Times bed in June and can I remind him in

:51:45.:51:49.

that context when discussing the early adoption of drugs which we

:51:50.:51:53.

talk about today we should bear in mind the work the Times dead in the

:51:54.:51:59.

1960s to uncover thalidomidd as a terrible drug and one which was

:52:00.:52:04.

never licensed in the USA bdcause of their concerns the testing was not

:52:05.:52:10.

adequate. Yes, we want things, it's a market where possible but we must

:52:11.:52:16.

be very careful. -- we want things earlier to market. I believd it was

:52:17.:52:22.

actually Sunday Times investigative team that focused on that issue We

:52:23.:52:28.

should pause and reflect and be thankful for the tremendous

:52:29.:52:31.

tradition operatives investhgative journalism that does help and is an

:52:32.:52:36.

ally to us in this place and it is important to put that on thd record.

:52:37.:52:41.

Part of what the Times did contributed to the secretarx of

:52:42.:52:46.

state launching the CMA enqtiry and it was quite right the compdtition

:52:47.:52:51.

and market authority enquirx and I am pleased that was put on the way.

:52:52.:52:56.

A number of speakers this evening have made the completely valid point

:52:57.:53:02.

which I agree with that it hs of vital we continue to have a strong

:53:03.:53:08.

pharmaceutical industry in the UK. In the month in which she w`s

:53:09.:53:15.

appointed, the Prime Ministdr said, "It is hard to think of an hndustry

:53:16.:53:20.

or greater strategic import`nce to Britain than our pharmaceuthcal

:53:21.:53:24.

industry." And she was absolutely right to say so. I have bridf

:53:25.:53:30.

comments that says the outptt of the pharmaceutical industry in the UK in

:53:31.:53:39.

2015 was ?12.7 billion, 8% of the UK's and tyre manufacturing output.

:53:40.:53:44.

If we look at one or two of the larger players, one company, for

:53:45.:53:51.

example, is active in over 050 markets around the world, 100,0 0

:53:52.:53:58.

employees globally, a seat manufacturing site and the largest

:53:59.:54:03.

vaccine business in the world. Of particular significance is ht

:54:04.:54:08.

conducts all research into research hops, one in Philadelphia, the other

:54:09.:54:14.

in Stevenage and a number of my constituents are proud to work at

:54:15.:54:20.

that site. If we look at a second company, another large

:54:21.:54:26.

pharmaceutical company in the UK, it has 6700 UK employees, support a

:54:27.:54:31.

further 35,000 jobs here and operates across seven different

:54:32.:54:35.

sites, one of which is in Ltton close to my constituency whdre again

:54:36.:54:40.

in number of my constituents are proud to work and be a right to be

:54:41.:54:47.

proud to work there. As the Secretary of State said earlier the

:54:48.:54:53.

medicines Bill for NHS Engl`nd's at ?15.2 billion in 2015 - 16 hs the

:54:54.:55:02.

second largest cost to NHS `ngered after hot on staff so it is of vital

:55:03.:55:09.

-- after costs on staff. It is vital we secure value for money. Ht is of

:55:10.:55:16.

concern competition and market authority has spoken of, "Excessive

:55:17.:55:23.

and unfair prices." And also referred to companies which have,

:55:24.:55:29.

"Abused a dominant position." There has been incidents where thdre has

:55:30.:55:35.

been no competition or insufficient competition and so it is absolutely

:55:36.:55:41.

right the Government has in to deal with this issue. This touchds on a

:55:42.:55:46.

broader philosophical point and we have a brief exchange on thhs

:55:47.:55:51.

earlier, but in response to me on the morality of business behaviour

:55:52.:55:55.

the Prime Minister wrote to me a couple of days ago and she said "We

:55:56.:56:04.

need to ensure the free market has an ethical basis." I absolutely

:56:05.:56:07.

agree with that. The House of agree with that. The House of

:56:08.:56:12.

Commons brief for this debate looks at the top you live in medicine

:56:13.:56:16.

where there has been these huge price increases, ranging from one

:56:17.:56:24.

would the eye watering Baha'i 1 12% price rise right up to another drug

:56:25.:56:28.

which had a 5281% price risd. There maybe some reasons in some

:56:29.:56:39.

cases if some of the ingredhents, the raw material a particul`r drug

:56:40.:56:45.

are suddenly in very short supply, why a price increase like that would

:56:46.:56:50.

be justified by the departmdnt knows that in the majority of casds, there

:56:51.:56:55.

is no valid reason for thosd huge increases and that is why the

:56:56.:57:01.

Government has quite properly acted. I welcome the powers in the bill to

:57:02.:57:07.

reduce prices and to impose price controls and very importantly has

:57:08.:57:11.

been referred to earlier to gather information. I do have a cotple of

:57:12.:57:16.

questions for the Minister when he replies about the gathering of

:57:17.:57:23.

information. Getting inform`tion is absolutely vital and I am pleased

:57:24.:57:26.

that the Government has got measures in this bill to get completd

:57:27.:57:30.

information but my question to my honourable friend on the front bench

:57:31.:57:33.

is whether he is satisfied that there is sufficient analytical

:57:34.:57:40.

really know what is going on? The really know what is going on? The

:57:41.:57:44.

reason I ask that is that I've had a huge privilege to work with members

:57:45.:57:49.

of the senior civil service in a different department of the last two

:57:50.:57:53.

years but sometimes I think we expect civil servants to have a

:57:54.:57:57.

range of skills that it is not fair for us to expect them to have. My

:57:58.:58:03.

question again to the Minister is that the necessary commerci`l

:58:04.:58:06.

expertise within his departlent to really work out what is going on

:58:07.:58:10.

he and his officials will h`ve at he and his officials will h`ve at

:58:11.:58:17.

their fingertips, is there ht is scheme between pharmaceutic`l

:58:18.:58:21.

businesses and the Department of Health? So his officials re`lly know

:58:22.:58:25.

how the market works in any particular gains that might be being

:58:26.:58:31.

played. And this is something that I think is really important, H'm aware

:58:32.:58:34.

there is one permanent secrdtary post at the moment who had `

:58:35.:58:39.

secondment earlier in his chvil service career with d'Anjou. I think

:58:40.:58:45.

it is a really important pohnt for both ministers and the perm`nent

:58:46.:58:48.

Secretary to make sure that is lacking ability within the

:58:49.:58:51.

Department and if it's not there, I hope the key and the ministdrial

:58:52.:58:55.

team will take steps to makd sure that it is. I say that becatse if

:58:56.:59:00.

you look at some of the e-m`ils which came into the public domain as

:59:01.:59:06.

some of them were brought to light some of them were brought to light

:59:07.:59:10.

through Freedom of informathon requests, it would seem to le there

:59:11.:59:14.

was not quite the level of serious analysis and probing and enpuiry

:59:15.:59:17.

that we all really would have liked to have seen and I'm sure mx

:59:18.:59:20.

honourable friend would've liked to have seen. In conclusion, M`dam

:59:21.:59:24.

Deputy Speaker, the Governmdnt are bringing forward this bill because

:59:25.:59:29.

the care passionately about the future of our National Health

:59:30.:59:33.

Service and they will do evdrything necessary to protect it and that

:59:34.:59:36.

very much includes getting value for money from the drugs that the NHS

:59:37.:59:41.

pays for. But it's also bec`use on the side of the house, we v`lue and

:59:42.:59:45.

care about the role of the free market. We know the greatest

:59:46.:59:48.

economic mechanism in the hhstory of economic mechanism in the hhstory of

:59:49.:59:52.

mankind for creating wealth and relieving poverty and is because we

:59:53.:59:57.

care about it that we will `ct to reform it square that is necessary,

:59:58.:00:00.

whether it's in the interests of the NHS are every -- any other part of

:00:01.:00:11.

our country. This is an uncontroversial set of meastres and

:00:12.:00:15.

I confirm my support for thd bill as it stands. Madam Deputy Spe`ker the

:00:16.:00:20.

great strides in medical schence of the last decade and further back

:00:21.:00:27.

robustly to be celebrated whth cutting-edge new treatments for life

:00:28.:00:30.

threatening and life shortening conditions, including a number of

:00:31.:00:33.

rare diseases and cancers, offering many people the hope of improved

:00:34.:00:37.

health, longer life and quality-of-life that in the past

:00:38.:00:41.

would just not have been possible. As well as the enormous bendfits it

:00:42.:00:46.

brings to patients, the indtstry it also makes an incredibly valuable

:00:47.:00:50.

contribution to the UK and ht's only right that we acknowledge that here

:00:51.:00:56.

today. But there is an inevhtable cost attached to the triumph of

:00:57.:01:00.

modern medicine and the challenge is to ensure patient access to new

:01:01.:01:03.

treatments as quickly as possible whilst ensuring value for money for

:01:04.:01:08.

the NHS. The bill seeks to `ddress some of the shortcomings and

:01:09.:01:11.

addresses clear abuses of the current system and I think will

:01:12.:01:17.

bring greater consistency to the existing arrangements for

:01:18.:01:20.

controlling the cost of medhcines, new and old and I find myself, as I

:01:21.:01:24.

have said in agreement with the proposals. It's good that so many

:01:25.:01:29.

companies recognise their responsibility for keeping the

:01:30.:01:32.

branded medicines bill in check by signing up to the pharmaceutical

:01:33.:01:37.

price regulation scheme. Under the terms of the scheme, manufacturers

:01:38.:01:38.

pay a rebate to the Departmdnt of pay a rebate to the Departmdnt of

:01:39.:01:42.

Health to cover expenditure on branded medicines above agrded

:01:43.:01:45.

limits. It's a responsible `pproach, helping to insure that patidnts can

:01:46.:01:49.

benefit from access to novel drugs anyway which is sustainable to the

:01:50.:01:54.

taxpayer. I would agree with the Secretary of State and the need to

:01:55.:02:00.

address the current disparity for by the statutory medicines pricing

:02:01.:02:03.

scheme delivers lower savings than the voluntary scheme. These

:02:04.:02:07.

differences are expected to widen, which is clearly not in keeping with

:02:08.:02:11.

the spirit of either arrangdment. So it makes sense that should be more

:02:12.:02:16.

closely aligned and, as the Secretary of State says, we have to

:02:17.:02:19.

remove the incentive to shift from one scheme to the other. I

:02:20.:02:24.

particularly welcome the proposals to strengthen the authority of the

:02:25.:02:28.

Secretary of State to intervene when on branded medicines are prhced

:02:29.:02:33.

excessively. The NHS and patients benefit immensely from medicines

:02:34.:02:39.

which where one is availabld only at high public expense becoming

:02:40.:02:43.

available farmer cheaply after the page and expires and generic

:02:44.:02:47.

products come into the markdt. We should recognise the great value

:02:48.:02:51.

that this competitive market brings, saving the NHS more than ?13 billion

:02:52.:02:57.

every year, according to thd British generic manufacturing assochation.

:02:58.:03:02.

We also know that the overall cost of generic items is increashng at a

:03:03.:03:06.

faster rate than branded itdms and have been -- there have been some

:03:07.:03:11.

outrageous increases which other honourable members have refdrred to

:03:12.:03:15.

in the price of some individual generic drugs in recent years where

:03:16.:03:18.

there is only a single comp`ny producing that drug. It looks like a

:03:19.:03:26.

clear case of profiteering for the NHS is being ripped off. Let's just

:03:27.:03:30.

of this is when a particular company of this is when a particular company

:03:31.:03:34.

takes an excessive profit from takes an excessive profit from

:03:35.:03:37.

increasing the price of the drug in increasing the price of the drug in

:03:38.:03:40.

this way. It means that othdr patients of the NHS, partictlarly

:03:41.:03:46.

those in the more marginal `reas which don't get the attention that

:03:47.:03:51.

they deserve, they lose out because there is less money to spend, less

:03:52.:03:56.

money for example on teenagdrs with mental health problems, learning

:03:57.:04:01.

disabilities, there is the cost and the price to be paid for thhs

:04:02.:04:09.

excessive profiteering and ht is utterly unethical behaviour. I hope

:04:10.:04:13.

very much that the competithon and market authority can find a way to

:04:14.:04:17.

take action against these companies, who appear to have constructed a

:04:18.:04:23.

business model to exploit this particular loophole. In number of

:04:24.:04:27.

generic medicines increased as other honourable members have said in

:04:28.:04:32.

price by more than 2000% in the last decade. The most horrific example

:04:33.:04:37.

that I came across was a medicine increasing from ?13 and 90p in 005

:04:38.:04:48.

two ?632 in 2015. A rise of more than ?600 per item dispensed. That

:04:49.:04:55.

is utterly despicable for any private company to think th`t they

:04:56.:04:58.

can do that and the Governmdnt is absolutely right to take action to

:04:59.:05:04.

end this outrageous practicd. Generic account for three qtarters

:05:05.:05:09.

of prescription items dispensed in the community, so in those cases

:05:10.:05:13.

where competition fails to deliver value for money, it is important

:05:14.:05:17.

that there are measures at our disposable -- disposal to control

:05:18.:05:23.

these prices and abuses which place intolerable pressure on NHS budgets.

:05:24.:05:27.

It makes little sense that generic medicines can be controlled the

:05:28.:05:30.

statutory scheme but that the Government is currently prevented

:05:31.:05:34.

from stepping in for companhes branded products are regulated to

:05:35.:05:39.

BPP RS. It seems clear we should remove this anomaly. I would add

:05:40.:05:43.

that in using these powers to introduce price controls, the

:05:44.:05:48.

Government should of course exercise caution and guard against any

:05:49.:05:52.

unintended consequences that may impact on the viability of smaller

:05:53.:05:55.

companies and I am sure that the Government will be alert to that.

:05:56.:06:02.

The aims and provisions of the bill are admirable but it is onlx part of

:06:03.:06:07.

a much wider debate about how we can sustain access to a ground-breaking

:06:08.:06:11.

new treatments for the NHS hs in the middle of the longest financial

:06:12.:06:15.

squeeze in its history. There was one intervention on the Govdrnment

:06:16.:06:19.

side to Secretary of State which drew attention to the fact that the

:06:20.:06:24.

total Belfour drugs is rising at an unsustainable rate. The Right

:06:25.:06:29.

honourable member four at Chelmsford also raises questions and wd have to

:06:30.:06:34.

address this. The NHS will not be sustainable at the current rate of

:06:35.:06:39.

of drugs that we are witnessing at the moment. It is no secret the NHS

:06:40.:06:47.

has struggled to adapt to ndw modern medicines, particularly those that

:06:48.:06:52.

carry a large budget impact, both any case have had great difficulty

:06:53.:06:57.

in figuring out which medichnes to approve and how those medichnes are

:06:58.:07:02.

to be afforded and brought to patients. Recently, NHS England has

:07:03.:07:05.

delayed funding for the new hepatitis C treatments that I was

:07:06.:07:10.

interested in the points made by the SNP wrappers and to live a little

:07:11.:07:16.

earlier. Despite being recolmended for use in the NHS, we also have the

:07:17.:07:21.

ongoing and deeply unsavourx case of the prep treatment. Not onlx is NHS

:07:22.:07:27.

England taking its legal ch`llenge to the bitter end to avoid having to

:07:28.:07:31.

pay for the drug, there havd also been reports of it hitting patient

:07:32.:07:35.

groups against each other bx saying that patients could miss out on

:07:36.:07:41.

vital treatments for cancer, rare diseases for children, should prep

:07:42.:07:45.

be funded. We don't want to get into this debate of comparing thd rights

:07:46.:07:49.

and interests of one group of patients against another in this

:07:50.:07:53.

way. Earlier this month, NHS England launched a consultation on proposals

:07:54.:07:59.

to change the way some drugs are funded for there is a high costs

:08:00.:08:05.

involved. Currently, NHS England are at legally required to fund drugs

:08:06.:08:11.

recommended as being clinic`lly and cost effective, normally within

:08:12.:08:15.

three months of guidance behng issued barring unique circulstances.

:08:16.:08:20.

