House of Commons
Tuesday 19 June 2018
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
Health and Social Care
The Secretary of State was asked—
NHS England, NHS Improvement and Health Education England are working with trusts on a range of recruitment, retention and return-to-practice programmes to ensure that the required workforce are in place to deliver safe and effective services.
The nursing vacancy rate in England is more than double that in Scotland, with one in 10 positions unfilled. The Royal College of Nursing has welcomed the Scottish Government’s Health And Care (Staffing) (Scotland) Bill, which will enshrine safe staffing levels in law. Will the Minister now follow the Scottish Government’s example and bring such a provision into law for NHS England?
I fear that the hon. Gentleman wrote his question before yesterday’s announcement. I thought that he might have started by welcoming the additional £2 billion of investment that Scotland’s NHS will be receiving. We are making historic investment in recruitment, which is why we are opening five new medical schools in England, training 1,500 new medical doctors, taking initiatives such as on apprenticeships and opening new pathways into clinical roles.
While I welcome yesterday’s announcement and the workforce strategy that is coming out in the autumn, will the Minister comment on the Home Office’s new proposals to allow greater flexibility for professional clinicians coming to work in the UK, and on what impact that might have on filling vacancies?
My hon. Friend is right to draw attention both to the Home Office’s welcome announcement on tier 2 visas and to the work on the workforce strategy, in which he played a key role. It will ensure that we have the right workforce for the NHS for the next 10 years.
But the Royal College of Nursing and the Nursing and Midwifery Council are both now so worried about Brexit’s impact on the staffing crisis that they have called for a people’s vote on a deal. Given their on-the-ground experience and the demolition of the myth of a Brexit dividend for the NHS, is it not becoming ever more clear that the dogmatic hard Brexit being pursued by the Government is already doing untold damage to our NHS?
The right hon. Gentleman, as a former Minister of State, will not want to choose selectively from the data on European economic area recruitment into the NHS. He will know full well that there are 3,200 more NHS staff from the EU since the referendum, which shows that people are still coming. If he has an issue with the Brexit dividend, perhaps, as my right hon. Friend the Secretary of State pointed out yesterday, he will raise that with his party leader, who sees that there is a Brexit dividend.
Kettering General is a wonderful hospital with amazing staff, but one of its big financial problems is caused by its over-reliance on agency staff. What can be done to reduce the reliance of so many hospitals, including Kettering, on agency staff to populate their wards?
My hon. Friend rightly points to the key issue of how we bring down the £2.5 billion of agency spend. That goes to the heart of the Prime Minister’s announcement yesterday. Up-front investment in our workforce will allow us to reduce that agency cost.
Order. The question should relate to the workforce, which is the matter we are dealing with now, but never mind. I am sure that the hon. Gentleman is interested in hearing about the workforce situation.
The two do go together because the mental health workforce is a key component of the NHS workforce. I am sure that the hon. Gentleman will welcome the extra £1 billion by 2020 that the Prime Minister announced yesterday, as well as the Government’s prioritisation of mental health, which for too long has been seen as a Cinderella service within the NHS.
In 2015, the Secretary of State suggested that junior doctor rotas contributed to avoidable hospital deaths, but research shows that the most important factor is the number of patients under the care of each registered nurse. A 7% increase in mortality for every patient means that 36,000 nursing vacancies in England pose a real threat to patient safety. So with no announcement, and a 33% drop in applications since the removal of the nursing bursary, will the Government follow the Scottish Government’s policy and reintroduce the bursary?
The hon. Lady will be well aware that there are 14,000 more nurses in the NHS than five years ago, but she is right to point to the wider issue of long-term workforce planning. That is why she will be aware that Audit Scotland criticised NHS Scotland for its lack of long-term workforce planning.
The hon. Lady’s second question will be a lot shorter, I am sure.
As the Minister heard, the Scottish Government have just passed a law on staffing. With an ageing population, social care is critical to the function of the NHS, but the charity Independent Age says that we will be short of 700,000 care workers by 2037. With no extra funding for social care announced yesterday, how will the Secretary of State make caring a real profession? Would not it be good to start with a decent wage?
The hon. Lady’s supplementary question really reinforces the answer that I gave a moment ago: the essence of why we need a long-term plan is so that we anticipate these issues. We are addressing that through the Green Paper on social care, and that is part of the investment that the Prime Minister announced yesterday.
Yesterday the Prime Minister said that
“current workloads are not sustainable”—
is that any wonder after eight years of Tory cuts and austerity? The Minister knows that the number of health visitors in the workforce is falling, and that health visitors are vital to improving child health and wellbeing outcomes. No new public health money was announced yesterday; new money will come in 2020. Can the Minister guarantee that health visitor numbers will not continue to fall and that the public health budget will be ring-fenced?
I am grateful that the shadow Secretary of State has drawn attention to public health because the Government have been making significant progress in that area. We have the lowest ever number of teenagers smoking and the lowest ever teenage pregnancy rate. Binge drinking is down and we are addressing child obesity with the sugar tax, which is among a number of measures that the Government have been bringing forward. We are making progress on public health and the hon. Gentleman is right to draw that to the attention of the House.
This Government are breaking the Tory manifesto promise and raising taxes, yet they cannot even answer basic questions about health visitor numbers. The NHS workforce deliver the constitutional performance targets, including the 18-week referral-to-treatment target, and targets for accident and emergency and cancer treatment. Will the Minister reassure patients and the taxpayers whose taxes are going up that he will rule out dropping those essential targets?
Once again—as we heard yesterday—there is no welcome for the announcement of additional funding for the NHS. Opposition Front Benchers are playing politics and talking down our NHS. The Prime Minister has set out a long-term vision to improve standards and raise mental health, which Labour Back Benchers highlighted. The hon. Gentleman should come to the House and welcome that investment in our NHS.
Regional Health Inequalities
We take a comprehensive approach to reducing health inequalities, underpinned by legal duties. This includes addressing the wider causes of ill health, promoting healthier lifestyles, and tackling differences in health access and outcomes. A formula is used to allocate funding to clinical commissioning groups, and health inequalities form part of this.
Birmingham has some of the worst health outcomes in the country. It is not a surprise, as A&E waits of over four hours are up by more than 127% in recent years, and waits of more than 18 weeks for treatment are up by 65%. Yet, according to freedom of information request responses I have received, our trusts in Birmingham have to make savings of £155 million this year. What are the Government going to do to save the health system in Birmingham, which is currently in a state of collapse?
It is disappointing to hear the right hon. Gentleman making such negative points about his local NHS when 86% of GPs in his area are rated good or outstanding. Everything about yesterday’s announcement will tell Members that we are not complacent about the health challenges facing us, and we will make the necessary resources available. It ill behoves Opposition Members to keep continually talking down our NHS.
Does the Minister agree that the best way in which to reduce health inequalities across the country is to continue to build a strong economy that offers good jobs and prospects to all the people of our country?
I could not have put that better myself—[Laughter.] Opposition Members can laugh, but the Government firmly believe that work is good for people’s health. We are committed to getting 1 million more people with disabilities into work so that we actually treat them as assets, and we are encouraging them to be more independent and to take control of their own lives. The only way to achieve that is by having a strong economy.
When the coalition Government came into office in 2010, life expectancy began to stall for the first time in over a century. This, coupled with eight years of funding cuts, means that there are grossly disproportionate health inequalities across the country. For example, according to Northern Health Science Alliance, people in the north are 20% more likely to die early than people in the south. Is not it a failure of the Government’s funding deal for the NHS that it comes with no public health money to tackle these astonishing regional health inequalities?
No, it is not. Labour Members like to draw attention to north-south divides and so on, but the issues about health inequalities are much more complex than how money is spent and where. Within my constituency, for example, there are differences of 10 years in life expectancy depending on the particular locality. We need a much more multi-layered approach to tackling inequality, and that is what this Government will have.
Tier 2 Visa Cap
Last week the Home Secretary removed doctors and nurses from the tier 2 visa cap.
In Oxfordshire, the situation with social care workers is at least as bad a problem. Of course we all very much welcome the removal of doctors and nurses from the cap, but what about social care workers? Why are we focusing on only half the problem?
Perhaps I can help the hon. Lady by pointing out that tier 2 visa cap is specifically for higher-paid workers. We do need to think about social care workers, but a lot of them are lower paid. That is why we are putting together a 10-year workforce plan for the health and social care sectors, both of which are very important. We will make sure that that goes hand in glove with the NHS plan that we announced yesterday.
The real effect of the cap is that there are not enough staff in the health service, as is shown by “NHS SOS”, a campaign run a few weeks ago in Stoke by The Sentinel that highlighted the lack of doctors and nurses. Realistically, what will the Secretary of State do to remedy that situation in Stoke-on-Trent? Will he meet people from The Sentinel so that they can present the evidence?
Let me tell the hon. Gentleman what we have been doing in the past five years: we have 14,300 more nurses, 10,100 more doctors, and over 40,000 more clinicians across different specialties. He will be very relieved to know that, on top of that, we are promising 50% more than his party did at the last election.
People with Learning Disabilities
Commissioning high-quality health and social care services is a local responsibility. The Care Quality Commission monitors, inspects and regulates services that people with a learning disability may use. Where quality and safety standards are not met, it will take action.
The Association of Directors of Adult Social Services warned this week that social care services are on the verge of collapse. Despite the announcement of £20 billon yesterday, there was no mention of social care. Cuts of more than £7 billion have left hundreds of thousands of elderly and disabled people without adequate support. What specific measures are the Government taking to ensure that the elderly and disabled are receiving proper care?
Adult social care was mentioned yesterday, specifically in the news that we plan to bring together the way in which health and social care interoperate. We need more collaborative work between health and social care to reduce the amount of pressure that one puts upon the other. We have set out very clearly that we will produce a Green Paper later this year to address how we will tackle the challenges that we face in adult social care, and we will look at how we fund that.
Providers of day care services for people with learning disabilities are not currently subject to an inspection regime. Will the Minister consider bringing such services within the scope of the Care Quality Commission to reassure families about quality and safeguarding issues?
My hon. Friend is absolutely right to draw attention to the fundamental importance of being reassured that all services that are provided are safe and reliable. Since the CQC has been looking at services up and down the country, it has brought to them a level of transparency and, indeed, quality. We keep under review the services that it regulates, and this is certainly something that we can discuss with it.
Will the Government end uncertainty for people with learning difficulties who need social care by funding the historical liabilities associated with the sleep-ins crisis?
We are aware of concerns in the sector with regard to sleep-ins and we are looking very carefully at the options. We have been developing the evidence base very carefully. We have been engaging with the European Commission, the sector and other Government Departments.
Oxford Health NHS Foundation Trust recently won a bid under the Beyond Places of Safety scheme to put in place IT support for users of learning disability services. Is that not a very useful way of taking forward such projects?
