06/12/2016

:00:00. > :00:07.look forward to seeing what more we can do. Thank you, order. Oh, point

:00:08. > :00:12.of order. Alison view list. Thank you very much, Madam Deputy Speaker.

:00:13. > :00:17.I am not sure if you can say this was an order or not. I asked the

:00:18. > :00:20.Secretary of State four legitimate questions and he refused to answer

:00:21. > :00:26.any of those until I was more serious. Could you tell me, Madam

:00:27. > :00:31.Deputy Speaker, how I can resolve this issue? I thank the honourable

:00:32. > :00:38.lady for raising her point of order and indeed I heard her ask the

:00:39. > :00:42.questions and I heard the Secretary of State's reply and I have to say

:00:43. > :00:47.the Secretary of State is at liberty to give whatever reply he wishes as

:00:48. > :00:53.long as he does so in an orderly and polite manner, which of course he

:00:54. > :00:58.did. But the honourable lady is also at liberty to ask her questions in

:00:59. > :01:02.other ways at question time by asking for an adjournment debate, by

:01:03. > :01:07.putting down other questions to the Secretary of State and by raising

:01:08. > :01:12.her issues again. It is not a matter for the chair at what the answer is.

:01:13. > :01:15.I am satisfied the honourable gentleman was orderly in the way in

:01:16. > :01:23.which he gave the answer to the honourable lady. Further to that

:01:24. > :01:27.previous point of order, the honourable lady has said she asked

:01:28. > :01:32.four questions to the Secretary of State. Could the chair give advice?

:01:33. > :01:37.I thought members were only allowed to ask one question. I am delighted

:01:38. > :01:42.to give the honourable gentleman that piece of advice. The honourable

:01:43. > :01:48.gentleman is allowed to ask only one question. But the honourable lady is

:01:49. > :01:52.here this afternoon in her capacity as a spokesperson for the Scottish

:01:53. > :01:57.National party. In that capacity she may ask as many questions as she

:01:58. > :02:09.likes, as long as it takes her only one minute to do so. Order. We now

:02:10. > :02:15.come to the ten minute rule motion. Mrs Anne-Marie Trevelyan. Thank you,

:02:16. > :02:20.Madam Deputy Speaker. I beg to move that leave be given to bring in a

:02:21. > :02:23.bill to make provision for children of the serving members of the Armed

:02:24. > :02:27.Forces to have a right of high priority admission to schools

:02:28. > :02:32.outside the normal admissions arounds. It is an honour to stand to

:02:33. > :02:38.present my first ten minute Law Bill on schools admissions for children

:02:39. > :02:41.of our serving armed forces. Today is the patron Day of Saint Nicholas,

:02:42. > :02:55.the patron saint of children and sailors. Tens of thousands of

:02:56. > :03:02.military schoolchildren. Saint Nicholas is the guardian of children

:03:03. > :03:05.and I hope very much that the Minister listening today will agree

:03:06. > :03:10.with me that we have a collective duty to all of those children born

:03:11. > :03:13.to military families to do everything in our power to reduce

:03:14. > :03:19.the educational disadvantages which these school moves create, by

:03:20. > :03:23.ensuring that when they need to take place we have done everything we can

:03:24. > :03:28.to make the transition as stress-free as possible for parents

:03:29. > :03:32.and child. This issue was brought to my attention earlier this year when

:03:33. > :03:36.a serving army officer contacted me in my capacity as the chairman of

:03:37. > :03:41.the all-party Parliamentary group for the Armed Forces Covenant. I

:03:42. > :03:48.take the greatest pleasure and responsibility in holding this role

:03:49. > :03:55.and I am privy to the anxieties of many serving soldier, service man or

:03:56. > :03:59.a woman. I am honoured to champion their needs as they have no voice of

:04:00. > :04:04.their own as a result of their service. This bill highlight one

:04:05. > :04:11.such concern which I believe we must sort out for them. This army officer

:04:12. > :04:20.was being posted 200 miles from his existing job at seven weeks' notice.

:04:21. > :04:25.The family had but a few weeks to research local schools and get a

:04:26. > :04:30.place for their child. This little boy, let's call him James, at the

:04:31. > :04:35.grand old age of six has lived in four different houses and has been

:04:36. > :04:38.to three different educational establishments already. That is

:04:39. > :04:45.making new friends three times over by the age of six. With all the

:04:46. > :04:49.family support in the world, this little boy is being asked to develop

:04:50. > :04:55.levels of resilience which few of us would expect from our own children.

:04:56. > :05:00.Not only did his parents have a very few weeks to find a school all over

:05:01. > :05:04.the summer holidays, but they were initially told that the choice with

:05:05. > :05:10.children from neighbouring houses on the base also attending, giving

:05:11. > :05:15.James supportive friends, was not possible. The local authorities

:05:16. > :05:19.stated that whilst he was a service child, there is no right of entry

:05:20. > :05:25.and they are within their rights to refuse admission. This struck me as

:05:26. > :05:30.extremely stressful for the family, but going wholly against the Armed

:05:31. > :05:34.Forces Covenant. On the basis that a few local schools were struggling

:05:35. > :05:38.with armed services children arriving at once, I asked them how

:05:39. > :05:44.many of their schools had children in receipt of service school

:05:45. > :05:49.premiums and in what proportions. There are a few servers children in

:05:50. > :05:52.a very large proportion of any local authorities schools, regardless of

:05:53. > :06:01.whether they are close to a military base or not. In Northumberland we

:06:02. > :06:07.have two military bases. But service children are to be found in only

:06:08. > :06:13.very small numbers, often in ones or twos, in 63% of all of

:06:14. > :06:20.Northumberland's schools. In another authority, the proportion of schools

:06:21. > :06:25.with service pupils is 76%, but only six schools have more than 30

:06:26. > :06:28.children in their cohort. The impact of a single child arriving or

:06:29. > :06:35.leaving will not have a major impact on numbers. Another distressing part

:06:36. > :06:39.of trying to sort out the place for James was that the local authorities

:06:40. > :06:44.stated they would accept him onto the waiting list, but would not

:06:45. > :06:55.inform the family of a place until the first day of term. Whilst the

:06:56. > :06:59.family were hopeful that plays would be available, they could not rely

:07:00. > :07:03.upon it, nor introduced James two other children who he might end up

:07:04. > :07:08.in the class with since the authority refused to give him any

:07:09. > :07:13.certainty. This is not meeting our commitment to service personnel and

:07:14. > :07:20.there. Young James had a place confirmed a week before the school

:07:21. > :07:26.started thanks to the family's new MP's intervention, but not to a code

:07:27. > :07:32.that would make cancelled obliged to find a place for a service family's

:07:33. > :07:36.child. I have met a family with two children who were offered places in

:07:37. > :07:42.different schools with a parent who does not drive. The child would have

:07:43. > :07:47.to be late into reception and another would have to be collected

:07:48. > :07:51.on foot. Another child was offered a place at a failing school and the

:07:52. > :07:55.mother said, why is it that army kids have to endure the worst

:07:56. > :08:03.schools alongside all the other pressures they have to endure? Some

:08:04. > :08:09.go to schools with special needs. The present system is structured

:08:10. > :08:12.towards two admissions per academic year, meaning any child seeking

:08:13. > :08:17.admission outside that has to confirm that the school has the

:08:18. > :08:22.capacity. Military families do not have the luxury of timing their

:08:23. > :08:25.moves within this timetable. Councils are failing to live up to

:08:26. > :08:30.the commitment they have pledged to uphold when they signed the

:08:31. > :08:34.community covenant. Some local authorities do think about how to

:08:35. > :08:39.apply their commitment in practical terms, but others have not moved

:08:40. > :08:42.beyond good intentions. One local authority informed a military family

:08:43. > :08:50.that the Armed Forces Covenant does not apply to them. Our education

:08:51. > :08:52.system is geared to acknowledge some children face exceptional

:08:53. > :08:57.circumstances and they won the priority with admissions in order to

:08:58. > :09:01.offset the difficulties they have already faced. That is why look

:09:02. > :09:08.after children have top priority. This bill seeks to recognise that

:09:09. > :09:10.military children face significant upheaval and educational

:09:11. > :09:14.disadvantages through no fault of their own and they should have high

:09:15. > :09:19.priority for admissions. The bill would have the secondary effect of

:09:20. > :09:22.relieving pressure on military families who often have short notice

:09:23. > :09:29.moves and then have children in schools miles from base. It seems to

:09:30. > :09:32.often some local authorities are pushing back against the Armed

:09:33. > :09:38.Forces Covenant, despite having signed up to it, leaving families

:09:39. > :09:44.anxious and having to fight appeals which are sometimes lost. The

:09:45. > :09:49.schools admission code is not robust enough to ensure that whatever and

:09:50. > :09:53.wherever a military family has to live they will find the right school

:09:54. > :09:57.for their children. We are not doing in practice what we talk about when

:09:58. > :10:02.we say we are committed to the covenant. I never want to hear again

:10:03. > :10:06.from a serving member of our Armed Forces who is trying to find a

:10:07. > :10:11.school for their child the phrase this should not be this hard. I

:10:12. > :10:17.cannot bear putting my child through this stress every two years, so I

:10:18. > :10:22.will leave as soon as I am able, even though I love my job. At a time

:10:23. > :10:25.when we want to retain as many of our committed staff as possible,

:10:26. > :10:33.this is unacceptable. My wonderful grandmother used to say

:10:34. > :10:36.that whilst I not be possible to feed 1000 starving children, it is

:10:37. > :10:42.almost always possible to feed one. We cannot resolve the plight of

:10:43. > :10:46.children in Mosul or give continuing education to children in camps

:10:47. > :10:55.displaced from homes. But I am certain that the first -- a simple

:10:56. > :10:58.change in a lot here, every British trial can be guaranteed that place

:10:59. > :11:04.at the right school for him and his family's unique needs, regardless of

:11:05. > :11:08.whether they apply for a place in which ever year group they land. Jon

:11:09. > :11:14.James and the 40,000 other military children whose parents put their

:11:15. > :11:21.lives on the line for us deserve nothing less, Madame deputies. The

:11:22. > :11:24.question is that the honourable member have leave to bring in the

:11:25. > :11:35.bill. As many allies of the opinion, say aye. The ayes have it. Who will

:11:36. > :12:22.bring in the Bill? Children of armed services personnel

:12:23. > :12:31.schools admission bill. Second reading, what day? 20th of January

:12:32. > :12:36.20 17. The clerk will proceed to read the

:12:37. > :12:44.orders of the day. Health Service medical supplies costs bill to be

:12:45. > :12:53.considered. We begin with new clause one, with

:12:54. > :13:00.which it will be important to consider this on a selection paper.

:13:01. > :13:06.I rise to speak to new clause one, which stands in my name, in the name

:13:07. > :13:10.of my honourable friend, the member for Burnley, and other amendments in

:13:11. > :13:14.the group. On behalf of the opposition, we are not opposing this

:13:15. > :13:16.bill. The amendments add a constructive attempt to help the

:13:17. > :13:26.Government stated zone stated aims and close the growing gap between

:13:27. > :13:31.the UK's record on drugs and the ability of patients to access them.

:13:32. > :13:34.We want to focus on the impact of the bill in three areas. The price

:13:35. > :13:39.and availability of drugs and medical supplies. Research and

:13:40. > :13:41.development. And the NHS's legal duty to promote innovation. The

:13:42. > :13:46.pharmaceutical industry in this country employs over 70,000 people

:13:47. > :13:50.in predominantly high skilled and well-paid jobs. Just the sort of

:13:51. > :13:56.jobs members on all side of the Houses would want to encourage. This

:13:57. > :13:59.has been one of a great success stories but we can't take it for

:14:00. > :14:02.granted. Particularly as investment decisions are often taken by parent

:14:03. > :14:05.companies and other parts of the world. There is considerable unease

:14:06. > :14:10.in the sector about the relatively low take-up of new medicines by the

:14:11. > :14:13.NHS compared with compatible nations and also the ongoing uncertainty

:14:14. > :14:17.surrounding the future of the European medicines agency. In

:14:18. > :14:19.relation to the latter, a number of major companies have placed

:14:20. > :14:22.themselves here because of the European medicines agency and the

:14:23. > :14:27.Warriors clearly that they might wish to follow if it was to relocate

:14:28. > :14:31.following Brexit. The impact assessment for the bill states, as

:14:32. > :14:34.we might expect, that there will be an impact on the revenue of the

:14:35. > :14:38.pharmaceutical sector which could lead to in research and development

:14:39. > :14:47.and consequent losses to the UK economy estimated at ?1 million per

:14:48. > :14:54.annum. We fully agree with what the Government is seeking to achieve. We

:14:55. > :14:57.want to review to take place within a reasonable time frame to ensure

:14:58. > :15:00.there are no unintended consequences and that we can remain confident the

:15:01. > :15:05.pharmaceutical sector in this country will continue to be at the

:15:06. > :15:07.forefront. We face competition not a minute but from an urgent nations

:15:08. > :15:13.such as Brazil and China and we need to ensure the NHS does not drop away

:15:14. > :15:19.from the take-up of new drugs. 14 high income studies were shown

:15:20. > :15:25.analyst and the UK ranked ninth of all medicines studies. Studies have

:15:26. > :15:28.shown relatively low take-up of new medicines in the UK which is bad for

:15:29. > :15:34.patients in the pharmaceutical industry. The bill means to achieve

:15:35. > :15:38.balance. We need the best possible access for patients and medication

:15:39. > :15:41.at the fairest price but we need to encourage the pharmaceutical

:15:42. > :15:49.industry to increase research and develop them. I will give way. I

:15:50. > :15:52.intervene in my capacity as chairperson of the all-party group

:15:53. > :15:57.on diabetes. And the diabetes drugs bill is enormous. It runs into

:15:58. > :16:01.hundreds of millions of pounds. While I accept what my honourable

:16:02. > :16:03.friend has said, that we need to make sure pharmaceutical companies

:16:04. > :16:08.are able to invest in the provision of new drugs for diabetes, there are

:16:09. > :16:11.also other choices such as lifestyle choices. These also need to be

:16:12. > :16:17.investigated at the same time as looking for new drugs. Does he

:16:18. > :16:23.agree? Thank you. Thank you for the question. If I had known he was

:16:24. > :16:31.here, I could haven't dissipated the tone of the question and he is

:16:32. > :16:35.absolutely right to raise the issue of diabetes and a real need for us

:16:36. > :16:43.to increase measures to improve prevention. I was interested to

:16:44. > :16:47.visit a launch last week with a number of interesting initiatives. I

:16:48. > :16:53.believe that it was called the diabetes village. It is an

:16:54. > :16:58.interesting concept that will hopefully reduce the cost of

:16:59. > :17:01.diabetes treatment on the NHS. Madam Deputy Speaker, in terms of the

:17:02. > :17:05.amendment, the review would look at the impact of the Bill and the

:17:06. > :17:08.pricing of medicines and medical supplies. We pointed to the Minister

:17:09. > :17:14.that the years ago, the Government said it would provide an

:17:15. > :17:19.unprecedented level of certainty on almost all NHS branded medicines.

:17:20. > :17:22.That has not come to pass. The review would identify issues at an

:17:23. > :17:26.early stage and take appropriate action. The Government was not

:17:27. > :17:30.willing to commit to such a review of the committee stage. The Minister

:17:31. > :17:34.referred as to the clause referring to give you one year on in the

:17:35. > :17:38.regulations. This is not the same thing as looking at the impact that

:17:39. > :17:46.the legislation in its totality. In the way regulations are currently

:17:47. > :17:59.drafted... The draft regulations talk about the review in a much

:18:00. > :18:08.narrower sense. Will my friend give way? Certainly. Does he find it

:18:09. > :18:13.strange, as he has just referred to, that the regulations that might

:18:14. > :18:23.happen in relation to this act talk about a review being carried out to,

:18:24. > :18:30.quote, this is 14.2 of the regulations. 14.2 says that the

:18:31. > :18:32.report must set out objections intended to be achieved by these

:18:33. > :18:37.regulations. Wouldn't one expect those objectives to be set out

:18:38. > :18:43.before the regulations were made? Isn't that the cart before the

:18:44. > :18:46.horse? Thank you for the intervention. He is absolutely

:18:47. > :18:48.right. That is why there is some anxiety that we might end up with a

:18:49. > :18:56.self-fulfilling prophecy with these reviews. No doubt the Minister can

:18:57. > :19:05.address that when he replies. What is not there is anything to assess

:19:06. > :19:08.the potential impact of these regulations on research development

:19:09. > :19:13.and innovation. There is nothing on the availability on medicines and

:19:14. > :19:17.medical supplies. We believe our anxieties on this are well placed

:19:18. > :19:20.and felt the Minister will reconsider his stance on this

:19:21. > :19:23.proposal and provide some reassurance on these areas of

:19:24. > :19:27.concern and that they will be carefully monitored in future.

:19:28. > :19:30.Turning to amendment eight, this seeks to compel the Government to

:19:31. > :19:39.invest in rebate from the pharmaceutical sector to improve

:19:40. > :19:43.access to new innovative treatments. The Secretary of State confirmed

:19:44. > :19:52.that ?1.24 billion is beam it onto the Department of Health. That is a

:19:53. > :19:56.considerable amount. Despite numerous questions being asked

:19:57. > :20:01.through the passage of this bill, we have not heard from the Government

:20:02. > :20:04.will this money has gone. This new money, which could have delivered a

:20:05. > :20:08.StepChange in access to treatment to the benefit of patients and the life

:20:09. > :20:22.sciences sector, could simply be added to the baseline. It would mean

:20:23. > :20:26.?1 less coming from the Treasury. It would aid transparency to make clear

:20:27. > :20:29.this money was put over and above Government funding and was

:20:30. > :20:34.ring-fenced for a specific use. We know for example that in Scotland

:20:35. > :20:40.the money has been ring-fenced to provide new treatments for

:20:41. > :20:43.medicines. And there is nothing the Minister has said so far that has

:20:44. > :20:48.persuaded us from believing that is the correct approach. According to

:20:49. > :20:59.an expert from the Cystic Fibrosis Trust, this rebate is necessary...

:21:00. > :21:04.He cites a drug that could increase the lung capacity of someone with

:21:05. > :21:08.cystic fibrosis considerably. Patients in England cannot access

:21:09. > :21:14.the winners patients in Europe and Scotland can benefit from this

:21:15. > :21:18.transformative drug. I quote him when he says, there is no comparable

:21:19. > :21:20.fund in England. Having your medicines funded and skull and

:21:21. > :21:23.provides a much greater chance for patients to access these medicines.