Under the new proposals, if it is recommended a drug will bring a

:08:21.:08:24.

wreck -- estimated cost of the NHS wreck -- estimated cost of the NHS

:08:25.:08:29.

above is certain eight, ?20 million of the suggested figure, NHS England

:08:30.:08:34.

can go back and ask for longer to rule out the medicine if it's unable

:08:35.:08:37.

to agree a lower price with the manufacturer. Surely this is

:08:38.:08:41.

precisely the opposite of what we ought to be trying to achieve in

:08:42.:08:45.

terms of speedier access to new drugs that are coming on stream

:08:46.:08:50.

Ignoring questions about how that somewhat arbitrary cost of the 20

:08:51.:08:56.

million figure I referred to was arrived at, there is a concdrn that

:08:57.:09:01.

this is the creeping step towards the rationing of approved treatments

:09:02.:09:07.

in the NHS. It seems to me to be an admission in effect that thd NHS

:09:08.:09:11.

cannot afford to pay even for the drugs which are found to be

:09:12.:09:15.

have been raised by Nicholas have been raised by Nicholas

:09:16.:09:21.

Timmins, the highly respectdd observer who was a senior fdllow at

:09:22.:09:26.

the Kings fund. The great worry is that opening up the debate on how or

:09:27.:09:32.

slowly approved treatments can be adopted will put us on a slhppery

:09:33.:09:36.

slope to a new discussion on whether approved treatments should be

:09:37.:09:41.

adopted at all and, at the very least, UK patients will be further

:09:42.:09:45.

disadvantaged and the SNP spokesperson has already made the

:09:46.:09:49.

point that we compare very badly with many other countries whth more

:09:50.:09:53.

delays in getting access to new cost-effective treatments. H wonder

:09:54.:09:59.

if he recognises the fact that Western the other countries, we are

:10:00.:10:03.

one of the tiny handful that have allowed that opening price to be

:10:04.:10:07.

completely set by the pharm`ceutical industry as high as they like. I

:10:08.:10:13.

absolutely know at that point. I suppose the overall point I'm making

:10:14.:10:18.

is that given the unsustain`ble increase of the total drugs bill,

:10:19.:10:24.

given the actions that NHS Dngland are now taking, it appears `s if we

:10:25.:10:28.

are going to be any more difficult position in terms of getting speedy

:10:29.:10:32.

access to new drugs, which can be life-saving, and I think thd

:10:33.:10:38.

Government needs to reflect on this. The SNP spokesperson made this point

:10:39.:10:41.

in her speech, that this Bill tidies up things that have to be thdied up.

:10:42.:10:46.

There is a much bigger debate about how unearthed the NHS is able to

:10:47.:10:54.

afford vital treatments, whhch in other countries patients ard getting

:10:55.:10:59.

access to much sooner. It strikes me that if we are approaching `

:11:00.:11:04.

situation where we are unable to cope with new treatments th`t have

:11:05.:11:09.

been judged by an arms length expert body to be clinically effective for

:11:10.:11:13.

patients and cost-effective for the NHS then it is yet more evidence

:11:14.:11:20.

that the NHS needs more resources and I just repeat again to the

:11:21.:11:25.

Minister, he will be very shck of hearing me say it, but at some

:11:26.:11:29.

point, the Government has to recognise that we are simplx

:11:30.:11:33.

drifting towards a crash with the NHS. We face, and existenti`l talent

:11:34.:11:40.

which this debate this evenhng have highlighted. It has to be confronted

:11:41.:11:46.

at some point. I urge the Government again to consider a cross-p`rty

:11:47.:11:52.

approach so that we can achheve ultimately, any discussion with the

:11:53.:11:55.

public a long-term sustainable settlement for the NHS which

:11:56.:12:00.

recognises this dramatic increase in the cost of drugs but recognises

:12:01.:12:05.

also that all of our loved ones want to get access to those

:12:06.:12:10.

We should also be mindful of the potential impact of Brexit on the

:12:11.:12:17.

life sciences industry and the additional challenges we face in

:12:18.:12:23.

keeping the NHS medicines Bhll under control if trade between thd UK and

:12:24.:12:28.

the EU becomes subject to ctstoms duties, import VAT and borddr

:12:29.:12:33.

controls, thereby increasing costs to the life sciences industry and in

:12:34.:12:37.

turn potentially drive up the costs of new medicines to the NHS and

:12:38.:12:43.

impact access on UK patients to the most innovative treatments. Finally,

:12:44.:12:52.

we also need to make sure evaluation process and methodology are fit for

:12:53.:12:56.

purpose. Traditional appraisal methods and the notions of cost

:12:57.:13:01.

effectiveness are unsuitabld for many modern medicines, especially

:13:02.:13:05.

drugs of immense scientific innovation that target just a small

:13:06.:13:10.

number of patients but the NHS has been slow to respond. The C`ncer

:13:11.:13:16.

Drugs Fund is the case in point established as a sticking plaster

:13:17.:13:20.

after a cost of promising drugs were judged to be not cost-effective

:13:21.:13:24.

While it is almost certainlx the case many of these treatments came

:13:25.:13:30.

with too high a price to be routinely funded, few would deny

:13:31.:13:35.

they were being evaluated under outdated processes that could not

:13:36.:13:39.

for the capture of their value, many rare disease treatment suffdr from

:13:40.:13:43.

the same problem. Companies have a duty to ensure their medicines are

:13:44.:13:51.

priced but NHS England and Knives have a duty to make sure thdir

:13:52.:13:55.

evaluation processes and decision-making criteria ard fit for

:13:56.:13:57.

purpose sought new medicines are given a fair hearing what ott some

:13:58.:14:02.

of the excessive delays we have seen recently. We owe it to patidnts to

:14:03.:14:08.

make sure it happens. To conclude, I support this tidying up measure and

:14:09.:14:13.

I support in particular endhng the outrageous practice of a nulber of

:14:14.:14:18.

companies in profiteering at the expense of NHS patients. Thhs debate

:14:19.:14:23.

has also raised it much bigger issue about how we afford in this country

:14:24.:14:28.

ground-breaking treatments which keep our loved ones alive.

:14:29.:14:36.

It is a pleasure to speak in support of the medical supplies costs bill

:14:37.:14:42.

which affects my constituents in North Wales as it applies UK wide.

:14:43.:14:47.

It is an example of the Govdrnment responding reasonably quickly to

:14:48.:14:51.

issues brought to its attention and it deserves credit that. My

:14:52.:14:56.

principal reason for supporting this bill relates to the vast increase in

:14:57.:15:02.

cost of certain of patented drugs. As we heard, and also the ilpact of

:15:03.:15:08.

those. I first had contacts from constituents in June about `

:15:09.:15:14.

loophole in existing regulations leading to some generic drugs being

:15:15.:15:20.

high price up to 12,000%. This fall on from the Times investigation 50

:15:21.:15:28.

drugs were identified, costhng 262 million a year for the NHS. That

:15:29.:15:32.

practice followed on. The epuivalent of 7000 junior doctors. There has

:15:33.:15:39.

not been similar price incrdases are coming in mainland Europe or I do

:15:40.:15:43.

not believe there has been, which tends to suggest we have sole

:15:44.:15:49.

fielders in our own regulathons We also discussed this matter hn the

:15:50.:15:54.

select committee and saw evhdence of correspondence which highlighted it

:15:55.:15:59.

for at least one year. We should not just refer to costs, there `re also

:16:00.:16:05.

real big impact on patients themselves when they have the drugs

:16:06.:16:11.

withdrawn from them. The issue hits home particularly for me whdn I make

:16:12.:16:15.

a constituents at the surgery of mine in the summer and she has given

:16:16.:16:21.

me permission to talk about her story. She was diagnosed with

:16:22.:16:27.

hypothyroidism, and underactive thyroid, in 2006 and had typical

:16:28.:16:32.

symptoms of weight gain, here are stunning, brittle nails, tiredness,

:16:33.:16:37.

peeing all over and a low moods and was prescribed the usual trdatment

:16:38.:16:43.

in such circumstances. She was also given a cocktail of other drugs

:16:44.:16:49.

because the other drug did not work so she was on quite strong

:16:50.:16:53.

medication for an extended period of time. She saw her endocrinologist

:16:54.:17:02.

and 2014 and he started a dhfferent drug which she described as an

:17:03.:17:07.

absolute revelation and she said she was so much better than four years

:17:08.:17:11.

and brain fog lifted at energy levels soared. When she tridd to

:17:12.:17:15.

reduce the dose of the drug she found her symptoms began to return

:17:16.:17:20.

and had to have some time off work. She is now a teaching and c`retaker.

:17:21.:17:28.

The daughter she is taking now was acquired from a company in 0992 and

:17:29.:17:39.

to put the costs into perspdctive, a packet of this drug in 2011 was ?34

:17:40.:17:47.

65 and this year it is ?250 20. A 645% increase which is a relatively

:17:48.:17:54.

insignificant compared to some of the other examples but is still an

:17:55.:18:02.

example of a really quite significant increase nevertheless. I

:18:03.:18:06.

understand drugs that work costing ?3.4 million a year in 2010 now cost

:18:07.:18:11.

the NHS over 20 million. My local health board is on .gov --

:18:12.:18:18.

understandably concerned as other elements of the NHS also ard and is

:18:19.:18:25.

looking into withdrawing thhs drug. For my constituents that makes

:18:26.:18:28.

anxious and she is worried `bout the impact on her colleagues if she

:18:29.:18:34.

cannot work and her pupils `nd she has two children of her own as well.

:18:35.:18:41.

The Department of Health as the competition and market authority to

:18:42.:18:43.

investigate this issue which may or may not result in a good outcome but

:18:44.:18:48.

it is not a sustainable way forward. It will much about the loophole or

:18:49.:18:51.

stop the same thing happening again which is why we need this

:18:52.:18:59.

legislation. The generic market is generally competitive with fair

:19:00.:19:03.

prices for all and I believd it comprises of ?4 billion of the 15.2

:19:04.:19:09.

billion spent by the NHS on drugs per annum or ?4 billion is ` 20

:19:10.:19:14.

rise over the past five years. There is a statutory system which can in

:19:15.:19:19.

theory control prices of both branded and non-branded drugs

:19:20.:19:23.

however there is the loophole is discussed. The loophole involves all

:19:24.:19:29.

generics are available usually via one manufacturer or supplier which

:19:30.:19:35.

also market branded drugs and is a member of the voluntary regtlation

:19:36.:19:40.

scheme, PPRS, in relation to these. Their membership of the PPRS means

:19:41.:19:44.

under existing legislation they cannot currently be subject to the

:19:45.:19:49.

statutory scheme, even for the generic drugs. There are concerned

:19:50.:19:54.

this loophole has been exported by some and, indeed, it has potentially

:19:55.:20:01.

been a delivers business model to purchase off patented medichnes for

:20:02.:20:05.

which there are no competithve manufacturers, in other words, where

:20:06.:20:10.

there is no competition. Yot might ask why with other drug companies

:20:11.:20:15.

not seek to manufacture these drugs if they are being sold for such

:20:16.:20:20.

large quantities. Introducing new competition is not always fdasible

:20:21.:20:26.

due to the time taken to obtain and licensing due to often small size of

:20:27.:20:31.

the market once they are produced and also of due to a diffictlt

:20:32.:20:36.

manufacturing process. I support change in primary road legislation

:20:37.:20:42.

to the 2006 act which would allow Government to consult and bring

:20:43.:20:45.

forward enforcement of statttory controls on all generic drugs to

:20:46.:20:50.

require, if necessary, comp`nies to reduce the price of drugs or for

:20:51.:20:52.

other controls to be imposed. This other controls to be imposed. This

:20:53.:20:57.

amounts to an extension of dxisting deterrent power was the secretary of

:20:58.:21:01.

state has not yet used to dhrect the prices of drugs which already fall

:21:02.:21:07.

under the statutory scheme. Assuming Royal assent of this bill in early

:21:08.:21:12.

2017 we would then need investigations and discussions with

:21:13.:21:14.

the companies concerned where that have been issues raised and it is

:21:15.:21:19.

important we are fair not only to the taxpayer but also to thd

:21:20.:21:23.

companies. If not, the ultilate risk remains the product should be taken

:21:24.:21:29.

off the market. For my constituents, where is she left? She is hoping

:21:30.:21:34.

this bill goes through, she will also be looking to BCMA to come

:21:35.:21:40.

forward with some good news. -- the CMA. She may be tempted to purchase

:21:41.:21:48.

the drug from abroad or onlhne. I think interim agreements allow

:21:49.:21:54.

patients like her to continte to receive her prescription nedds to be

:21:55.:21:59.

considered and if the Government does feel that the drugs can be

:22:00.:22:04.

acquired from abroad at a mtch better rate than people likd her

:22:05.:22:08.

would appreciate if that cotld be assisted. I think for all, ` routine

:22:09.:22:12.

and systematic monitoring of drug costs is good to be important. There

:22:13.:22:17.

are two other principal elelents of the bill which I will briefly

:22:18.:22:22.

referred to. Secondly, therd are changes to the statutory scheme

:22:23.:22:27.

proposed and in autumn 2015 the secretary of state consultant on

:22:28.:22:31.

strengthening the statutory scheme. This bill proposes to bring

:22:32.:22:36.

statutory scheme in line with the voluntary 2014 PPRS for all those

:22:37.:22:41.

manufacturers or supplier is not PPRS members. There are 166

:22:42.:22:47.

within the PPRS and ?8 billhon and within the PPRS and ?8 billhon and

:22:48.:22:55.

is currently sped through a mechanism and ?647 million `rt

:22:56.:22:57.

brought back to the taxpayer each year when the agreed cap has been

:22:58.:23:03.

exceeded. There are just 17 companies within the statutory

:23:04.:23:07.

scheme through which ?1 billion is spent. There is evidence of

:23:08.:23:11.

companies switching from thd voluntary to the statutory scheme

:23:12.:23:17.

for financial reasons, meanhng an annual ?88 million annual loss to

:23:18.:23:22.

the taxpayer. These companids should be. -- are mostly small and non UK

:23:23.:23:27.

based. Changes to the schemd will require companies to make p`yments

:23:28.:23:30.

back to the Department of Hdalth based on level of sales to the NHS.

:23:31.:23:34.

This can be in addition to other mechanisms. Whereas the existing

:23:35.:23:41.

statutory scheme operates vha a cut to the public, splice currently set

:23:42.:23:47.

at 15% so the existing schele and brings in less money but also result

:23:48.:23:53.

in an equity to companies, risk to supply and uncertainty of fhnancial

:23:54.:23:57.

outcomes for complex reasons that I will not go into. But, so the bill

:23:58.:24:05.

proposes new penalties for noncompliance and recovery of

:24:06.:24:09.

payments owed to the courts. Ultimately, this bill creatds a more

:24:10.:24:12.

level playing field between companies in the two schemes and it

:24:13.:24:16.

merely extends what is in place for the vast majority of companhes so I

:24:17.:24:21.

do not see it as being in any way unreasonable and I do not bdlieve

:24:22.:24:24.

there should be major concerns regarding the impact on resdarch and

:24:25.:24:28.

investment. The third part of the bill refers to inflammation powers

:24:29.:24:32.

and that brings together thd information requirements for NHS

:24:33.:24:37.

medicines and other supplies in the NHS act. It enables the Govdrnment

:24:38.:24:42.

regulations to obtain inforlation on the sales and purchases of ledicines

:24:43.:24:46.

and other supplies from all parts of the supply chain, manufacturing and

:24:47.:24:51.

distribution, pharmacy to ddfine purposes. This will improve the data

:24:52.:24:55.

which informs reimbursement arrangements for the communhty

:24:56.:24:58.

pharmacy and GP practices. Ht will also help to ensure value for money.

:24:59.:25:05.

These are positive proposals but it is important they are not over

:25:06.:25:08.

bearing on the companies concerned. In particular, I want to make the

:25:09.:25:13.

case for medical technology and devices businesses as they have not

:25:14.:25:17.

been subject to such data collection in the past the secretary of state

:25:18.:25:20.

has given us some reassurance about that today but we need to rdcognise

:25:21.:25:24.

a large proportion of these businesses, maintaining percent our

:25:25.:25:29.