My hon. Friend makes an excellent point. It is vital that when we look at how to move forward with both our health and social care services, we are able to capture all the latest technology to ensure that we improve the experience for all our service users.
Much of the health and social care for people with learning disabilities in Plymouth is provided by Livewell Southwest, a social enterprise. The new pay increases for NHS staff will not be mapped over to social enterprise staff, so when they merge back into the NHS, we risk a two-tier workforce. Will the Minister consider extending the pay increases to support those who work with people with learning difficulties in the social enterprise sector so that we ensure that everyone doing the same job is paid the same amount?
The hon. Gentleman makes an excellent point. It would be terrible to see a health and social care sector in which people doing the same work are valued differently, so I will look carefully at the point he raises.
Life Sciences and Medical Research
The life sciences sector is critical to the UK economy, which is why we support it with a £1 billion annual grant through the National Institute for Health Research.
What steps is my right hon. Friend taking to further life sciences in Scotland? Will he meet me to see what the UK Government can do to support the forthcoming International Environment Centre in Clackmannanshire in my constituency?
I am happy to do that. The life sciences industry is critical to Scotland, and Scotland’s role is critical to the UK. We all remember Dolly the sheep being pioneered in Edinburgh University, and last week’s announcement of a new centre in Renfrewshire is another good example of the great things happening in Scotland.
The use of big data and artificial intelligence in medical research has the potential to save hundreds of thousands of lives. Will my right hon. Friend consider setting up data hubs and support the full digitisation of patient records?
My hon. Friend is very knowledgeable about that area. We have announced the creation of a set of digital innovation hubs, and perhaps we can broaden those to turn them into the hubs that he thinks would be a good idea.
Getting new drugs approved more quickly would not just be a big boost for the life sciences and medical research sectors, but would help my constituents and others across the country with cystic fibrosis who desperately need access to Orkambi. They have been waiting for years; it is not good enough. Why can the Secretary of State not sort this out, get a grip, get his officials and Vertex in a room, and force them to come to an agreement? People have waited too long for this.
That is exactly what we have been doing, but we need Vertex to be reasonable regarding the price that it offers the NHS. We need to pay fair prices. We have heard that it will be coming back with a new offer next week—we hope it is a reasonable one—but we urge Vertex to waive commercial confidentiality so that we can all see, in the interests of transparency, the kind of prices it is trying to charge the NHS.
Will the Secretary of State consider West Yorkshire in particular? We have the universities, the science, the technology and the life sciences; all we need is a new teaching hospital in Huddersfield.
We have great teaching hospitals in Yorkshire and we have introduced five new medical schools. When we do the new workforce plan later this year, who knows? We may need more.
Further to the point made by the hon. Member for Dudley North (Ian Austin), we know that the UK is a world leader in research into rare conditions, but that does not always translate into timely access to those treatments. The Secretary of State will know that there are many CFTR—cystic fibrosis transmembrane conductance regulator—treatments in the pipeline that could benefit people who are living with cystic fibrosis. Will he meet me to see how we can ensure that those are available in a timely manner for the people who desperately need them?
Of course I am happy to meet my hon. Friend. I recognise that this is one of the things that we are not good at at the moment. We have fantastic research, with amazing new drugs developed in this country, but our uptake can be painfully slow, and that is of course something that we want to put right.
ME affects approximately a quarter of a million people across the UK, and while there has been substantial psychological research into the condition, there has been very little biomedical research. What funding will the Secretary of State make available specifically for biomedical research into the treatment and diagnosis of ME?
I am grateful to the hon. Lady for raising that issue. She is introducing a debate on it in Westminster Hall on Thursday. I have met a number of families who have suffered very badly as a result of ME, and we would all like better research, so I hope that her campaign is successful.
Sport: Public Health
There is a strong body of evidence on the health benefits of participating in sport— possibly not watching it, if last night is anything to go by. Last year, a review by Sport England brought together evidence to show the association between sport and physical and mental wellbeing.
As the Minister may be aware, I co-chair the all-party parliamentary group for golf—a sport sometimes labelled, rather unfairly, a good walk spoiled. Does he agree that there are many positive health benefits associated with participation in golf, especially for people with long-term conditions?
I certainly would, as someone who used to work in the golf industry before coming to the House. I was at Wentworth last month for the PGA, and a good example of what my hon. Friend refers to is a social enterprise that I met called Golf in Society led by an inspirational chap called Anthony Blackburn. He founded a project at Lincoln Golf Centre that works with people with dementia and Parkinson’s disease to show that golf is one of the best leisure activities out there, and gives people with those long-term conditions a sense that their life is not over and that they can still play golf, and play it rather well—probably better than me.
In 2016, Stoke-on-Trent was the European city of sport, but it faces some of the highest health inequalities in the country. The Stoke newspaper The Sentinel highlighted the power of exercise in its recent NHS SOS campaign. Will the Minister meet the editor Martin Tideswell and my hon. Friend the Member for Stoke-on-Trent Central (Gareth Snell) to receive details of that incredibly important local campaign?
I am aware of that campaign. Something that we want to see in schools across the country, including in Stoke, is the Golden Mile. I see good examples in schools in my constituency and across the country when I travel. We are interested to learn more about what Stoke has done on this subject.
NHS England has a legal duty to commission services to meet local need, which includes people who are homeless, and we are very clear that a patient should not be turned away from a GP if they cannot produce any supporting documentation. If they state that they reside within the boundaries for the practice, the GP is expected to accept the registration. The same applies for dentistry, and training is in place to remind people of their obligations.
Mags Drummond is a Walthamstow woman on a mission, to try to help our many rough sleepers get decent quality healthcare, but she, like me, has hit a brick wall with our local dentists and doctors. It is little wonder that one study shows that 15% of homeless people have pulled out their own teeth because they cannot get access to services. Will the Minister meet Mags and me to look at what we can do to change that and make sure that her promises are not toothless?
Very good—I commend the hon. Lady for her wit, and I agree with her. Notwithstanding our expectations of GPs and dentists in this regard, it is quite clear that homeless people do not always have access to the treatment they should have. The hon. Lady will be aware of the work that we are doing to support rough sleepers, and I would be delighted to meet her and Mags Drummond to see what insight they can provide on how we can improve services in this area.
Order. It is of the utmost importance that we are ready for the one-minute silence, so I shall take a brief inquiry from Mr Nic Dakin, and a brief reply.
There are homeless people in the Scunthorpe area who present with mental health problems. What are the Government doing to ensure that proper mental health support is there for people who present as homeless?
The hon. Gentleman is quite right. Mental health is both a symptom and a cause of homelessness, and we will tackle that as part of our work on rough sleepers.
Does anyone else want to come in on this? Apparently not. I do not wish to proceed to the next question because of the unpredictability of the time that it will take. Colleagues will want to prepare themselves for the one-minute silence that we are about to observe. I think I can say with some confidence that everyone who is in the House today will wish to observe that one-minute silence. Perhaps they will think it appropriate to stand. That one-minute silence is going to start very soon. The next question is grouped, so it would be highly inconvenient to take it. Any moment now we shall observe the silence. [Interruption.] There is much merit in repetition in certain circumstances.
Order. We shall now observe silence for one minute to remember those who died or were affected by the attack outside Finsbury Park mosque, I remind colleagues, a year ago today.
The House observed a minute’s silence.
Personal Health and Care Budgets
I know that the thoughts of the whole House are with the families affected by the terrible atrocity a year ago.
Personal health budgets have a transformative effect on people with very complex health needs, and we plan for 50,000 to 100,000 more people to benefit from them by 2021.
I thank the Secretary of State for that reply. Does he agree that a key part of integrating health and social care is giving individuals more say and flexibility in how they use their entitlements? Will he consider extending his pilots to my constituency of North West Norfolk?
Absolutely, and not just to North West Norfolk, but to the whole country. We are currently consulting on giving a right to personal health budgets to people with the most complex health needs. That would be about 350,000 people and would include anyone with a continuing NHS need combined with a mental health need, a learning disability, autism or PTSD. Obviously, it would be hugely significant if we were able to proceed with that.
Will the Minister ensure that the long-term NHS plan puts a major emphasis on empowering patients through the wider availability of personal budgets? May I also join my hon. Friend the Member for North West Norfolk (Sir Henry Bellingham) and make a pitch for my local area of Northampton for one of the next wave of pilots?
Absolutely, and technology will have a big role, because this year we intend all NHS patients to be able to access their health records through an app. That will be extremely empowering, but my hon. Friend is right that giving people with long-term conditions control over their health and care destiny is a potentially huge leap forward.
While I agree with the philosophy and approach behind health and personal care budgets, will the Secretary of State acknowledge that the 21% fall in social care funding between 2010 and 2015-16 has caused a catastrophe in this area? Will he acknowledge that if this approach is to work in future, the funding has to be there?
I congratulate the last Labour Government on introducing direct payments, which were the first step in this process. The hon. Lady talks about cuts in social care, which I acknowledge, but, with respect to her, she never talks about the reason, which was that in 2008 we had the worst financial crisis in our peacetime history, and we had to take measures. It is as a result of creating 3.2 million jobs since then that funding for social care is now going up.
Bearing in mind that the number of bed days lost increased in the second quarter of 2017-18, with most of the patients subject to delays being elderly people, will the Minister outline a dedicated strategy for getting people out of hospital and back home with appropriate care as a matter of urgency, for the good of the patient as well as the public purse?
This is a huge challenge in all parts of the United Kingdom. In England, about 22% of bed days are occupied by people who have been in hospital for more than three weeks, and probably less than 20% of those people should be in hospital. We are taking urgent steps to rectify that, because it is very, very bad for the patients involved.
Mental Health Workforce
The mental health workforce plan published last summer underpins our expansion of mental health services, as set out in the “Five Year Forward View for Mental Health”. We aim to create 21,000 new posts in mental health by 2021.
I thank the Minister for her response. Mental health is one of the many complex drivers of rough sleeping, and can add to the complexity of getting rough sleepers off the street and into accommodation. Will my hon. Friend say how the new mental health employees in the NHS can help us to get rough sleepers off the streets and into accommodation?
I hope the expansion of mental health services will stop people becoming rough sleepers in the first place by bringing forward support earlier in the process. In January, we announced a £1 billion investment in mental health, part of which will be focused on crisis care and helping people who are experiencing crisis to stay out of hospital. The workforce plan backs that commitment by planning 5,200 posts to support those in crisis. We will be working with the Ministry of Housing, Communities and Local Government on a forthcoming strategy to make sure we honour our commitments.
It is not just the size of the mental health workforce that is critical, but the pressures faced within those workforces. We have just learned that there was the highest number of out-of-area placements in January since records were first kept. Mental health doctors and nurses often spend hours hunting for out-of-area beds, taking them away from other patients. When is the Government’s pledge to reduce and eventually ban out-of-area placements actually going to start to become a reality?