:21:24. > :21:27.We do not see a clear pathway for how patients can access these

:21:28. > :21:36.medicines. Of course, there are many other examples. The -- it is

:21:37. > :21:41.shameful that people in England are deprived of these drugs on the basis

:21:42. > :21:47.of financial rather than clinical judgments. We understood the purpose

:21:48. > :21:51.of the bill was to deliver certain sea and in any event ring fencing

:21:52. > :21:54.does not include additional resources. We look the Government

:21:55. > :22:00.will give serious consideration to this proposal. Madam Deputy Speaker,

:22:01. > :22:05.timing finally to the remaining amendments, we welcome the father

:22:06. > :22:07.improvements in relation to the devolved administration is.

:22:08. > :22:13.Questions have to be asked about the concentration process. --

:22:14. > :22:19.consultation process. Perhaps this can be reflected on in future

:22:20. > :22:24.legislation. We will come amendments made by the SNP to Klauss five and

:22:25. > :22:29.six and welcome consultation on the potential impact of controls on

:22:30. > :22:32.other medical supplies. These provisions were lacking from initial

:22:33. > :22:34.consultations. There are some considerable anxiety within the

:22:35. > :22:39.sector about how controls will be used. This is a matter for future

:22:40. > :22:42.regulations but it is less than satisfactory for the Government to

:22:43. > :22:46.ask for powers without telling us how they will be used. We would say

:22:47. > :22:50.that this is another reason for us to seriously consider the kind of

:22:51. > :22:59.review we have set out in new clause one as well. New clause one, review

:23:00. > :23:03.of the impact of the act on pricing, research and development and

:23:04. > :23:09.innovation. The question is that new clause one

:23:10. > :23:12.B read a second time. I will not get in the House for

:23:13. > :23:19.long. That is normal at the start of a very, very long speech. But in

:23:20. > :23:23.fact I will be very brief. I wanted to rise firstly by declaring my

:23:24. > :23:29.interest as the chairperson of the all-party diabetes group and as a

:23:30. > :23:34.type two diabetic to welcome the proposals that have been put forward

:23:35. > :23:38.by my honourable friend on the front bench. I hope the Government will

:23:39. > :23:42.accept it, because these are reasonable portals which are

:23:43. > :23:46.designed to look at the impact of the act. -- reasonable proposals.

:23:47. > :23:51.And to make sure that achieves what it wants to achieve. That is not

:23:52. > :23:54.always the case as far as legislation is concerned. There's a

:23:55. > :23:57.lot of agreement in respect of this bill. The Minister should be

:23:58. > :24:01.commended for the way in which he has introduced the bill and the

:24:02. > :24:05.reasons behind this bill, the ever rising cost of drugs to the National

:24:06. > :24:14.Health Service. We know of the work that was done by the Times newspaper

:24:15. > :24:22.in particular. It is always a battle for diabetics, especially when they

:24:23. > :24:26.meet in informal circumstances, such as last week, when we launched our

:24:27. > :24:30.new report at the all-party group. It was launched by the Secretary of

:24:31. > :24:38.State, who came along. The Minister was due to come and might have gone

:24:39. > :24:43.before I arrive. He is nodding. He did not come. I know that you do not

:24:44. > :24:48.like secondary units as I was tempted to say he nodded. But the

:24:49. > :24:51.Secretary of State and apartment officials were very helpful to the

:24:52. > :25:01.all-party group. Our concern is the ever-increasing level of cost to the

:25:02. > :25:05.NHS for diabetes drugs. Diabetes complications, as the House knows,

:25:06. > :25:13.Costa National Health Service 10% of its budget. -- cost the National

:25:14. > :25:21.Health Service. The drugs bill is in the order of 900 or so million. The

:25:22. > :25:28.problem is that the desire by local GPs to prescribe drugs instead of

:25:29. > :25:35.looking for alternatives. That is why I very much support what is in

:25:36. > :25:55.clause one, sub clause C, the duty to promote innovation.

:25:56. > :26:12.Last week at the invitation to the steno centre in Denmark and to the

:26:13. > :26:21.Leicester Diabetes Centre, I spoke about looking at innovation. The NHS

:26:22. > :26:26.is innovating will result in a reduction in the overall cost of the

:26:27. > :26:31.drugs budget. Now, when I was diagnosed with type two diabetes,

:26:32. > :26:38.the first thing my GP said to me was he had to put me on drugs. If I had

:26:39. > :26:43.been aware of the potential of being a diabetic a few years earlier, and

:26:44. > :26:49.my mother had had diabetes before me, that is usually a family

:26:50. > :26:53.history, not exclusively in respect to type one diabetes, but certainly

:26:54. > :27:00.in respect of families in particular from the South Asian community, even

:27:01. > :27:04.the diabetes affects all communities. My mother had it, but I

:27:05. > :27:09.was not aware of what diabetes meant because at the time I was in

:27:10. > :27:13.government, I was Minister for Europe, flying around making Britain

:27:14. > :27:19.a more integrated into the European Union, unlike 15 years later when it

:27:20. > :27:22.has all changed, so I never had the opportunity of sitting down with my

:27:23. > :27:28.mother who subsequently died and finding out how diabetes operated.

:27:29. > :27:34.As a result I diabetes was caught very late exactly ten years ago. Had

:27:35. > :27:42.I been told by my doctor I am not putting you on tablets, actually I

:27:43. > :27:46.am going to send you off to the gym, I am going to prescribe gym for an

:27:47. > :27:51.hour and you will walk for an hour and you will make these kind of

:27:52. > :27:55.lifestyle changes, perhaps I would not have stopped the type two

:27:56. > :28:00.diabetes affecting me, but perhaps I could have delayed the onset. In the

:28:01. > :28:07.long run I am saving the taxpayer a huge amount of money. That is why

:28:08. > :28:11.innovation is so vital to what is being proposed. Innovation permits

:28:12. > :28:16.so much to be done to reduce the cost to the taxpayer. I know that is

:28:17. > :28:22.not all that is designed in respect of what the government is doing with

:28:23. > :28:27.this bill, but it is a big chunk of it. If we can reduce the cost to the

:28:28. > :28:32.taxpayer of the huge amount of money that is spent on pharmaceutical

:28:33. > :28:34.drugs and given to the pharmaceutical companies, then in

:28:35. > :28:40.the long term it will help the taxpayer. So, that is why I think it

:28:41. > :28:44.is very important... Of course I will give way. Would he agree we

:28:45. > :28:49.have to educate people more, make them aware of what could happen,

:28:50. > :28:55.particularly with obesity levels rising at the levels they are? The

:28:56. > :28:58.honourable gentleman is absolutely right and we both served on the

:28:59. > :29:02.Administration committee and whenever banqueting is raised and we

:29:03. > :29:06.always raise the need to make sure that the food that members of

:29:07. > :29:10.Parliament get especially in the tearoom is food that is compatible

:29:11. > :29:16.with ensuring that our obesity levels are decreased. Madame Deputy

:29:17. > :29:22.Speaker, you will know that when you have your cup of tea that what you

:29:23. > :29:25.have on offer is club biscuits and cakes, Victoria sponge, and all

:29:26. > :29:33.these other things to encourage us to do this. I am not saying whether

:29:34. > :29:36.this would come within Klaus won the seat, but sometimes we regard

:29:37. > :29:43.innovation is just being about new technology. There is incredible new

:29:44. > :29:49.technology around as far as diabetes is concerned. I saw it last week.

:29:50. > :29:54.People are no longer able to use the fingerprint test, you can buy a test

:29:55. > :30:03.at your local chemist. It costs slightly more than a finger prick

:30:04. > :30:07.test. It will allow you to test your diabetes without having to fast and

:30:08. > :30:14.it will give you a three-month reading. There are no machines where

:30:15. > :30:20.you can clamp to the side of your arm and take your mobile phone and

:30:21. > :30:25.put it onto the device and it will tell you what your glucose levels

:30:26. > :30:31.are. Incredible innovations and that is why I think this clause is worth

:30:32. > :30:36.accepting. I think it is very carefully thought out by my

:30:37. > :30:39.honourable friend who is doing an amazingly important job on the front

:30:40. > :30:48.bench in respect of these matters. But also it will benefit the

:30:49. > :30:52.taxpayer because innovation is very, very important as far as an illness

:30:53. > :30:58.such as diabetes is concerned. It is not just about the technological

:30:59. > :31:05.revolution that occurs, it is also what we can do with lifestyle

:31:06. > :31:13.changes. I notice the spokesman for the Scottish National party is here.

:31:14. > :31:22.Scotland is highly advanced as far as diabetes monitoring is concerned.

:31:23. > :31:27.You can get statistics in respect of diabetes in Scotland. That is why

:31:28. > :31:34.new legislation designed to bring down the cost to the taxpayer of the

:31:35. > :31:39.cost of drugs is very important in respect of a review and that is why

:31:40. > :31:46.I support very much what is in the clause one C. Finally, some of these

:31:47. > :31:51.diabetes companies, some of these pharmaceutical companies make an

:31:52. > :31:55.enormous amount of money. They are some of the biggest companies in the

:31:56. > :32:01.world. But what we need to do is to make sure that we encourage them to

:32:02. > :32:09.plough back a good proportion of their profits into research and

:32:10. > :32:13.development. The Steno Centre in Denmark only exists because of the

:32:14. > :32:22.money that was given to it by one of the biggest diabetes drug companies

:32:23. > :32:29.in the world. And there, in the centre, which is where research and

:32:30. > :32:34.development comes in, you can go to the Steno Centre and you can have

:32:35. > :32:39.your blood taken by a diabetes nurse and in the next room you can have

:32:40. > :32:44.your feet looked at by an expert in diabetes. In the next room you can

:32:45. > :32:49.have your eyes tested, because those of us with diabetes have problems in

:32:50. > :32:54.respect of our eyes, and in the next room you can have your consultation

:32:55. > :32:59.with your GP and if necessary you can see a consultant. That is what I

:33:00. > :33:04.meant when I talked about the diabetes village. It comes from the

:33:05. > :33:09.concept of the Steno Centre. At the moment I have to go to different

:33:10. > :33:17.hospitals and see my GP and others. In one case I had to carry my own

:33:18. > :33:20.blood. I carry mine all the time! In a little test tube I say to my

:33:21. > :33:25.honourable friend from Wolverhampton. I carried my own

:33:26. > :33:30.blood to the laboratory because it was the quickest way I could get a

:33:31. > :33:36.reading. He carries his blood very well if I may say so from looking at

:33:37. > :33:39.him. The fact is we want this innovation, research and

:33:40. > :33:44.development. We know the drugs companies should be able to plough

:33:45. > :33:47.back profits from within the industry because in the long run it

:33:48. > :33:54.is these innovations that will make a great deal of difference. I went

:33:55. > :33:59.to New York to attend a meeting concerning Yemen, but I stopped in

:34:00. > :34:05.at that Diabetes Centre of the Mount Sinai Hospital. They were telling me

:34:06. > :34:08.about the incredible innovation that is occurring in the united states of

:34:09. > :34:19.America as far as diabetes is concerned. I then went to see the

:34:20. > :34:25.diabetes team in New York. As you know New York cut the level of sugar

:34:26. > :34:31.that was available to people in their soft drinks as we are doing at

:34:32. > :34:37.the moment, but the centre of their diabetes initiative was a lifestyle

:34:38. > :34:46.coach, not a GP, but a lifestyle coach. As we look at the subclauses,

:34:47. > :34:51.Madame Deputy Speaker, we see every opportunity for a cogent and

:34:52. > :34:55.coherent review that will help in particular and that is my main

:34:56. > :35:00.argument today. But also it will effect and help others with similar

:35:01. > :35:07.problems in respect of their illnesses. I would urge the

:35:08. > :35:10.Minister, who I know is extremely reasonable in respect of this bill,

:35:11. > :35:16.to look at this clause to see whether if he cannot accept the

:35:17. > :35:20.clause but at the very least give an undertaking from the dispatch box

:35:21. > :35:25.that the points from within the clause will be reported back to

:35:26. > :35:33.Parliament in a few months' time. Doctor Filippo Whitford. And he very

:35:34. > :35:37.much, Madame Deputy Speaker. As with the shadow health minister, we also

:35:38. > :35:43.will not be obstructing this bill and we support the basic aim of it,

:35:44. > :35:48.to try and control prices and achieve a good return to the NHS in

:35:49. > :35:55.the drugs that they use, and a good price control. With regard to new

:35:56. > :35:59.clause one put forward by the members of Ellesmere Port and

:36:00. > :36:04.Neston, we would also support this in principle. I think perhaps six

:36:05. > :36:08.months out might be a little bit early to technically bring back

:36:09. > :36:12.together, but I also would tend to suggest it should not just be a

:36:13. > :36:18.single report. You will only see change over time, and in particular

:36:19. > :36:23.to look at the success of these actions, we want to see a price

:36:24. > :36:28.being controlled and to be able to spot prices that are sliding out of

:36:29. > :36:33.control. I would suggest there should be some degree of looking at

:36:34. > :36:37.the data and information on an annual basis and laying that before

:36:38. > :36:43.Parliament to show that the aim of the bill has been achieved and also

:36:44. > :36:47.that the concerns of the official opposition are actually being laid.

:36:48. > :36:52.With regards to Amendment eight, we would support this as this is the

:36:53. > :36:59.approach we have in Scotland. While the cancer drugs found in England is

:37:00. > :37:04.clearly helpful and has helped many patients, it is limited. If you do

:37:05. > :37:08.not have cancer, you cannot access the fund. That means people with

:37:09. > :37:14.rare diseases are left somewhat abandoned. At the moment this was

:37:15. > :37:20.left to NHS England and frankly they seem to be left in the desert. It is

:37:21. > :37:25.quite important. There will be significant money hopefully released

:37:26. > :37:28.from this. It also gains support from the pharmaceutical industry if

:37:29. > :37:32.they see the money they are returning is actually enabling

:37:33. > :37:38.innovative medicines to come to the NHS earlier. Sometimes when we

:37:39. > :37:43.compare ourselves for certain illnesses such as cancer, where we

:37:44. > :37:47.find the gap is people with more advanced disease struggling to

:37:48. > :37:54.access the newest medicines. It would be something we would support

:37:55. > :37:58.if this was a result of this bill. In 2014 the Scottish medicines

:37:59. > :38:05.Consortium was reformed and we have moved up from passing 53% of all

:38:06. > :38:08.applications to 77%. There is a further review going ahead at the

:38:09. > :38:14.moment to look at how to improve this. The aim is not to avoid using

:38:15. > :38:19.drugs, the aim is to try and access them at a decent price. If

:38:20. > :38:25.pharmaceutical industries are returning money to the NHS, that

:38:26. > :38:31.should enable that earlier access. With regards to our own amendment,

:38:32. > :38:37.amendment nine, did we laid before the Public Bill Committee regarding

:38:38. > :38:43.clause five which extends a power that already existed but never used,

:38:44. > :38:49.which is to control the price of medical services and supplies as

:38:50. > :38:53.well as drugs. I raised again, as I am disappointed we did not manage to

:38:54. > :38:59.get this taken into the built in time for this reading today, the

:39:00. > :39:04.issue of quality control and ask the government to consult on that. I

:39:05. > :39:09.spoke extensively about the issue of surgical gloves, but they are a good

:39:10. > :39:14.example in that the range of quality is vast. If poorer quality ones are

:39:15. > :39:19.used, there is either extra cost to the NHS because you can end up

:39:20. > :39:24.changing your blood two or three times within one operation, or if it

:39:25. > :39:29.is more subtle that you discover you have been exposed to blood from a

:39:30. > :39:34.tiny pinhole that was not visible to you. This applies to things like

:39:35. > :39:39.gowns and drapes and to take off that is meant to be protected and

:39:40. > :39:45.discover you are soaked in blood through to your skin is a pretty

:39:46. > :39:49.unpleasant experience and increases risk to staff. The idea that

:39:50. > :39:56.surgeons are not exposed to diseases like HIV and hepatitis be and

:39:57. > :40:00.hepatitis C is naive. I have heard colleagues over my career who have

:40:01. > :40:05.suffered from these conditions that they have caught from patients.