SMEs supplement to work with industry to develop approprhate

:25:30.:25:35.

regulations. We need to avohd onerous and routine data collection

:25:36.:25:40.

is going beyond existing data required by future Massey. H support

:25:41.:25:45.

the principles of this bill and the Association of British

:25:46.:25:47.

pharmaceutical industry largely support it also but the det`il will

:25:48.:25:50.

be subject to consultation during be subject to consultation during

:25:51.:25:53.

2017 and I look forward to scrutinising progress over the

:25:54.:25:58.

coming months. It is a pleasure to form up my

:25:59.:26:04.

honourable friend. And if you're much of the points he has m`de. One

:26:05.:26:10.

point he bit was about how 252 million being spent by the NHS and

:26:11.:26:18.

50 drugs. It is actually 262 million extra backs to the increase in

:26:19.:26:24.

prices. That really brings home the problem this is causing and why we

:26:25.:26:30.

need to look at this bill again Devon the many members have already

:26:31.:26:33.

focused on a range of areas I wanted to focus on the issue of generic

:26:34.:26:39.

drugs and some of the huge price increases we have seen. It hs right

:26:40.:26:44.

to say and I've audit following the intervention of the member from

:26:45.:26:50.

Wolverhampton South West, actually, it is not unreasonable for `

:26:51.:26:53.

pharmaceutical company to m`ke a profit in exchange for investment it

:26:54.:26:58.

has made to develop a new drug and bringing to market. That is what

:26:59.:27:02.

operating system is therefore. The paper is there to protect for a

:27:03.:27:05.

period of time the ability for the company to charge a reasonable price

:27:06.:27:09.

to reflect the risk and invdstment. The keyboards at about the struggles

:27:10.:27:14.

of the out of the pit. They are drugs no longer patented. The

:27:15.:27:19.

company had a reasonable period of time to make investment bank and

:27:20.:27:23.

there is a limited supply and therefore it is on the road we go in

:27:24.:27:28.

and deal with what is an emdrging business. There is 02 bits `bout

:27:29.:27:35.

that. Some of the names the list -- there are no two ways about that.

:27:36.:27:39.

Some of the companies are consistently having unusually high

:27:40.:27:44.

increases in prices and it hs clearly business model is ddveloping

:27:45.:27:47.

to take advantage of the loophole and at the end of the day not to

:27:48.:27:52.

make a profit but to property and to property of the energy -- of the NHS

:27:53.:28:00.

-- to property of the NHS. We can all think of instances were drug

:28:01.:28:04.

company lobbying points the patient is unable to get treatment `nd this

:28:05.:28:08.

is the sort of thing that mdans people cannot get treatment. Here we

:28:09.:28:18.

are as Conservatives are dohng prose controls but it is clear thhs is not

:28:19.:28:23.

about intervening in a markdt, it is about market failure. Where the

:28:24.:28:26.

normal procedures of compethtion are not producing fair or reasonable

:28:27.:28:33.

outcomes either for the NHS patient we are providing products on behalf

:28:34.:28:39.

of all. I saw the amazing work done on brain tumour research at Plymouth

:28:40.:28:44.

University recently and saw some of the skills and ground-breakhng

:28:45.:28:49.

research they use that bring real benefits but that is not thd

:28:50.:28:52.

business model of these particular companies, the model is to look for

:28:53.:28:57.

a drug that is to be prescrhbed and has one supply, buy it, get hold of

:28:58.:29:01.

the supply and increase price. That is nothing to do with delivdring new

:29:02.:29:07.

and products. For me this bhll is very welcome and its propos`ls to...

:29:08.:29:20.

And if you are putting to look up your product 12,000%, you whll not

:29:21.:29:29.

be co-operative into an enqtiry The Secretary of State will havd powers

:29:30.:29:31.

to require more information to be supplied. I give way. I am grateful

:29:32.:29:38.

to my new friend, another socialist, for giving way. Can I suggest other

:29:39.:29:44.

areas of the economy where his Christian Democrat fellows would be

:29:45.:29:52.

prepared to address profitedring? Well, I thank him, he tempts me but

:29:53.:29:58.

seeing Mr Deputy Speaker is in the chair, it is tough on relathve

:29:59.:30:02.

points going off the subject and I could be dangerous territorx. We

:30:03.:30:10.

have seen work government h`s done in other sectors, the energx sector

:30:11.:30:17.

but this is a unique practice where there is only one customer, the NHS

:30:18.:30:21.

in large part, and where thdre is only one supplier. I'm struggling to

:30:22.:30:26.

think of other industries that replicate that but that is why these

:30:27.:30:32.

price rises are disgraceful and this industry is about profiteerhng of

:30:33.:30:36.

illness and pain. I briefly give way. Can I suggest another hndustry

:30:37.:30:43.

where it is worth looking at, the defence Supply industry. Parts of

:30:44.:30:48.

it. I thank him for the intervention. I have spent plenty of

:30:49.:30:54.

time looking through examplds of defence procurement that have gone

:30:55.:31:00.

wrong although to be fair to the minister, he may be new to the

:31:01.:31:03.

health department but not the issues of tackling in defence proctrement.

:31:04.:31:09.

It is noticeable that most of the issues making their way for the

:31:10.:31:13.

review of what went wrong otr legacy issues that were still -- wd are

:31:14.:31:19.

still dealing with rather than the modern procurement. I'm conscious we

:31:20.:31:24.

do have the Deputy speaker hn the chair and I need to get back to the

:31:25.:31:30.

price of drugs. It is clear from looking to the evidence that the

:31:31.:31:34.

current system of regulation is not effective given that you can put

:31:35.:31:38.

branded projects into the voluntary scheme and use that to jack up costs

:31:39.:31:43.

for your generic products. @nd that is not right. As other membdrs said,

:31:44.:31:50.

we are all facing demands on the NHS and I have no problem with companies

:31:51.:31:54.

who give good service charghng a fair price and making a fair return.

:31:55.:31:59.

But that is clearly not what is going on with this business model

:32:00.:32:04.

and we can see numerous exalples, especially the chart in the library

:32:05.:32:08.

showing thousands of percents across a number of products. It is

:32:09.:32:12.

impossible to believe the thousands of % increases are going on in any

:32:13.:32:19.

of the input materials to this products. This is vagrant

:32:20.:32:23.

racketeering and profiteering going on at the expense of patients and

:32:24.:32:29.

people in pain. Even if the drug is still provided, it is money and

:32:30.:32:31.

resources that should have been spent elsewhere. That is whx pleased

:32:32.:32:38.

to see the unanimity breaking out in the house this evening around these

:32:39.:32:41.

proposals although there is a need to discuss them in more det`ils in

:32:42.:32:47.

committee but this bill is the right time, it is not about tacklhng

:32:48.:32:50.

legitimate profits, it is about getting rid of profiteering and it

:32:51.:32:57.

has my full support. It is ` pleasure to be called to spdak in

:32:58.:33:02.

this debate today and to follow my honourable friend from Torb`y. From

:33:03.:33:06.

what I understand, it will close the loopholes and gaps that exist in the

:33:07.:33:12.

current powers given to the Secretary of State and my friends

:33:13.:33:17.

before me have highlighted the loopholes and gaps. Overall the

:33:18.:33:23.

measures are important to ensure we have value for the taxpayer across

:33:24.:33:29.

the medicines budget. But where I take issue with the proposals is the

:33:30.:33:35.

inclusion of medical supplids, other related products. As part of the

:33:36.:33:42.

third element of the bill. This element introduces a new information

:33:43.:33:46.

power for the Secretary of State and while I welcome this in principle,

:33:47.:33:52.

it may be own arrest for sm`ll enterprises that supplied to this

:33:53.:34:00.

side of the business. I am sure much of the required information has been

:34:01.:34:07.

collated by each company but it s important it can be transmitted in

:34:08.:34:13.

an easy and timely fashion. I was listening carefully to the Secretary

:34:14.:34:16.

of State and he implied he does not want the measures he suggests to be

:34:17.:34:22.

burdensome but I seek the mhnisters assurance on this issue. Dods my

:34:23.:34:32.

honourable friend, it is thd ability to use the data effectively that is

:34:33.:34:37.

important, there is no point in collecting data and not being able

:34:38.:34:45.

to use it. I give way. Coupling those two together, does shd agree I

:34:46.:34:50.

be advisable for the governlent to look at a threshold, a turnover

:34:51.:34:53.

threshold below which this information were not have to be

:34:54.:34:59.

supplied or might be supplidd to a lesser extent and quantity

:35:00.:35:02.

addressing the issue of how homeless this might be but could address

:35:03.:35:07.

issues of whether the government has the capacity to crunch the figures.

:35:08.:35:14.

He makes a good point, therd is a cut off for some of the dat`

:35:15.:35:19.

collection or different parts in existence and it might be ?4 million

:35:20.:35:25.

turnover but we can get clarification on that. What concerns

:35:26.:35:28.

me more is who will define what is classified as a medical supply and

:35:29.:35:39.

other related products? As we heard, in an intervention, really ht is how

:35:40.:35:45.

long is that piece of string? Section 264 supplements and it

:35:46.:35:54.

requires the Secretary of State to consult anybody like the Association

:35:55.:36:00.

of the pharmaceutical industry which appears to represent manufacturers

:36:01.:36:04.

and distributors and supplidrs of health service medicines, mddical

:36:05.:36:06.

supplies or related products acquired for the purposes of the

:36:07.:36:11.

health service in England or the UK before making any regulations under

:36:12.:36:19.

section 264 a or B. But, if the definition of supplies is unclear,

:36:20.:36:22.

how would the Secretary of State know who to consult with? Hd

:36:23.:36:27.

indicated he has had discussions with medicine and medical ddvice

:36:28.:36:32.

suppliers but I fear there lay be more product areas out therd that

:36:33.:36:36.

have been missed out of the initial discussions. I ask the Secrdtary of

:36:37.:36:42.

State to provide guidance on what he understands as medical supplies and

:36:43.:36:48.

other related products. For example, does it include in vitro di`gnostic

:36:49.:36:59.

products or IVDs? So, if it includes IVDs, does he agree to constlt with

:37:00.:37:05.

the Association, the trade association which represents this

:37:06.:37:11.

industry across the UK? This is an important area for the life sciences

:37:12.:37:15.

industry with nearly 900 million pathology tests performed every

:37:16.:37:20.

year. And with 70% of every clinical decision being made using some form

:37:21.:37:26.

of IVD. If they are included, we need to be around the table to

:37:27.:37:33.

participate. I wish to conclude by saying in general terms I al in

:37:34.:37:37.

favour of this bill as it is ensuring good value for mondy for

:37:38.:37:40.

taxpayers and ultimately for patients. That is what we nded to be

:37:41.:37:46.

thinking about, the patient. However, there does need to be some

:37:47.:37:50.

clarification throughout thd bill which will be sought out at

:37:51.:37:55.

committee stage and I support the bill tonight. Thank you. It is a

:37:56.:38:02.

pleasure to follow my honourable friend. We know old ground, the

:38:03.:38:13.

ageing population, the costs bearing down which other members alluded to

:38:14.:38:19.

earlier. We know the advancds in science are going quicker than we

:38:20.:38:26.

can make the legislation. One of my local CCGs suffered an exorbitant

:38:27.:38:32.

increase in capsules having to find another 600,006 months. Needing to

:38:33.:38:39.

look at drugs more widely, the honourable member from South Suffolk

:38:40.:38:43.

mentioned if paracetamol was not prescribed in that CCG it would save

:38:44.:38:48.

?1 million a year. The meastres in the bill aimed to manage thd cost of

:38:49.:38:53.

drugs. The measure to make dfficient data correction is also most welcome

:38:54.:39:00.

so that we start to have a decision-making based on evhdence.

:39:01.:39:05.

Last autumn the Secretary of State consulted publicly on how to address

:39:06.:39:09.

the problem of excessively priced unbranded medicines and the industry

:39:10.:39:14.

fed back. They were glad of the dialogue. Drug costs are

:39:15.:39:19.

unsustainable. A saving of 80 million per health area was

:39:20.:39:26.

identified, my only CCG could save ?1 million per annum from an repeat

:39:27.:39:30.

prescriptions. Nationally, ht would mean more than 12,000 more community

:39:31.:39:35.

nurses could actually be employed. We need to start making these

:39:36.:39:39.

decisions where we want to be spending the money. The pressure on

:39:40.:39:45.

social care, as was alluded to, I decisions we are going to h`ve to

:39:46.:39:49.

make as a government, and as patients. The current systel allows

:39:50.:39:54.

for some to be in and others to be outside the system and it lhmits the

:39:55.:39:59.

robustness and I support it wholeheartedly. Does not target

:40:00.:40:02.

those who do not play fair `nd we need to stamp down on it. It is

:40:03.:40:07.

those better patient outcomds that I'm passionate about. We all play a

:40:08.:40:12.

part including the pharmacist industry because of the unipue

:40:13.:40:15.

industry in this country. The industry is important to us as the

:40:16.:40:23.

member for Chelmsford and South West Bedfordshire and the Cities of

:40:24.:40:26.

London and Westminster have alluded to, we need to be supportivd of the

:40:27.:40:31.

companies that work positivdly for patients and engage in trying to

:40:32.:40:37.

find solutions. The Association of British pharmaceutical industry

:40:38.:40:39.

supports the government in increasing powers where market

:40:40.:40:43.

failure has occurred. There is a balance between ensuring new drugs

:40:44.:40:48.

are developed which brings le to off label drugs, those that havd another

:40:49.:40:52.

use the which they were originally formulated.

:40:53.:41:03.

Many drugs originally developed for morning sickness but have bden found

:41:04.:41:09.

latterly to be very benefichal for the treatment of some cancers and

:41:10.:41:14.

skin conditions. We need to understand these new uses for

:41:15.:41:19.

approved drugs for the speediest of transitions from bench to bddside.

:41:20.:41:23.

As they have not been through trials yet, we also need to be mindful this

:41:24.:41:28.

is not a new drug, and just because the target... Drug should bd costed.

:41:29.:41:40.

Does she remember the time that was spent last November debating the

:41:41.:41:47.

offer patented drugs bill and when I flagged up the concern that for a

:41:48.:41:52.

doctor prescribing a drug whth a license for use takes precedence

:41:53.:41:55.

over and off Peyton drug whhch may do the same and with this g`ming we

:41:56.:42:01.

have seen, there is a concern that the drug companies will twe`k a drug

:42:02.:42:05.

in a slight manner and sell it to the NHS at hundreds of thousands

:42:06.:42:11.

when an offer patented drugs would do the same and that has not been

:42:12.:42:12.

dealt with. I thank her after making thd point

:42:13.:42:21.

so succinctly. I am also gr`teful for the Secretary of State for the

:42:22.:42:25.

clarification and the honourable member comments around the

:42:26.:42:28.

technology industry which I do believe need looking at. I would be

:42:29.:42:34.

grateful to know that the s`vings made are likely to be reinvdsted

:42:35.:42:39.

into patients particularly given my position as chair of the APG on

:42:40.:42:42.

personalised medicine into the latest medicines and treatmdnt. This

:42:43.:42:47.

Bill is designed to stop individuals making vast sums of money and taking

:42:48.:42:51.

advantage of a loophole and I backed the Government's aim of valte for

:42:52.:42:56.

money and fair prices for optimum patient outcomes. I am heartened to

:42:57.:43:00.

see the cross-party support for this Bill and look forward to seding it

:43:01.:43:09.

to make positive progress. Thank you, Mr Deputy Speaker. I would like

:43:10.:43:13.

to thank those members who lade contributions to the debate today.

:43:14.:43:17.

We find ourselves in a situ`tion where we have some time avahlable

:43:18.:43:22.

which is amazing. What we rdfer to the interventions that we hdard in

:43:23.:43:26.

the early part of the debatd because I think there have been a r`nge of

:43:27.:43:29.

interesting points. The honourable member for Totnes rage the view that

:43:30.:43:36.

it gives the opportunity to that that drugs that have not bedn

:43:37.:43:44.

licensed, but so needed eye that group of people. And I was pleased

:43:45.:43:48.

to hear the Secretary of St`te say that he would look at that. My

:43:49.:43:55.

friend Wilbur Hampton Southwest -- Wolverhampton South West. In a

:43:56.:43:59.

number of quite a music interventions has talked about a

:44:00.:44:04.

policy on profit control of the farm sector and said that the party of

:44:05.:44:07.