The hon. Lady is right to raise this issue. We are determined to end out-of-area placements, but clearly that will require behavioural change on the part of commissioners, as well as making sure that the investment takes place. I know she will continue to hold me to account on this issue, because it is clear that out-of-area placements can cause harm and we must tackle them.
According to data from 48 of 56 NHS mental health trusts, 3,652 patients suffered an injury in 2016-17 through being restrained—the highest number ever. There are concerns that increased use of insufficiently trained agency and bank staff since 2013 is contributing to this increase. Employing 21,000 new staff by 2021 just is not good enough. What is the Minister doing now to ensure that wards are safely staffed and patients are not injured?
I am grateful to the hon. Lady for her question. She will be aware that I have been working with her colleague the hon. Member for Croydon North (Mr Reed) on his Bill to limit the use of restraint, because we on the Government Benches also very firmly believe in that. An essential part of his measure will be to improve training for staff in mental health units. That will be a tool in making sure that restraint is minimised.
Capital Investment Projects
In the Budget we announced £3.9 billion of additional capital funding, and 77 projects have conditional approval.
Could my right hon. Friend indicate what implications that welcome statement might have for the much needed rebuilding and refurbishment of the A&E unit at the Queen Elizabeth the Queen Mother Hospital in Margate?
I hope it will have a positive impact. We are asking NHS trusts to get their proposals in during July. We are also delighted that there is a new medical school in Canterbury and we hope that this will be the start of a transformation of NHS services.
Earlier this year, Torbay and South Devon NHS Foundation Trust was allocated £13.3 million of capital funding for improved urgent care and a new emergency department at Torbay Hospital. Will my right hon. Friend confirm what progress is being made to get those major construction projects under way?
I think it will be brilliant not just for patients at Torbay Hospital but for patients living in Newton Abbot and Torquay. My understanding is that this project is on track, and my hon. Friend should be very proud, because he campaigned hard.
Warrington desperately needs a new hospital to replace its old, out-of-date buildings, so in allocating future capital funding will the Secretary of State bear in mind the levels of health deprivation that exist in the area, and will he ensure that any new hospital is accessible to those in my constituency, which has areas that are among the most health deprived in the borough?
I visited the hospital not too long ago and was able to see for myself some of the estate issues the hon. Lady talks about. I can assure her that need is a fundamental criterion when we look at allocating capital funding.
The Secretary of State knows that he has presided over a crisis in capital funding, with a £5.5 billion estimated maintenance backlog, £1 billion of which is classified as urgent. Yesterday’s statement hopefully goes some way to addressing that, although it was far from clear whether capital funding was included in that announcement. Can the Secretary of State confirm today whether any cash generated by the sale of NHS property under the Naylor review is in addition to the money announced yesterday?
Yes, I can.
Highly Specialised Technologies Evaluations
My officials have regular discussions with the National Institute for Health and Care Excellence, of course, but we are clear that there is no fixed capacity in NICE’s HST programme. The number of drugs that it evaluates each year is driven by the pipeline of drugs expected to come to market, and we will refer any suitable drugs to it for evaluation.
There is a risk that new treatments for life-limiting conditions, such as Duchenne muscular dystrophy and spinal muscular atrophy, might not be approved by NICE, so will the Minister meet me and Muscular Dystrophy UK to discuss ways to facilitate access to treatments, as highlighted by the charity’s FastTrack campaign?
NICE has recommended the drug Translarna for use in the treatment of Duchenne muscular dystrophy; it is now routinely available on the NHS. It is a disease that I grew up with—the friends that I grew up with did not, and I did, and this is a timely reminder of how terrible this disease can be. I would be really pleased, therefore, to meet the hon. Lady and the charity that she mentioned.
Is the Minister aware of the recent NICE draft review regarding treatment of abdominal aortic aneurysms? Some 1,500 to 2,000 lives are saved yearly by NHS AAA screening. If the draft recommendations are adopted, a patient is likely to have an aneurysm erupt before treatment and 80% of patients are then likely to die. Will the Minister look carefully at this issue to avoid this unintended consequence?
I am not the all-seeing eye, so all I can say is yes, I will look very carefully at the issue that my hon. Friend raises.
Community First Responders
Community first responders play a valuable role in helping ambulance services. Support includes ongoing training, necessary medical equipment and occupational health support.
In just five years, the Neilston and Uplawmoor first responders have responded to over 1,300 calls, saving many lives, and earlier this month they received the Queen’s award for voluntary service. Will the Minister join me in congratulating all the volunteers and paying tribute to community first responder units right across the United Kingdom?
I am very happy to join my hon. Friend in congratulating Stuart McLellan, Ross Nelson and the volunteers that play such a key role. I know that my hon. Friend the Member for Brigg and Goole (Andrew Percy) also performs this service in his constituency. I have spoken to him about it and I know that it plays a very valuable role.
Ah yes, in the frame, we now have a dame—I call Dame Cheryl Gillan.
Epilepsy Guidance (Autism)
NICE is currently in the early stages of updating the clinical guidelines on the diagnosis and management of epilepsies in adults, and plan to go out to consultation on a draft scope in October this year.
The UK’s autism research charity Autistica advises that up to 40% of people with epilepsies are, in fact, autistic, and that epileptic seizures are the leading cause of early death for autistic people with a learning disability. NICE guidance has never mentioned autism when referring to epilepsy, and autistic people have distinctive types of epilepsies that require different clinical approaches. Will the Minister please ensure that NICE includes autism in the guidelines on epilepsy?
At this stage, it is too early in the update process for NICE to say exactly what its guidance will cover. However, my right hon. Friend is chair of the all-party group on autism and vice-chair of the all-party group on epilepsy, and she was the driving force behind the Autism Act 2009. I think that NICE would do very well to heed her advice.
And that advice will be proffered on a very large number of occasions in this Chamber until the right hon. Member for Chesham and Amersham (Dame Cheryl Gillan) gets what she seeks—I think I can say that with not just confidence, but certainty.
Clinical Staff Shortages
The workforce strategy we are bringing forward will include investment and an expansion in the number of medical schools— five new medical schools—alongside those 1,500 new doctor places.
I had wanted to ask the Secretary of State to get behind exempting nurses and doctors from the tier 2 visa process, but I do not need to do that; I just have to thank him for his support in doing that. Instead, for his next challenge, will he commit to looking again at the pensions cap, which I fear might be one reason some senior NHS professionals and doctors are retiring sooner than they might otherwise do?
I am grateful for my hon. Friend’s support on tier 2 visas. She will be aware that clinicians who reach the £1 million lifetime allowance limit can expect a pension of about £44,000, payable at age 60, increasing with inflation, plus a tax-free lump sum of about £132,000. Although these are ultimately issues for the Treasury, it is important that we ensure that tax allowances, two thirds of which go to higher-rate taxpayers, are fair to other taxpayers.
Innovative Drugs and Devices
The Government are committed to ensuring that innovative healthcare products reach patients faster than ever before. We have established the Accelerated Access Collaborative to identify transformative innovations and help their route to market, and today we have appointed Lord Darzi as the new chair of the AAC to lead this work.
I welcome the fact that the Prime Minister in her speech yesterday announced much more funding for personalised medicines and new technologies that will transform care. On that basis, will the Minister update the House on when the groundbreaking CAR-T— chimeric antigen receptor T-cell—therapy might be made available to NHS patients suffering from cancer?
Yes, indeed. As the cancer Minister, I consider CAR-T to be one of the most innovative and exciting treatments ever offered on the NHS. NICE is considering the first of the therapies this year and preparations are well under way. We are working closely with NHS England to make these transformative medicines available to cancer patients.
Patients with PKU—phenylketonuria—are awaiting progress on the approval of a drug called Kuvan. In the meantime, their illness is controlled by diet. Will the Secretary of State and other Members join me in Committee Room 21 after this meeting to hear about the “Diet for a day” challenge, which many Members across the House are taking up next Thursday?
Having just dialled into the Secretary of State’s diary, I know that he is going right after these questions.
That is very impressive, up-to-the-minute information from the hon. Gentleman.
Does the Minister have proposals for the reform of the Medicines and Healthcare Products Regulatory Agency? I hope so.
We keep all our arm’s length bodies, including the MHRA, under review to provide best value for taxpayers, and we are working closely with Lord O’Shaughnessy, who is the Minister responsible for this area.
We have been so brief that we must now include Mr Hollinrake.
Thank you, Mr Speaker. Probably the most important recommendation in the new O’Neill review into antimicrobial resistance was the requirement for diagnostics prior to the prescription of antibiotics by 2020. Will the Minister update the House on progress towards that goal, and will he agree to meet me and colleagues, including Lord O’Neill, to discuss the establishment of an antibiotic diagnostics fund?
Yes, the Government’s response to Lord O’Neill’s review in 2016 set out new ambitions building on existing progress, including ensuring that tests on epidemiological data are used to support clinical decision making and delivering high-quality diagnostics in the NHS in support of our other ambitions. My hon. Friend is right to raise this issue, and I am happy to meet him.
We are delivering the most ambitious childhood obesity plan in the world, and we are already seeing results. We always said that our 2016 plan was the start of the conversation, not the final word. [Interruption.] Yes, it does say that here, but I have also said it everywhere else many, many times.
With one in three primary school children leaving either obese or overweight and more than 77% of children not doing the minimum requirement for physical activity, surely the Government’s priority should be getting children active by opening up school facilities after hours and in the holidays, not faffing around with political gestures on television advertising that children have long since stopped watching.
I do not think that it is a binary choice. We recognise that child obesity is caused by many different factors, and that no one policy will work on its own. Yes, this is about tackling advertising, and yes, it is about tackling children’s activity and working with schools; and, as I said recently, we will present new proposals very shortly.
As the Minister will know, perhaps the two biggest challenges that we currently face in relation to young people’s health are mental health and child obesity. Will he update the House on the progress of chapter 1 of his childhood obesity plan in reducing the amount of sugar in both food and drink?
Since we published the plan, progress has been made on sugar reduction. The amount of sugar in soft drinks has been reduced by 11% in response to the industry levy, and Public Health England has published a detailed assessment of progress against delivery of the 5% reduction for the first year. Progress is good, but it is not good enough, which is why we have said that we will produce chapter 2 shortly.
The Minister says that progress is not good enough, so why does he not introduce a levy on high-sugar food as well as the one on sugary drinks? Manufacturers would then reformulate the food that they produce.
Because we believe that there should be a mixture of carrot and stick. We believe that the soft drinks industry levy has been successful, but we are also working with the industry on reformulation across the board. I recently visited Suntory, which makes Lucozade and Ribena. If we work with industry, we see transformative results for companies and for the people who buy their products.