:40:06. > :40:10.and patients to avoid any and patients to avoid any

:40:11. > :40:17.possibility of cross contamination. Fairly cheap things like gauze swab

:40:18. > :40:22.if they are shredding thread can lead to intra-abdominal infection,

:40:23. > :40:23.something we do not want to see. I think it is asking for consultation

:40:24. > :40:33.and to look at the mechanism. We have national procurement and

:40:34. > :40:39.logistics system in Scotland which takes up a sort of Amazon on system

:40:40. > :40:43.will award will order the supplies they need. They are picked from 9000

:40:44. > :40:47.items held by national procurement and delivered by national logistics

:40:48. > :40:52.all the way to the ward. The supply chain, as it is called in England,

:40:53. > :40:57.has 600,000 items. That suggest that, in actual fact, the proposal

:40:58. > :41:02.of reverser Carter to try and limit what is used and look at procurement

:41:03. > :41:09.is not yet happening. -- Professor Carter. There is an option from this

:41:10. > :41:15.discussion to ensure that comes about. That would be the point at

:41:16. > :41:18.which quality could be assessed. Anything that is going to go in that

:41:19. > :41:22.supply chain would be rigorously tested by staff with feedback and it

:41:23. > :41:28.would be up to a national procurement group to decide whether

:41:29. > :41:34.they were going to actually stop it. And supply. -- stock it. And

:41:35. > :41:38.finally, an amendment ten comes back to the issue of sharing information

:41:39. > :41:45.that will be collected by the Secretary of State and ensuring that

:41:46. > :41:50.this data, as it relates to devolved administrations and is therefore, in

:41:51. > :41:54.essence, the data, is freely accessible to them. The Minister

:41:55. > :41:57.mentioned the memorandum of understanding. I would like to hear

:41:58. > :42:01.what point along we are fat and whether it is a real-time access to

:42:02. > :42:04.a database that would be given to the authorities listed here or

:42:05. > :42:11.whether it would be that they must put in a request. I would suggest it

:42:12. > :42:14.is absolutely vital that data is provided to the devolved

:42:15. > :42:18.administration 's when they request it and not on some fixed annual

:42:19. > :42:24.dates chosen by the Secretary of State year. So that if they perceive

:42:25. > :42:29.they have an emerging problem, they can do with it. Having been involved

:42:30. > :42:33.in clinical data collection, there is nothing more frustrating for the

:42:34. > :42:36.team than to be doing the work to gather data and whenever you want to

:42:37. > :42:41.interrogate it, you have no option to actually access it. I would

:42:42. > :42:44.simply ask the minister again if we can find out where we are with the

:42:45. > :42:47.memorandum of understanding and I would welcome his commitment to this

:42:48. > :42:54.going forward. Thank you. Overall, as honourable

:42:55. > :43:03.members know, I welcome this bill. It is broadly socialist bill. Every

:43:04. > :43:08.forces -- it reinforces pricing controls on big pharmaceuticals

:43:09. > :43:11.where appropriate. I like to congratulate the Conservative Party

:43:12. > :43:23.to come further than the socialist road. On new clause one, table by my

:43:24. > :43:25.honourable friend, it is very central to what we ought to be

:43:26. > :43:31.talking about in many skills of public life. That is evidenced by

:43:32. > :43:37.Mike evidence -based policy. -- evidence -based policy. All too

:43:38. > :43:47.often in this House, policy appears to be made on a political whim. I

:43:48. > :43:50.remember, I think it was 2008 when the then Leader of the House, the

:43:51. > :43:54.right honourable member for Blackburn, Jack Straw, wrote

:43:55. > :44:01.certainly two Labour MPs asking what we wanted in the Queen's speech that

:44:02. > :44:05.year. I said to Labour MPs that we were in Government, he should have

:44:06. > :44:09.written to the right honourable member of Cheltenham. As with that

:44:10. > :44:14.of the House, asking what the members wanted in the Queen's

:44:15. > :44:17.speech. I replied, because I believe in evidence -based policy, that in

:44:18. > :44:22.the Queen's speech that year, I wanted not a single piece of

:44:23. > :44:27.legislation. That want a parliament, after ten years of Labour

:44:28. > :44:32.Government, to spend a year in scrutiny looking at the legislation

:44:33. > :44:37.we had introduced over that ten years. To see what had worked and

:44:38. > :44:41.what had not worked. To my astonishment, the Leader of the

:44:42. > :44:46.House did not accept that proposal, as those of us who were members

:44:47. > :44:52.there now, and we had another Phil legislative programme. If you like

:44:53. > :44:55.the -- allowed me a small bit of attitude you, by the end of the

:44:56. > :45:01.Labour Government, I stopped putting on criminal bills because we had so

:45:02. > :45:03.many. This might have happened under the previous Conservative

:45:04. > :45:07.Government. We had criminal bills that repaired parts of previous

:45:08. > :45:13.criminal bills brought in by a Labour Government, with parts that

:45:14. > :45:21.had never been brought into force. Absolutely extraordinary. I urge the

:45:22. > :45:25.Minister to go with this and when perhaps it catches your eye and you

:45:26. > :45:30.make some remarks, I hope you conceal at about innovation, which

:45:31. > :45:35.was so eloquently addressed by my right honourable friend for

:45:36. > :45:42.Leicester. There is an issue on the right honourable -- about cystic

:45:43. > :45:46.fibrosis and a drug that was turned down because of lack of sufficient

:45:47. > :45:53.data. I understand that, weighing up of evidence. Since it was used in

:45:54. > :45:58.this country but not available on the NHS, since Mice decided the cost

:45:59. > :46:04.effective and artist didn't stack up, some long-term data from the

:46:05. > :46:12.states has been made available. I understand that Nice as not reviewed

:46:13. > :46:21.as this is non-cystic fibrosis -- reviewed its decision on a drug for

:46:22. > :46:23.use on cystic fibrosis. Did the Minister say, will meet up about the

:46:24. > :46:30.process of innovation, efficiency and Aussie -based decision-making, a

:46:31. > :46:38.little bit... Perhaps not about the actual drug itself, but the process

:46:39. > :46:50.whereby Nice might promptly reviews decisions. This additional issue of

:46:51. > :46:57.drugs or treatments actually being passed by Nice but not brought in,

:46:58. > :47:11.like hepatitis C drugs rationed to certain patients per month, or we

:47:12. > :47:16.are in -- enshrining these drugs. I agree on this. We don't like the

:47:17. > :47:19.postcode lottery. We have a cross border between England, Wales,

:47:20. > :47:24.Scotland and Northern Ireland but it is a lot worse when we get different

:47:25. > :47:30.CCGs within England, some of whom make a drug available that has been,

:47:31. > :47:37.as I understand, signed off by Nice and that process as safe for use but

:47:38. > :47:46.not mandatorily available. That is for every patient who it is

:47:47. > :47:51.medically appropriate do not necessarily get it. That is

:47:52. > :47:59.regrettable. Moving on to amendment eight... Introduced by my honourable

:48:00. > :48:03.friend from Burnley. This, as I understand it, would seek to ring

:48:04. > :48:07.fence the savings made through the provisions of this bill and

:48:08. > :48:13.legislation to ensure that money thereby saved or paid into the pot

:48:14. > :48:19.by pharmaceutical companies would be retained for expenditure on medical

:48:20. > :48:25.supplies. I hope that the Government this afternoon supports that. Very

:48:26. > :48:31.often, we hear that Government does not like ring fencing. I understand

:48:32. > :48:37.why. But earlier this afternoon. -- this afternoon, I asked the

:48:38. > :48:42.Secretary of State whether the education costs would be ring-fenced

:48:43. > :48:47.because I was concerned the demolition of money to lose and

:48:48. > :48:49.governors who might be pressed with other budgetary matters, the money

:48:50. > :48:55.would not be spent on education and prison education would not be

:48:56. > :49:01.improved. I was greeted with a very welcome one word answer from the

:49:02. > :49:11.Secretary of State, which was yes. It would be ring-fenced. In a

:49:12. > :49:14.slightly different context, in relation to amendment eight, I hope

:49:15. > :49:17.we can be reassured this afternoon because it is an excellent amendment

:49:18. > :49:22.which clarifies a slight gap in the bill. In terms of the amendment

:49:23. > :49:29.nine, moved by the honourable member for Central Ayrshire, and she spoke

:49:30. > :49:36.eloquently, efficiency is of course important but so is quality. It is

:49:37. > :49:40.the saying about penny wise and pound foolish. The honourable member

:49:41. > :49:45.is nodded. It is used on my part of the West Midlands and England. We

:49:46. > :49:51.have seen that time the game of privatisations. Services are

:49:52. > :49:56.privatised, they go to the lowest bidder, and what do we find? The

:49:57. > :50:02.service either is not up to scratch or, in fact, all too often, as it

:50:03. > :50:09.happened with Circle Health, they go bust. Because they find it is not as

:50:10. > :50:13.easy as they thought it was to make a profit out of, in this case, the

:50:14. > :50:16.Health Service. That might happen to other suppliers. It is because

:50:17. > :50:21.quality matters and because the National Health Service is not a

:50:22. > :50:28.commercial organisation. I will give way. I have listened very carefully

:50:29. > :50:33.to the honourable gentleman's point about Hinchingbrooke Hospital. My

:50:34. > :50:39.take tactfully suggest that he goes and looks at it. The provision of

:50:40. > :50:48.health care, if one spoke to the patients in Huntingdon, was that it

:50:49. > :50:52.vastly improved. The because of the conditions, they were not able to

:50:53. > :50:57.make a financial success of it. The company did not go bust. It decided

:50:58. > :51:02.to withdraw. But the quality of the care, from what had been a failing

:51:03. > :51:06.hospital, vastly improved in the view of the patients who used it.

:51:07. > :51:13.And the trade unions agreed to the deal that was done to put the

:51:14. > :51:18.company there. I am grateful to him for making my point for me. It is

:51:19. > :51:27.right quality, not just price. I will in a moment. That company got

:51:28. > :51:33.its price wrong and provided the quality, but not for the price and

:51:34. > :51:36.it jacked the contract in. What he said at the beginning of his

:51:37. > :51:41.comments was, we will now only see the official report tomorrow, was he

:51:42. > :51:47.was using it inaccurately as a point about privatisation and said the

:51:48. > :51:53.quality goes down. In this case, the company went bust. Wrong on both

:51:54. > :51:57.points. The right honourable member might well be correct about the

:51:58. > :52:02.specific thing and I fully accept that. But there is, in

:52:03. > :52:11.privatisations, E nexus between quality and price. And very often,

:52:12. > :52:17.not always, those companies who promise quality at a certain price

:52:18. > :52:24.too often are unable to deliver it. Either they cannot deliver the

:52:25. > :52:30.quality of service and or cannot do so at the price they promised they

:52:31. > :52:33.would do so. And we do see it, and the right and will member can get me

:52:34. > :52:36.on the city wishes, we do this yet time and again with railway

:52:37. > :52:40.franchisees who come back to the Government and say, we promised a

:52:41. > :52:51.certain level of service for a certain price, we can't do it, we

:52:52. > :53:00.need a bigger amount. I thank the honourable gentleman. He might have

:53:01. > :53:04.stumbled into a quagmire here by referencing something. The committee

:53:05. > :53:10.I sat on for several years down the issues around pricing are not the

:53:11. > :53:15.significant issues which led to the ending of the private contractor,

:53:16. > :53:21.but issues around the wider health care economy and the failure to

:53:22. > :53:26.discharge insecurities in respect of clinical business, so to speak, for

:53:27. > :53:30.that hospital. The honourable member has considerable more knowledge than

:53:31. > :53:33.I do and they told about evidence -based policy making. I am repelled

:53:34. > :53:37.absolutely to accept the evidence he puts forward. But that company could

:53:38. > :53:41.not make a go of it. It might not have been the company's fault. I

:53:42. > :53:52.accept that. It could not make a go of it. But, moving on, if I might,

:53:53. > :53:56.to clauses 1-5. I hope the Minister can... As I understand it, they are

:53:57. > :54:00.a package of amendments that go together. I hope that the Minister

:54:01. > :54:10.can talk us through them little bit because if we look at amendment 40B,

:54:11. > :54:19.-- Amendment three, which is since Dan -- substantive... I would like

:54:20. > :54:24.the Minister to talk us through this. There is a trend starting in

:54:25. > :54:30.some parts of England and is most advanced in Salford, where the GPs

:54:31. > :54:36.who are providing primary services are directly employed by the

:54:37. > :54:42.hospital trust. So the hospital trust is no longer just secondary or

:54:43. > :54:48.even tertiary, it is primary. I wanted to and picked the wording to

:54:49. > :54:52.make sure that that development of service delivery in England has been

:54:53. > :54:57.taken into account and the amendments do not assume that the

:54:58. > :55:02.existing silos between primary and secondary continue. Because that

:55:03. > :55:07.development has now started in Wolverhampton, when I represent,

:55:08. > :55:16.well there are three GP practices which are piloting their staff being

:55:17. > :55:19.employed by the excellent Royal Wolverhampton Hospitals Trust. I say

:55:20. > :55:24.excellent, it is one of the 15% of hospital trusts in England which

:55:25. > :55:29.does not have a deficit. After that is related to the fact that it has

:55:30. > :55:31.only ?15 million of PFI. That is another debate, which I won't get

:55:32. > :55:43.into just now. In terms of amendment ten from the

:55:44. > :55:47.Scottish National party, this is a reprieve is of an amendment which

:55:48. > :55:54.was put in on committee, and I had the pleasure of serving on the

:55:55. > :55:58.committee. Just like amendment nine relating to quality, it is a

:55:59. > :56:02.reprieve is of what was put in at the Bill committee. I hope the

:56:03. > :56:08.Minister can explain, in relation to amendment nine, I had understood

:56:09. > :56:13.him, perhaps wrongly, to say in the committee that he liked what the SNP

:56:14. > :56:17.was putting forward in terms of policy but he did not think they got

:56:18. > :56:21.the wording quite right and he hoped to be able to come back on the

:56:22. > :56:25.report with an amendment relating to quality. I may have missed

:56:26. > :56:30.understood what the minister said, but I cannot see on the order paper

:56:31. > :56:33.and amendment from the government relating to quality and I hope the

:56:34. > :56:39.Minister this afternoon can explain how that has come about, that he

:56:40. > :56:42.hopes to be able to bring one forward on quality, but has not yet

:56:43. > :56:48.been able to do so and whether he will do so at a later stage. Turning

:56:49. > :56:54.to the final amendment on the order paper of the day, amendment seven,

:56:55. > :56:59.which is to do with the definition of medical supplies, I have to say

:57:00. > :57:04.to the minister I am bemused, but no doubt in his usual way he will be

:57:05. > :57:07.able to elucidate later. I am bemused because in the committee I

:57:08. > :57:16.managed to persuade the government to clarify the definition of medical

:57:17. > :57:21.supplies contained in section 260 of the National Health Service act

:57:22. > :57:27.2006. That definition, as I understand it, relates only to

:57:28. > :57:32.England. Amendment seven before us this afternoon, as I understand it,

:57:33. > :57:43.relates only to Wales. But the two seemed to me to be on all four is

:57:44. > :57:50.because section 260, subsection five of the NHS act 2006 says, quote,

:57:51. > :57:55.medical supplies include surgical, dental and optical materials and

:57:56. > :58:08.equipment. I then look at this bill, the part that relates to Wales, page

:58:09. > :58:14.nine, clause seven, inserting section 2001A into the NHS Wales act

:58:15. > :58:20.2006, and if we look at line 37 on page nine of the bill, it says,

:58:21. > :58:25.quote, medical supplies include surgical, dental and optical

:58:26. > :58:32.materials including equipment, which I think is the same wording, this

:58:33. > :58:39.time applied to Wales, as it is in section 260, sub-clause five in the

:58:40. > :58:43.NHS act 2006 applying to England. But this afternoon we then have

:58:44. > :58:47.amendment seven which amends the Welsh legislation very

:58:48. > :58:52.understandably to clarify the definition of medical supplies. So

:58:53. > :58:57.in committee the government did not want and did not see the need to

:58:58. > :59:00.clarify the definition for medical supplies as applied to England, but

:59:01. > :59:06.this afternoon it is seeking to clarify the same definition of

:59:07. > :59:14.medical supplies as it applies to Wales. I am again bemused. I give

:59:15. > :59:18.way. I am very interested in his analysis of what medical supplies

:59:19. > :59:22.are because one of the things that strikes me is I would have thought

:59:23. > :59:27.pharmaceutical things would have been medical supplies. I am

:59:28. > :59:36.surprised that is not included in that definition. Medical supplies

:59:37. > :59:41.here in this part of the bill seems to be to do with physical equipment,

:59:42. > :59:47.but again what is equipment? Hence the definitions. They include

:59:48. > :59:52.surgical, dental and optical materials. Drugs are dealt with

:59:53. > :59:57.elsewhere. I think the Minister has got the point. He is seeking

:59:58. > :00:01.clarification for the Wales legislation by amendment seven when

:00:02. > :00:05.I understood him to say that he did not think such clarification was

:00:06. > :00:09.needed for the same definition contained in the legislation

:00:10. > :00:14.pertaining to England and I would like him to explain that apparent

:00:15. > :00:18.anomaly. If it is not an anomaly, perhaps he could tell the House he

:00:19. > :00:26.will clarify the definition in the later stage passage of this bill as

:00:27. > :00:33.it relates to England. Madame Deputy Speaker, I rise to speak to the new

:00:34. > :00:36.clause, the government amendments and all other amendments tabled

:00:37. > :00:41.today for this report stage and I would like to start by expressing my

:00:42. > :00:46.gratitude to the front bench spokesmen opposite who have both

:00:47. > :00:50.confirmed an intent to continue the spirit of constructive dialogue that

:00:51. > :00:55.we have had in taking this bill to this stage thus far. I am pleased

:00:56. > :01:02.they are supportive of the intent of the bill, and the objectives, and I

:01:03. > :01:07.will seek to raise during my remarks today a response to the particular

:01:08. > :01:11.amendments that they have posed. Honourable members will recall that

:01:12. > :01:16.in relation to new clause one this was an area that we debated at

:01:17. > :01:20.length during committee and I would like to take this opportunity to

:01:21. > :01:25.provide some additional reassurance that this is an important issue for

:01:26. > :01:30.the government. We have already included in the illustrative

:01:31. > :01:34.regulations for both the statutory scheme in regulation 32 and the

:01:35. > :01:38.information regulations in regulation 14 an annual review of

:01:39. > :01:43.the regulations and a requirement to publish our report of each review.

:01:44. > :01:48.These annual reviews we think go further than the specific single

:01:49. > :01:53.review which the honourable gentleman speaking for the

:01:54. > :01:57.opposition has put forward in new clause one. The effect of new clause

:01:58. > :02:02.one would only require the government to undertake a single

:02:03. > :02:08.review within six months of the act coming into force. But we accept

:02:09. > :02:10.reporting is an important principle. However, setting out the

:02:11. > :02:17.requirements in primary legislation we believe to be too restrictive. We

:02:18. > :02:21.think the single review as proposed within the first six months of the

:02:22. > :02:25.act coming into force would not provide a sufficient time frame in

:02:26. > :02:30.which to assess the impact of these provisions. Whereas the annual

:02:31. > :02:34.reviews we have set out in the illustrative regulations places a

:02:35. > :02:37.duty under government to review both the statutory scheme and the

:02:38. > :02:42.information regulations to ensure the effectiveness and to do it every

:02:43. > :02:49.year. These provisions will be to consultation. Over time we expect

:02:50. > :02:55.that both the statutory scheme and the information requirements will be

:02:56. > :02:58.amended through their respective regulations to reflect changing

:02:59. > :03:02.circumstances. It is essential that the review reporting arrangements

:03:03. > :03:08.are able to be similarly flexible so they remain appropriate to the

:03:09. > :03:11.schemes in operation. The honourable gentleman asks specifically whether

:03:12. > :03:16.objectives should be set out before the regulations come into force. The

:03:17. > :03:21.government will consult on regulations before they come into

:03:22. > :03:24.force. The objectives of the regulations will be explored in the

:03:25. > :03:30.consultation and set out in the government response. Specifically

:03:31. > :03:34.the illustrative regulations require an annual review two set at the

:03:35. > :03:40.objections of the scheme, to assess the extent to which the objectives

:03:41. > :03:43.have been achieved and to assess whether the objectives remain

:03:44. > :03:47.appropriate. These requirements will be tested through the consultation

:03:48. > :03:54.on the regulations and we will take into account those views. I will. I

:03:55. > :03:58.am very grateful. Again I say I am very grateful to the government for

:03:59. > :04:02.publishing these illustrative draft regulations to help us debate the

:04:03. > :04:11.bill. But if I look at the provisional information on page

:04:12. > :04:14.eight, draft clause 14 it says, the report must set out the objectives

:04:15. > :04:21.intended to be achieved by these regulations and then assess the

:04:22. > :04:25.extent to which these objectives are achieved. That seems odd that in one

:04:26. > :04:28.review you will set out the objective and then decide whether

:04:29. > :04:35.the objective has been achieved or not. That seems to be a bit wrong

:04:36. > :04:40.tempura leaf. We will undertake these reviews every year so that the

:04:41. > :04:47.second element will be impossible to access in the first review, it will

:04:48. > :04:54.be harder in the first one, there may be some ability to assess it,