Sid is marching on to the cdntre ground and perhaps gone past the

:44:08.:44:16.

march of dissent. -- opposite. The member for Leicester East

:44:17.:44:18.

particularly talked about the proportion of the NHS budget spent

:44:19.:44:23.

on diabetes, he was concerndd about the increase in the drugs Bhll and

:44:24.:44:27.

suggested the use of structtred interventions, not just for drugs

:44:28.:44:29.

for those people because it is such a large proportion of the NHS Bill

:44:30.:44:37.

that is spent on diabetes. Honourable friend for Alan `nd

:44:38.:44:40.

Deeside made the point that we need to make sure that measures of this

:44:41.:44:43.

Bill do not act as a disincdntive for Pharma companies to makd

:44:44.:44:50.

contributions to companies. I think many of the members contribtting to

:44:51.:44:53.

make know we are walking thd line here in terms of making savhngs but

:44:54.:44:57.

making sure there aren't disincentives. The red honotrable

:44:58.:45:00.

member for Chelmsford welcoled the Bill. He talked about our ageing

:45:01.:45:04.

conch dashed back on probathon and we talked about that. The ilportance

:45:05.:45:10.

of new drugs but they need to deal with unacceptable profiteerhng and a

:45:11.:45:14.

number of members of refer to that. The honourable lady for Central

:45:15.:45:17.

Ayrshire talked about having the biggest research network in the

:45:18.:45:20.

world but topped about change and talked that the Pharma comp`nies

:45:21.:45:26.

would be anxious and... She welcomed the tidying up aspect of thd Bill

:45:27.:45:29.

and I think that was a general view that members on all sides of the

:45:30.:45:33.

housework not. She talked and the number of members have done in this

:45:34.:45:38.

debate about not just in a building the management of cost pressures but

:45:39.:45:41.

doing something more radical and I think that has been a real flavour

:45:42.:45:46.

of this debate. Using this `s an opportunity to do something

:45:47.:45:50.

different, I agree with her concerns about the data collection aspects of

:45:51.:45:53.

the Bill and I will say mord about that. But I also agree that we need

:45:54.:45:57.

to do something more radical and for instance she talked about t`ckling

:45:58.:46:01.

the five-year delay to access new medicines and rightly points out

:46:02.:46:04.

that that is probably where or poorest survival rates are coming

:46:05.:46:08.

from. The honourable member for Southwest at Fisher commenddd the

:46:09.:46:13.

Times for investigating this issue we are talking about that tonight.

:46:14.:46:15.

Also talked about the inforlation powers. He talked about was of the

:46:16.:46:19.

Department for health at thd analytical ability to use the data

:46:20.:46:23.

being gathered and that is `n important question. If new data is

:46:24.:46:26.

being required to be gatherdd what are we going to do with the? The red

:46:27.:46:31.

honourable member per in West Norfolk acknowledge the valte of the

:46:32.:46:34.

competitive market but also talked about the sometimes outrageous

:46:35.:46:37.

increases in the price of gdneric drugs and we have heard somd

:46:38.:46:40.

staggering examples today including the example of a rise of ?600 per

:46:41.:46:45.

item dispensed in one particular case. He hoped as other members have

:46:46.:46:50.

that the Competition and Markets Authority would take action and I

:46:51.:46:53.

think that has been a key theme tonight. He talked also abott not

:46:54.:46:57.

wanting to fit the needs and interests of some patients were

:46:58.:47:00.

needing drugs like prep versus other needed drugs and I agree. I don t

:47:01.:47:05.

think we want to go there. He also talked about the fact that this is a

:47:06.:47:09.

slippery slope when we get hnto debating whether to delay adopting

:47:10.:47:14.

even approved treatments. In his view that is more evidence that the

:47:15.:47:17.

NHS needs more resources. The honourable member Clwyd talked about

:47:18.:47:23.

the impact on his constituent of a drug prescribed to her which helps

:47:24.:47:25.

her work and increases energy levels but the cost of which has increased

:47:26.:47:31.

by 645% and we must keep focus on the impact of individuals of the

:47:32.:47:34.

decisions that we make becatse having found a drug that suhts her

:47:35.:47:37.

it would be dreadful that w`s withdrawn. He also talked about the

:47:38.:47:43.

difficulties of increasing new competition into the market. His

:47:44.:47:46.

constituent is hoping the Bhll goes through as are many tonight and for

:47:47.:47:50.

action on competition and m`rkets and let's all hope that goes

:47:51.:47:54.

through. The honourable member for Torbay talked about intervening to

:47:55.:47:57.

deal with market failure and his view was that we need to separate

:47:58.:48:03.

out the companies that are doing good research, brain tumour research

:48:04.:48:06.

that he has seen recently, `nd those that are having nothing to do with

:48:07.:48:08.

producing new and innovativd products but are just making money.

:48:09.:48:15.

Will my friend give way? Can I cite her and he has the library brief

:48:16.:48:18.

because it isn't exactly as cut and dry as the honourable member for

:48:19.:48:22.

Torbay may have been thinking. The library brief tells us that the

:48:23.:48:27.

competitions and market authority took action against pharmacdutical

:48:28.:48:30.

companies with regards to gdneric pricing. Glaxo Smith Kline `nd a

:48:31.:48:35.

number of other companies wdre fined 45 million when it was found that

:48:36.:48:38.

payments had been made in order to prevent the added. The situ`tion

:48:39.:48:43.

being offered on the market. So SmithKline is a great Pharm` company

:48:44.:48:48.

incomes are turning up of ndw drugs that crossed the line in thhs case

:48:49.:48:51.

according to the library brhefs with is not either or. No, but I think

:48:52.:48:57.

the honourable member for Torbay was talking about companies that are not

:48:58.:49:01.

even doing research, just btying up generic drugs and profiteerhng. I

:49:02.:49:04.

think generally that has bedn a condemnation on all sides of that. I

:49:05.:49:10.

thank the Shadow Minister forgiving way. To be clear I think shd

:49:11.:49:14.

probably agreed that it is names that keep on popping up particularly

:49:15.:49:18.

in the Times investigation of companies who seem to be quhte

:49:19.:49:23.

regularly revolve in the most eye watering price increases and this is

:49:24.:49:26.

about tackling anyone else who might be thinking about going down that

:49:27.:49:30.

business model out of explohting the NHS. Very much so. The honotrable

:49:31.:49:36.

member for Bury Saint Edmund welcomed the Bill talked about the

:49:37.:49:41.

fact that individual CCG 's could actually save ?1 million with unused

:49:42.:49:46.

repeat prescriptions, so thdre clearly are a number of isstes here

:49:47.:49:49.

in terms of savings that cotld be made and also talked about the

:49:50.:49:54.

pressure on social care. I join her in being concerned about prdssures

:49:55.:49:57.

on social care, although thd honourable member perchance bird

:49:58.:50:01.

talk further about an ageing population and the need for drugs,

:50:02.:50:06.

older people also don't need to be isolated. It is worrying th`t 1 ,000

:50:07.:50:11.

cases of malnutrition were found last year with an average age of 64

:50:12.:50:17.

among those cases. People nded to social care and I hope the new

:50:18.:50:21.

Chancellor will listen and this year bring forward funding for social

:50:22.:50:24.

care in the Autumn Statement, because people do need thesd drugs.

:50:25.:50:31.

As my right honourable friend made earlier, Labour supports thd broad

:50:32.:50:34.

aims of this Bill and what the Government is seeking to achieve in

:50:35.:50:38.

terms of better control over the cost of medicines, however `s he

:50:39.:50:40.

also outlined we have a number of concerns. I have a list. In his

:50:41.:50:47.

closing speech is concerns... We do have concerns about some me`sures in

:50:48.:50:50.

the Bill. As well as the understandable measures to collect

:50:51.:50:53.

pharmaceutical data and man`ge costs, the Bill also introdtces

:50:54.:50:58.

provisions to manage the purchase of other medical supplies. I w`s glad

:50:59.:51:02.

to hear the Secretary of St`te raise the issue of the impact on the

:51:03.:51:05.

medical supply sector which he did in his opening speech. I have had

:51:06.:51:10.

concerns expressed at the mddical technology sector seeing thd new

:51:11.:51:12.

information measures as owndrs for the sector and the honourable member

:51:13.:51:17.

for error was mentioned that in the debate also. There is a concern that

:51:18.:51:22.

measures in the Bill filter taken to the account the unique

:51:23.:51:26.

characteristics medical devhces in the medical device industry and they

:51:27.:51:28.

hope they will start to be taken into account as the Bill progresses.

:51:29.:51:31.

That is seen to be a danger that the measures included in the Bill will

:51:32.:51:35.

put additional burdens on the sector and the NHS and actually le`d to

:51:36.:51:38.

higher costs. I hope that is not the intention of the Government. But we

:51:39.:51:42.

be Dick is to be increasing costs in a Bill that was trying to m`nage

:51:43.:51:45.

them. -- it would be ludicrous. We need to bear in mind that the

:51:46.:51:50.

medical technology industry are poised around 89,000 people in the

:51:51.:51:53.

UK and an annual turnover of more than 70 billion and hesitancy

:51:54.:51:57.

implement growth of 11% in recent years. 99% of UK's 3300 medhcal

:51:58.:52:03.

technology firms are small `nd medium enterprises and 85% of them

:52:04.:52:08.

having a turnover of less than million. And so might honourable

:52:09.:52:14.

friend talked about cap levdls at which or data could be colldcted.

:52:15.:52:17.

That is a lot of small comp`nies and we need to bear that in mind. The

:52:18.:52:21.

Bill imposes a regulatory btrden on all companies in the supply chain

:52:22.:52:25.

and the reporting requirements will and the reporting requirements will

:52:26.:52:28.

affect all firms producing ledical supplies including those very small

:52:29.:52:33.

organisations. The issues wd have discussed extensively in thhs debate

:52:34.:52:37.

on pharmaceutical pricing, they bear no relation to the price of other

:52:38.:52:40.

medical supplies and the honourable member opposite gave an exalple of a

:52:41.:52:44.

particular type of product. But they do seem to be treated the s`me way

:52:45.:52:49.

in this Bill. In terms of the scale of the burden being imposed the

:52:50.:52:51.

Government's impact assessmdnt is Government's impact assessmdnt is

:52:52.:52:55.

not much help. It says the lain costs will be on manufacturdrs,

:52:56.:52:59.

wholesalers and dispensers. These costs about been quantified as the

:53:00.:53:00.

magnitude will not be known until magnitude will not be known until

:53:01.:53:03.

after consultation with subsequent regulations. It seems and I think

:53:04.:53:08.

other members have referred to this that measures have been bolted onto

:53:09.:53:12.

this Bill at the last minutd. But because they could have a ndgative

:53:13.:53:16.

impact on sectors like the ledical technology sector, we need to be

:53:17.:53:20.

very aware of them. The new information power is being proposed

:53:21.:53:22.

by the Government are being put forward at a time when manufacturing

:53:23.:53:26.

firms are going through the uncertainty around this country

:53:27.:53:29.

leaving the EU and these me`sures can only add to that uncert`inty

:53:30.:53:34.

because as I have said, 99% of the medical technology firms ard SMEs

:53:35.:53:39.

with 85% having a turnover of less than ?5 million. Notes on the

:53:40.:53:43.

financial implications of the Bill put forward a curious posithon that

:53:44.:53:46.

no policies will be directlx into mentored as a result of these

:53:47.:53:50.

changes. Their implementation would require additional future changes to

:53:51.:53:54.

secondary legislation and additional impact assessments to assess their

:53:55.:53:59.

cost effectiveness. Ministers have actually asking the House to change

:54:00.:54:02.

primary legislation to give government new information powers

:54:03.:54:06.

but the details and the imp`ct of the new powers on the supplx chain

:54:07.:54:11.

will only emerge in future. And that level of uncertainty is unacceptable

:54:12.:54:15.

to us on the side. We will seek to amend the relevant clauses hn

:54:16.:54:18.

Committee if we need to resolve them still. Importantly, the information

:54:19.:54:25.

powers was also impacting on dispensing GPs and pharmacists. I

:54:26.:54:28.

note that the BMA were not represented at the workshop held by

:54:29.:54:31.

the Department of Health and the information powers. We wait to hear,

:54:32.:54:37.

but I would find it unusual, if hard pressed dispensing GPs would welcome

:54:38.:54:40.

additional work that would be required of them in providing

:54:41.:54:45.

information to the Government. The other part of the supply ch`in

:54:46.:54:48.

affected by the new information powers of this Bill will be

:54:49.:54:52.

pharmacists. The Government has just imposed punitive cuts on ph`rmacists

:54:53.:54:55.

which we discussed in the House last week. I am still deeply concerned

:54:56.:55:01.

about these cuts. Ministers do not seem to understand what thex are

:55:02.:55:04.

doing to the sector. I heard on Friday from an independent community

:55:05.:55:08.

pharmacist in my constituency who told me that he estimates that

:55:09.:55:13.

government cuts will cost hhm ?86,000 a year and he can sde an

:55:14.:55:18.

average cut of 60,000 from `ny pharmacists. This will cert`inly

:55:19.:55:22.

mean staff cuts but also potential bankruptcies forbid pharmaches which

:55:23.:55:27.

are hardest hit. In terms of this, and the new information powdrs being

:55:28.:55:32.

posed by the Bill, pharmacy voice told me small volume pharmacies are

:55:33.:55:35.

the hardest hit by the proposals. And many of those faced a ftnding

:55:36.:55:41.

cut of around 20% in 2017-18 from the imposition of the cuts

:55:42.:55:46.

announced. They do not have teams of administrative staff who can respond

:55:47.:55:49.

to demands would information and the likelihood is that the NHS would

:55:50.:55:53.

exist on information being provided in a specific format. It cotld be

:55:54.:55:57.

information that they do not currently analyse, for example, when

:55:58.:56:02.

a pharmacy buys stock for dhspensing it may also include purchasds of

:56:03.:56:06.

medicines for sale over the counter. The overall discount the ph`rmacy

:56:07.:56:09.

gets on the order is not allocated to each item and pharmacies could

:56:10.:56:14.

not provide the actual pricd paid per item. On behalf of the

:56:15.:56:16.

pharmacists they represent they would want to ensure that the cost

:56:17.:56:20.

of meeting the Government's information requirements is fully

:56:21.:56:24.

met by the NHS. They feel that the imposition of cuts has alre`dy put

:56:25.:56:27.

the future of the pharmacy sector, particularly smaller pharmacy

:56:28.:56:30.

businesses, in jeopardy. Can the minister assure me that the cost of

:56:31.:56:35.

the information required to be gathered under the new information

:56:36.:56:38.

powers will not represent an additional cost burden on

:56:39.:56:43.

pharmacists? To conclude, the Labour opposition supports the bro`d aims

:56:44.:56:46.

of this Bill, in terms of mdasures to control the costs of medhcines.

:56:47.:56:51.

But we have concerns as I h`d said about the information powers the

:56:52.:56:54.

Government wants to take to itself, they are seen as onerous by the unit

:56:55.:56:59.

and medical supply sectors but we want to make sure they are not.

:57:00.:57:06.

The pharmacy sector is counting the costs of the government imposition

:57:07.:57:11.

of funding cuts amounting to 12 for the rest of this year and over %

:57:12.:57:16.

next year. We will move amendments in committee on these issues of the

:57:17.:57:21.

work and cost of information gathering. We asked ministers to

:57:22.:57:26.

look at using all future rebates from the pharmaceutical sector to

:57:27.:57:30.

improve access to treatments for patients. A number of honourable and

:57:31.:57:34.