A few years ago, I initiated a debate on this issue in Westminster Hall. Since then, no progress has been made on childhood obesity. Would the Minister care to outline what he thinks will happen in the lifetime of this Parliament in terms of achieving the objectives that he has set out?
We assess the plan all the time, and we make progress reports on it, as we did last month with the sugar report. However, when I addressed the Health Committee recently, I could not have made it clearer that we think there has been progress.
This is a world-leading plan. When we talk to other people around the world, they are very keen to hear about what we are doing and very interested, and we are interested in learning from them. If we do not take action, one of our biggest public health challenges will get worse and worse, and that will have implications for the health service and for all our constituents.
When something goes tragically wrong in healthcare, the best apology to grieving families is to guarantee that no one will experience the same heartache again. Last week I accepted the recommendations of the Williams review of gross negligence manslaughter, and we announced a new national clinical improvement programme to provide NHS consultants with confidential data on their clinical outcomes. From next April independent medical examiners will examine every hospital death, and the learning from deaths programme will be extended to primary care.
Will the Secretary of State encourage NHS England to respond to my freedom of information request of 13 March this year regarding Greater Manchester Shared Services and the likely failure of the NHS to correctly enforce guidance on recruiting agency staff in the reappointment of Deborah Hancox after her criminal conviction and two-year prison sentence for defrauding the NHS? How can we employ these people?
The hon. Lady has highlighted what is potentially an extremely serious issue. Obviously the FOI is a matter for NHS England, but let me reassure her that the Minister for Health, my hon. Friend the Member for North East Cambridgeshire (Stephen Barclay)—the hospitals Minister—met the chief executive of the NHS Counter Fraud Authority this morning.
I thought that the report made powerful reading, and I know that my hon. Friend was associated with it. Yesterday the Prime Minister was straightforward about the fact that, if we are to preserve our NHS and make it one of the best systems in the world, the burden of taxation will need to increase, and she was willing to listen to the views of colleagues about the most appropriate way in which that should be done.
The Association of Directors of Adult Social Services has reported a £7 billion reduction in adult social care funding since 2010, and Age UK has reported there are now “care deserts” in some parts of the country. There are 1.2 million older people living with unmet care needs, and one in five care services has the poorest quality ratings from the Care Quality Commission.
As well as a long-term funding solution for social care, we need the extra £1 billion this year and £8 billion in the current Parliament that Labour pledged before last year’s general election. However, all that the Government offer is a delayed Green Paper. When will the Secretary of State deal with the current crisis in social care?
No, that is not correct. Yesterday we made very clear our support for the social care system and our recognition that reform of the NHS must go hand in glove with the social care system, and we said there would be a new financial settlement for the social care system. It is also time that the Labour party took some responsibility for the financial crisis that made all these cuts necessary.
Survival rates are high, but I am ambitious for more. That is why the Prime Minister recently announced £75 million to support new research into the early diagnosis and treatment of prostate cancer. We will recruit 40,000 patients into more than 60 studies over the next five years, and further to this even more exciting is the rapid pathway that I was discussing yesterday with Cally Palmer, our national cancer director, which we are trialling across three hospital sites in west London as part of its local cancer alliance.
May I gently remind the hon. Lady that it was this Conservative Government who introduced the national living wage, and we did that on the basis of transforming the economy, championing policies that were by and large opposed every step of the way by the Scottish National party?
The Minister of State visited my hospital trust last month. Is he in a position to support its requests, and will he say whether he is satisfied with the progress it is making to remove itself from special measures?
I very much enjoyed visiting the trust with my hon. Friend. As he will be aware from our discussion during that visit a process for capital bids is under way. As my right hon. Friend the Secretary of State set out, the date for that is mid-July and I look forward to seeing the bid from my hon. Friend’s trust.
I recently met the hon. Gentleman’s party colleague, the hon. Member for Birmingham, Selly Oak (Steve McCabe), to discuss this matter with the facility. We are very clear: we expect all clinical commissioning groups to honour the NICE guidelines. I am very cross that CCGs tend to view IVF services as low-hanging fruit with which to make cuts. That is totally unacceptable and I will be taking steps to remind them of that.
My hon. Friend has visited Princess Alexandra Hospital in Harlow and has acknowledged that it is not fit for purpose. Will he use the excellent £20 billion of extra NHS funding to ensure we get the Harlow hospital health campus we need?
My right hon. Friend is right to champion this, as he did through the recent Adjournment debate, when he set out the case in more detail. We recognise, as we did at the last Health questions and in the Adjournment debate, that there are significant issues with the local hospital, and that is why it is working very actively on its bid for capital funding.
I reject that accusation; we are far from burying it. The Prime Minister is looking at responding to the interim report. I will repeat what I said to the hon. Lady when she last asked this question. We are quite clear that the child migrant policy was wrong. We have apologised for that policy, and we have established a £7 million family restoration fund. The response from the Government to that report will be laid in due course.
Can the Minister provide an update on the work being undertaken by the policy research unit on obesity to consider the relationship between the many streams of marketing and obesity, and can he tell us whether the unit is looking specifically at childhood obesity?
The National Institute for Health Research—the policy research unit—is specifically looking at the impact of the marketing of products with a high sugar, fat or salt content on children’s food and drink preferences and consumption. The unit has already published a report on children’s exposure to television advertising, and it will be publishing further findings from other projects later this year.
Will the hon. Gentleman be transparent, if he disagrees with the Brexit dividend, and challenge his own party leader, who supports it?
I am delighted that our NHS will be getting an extra £20 billion. This has long been at the top of my agenda, and the agenda of my constituents. Does my right hon. Friend agree that, to ensure that that money is always spent on the NHS, we need to consider a hypothecated tax as part of the funding plan?
As I say, there are compelling arguments in favour of hypothecated taxes, but there are also strong reasons why we have to be cautious—namely, the fact that tax revenues go up and down, year on year, while the NHS needs stable funding. Important arguments and discussions need to happen between now and the Budget, when the Chancellor will make that decision.
I thank the hon. Gentleman for his private Member’s Bill. Palliative care is something that we do well in the UK—thanks, a lot, to the brilliant hospice movement—but we can do a lot better. I know that this will be an important part of the NHS plan.
Stroke is the fourth largest single cause of death in Britain. What action are the Government taking to prevent stroke and to raise awareness? And will the Minister meet me to discuss my GP surgery at Sutherland Lodge?
Two for the price of one. Up to 70% of strokes are preventable if hypertension, atrial fibrillation, diabetes, cholesterol and other lifestyle factors are detected and managed earlier. The current national stroke strategy came to an end last year, so we are working closely with NHS England and the Stroke Association on a new national plan, which I hope to publish this summer.
The fundamental issue here is that we need a social care system that works hand in hand with our health services—the two are umbilically linked. The key plank of the new NHS 10-year plan must be the full integration of health and care services. It does not make sense to publish the Green Paper before the NHS plan has even been drafted. We will bring forward a Green Paper, but in the meantime, spending on adult social care has gone up by 8% this year.
Like many others, I welcome the announcement yesterday of the £20 billion investment in the NHS. Will my right hon. Friend join me in seeking assurances that the £2 billion extra for the Scottish Government shall be allocated to spending on the NHS in Scotland?
I sincerely hope so, because Scottish NHS patients are currently 30% more likely to wait too long for their elective care.
What comparison has the Minister made of the cost of preventing children and young people’s mental health issues by tackling adverse childhood experience in the first few years of life, rather than letting them develop into much costlier issues for school-age children?
The hon. Lady will be aware that there is much work going on in this area. We are clear that we need to tackle these issues in schools, which is in the Green Paper, but more support also needs to be given in the early years. We are looking at how we can do that.
Northern Devon Healthcare Trust recently announced that it is to share the chairman and chief executive of the Royal Devon and Exeter NHS Foundation Trust. Will the Minister meet me to ensure that the new arrangements will help to secure services in North Devon?
I am happy to agree to meet my hon. Friend.
Last November, the Health Secretary committed to ending out-of-area mental health placements by 2020, but the number of people placed more than 100 km from their home rose by 65% over the past year. The earlier response from the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price), was no answer, so what are the Government actually going to do to turn the situation around?
There are record numbers of tier 4 beds, and we are putting record amounts of money into mental health.
Mr Speaker, you will recall recently granting me a Westminster Hall debate on the HPV vaccine for boys. Will the Department update me on progress?
I remember that debate. The matter was on the Joint Committee on Vaccination and Immunisation’s June agenda, and I am awaiting its advice with bated breath. As I said in the debate, I will turn that advice around as soon as I get it and get a decision. I know a lot of people are waiting on that.
Order. I am sorry, but we have run out of time. However, the person whom I think has been standing the longest is Rachael Maskell.
Thank you, Mr Speaker. NHS Property Services intends to sell the Bootham Park Hospital site, but reinvesting in that site would make such a difference to the health needs of our city. Will the Minister ensure that that happens?
I have met the hon. Lady, and she made her case in a characteristically powerful fashion. The matter is being looked at actively.
On a point of order, Mr Speaker.
As I understand that the point of order flows from Health questions, I will take it if it is brief.
Very brief, Mr Speaker. Yesterday, the Secretary of State for Health and Social Care said that he would place the details of the funding settlement in the Library, but the paper has not yet been deposited. Mr Speaker, given the implications for higher tax and spending, will you use your good offices to ensure that that paper is deposited as soon as possible?
I dare say that it will be, but the Secretary of State has heard the hon. Gentleman and is nodding enthusiastically from his sedentary position, and I take the nod as an indication of good intent.
I am happy to confirm that we will do that forthwith.
Forthwith. Splendid. The hon. Gentleman looks satisfied—at least for now.
We have an urgent question in a moment from Alison Thewliss. I advise the House that it is on an extremely important matter that warrants urgent treatment on the Floor of the House, but it does not warrant treatment at length. I do not intend to run it for any longer than 20 minutes, because there is other business to protect.
Glasgow School of Art
(Urgent Question): To ask the Secretary of State for Scotland to respond to the fire at the Glasgow School of Art.
As the House will be aware, a fire broke out at Glasgow School of Art’s renowned Mackintosh building on the night of 15 June. The building is one of Glasgow’s iconic landmarks and is regarded as Mackintosh’s greatest work. It is rightly of global architectural significance and a unique and irreplaceable building in the eyes of many people worldwide. The art school itself is a work of art—a jewel in a city that sparkles with architectural splendour. It is worth noting that the building next door, the O2 ABC music venue, has also been affected, and it is even older and has a colourful and varied history. The art school was never a museum piece, but a living, breathing, working art school—a powerhouse of creativity and a much-loved part of the fabric of Glasgow. We can be grateful, however, that the tragedy was not worsened by loss of life, and my heartfelt thanks go out to the emergency services, particularly the fire service, who attended the scene under such adverse conditions and in the heart of the vibrant city’s nightlife.