:04:55. > :04:57.but we can look back and see how well the objectives have been

:04:58. > :05:02.received. I noticed the honourable member for Leicester East is heading

:05:03. > :05:07.for the exit and before he does so, he has now resumed his seat, while

:05:08. > :05:11.this is not specifically at the right point in my remarks to pick up

:05:12. > :05:16.the comments he made, I would like in response to his constructive

:05:17. > :05:23.contribution on the subject of diabetes, of which he is the

:05:24. > :05:27.parliament to cheer on the all-party Parliamentary group, and he may

:05:28. > :05:31.recall in a former period in this house I was the vice-chair of the

:05:32. > :05:35.all-party Parliamentary group on diabetes having family members with

:05:36. > :05:40.both type one and type two, so I have considerable sympathy for the

:05:41. > :05:43.points he was making about the importance of adequate advice for

:05:44. > :05:49.individuals who may not be aware they have got diabetes and for

:05:50. > :05:52.adopting innovation through the NHS treatment of those who do have

:05:53. > :05:57.diabetes. We shared that objective and I do not think any thing we are

:05:58. > :06:01.proposing in this bill will do anything other than to continue to

:06:02. > :06:06.encourage innovation. I will be making other remarks perhaps when he

:06:07. > :06:11.is not with us on the subject of innovation. I just wanted him to be

:06:12. > :06:17.aware that I have taken his point on board. He may be disappointed by the

:06:18. > :06:24.conclusion I come to in relation to specific amendments. It has been

:06:25. > :06:28.addressed in other ways. Reverting to new clause one and the issue of

:06:29. > :06:36.the regulations, I will make a second point. Much of the

:06:37. > :06:38.information provided by the Secretary of State will be

:06:39. > :06:43.commercially confidential. We touched on this in committee. I am

:06:44. > :06:47.sure suppliers have every confidence that the government will maintain

:06:48. > :06:51.the confidentiality in anything it publishes. It is important to

:06:52. > :06:57.reinforce that principle. There is a limit to the level of detail we can

:06:58. > :07:03.publish and I am sure the honourable member will appreciate that. Any

:07:04. > :07:07.information we do publish would be at a consolidated level protecting

:07:08. > :07:11.suppliers' confidentiality, but allowing the Secretary of State to

:07:12. > :07:14.be clear on the basis of the conclusions of his review. We could

:07:15. > :07:21.use supporting information to evidence our conclusions. While the

:07:22. > :07:26.requirements set out in that clause reflect the duties of the Secretary

:07:27. > :07:30.of State, the content of such a report should not be restricted and

:07:31. > :07:33.must be able to address the key issues arising during the year that

:07:34. > :07:38.may affect the operation of the schemes. The other significant

:07:39. > :07:44.element of the proposed new clause which I have just touched on, in

:07:45. > :07:46.response to the member for Leicestershire East, which we

:07:47. > :07:52.discussed at length in committee, is whether it would be appropriate for

:07:53. > :07:57.such a report to address matters relating to promotion of innovation.

:07:58. > :08:01.It is not appropriate to link measures in this bill which relate

:08:02. > :08:07.purely to the cost of medicines and medical supplies to the NHS duty to

:08:08. > :08:11.promote innovation. Promoting innovation is a high priority, not

:08:12. > :08:16.only for the government and the NHS, but for many other stakeholders.

:08:17. > :08:21.Innovation requires action across many different fronts and it would

:08:22. > :08:25.not be possible to quantify the contribution of the schemes in this

:08:26. > :08:29.bill to that endeavour in any meaningful way. The NHS is doing

:08:30. > :08:34.great work to promote innovation and I would like to draw honourable

:08:35. > :08:38.members' attention to the latest data from the innovation scorecard.

:08:39. > :08:43.It is a quarterly data publication which shows the uptake of innovative

:08:44. > :08:48.drugs and medical technologies following approval in England. This

:08:49. > :08:53.is now a nationally published statistic. In response to the

:08:54. > :08:57.request from the member for Wolverhampton South West to raise

:08:58. > :09:03.this specifically, the latest publication of the 12th of October

:09:04. > :09:08.this year shows the rate of uptake for 85 medicines recommended is

:09:09. > :09:15.increasing. 77% of these medicines have positive growth uptake in the

:09:16. > :09:22.year between March 2000 and 15-2016. 54% of the medicines had a growth

:09:23. > :09:25.uptake greater than 10%. This is available on a quarterly basis and

:09:26. > :09:31.honourable members can follow this process. The government is taking

:09:32. > :09:35.broader action to secure the UK's future as an attractive place for

:09:36. > :09:41.the life sciences sector, particularly in light of Brexit. We

:09:42. > :09:46.are clear in our commitment to life sciences and to building a long-term

:09:47. > :09:50.partnership with industry. The honourable gentleman for

:09:51. > :09:55.Wolverhampton South West also asked me to address the Nice process and

:09:56. > :09:59.whether this takes into account evidence and the process for the

:10:00. > :10:04.subsequent review of previous decisions. This is a continuous

:10:05. > :10:09.process. It does not happen in every drug all the time, but there is a

:10:10. > :10:14.routine procedure under which Nice will look again at the previous

:10:15. > :10:18.decision and will decide whether to continue with the decision they had

:10:19. > :10:22.taken before or to amend that decision and that might allow drugs

:10:23. > :10:27.which had previously not been approved to become approved on the

:10:28. > :10:32.basis of new evidence. I hope that reassures the honourable gentleman.

:10:33. > :10:40.I would like to draw your attention to the Access review which would

:10:41. > :10:44.accelerate reforms to access to medicines and facilities to NHS

:10:45. > :10:48.patients. The government and partners are considering those

:10:49. > :10:52.recommendations. We want to make the UK the best place in the world to

:10:53. > :10:56.design, develop and deploy life science products. We do not believe

:10:57. > :11:01.the bill will have any material impact on Matt at that, other than

:11:02. > :11:05.the minor impact noted in the impact assessment. This is backed by

:11:06. > :11:08.evidence which suggests there is no obvious reason why national health

:11:09. > :11:13.service pricing policy for pharmaceuticals or the time taken to

:11:14. > :11:17.make decisions on reimbursement should affect decisions to invest in

:11:18. > :11:22.research and development in pharmaceuticals in the United

:11:23. > :11:25.Kingdom. The evidence instead, suggests the most important traction

:11:26. > :11:29.for companies to invest in research in the UK is the availability of

:11:30. > :11:34.world-class scientific expertise which is the focus of the

:11:35. > :11:38.government's effort to ensure the UK remains at the forefront of Global

:11:39. > :11:45.Research Chartered development. The honourable member Astra for reports

:11:46. > :11:50.to be laid before Parliament. We will be publishing these reports on

:11:51. > :11:54.an annual basis and I am happy to commit the first report will be laid

:11:55. > :11:58.before Parliament and we can see how much interest there is in it to see

:11:59. > :12:03.if we need to do that in subsequent years of whether we publish it in

:12:04. > :12:06.the normal way. On that basis, I hope the honourable member, the

:12:07. > :12:17.Shadow minister, will withdraw his new clause will stop turning to

:12:18. > :12:21.amendment eight. This aims to require the income from the

:12:22. > :12:26.voluntary scheme and the statutory scheme to be ring fenced to

:12:27. > :12:31.reimburse the NHS for expenditure on medicines and medical supplies in

:12:32. > :12:35.order to increase access to new and innovative if treatments. We are

:12:36. > :12:40.committed to ensure patients have faster access to new and innovative

:12:41. > :12:44.of medicines and treatments. We know that investing in new medicines and

:12:45. > :12:47.treatments where they are proven to work and our clinical priority has

:12:48. > :12:53.the potential to transform the care of patients and lead to improve

:12:54. > :12:57.outcomes. It is a fundamental principle of the NHS funding should

:12:58. > :13:02.be allocated according to clinical priorities based on the judgment of

:13:03. > :13:06.commissioners. That might include new treatments, but it just as well

:13:07. > :13:11.might include scaling up older, effective treatments or investing in

:13:12. > :13:16.more staff. While we can and do understand the intention behind this

:13:17. > :13:20.amendment, it is for NHS England and clinical commissioning groups, in

:13:21. > :13:25.our view, to determine clinical priorities and spend this money on

:13:26. > :13:28.what is clinically most important. The honourable lady for Central

:13:29. > :13:33.Asher has supported this amendment and while it is not for me to

:13:34. > :13:37.comment on the policies of the Scottish Government, we do know the

:13:38. > :13:42.NHS in Scotland has raised concerns the new medicine fund she has

:13:43. > :13:46.referred to only funds medicines at the end of life or for red diseases,

:13:47. > :13:51.meaning funding for other areas are not getting the same priority. She

:13:52. > :13:56.is shaking her head as though that is not the case. That was my

:13:57. > :14:02.information. If you would like to enlighten me further, perhaps we can

:14:03. > :14:11.discuss it now or later. New medicines and red diseases funds and

:14:12. > :14:18.it often includes end of life. Also for rare diseases, was my

:14:19. > :14:27.understanding. I stand corrected. However, the concern is one in which

:14:28. > :14:29.my primary point is it should be for clinicians to decide across the

:14:30. > :14:36.range of activity what funding is spent on, whether that is ring

:14:37. > :14:39.fenced into a specific fund for new medicines, our concern is that it

:14:40. > :14:47.might not always be the right clinical decision. Does the Minister

:14:48. > :14:51.not accept it is a slightly PR and slightly bizarre thing to have a

:14:52. > :14:55.medicine fund that is only for cancer and rules are people who have

:14:56. > :15:02.other life-threatening illnesses, which is the case here in England?

:15:03. > :15:09.Then new cancer drug fund was set up to provide funds for dealing with

:15:10. > :15:12.one of the most common causes of mortality in the country and was a

:15:13. > :15:20.priority of the previous government. I am not going to go into the

:15:21. > :15:27.reasons for that. I would like to come back to the amendments, if I

:15:28. > :15:31.may, and refer to the fact that all income generated through both the

:15:32. > :15:36.voluntary and statutory scheme is reinvested in the NHS and there was

:15:37. > :15:42.a suggestion made that it is not clear what happens to any receipts

:15:43. > :15:48.made under these schemes. Estimates of income under the PPR rests are

:15:49. > :15:53.part of the baseline used in the Department's spending review model.

:15:54. > :15:56.This model was used to calculate the increase in funding the NHS was

:15:57. > :16:04.seeking at the end of the spending review in 2015 and helped secure the

:16:05. > :16:09.?10 billion of real terms funding in the course of this Parliament. The

:16:10. > :16:14.income from the voluntary and stature she scheme can and does

:16:15. > :16:20.fluctuate. This is the biggest problem we see with ring fencing

:16:21. > :16:24.funding. Ring fencing this money to this specific area could bring risk.

:16:25. > :16:33.And just to give an example, the annual income from the PPRS has

:16:34. > :16:39.varied between ?310 million and ?839 million in a full financial year in

:16:40. > :16:46.England. So it has the potential to have quite wide variability in the

:16:47. > :16:51.income it generates and for that reason, primarily, we think it could

:16:52. > :16:56.potentially disadvantage patients by making treatment dependent on income

:16:57. > :17:03.from a pricing scheme whose income generation is not steady. I

:17:04. > :17:07.understand where he is going, but I would caution him, when he was

:17:08. > :17:13.talking about flexibility, he gave the example that a CCG or medical

:17:14. > :17:19.body might wish to spend some of this money on staffing. I caution

:17:20. > :17:24.him because of the fluctuation to which he refers, deciding to spend

:17:25. > :17:28.it on staffing is probably not a good idea. I am grateful to be

:17:29. > :17:35.honourable gentleman for his advice and I am afraid I don't think it is

:17:36. > :17:38.very relevant to my point on fluctuation of income coming out of

:17:39. > :17:47.the scheme. I think it is relevant in relation to whether or not it is

:17:48. > :17:52.NICE or politicians who make these decisions. It needs to be made by

:17:53. > :17:58.clinicians. I will, then I will make some progress. I thank the Minister

:17:59. > :18:02.for giving way. Is it not the case Cancer Drugs Fund has a budget of

:18:03. > :18:09.approximately 350 million and therefore if he is saying the money

:18:10. > :18:13.retrieved from this is varying from 300 million to over 800 million, it

:18:14. > :18:18.would allow an expansion of a new medicine fund. It might if it always

:18:19. > :18:26.moved in the same direction. That is my concern, it could conceivably

:18:27. > :18:32.decline between one year and the next and not always go up, certainly

:18:33. > :18:35.not up in a straight line. Separately, government is taking

:18:36. > :18:42.action to secure the UK's future as an attractive place for the life

:18:43. > :18:44.sciences sector. I have touched already on the recently published

:18:45. > :18:51.accelerated access review which sets out the ways in which to increase

:18:52. > :18:55.the speed 21st-century innovation in mental technology and products get

:18:56. > :18:59.to NHS patients and their families. Recommendations under this review

:19:00. > :19:03.included bringing together organisations from across the system

:19:04. > :19:07.in an accelerated Access partnership and creating a strategic commercial

:19:08. > :19:11.unit within NHS England which can work within industry to develop

:19:12. > :19:15.commercial access arrangement. Considering these recommendations

:19:16. > :19:21.with partners and we will respond in due course. NHS England and NICE are

:19:22. > :19:26.consulting on a number of proposed changes to NICE proposals and

:19:27. > :19:30.specialised technology appraisals including around speeding up the

:19:31. > :19:34.appraisal process. The Department of Health works closely with NHS

:19:35. > :19:43.England and other stakeholders to improve the uptake of other

:19:44. > :19:48.stakeholders and the innovation scorecard on uptake is what I have

:19:49. > :19:53.proposed. What is proposed in amendment eight, I would ask the

:19:54. > :20:01.honourable lady to withdraw her amendment. Turning to amendment

:20:02. > :20:06.nine, the government recognises the act has currently drafted does not

:20:07. > :20:10.explicitly state in the relevant section 260 that the government is

:20:11. > :20:13.obliged to consult industry. I'm worthy act in relation to

:20:14. > :20:18.controlling the cost of medicines does state there is an obligation on

:20:19. > :20:22.the government to consult. A similar amendment was tabled by the

:20:23. > :20:26.honourable lady in committee. I would like to reiterate to her that

:20:27. > :20:31.I am happy to consider with her, how we could best introduced the

:20:32. > :20:35.requirement to have a general requirement to consult industry in

:20:36. > :20:38.section 200 60. I know my officials have been in discussion with her and

:20:39. > :20:45.I'm grateful for the time she has given and the constructive comments.

:20:46. > :20:49.I note the honourable member reference to the effect of any

:20:50. > :20:51.pricing controls for medical supplies on the maintenance on the

:20:52. > :20:57.quality of these products and I can assure head the government were take

:20:58. > :20:59.into account all relevant factors, including any concerns raised by

:21:00. > :21:03.industry about the quality of medical supplies when making an

:21:04. > :21:07.consulting any price controls for medical supplies. The government

:21:08. > :21:12.would not however, be in favour of putting one of these many factors on

:21:13. > :21:17.the face of the bill. The medicines and health care products regulatory

:21:18. > :21:20.agency is responsible for the safety and efficacy and quality of medical

:21:21. > :21:27.supplies and this bill will not change that. MHRA has assured me any

:21:28. > :21:32.use of the control powers in this bill would not affect any quality or

:21:33. > :21:35.safety requirements that must be met before medical supplies could be

:21:36. > :21:42.placed on the market. I would also like to assure the honourable lady

:21:43. > :21:46.the government is committed to procurement across the NHS and she

:21:47. > :21:50.has referenced the procurement system in Scotland. She is aware of

:21:51. > :21:54.the Carter report, which concluded there is considerable variation

:21:55. > :21:59.between trusts as to what value they extract from expenditure on goods

:22:00. > :22:03.and material from medical supplies. The NHS Supply chain is working hard

:22:04. > :22:07.to deliver these procurement deficiencies. They are working to

:22:08. > :22:16.meet recommendations to price transparency, lower costs and

:22:17. > :22:21.deliver economies of scale. She referred to 600,000 products. They

:22:22. > :22:25.had success in reducing the product range in the effective catalogue

:22:26. > :22:30.from that figure down to the current figure of 315,000 to help NHS

:22:31. > :22:35.organisations purchase products more efficiently. They are continuing to

:22:36. > :22:40.work to reduce that number. I am aware of the similar work in

:22:41. > :22:45.Scotland and in England we are using Carter to deliver this. What I

:22:46. > :22:49.understand the intent, I am not fully convinced that as drafted, it

:22:50. > :22:54.would have the effect she is hoping to achieve. If she will continue to

:22:55. > :22:57.work with me and my officials, the government would be happy to

:22:58. > :23:00.consider, while the bill is in the other place, how we could best

:23:01. > :23:04.introduced the requirement to consult in section 260. On that

:23:05. > :23:11.basis I would invite her to withdraw the amendment for now. I must press

:23:12. > :23:19.on to cover the government amendments, which are in two groups.

:23:20. > :23:24.Amendments one to five address a loophole in the bill. Clause six of

:23:25. > :23:27.the bill amends the NHS act to give the secretary of State the power to

:23:28. > :23:34.make regulations to obtain information from any UK producer. A

:23:35. > :23:39.UK producer is defined in the bill as anyone involved in the

:23:40. > :23:42.manufacture, distribution or supply of health service medicines, medical

:23:43. > :23:44.supplies or any other related products required for the purposes

:23:45. > :23:50.of health services in the United Kingdom. An accepted person is

:23:51. > :23:54.defined as any person providing pharmacy or GP services for the

:23:55. > :23:58.health services in Scotland, Wales and Northern Ireland. The purpose of

:23:59. > :24:03.these provisions was to reflect the agreement with the devolved

:24:04. > :24:05.administrations the devolved administrations would collect

:24:06. > :24:09.information from pharmacies and GP practices in their nations. But

:24:10. > :24:14.there may be circumstances when a company which supplies products and

:24:15. > :24:19.the devolved Administration is also provides products in England but

:24:20. > :24:23.could claim the language as drafted would allow them to become accepted

:24:24. > :24:26.person is because they were operating in the devolved

:24:27. > :24:30.Administration is. This is not the intent of the bill and we have

:24:31. > :24:39.therefore propose these amendments in order to address this potential

:24:40. > :24:43.loophole. Amendments six is a minor amendment which was an intentionally

:24:44. > :24:47.omitted. It relates to clause six of the bill which provides the

:24:48. > :24:56.Secretary of State power to disclose information to the list of bodies

:24:57. > :25:00.stated. It includes those persons providing services to the regional

:25:01. > :25:05.business services organisation in Northern Ireland. Which had been

:25:06. > :25:09.previously omitted. I hope members will access these amendments. I have

:25:10. > :25:12.a couple of remarks to make immigration to amendment ten from

:25:13. > :25:18.the honourable lady from Central Ayrshire.