Right Honourable member is spoken of the need to look at this big issue

:57:35.:57:40.

of access to drugs and treatments. I hope ministers will take up the

:57:41.:57:49.

opportunity is the bill progresses. What a great pleasure it is to stand

:57:50.:57:54.

before you after this important debate but with a little tile to be

:57:55.:57:59.

able to satisfy as many of the honourable member is as I c`n but

:58:00.:58:02.

recognising we will be going into committee shortly and will have an

:58:03.:58:07.

opportunity to discuss thosd points I cannot pick up today. I would like

:58:08.:58:12.

to start by thanking everyone who has taken part in the debatd. We

:58:13.:58:16.

have had some excellent contributions from members `re some

:58:17.:58:21.

showing a surprising knowledge of the intricacies of pharmacettical

:58:22.:58:25.

pricing but nonetheless welcome The bill is dealing with a treasured

:58:26.:58:31.

national institution. And the need to get best value for the. Ledicines

:58:32.:58:37.

are the second largest cost to the NHS after staff it is important we

:58:38.:58:42.

do not pay over the odds. The level of interest and quality of

:58:43.:58:46.

contributions today show how important that is for all mdmbers. I

:58:47.:58:51.

think it is refreshing to h`ve a debate involving the NHS with the

:58:52.:58:56.

degree of consensus that has erupted across the house today. I al led to

:58:57.:59:02.

believe and it has been said by others, this is a relativelx unusual

:59:03.:59:07.

occurrence so I will enjoy ht as long as I can. The debate rdinforces

:59:08.:59:13.

the principles of getting the best value for the NHS, making ddcisions

:59:14.:59:17.

on the basis of good qualitx information and supporting this

:59:18.:59:21.

country is innovative pharm`ceutical industry, referred to many. These

:59:22.:59:28.

principles upon which I can agree. The debate has raised a number of

:59:29.:59:35.

issues some of which I will clarify now for members who have made

:59:36.:59:39.

comments and I would like to start by responding to the honour`ble

:59:40.:59:45.

lady, one of her closing st`tements linking announcements in relation to

:59:46.:59:51.

pharmacy funding and this bhll and to reassure her that there hs no

:59:52.:59:53.

link whatsoever between the provisions in this bill on

:59:54.:59:58.

information collection and last weeks announcement on the ddcisions

:59:59.:00:04.

on funding. Community pharm`cy funding changes will come into

:00:05.:00:08.

effect in December and are not reliant on any of the provisions of

:00:09.:00:12.

this bill nor the provisions change those decisions. I was not laking

:00:13.:00:24.

the point of that, the cuts imposed by government will mean that some

:00:25.:00:29.

community pharmacies for thd Independent ones will not h`ve staff

:00:30.:00:34.

to do it. If the government is imposing a new information gathering

:00:35.:00:38.

requirement, who will do th`t? The cuts might mean 60 or ?80,000 cuts,

:00:39.:00:43.

staff cuts and people not bding able to absorb a new requirement. Well,

:00:44.:00:52.

just to reassure her, the establishment cost for each pharmacy

:00:53.:00:56.

is currently ?25,000 and is a reduction in that cost rathdr than

:00:57.:01:01.

large cost. She must be refdrring to companies that have several

:01:02.:01:05.

established by the individu`l one and though on the information

:01:06.:01:09.

gathering points she has rahsed during my remarks. We have had a

:01:10.:01:18.

number of allusions during the debate started by the honourable

:01:19.:01:23.

member for Ellesmere Port who I am sure will join a shortly th`t the

:01:24.:01:27.

Conservative party appears to have broken out in a rash of Jerdmy

:01:28.:01:32.

Corbyn but I can assure her categorical -- categoricallx it is

:01:33.:01:35.

not the case. We are seeking through this bill to rectify points made by

:01:36.:01:43.

members on both sides about the potential for exploitative pricing

:01:44.:01:49.

and in particular unbranded generics which are of low volume and weather

:01:50.:01:56.

isn't a competition of alternative supplier in the market -- and where.

:01:57.:02:00.

There is agreement across the house. But I welcome the support from the

:02:01.:02:06.

front bench of the Labour P`rty the front bench of the SNP and the Lib

:02:07.:02:12.

Dems, all of whom are supporting the principles of the bill and H look

:02:13.:02:19.

forward to a rapid conclusion to this short bill in committed,

:02:20.:02:26.

doubtless you will be raising important points in the comlittee

:02:27.:02:30.

but I am sure we will have continuing constructive

:02:31.:02:33.

contributions or the way through. The member for Ellesmere Port asked

:02:34.:02:43.

about in particular difficulties of access and funding for new ledicines

:02:44.:02:46.

and this was raised by the lember for Central Ayrshire. The NHS is

:02:47.:02:52.

investing in innovative medhcines and in the first year of thd current

:02:53.:02:57.

voluntary scheme, medicines covered by the innovation scorecard saw an

:02:58.:03:04.

increase of 18% compared to growth of 5% in medicines not on the

:03:05.:03:07.

scorecard so that illustratds we are prepared to fund innovative

:03:08.:03:14.

medicines under the existing scheme but we recognise the need to

:03:15.:03:18.

continue to ensure patient `ccess to new medicines and that is why as the

:03:19.:03:23.

Secretary of State referred to, the exhilarated Access review announced

:03:24.:03:30.

earlier today will accelerate the speed at which 21st century

:03:31.:03:34.

innovation in medicine and ledical technologies can get taken tp by

:03:35.:03:39.

patients and their families through the NHS. This is a real adv`ntage in

:03:40.:03:49.

bringing the innovation which we see in pharmaceutical companies, not

:03:50.:03:56.

just here but driving those through that driving is through to tse the

:03:57.:04:00.

NHS. A number of members referred to the investigative work of The Times

:04:01.:04:05.

newspaper in helping to highlight the problems of the unbranddd

:04:06.:04:12.

generics and I would like to add are welcome to the investigation

:04:13.:04:16.

undertaken by those journalhsts at point out the government was all

:04:17.:04:22.

ready aware of some of the problems and we published a consultation on

:04:23.:04:28.

December last year raising the issue and it was partly in light of that

:04:29.:04:32.

that the Times newspaper did their work, not to decry it, it w`s

:04:33.:04:38.

helpful. We referred cases to the Competition and Markets Authority is

:04:39.:04:44.

referenced by the member for Wolverhampton South West. They have

:04:45.:04:52.

imposed fines in one case, ht is expecting to reach a final decision

:04:53.:04:57.

in the coming months on another case and two more cases were opened in

:04:58.:05:04.

March and April earlier this year so we are looking to refer exalples of

:05:05.:05:09.

bad practice when we come across them to the relevant authorhties.

:05:10.:05:14.

The honourable lady for Central Ayrshire asked about data collection

:05:15.:05:21.

and how it will work and thhs was raised by others in interventions.

:05:22.:05:27.

We all ready collect signifhcant data from the supply chain to

:05:28.:05:31.

medicines, and both voluntary and statutory schemes for minor fracture

:05:32.:05:37.

and wholesalers of generics and pharmacies themselves all rdady so

:05:38.:05:44.

what we are looking to do as part of developing the regulations before we

:05:45.:05:50.

introduce this scheme, we are looking to try to identify `s many

:05:51.:05:54.

automated data collection solutions as possible to minimise the burden

:05:55.:06:00.

the honourable lady referred to and recognising that some of thd medical

:06:01.:06:07.

products companies are small companies and we want to make that

:06:08.:06:11.

burden as light as possible. She also referred to the devolvdd

:06:12.:06:15.

administrations and how we will be working with them. The intent is

:06:16.:06:23.

they can access data not on a timing of our choosing but as they require

:06:24.:06:29.

it. And that that will be undertaken again in a manner that we h`d to

:06:30.:06:32.

capture in a memorandum of understanding siders claritx between

:06:33.:06:39.

each administration and ourselves. The honourable member for North

:06:40.:06:53.

North asked in particular about how we intend to control the medicines

:06:54.:06:58.

bill overall and members mentioned this, the cost of medicines are

:06:59.:07:05.

rising quite rapidly. This hs a concern and it gets to the heart of

:07:06.:07:09.

why we have sought to introduce this legislation. We are looking in the

:07:10.:07:17.

first place to align the st`tutory and voluntary cost control schemes

:07:18.:07:23.

for supply of medicines. Colpanies are present can decide to join

:07:24.:07:26.

either scheme depending on the other benefits they perceive to the

:07:27.:07:31.

schemes but we believe the financial benefits to the NHS should be the

:07:32.:07:37.

same. The proposals will put beyond doubt the powers to amend the scheme

:07:38.:07:44.

and the impact that has indhcated it should say that taxpayers ?80

:07:45.:07:49.

million year. Draft regulathons will be available for discussion around

:07:50.:07:52.

the provisions at the committee stage. The second element of the

:07:53.:07:57.

bill strengthens powers to set prices of medicines were colpanies

:07:58.:08:02.

charge and reasonably high prices for unbranded generics. In lost

:08:03.:08:06.

cases, competition works well to keep prices down but when it does

:08:07.:08:11.

not, and when companies are making excessive profits, the government

:08:12.:08:15.

should be able to take action. This bill will close this current

:08:16.:08:21.

loophole in the framework and we all agreed we cannot allow propdr

:08:22.:08:29.

tipping at the expense of the NHS. Thirdly, the bill strengthens powers

:08:30.:08:34.

to collect information on the costs of medicines, medical supplhes and

:08:35.:08:37.

other products from across the supply chain. By putting thd

:08:38.:08:41.

existing provisions regarding medicines on a statutory butting, it

:08:42.:08:45.

enables the government more accurately and fairly to set

:08:46.:08:49.

reimbursement arrangements for community pharmacies and dispensing

:08:50.:08:55.

GPs and the power will provhde vital data to underpin the reform scheme

:08:56.:08:59.

for controlling medicine and pricing and gives us more evidence `bout

:09:00.:09:02.

whether companies are making excessive profits at the expense of

:09:03.:09:08.

the NHS. I would like to rehterate what might have a friend sahd in his

:09:09.:09:12.

remarks. To assure the housd about the impact of the information powers

:09:13.:09:16.

on the medical technologies industry. It may surprise mdmbers

:09:17.:09:22.

that the powers to require information from suppliers `ll ready

:09:23.:09:30.

exists in section 260 of thd 20 NHS act which the honourable melber

:09:31.:09:34.

remembers bringing into effdct. These powers were Draconian so we

:09:35.:09:42.

wish to make these more proportionate. As it happens, the

:09:43.:09:45.

government has never used the powers that exist and the act and so what

:09:46.:09:53.

we are looking to do is to bring these powers within it to m`rry up

:09:54.:09:58.

the same powers for information gathering so there is no confusion

:09:59.:10:03.

in future over which inform`tion regime applies. It does not sound

:10:04.:10:10.

Draconian if they're never dnforced but that section of the act refers

:10:11.:10:18.

to medical supplies and it defines them as surgical dental and optical

:10:19.:10:22.

materials and equipment, wotld you look at the definition becatse it

:10:23.:10:26.

seems it is not as wide as lany people think it is and therd is a

:10:27.:10:31.

way around it for certain technological companies if they wish

:10:32.:10:35.

to get around it like the manufacturers of MRI scanners and

:10:36.:10:38.

that is not the intention of the house. He may be making a phtch to

:10:39.:10:48.

join the committee of selection .. And for my part I would be delighted

:10:49.:10:52.

to see him committing his considerable intellect to this

:10:53.:10:56.

topic. We will spend much of the discussion in refining the

:10:57.:11:02.

definitions of what information is appropriate and how it will be

:11:03.:11:06.

gathered. The government intends to table amendments to the bill to

:11:07.:11:10.

reflect how the information power provisions were applied in the

:11:11.:11:13.

devolved administrations and these amendments would ensure the

:11:14.:11:16.

government can collect information relating to the devolved purposes,

:11:17.:11:21.

share it with safeguards ovdr confidentiality with the devolved

:11:22.:11:25.

administrations to enable them to use information for their own

:11:26.:11:36.

purposes. We agreed the devolved... Avoiding duplication while dach

:11:37.:11:39.

country collect information from the pharmacies and GPs. Mr Deputy

:11:40.:11:46.

Speaker, this has been a relarkable debate for the consensus and support

:11:47.:11:51.

we have had for which I and my colleagues are extremely

:11:52.:11:52.

appreciative. Robust cost control and dat`

:11:53.:12:02.

requirements are key tools to ensure that NHS spending on medicine across

:12:03.:12:07.

the UK continues to be affordable while delivering best value for

:12:08.:12:10.

would support access to services and would support access to services and

:12:11.:12:14.

treatments. This Bill will dnsure there is a more level playing field

:12:15.:12:18.

between our medicine pricing schemes while ensuring that decisions made

:12:19.:12:22.

by the Government are based on more accurate and robust information on

:12:23.:12:26.

medicine costs. This will bd fairer for the industry, pharmacies and the

:12:27.:12:32.

NHS, patients and the taxpaxers I am pleased to commend the Bhll to

:12:33.:12:38.

the House. The question is that the Bill now be read a second thme. As

:12:39.:12:46.

many of that opinion say nod. On the contrary noe. The ayes have it. The

:12:47.:12:56.

question is on the order paper, as many as a opinion site eye, contrary

:12:57.:13:05.

noe, the ayes have it. Question is as on the order paper, as m`ny of

:13:06.:13:11.

that opinion say eye. On thd contrary know, the ayes havd it the

:13:12.:13:21.

ayes have it. We come to... The question is as on the order paper,

:13:22.:13:26.

as many of that opinion say eye the contrary one.

:13:27.:13:36.

I beg to move this has adjotrned. Caroline Lucas. Thank you, Lr Deputy

:13:37.:14:01.

Speaker. This debate is intdnded to highlight the ongoing NHS crisis

:14:02.:14:04.

which is affecting my consthtuency and the city of Brighton and Hove as

:14:05.:14:09.

well as to outline some solttions to what is far more than just ` purely

:14:10.:14:15.

local problem. The very concept of a public funded National Health

:14:16.:14:20.

Service is at risk and the situation in Brighton and Hove reveals a whole

:14:21.:14:23.

host of systemic problems that stem in large part I would argue from the

:14:24.:14:29.

2012 NHS Health and Social Care Board act. Patients and staff are

:14:30.:14:32.

being let down in my constituency and elsewhere and it is mord than

:14:33.:14:37.

likely than the additional strain of the winter months will exacdrbate

:14:38.:14:40.

the crisis still further. The picture I will paint of the

:14:41.:14:44.

situation in Brighton and Hove is deeply worrying. It encompasses our

:14:45.:14:49.

hospital, GP provision, Ambtlance Service and community care. These

:14:50.:14:55.

services are held together by incredibly dedicated. Staff Often

:14:56.:14:58.

working well beyond the hours they are paid to keep things going. I

:14:59.:15:01.

want to take this opportunity to thank and paid should be to each and

:15:02.:15:07.

every one of them. And yet despite their tireless efforts, the overall

:15:08.:15:11.

picture of Health and Social Care Board in Brighton and Hove hs

:15:12.:15:13.

currently chaotic. Not becatse of the lack of hard-working st`ff but

:15:14.:15:18.

primarily as a result of two things. Hajj funding cuts and an

:15:19.:15:24.

increasingly fragmented strtcture based in increased marketis`tion and

:15:25.:15:27.

commercialisation and privatisation of our NHS. So let me give ` quick

:15:28.:15:32.

overview, Mr Deputy Speaker. First our local royal source of hospital

:15:33.:15:34.

is in special measures but the quality and finance. As of July

:15:35.:15:39.

there are over 9000 people waiting for more than 18 weeks to start

:15:40.:15:43.

treatment. That is the worst recorded amongst 185 providdrs and

:15:44.:15:49.

the 208 CCGs who submit dat` nationally. More than 200 pdople

:15:50.:15:52.

have been on the waiting list for over a year. When I'm talking about

:15:53.:15:57.

the hospital that they could be put on record that I am very gr`teful

:15:58.:16:01.

that we are seen to have a brand-new building and we certainly nded it.

:16:02.:16:06.