Many people, such as myself, are still in disbelief that this could happen again after the devastating fire of 2014, particularly given the painstaking and careful efforts that have taken place to restore the building over the past years. I visited the building on 1 June as the guest at the opening of the 2018 degree show and saw the restored library and the famous “hen run”. I was struck by the love and passion of those involved in restoring the building. I am personally devastated by the fire, a fact which I communicated directly when speaking to the school’s director, Professor Tom Inns, over the weekend. My heart goes out to the school, its students and supporters, who did so much to raise funds for the restoration after 2014.
At this point, we do not know the cause of the fire, but I note that the fire service has assured us that a comprehensive and professional probe will be carried out in due course. The UK Government previously gave £10 million to rebuild the school after the last fire, and we stand ready to help again. There was never a question about the need to rebuild and restore the building when tragedy struck four years ago. The situation is far worse after the weekend’s fire, but I hope we can start with that aim in mind.
Obviously, there are real questions about what will happen next. We stand ready to work with the school, the city council and the Scottish Government. I am visiting the site and meeting the head of the school on Friday, and I will update Members when I am in a position to do so.
I thank the Secretary of State for his comprehensive response and for the support he has given.
The loss of the Glasgow School of Art, particularly in the 150th anniversary year of Mackintosh’s birth, is a very sore loss indeed for the city. As the Secretary of State mentioned, the building is internationally significant and is held very preciously in our hearts in Glasgow. All who have visited and studied there, and even those who have not been inside, feel that the building belongs to the city of Glasgow and to each individual.
It is a catastrophe to lose the building, and my heart goes out to the staff at the GSA, to Professor Tom Inns and his staff, to those who worked on the restoration and particularly to the craftspeople who put so much love, care and attention into bringing back skills that have gone out of fashion to bring the school back to its former glory.
The Secretary of State is right to mention the vibrant O2 ABC venue, which was very much part of the cultural scene in the city of Glasgow. That will also be a very sore loss to Glasgow.
Like the Secretary of State, I pay tribute to the Scottish fire and rescue service, which pumped water uphill from the Clyde to try to douse the huge flames of the inferno on Friday night; the police, who kept everybody safe; and the Salvation Army, which was on hand to provide rolls, sausages and Irn-Bru to the Weegie fire crews. They did a tremendous job in reacting to the fire, too.
Does the Secretary of State agree that speculation at this time about the future of the building and the cause of the fire is unhelpful and that we should allow the experts in the fire and rescue service to do their investigations and to carry out their very detailed work, which may take some time to reach a conclusion? It is important that we get the answers and that we learn the lessons of this fire.
Will the Secretary of State support looking at all options to ensure that traders and residents of the Sauchiehall Street and Garnethill area are supported through this and are given the financial support they need? Will he look at the further detail of whether sprinklers can be made mandatory in historic buildings?
Finally, I am glad to hear that the Secretary of State is offering support for the renovations, and I look forward to hearing more on that in the coming weeks. Can he confirm that he will give more support for donations coming from other sources and that he will use the Government’s efforts to bring in more money?
The House can hear the hon. Lady’s passion for the Glasgow School of Art, which is reflected across the city of Glasgow, across Scotland and across the world. She is right that speculation is unhelpful at this time, which is why I do not support calls at this stage for a public inquiry. The investigations that would normally follow a fire and the detailed investigations that are under way should be allowed to follow their course. Of course, some of those investigations will be into the structure of the building and will determine what can happen next.
As I have said, I want to work with the school, the city council and the Scottish Government once views are formulated on how a restoration can be taken forward. We stand ready to help, as we did in 2014. I will discuss the traders, businesses and residents around the Glasgow School of Art with the Scottish Government and the council.
My daughter-in-law is a postgraduate of the Glasgow School of Art, which is a much loved institution. Will the Secretary of State undertake to come back to the Dispatch Box when things are much clearer, so that we can get a clear understanding of what the UK Government’s undertaking will be?
Yes, I am happy to do that. As the original questioner indicated, it is clear that it may take some time for there to be clarity about what will happen next, and I am certainly willing to come back to the Dispatch Box.
I pay tribute to the hon. Member for Glasgow Central (Alison Thewliss) for securing this urgent question. I fully support her efforts, and I am sure all Glasgow Members will stand in total solidarity to ensure we get the best outcome possible for our city.
Charles Rennie Mackintosh’s Glasgow School of Art, that magnificent edifice that dominates the skyline of Garnethill, is the epitome of what it means to be a Glaswegian. It embodies the very essence of the city’s character and soul, and is a true example of human genius. The grief I experienced after the first fire in 2014 was profound; it felt like part of our city had died that day. Now to witness an even more severe conflagration consume this precious art nouveau masterpiece has left me both angry and incredulous that it could have happened again. What on earth has gone wrong here?
More generally, this fire represents a wake-up call for Glasgow and the entire country. We need to have a much more robust approach to protecting our amazing Victorian architectural legacy in Britain in the future or we will continue to see these tragic losses mount up as buildings of these ages continue to suffer degradation. Government at all levels—city, Scottish and British—needs to step up to meet this challenge with radical and imaginative measures.
The good thing about the Glasgow School of Art is that the past four years have seen a meticulous process of understanding the building take place. The work of the architects and craftspeople has been extraordinary. We therefore have a critical mass of knowledge and understanding of this iconic building and its construction that makes it easier than ever before to restore Mackintosh’s original vision. They are geared up and more than ready to take on that challenge, and I will be making the strongest possible case that they should be allowed that chance.
In the face of reckless calls to tear the building down, what plans do the Government have to support the safeguarding and renewal of such an iconic and important cultural asset for the world? What conversations has the Secretary of State had with the Scottish Government on the need to safeguard the building and ensure it is appropriately restored? Given that Glasgow needs a more preventive, comprehensive strategy for preserving its ageing stock of Victorian architecture, much of which is vulnerable to fire, what plans do the Government have to support a review of the way that heritage buildings are managed and safeguarded, with fire prevention policy as a priority? What discussions has the Secretary of State had with the Scottish Government on the need to set up an investigation into the safety measures taken by the contractors for the restoration works? All I would say in conclusion is that the people of Glasgow deserve roses as well as bread, and the Mack will rise again.
The hon. Gentleman raises important points, and I know that he has a strong personal connection with the School of Art. Like those people who have been part of it, he feels this tragedy, but, as the hon. Member for Glasgow Central said, people who have never crossed the threshold of the School of Art feel it, too. I feel particularly for those craftsmen who restored the “hen run” and the library, bringing back these crafts, and how they must be feeling this week, when their work has been decimated. I take on board the points he makes about safety issues in buildings. The Under-Secretary of State for Digital, Culture, Media and Sport, my hon. Friend the Member for Northampton North (Michael Ellis), who is responsible for heritage in the UK and is in his place, will also have heard what he said and we will respond specifically to that.
As a representative of many of the students and staff of the school, and as a former frequent visitor to the ABC, this fire was a real blow to me. When the Secretary of State meets representatives of the school on Friday will he talk about ways in which the community and alumni can most appropriately help with any fundraising efforts for future restorations?
I most certainly will do that. The effort to raise funds after the 2014 fire was tremendous. One way in which the Government can help is through Government funding, which can be a catalyst for other funding coming in. That was very much the case in 2014, and it is very much in my mind at this time.
This was a cruel and gut-wrenching blow to the people of Glasgow, coming just as the refurbishment from last time was nearing completion. Last night in this House we demonstrated our ability to disagree with each other and have a vigorous debate, but I am pleased that this morning we are seeing all shades of political opinion in Scotland come together in solidarity with the people of Glasgow as they deal with this great tragedy. I want to ask a couple of specific questions. Yesterday, the Secretary of State for Housing, Communities and Local Government said that it was a matter for the owners of buildings to determine whether or not to install sprinklers. What action does the Secretary of State for Scotland think the Government should take to ensure that sprinklers are installed in such public buildings? He mentioned the need for a thorough investigation. Does he agree that erroneous press speculation on the cause of the fire before that investigation is complete is unhelpful and undesirable?
I certainly agree with the hon. Gentleman’s last point: press speculation on the cause of the fire is very unhelpful. We need to let those people who are carrying out the professional investigation get on with it. I also agree that it is important that all levels of government—the city council, the Scottish Government and the UK Government—work together, and whatever our other differences, I absolutely commit to do that. The issue of sprinklers has been debated extensively in the House in recent times. The hon. Gentleman will be aware that a sprinkler system was in the process of being installed in the building, but sadly that process had not been completed.
Glasgow School of Art has a base in Moray; I spoke to people at the Altyre campus this morning, and they asked me to express their sympathies and thoughts for everyone involved in Glasgow. What can our constituents throughout Scotland do to support the efforts to restore Glasgow School of Art?
When I visited the School of Art on 1 June, I met some of my hon. Friend’s constituents from Moray who had raised very considerable sums of money for the first restoration. Although those fundraisers will be as devastated as the rest of us, I am sure that, given the vigour and passion that I witnessed, they will stand ready in Moray and throughout Scotland to start the process again.
As we know, highland chieftains are very good at getting rich clan members and estates to help to pay for repairs to the roofs of their castles and mansion houses. There are some extremely well endowed art-supporting funds out there, in the US and the rest of the world; what efforts will be made to see whether they would help to pay for the restoration?
I am sure that every effort will be made, because the School of Art has a world-class fundraising operation. It has alumni around the world and, indeed, campuses around the world—for example, I had the pleasure to visit the campus in Singapore. We stand ready to help and support the School of Art in any of those efforts, but one thing that the experience over the past four years has demonstrated is its skill and ability in respect of fundraising.
What caused the fire four years ago? Does the Secretary of State share my general concern that, given modern safety standards, far too many fires are breaking out in large buildings in this country—for example, the London hotel fire last week—that are either undergoing or have recently undergone renovation?
The issue of renovations has been the subject of some comment in recent days, and it merits some attention.
Prior to my being elected to this House, I had the great honour not only of being the bailie for Garnethill, in which the GSA is found, but of having done most of my postgraduate study in the bowels of the Mack building. In resurrecting the GSA, with its critical role as a place of artistic education, what work will the Secretary of State do in conjunction with my hon. Friend the Member for Glasgow Central (Alison Thewliss), the Member of the Scottish Parliament for Glasgow Kelvin and the Lord Provost of Glasgow, who also now represents Garnethill?
One thing that was clear when I visited the School of Art on 1 June was the wish to get students back into that building to see it as a functioning building for students, and there were detailed plans about which students and courses would be taught there. I am absolutely sure that if a restoration can go ahead, the School of Art will very much want the building to return to being a living, breathing art-school building. I will certainly do everything that I can to support that.