:25:19. > :25:27.New section 264 B enables the Secretary of State to give

:25:28. > :25:31.information to NHS, other government departments and the devolved

:25:32. > :25:37.administrations. The government has concerns about the proposed

:25:38. > :25:39.amendment. We are dealing with confidential and commercially

:25:40. > :25:45.sensitive information that can only be used for specific purposes and we

:25:46. > :25:48.are reluctant to introduce a requirement to disclose information

:25:49. > :25:51.to any government department or NHS England. It is important the

:25:52. > :25:59.government can be trusted with the information they collect. I would

:26:00. > :26:05.like to conclude a point to the honourable lady because I think it

:26:06. > :26:09.will satisfy her. Her concern is how the government will behave in

:26:10. > :26:13.relation to the request from devolved administrations. We

:26:14. > :26:18.recognise we need to give reassurance to devolved

:26:19. > :26:21.administrations that in light of the very constructive conversations we

:26:22. > :26:24.have already had with them that they will have full access to all

:26:25. > :26:30.relevant data that the government collects. We are happy to do that.

:26:31. > :26:34.We have indicated we will be entering into a memorandum of

:26:35. > :26:40.understanding and that will be discussed with the devolved

:26:41. > :26:44.administrations and agreed and those discussions will consider whether

:26:45. > :26:49.they have automatic access to this information, whether that is in

:26:50. > :26:54.real-time or some other format, and whether that is through direct

:26:55. > :26:56.access to the systems or by forwarding data we collect

:26:57. > :27:01.immediately on request. We need to get onto the detail of that in

:27:02. > :27:07.discussing the memorandum of understanding rather than committing

:27:08. > :27:13.it to the bill at this stage. On that basis I hope the honourable

:27:14. > :27:16.lady will withdraw her amendment. I welcome the comments from the

:27:17. > :27:21.Minister and I am happy to withdraw the amendment if we can get to a

:27:22. > :27:26.clear point on the memorandum of understanding. All my amendment does

:27:27. > :27:32.it say that the groups listed by the bill should be able to ask for data

:27:33. > :27:36.on request. I understand my attempts to move the amendment in committee

:27:37. > :27:42.included groups that it should not have. That has been corrected. It is

:27:43. > :27:46.not spreading confidential information any more widely. I am

:27:47. > :27:51.grateful to the honourable lady for that clarification. I think this is

:27:52. > :28:01.better dressed in the memorandum of understanding. Finally, Madame

:28:02. > :28:06.Deputy Speaker, I would just like to address a couple of amendments,

:28:07. > :28:12.amendment seven, which provides a definition for equipment. The

:28:13. > :28:16.honourable gentleman for Wolverhampton South West took us

:28:17. > :28:21.through this specific drafting for a definition of medical supplies. This

:28:22. > :28:28.clause provides a definition of equipment in the NHS Wales act 2006

:28:29. > :28:34.to ensure consistency within the NHS act 2006. Equipment is defined as

:28:35. > :28:39.including any machinery, apparatus or appliance, whether fixed or not,

:28:40. > :28:44.and any vehicle. This definition is broad enough to be able to capture

:28:45. > :28:49.any medical supply when taken in tandem with the common definition of

:28:50. > :28:55.medical supplies on the market from a bandage to an MRI scanner. The

:28:56. > :29:00.point is about the definition of equipment which is a subset of

:29:01. > :29:07.medical supplies. I hope honourable members will accept that amendment.

:29:08. > :29:12.I have spoken at some length of these amendments, but I hope I have

:29:13. > :29:14.made my position clear and honourable members opposite will

:29:15. > :29:21.withdraw their amendments and accept the government amendments. I would

:29:22. > :29:29.like to withdraw new clause one and amendment eight. Is it your pleasure

:29:30. > :29:32.that new clause one be withdrawn. As many as are of the opinion, say

:29:33. > :29:40."aye". To the contrary, "no".. The ayes have it. New clause one is

:29:41. > :29:46.withdrawn. We shall take government amendments 1-7 together. I called

:29:47. > :29:52.the Minister to move the amendment formally. The question is that

:29:53. > :29:54.amendments 1-7 be made. As many as are of the opinion, say "aye". To

:29:55. > :30:05.the contrary, "no".. The ayes have it. Third reading. Now. Minister to

:30:06. > :30:10.move third reading. Madame Deputy Speaker, as we have already

:30:11. > :30:16.discussed, this has been a pleasure to take this short, albeit

:30:17. > :30:21.technical, Bill through the House with a wide degree of consensus from

:30:22. > :30:26.all parties who have participated. I will formally beg to move that the

:30:27. > :30:30.Bill now be read a third time. We have had a very constructive debate,

:30:31. > :30:35.points have been raised by honourable members from all sides

:30:36. > :30:40.through amendments and in debate and we have sought to take on board

:30:41. > :30:46.their comments and will look to take some of those forward at the next

:30:47. > :30:54.stage as the bill moves into the other place. I would like to, if I

:30:55. > :30:58.may, thank honourable members who have spoken for the opposition, the

:30:59. > :31:03.honourable member for Ellesmere Port, the honourable member for

:31:04. > :31:06.Burnley who is just about in her place, and the honourable member for

:31:07. > :31:13.Central Ayrshire leading for the SNP. We have had some strong

:31:14. > :31:16.contributions from backbench speakers, the honourable member for

:31:17. > :31:19.Wolverhampton South West who serves on the committee in his diligent

:31:20. > :31:25.fashion, the honourable member for Leicestershire East. We have also

:31:26. > :31:28.had contributions from honourable members on my side of the House and

:31:29. > :31:34.I would like to die in particular the honourable member for Torbay who

:31:35. > :31:40.was active in committee. I would like to thank my private secretary

:31:41. > :31:49.for his support and the whips on both sides. The purpose of this bill

:31:50. > :31:54.has been to seek to ensure that from the ?15.2 billion spent on medicines

:31:55. > :32:01.in the most recent full-year an increase of nearly percent since

:32:02. > :32:06.2010 and 2011, 7% higher than last year, that such loopholes are closed

:32:07. > :32:11.down to ensure that the NHS that she was as much value for money as it

:32:12. > :32:16.can from this very significant spending on pharmaceutical and

:32:17. > :32:20.medical products. We are looking to clarify and modify positions, to

:32:21. > :32:24.control the cost of health service medicines and to ensure that sales

:32:25. > :32:29.and purchase information can be appropriately collected and

:32:30. > :32:33.disclosed. Briefly, Madame Deputy Speaker, the bill puts beyond doubt

:32:34. > :32:36.that the Secretary of State camera acquired companies in the statutory

:32:37. > :32:41.scheme to make payments to control the cost of health service

:32:42. > :32:46.medicines. This will save the health service across the UK some ?19

:32:47. > :32:50.million a year. Secondly, the bill would enable the Secretary of State

:32:51. > :32:58.to require companies to reduce the price of an unbranded, generic

:32:59. > :33:04.medicine. Or to impose controls on that medicine even if the company is

:33:05. > :33:09.in the voluntary scheme. Honourable members will recall examples raised

:33:10. > :33:15.during the second reading debate and in committee where companies have

:33:16. > :33:17.charged the NHS unreasonably high prices for unbranded, generic

:33:18. > :33:24.medicine. Without competition companies have raised prices and in

:33:25. > :33:28.the most extreme case by as much as 12,000%. Companies can do this

:33:29. > :33:33.because we rely on competition to keep prices down and while this

:33:34. > :33:37.generally works well, the government needs the tools to be able to

:33:38. > :33:42.address the situation where a small number of companies are exploiting

:33:43. > :33:47.the NHS, patience and the taxpayer by raising prices when there is no

:33:48. > :33:51.competition. Thirdly, the bill enables the Secretary of State to

:33:52. > :33:55.make regulations to obtain information on sales and purchases

:33:56. > :34:01.of health service products in all supplies and in all parts of the

:34:02. > :34:03.supply chain. These purposes are reimbursement of community

:34:04. > :34:10.pharmacies and GPs determining value for money in the supply chain and

:34:11. > :34:14.schemes to control the cost or prices of medicines. By bringing

:34:15. > :34:18.these requirements together the bill streamlines and clarifies all the

:34:19. > :34:23.relevant requirements in place providing a statutory footing for

:34:24. > :34:28.them all. This includes the existing statutory requirements already in

:34:29. > :34:33.the NHS Act 2006 and those agreements that have a voluntary

:34:34. > :34:37.basis only. At committee stage the government tabled an number of

:34:38. > :34:44.important amendments that reflect the reviews and requests from the

:34:45. > :34:46.devolved administrations. We tabled these amendments following

:34:47. > :34:52.constructive discussions which resulted in an agreement that the UK

:34:53. > :34:56.Government will collect information from wholesalers and manufacturers

:34:57. > :35:00.from the whole of the UK. It would not make sense for each nation to

:35:01. > :35:06.collect information which would lead to duplication of effort and lead to

:35:07. > :35:11.increased costs. Each nation will collect information from its own

:35:12. > :35:13.pharmacies and GPs. The devolved administrations will have full

:35:14. > :35:18.access to all information that the government collect and I have

:35:19. > :35:23.committed again today to develop a memorandum of understanding to

:35:24. > :35:26.underpin these arrangements. My officials are working closely with

:35:27. > :35:31.officials in the devolved administrations to do this. To

:35:32. > :35:35.ensure the bill makes clear the government's intentions, I would

:35:36. > :35:39.also highlight the small number of technical amendments we have

:35:40. > :35:43.introduced at report to bring clarity to the bill. These closed

:35:44. > :35:48.down a potential loophole that would enable some companies not to provide

:35:49. > :35:53.us with any information if they also provide pharmacy or GP services to

:35:54. > :35:58.the devolved health services. This has been a relatively small bill,

:35:59. > :36:02.technical in nature, which has received considerable support from

:36:03. > :36:06.across the House for which I am extremely grateful. The bill will

:36:07. > :36:10.help to secure better value for money for the NHS on its ban on

:36:11. > :36:14.medicines while ensuring decisions made by the government are based on

:36:15. > :36:19.more accurate and robust information. I would like to thank

:36:20. > :36:24.you, Madame Deputy Speaker, for presiding over today's sessions. I

:36:25. > :36:29.would like to thank members of the chairman's committee, in particular

:36:30. > :36:34.the member for Telford, under whose chairmanship I served for the first

:36:35. > :36:36.time. I would like to thank the Parliamentary clerks, the Hansard

:36:37. > :36:43.writers and the doorkeepers for making this bill proceed. The

:36:44. > :36:48.honourable member for The Wrekin, I am corrected, I would like to thank

:36:49. > :36:55.all of those people for helping us proceed to our conclusion today.

:36:56. > :36:59.Thank you, Madam Deputy Speaker. As we have heard from the ministers

:37:00. > :37:03.today, this bill seeks to allow the NHS to better control the costs of

:37:04. > :37:08.medicines and medical supplies and to control and close loopholes in

:37:09. > :37:13.the system would have been the subject of abuses in recent years.

:37:14. > :37:18.In seeking to achieve those aims the government has our support. I would

:37:19. > :37:21.like to place on record our appreciation for the Minister and

:37:22. > :37:26.the amiable way he has dealt with this bill. Although he has not

:37:27. > :37:31.agreed with our amendments, he has explained why in a reasonable and

:37:32. > :37:38.constructive manner. I would like to record my appreciation to the

:37:39. > :37:41.members who served on the committee. The member for Central Ayrshire who

:37:42. > :37:48.spoke on behalf of of the Scottish National party and other thanks go

:37:49. > :37:51.to the honourable member for Wolverhampton South West who has

:37:52. > :37:57.engaged and informed in equal measure throughout the entire

:37:58. > :38:01.passage of this bill. Expenditure on medicines is a significant and

:38:02. > :38:08.growing proportion of the NHS budget, standing at ?15.2 billion,

:38:09. > :38:14.which is an increase of over 20% since 2010-2011. This reflects the

:38:15. > :38:17.incredible advances that we see in the development of innovative

:38:18. > :38:23.medicines, often by our own bile and life sciences industries in the UK.

:38:24. > :38:29.It is clear tax payers and patients have not always been well served by

:38:30. > :38:36.the market. It is important we do everything we can to secure value

:38:37. > :38:41.for money for the NHS, particularly following six years of

:38:42. > :38:45.underinvestment by normal standards. When the price regulation scheme was

:38:46. > :38:52.agreed in early 2014, the government said it would provide an

:38:53. > :38:56.unprecedented level of certainty. But as was reported by the

:38:57. > :39:03.honourable member for Mid Norfolk, estimated PPI payments were ?647

:39:04. > :39:08.million, a considerable reduction from the ?800 million received in

:39:09. > :39:14.2015 when at a time the overall drugs bill has been increasing at a

:39:15. > :39:19.pace. So, those figures and the fact we are debating these measures in

:39:20. > :39:24.the bill showed the original scheme has not gone entirely to plan. There

:39:25. > :39:28.is much in the bill to be welcomed and we would like to see an end to

:39:29. > :39:34.the playing of the system that has been going on and we hope the bill

:39:35. > :39:35.will put an end to such antics and it will seek consistency being

:39:36. > :39:43.derived in appropriate circumstances. We support the

:39:44. > :39:47.rationale behind the statutory schemes and it will give a much

:39:48. > :39:57.better chance of delivering savings to the taxpayer. We support measures

:39:58. > :40:06.to tackle regulations to stop companies exploited a loophole.

:40:07. > :40:09.Sometimes the price of medicines was inflated by ?262 million a year as a

:40:10. > :40:17.result of this practice. Those issues impact on patients. The

:40:18. > :40:25.example is a drug that has been found to be effective in treating

:40:26. > :40:28.muscular dystrophy. Until 2005 this was relatively inexpensive. It was

:40:29. > :40:34.discontinued by its only factor until recently one pharmaceutical

:40:35. > :40:41.company decided to manufacture it again. But their price is ?35,000

:40:42. > :40:45.per patient per year, despite the fact there has been no new research

:40:46. > :40:48.and development costs incurred by the company and it was difficult to

:40:49. > :40:59.see what justification there could The NHS in England is refusing to

:41:00. > :41:04.provide reimbursement for the drug which means patients lose out. It is

:41:05. > :41:07.this deliberate manipulation of the system we want to see dealt with and

:41:08. > :41:12.we hope this bill puts an end to such scandalous practice. Whilst we

:41:13. > :41:17.support the broad aims of the bill, we have some wider concerns. Perhaps

:41:18. > :41:22.what is missing from the bill and the government's policy on access to

:41:23. > :41:25.medicines and treatment. This country has a world leading

:41:26. > :41:33.pharmaceutical sector, there is a relatively low take-up of medicines.

:41:34. > :41:36.Members from across the House will have received correspondence from

:41:37. > :41:40.their constituents concerned about the lack of availability of

:41:41. > :41:45.medicines they or their relatives are trying to obtain. We see

:41:46. > :41:48.clinical commissioning groups rationing treatment in ways that

:41:49. > :41:52.would have previously been seen as unthinkable. To create a level

:41:53. > :41:58.playing field for drugs we should be doing the same for patients as well.

:41:59. > :42:03.One measure is to ring fence future rebates from the sector and improve

:42:04. > :42:07.access to medicines and treatments. ?1.24 billion of new money has been

:42:08. > :42:11.returned on rebate since it was established. There could be no more

:42:12. > :42:18.logical use for this money and use it to tackle developing new drugs.

:42:19. > :42:21.We know the government are not willing to back the amendments, but

:42:22. > :42:26.I would urge the Minister to look again how this measure has worked in

:42:27. > :42:29.Scotland. We have heard in the debate on this today, and there

:42:30. > :42:34.seems to be difference of opinion on how that has worked. We know the

:42:35. > :42:39.member for Central Ayrshire has spoke strongly in support. We note

:42:40. > :42:44.in terms of the issues of devolution a number of amendments have been

:42:45. > :42:53.tabled by the government which have sought for the devolved regions to

:42:54. > :42:56.be subject to the same. I recall when the minister responded to my

:42:57. > :43:04.questioning on this point, he suggested ring fencing might lead to

:43:05. > :43:08.chaos as their allocation from NHS England includes an element of

:43:09. > :43:12.income from the rebates. I do think the minister underestimate his

:43:13. > :43:17.ability to resolve this and overestimates the difficulty that

:43:18. > :43:20.would ensue. The annual budget for Greater Manchester is around ?6

:43:21. > :43:25.billion, half of the Scottish budget and less than the Welsh budget. It

:43:26. > :43:31.is not the budget that is an issue, but what is an issue is transparency

:43:32. > :43:35.and consistency. While I am not expecting a late change of heart, we

:43:36. > :43:38.will watch the developments in English devolution and accompanying

:43:39. > :43:50.budgets with some interest. The other areas of concern how these

:43:51. > :43:55.proposals will impact the future. We will be keeping a close eye on both

:43:56. > :43:58.the operation of the scheme and general health of the sector,

:43:59. > :44:02.particularly in terms of future investment in research and

:44:03. > :44:06.development. To conclude, we support the broad aims of this bill and what

:44:07. > :44:10.the government is seeking to achieve in terms of controlling better, the

:44:11. > :44:14.costs of medicines. We do think they should be doing more to tackle the

:44:15. > :44:17.present situation to prevent patients missing out on treatments

:44:18. > :44:22.made available particularly when we compare our record to countries with

:44:23. > :44:25.similar well. We do hope the annual review envisaged in the draft

:44:26. > :44:36.regulations is broad enough in its scope to produce a effectiveness. We

:44:37. > :44:40.look forward to the government response. This is a small Bill

:44:41. > :44:44.Butler sums at stake are considerably large and I believe we

:44:45. > :44:51.should hopefully see a positive outcome for the NHS as a whole as a

:44:52. > :44:53.result of this. Only leaves me to conclude by thanking yourself for

:44:54. > :44:58.chairing today and thanking the members who are standing in the bill

:44:59. > :45:02.committee, the staff and civil servants who have successfully led

:45:03. > :45:10.this passage through the chamber today. Thank you. I will open with

:45:11. > :45:14.my thanks, this is the first bill I have taken through and I am grateful

:45:15. > :45:17.to yourself, the chairs in the bill committee and all the staff who have

:45:18. > :45:23.worked on this and the procedural hub. That someone who is a new beat

:45:24. > :45:32.to be able to say, what happens next has been helpful. We have welcomed

:45:33. > :45:36.the basic premise of this bill and particularly now clauses one to four

:45:37. > :45:39.do give the Secretary of State power to control prices of drugs and in

:45:40. > :45:44.particular to avoid the excesses we have seen recently and the

:45:45. > :45:51.highlighted in the article in The Times. Companies in the voluntary