The hard-working staff in that hospital now are currently operating

:16:07.:16:09.

in a building that stems from pre-Florence Nightingale. The oldest

:16:10.:16:14.

estate in the whole of the NHS. That is at the same time as undertaking

:16:15.:16:18.

an increasingly complex work for the whole of Sussex as a major trauma

:16:19.:16:24.

centre for the wider region. I will be happy to give away. I am very

:16:25.:16:28.

grateful for my honourable friend forgiving way and by honour`ble

:16:29.:16:30.

neighbour forgiving way. Shd mentions the fact that we are

:16:31.:16:35.

constructing a new wing to the hospital and a whole bunch of other

:16:36.:16:39.

services locally. Thus another gripping artefact of this going to

:16:40.:16:41.

place an additional administrative burden and challenges our staff and

:16:42.:16:47.

clinical staff in the area, that means we have to get the situation

:16:48.:16:51.

in Brighton and Hove absolutely right now otherwise it will add an

:16:52.:16:53.

additional burden but could just be too much to the system locally. I am

:16:54.:17:00.

grateful to the MP for home because he anticipates exactly what I'm

:17:01.:17:03.

going to say. Of course we need new bricks and mortar but we also need

:17:04.:17:07.

finances for the services inside those bricks and mortar. We

:17:08.:17:12.

desperately need a central funding settlement recognises the unique

:17:13.:17:15.

pressures on our hospital. So that the systems can be updated for

:17:16.:17:19.

example we need a computerised record system. This isn't rocket

:17:20.:17:23.

science but we get but we nded it. We increased capacity particularly

:17:24.:17:27.

for Andy because we are now serving a much wider region by being a

:17:28.:17:35.

central trauma centre. With debts currently of around 45 millhon, but

:17:36.:17:37.

Mansell to do with all is f`cing the situation that's quite simply

:17:38.:17:42.

unsustainable. That is just one example but there are plentx of

:17:43.:17:47.

others of what is going wrong when comes to the health service in

:17:48.:17:50.

Brighton and Hove. Patients in the city for examples are seen six GP

:17:51.:17:54.

practices go so far this ye`r alone. When the practice announced they

:17:55.:17:58.

were walking away from the contract to run five surgeries in thd city

:17:59.:18:05.

decision was largely financhal. With almost 11,500 patients registered,

:18:06.:18:08.

the disruption and uncertainty was widely felt and other nearbx

:18:09.:18:11.

surgeries were simply expected somehow to manage increased patient

:18:12.:18:15.

numbers. NHS England wasn't required to step in to help because of the

:18:16.:18:20.

terms agreed with the practhce group. Now that this type of

:18:21.:18:23.

contract is no longer permissible, it was of course but little comfort

:18:24.:18:28.

for those patients forced to register with the new GP. I

:18:29.:18:33.

particularly recall a consthtuent who to contact me after a shck

:18:34.:18:37.

surgery was closed and she was unable to stop by somewhere for a

:18:38.:18:43.

new inhaler prescription because of their own -- their own desphte their

:18:44.:18:51.

own disability. And then thdre is the Ambulance Service, our dmergency

:18:52.:18:53.

Ambulance Service. It was placed in special measures on the 29th of

:18:54.:18:56.

September following a CQC rdport that rated it as inadequate. The

:18:57.:19:01.

inspectors praised by self identified unsafe levels of staffing

:19:02.:19:03.

as well as poor procedures `nd leadership. The mental health

:19:04.:19:07.

services, especially those serving children and young people are

:19:08.:19:13.

overstretched and underfunddd. Adult social care services in Brighton and

:19:14.:19:16.

Hove face ongoing cuts desphte the cost to individuals and the NHS and

:19:17.:19:20.

that means that over the next four years the City Council is looking at

:19:21.:19:24.

cuts are particularly 24 million and the complete privatisation of

:19:25.:19:27.

remaining council adult sochal care. They centres, carers and so forth. I

:19:28.:19:32.

have lost track of the numbdr of times that government ministers

:19:33.:19:34.

assert that they are investhng record amounts in the NHS, xet

:19:35.:19:38.

conveniently failing to mention the record amounts that they ard

:19:39.:19:41.

simultaneously cutting from local authority budgets that are supposed

:19:42.:19:45.

to cover essential care services for vulnerable people. Referring back to

:19:46.:19:51.

some of the comments made bx my neighbour earlier, she is d`ting a

:19:52.:19:57.

very gloomy picture and idolised the problems but the see also

:19:58.:20:03.

acknowledged that next door the West Sussex hospitals trust is one of

:20:04.:20:06.

only five hospital trusts and the whole of the country rated

:20:07.:20:09.

outstanding? And yet we havd the pressures of one of the most elderly

:20:10.:20:14.

operations in the country and increasing pressures placed on us

:20:15.:20:18.

because of people coming from Brighton and Hove to access services

:20:19.:20:22.

across the county will stop why is it that Brighton and Hove is in such

:20:23.:20:26.

a state at the moment yet a few miles down the road we are `ble to

:20:27.:20:32.

run actually read -- good hospital services? I congratulate hil on the

:20:33.:20:35.

performance of his own hosphtal trust, but they recognise what he is

:20:36.:20:38.

saying about the extra pressures that are put on the surrounding area

:20:39.:20:44.

when there is a particular problem in Brighton and Hove. I certainly

:20:45.:20:47.

would contest and the implication of what they are saying is if there is

:20:48.:20:50.

something particularly to Brighton and Hove in the sense that hf you

:20:51.:20:54.

look around the country there are sadly a great many hospital trusts

:20:55.:20:58.

severe difficulties. We havd a public house Committee a few months

:20:59.:21:01.

ago absolutely saying the s`me thing and I shall refer to that vdry

:21:02.:21:06.

shortly. They asked specifically about Brighton and Hove I think

:21:07.:21:08.

there are some issues about the fact that for example we are working in

:21:09.:21:12.

the oldest building in the whole of the NHS. I think a particul`r

:21:13.:21:17.

problems with comes together for example with the demographics. I

:21:18.:21:21.

think there are particular charm that challenges when you have got

:21:22.:21:24.

for example in Brighton and Hove a number of older people, complex

:21:25.:21:30.

mental health problems, homdless projects. I want to challenge the

:21:31.:21:33.

idea that this might be somdthing that is simply a problem in Brighton

:21:34.:21:35.

and Hove because it isn't and they'll come to that in just a

:21:36.:21:42.

minute. We have lots of timd to debate this unfortunate --

:21:43.:21:44.

fortunately. She must acknowledge that when we last enquired the

:21:45.:21:49.

average age of a patient in the hospital taking up age period is is

:21:50.:21:56.

85. At places considerable dxtra pressures on our hospital sxstem.

:21:57.:22:00.

The average age in Brighton and Hove the city is considerably yotnger.

:22:01.:22:04.

The average age of people accessing treatment in her city is

:22:05.:22:06.

considerably younger and thdrefore less demanding. So, why is there

:22:07.:22:11.

such a contrast in the performances of our respective hospital trusts?

:22:12.:22:16.

That would be a very interesting issue to debate and he is at will to

:22:17.:22:20.

be able to get his own debate about Worthing Hospital but what H know

:22:21.:22:23.

about is the particular problems that are facing Brighton and Hove

:22:24.:22:27.

and I will point to it again to the particular complex needs of come

:22:28.:22:29.

together when you have got ` city full of young people as well as very

:22:30.:22:34.

elderly people, mental health problems, homeless as probldms, the

:22:35.:22:37.

mobility problems and so on, but if he will give me a little bit more

:22:38.:22:40.

time there will be able to set up camp but I think some of thd Proms

:22:41.:22:44.

are in Brighton and Hove and Chris Wood and all the answers ard

:22:45.:22:48.

also talking about the fact that uncertainty -- unfortunatelx the

:22:49.:22:54.

Government is cutting money from budgets that are supposed to cover

:22:55.:22:57.

those essential care servicds for vulnerable people. The Government

:22:58.:23:00.

knows that social care in places like Brighton and Hove is on its

:23:01.:23:03.

knees and that this has a vdry knock-on impact in terms of the NHS

:23:04.:23:06.

that no amount of financial smoke and mirrors can conceal. Brhghton

:23:07.:23:09.

and Hove National pensioners Convention has become a valhant

:23:10.:23:13.

campaign to protect adult social care services from cuts with the GMB

:23:14.:23:16.

union fighting alongside thdm and I hope the Minister will be lhstening

:23:17.:23:26.

to that. Because this is a crisis that let everyone down and there is

:23:27.:23:29.

no hiding from it, so where should responsibility for this cat`logue of

:23:30.:23:31.

troubles lie? I believe that what has happened to the city's

:23:32.:23:33.

nonemergency patient transport service goes some way to looking at

:23:34.:23:36.

that question and they want to look at this in more detail becatse it

:23:37.:23:38.

also demonstrates what can only be cold an utter dereliction of duty on

:23:39.:23:42.

the part of State for Health and I'm off to repeat my call again today

:23:43.:23:46.

for his department to step hn and him personally to step in to resolve

:23:47.:23:49.

an unacceptable and untenable situation. I am referring to a

:23:50.:23:56.

service that takes people to essential non-emergency appointments

:23:57.:24:00.

for example kidney patients going for the analysis, cancer patients to

:24:01.:24:02.

and from chemo and radiotherapy Since April it has been won by a

:24:03.:24:09.

private company and another member of subcontractors could perform a

:24:10.:24:14.

phased criticism from the ottset with sub contractors not bedn paid.

:24:15.:24:24.

Two of those sub contractors went bust leaving some ambulance drivers

:24:25.:24:27.

leaving with six weeks of w`ges unpaid. In early October drhvers

:24:28.:24:35.

from another subcontractor turned up to work only to be sent homd again.

:24:36.:24:38.

Last week it was punched into fresh controversy after an investhgation

:24:39.:24:43.

by the local paper that revdaled that one subcontractor may not even

:24:44.:24:46.

have been licensed to operate a fleet of 30 and lenses. I h`ve got

:24:47.:24:50.

the headline from the paper here that you can see very clearly. That

:24:51.:24:53.

absolutely said that ambulances are now in a total shambles. Do you want

:24:54.:25:04.

to just put it down on the bench? The subcontractor is a comp`ny

:25:05.:25:09.

called Docklands medical services Limited. This is apparently a

:25:10.:25:14.

Phoenix company. As I understand it the new company seems to be

:25:15.:25:17.

suggesting it was acceptabld for them to operate under the s`me CQC

:25:18.:25:22.

license that was issued to hts predecessor at the bankrupt

:25:23.:25:26.

dockland. The application process is carefully designed to make sure that

:25:27.:25:28.

standards for vehicles and other safety checks have been met. To stay

:25:29.:25:33.

long in new successor or Phoenix company to inherit a licencd is

:25:34.:25:37.

setting the bar dangerously low and I think exposes patients and staff

:25:38.:25:40.

to unacceptable risks. As a result of this particular the back,up of

:25:41.:25:44.

struggling hospital trust, the same one that is in financial spdcial

:25:45.:25:51.

measures, is incurred ?121,000 of private and bills custom for this

:25:52.:25:54.

year in order to plug that gap left by Coperforma and its

:25:55.:25:58.

subcontractors. To recoup the cost, the trust has quite rightly invoiced

:25:59.:26:03.

the CCG which appointed Copdrforma and no doubt other trusts whll have

:26:04.:26:06.

done the same with serious consequences for CCG budgets and

:26:07.:26:09.

therefore for the money avahlable for other services. But whichever

:26:10.:26:13.

part of the Department of Hdalth ends up putting the Coperforma Bill,

:26:14.:26:17.

it represents an unforgivable waste of money and resources and the

:26:18.:26:21.

diversion away from patient treatment and care. I trust the

:26:22.:26:25.

Minister will agree that nehther patients in Brighton or anywhere

:26:26.:26:28.

else should be paying the price for failure of private companies who are

:26:29.:26:32.

profiting from NHS contracts and so will he therefore ensure th`t the

:26:33.:26:36.

CCG is not out of pocket in turn as a result of Coperforma's thd air

:26:37.:26:40.

would also like his apartment to stop passing the buck when his

:26:41.:26:43.

government passing legislathon that requires services like nonelergency

:26:44.:26:48.

patient transport to be put out to tender. It is simply unacceptable

:26:49.:26:51.

for no one in the Department of Health to know whether a fldet of 30

:26:52.:26:55.

ambulances where properly ldssons to be transporting Sussex patidnts for

:26:56.:26:58.

three months over the summer. I wonder if the Minister will tell us

:26:59.:27:00.

when he responds with a he would agree with that. I am grateful for

:27:01.:27:07.

her to give away again, but isn t it extraordinary that this contract was

:27:08.:27:11.

awarded in the first place? This is a company, Coperforma, all the

:27:12.:27:15.

Supply chain automated, which is underperformed and failed p`tients

:27:16.:27:20.

from the very first day that it took over the contract and continues to

:27:21.:27:23.

do so today. It can't be returned back to where it was before because

:27:24.:27:26.

the Ambulance Trust it was taken from is also in special measures and

:27:27.:27:29.

now no longer has the capachty to take it over. Isn't the lesson here

:27:30.:27:35.

that the Government if anybody does outsource this type of contract it

:27:36.:27:37.

has got to make sure that dte diligence is done correctly to make

:27:38.:27:41.

sure that patients do not stffer in this way?

:27:42.:27:45.

I agree and when I talk to the CCG what they are using as an

:27:46.:27:55.

off-the-peg contract which hs not suitable for this service and

:27:56.:27:57.

therefore there have been problems in the system and the company we

:27:58.:28:04.

ended up with you are not providing the service people in the chty

:28:05.:28:12.

deserve. I thank. I can see due diligence was not done in the

:28:13.:28:15.

contract, is there an underlying principle that when a piece of NHS

:28:16.:28:20.

service is outsourced, the NHS version ceases to exist and at a

:28:21.:28:25.

future date if the service hs not good enough or things changd, it is

:28:26.:28:31.

impossible to take it back hn-house. I thank for the intervention, she

:28:32.:28:37.

knows a great deal about thd issues and I agree that you are on a

:28:38.:28:44.

one-way direction and once outsourced, doing a U-turn has been

:28:45.:28:48.

taken away and it is failing patients in Brighton and Hove. The

:28:49.:28:55.

department says allegations of ambulances operating legallx warrant

:28:56.:28:59.

investigation by the CQC and I have written to demand that happdns and

:29:00.:29:03.

the CQC. Will he gave furthdr tonight and simply admitting the

:29:04.:29:08.

severity of the project -- problem and let us know what he can do.

:29:09.:29:12.

Would he provide assurances the Department of Health is no longer

:29:13.:29:15.

content to leave patient safety in the hands of private companhes and

:29:16.:29:21.

it will step in, bring the service in-house and check these contracts

:29:22.:29:26.

of the subcontractors are mdeting requirements? On this issue of the

:29:27.:29:37.

privatisation of the ambulance service, was their health and safety

:29:38.:29:42.

issues they had to meet and was there ever any occasions whdn the

:29:43.:29:47.

ambulance fell below that ldvel of service required? It is a good

:29:48.:29:55.

question and when I asked the CQC, the CCG that question, the `nswer

:29:56.:30:00.

has not been clear. I have been told the performance of the comp`ny is

:30:01.:30:04.

not such meaning the contract has been breached but one issue and

:30:05.:30:08.

difficulty is so much of thd contract is not in the publhc domain

:30:09.:30:13.

so if the CCG wants to see the subcontracts between co-performer

:30:14.:30:19.

and the different companies they do not have access to those contracts

:30:20.:30:23.

so they cannot assure us wh`t is in them. My point really is we have an

:30:24.:30:28.

opaque and transparent systdm where is difficult as they were

:30:29.:30:33.

accountability lies. That is why this is a failed model. The example

:30:34.:30:40.

goes some way to illustrating the underlying causes of the NHS crisis

:30:41.:30:44.

we are experiencing because trying to get to the bottom of these

:30:45.:30:49.

contracts and subcontracts `nd responsibility is like Rupp link

:30:50.:30:56.

with a Gordian knot. They admit that one big challenge is identifying

:30:57.:31:01.

responsibility when things go wrong when people providing the sdrvice

:31:02.:31:04.

are not paid, it is not cle`r where the responsibility lies,

:31:05.:31:10.

co-performer of the subcontractors. This lack of transparency is

:31:11.:31:18.

concerning and it is serious example of the problems are risks associated

:31:19.:31:23.

with outsourcing of key services. The driving force behind thhs is

:31:24.:31:28.

commercialisation. It is made worse by the 2012 Health and Soci`l Care

:31:29.:31:33.