I welcome the Secretary of State’s comments and the cross-party nature in which this tragedy is being approached. Does he agree that the craftspeople, artists and performers who often perform at the O2 ABC need to be supported with specific funding, along with local shop owners? In the short term, before the big fundraising efforts take place, what can he do to ensure that they are specifically supported?
I am happy to look into the detail of that specific point, because it is relevant. I understand that several events that were due to take place have been rearranged and will go ahead at other venues in Glasgow. I am happy to take forward any specifics that flow from the hon. Lady’s question.
The sense of devastation is felt so keenly in Glasgow because Charles Rennie Mackintosh’s work has touched our lives in many different ways—for example, I have been to the weddings of my sister and some of my best friends at the House for an Art Lover. The Charles Rennie Mackintosh Society is based in another of his masterpieces, the Queen’s Cross church, which is just around the corner from my constituency office. Will the Secretary of State make sure that the society is included in any communications or information flows that the Government initiate?
Yes, I am happy to do that. As a previous contributor said, it is a great irony that Mackintosh’s 150th anniversary was only on 7 June, when we saw, through the worldwide celebrations, how relevant he remains around the globe.
Mackintosh once lived in a house just three doors down from where I currently live, but the Secretary of State will know that that is not the only place we can learn about Mackintosh: an exhibition is on right now at Kelvingrove Art Gallery, and it is open until the middle of August so that people can learn about his work. Will the Secretary of State encourage everybody to go and see it?
I most thoroughly encourage everyone to go along to that Mackintosh exhibition in Kelvingrove and, indeed, to visit any of Mackintosh’s other properties, if they have not done so, or attend the Willow Tea Rooms in Sauchiehall Street.
I agree with and associate myself with the remarks that everyone has made about the heartbreaking scenes on Friday night. Does the Secretary of State agree that the creative arts and creative industries can find young people work in a way that conventional industry cannot? Will he take that into account when he considers what Government funding will be available?
I absolutely agree with the hon. Gentleman. We do not always agree, but I do believe that the creative industries are a much undervalued part of our economy. They have played a huge part in Glasgow’s regeneration and are an enormous part of Edinburgh’s success as a global festival city, and they merit more attention.
Last year, some Members from Glasgow were given a tour of the painstaking restoration of the Mackintosh building by the School of Art’s director, Professor Tom Inns, who told us how the team who had been involved in the restoration of Windsor castle had offered their advice. Will the Secretary of State join me in thanking the international teams that are appearing to offer their advice, both practical and financial? Like the people of Glasgow, we are not kept down for long, and nor will be the Mack.
The hon. Lady ends her question with a very good sentiment, and I echo it fully. The School of Art has been able to draw on worldwide expertise and to develop and see through skills that were not previously exercised, and it stands in a good position to know what would be needed in a future restoration, although the scale of this restoration would obviously be much greater than the previous one.
I am someone who delivered to Glasgow for 25 years as a postal worker, and the Mackintosh building was one my favourite buildings to deliver to. Will the Secretary of State not only deliver on the promise that he has just given to re-fund the building, but bear in mind the students and workers in the building?
One of the issues that I will discuss with Professor Inns and others is students, workers and the current capacity, because although the Mackintosh building was in effect destroyed, the School of Art’s principal building was also badly damaged in terms of its operability. We want to discuss those issues and how they can be most helped in that regard.
With permission, Mr Speaker, I would like to make a statement on the medical use of cannabis.
Over the weekend, I issued an emergency licence to allow Billy Caldwell’s medical team to access cannabis-based medicine to treat life-threatening seizures caused by a severe form of epilepsy. This was an emergency procedure, which was led by a senior clinician with the support of the medical director at the Chelsea and Westminster Hospital.
I am pleased to say that Billy has now been discharged from hospital. It is now for his senior clinicians to develop a long-term care plan. I am sure that the whole House would like to join me in expressing our sympathy for what Billy and his family have been going through and the very difficult time that they have faced.
The course of action in this case was unprecedented. There is strong scientific evidence that cannabis can harm people’s mental and physical health and damage communities. There are currently no legally recognised medicinal or therapeutic benefits. To date, under successive Governments, Home Office policy has been to permit the production, supply and possession of raw cannabis solely for the purposes of research with a Home Office licence. The cannabis-based medicine Sativex can, however, be prescribed in the UK because there is a proven case for its safety and efficacy. However, cases such as Billy’s, Alfie Dingley’s and others like them, have shown that we now need to look more closely at the use of cannabis-based medicines in the healthcare sector in the UK.
It has become clear to me since becoming Home Secretary that the position we find ourselves in is not satisfactory. It is not satisfactory for the parents, it is not satisfactory for the doctors, and it is not satisfactory for me. I have now come to the conclusion that it is time to review the scheduling of cannabis. Before I go into the detail of the review, let me be absolutely clear that this step is in no way the first step in the legalisation of cannabis for recreational use. This Government have absolutely no plans to legalise cannabis, and the penalties for unauthorised supply and possession will remain unchanged. We will not set a dangerous precedent or weaken our ability to keep dangerous drugs off the streets.
The approach that we will be asking the review to consider will be no different than that used previously for controlled drugs where there is evidence of medicinal benefits. The Government review will take place in two parts. Part 1 of the commission will consider the evidence available for the medicinal and therapeutic benefits of cannabis-based medicines. Professor Sally Davies, who also serves as the Chief Medical Officer, will take that part forward. It will then inform exactly which forms of cannabis or cannabis-based medicines should be taken forward to part 2.
Part 2 will be led by the Advisory Council on the Misuse of Drugs. The ACMD will not reassess the evidence issued by Professor Sally Davies, but will provide an assessment, based on the balance of harms and public health needs, of what, if anything should be rescheduled. If the review identifies that there are significant medical benefits, we will reschedule. We have seen in recent months that there is a pressing need to allow those who might benefit from cannabis-based products to access them. It will, of course, take time for Sally Davies and the ACMD to complete their work and for the Government to consider their recommendations.
In the short term, my hon. Friend the policing Minister announced yesterday that the Government would be establishing an expert panel of clinicians to advise Ministers on any applications to prescribe cannabis-based medicines. This is intended to ensure that advice to Ministers on licensing in these cases is clinically led, based firmly on medical evidence and as swift as possible. The Chief Medical Officers across the UK have already been actively working together on the panel, and the expert panel will start considering applications within a week.
Earlier today, my hon. Friend the policing Minister also spoke to Alfie Dingley’s mum, Hannah Deacon, and informed her that we would issue a licence for Alfie later today. All of the work I have outlined today is about making sure that we keep in step with the latest scientific evidence, and that patients and their families have access to the most appropriate course of medical treatment. I pay tribute to the Policing Minister for all his excellent and sustained work on this important issue.
As a father, I know there is nothing worse than seeing your child suffer. You would do anything to take away their pain. That is why I have the utmost sympathy for Billy Caldwell, Alfie Dingley and many others like them, and for their parents who have been under unimaginable stress and strain. I know that they are following a gut parental instinct to do whatever is in their power to alleviate the suffering of their child. Today I would like to say to this House that I will do everything in my power to make sure that we have a system that works so that these children and these parents get access to the best medical treatment. I commend this statement to the House.
I thank the Home Secretary for prior sight of his statement. I am well aware of the damage that cannabis consumption can cause, whether it is the health of very young consumers or ganja psychosis. The newer forms of cannabis, notably skunk, are very much stronger than the cannabis available a generation ago. However, I am also aware, as the Home Secretary will be, that a former chairman of the Advisory Council on the Misuse of Drugs, Professor Nutt, has said that cannabis is less harmful than alcohol. I note that Baron Hague of Richmond is calling for complete decriminalisation.
The Opposition welcome the Home Secretary’s statement that he will look more closely at the use of cannabis-based medication in healthcare in the UK. We agree that this is the right time—if not long overdue—to review the scheduling of cannabis, and we are glad to hear that the policing Minister has spoken to Alfie Dingley’s mother. After the meeting in 10 Downing Street, she was very concerned about the length of time that it was taking to issue a suitable licence.
The Home Secretary has released some of the supply of medication that Billy Caldwell’s mother brought into the country, but does he intend to release the complete supply? Is he aware of the concern at the delays in the current process? Although we welcome the review, something must be done to manage the current process more effectively, including the use of an advisory panel. It is simply not acceptable that parents and families have to suffer, as they have been, as a result of the interminable delays in agreeing licences.
Cannabis and the drug issue generally are big issues of concern for the community. It is important that we base whatever we do on scientific fact and evidence, and we do not just bow to what might be popular sentiment. There are harms connected with cannabis consumption, but it is time to move forward and establish once and for all the potential of cannabis-based medicine to alleviate pain and suffering.
I thank the right hon. Lady for her comments and her support for my statement. I think she agrees with me that it is absolutely the right time for the Government to look at this issue. She will be aware that under successive Governments, policy in this area has not changed for a long time, but given what we have all seen and heard all too clearly on our television screens, on the radio, and given the many meetings that my hon. Friend the policing Minister has had with the families affected, it is the right time to look at this issue and act as quickly as possible.
There are two parts to our action. I wish to reassure the House—all hon. Members will appreciate that rules of this type cannot be changed overnight. The changes have to be based on evidence. If they are not and are not properly made, some people out there may have different views and may try to challenge the rules legally. They have to be sufficiently robust. That is why we have put in place this process and why we wanted to act as quickly as possible. Professor Sally Davies’ office has said that she can complete her work within a week. We are moving as fast as we possibly can, and I hope that the ACMD can then act within weeks.
At the same time, we do not want any other families to suffer, so we want to ensure that we have a process in place to act much more swiftly. That is why we have established the expert panel. The chief medical officers from all the devolved nations, including Northern Ireland, are involved in that, so we are co-ordinating and will work well together. The expert panel will be able to act very swiftly and Ministers will be able to take action very quickly based on medical advice, which is what we all want to see.
The right hon. Lady asked me about Alfie Dingley. As I mentioned, we will be issuing the licence today. Alfie’s mother has already been informed and is of course very happy with the decision. I am sorry that she has had to wait so long and go through all the distress that she has faced. I am grateful to the policing Minister for all the work that he has done, and to Alfie’s mother’s Member of Parliament—the Attorney General, my right hon. and learned Friend the Member for Kenilworth and Southam (Jeremy Wright)—for all the work that he has done.
The right hon. Lady asked me about Billy Caldwell’s situation. We are working very closely with the family. Now that the licence has been issued, we will ensure that the right amount of medicine is available for the right time. The situation depends somewhat on whether Billy Caldwell’s mother decides to go back to Northern Ireland, because licensing is an entirely devolved matter. We are working closely with the Northern Ireland authorities to ensure that, if she does decide to go, the move is seamless and does not affect Billy Caldwell in any way.