:45:52. > :45:55.scheme who also produce generics and therefore the price of those

:45:56. > :45:58.generics is not controlled and also these companies that have picked up

:45:59. > :46:06.drugs no longer produced by anyone else as an orphan status and have

:46:07. > :46:11.literally basically robbed the NHS by increasing them by many thousands

:46:12. > :46:15.of percent. It is unacceptable. One of the things I would point out,

:46:16. > :46:20.when we accept relatively high prices for new drugs, we often

:46:21. > :46:25.excuse that on the basis of research and development. Not all research

:46:26. > :46:32.and development is done by big pharmaceutical companies. They are

:46:33. > :46:37.often small, spin out companies from universities and from the point of

:46:38. > :46:44.view of generic or repurposed patented drugs, this work is done

:46:45. > :46:48.within the NHS by clinicians or academic university departments. It

:46:49. > :46:52.has been admitted in the past by companies that they are not always

:46:53. > :46:55.pricing these drugs in relation to the cost of research and

:46:56. > :47:00.development, but what the market will bear. It is something we need

:47:01. > :47:05.to not always give them this excuse that they are expending huge amounts

:47:06. > :47:09.on R, because that is not always the case. I did raise two new

:47:10. > :47:13.clauses in committee and now the Secretary of State will have the

:47:14. > :47:19.power, I have those issues will be dealt with. One was the issue of

:47:20. > :47:23.specials, the handmade preparations, usually point met for a

:47:24. > :47:31.dermatological use and I did arrange that the briefing from the

:47:32. > :47:35.Association of dermatology, who highlighted companies who had a

:47:36. > :47:40.Scottish price list and an English price list, I have these powers will

:47:41. > :47:44.be used. In Scotland it is used by using an NHS producer, who makes the

:47:45. > :47:50.drug and keeps the price down, rather than paying simply a

:47:51. > :47:54.pharmaceutical company or a pharmacy company, because the pharmacy with

:47:55. > :47:58.which the patient is dealing may have a mother or sister company and

:47:59. > :48:02.they are simply taking a very high price from them. The other one is

:48:03. > :48:08.the issue that was raised last November of repurposed patented

:48:09. > :48:15.drugs. Exact same things can happen, as was raised by the Shadow Minister

:48:16. > :48:19.of health, which is a drug which is of paint and maybe picked up by a

:48:20. > :48:27.new company and used for a new purpose, such as the statin in

:48:28. > :48:32.multiple sclerosis but with just a tweak, can be put out as a new drug

:48:33. > :48:39.at a price that people cannot access. Doctors must prescribe the

:48:40. > :48:43.licensed version before an unlicensed version. If a licensed

:48:44. > :48:47.drug came on the market that was just a version of Anne off patented

:48:48. > :48:53.drug, doctors would be under pressure to prescribe it. I

:48:54. > :48:55.understand there has been work going ahead, I just exhort the miniature

:48:56. > :49:01.and threw him the Secretary of State, to ensure the powers that are

:49:02. > :49:04.given by this bill are used in all of the circumstances to ensure

:49:05. > :49:10.prices are controlled. Because otherwise what happens is not

:49:11. > :49:13.expenditure to the NHS on its own, but usually CC jays will not allow

:49:14. > :49:20.these drugs to be accessed and that is what is happening in this case of

:49:21. > :49:27.specials. It is weird we have the powers, and we welcome mat but hope

:49:28. > :49:33.they will be used. I propose not to take the remaining three hours. The

:49:34. > :49:38.Minister earlier, when he wouldn't take in intervention seemed to think

:49:39. > :49:42.there was a rush on time, I read we had another three hours of this

:49:43. > :49:49.bill. But I wanted to put the bill into some context. This is a

:49:50. > :49:55.socialist bill. It builds on the Labour government's NHS act which

:49:56. > :50:02.applied to England. Looking round, it may be the case that you and I

:50:03. > :50:07.are the only members present who voted for the 26 NHS act, before you

:50:08. > :50:15.were in your esteemed position. It is worth reviewing before we put the

:50:16. > :50:25.current bill in context what it is building on with the previous act.

:50:26. > :50:34.The 2006 act was the pharmaceutical price regulation scheme, the PPRS.

:50:35. > :50:38.Those voluntary schemes were to do with limiting the profits of

:50:39. > :50:43.pharmaceutical companies. Can I stress to the House, my party and I

:50:44. > :50:48.are not opposed to pharmaceutical companies. They do fantastic

:50:49. > :50:52.research and there are probably millions and millions of people who

:50:53. > :50:56.are alive now who would not otherwise be alive, because of the

:50:57. > :51:01.research and development done by pharmaceutical companies, many of

:51:02. > :51:06.them happily based, or having major operations in the United Kingdom.

:51:07. > :51:13.They are very welcome here, but they have to play by the rules and so do

:51:14. > :51:16.those who buy up of patent drugs and horse surrounded them and put up

:51:17. > :51:20.their prices by hundreds and hundreds of percent. Sometimes it is

:51:21. > :51:24.a minority of private equity companies who are doing that and

:51:25. > :51:28.they are not welcome here. Pharmaceutical companies must act

:51:29. > :51:35.responsibly and they may need statutory encouragement to do so.

:51:36. > :51:40.The 2000 SIS act started the process of statutory encouragement with a

:51:41. > :51:45.statutory scheme, which enabled Her Majesty's governments, in

:51:46. > :51:49.appropriate cases, to limit prices and limit profits of pharmaceutical

:51:50. > :51:52.companies. And that is why I say it is a socialist scheme. Before the

:51:53. > :51:58.government benches get area weighted about this, I and my party do not

:51:59. > :52:02.wish to nationalise or control the prices in every corner store in the

:52:03. > :52:07.country. But there are big operations where market intervention

:52:08. > :52:12.is helpful and is needed where there is market failure. And it was

:52:13. > :52:15.perceived I think, rightly, by the Labour government, that there was

:52:16. > :52:23.some market failure and it needed some stern measures to sort it out.

:52:24. > :52:32.This bill builds on that work from ten years ago because, as averted to

:52:33. > :52:37.buy my honourable friend, there were some, and minority of drug supply

:52:38. > :52:44.companies who were, frankly, taking the Mickey, because they were

:52:45. > :52:48.leaving the voluntary scheme in favour of the statutory scheme

:52:49. > :52:53.because that was more advantageous to that company. I understand why

:52:54. > :52:57.they would do that, they which to maximise their profits but they must

:52:58. > :53:00.act in a responsible way. If they will not do so through the urging of

:53:01. > :53:05.corporate social responsibility, which some of them will not, then we

:53:06. > :53:10.need statutory measures. That is what the bill before the House this

:53:11. > :53:14.afternoon bills. One of the things it does is addressed that issue of

:53:15. > :53:19.companies leaving the voluntary scheme to go in a statutory scheme

:53:20. > :53:23.because it was a better deal. It resets the schemes, as it were, this

:53:24. > :53:26.bill, to make sure our company is not encouraged to do so because

:53:27. > :53:31.there is not that comparative advantage. The bill also makes

:53:32. > :53:38.provision for a new power which will enable the Secretary of State for

:53:39. > :53:43.Health to require a company, which is in the voluntary scheme, to pay

:53:44. > :53:47.sums due under that scheme. Even though it is a voluntary scheme,

:53:48. > :53:53.this would give the Secretary of State the power to pursue such a

:53:54. > :53:56.non-payers through the courts. I regard that as progressive

:53:57. > :53:59.legislation for those companies which knocked acting responsibly,

:54:00. > :54:05.which are taking the Mickey, as characterised it. That is a good

:54:06. > :54:10.thing. This government has come down the socialist path to agree with

:54:11. > :54:16.that market intervention. It has also come down our path in wanting

:54:17. > :54:20.to martial information so that we can treat these companies equally

:54:21. > :54:28.and fairly. So they treat the society in which they operate,

:54:29. > :54:31.through their supply of medicines to the NHS equitably and fairly, and

:54:32. > :54:36.the Secretary of State will, under this bill, have the power to make

:54:37. > :54:39.regulations for the marshalling of information, building upon the work

:54:40. > :54:47.done in the NHS act ten years ago. That is important. But in terms of

:54:48. > :54:50.the context of this bill, I would like to tempt health service

:54:51. > :54:56.minister is a little further down the Socialist Party. The context of

:54:57. > :55:00.this bill, which the minister described as a technical bugs, it

:55:01. > :55:03.broadly is technical. But there is an ideological or philosophical

:55:04. > :55:09.aspect to it, which I have tried to set out because it is broadly a

:55:10. > :55:15.socialist bill. One of the things it seeks to do is save money for the

:55:16. > :55:20.NHS and raise money by claw-backs on overpriced medicines and so on, or

:55:21. > :55:25.medical supplies, so to raise and save money for the NHS because the

:55:26. > :55:31.NHS, and this is the context of this bill, and it is not purely

:55:32. > :55:37.technical, is that the NHS is in serious financial difficulty. The

:55:38. > :55:39.Minister refers to an extra ?10 billion of funding, even the Health

:55:40. > :55:48.Select Committee doesn't accept that calculation. It is what is being

:55:49. > :55:49.done on social care and that is leading to a growing problem of

:55:50. > :56:05.delayed discharges. Social care is not being properly

:56:06. > :56:08.funded in this country and it is effectively a mandatory charge

:56:09. > :56:14.because the government calculates it on the assumption that those cancels

:56:15. > :56:20.will do that precept and that is having an effect on the NHS because

:56:21. > :56:24.of delayed discharges. In the context of the crisis in social

:56:25. > :56:31.care, this bill and the extra funding it will provide for the NHS,

:56:32. > :56:36.whilst welcome, goes nowhere near addressing the underfunding of the

:56:37. > :56:42.NHS. It is in financial terms, this bill and what it will raise or save

:56:43. > :56:47.for the NHS, in financial terms in relation to what the NHS needs and

:56:48. > :56:53.what social care Council in England need, it is a drop in the ocean. The

:56:54. > :56:57.bill will encourage a certain level of efficiency in production of

:56:58. > :57:03.medicines, in practice and procurement of medicines and medical

:57:04. > :57:07.supplies and all of us in this house would sign up to the concept of

:57:08. > :57:13.efficient procurement. We might have different definitions as to what

:57:14. > :57:18.constitutes efficient procurement, but procurement is essential to this

:57:19. > :57:22.bill. We need to bear in mind that whilst the NHS is a massive

:57:23. > :57:26.organisation and it can almost always act more efficiency like any

:57:27. > :57:34.other enormous organisation, and this bill may help them do so, but

:57:35. > :57:39.the NHS is one of the most efficient health care organisations in health

:57:40. > :57:43.care delivery in the world. If one looks at health care delivery in the

:57:44. > :57:47.United States of America, they spent as a proportion of GDP as much on

:57:48. > :57:53.public health as the United Kingdom does. But because their public

:57:54. > :57:58.health is not run efficiently at all because it is fragmented, the USA

:57:59. > :58:04.spends the same proportion of GDP again on private health. I must

:58:05. > :58:09.remind the honourable gentleman it is a specific bill and it is a third

:58:10. > :58:13.reading and he is venturing into areas that are specifically not in

:58:14. > :58:18.this bill and maybe he would like to come back to what is in the bill. I

:58:19. > :58:22.am grateful for your guidance. I am putting this bill in context with

:58:23. > :58:27.the context of the NHS and the effect this bill will have in terms

:58:28. > :58:35.of addressing the much deeper problem is that the NHS has and I

:58:36. > :58:39.was advert and to some of those deeper problems. But I will take

:58:40. > :58:44.your guidance. I will repeat to the government that the government has

:58:45. > :58:58.come somewhere, as demonstrated by this bill, down a socialist path by

:58:59. > :59:03.deliberate delivery of the health care, so let's have a public NHS.

:59:04. > :59:06.The question is that the bill be read a third time. As many as are of

:59:07. > :59:15.the opinion, say "aye". To the contrary, "no". . The ayes have it.

:59:16. > :59:22.Motion number three, representation of the people. Minister to move. The

:59:23. > :59:25.question is as on the order paper. As many as are of the opinion, say

:59:26. > :59:33."aye". To the contrary, "no".. The ayes have it. Motion number four on

:59:34. > :59:37.children and young persons. The question is as are the order paper.

:59:38. > :59:40.As many as are of the opinion, say "aye". To the contrary, "no".. The

:59:41. > :59:44.ayes have it. Motion number five on banks and banking. The question is

:59:45. > :59:47.as on the order paper. As many as are of the opinion, say "aye". To

:59:48. > :59:53.the contrary, "no". The ayes have it. Motion number six, financial

:59:54. > :59:57.services and markets. The question is as on the order paper. As many as

:59:58. > :00:06.are of the opinion, say "aye". To the contrary, "no". The ayes have

:00:07. > :00:13.it. I beg to move that this house can now adjourned. The question is

:00:14. > :00:18.that this house can now adjourned. Madame Deputy Speaker, Christmas

:00:19. > :00:21.seems to come somewhat early for myself with the German being reached

:00:22. > :00:28.rather earlier than would otherwise have been the case. I do hope,

:00:29. > :00:33.Madame Deputy Speaker, and I say this to my honourable friend the

:00:34. > :00:37.Minister in good heart, there is no good point having an adjournment

:00:38. > :00:42.debate exchanging 15 minutes of words unless there is a positive

:00:43. > :00:45.outcome and that is what I am expecting, a positive outcome. There

:00:46. > :00:53.could be no finer Christmas present for my constituents if the very

:00:54. > :01:01.disappointing train service offered by CQC, and IBM greater Anglia was

:01:02. > :01:08.an improved. In fact there is some irony in this debate because I seem

:01:09. > :01:11.to recall of the year I also had an adjournment debate on this same

:01:12. > :01:18.subject and again the business ended rather earlier. On that occasion the

:01:19. > :01:27.Minister and I were caught out. We have certainly not been caught out

:01:28. > :01:31.this time my honourable friend the Minister was elected to this house

:01:32. > :01:37.in 2010, so he has not had the opportunity before of listening to

:01:38. > :01:41.myself talk about the railway service of which my constituents

:01:42. > :01:45.enjoy or suffer. My honourable friend the Minister is dependent on

:01:46. > :01:49.the briefing that is given to him by his officials. His officials are

:01:50. > :01:56.dependent on the briefing that they are given by the people who run

:01:57. > :02:01.these services. That of course, Madame Deputy Speaker, is how things

:02:02. > :02:06.have changed in this place. Once upon a time, the violins come out,

:02:07. > :02:11.the member of Parliament democratically elected would raise

:02:12. > :02:14.an issue, the Minister would be very concerned and he would do something

:02:15. > :02:23.about it and he could make a difference. In 2016 it does not feel

:02:24. > :02:28.like that, which is why I find increasingly it very disappointing

:02:29. > :02:32.the way power has seeped away from this place. But no doubt the

:02:33. > :02:37.Minister will shock me at the end of this debate and I will leave here

:02:38. > :02:42.very happy with him guaranteeing that he is going to have a good word

:02:43. > :02:47.with the deliverers of the two rail services and things will improve.

:02:48. > :02:53.When I was a member of Parliament for Basildon, and the violins will

:02:54. > :02:59.come out now, I called for the privatisation of the Fenchurch

:03:00. > :03:04.Street line. Madame Deputy Speaker, I am not an MP sort of talking about

:03:05. > :03:11.rail services hypothetically. I am a commuter. I have been a commuter for

:03:12. > :03:18.many years. I was a commuter before I became a member of Parliament and

:03:19. > :03:24.I and my wife remember standing on crowded platforms, our hearts in our

:03:25. > :03:29.mouths, because the trains would stop, the carriages would open and

:03:30. > :03:34.people would fall out they were so crashed into these carriages. We

:03:35. > :03:38.would think, crikey, we cannot get on the next train, we will be late

:03:39. > :03:43.for work, what will our bosses think about this? Madame Deputy Speaker,

:03:44. > :03:51.our train services have improved, and I pay tribute to my predecessor

:03:52. > :03:54.the late Lord Channon, and also the late Lord Parkinson. Both of those

:03:55. > :03:58.former colleagues when they were secretaries of state are responsible

:03:59. > :04:08.for much of the improvement we take for granted today, the Tube

:04:09. > :04:12.services, and the railway services. But if both of them were alive

:04:13. > :04:26.today, they would be very disappointed at what has happened

:04:27. > :04:31.about the C2C line. I do not blame the men and women who work for these

:04:32. > :04:37.companies. They do a wonderful job under difficult circumstances. But I

:04:38. > :04:40.blamed the management and the senior management, particularly National

:04:41. > :04:46.Express and the way they try to shut me up earlier in the year because I

:04:47. > :04:53.was trying to get an improvement in the services. I absolutely do blame

:04:54. > :04:58.them and I am not going to stop raising these matters in the House

:04:59. > :05:06.of commons until there is a dramatic improvement in the services. Going

:05:07. > :05:12.back all those years when live on national TV when things that we did

:05:13. > :05:17.here were reported, and I had an argument with the then chairman of

:05:18. > :05:23.British rail, all this was live on TV and everything changed. Indeed I

:05:24. > :05:27.can remember coming back from this broadcast as I went through one of

:05:28. > :05:31.the division lobbies and my colleagues applauded me because they

:05:32. > :05:36.thought it was good that a local MP was actually taking the then

:05:37. > :05:42.National rail service to task. All that changed. We used to be called

:05:43. > :05:50.the misery line. The line was privatised and then we became a

:05:51. > :05:52.happy line. It was completely transformed and the constituent I

:05:53. > :06:01.represented were very pleased with the improved services. Then since

:06:02. > :06:07.1997I have been the member of Parliament for Southend West using

:06:08. > :06:13.the same railway line and the stations that serve the area I

:06:14. > :06:17.represent our Westcliff, chalk well, Leigh on Sea, and the one railway

:06:18. > :06:26.station that covers the constituency I represent is out pretty well and

:06:27. > :06:31.they are served by Abelia greater Anglia. I am pleased to see in his

:06:32. > :06:35.plays my honourable friend the member for Rochford and Southend

:06:36. > :06:38.East and my honourable friend the member for Thurrock. It is always

:06:39. > :06:44.good to have the support of my honourable friend, and I could go on

:06:45. > :06:50.and on with other colleagues. I know my right honourable friend, the

:06:51. > :06:55.member for Rayleigh who is not in his plays, would also support me. My

:06:56. > :07:01.honourable friend mentions my presence here. I am here as a member

:07:02. > :07:07.of the transport Select Committee. This is a matter where I want to

:07:08. > :07:14.take this back and share this with the Select Committee and see if this

:07:15. > :07:18.is something we can look at. I am flattered and honoured man. I forgot

:07:19. > :07:22.my honourable friend was a member of the transport Select Committee, said

:07:23. > :07:26.that is very good news is that he in his capacity may raise it with the

:07:27. > :07:33.chairman and the rest of the committee. We arrived at a situation

:07:34. > :07:38.whereby this time last year I was looking forward to Christmas. And

:07:39. > :07:42.the gentleman running the line contacted myself and my other

:07:43. > :07:50.colleagues to say there would be some changes but it was all good

:07:51. > :07:55.news. The wonderful service we had was going to be better, Madame

:07:56. > :08:02.Deputy Speaker. So on the 30th of December last year, the timetable

:08:03. > :08:10.changed. We were told that as a result of the timetable there would

:08:11. > :08:17.be improved passenger experiences, definitely not the case judging by

:08:18. > :08:21.my inbox. Increased reliability and other constituents as, I quote, it

:08:22. > :08:28.is rare to have a day without issues than a day with. Also we were

:08:29. > :08:35.promised quicker commutes. We were promised more seat availability.