Act which exposes patients to an acceptable risk but engenders

:31:34.:31:36.

structures and terms and conditions that appear to protect a profit led

:31:37.:31:43.

companies. That is not the NHS public want or deserve, it hs not

:31:44.:31:48.

effective. The model is failing contracts do not work and nded to be

:31:49.:31:52.

brought back in-house and I pay tribute to the work of the lember

:31:53.:31:56.

for Bexhill and Battle who has done good work on this issue, a

:31:57.:32:01.

cross-party agreement and she has asserted in this instance private

:32:02.:32:05.

contracting has not worked `nd the ambulance service will be operated

:32:06.:32:09.

within the NHS. I go further still because it is not just patidnt

:32:10.:32:14.

transport services, it is one example of the kind of fraglentation

:32:15.:32:19.

and marketing that is damaghng the NHS. Fragmentation matters because

:32:20.:32:23.

the health care picture is lade up of parts that are interconndcted and

:32:24.:32:26.

it is hard for one part to hnfluence the other. Ambulance handovdr times

:32:27.:32:33.

at Royal Sussex have risen 60% largely because of the ongohng flow

:32:34.:32:40.

issue caused by lack of places to discharge people too, the sxstem

:32:41.:32:42.

gets blocked when there is no overview. A is the pinch point

:32:43.:32:50.

failures elsewhere, most notably in capacity in social care.

:32:51.:32:54.

Fragmentation is an inevitable part of a system that is designed to give

:32:55.:32:58.

private providers as many opportunities to complete the

:32:59.:33:00.

services through a continuots cycle of bidding and contracting out

:33:01.:33:04.

despite being inefficient and counter-productive. Take thd

:33:05.:33:10.

community nursing and local phrases may be taken over by a priv`te

:33:11.:33:15.

company that virgin care. Stssex community NHS trust has preferred

:33:16.:33:19.

bidded status to develop th`t deliver services but the cotncil is

:33:20.:33:23.

forced to undertake procurelent processes in the name of market

:33:24.:33:27.

competition. That process is a waste of time and effort and monex and

:33:28.:33:32.

increases the risk of a private company stepping in and unddrcutting

:33:33.:33:38.

a highly effective provider. A risk which is exacerbated by the

:33:39.:33:44.

government s short minded ddcision to cut spending each year until

:33:45.:33:49.

2021. This equates to ?1 billion less for the city over the same

:33:50.:33:54.

three years and it results hn important services being

:33:55.:33:58.

decommissioned all ready, the family nurse partnership which provides

:33:59.:34:01.

regular visits for teenage lums during pregnancy, it makes no sense.

:34:02.:34:08.

But it is what happens when you do not have a coherent publiclx

:34:09.:34:13.

provided NHS. When you do not have a model putting health needs before

:34:14.:34:18.

private profit, based on co-operation competition. That is

:34:19.:34:20.

the model that has been set out in the bill which I tried to bring to

:34:21.:34:27.

the house in the last term `s a Private Member's Bill and which is

:34:28.:34:29.

currently before the house hn the name of the Honourable membdr for

:34:30.:34:35.

rural West. That is the kind of NHS I think my constituents want and it

:34:36.:34:38.

has to go hand in hand cruchally with funding. According to `n

:34:39.:34:45.

economist over the last Parliament, the annual average increase in UK

:34:46.:34:50.

NHS spending was .84%. That is the smallest increase in spending for

:34:51.:34:56.

any party period in office since World War II. For local and lives

:34:57.:35:01.

drivers caught up in the debacle and junior doctors, staff are

:35:02.:35:04.

universally respected except it seems that nurses should not have to

:35:05.:35:11.

fight for a 1% pay rise aftdr years of freezes, this does not jtst have

:35:12.:35:17.

consequences for the individuals. HealthWatch point out staff

:35:18.:35:20.

retention is a problem in the city with poor morale and high housing

:35:21.:35:24.

costs as factors. I'm worridd about the impact of the referendul on NHS

:35:25.:35:31.

staffing. Brighton and Hove is set to benefit hugely from a major new

:35:32.:35:37.

County Hospital redevelopment due to capital investment. I'm grateful but

:35:38.:35:42.

I would like to extend the logic of public provision to the services

:35:43.:35:47.

which will be based in the new hospital. As ministers know, the

:35:48.:35:49.

issue is running costs. She is straying into the iddology of

:35:50.:36:08.

NHS funding but can I remind her, she might like to mention an example

:36:09.:36:13.

in her own city of which I `m chairman of the trustees to declare

:36:14.:36:19.

an interest of a company working to promote the first critical days

:36:20.:36:24.

agenda to help children before they are born and their parents `nd tears

:36:25.:36:31.

after which is an excellent example of the NHS working with the

:36:32.:36:36.

Independent and charities sdctor to provide a much needed service which

:36:37.:36:40.

I'm sure she will want to promote in her constituency. It is not all bad

:36:41.:36:46.

if it is outside the NHS. If he had been listening carefully he notices

:36:47.:36:50.

I'm talking about private companies taking over cherry picking key

:36:51.:36:54.

services of the NHS. He knows because we have worked together on

:36:55.:36:57.

Brighton and I'm proud about what they have achieved but it is not

:36:58.:37:02.

working for profit, it is a charity ploughing back money into the

:37:03.:37:05.

service it provides, it would example. There are many othdrs from

:37:06.:37:10.

hospices and the member Hovd knows well, they would for hospicd. There

:37:11.:37:16.

are plenty of examples of the charitable sector doing amazing work

:37:17.:37:21.

and the NHS bill made provision for them as well. We're talking about

:37:22.:37:25.

and would I criticise is whdn the private sector come in and cherry

:37:26.:37:30.

pick services and the loss with NHS and your services working for

:37:31.:37:35.

profit. I want to finish making the case I'm making about funding. Last

:37:36.:37:41.

week the Prime minister clahmed NHS funding was being increased by 10

:37:42.:37:47.

billion. She ignored a plea from the respected share of the health Select

:37:48.:37:51.

Committee for ministers to stop using misleading figures whdn the

:37:52.:37:55.

correct figure is less than half the amount being claimed. The chief

:37:56.:38:00.

economist of the Nuffield trust says that even overstates the case where

:38:01.:38:07.

inflation puts the increase to around ?1 billion, a tenth of the

:38:08.:38:11.

figure at the Secretary of State has used and it is not ?350 a wdek. I'm

:38:12.:38:17.

surprised if any ministers will repay that blatant lie again but

:38:18.:38:22.

anyone who claims investment of 10 billion is playing hard and fast

:38:23.:38:26.

with the trees. The NHS chidf executive admitted to the hdalth

:38:27.:38:28.

Select Committee the Spending Review settlement would deliver negative

:38:29.:38:35.

per person NHS funding growth in 2018 and 19 with very modest

:38:36.:38:40.

increases in other years. Mhnisters are expecting the NHS to find ? 2

:38:41.:38:47.

billion inefficiencies by 2021. No one with expertise thinks it is

:38:48.:38:52.

possible. In a scathing report, the committee found a significant number

:38:53.:38:58.

of acute trusts are in serious and persistent financial distress. There

:38:59.:39:01.

is a spiralling trend of increased deficits and the current paxment

:39:02.:39:08.

system is not fit for purpose. That is perhaps most starkly demonstrated

:39:09.:39:13.

by the social care provision, the funding is agreed to be affdcting

:39:14.:39:17.

the NHS and they warn it must be funded sustainably as a priority.

:39:18.:39:22.

Yes, we have the better card funds to advance integration of hdalth and

:39:23.:39:25.

Social Care Act services but the majority is coming directly from the

:39:26.:39:31.

NHS budget resulting in a sharp and sudden reduction in hospital

:39:32.:39:35.

revenue. The government is robbing Peter to pay Paul was local

:39:36.:39:39.

authority social budgets sl`shed and people offering their homes to pay

:39:40.:39:45.

for care. Nor is the governlent secretive sustainability

:39:46.:39:48.

transformation programme thd solution. Many constituents are

:39:49.:39:52.

worried about the plans being conducted behind closed doors and

:39:53.:39:55.

vital services could be cut. We urgently need clarity on wh`t it

:39:56.:39:58.

will mean in practice the p`tients and staff. In the area covering

:39:59.:40:06.

Brighton and Hove, they facd a financial funding gap of hundreds of

:40:07.:40:11.

millions by 2021 and it is not clear how the STP will bridge the gap or

:40:12.:40:18.

whether services will be cut. Does she recognise that the principle of

:40:19.:40:26.

STP is going better placed based planning could help reintegrate the

:40:27.:40:31.

NHS but if it is just done with budgets censored here first instead

:40:32.:40:34.

of quality and patient centred care, will get the wrong answer. H do

:40:35.:40:41.

agree with her that place -based planning is potentially a useful

:40:42.:40:45.

tool but it is being used as a back door way of making more cuts and

:40:46.:40:50.

what worries me is that this is happening in and transparent way

:40:51.:40:53.

raising concerns amongst my constituents about what is happening

:40:54.:40:58.

and what is set out. Winter is coming and the crisis ready playing

:40:59.:41:01.

out in Brighton and Hove will get worse if the NHS continues down the

:41:02.:41:06.

path the government has put it. We spent 2.5% less of GDP on hdalth

:41:07.:41:10.

than France and Germany. I `m prepared to say what few others will

:41:11.:41:17.

say which is if you want NHS that meets our needs, we do not need

:41:18.:41:20.

privatisation in competition, we need those can afford it to pay more

:41:21.:41:25.

tax. This is something we c`n put a price on whereas the cost of the

:41:26.:41:28.

worry and misery and pain and uncertainty of so many of mx

:41:29.:41:33.

constituents is incalculabld. Whole families live with the weight of a

:41:34.:41:36.

loved one is to get treated and forced them to act as carers. The

:41:37.:41:43.

knock-on effect of NHS delaxs should not be dismissed. Concerns `bout

:41:44.:41:49.

delays and cancellations cole up repeatedly, operations repe`tedly

:41:50.:41:52.

cancelled and patience in dhstress. And the amazing mother fighting for

:41:53.:41:56.

adequate care and support for her disabled son. For her, the system

:41:57.:42:01.

has been a battle ground. Coordinating equipment betwden four

:42:02.:42:03.

different places and putting up with delays.

:42:04.:42:07.

She told me it is this that pushes people to despair and beyond

:42:08.:42:13.

breaking point. Breaking pohnt is I think exactly where we are. A

:42:14.:42:18.

perfect storm caused by dec`des of chronic underfunding and

:42:19.:42:19.

privatisation, meeting the consequences of fragmentation and

:42:20.:42:24.

run the organisation. Terms of policies that manifest themselves in

:42:25.:42:27.

grave and very real problems of the kind I opened this debate bx

:42:28.:42:31.

describing. Problems but yot need to my constituency were city btt

:42:32.:42:34.

Brighton and Hove does have an unusual demographic profile of many

:42:35.:42:37.

younger people as I said earlier with complex needs, mental health,

:42:38.:42:41.

drugs, alcohol, homelessness as well as some very elderly people. That

:42:42.:42:46.

means the array of services to support people using the NHS may

:42:47.:42:50.

need to be more complex, more tailored and more of the agdncy

:42:51.:42:56.

including voluntary agencies. An ecosystem of health care were each

:42:57.:42:59.

part components each other `s well as the whole is achievable locally

:43:00.:43:04.

and nationally if we step b`ck the unnecessary ineffective and damaging

:43:05.:43:08.

complexity that currently infects the NHS. If we reinstate th`t basic

:43:09.:43:12.

principle of a publicly funded and provided National Health Service

:43:13.:43:17.

that is free at the point of access. If we give patients, staff `nd the

:43:18.:43:20.

public a voice from the outside with matters as part of a box ticking

:43:21.:43:23.

exercise I believe that is how to bring us back from the brink. So

:43:24.:43:28.

finally, let me just acknowledge I have raised a number of questions

:43:29.:43:31.

throughout this debate and H will distribute them now for Minhster 's

:43:32.:43:35.

sake before I give up the thought his response. Lead from the felt

:43:36.:43:38.

step in to bring back accountability and stability to the nonemergency

:43:39.:43:41.

transport system in Brighton and Hove, bring the service back into

:43:42.:43:44.

the public sector as a mattdr of urgency and up the Bill could sack

:43:45.:43:49.

and he promised us that the plans will not mean that the servhces and

:43:50.:43:53.

closures? Will our possible trusts and mental Health Trust get the

:43:54.:43:56.

money they desperately need to trace the cuts -- without having to stress

:43:57.:44:01.

that this efficiency savings? Will he and other governors to stop using

:44:02.:44:06.

inaccurate figures and use the Autumn Statement to announcd a

:44:07.:44:09.

genuine step change when it comes to funding social care via loc`l

:44:10.:44:12.

authorities and NHS services in the round ticking for the habit of any

:44:13.:44:18.

test specific inflation covdr or he petitioned Home Secretary community

:44:19.:44:22.

guaranty EU workers to remahn and prevent the NHS from further

:44:23.:44:25.

instability and uncertainty and will he finally take a really honest look

:44:26.:44:29.

of the knock-on effects and inefficiencies of health care model

:44:30.:44:31.

that is jeopardising accountability, transparency standards and patient

:44:32.:44:41.

care? I would like to start by congratulating the honourable lady

:44:42.:44:43.

and not just in securing thhs debate but securing it on a day in which

:44:44.:44:47.

she was able to get through her entire speech and take into mention

:44:48.:44:52.

from the honourable gentlem`n for home and by honourable friend from

:44:53.:44:57.

East Worthing and Shoreham? A considerable achievement. Wd know

:44:58.:45:02.

that she has a long standing interest in the health outcomes for

:45:03.:45:07.

her constituents, as do all of us in this House. I would like to join her

:45:08.:45:12.

at the start of my remarks by highlighting the excellent work

:45:13.:45:15.

carried out every day by all those who work in the NHS, not just in her

:45:16.:45:20.

constituency but equally in my home and across the country. Before

:45:21.:45:25.

addressing the honourable l`dy's specific points I would likd to give

:45:26.:45:29.

the House and overall view of the NHS in her constituency. Brhghton

:45:30.:45:34.

and Hove CCG has a geographhcal area of approximately 34 square liles and

:45:35.:45:38.

covers a patient population of some 300,000. Commissions a wide range of

:45:39.:45:45.

health care services includhng from the main local acute trust, Brighton

:45:46.:45:48.

and Sussex University Hospitals NHS Trust. The regional teaching

:45:49.:45:53.

hospital working across two sites in Brighton and Hove. I understand that

:45:54.:45:56.

the trees that a recruit trtst treats over three quarters of a

:45:57.:46:00.

million patients every year and it recognises its growing role as a

:46:01.:46:04.

developing academic centre. The honourable lady has asked not for

:46:05.:46:08.

the first time for more funding to improve services and facilities in

:46:09.:46:12.

Brighton and I am pleased that she recognised in her speech thd over

:46:13.:46:17.

half ?1 billion capital invdstment under way at the Royal Sussdx County

:46:18.:46:22.

Hospital replacing some verx old buildings as she said and stpporting

:46:23.:46:26.

the service quality improvelents planned by the trust. I was a little

:46:27.:46:29.

bit disappointed that the honourable gentleman in his intervention which

:46:30.:46:33.

came just around the time that she was referring to this capit`l

:46:34.:46:37.

investments didn't also acknowledge that this is a significant

:46:38.:46:41.

investment in the facilities at the heart of health provision in

:46:42.:46:47.

Brighton. But this government has created the Care Quality Colmission

:46:48.:46:51.

to shine a light on good and bad health care quality up and down the

:46:52.:46:55.

country and their independent inspection teams provide a vital

:46:56.:46:59.

function on behalf of patients and everyone in England in challenging

:47:00.:47:04.

health hospitals, GP surgerhes, care homes and all other health care

:47:05.:47:06.

providers are delivering to the standards we should all expdct. CQC

:47:07.:47:13.

have identified that local NHS in the honourable lady's consthtuency

:47:14.:47:17.

faces some challenges and I would acknowledge that the confludnce of

:47:18.:47:23.

inspection reports coming ott around the same time as several of the

:47:24.:47:27.

different providers and commissioners in her area is an

:47:28.:47:37.

unusual challenge to correct. This does come in stark contrast as was

:47:38.:47:42.

pointed out by my honourabld friend for East Worthing and Shoreham that

:47:43.:47:51.

next door there is an outst`nding rated Western Sussex Hospit`l NHS

:47:52.:47:53.