The right hon. Lady is interested in how quickly we acted. The first time we received a request from a clinician in the case of Billy Caldwell was at around 11.15 am on Friday just gone; by noon I had issued a licence and the drug was in possession of the family. I do not believe that we could have acted any quicker from the point at which we received a request from the clinician.
Once again, let me say that I really appreciate the right hon. Lady’s comments. By working together, we can bring to an end the suffering of all these families and help in every way that we can.
I thank my right hon. Friend for his statement and the rapid way in which he has gripped this issue. As co-chair of the all-party parliamentary group for drug policy reform, let me say that this is a very welcome step forward. There is a substantial amount of medical evidence out there, including a 2016 paper on this issue—commissioned by my predecessor co-chairs of the APPG—by Professor Mike Barnes, who has been associated with the Alfie Dingley case. Will my right hon. Friend make it clear that Professor Sally Davies has been given two tasks, including one on the expert panel to advise on immediate applications for licences? Will he confirm that people will not be asked to pay the swingeing fees that were being asked of the Dingley family in respect of their licences? Finally, what is the expected timescale for the second task that my right hon. Friend has asked the chief medical officer to undertake?
I welcome my hon. Friend’s comments, the work that he has done in this area over a number of years and the interest that he takes in the issue. I can confirm that Professor Sally Davies is helping—first with the expert panel so that we can bring help before the review is complete, and then of course with the review itself. He also mentioned the important issue of fees, which I am looking at to see how we can help.
I thank the Home Secretary for his statement. May I just gently say to him that it would be nice if the third party could have a little bit more advance notice than the statement literally being put in my hand as he gets to his feet? That said, I am pleased about the statement.
The Home Secretary is making significant progress in this area. I am particularly pleased for the individual families concerned, and to read about the review, but of course there are thousands of people across the United Kingdom who want to access these medicines for the treatment of conditions for which there is evidence that they can alleviate the symptoms and pain. These individuals and their families are worried about the bureaucracy and the hurdles that have to be crossed to access the medicines. Can the Secretary of State give me some assurance that his review will focus on removing bureaucracy and hurdles? Does he agree that this matter should eventually be seen as a public health matter that should be taken out of the Home Office and put into the hands of health departments across the UK?
In the meantime, I am pleased to hear that the chief medical officers of the devolved countries are involved, but will the Secretary of State confirm what other liaison there is—with the Scottish Government, for example—in relation to both health and policing, which has been mentioned, as these are devolved matters?
I thank the hon. and learned Lady for her comments. She is right to highlight that thousands of people may be suffering. No one knows the exact number, but it is estimated that at least 10,000 children in the UK have a drug-resistant form of epilepsy. That really puts into focus what a big difference these measures can make. I can also give her an assurance about bureaucracy and hurdles. Frankly, there has been a lot of bureaucracy and many hurdles in the way until now. The decision that we made on Friday was unprecedented, as are the measures that we are putting in place. The expert panel will make a huge difference. Its whole purpose is to make the process as smooth and quick as possible, based on medical advice at all points. I do not want to prejudge the review, but I am sure that the hon. and learned Lady can sense the direction.
As chair of the all-party parliamentary group on cannabis: harmful effects on developing brains, I thank my right hon. Friend for his assurances that any future medicinal use of cannabis will not be conflated with any weakening of the Government’s position on recreational use. Is he aware of the increasingly clear evidence of permanent psychosis and depression among young people who are users of what we see on our streets more regularly—skunk cannabis?
I am very much aware of that. It is perfectly correct for my hon. Friend to highlight this point. As I made clear in my statement and I am happy to make absolutely clear again, there are no plans at all to decriminalise cannabis. It is a controlled class B drug under the Misuse of Drugs Act 1971, and that will not change.
All of us must want children—and also adults—to get the medical treatment that they need without additional hurdles that have nothing to do with medicine. I welcome the Home Secretary’s announcement that he will look at the scheduling of cannabis, because it is incredibly hard to explain the scheduling classification of cannabis compared to opiates, and the additional burdens that that scheduling poses for the health service if such products are needed for treatment. May I ask him again to look more widely at the barriers and obstacles in his review? Will he look at whether these kinds of scheduling or licensing decisions should be passed to the Department of Health and Social Care, and whether much more drugs policy should, in fact, be led by that Department?
The right hon. Lady makes a number of good points. She is right to highlight that there are currently drugs that are under schedule 2, meaning that the medical benefits are accepted, but which can be a lot more harmful than other drugs if they are used in the wrong way. She asked about the role of the Department of Health and Social Care in these kinds of decisions. This requires a cross-Government approach, with the Home Office and the Department of Health and Social Care working closely together, as we have seen. We have an issue in that these drugs are categorised as illegal under the Misuse of Drugs Act, but we need to recognise, where appropriate, that some of them have medicinal benefits, as has already been recognised with, for example, cocaine and morphine. It is therefore appropriate that the two Departments work together.
I absolutely understand the Government’s review of this policy, and I welcome it for those who suffer and need this drug to make them better, but may I just say that, from my own life experience, I am delighted that the Government are not going to decriminalise the use of drugs. All too often, people start on cannabis and end on something far worse, and I have personally seen the devastation to families and the loss of children because of drugs.
I agree wholeheartedly.
I welcome the move that the Home Secretary has made, on behalf of my constituents. It is really important to me that the grandfather of Charlie Jones and the parents of Jace Newton-Sealey know how to go about applying for a licence. Will the Home Secretary and his Department make the process clear, so that people know how to access a licence?
Yes, I think that there is a need to make the process clearer. I have been quite open that I do not think that the current process is a friendly one at all. The decision made in the case of Billy Caldwell was unprecedented; no Government in the past had recognised the medicinal benefits of cannabis by making such a decision and issuing a licence. We need to make the process—even the interim process, through the expert panel—much smoother and more straightforward. Once the panel is set up, which will happen by next week, we will set out exactly how the process will work for the hon. Lady’s constituents and others.
Clinical leadership may have its place, but for years the crying need has been for political leadership, so may I thank my right hon. Friends the Secretary of State and the Policing Minister for providing it?
The Minister and I both thank my right hon. Friend.
I genuinely welcome this announcement, which does mark a significant shift, but is there not a dreadful hypocrisy in Government policy on drugs more generally? Probably most of the Cabinet drinks alcohol, the most dangerous drug of all. Probably half the Cabinet has used cannabis—maybe even the Home Secretary—unless it is a very odd group of people, but perhaps that is the case. Should not the Home Secretary follow the advice of the former Conservative leader, Lord Hague, who makes the case for a regulated, legalised market, which would be the best way to protect from harm people who, at the moment, buy from criminals who have no interest in their welfare at all?
This is about making sure that the best possible medical treatment is available for everyone in the UK, but especially our children. It is about medical treatment, not the recreational use of drugs, which can cause severe damage to people. I am afraid that I do not agree with the right hon. Gentleman on that point, and nor, on this occasion, do I agree with Lord Hague.
I thank my right hon. Friend for very much humanising this issue. As chairman of the all-party group on multiple sclerosis, I welcome his announcement about the medical aspect of cannabis. May I offer the services of the MS Society in any inquiry and call for evidence that he might have? May I also associate myself with his remarks about drugs? I am frankly staggered that my right hon. and noble Friend Lord Hague—or indeed anybody else—could advocate such a thing. We will all have seen at first hand in our constituencies the devastation that cannabis causes. This is not recreational use—it steals lives and futures, and we must be robust in ensuring that it stops.
My hon. Friend is absolutely right on that point. He will know that Sativex, which has a cannabis base, is already licensed for those with MS, but today’s announcement is about how we can improve on the medical use of cannabis even further.
I, too, genuinely welcome the licence for Alfie today, but what a scandal it is that it has taken three months since Hannah Deacon met the Prime Minister and was promised swift and compassionate action, and what an outrage it is that, frankly, it is only the press attention that has finally shamed the Government into action. With regard to the expert panel, what assurance can the Home Secretary give that there will be enough Home Office staff to deal with the thousands of applications that might well now come?
Let me say gently to the hon. Lady that in the case of Alfie Dingley, of course we are all pleased that we have been able to issue the licence today. She should know that before the application—the approach by his clinicians—no Government had even entertained the idea, given that cannabis is classed as a schedule 1 drug, of looking at this from a medical point of view. This Government have done that. I hope that she can join us in not just welcoming that, but working together on how we can end the suffering of so many other people, particularly children, who could benefit from these kinds of medicines.
I commend the Home Secretary for his statement. I support the legalisation of cannabis for medical use. May I urge him to encourage the clinical review team to get on with it? There is already a mass of internationally accredited research available that they can draw on, so we do not need to reinvent the wheel. The research is there—it just needs to be studied and then a decision can be made quickly.
My hon. Friend makes a good point. One of the issues has been that our rules in this area have not kept up with medical research and evidence. At least 13 European countries, as well as Canada and over 30 US states, have recognised the medicinal benefits of cannabis. The World Health Organisation has also done work on this and pointed to evidence. We will be using and drawing on all that evidence. That is why I am pleased that Professor Sally Davies has said that she can complete her work in days.
The Home Secretary says that he wants a system that works. I am bit concerned about the role of the Advisory Council on the Misuse of Drugs in the light of what has happened in recent days. Is it still fit for purpose?
Yes, it is. It has an important role to play, which is to advise Ministers on the scheduling of drugs. If we are to change a scheduling, it is important to listen to its point of view.
I welcome the fact that the Home Secretary set out at the start of his statement that
“cannabis can harm people’s mental and physical health and damage communities.”
I also welcome the fact that any change will be science-led. Will he also look at international examples? He mentioned Canada, where a law was introduced very recently. Will he see what works—and, importantly, what does not work—with that law, in particular, because the evidence is mixed?
My hon. Friend is absolutely right. We will certainly be looking at international evidence. A lot has changed in the UK since the current rules were put in place, and we will take all that into account.
I welcome what the Home Secretary has said today. I have long supported decriminalisation of the use of cannabis for medicinal purposes, not least having heard some really heartbreaking stories from my own constituents, particularly those with degenerative conditions, some of whom, sadly, passed away unable to get the pain relief and support that they needed. Given the speed at which this review will be undertaken, will the Home Secretary, the Policing Minister and the Attorney General be giving any guidance in the interim to police forces or the Crown Prosecution Service on the public interest in pursuing the impounding of material, or prosecuting individuals who are using it for medicinal purposes?
The current rules are clear. We have discussed today and debated in Parliament how we would like to see a change in the process, but until those rules change, they would have to be applied. The hon. Gentleman raises a perfectly good point about working with law enforcement agencies and making sure that they are taking emerging policy into account.
I have long advocated the use of medical cannabis and therefore very much welcome the Home Secretary’s announcement of a review. May I have assurances that that review will be very much patient-centred and led by evidence of how the use of medical cannabis can help those with chronic conditions?