:08:36. > :08:39.Again I quote from another constituent, people are already

:08:40. > :08:47.standing by the time the train arrives at Westley. So I am not

:08:48. > :08:51.criticising my honourable friend's constituents who get on at Thorpe

:08:52. > :08:55.Bay and all the other stations which they are entitled to, but by the

:08:56. > :09:01.time they get on the train and reach where I get on the trains are

:09:02. > :09:07.already pretty packed. We were also told that as a result of the changed

:09:08. > :09:12.timetable that if this failed, more than likely we would return to the

:09:13. > :09:17.old timetable if the new timetable was not successful. That has

:09:18. > :09:24.obviously not happened. Madame Deputy Speaker, within days of the

:09:25. > :09:29.initial changes in December 2015, my mailbox and my inbox were piling up

:09:30. > :09:35.with complaints. So I did not have as happy a Christmas as I had

:09:36. > :09:42.anticipated. And constituents showed the extent of their upset by

:09:43. > :09:47.protesting at a famous, or infamous rally. You do not often have rallies

:09:48. > :09:53.on platforms, but we did, at Fenchurch Street station. That was

:09:54. > :10:00.on the 14th of January this year. Following this public rally on a

:10:01. > :10:06.railway station, a radio interview was conducted between Dave Monk, a

:10:07. > :10:13.wonderful Essex radio broadcaster, with the gentleman Mr Drury, who is

:10:14. > :10:18.responsible for running the line. This was in April this year. Mr

:10:19. > :10:25.Drury said, quote, we are going to reduce the number of trains. We are

:10:26. > :10:30.going to reduce the number of trains? OK. And use those carriages

:10:31. > :10:36.to lengthen the other trains. So we have got longer trains. A little

:10:37. > :10:43.confusing the logic in all of that as to how that is going to please

:10:44. > :10:52.And this he said in response to people saying we don't want for

:10:53. > :10:57.coach trains. He was saying we will have longer trains but not so many.

:10:58. > :11:02.Yes, but that doesn't mean they want fewer trains. During the interview

:11:03. > :11:05.he was told you are not meeting an increased demand if you increase the

:11:06. > :11:11.length but decrease the number of trains running. That was the

:11:12. > :11:15.interview. Daily correspondence continued and the misery line has

:11:16. > :11:22.now returned, at least for my constituents. There was an exchange

:11:23. > :11:27.between myself and the then chairman of the Conservative Party. I

:11:28. > :11:31.received a letter from the then chairman, in which it was suggested

:11:32. > :11:43.he had received a complaint from the chairman of National Express group.

:11:44. > :11:49.The gentleman in overall charge of C2C. He wrote to the party chairman

:11:50. > :11:52.who said, was he aware one of his colleagues was making life difficult

:11:53. > :12:00.in rather disagreeable fashion complaining about the C2C service.

:12:01. > :12:06.Now, that is not acceptable and it is gutless. If anyone has a beef,

:12:07. > :12:11.let them eat BMP eyeball to eyeball. You don't go behind their back. What

:12:12. > :12:17.did the chap think he was going to do, the chairman of the Conservative

:12:18. > :12:21.Party was going to tell me. If he had, he would have got it all guns

:12:22. > :12:29.blazing. That backfired and I will never forget what but gentleman did.

:12:30. > :12:32.It was undermining my role and any colleague's role as an MP to

:12:33. > :12:44.represent the views of their constituents. This is a sample of

:12:45. > :12:49.letters. They appear to have cancellations, delays and faults

:12:50. > :12:53.virtually every day now, which is extremely frustrating, given their

:12:54. > :12:59.previous excellent performance. Previous excellent performance. The

:13:00. > :13:03.next one... I have written to you, this is C2C, before, expressing

:13:04. > :13:07.unhappiness when things go wrong. Passengers are pretty much left to

:13:08. > :13:11.fend for themselves. There seems to be no information at Barking and it

:13:12. > :13:15.is exhausting to keep swapping platforms. It is, it is not just

:13:16. > :13:20.walking across, there is quite a journey to get to the other

:13:21. > :13:27.platform. For services that do not then run or have left by the time

:13:28. > :13:35.you get there. You, meaning C2C, apologise for the inconvenience and

:13:36. > :13:41.state it will be looked into and improved. Obviously it hasn't. The

:13:42. > :13:45.next one... I am also starting to tire of all the apologies made to

:13:46. > :13:50.the travelling public. Like many others, I would prefer to see real

:13:51. > :13:54.change and proper information given to customers, rather than the

:13:55. > :13:59.current mantra, which seems to imply we can do as we like as long as we

:14:00. > :14:03.say sorry. My feeling is, this is not acceptable given my fare is over

:14:04. > :14:08.?3000 per annum and my second largest bill only to my mortgage.

:14:09. > :14:13.This is a lot of money. Another one... This morning I checked the

:14:14. > :14:21.website, the 6:45am to see if the service was OK. It was, the fast

:14:22. > :14:27.train was on time. I walked to the station to discover it was

:14:28. > :14:32.cancelled. No reason. I asked C2C on Twitter. I was told it was under

:14:33. > :14:37.investigation and despite repeated requests for an answer, I have been

:14:38. > :14:41.ignored. I will not accept being ignored by them. ... I shouldn't

:14:42. > :14:48.have to leave home early and get on a slower train but pay more money

:14:49. > :14:54.for the benefit. I agree. ... Constituents saying her affair is

:14:55. > :14:58.over ?3000 a year. ... The only thing we get from a C2C is there

:14:59. > :15:03.were, more carriages are coming. Carriages are not the answer, the

:15:04. > :15:09.problem is a shambolic timetable. The problem is this timetable, which

:15:10. > :15:14.I was told would be good news for constituents. Next one... I refused

:15:15. > :15:18.to take my children to London on the trains because of the poor state,

:15:19. > :15:21.especially the toilets if they are working, but I worry for their

:15:22. > :15:26.safety in awful conditions. The final one... Still major problems,

:15:27. > :15:33.no end in sight even with you carriages. When will C2C put

:15:34. > :15:39.passengers before the profits. I do hope my honourable friend and his

:15:40. > :15:44.wonderful officials and the briefing will not listen to the fact it will

:15:45. > :15:47.all be fixed because we will have a new, all dancing, all singing

:15:48. > :15:51.carriages and more trains. That will not fix the problems. The design of

:15:52. > :15:55.the new carriages is totally unacceptable. I think it has been

:15:56. > :16:01.done by somebody who clearly doesn't commute. There are, some very

:16:02. > :16:11.interesting statistics about the performance of the line. From autumn

:16:12. > :16:15.2015 to January 2016, the C2C website says there has been a 20%

:16:16. > :16:19.increase in passengers departing from Fenchurch Street in the

:16:20. > :16:25.evening. Surely this must be in large part, due to people using the

:16:26. > :16:29.train as a replacement for the tube between Barking and West Ham. In the

:16:30. > :16:37.same period, 5% increase in the morning at the busiest point. In

:16:38. > :16:44.January 2017, introducing 24 new carriages along with the new

:16:45. > :16:48.timetable. The new timetable promises for more fast services each

:16:49. > :16:55.morning and evening, cutting journey times by up to six minutes. And

:16:56. > :17:02.there is also the promise of a 6% increase in seats. But, the new

:17:03. > :17:07.timetable, yet again, another new timetable, from the 9th of January

:17:08. > :17:12.still has most of the trains stopping at Barking and West Ham.

:17:13. > :17:17.Which is where a lot of of the severe overcrowding occurs,

:17:18. > :17:22.particularly at peak times. This is because people are able to use the

:17:23. > :17:28.C2C line as opposed to the tube to get between Barking and West Ham. I

:17:29. > :17:37.think this is unfair. They are not paying the price the C2C customers

:17:38. > :17:42.are. They are paying the TEFL tube prices. I would like to know from

:17:43. > :17:54.the minister, do C2C receive a financial incentive from TfL to stop

:17:55. > :17:58.at London stations? The calculations are based on all trains arriving at

:17:59. > :18:05.Fenchurch Street and do not count trains that go via the loop, which

:18:06. > :18:14.is the wonderful little journey through the rack. It is not that my

:18:15. > :18:17.constituents and those of my honourable friend the member for

:18:18. > :18:24.Rochford and Southend East don't want to go via Tilbury or these

:18:25. > :18:32.other places, it is just it delays the journey quite a bit. So in 2015,

:18:33. > :18:38.wheezing Westcliff between these hours, there were 16 trains and a

:18:39. > :18:44.total of 144 carriages. With the 2017 timetable and this, Madam

:18:45. > :18:53.Deputy Speaker is the crunch, Westcliff will be served by 13

:18:54. > :19:01.trains, three less, with a total of 136 carriages. So this is eight less

:19:02. > :19:07.carriages. Again, this is absolute rubbish we are being fed. It is

:19:08. > :19:10.insulting my intelligence and those of my constituents. The figures are

:19:11. > :19:16.exactly the same for chalk well. Those were the longest commute, the

:19:17. > :19:22.first six stations on the line are the worst. There is an increase in

:19:23. > :19:27.the number of carriages at leaf. That Mac

:19:28. > :19:33.that great for the residents getting off there, but by reducing the

:19:34. > :19:39.earlier stations, there will be a bottleneck for commuters. On Friday,

:19:40. > :19:46.C2C announced a fare increase. I know it is not there in false, but

:19:47. > :19:49.that is in line with government policy, but that has upset

:19:50. > :20:02.constituents as well. Moving on very quickly, to the Greater Anglia

:20:03. > :20:11.service. One station that serves commuters for the constituency I

:20:12. > :20:19.represent, they upgraded the station physically, but the line is dire

:20:20. > :20:23.beyond belief. My honourable friend, I am not sure he was the minister

:20:24. > :20:30.when the franchise was reduced, but anyway the franchise has been

:20:31. > :20:35.renewed. ?150 million, invested to upgrade the network. I understand an

:20:36. > :20:41.agreement with C2C for specific acceptance between the two Alliance

:20:42. > :20:46.for engineering work will be given and the details will be given on the

:20:47. > :20:51.website shortly and they are in negotiations with C2C about ticket

:20:52. > :20:54.acceptance over the festive period. But the constituent has just

:20:55. > :20:58.complained to me that the trains are out of date, which they certainly

:20:59. > :21:04.are and overpriced, compared with other services. The lady said, I am

:21:05. > :21:09.shocked this franchise has been given the contract again to run this

:21:10. > :21:15.shocking service. I say to the Minister, having met the management

:21:16. > :21:19.of greater beer, given the other people who were bidding for the

:21:20. > :21:23.line, I am thinking they were probably the best of those offered

:21:24. > :21:29.to run the line and they were given the extra money to upgrade services

:21:30. > :21:33.and they thought let's go with it. My constituent says the impact it is

:21:34. > :21:36.having on her personal life is so detrimental that she has put her

:21:37. > :21:43.House on the market to move to another address. After commuting on

:21:44. > :21:47.the south Victoria train line for 20 years, I realise how terrible the

:21:48. > :21:52.service is and I cannot contemplate having to enjoy this nightmare

:21:53. > :21:57.commute any more. Going back to all those years before I became an MP

:21:58. > :22:01.when my wife and I stood there, hearts in our mouths, doors opening

:22:02. > :22:06.and you couldn't get on the trains, it is still a dreadful service. She

:22:07. > :22:12.goes on to say, every day there is an issue, at the weekends, no trains

:22:13. > :22:14.at all. Now we understand there is no service over the Christmas

:22:15. > :22:20.period, they will not allow season tickets to be used on the C2C line.

:22:21. > :22:24.That has to be sorted out. Why would commuters want to take trains to

:22:25. > :22:29.Billericay, buses to Newbury Park and the tube to London. This cannot

:22:30. > :22:34.be classed as an alternative service. She goes on to say the

:22:35. > :22:38.fares are much higher than other services. The rolling stock is

:22:39. > :22:41.ridiculously out of date, yet they are given the contract for our

:22:42. > :22:47.region. I'm hoping my complaint is one of many you are receiving. She

:22:48. > :22:54.says, something will have to happen to improve the misery of commuters

:22:55. > :23:01.who pay ?3000 for the tickets. The managing director of Greater Anglia

:23:02. > :23:05.said at the press launch last month, talking about corporate

:23:06. > :23:07.responsibility, it is the mark of a good business of how quickly we put

:23:08. > :23:13.things right. On proposed maintenance work, that will cause

:23:14. > :23:17.disruption on the Southend Victoria to London, Liverpool Street, he

:23:18. > :23:22.admitted there will be a tiny bit of pain for a very long game and there

:23:23. > :23:26.will be stepped change service improvement to the line which will

:23:27. > :23:31.have multi-million pound investment. Judging by some of the complaints I

:23:32. > :23:35.have received, if this tiny bit of pain means changes to the

:23:36. > :23:40.timetabling and frequency and capacity of trains, just as we have

:23:41. > :23:47.experienced on C2C, they will be held accountable by myself and other

:23:48. > :23:57.colleagues for their reputation. I do hope the railway company will get

:23:58. > :24:00.behind Southend being the alternative city of Culture next

:24:01. > :24:07.year, if they want to curry favour with local residents and local MPs,

:24:08. > :24:11.it will be wonderful as we start our celebrations as the alternative City

:24:12. > :24:17.of Culture on the 1st of January, if they could sponsor and help us in a

:24:18. > :24:23.few events. Well, Madam Deputy Speaker, I do hope that in the

:24:24. > :24:30.year's time, I don't have to seek another adjournment debate and raise

:24:31. > :24:36.the same subjects. I fully understand my honourable friend, I

:24:37. > :24:40.don't know if he is still reading his way into the brief, I don't know

:24:41. > :24:44.how familiar he would have been with this line, so I am not expecting him

:24:45. > :24:49.to wave a magic wand. But if he cannot raise all the points I have

:24:50. > :24:55.raced today, maybe in the New Year we can have a meeting with him and

:24:56. > :24:57.officials. I do wish the staff of C2C, Greater Anglia and everyone

:24:58. > :25:11.else a very happy Christmas. I am sure constituents will not

:25:12. > :25:16.appreciate that most junior members of Parliament only get half an hour

:25:17. > :25:22.to debate these issues. It is a great testament to my parliamentary

:25:23. > :25:29.neighbour that he has secured a half an hour debate not only once, but

:25:30. > :25:34.twice. It is also good to see the member for Thurrock in her place. I

:25:35. > :25:37.record as a whip one of the most frustrating things was not being

:25:38. > :25:44.able to ask questions and make speeches yourself. I know she will

:25:45. > :25:52.be making a beeline to the minister after and making a speech in person,

:25:53. > :25:57.bending his years. In particular if I can give you a preview of the

:25:58. > :26:03.speech she would have made in the words it would be, more rolling

:26:04. > :26:16.stock. You are forewarned. I thank the member for Southend to allow me

:26:17. > :26:18.to come in. Both lines pass through his constituency, but both lines

:26:19. > :26:26.terminate within the constituency I represent. We do not want to see a

:26:27. > :26:31.return to the misery line. I am a slightly more a glass half-full in

:26:32. > :26:39.contrast to my honourable friend. But we do share constituency

:26:40. > :26:42.experiences. During the initial timetable consultations with Julian

:26:43. > :26:52.Jewry I raised concerns from the outset. One things started to go

:26:53. > :27:05.wrong I look back at the letter and I quite shocked at the language I

:27:06. > :27:11.used in saying where it went wrong. We wanted to see a reversion to the

:27:12. > :27:17.faster trains and getting constituents into London. In fact,

:27:18. > :27:25.based on a campaign for the Norwich line into London, I adopted the

:27:26. > :27:28.terminology of their campaign, asking for trains from Schubert E to

:27:29. > :27:33.London to all be under 60 minutes. That is a critical point. These

:27:34. > :27:41.trains can currently be about an hour and ten minutes. Some fall into

:27:42. > :27:45.59 minutes, but if over the years we can get to a point where they are

:27:46. > :27:52.all under 59 minutes, that could be very useful. The department could be

:27:53. > :27:56.very helpful in this regard. C2C has some of the highest punctuality

:27:57. > :28:01.rates. It might be odd for me to say this, but I think we should give

:28:02. > :28:06.them permission to be less punctual in the sense that if in every four

:28:07. > :28:11.pays out of five we arrived two minutes later than advertise, that

:28:12. > :28:19.would be good if the other four days we arrived five minutes earlier than

:28:20. > :28:25.we currently arrived, particularly for constituents in the extremities.

:28:26. > :28:35.A previous individual, also a friend of mine, who ran the night at light

:28:36. > :28:38.ran it in only 32 minutes. Admittedly there were no other

:28:39. > :28:43.trains on the line and they did not stop at any of the stations. But the

:28:44. > :28:49.point he made is you could pick up time along the line and get

:28:50. > :28:53.everything under 59 minutes. The new timetable precipitated other

:28:54. > :28:59.problems. The fact everyone was coming back from Christmas holiday.