Foundation Trust which also serves residents of West Sussex. While

:47:54.:48:06.

next-door, as was clearly indicated by an honourable lady, Brighton and

:48:07.:48:10.

is six NHS Trust was rated inadequate earlier this year by the

:48:11.:48:14.

CQC Andrew support their recovery, NHS improvement has placed distrust

:48:15.:48:21.

into special measures. I am extremely grateful for him giving

:48:22.:48:24.

way soberly in his speech. He mentions there is an unusual

:48:25.:48:27.

confluence of reports coming in I would suggest that actually the

:48:28.:48:30.

unusual thing is that each of these reports are indicating such extreme

:48:31.:48:35.

failure in many different p`rts of our health system in Brighton and

:48:36.:48:40.

Hove. From the Ambulance Trtst to six GP surgeries brilliantlx

:48:41.:48:43.

outlined by the member for Brighton Pavilion right through to the

:48:44.:48:45.

hospital trust all in speci`l measures and the hospital in

:48:46.:48:49.

financial measures. That is the unusual thing. I would suggdst that

:48:50.:48:53.

the economy from Brighton and Hove is no bankrupt. Could I suggest the

:48:54.:48:58.

Minister that he doesn't do his thinking on his feet now but would

:48:59.:49:02.

he just consider that if his department would appoint solebody to

:49:03.:49:06.

our city who can take an ovdrview of what is right and wrong in our city,

:49:07.:49:10.

the funding and the relationship between the different health bodies

:49:11.:49:13.

and the local authority and that does bring together all of the

:49:14.:49:17.

health systems, figure out what is wrong and figure out how we can

:49:18.:49:20.

bring together to solve all these problems together because the

:49:21.:49:26.

fractures have got much. I will take up his invitation to think ly feet,

:49:27.:49:30.

but they will be preferring in remarks later to some the

:49:31.:49:34.

sustainability and transforlation plan the honourable lady referred to

:49:35.:49:38.

which is providing a forum for much closer collaboration across the NHS

:49:39.:49:43.

within an area. Clearly it hs a much larger area than Brighton itself.

:49:44.:49:47.

But it is I think going somd way towards meeting the kind of analysis

:49:48.:49:51.

the honourable gentleman is looking for and I will also look at some of

:49:52.:49:55.

the individual trust support that they are getting on a wider NHS

:49:56.:50:02.

group to provide additional qualified medical and managdrial

:50:03.:50:06.

support to help solve these problems. I simply want to put on

:50:07.:50:13.

record that again he referenced the fact that at the rotor is a more

:50:14.:50:16.

successful trust and I would just point that not only are we operating

:50:17.:50:20.

in a very old building but we are also trying to do that at the time

:50:21.:50:24.

when the hospital has becomhng this major trauma centre and that is a

:50:25.:50:28.

massive change to what is h`ppening in Brighton and Hove. So I would

:50:29.:50:30.

simply reemphasise the points that make honourable colleague from Hove

:50:31.:50:36.

made that what we need here is need -- real finance and I don't think it

:50:37.:50:39.

is good to do it, it need some money. Thank you. I think,

:50:40.:50:48.

acknowledging the point she has made, I hope in part the STP will

:50:49.:50:54.

focus the attention of the wider area to support the new tratma

:50:55.:50:57.

centre that is being establhshed, because that is part of the purpose

:50:58.:51:03.

of the STP although of course I have yet to see the full details. I think

:51:04.:51:08.

we all recognise that patients deserve the highest quality care. We

:51:09.:51:12.

expect the trust to take action to ensure that the root causes of the

:51:13.:51:18.

CQC concerns are addressed. NHS improvement has confirmed that the

:51:19.:51:22.

trust has developed a recovdry plan and as part of a package of support

:51:23.:51:27.

for the trust from being in special measures NHS improvement has

:51:28.:51:30.

appointed an improvement director and a board adviser. I think we

:51:31.:51:39.

should also acknowledge that in addition to the trust challdnges,

:51:40.:51:42.

there are some other good things going on in Brighton, I think we

:51:43.:51:48.

should praise the team that delivers services for children at thd Royal

:51:49.:51:51.

Alexandra Children's Hospit`l in Brighton, as the CQC has iddntified

:51:52.:51:57.

them as rated outstanding for being innovative and well fed. Emdrgency

:51:58.:52:03.

care services at the trust `re not as we would expect as she h`d

:52:04.:52:08.

identified. Support the nathonal emergency care improvement

:52:09.:52:11.

programme, a clinically led initiative that offers intensive

:52:12.:52:16.

practical help to trusts looking to improve their emergency services,

:52:17.:52:19.

NHS improvement is also working closely with local clinicians to

:52:20.:52:25.

make a difference for peopld Brighton and Hove seeking elergency

:52:26.:52:28.

care. The trust is also devdloping plans to create capacities to

:52:29.:52:31.

support delivery of the planned care standards. As the honourabld lady

:52:32.:52:37.

said on Monday last week NHS improvement announced that the trust

:52:38.:52:40.

had entered financial speci`l measures. A prop -- programle launch

:52:41.:52:44.

by the regulator that provides a rapid turnaround passage for trusts

:52:45.:52:49.

that have either not agreed savings targets with local commissioners or

:52:50.:52:52.

had planned to make savings but would you taking significantly from

:52:53.:52:55.

this plan in third quarterlx returns. As part of financi`l

:52:56.:53:00.

special measures the trust will agree a recovery plan with NHS

:53:01.:53:04.

improvement within a certain period of time. But trust will also get

:53:05.:53:09.

support from and is held accountable by a financial improvement director,

:53:10.:53:13.

being appointed to the trust. The honourable lady has also referred to

:53:14.:53:18.

the challenges faced by the Ambulance Services in her

:53:19.:53:25.

constituency and in the are` and in addition, South East Coast @mbulance

:53:26.:53:27.

Service was recommended for special measures by the CQC in its

:53:28.:53:31.

inspection report published last month. NHS improvement acknowledges

:53:32.:53:38.

that there are wide-ranging problems in the trust including Governor

:53:39.:53:42.

structures and processes, ctlture and performances and emerging

:53:43.:53:47.

issues. It has agreed a support package for the crossed that I could

:53:48.:53:50.

trust, formalised on August nine this year and this includes a formal

:53:51.:53:55.

peer support relationship whth a neighbouring Ambulance Trust that is

:53:56.:53:59.

rated good by the CQC. As p`rt of the support package, NHS Improvement

:54:00.:54:05.

has also appointed an interhm chair and is appointing an improvdment

:54:06.:54:13.

director in due course. For the second time, I am extreme are

:54:14.:54:15.

grateful for him giving way. We focus on the onus for improvement on

:54:16.:54:20.

the delivery bodies within the Brighton and Hove area NHS

:54:21.:54:25.

Improvement and CQC have bedn outlining plans and their

:54:26.:54:28.

responsibilities to instigate this improvement, does he accept also

:54:29.:54:36.

that NHS Improvement is also being scrutinised and is under scrutiny in

:54:37.:54:38.

the way that they unfold thhs improvement programme and if

:54:39.:54:43.

improvements don't happen f`st enough, they will also be ctlpable,

:54:44.:54:46.

because some of the dates that have already been outlined for

:54:47.:54:50.

improvement have passed without the improvements being met. I think the

:54:51.:54:58.

honourable gentleman will rdcognise that NHS Improvement only c`me

:54:59.:55:02.

together with effect from April this year as the two previous regulators

:55:03.:55:07.

were combined. It is to a ddgree finding its feet in working out how

:55:08.:55:13.

best to assist trusts that get into difficulty. It has introducdd a

:55:14.:55:17.

number of different schemes from different types of challengd and we

:55:18.:55:23.

touched on the care challenge and the financial special measures

:55:24.:55:29.

challenge. Also undertaking a 5-point A improvement plan to

:55:30.:55:32.

focus particularly on challdnges within emergency care. So, H think

:55:33.:55:38.

it is fair to say that it is early days to see how NHS Improvelent

:55:39.:55:44.

undertakes its functions, btt we have every confidence in NHS

:55:45.:55:52.

Improvement to be able to assist trusts in dealing with thesd

:55:53.:55:57.

challenges. Finally, in rel`tion to the south-east Ambulance Service,

:55:58.:56:05.

NHS Improvement is also unddrtaking a capability and capacity rdview and

:56:06.:56:09.

will provide the trust support with its finances. The honourabld lady

:56:10.:56:15.

has also touched on the problems with the non-urgent patient

:56:16.:56:18.

transport service provider `nd this has clearly been a very difficult

:56:19.:56:21.

time for its staff and for some patients. My understanding hs that

:56:22.:56:30.

high reverse haven CCG has overseen the implementation plans ensuring

:56:31.:56:34.

continuity of service, and has recently appointed a specialist

:56:35.:56:37.

transport adviser to look into the resilience of the contract `nd

:56:38.:56:40.

explore options to strengthdn this further. The provision of these

:56:41.:56:43.

services is quite rightly a matter for the local NHS and she asked who

:56:44.:56:48.

is responsible for monitoring contracts and the reality is that it

:56:49.:56:53.

is the CCG which is the statutory NHS body with responsibilitx for the

:56:54.:56:56.

integrity of the procurement as well as managing the contract. It has

:56:57.:57:01.

powers within the stand -- standard NHS contract to intervene where a

:57:02.:57:06.

contract performance. What hs expected. I am grateful to him. He

:57:07.:57:13.

is saying the CCG has that power but they told me they could not see the

:57:14.:57:18.

contract that was between co-performer and there

:57:19.:57:20.

subcontractors because that was not to see they cannot have that degree

:57:21.:57:25.

of oversight and if this is the last time he is going to give wax, could

:57:26.:57:28.

he say whether he is going to step in on the issue of whether or not

:57:29.:57:34.

Docklands Phoenix company actually is properly licensed to be providing

:57:35.:57:37.

be served at it is providing because right now we don't know and that

:57:38.:57:40.

could be putting our patients at risk.

:57:41.:57:44.

It is down to the CCG to undertake a contract giving it visibility

:57:45.:57:51.

through sub contracts. If that is a failing subsequent contracts, they

:57:52.:57:56.

need to get to and they will learn from that message. As to thd

:57:57.:58:01.

regulation of the provider, that is a matter for the CQC to look at and

:58:02.:58:07.

I will undertake to enquire of them what status the provider has to

:58:08.:58:17.

ensure that is properly regtlated. She spent much of her remarks

:58:18.:58:24.

talking about, in familiar terms about her understanding of the

:58:25.:58:28.

impact of her so-called privatisation of the NHS. I gently

:58:29.:58:33.

remind her the Health and Social Care Act 2012 did not introduce

:58:34.:58:38.

competition to the NHS. Previous governments have used patient choice

:58:39.:58:41.

and competition as part of their reform programme and independent

:58:42.:58:46.

sector providers have been providing care and services to NHS patients

:58:47.:58:52.

under successive governments since the NHS was founded. And in

:58:53.:58:56.

particular in the area of nonemergency patient transport, this

:58:57.:58:58.

has been happening across m`ny areas of the country. In the last year for

:58:59.:59:07.

which data is available, NHS commissioners purchased sevdn points

:59:08.:59:11.

6% of total health care frol the independent sector and in 2010, this

:59:12.:59:18.

was around 5%, the rate of growth of the use of private providers is

:59:19.:59:21.

lower under this government and labour. -- van labour. We h`ve about

:59:22.:59:36.

an hour left to carry on thd debate. That is only if the minister wishes

:59:37.:59:42.

to speak for an hour. Indulge me on this intervention. Whilst I have no

:59:43.:59:50.

problem with the principle of outsourcing and she is right, the

:59:51.:59:54.

level of outsourcing may go up and may give down because it should be

:59:55.:00:00.

based on the quality of altdrnative providers providing quality services

:00:01.:00:03.

and is the best place at thd time but will he acknowledge on this code

:00:04.:00:12.

performer company, where people are vulnerable people relying on regular

:00:13.:00:17.

treatment have been left at home or dumped elsewhere and have not

:00:18.:00:21.

accessed this. This has been going on for so long. But warmly put the

:00:22.:00:28.

contract to organisations lhke this, much better due diligence ndeds to

:00:29.:00:32.

be done and there needs to be a fallback plan because when the

:00:33.:00:35.

ambulance service, who declhne to take on this contract in thd first

:00:36.:00:39.

place are now not in a position to take it on anyway, there is little

:00:40.:00:43.

option for somebody else to come in and take on the service urgdntly and

:00:44.:00:48.

provide level of care consthtuents need and it has not happened. Well,

:00:49.:00:57.

he makes a powerful case and as I have undertaken to the membdr of

:00:58.:01:04.

Brighton Pavilion, I will bd looking and taking up this issue with CQC to

:01:05.:01:10.

ask them to give me some re`ssurance as to both the regulation and how

:01:11.:01:18.

the procurement... Is relev`nt to them, we should look at Chew

:01:19.:01:21.

diligence for this activity. I accept that. I will close whthout

:01:22.:01:28.

taking further interventions. A brief word more as I promisdd on the

:01:29.:01:33.

sustainability and transforlation plans. These are, were submhtted to

:01:34.:01:41.

NHS England by 44 regions dtring the course of last week and as H said,

:01:42.:01:51.

the intent of these plans is to build on the work ready unddrtaken

:01:52.:01:54.

to strengthen care and help deliver the NHS plans for the futurd set out

:01:55.:02:01.

in the five-year forward by encouraging providers and

:02:02.:02:04.

commissioners within an are` to work more collaboratively without the

:02:05.:02:13.

barriers of stove piping whhch have led to conflict between to

:02:14.:02:18.

incorporate to come up with the best plan for patients and taking into

:02:19.:02:24.

account as mentioned increasing integration with social card

:02:25.:02:29.

providers in the area. And so local authorities are an integral part to

:02:30.:02:37.

these plans. I cannot give way. We are expecting most areas will

:02:38.:02:42.

undertake public engagement from now until the end of the year and build

:02:43.:02:46.

on the engagement they have done to shape thinking but we are clear we

:02:47.:02:51.

do not expect changes to thd services people currently rdceive

:02:52.:02:58.

without proper local engagelent and public consultation. There `re

:02:59.:03:01.

long-standing processes in place to make sure this happens so in

:03:02.:03:05.

closing, I have been generots and I have spoken for substantially longer

:03:06.:03:13.

than I normally would in wide gap and debate. It is the responsibility

:03:14.:03:17.

of local NHS organisations to determine how local services are

:03:18.:03:21.

delivered. They are best pl`ced to understand the needs of the people

:03:22.:03:24.

they serve and we must ensure changes led locally. In somd cases

:03:25.:03:31.

with improved local managemdnt where there has been shortcomings and the

:03:32.:03:35.

need to be focused on the ndeds of local populations and not cdntral

:03:36.:03:39.

government driven. This govdrnment recognises the importance of

:03:40.:03:42.

ensuring the NHS is held to standards of care in her

:03:43.:03:47.

constituency and across the UK and we continue to work to ensure

:03:48.:03:51.

services of high-quality, s`fe and appropriate affordable. The question

:03:52.:04:00.

is that we do now adjourned. The ayes have it. Order, order!

:04:01.:05:01.

No one can deny politicians are pretty important people, as I am

:05:02.:05:07.

sure they are the first to remind us. After all, it is up to them to

:05:08.:05:11.

make the laws which govern the lives. You and I might call them

:05:12.:05:15.

bigwigs and the origin of this word can be found in Parliament s

:05:16.:05:20.

judicial heritage. Westminster Hall and the Houses of Parliament was the

:05:21.:05:23.

meeting point for the law courts for seven

:05:24.:05:25.

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