:29:00. > :29:03.The changes in London, they were clearly not thought through. The

:29:04. > :29:07.honourable member for Thurrock later on will be making the point to the

:29:08. > :29:14.Minister that TEFL at the time had made a number of representations

:29:15. > :29:18.with quite a narrow focus on people going from Barking and West Ham to

:29:19. > :29:26.the disadvantage of the constituents in South Bend, in Thurrock and

:29:27. > :29:32.Rochford. Following the problems, meetings between C2C and Shanna

:29:33. > :29:36.Doherty organised a petition to see what could be done to rectify some

:29:37. > :29:42.of the problems. There has been incremental change. A full reversion

:29:43. > :29:47.to the old timetable will be wrong. I want to speed up some of these

:29:48. > :29:54.trains rather than simply revert to the old timescale. I think some

:29:55. > :29:58.rolling stock will help. I agree with my honourable friend that the

:29:59. > :30:03.design is not perfect. I travelled on one of those trains, not since

:30:04. > :30:07.they were used during rush hour, but I went on a special trip with a

:30:08. > :30:11.local people to see what they would be like before they were introduced

:30:12. > :30:16.and there were some things obviously wrong. There were big sections for

:30:17. > :30:20.luggage as if you are travelling to Heathrow or Gatwick and it is rare

:30:21. > :30:24.to see somebody coming all the way down the line with that luggage. I

:30:25. > :30:29.made this point and they made the point to me that they could have got

:30:30. > :30:34.rid of that and put in an extra two seats, but that would require quite

:30:35. > :30:38.a big change. There would be standard trains that they could buy,

:30:39. > :30:45.but based on that format it was easier to get these in quickly. I

:30:46. > :30:51.know some people further down the line have been critical about the

:30:52. > :30:56.removal of three seats and they see that as making the service more like

:30:57. > :31:00.the Metro. As a slightly larger person I am rather sympathetic to

:31:01. > :31:05.the two seats. Ten years ago my doctor said I was just borderline

:31:06. > :31:12.obese which I thought was a little unfair. I have noticed even much

:31:13. > :31:16.smaller people will prefer to stand rather than sit three abreast where

:31:17. > :31:24.it is socially and comfortable. The rules in relation to seat sizing

:31:25. > :31:27.could be changed further by the Department. For my constituents the

:31:28. > :31:33.configurations of the new rolling stock certainly is a benefit. I

:31:34. > :31:37.fully appreciate my honourable friend has had many problems with

:31:38. > :31:42.C2C and his dialogue with them and find the correspondence with the

:31:43. > :31:48.party chairman slightly troubling and slightly wrong-footed from the

:31:49. > :31:53.organisation. Personally for me Julian Jewry has been quite good and

:31:54. > :31:59.has probably been one of the better representatives of big business

:32:00. > :32:04.working with the community. I cannot explain the difference in experience

:32:05. > :32:09.between the two. Perhaps some of those issues might be down to the

:32:10. > :32:13.constituents in my seat getting on those services earlier and not

:32:14. > :32:17.having quite the same problems. Indeed, I have not had the same

:32:18. > :32:26.experience my honourable friend has had on the misery line and so forth.

:32:27. > :32:33.Turning now more briefly to Abelia Greater Anglia. It was shocking, the

:32:34. > :32:36.service. On the face of it it was an incredible surprise that someone who

:32:37. > :32:41.was running such a shocking service got reappointed. In reality their

:32:42. > :32:44.hands were tied by the investment they could put in under the old

:32:45. > :32:50.contract and they were quite clever in making sure that the tender

:32:51. > :32:55.document required everyone to take a step up and as a result we could not

:32:56. > :33:00.get anyone coming in running the rubbish stock, which, to be frank, I

:33:01. > :33:06.felt my suit needed to be dry cleaned if I sat on the seat. This

:33:07. > :33:20.is more expensive than C2C. There was a bigger legislative problem in

:33:21. > :33:32.that the military -- misery line was cheaper to take into account the

:33:33. > :33:34.fact it was rubbish. Now rail fare increases have been proportionate

:33:35. > :33:42.across all the tracks so they have gone up across all the tracks and

:33:43. > :33:48.they are coded in the differential. Now it is the happy line. I think we

:33:49. > :33:54.can make changes. I think reunification will greatly help rail

:33:55. > :34:00.services, particularly on the C2C line where it is pretty clear 80% of

:34:01. > :34:05.that line is only used by C2C. There are other parts of the country where

:34:06. > :34:09.it would be less useful. I want to say one other thing about another

:34:10. > :34:14.train line in my constituency, a third train line. The honourable

:34:15. > :34:20.gentleman looks confused, but he forgets that there is a train on the

:34:21. > :34:24.pier and the peer is subject to the same rules and regulations as the

:34:25. > :34:27.other train lines. It is difficult for the local council to get the

:34:28. > :34:35.right expertise to run the train line. I did gently probe Mr Jewry

:34:36. > :34:39.and Rob Timlin, the chief executive, who has done an excellent job over

:34:40. > :34:46.the last ten years in Southend, and I asked whether C2C could take over

:34:47. > :34:53.the train, a 1.3 mile train, because they have the expertise to do that.

:34:54. > :34:57.I suggested to them that we had free ticketing so that people could come

:34:58. > :35:01.from London into Southend Central, have a short walk and still get to

:35:02. > :35:07.the end of the pier and encourage them to spend more money. It would

:35:08. > :35:12.be a nice publicity stunt and would give them the expertise of a

:35:13. > :35:22.professional railway team and it would get them down to the end of

:35:23. > :35:25.Southend Pier. Certainly we both agreed that robbed Timmins is

:35:26. > :35:31.fantastic, despite raising this with them a few years ago I rather hoped

:35:32. > :35:36.that the idea would come back. Sadly this has not happened and in this

:35:37. > :35:45.debate I nudge them a little bit in that direction. Will the Minister

:35:46. > :35:52.Paul Maynard replied to the debate? Thank you, Mr Speaker, it is an

:35:53. > :35:57.honourable to be called here again. In his customary style he has

:35:58. > :36:02.regaled us with tales with what occurs on the rail services to

:36:03. > :36:09.Southend. He invited me to shock him in my response to his opening

:36:10. > :36:13.speech. Possibly a shock and awe strategy is not what his railway

:36:14. > :36:16.line needs. I would urge him to think that he should never stop

:36:17. > :36:26.campaigning on behalf of his constituents. To me he is and your

:36:27. > :36:32.cell bunny. From the moment I was elected he seemed to chair all my

:36:33. > :36:36.early Westminster debates and was never less than an enthusiastic

:36:37. > :36:43.minister. If he chooses to raise an issue, far be it for me to say there

:36:44. > :36:49.is no issue at all. If I can be indulgent, I must start of by being

:36:50. > :36:55.slightly positive if I can bear to be that. As he may be aware, C2C is

:36:56. > :37:03.one of the best performing franchises in the UK, second only to

:37:04. > :37:06.Merseyrail. As of the 12th of November the number of trains

:37:07. > :37:13.arriving at the destination within five minutes of their booked time, a

:37:14. > :37:19.public performance measure, was 95%. As many have pointed out this is in

:37:20. > :37:26.stark contrast to the late 1990s when this line was known as the

:37:27. > :37:33.misery line. If we go back to Autumn 2000, passenger satisfaction was as

:37:34. > :37:37.low as 63%. It is now 81%, albeit a small decline compared to the

:37:38. > :37:49.previous survey when it reached a high of 89%. But I did expect C2C to

:37:50. > :37:53.improve that in the forthcoming survey which will shortly be

:37:54. > :38:00.announced. We have indeed come a fair way since the time he spoke of.

:38:01. > :38:05.With necessary infrastructure work, replace rolling stock, helping to

:38:06. > :38:12.deliver one of the best performing commuter railways in the UK, winning

:38:13. > :38:22.as recently as 2015 the Passenger Operator Of The Year award. A

:38:23. > :38:29.customer interfacing app and C2C one and innovation award for passenger

:38:30. > :38:33.experience at the 2015 railway industry innovation awards. There

:38:34. > :38:38.are some good things we can say about C2C's performance. But as he

:38:39. > :38:42.is aware, in the last couple of months performance has begun to

:38:43. > :38:47.suffer once again. A significant factor has been an unprecedented

:38:48. > :38:53.number of temporary speed in strictures imposed by Network Rail

:38:54. > :38:58.because of the London clay in the area expanding in response to the

:38:59. > :39:02.change in the weather. This open up small voids underneath the track and

:39:03. > :39:07.trains are required to reduce their speed in these areas. C2C have

:39:08. > :39:14.intensified their engagement with Network Rail in order to address

:39:15. > :39:21.these and other challengers. There are also issues within C2C's own

:39:22. > :39:24.control will stop this is something they have recognised and are working

:39:25. > :39:30.with their suppliers to address urgently. Today a lorry struck a

:39:31. > :39:36.bridge between Southend East and Thorpe Bay. This has meant that C2C

:39:37. > :39:39.will need to make adjustments to their evening timetable whilst

:39:40. > :39:43.emergency inspections are carried out on the damage to the

:39:44. > :39:45.infrastructure. I will be keeping a close eye on the progress of that

:39:46. > :40:03.work and have no doubt. Let me turn to the 2015 timetable.

:40:04. > :40:08.Journey on the networks have more than doubled. For C2C, the picture

:40:09. > :40:15.is no different. The number of passengers travelling to London on

:40:16. > :40:20.C2C morning peak services has risen by 15% since 2010. C2C has had to

:40:21. > :40:24.listen to passengers up and down the route and understand what they want,

:40:25. > :40:29.which in their view, is more services and better connectivity

:40:30. > :40:35.with the three in London stations. In addition to that, the honourable

:40:36. > :40:41.member for a in south-east pointed out they also want faster services.

:40:42. > :40:46.Is why C2C proposed the first significant change in their

:40:47. > :40:51.timetable for more than a decade. But timetable change designed to

:40:52. > :40:55.deliver 1400 more seats, space for 3000 more passengers into London in

:40:56. > :41:01.the morning, with 20% of more services on the network. Passengers

:41:02. > :41:06.in my right honourable friend constituency and along the route as

:41:07. > :41:10.a whole, undoubtedly benefited. The number of seats arriving in the

:41:11. > :41:19.Fenchurch Street from Westcliff increased by 4%. From Leigh On Sea

:41:20. > :41:22.by 53%. The increase in capacity at the stations is more than the

:41:23. > :41:28.increase in the morning peak demand. But the attractiveness of this new

:41:29. > :41:33.timetable brought more passengers than forecast to South Essex

:41:34. > :41:39.stations in the morning peak. In other words, they became a victim,

:41:40. > :41:42.almost, of their own success, with an overnight increase compared to

:41:43. > :41:48.Autumn 2015. This inevitably had similar effects on the evening peak

:41:49. > :41:56.leaving London to return to South Essex. This was access abated by the

:41:57. > :41:59.obligation to stop 95% of trains at Limehouse, West Ham and barking.

:42:00. > :42:05.This greater connectivity for long-distance commuters was welcomed

:42:06. > :42:09.by key stakeholders on the route. But the new service pattern provided

:42:10. > :42:15.a faster journey than the district line between these two stations and

:42:16. > :42:20.our own. This prompted passengers who had previously used the tube to

:42:21. > :42:25.use C2C servers, especially those requiring barking. It led to

:42:26. > :42:30.overcrowding, not least in the evening peak. This was a genuine

:42:31. > :42:34.cause for concern, as my right honourable friend rightly and

:42:35. > :42:41.properly identified at the time. As a consequence of both his

:42:42. > :42:47.observations and other campaigns, C2C did take some action to reduce

:42:48. > :42:51.this overcrowding. In response to his own specific concerns, I

:42:52. > :42:59.understand the 7:18am to Fenchurch Street which travels fast the entire

:43:00. > :43:06.length of the route was lengthened from eight carriages to 12. It

:43:07. > :43:10.provided and C2C also use an excellent and unique to C2C on-board

:43:11. > :43:14.automatic passenger counting system to fine tune their timetable yet

:43:15. > :43:19.further. With further changes, reducing the number of services

:43:20. > :43:26.departing with people standing from the three stations in my right

:43:27. > :43:33.honourable friend's constituency in the morning peak from four down to

:43:34. > :43:40.two. The services of our services with services either side of them

:43:41. > :43:44.having seats available. His constituents are understandably

:43:45. > :43:51.choosing to travel on the services because of the speed into London.

:43:52. > :43:57.This increases the number of seats from Fenchurch Street by 1000

:43:58. > :44:00.between five and 6pm. As a result, eight services leaving Fenchurch

:44:01. > :44:07.Street in the evening peak now do not stop barking. Following the

:44:08. > :44:12.positive changes made to home the timetable in January, C2C also made

:44:13. > :44:17.further use of the timetable change date in May 2016 to further improve

:44:18. > :44:21.services for passengers. Primarily this involves reducing barking stops

:44:22. > :44:24.on a further five services in the evening peak. This had the effect of

:44:25. > :44:29.reducing the number of services leaving Fenchurch Street in the

:44:30. > :44:36.evening peak with passengers standing, from 31 to 24. Clearly, 24

:44:37. > :44:41.remains too many, but that does demonstrate progress is being made

:44:42. > :44:46.and this is because of the removal of these stops further reduced the

:44:47. > :44:52.attractiveness of the C2C service compared to the district line,

:44:53. > :44:59.reducing overcrowding for C2C's evening commuters. C2C plan to make

:45:00. > :45:11.further challenges in January 20 17. Specifically they will chase Billy

:45:12. > :45:15.Andrade start... Further stops will be withdrawn in the evening peak

:45:16. > :45:21.with barking. He also mentioned some of the issues around the Greater

:45:22. > :45:26.Anglia franchise and some of the concerns his constituents might have

:45:27. > :45:30.had. I would stress and draw to his attention, as the Minister for roach

:45:31. > :45:35.wouldn't Southend East did, this franchise is perhaps one of the most

:45:36. > :45:40.ambitious ever embarked upon as a department. With 4.4 billion of

:45:41. > :45:44.investment, I am sure travellers across that network will welcome the

:45:45. > :45:48.fact we will be replacing every single piece of rolling stock on the

:45:49. > :45:55.franchise. That can only be good news. Not just for people in East

:45:56. > :46:00.Anglia, but also those in Derby because Bob Wadia will be making

:46:01. > :46:04.those carriages. By 2021 there will be over 32,000 seats on services

:46:05. > :46:10.arriving at Liverpool Street in the morning peak. Specifically in his

:46:11. > :46:14.area around Southend, there will be an extra train per hour on top of

:46:15. > :46:19.the existing three, between Liverpool Street and Southend

:46:20. > :46:21.Victoria. With two new fast peak journeys in east direction between

:46:22. > :46:27.Liverpool Street and Southend Victoria. This is on top of the

:46:28. > :46:32.station enhancements he referred to himself. So I think there is good

:46:33. > :46:38.news in that franchise. He is right to point out the need to continue to

:46:39. > :46:43.improve rolling stock across the network as a whole. 24 are currently

:46:44. > :46:49.being phased into service across the network by the end of December this

:46:50. > :46:56.year. They will provide 13,000 extra seats at peak times every week, from

:46:57. > :47:01.October 2019, a further 12 carriages will also be introduced, meaning

:47:02. > :47:04.that by the end of 2019, the new franchise will have introduced a

:47:05. > :47:10.total of 36 additional vehicles into service. My honourable friend the

:47:11. > :47:17.member for roach food and Southend East mentioned some of the issues

:47:18. > :47:24.around access ability and rolling stock. He is quite right to do so.

:47:25. > :47:29.We have a deadline of the 31st of December 2019 to make sure every

:47:30. > :47:33.rail carriage on the network the PPR and regulations for those with a

:47:34. > :47:38.disability. It is an immovable target we have two abide by. I will

:47:39. > :47:44.also point out, because it was alluded to in his speech, this is an

:47:45. > :47:49.enclosed network between London and Southend. That makes it right for a

:47:50. > :47:56.number of attempts to improve the service, not just in terms of

:47:57. > :48:00.bringing rail, train and track together, but it also makes it quite

:48:01. > :48:11.suitable for investigating whether we can progress with digital

:48:12. > :48:16.signature and -- digital signalling. There will be investment of 24

:48:17. > :48:20.million to out digital signalling across the network. That is good

:48:21. > :48:27.news and I would echo his comment and I very much hope C2C, if they

:48:28. > :48:32.can manage to run a railway between London and Jewsbury, they can offer

:48:33. > :48:36.some practical help on the 1.5 mile stretch down the peer. They are very

:48:37. > :48:41.important to our coastal town. I hope they may hear this and think,

:48:42. > :48:46.what practical support can we offer my honourable friend. My hope they

:48:47. > :48:52.are hearing that. If I go back to being positive again about C2C, they

:48:53. > :49:00.are leading the way in terms of compensation. In February, C2C

:49:01. > :49:04.provided automatic compensation of 3p per minute for registered smart

:49:05. > :49:09.card customers when their train delay between two and 29 minutes. It

:49:10. > :49:17.is over and above what we are committed to as a government

:49:18. > :49:32.nationally. The standard of 30 minutes plus have been automated.

:49:33. > :49:39.To my mind, I think it is a very important way of putting the

:49:40. > :49:44.interest of passengers first. Nobody wants to see delays on our network,

:49:45. > :49:47.but when they do occur, it is important we not only make that

:49:48. > :49:53.compensation available, but it is as easy to claim as possible on the

:49:54. > :49:57.part of passengers. I noted the concerns they both raised regarding

:49:58. > :50:04.passenger information during disruption. It is a frequent bugbear

:50:05. > :50:08.that I also hear from rail users. They may be having their breakfast

:50:09. > :50:12.at home, checking their mobile phone, their iPad, looking at social

:50:13. > :50:17.media to check their usual train is about to leave on time, all going

:50:18. > :50:22.according to plan, the smartphone tells them it is good to go, the

:50:23. > :50:26.train is on time. They arrive at the station to find the train was

:50:27. > :50:30.cancelled hours ago. There is a fundamental disconnect between the

:50:31. > :50:36.social media information being put out and that which is available at

:50:37. > :50:39.the stations. It is a matter that transport focus, passenger watchdog,

:50:40. > :50:44.is taking up closely and I have asked them to accelerate work on

:50:45. > :50:48.this to ensure all train operating companies, particularly in commuter

:50:49. > :50:51.areas, make sure that when information is available, it is put

:50:52. > :50:55.out on every channel at the same time. There is no discrepancy

:50:56. > :51:07.between one sort of information and another. It is what customers need.

:51:08. > :51:11.In conclusion, C2C are delivering more seats, more services and an

:51:12. > :51:17.improved journey experience for their passengers. I urge C2C to try

:51:18. > :51:21.to engage with key stakeholders, including local members of

:51:22. > :51:24.Parliament and make the necessary changes to address the overcrowding

:51:25. > :51:28.they face, because their current timetable is attractive to

:51:29. > :51:33.customers. There is an absolute commitment on behalf of the operator

:51:34. > :51:36.and the Department to make sure the passenger is at the forefront of

:51:37. > :51:41.decision making with regards to these changes. I am more than happy

:51:42. > :51:52.to meet my right honourable friend, but more than that, extend the

:51:53. > :51:56.invitation to come along and also invite Mr Drury along and have a

:51:57. > :52:00.very informed debate as to how to improve one of our better performing

:52:01. > :52:07.commuter networks to make it perform even better. Thank you, Mr Speaker.

:52:08. > :52:29.Order, the question is this House do adjourn. Order. Order.

:52:30. > :52:31.We will now be going live to the House of