I can absolutely give my hon. Friend that reassurance. The review must have the patient at its very heart and must be driven by medical evidence.
I welcome the statement, and particularly the news on Alfie Dingley. Of course, there is already evidence of the medical benefits of cannabis, because otherwise Sativex would not be available on licence. That is why it is so absurd that cannabis is still a schedule 1 controlled drug. I am therefore hopeful and confident that the review will lead to a recommendation to reschedule. Will the Secretary of State confirm that rescheduling could be carried out quite quickly and easily by means of a statutory instrument, meaning that we can get on with it?
First, Sativex was looked at for a particular condition. It is right that drugs are looked at the context of the condition that they are intended to help with. The hon. Gentleman makes a good wider point about whether, once the review is complete, we can get on with it, with any changes made quickly. That is exactly what I intend to do.
As chairman of the all-party group on 22q11.2 deletion syndrome, I know many parents of children who have a rare genetic condition that often goes undiagnosed and, when diagnosed, is not always appropriately treated. From that experience, I am sure that Billy’s family welcome today’s statement. I welcome the fact that elements of the statement show that the Government look to the evidence and respond to the public interest, as well as that of the patient at the forefront.
My hon. Friend is right. The process should absolutely be clinically led. We should listen to evidence from clinicians while drawing on international evidence, too. That is exactly what should feed into the outcome of the review.
I think we all welcome the progress that is being made, but there are questions about people who need help now. My constituents Laura Murray and John Ahern have a one-year-old daughter, Bláthnaid, who has been diagnosed with Aicardi syndrome. She suffers very severe seizures throughout the day and her parents believe that these medicines could help. I will write to the Home Secretary with more details about that situation, but may I ask him how much discretion he still has, and how much he is willing to exercise?
As the rules stand, until the review is complete and changes are made, any use of cannabis for medicinal purposes will require a Home Office licence or, in the case of Northern Ireland, a licence from the Health Department there. I hope that what I have set out today has given reassurance that I recognise the need for action now, not tomorrow or in a few weeks or months. We need action now, and that is the purpose of the expert panel—to make this a much smooth, quick and clinically-led process.
I welcome the Home Secretary’s announcement. I note that he is not going to reclassify cannabis, but will he look at how we deal with individuals in possession of a small amount of cannabis? To that end, will he look at Checkpoint, an alternative justice initiative by Durham police that aims to help individuals and to try to break the link between drugs and crime?
The right hon. Gentleman is right: this is not about the reclassification of cannabis. He makes an important point about the need for law enforcement to work with others, including the many good groups out there, to try to get people off drugs once they have a problem. It is important to do more work on that.
I welcome the Secretary of State’s announcement. Those treating my constituent, Caroline, are firmly of the view that she is alive today and living a good quality of life because her brain tumour has been slowed by the regular use of cannabis oil, but she is having to import that at a cost of hundreds of pounds every month. When can she expect her doctors to be able to prescribe that treatment? Is there anything she should be doing in the meantime to benefit from what the Secretary of State has announced today?
I do not know all the details of that case, but it might be good to look at the work of the expert panel that I have talked about. As I say, we will set out more details on that. Any changes to the rules will be made after the review and, as the House has heard, we are trying to do that as quickly as possible.
The mainstream media have highlighted this week the heartbreaking cases of Alfie Dingley and Billy Caldwell. The Secretary of State has said that an estimated 10,000 children in the UK who suffer seizures could benefit from these medicines, as could many more people suffering from degenerative conditions. It has always been the case that he could grant a specific licence, but given his comments about the time that it will take the ACMD to reach a conclusion and to look at international evidence from Canada and the 13 EU countries, what is his estimate of how long it will be before we get a more streamlined system?
First, I reassure the hon. Gentleman that we will take the international evidence into account. I know that Dame Sally Davies will look at that too, as will the ACMD. I want that work to be done as soon as possible, but right now I want to streamline the process, which means that the work of the expert panel will be very important.
I welcome the Home Secretary’s statement. It will be particularly welcomed by my constituents the Gray family, as Murray Gray suffers from a similar condition to Alfie Dingley and Billy Caldwell. I also welcome the speed with which the Home Secretary will act, but I urge him not to be thrown off track or to allow anything to affect the rescheduling of cannabis, such as reactionary fear about its availability for recreational use.
I thank the hon. Lady for her comments, and I reassure her that I will not be thrown off track.
I thank the Home Secretary very much for his statement and the urgency he has given this. I also thank the Minister for Policing and the Fire Service for all his hard work, which should not be ignored. My constituents Darren and Danielle Gibson took their eight-year-old daughter Sophia to Holland so that she could receive these drugs. It was very important that they did so, as that had a clear medical benefit for their child. The Minister will know—
Order. I express the cautious hope—it would probably be unrealistic of me to say this with enormous confidence—that the hon. Gentleman, whom we all love dearly, is approaching his peroration, at the end of which there will be an unmistakeable question mark.
There certainly will be, Mr Speaker.
When I met the permanent secretary of the Health Department in Northern Ireland, he said that he would have some difficulty giving the go-ahead in Northern Ireland. He needs direction from the Home Secretary. What discussions has the Home Secretary had with the permanent secretary to facilitate this urgently for my constituent Sophia Gibson?
The hon. Gentleman will know that the decision to issue a possession licence is completely devolved in Northern Ireland, so it is outside the Home Office’s area. That said, we want to work closely with Northern Ireland. The permanent secretary in my Department has been working with the permanent secretary in the Health Department in Northern Ireland. We want to help in every way possible, especially in the case of Sophia Gibson, and that is exactly what we are doing.
I have to say that I am a little perplexed by this. The Home Secretary is saying that there are currently no legally recognised medicinal or therapeutic benefits of cannabis. I am wondering what we are giving to Billy Caldwell that has led to such a turnaround in his situation and what we are proposing to give to Alfie Dingley, if it has no therapeutic benefits.
Under the current rules, those are not recognised. To be a bit clearer, all drugs that may or may not have a medicinal benefit are scheduled, and drugs in schedule 1, which is where cannabis is at the moment, are not recognised to have medicinal benefits under the law. That said, we of course want to look at the evidence, and to be led by evidence and clinicians, which was exactly why I made today’s announcement and why I took action last week.
Points of Order
On a point of order, Mr Speaker. Where is everybody? I hope, in the light of the extraordinary accusations of the right hon. Member for North Norfolk (Norman Lamb), they are not behind the bike sheds having a spliff.
That is a most unworthy thought. The right hon. Gentleman articulates it with his usual brio and panache, but I think he errs on the side of pessimism in his assessment of the character of his colleagues.
On a point of order, Mr Speaker. Yesterday I attempted to raise a point of order, which I do not think was a point of order, so I will try again today. I wonder how I can get on the record how thrilled I am, along with colleagues across the House, that it will no longer be necessary to go to Holland to get the drugs for Alfie Dingley. I was inundated with requests to come with me, but we will now not have to be put behind bars to get Alfie the drugs he needs.
That is a very heartwarming point of order by the right hon. Gentleman. I must admit that I had wrongly anticipated him. I did not know that he was going to make the very serious point that he just made, which is appreciated and respected. I thought he was going to use the occasion to make an entirely bogus but amusing point of order about Harry Kane’s two goals last night, which we all celebrate. I do not celebrate it when Harry Kane scores for Tottenham, although I know the right hon. Gentleman does, but I do celebrate it when Harry Kane scores for England.
Further to that point of order, Mr Speaker. I would like to put on the record how difficult that announcement was for you, as an ardent Arsenal supporter. I am sure that we all, including those from other countries in the United Kingdom, support England when they are playing other countries outside the United Kingdom, and especially when Harry Kane scores two goals.
We conclude our points of order today, people will have noticed, in a spirit of amity.
House of Lords (Abolition and Replacement)
Presentation and First Reading (Standing Order No. 57)
Mr Frank Field presented a Bill to abolish the House of Lords and make provision for its replacement by a Senate.
Bill read the First time; to be read a Second time on 26 October, and to be printed (Bill 230).
For the benefit of others, the right hon. Member for Birkenhead (Frank Field) said, “26 October 2018, unless the Speaker can get him a better time.” That is a very novel interpretation of the procedure.
Please, Mr Speaker.
He is exhorting me to find a better time.
It is about the abolition of the House of Lords. They are overruling us.
I think the right hon. Gentleman may be investing me with powers that it be would joyous to have, but which I do not possess. The House seems to be in a good mood at the moment.
Representation of the People (Gibraltar)
Motion for leave to bring in a Bill (Standing Order No. 23)
I beg to move,
That leave be given to bring in a Bill to provide for the representation of Gibraltar by a Member of the House of Commons; and for connected purposes.
All 14 of the UK’s overseas territories are different; all are special. All share our monarch, Queen Elizabeth II, as their Head of State; most are internally self-governing. The overseas territory that now sits in a unique constitutional position post-Brexit is Gibraltar. It is the only territory within the European Union and will be leaving the EU with the UK on 29 March 2019. Its relationship with the European Union is quite different from any other part of the Union, in that it is a member of the single market, but not its customs union or Schengen, despite having a land border with the EU. Gibraltar is not to be confused with the Crown dependencies of Jersey, Guernsey and the Isle of Man, which have very different constitutional arrangements and are not in the EU, now or in the future.
Few were surprised that Gibraltar voted remain in the EU referendum. This reflected its residents’ concerns that the EU had played, at times, a role in balancing the often fractious demands of its giant neighbour. The good life and strong economy—a beacon in an area of high regional unemployment—I can but guess also played a part in its local vote for no change.
For over 300 years, Gibraltar and its people have played their part in support of Britain’s history as a global leader in commerce and an international player of influence. It occupies a unique geographical position as the gatekeeper to the Mediterranean and has one of the Royal Navy’s most important international bases. Whenever Gibraltar has been presented with a choice over its future, notably in the shared sovereignty referendum of 2002, Gibraltarians have rejected any change by vast margins. Gibraltar has been and continues to be an unwavering supporter of the UK. Its outstanding support during times of conflict has been continuous, and we have a close relationship built on trust and reciprocal loyalty. Similarly, the people of Gibraltar have strong support in this House. I salute the good work of my hon. Friend the Member for Romford (Andrew Rosindell), as chairman of the all-party parliamentary group on the overseas territories, and my hon. Friend the Member for Bromley and Chislehurst (Robert Neill), the chairman of the all-party parliamentary group on Gibraltar.
Since the decision to leave the EU, the people of Gibraltar and its Government have shown nothing but pragmatism and respect for the decision of the referendum. Nobody could fail to be impressed and reassured by the evidence given by the Chief Minister to the Select Committee on Exiting the European Union in January last year. The UK’s Brexit vote must make us think anew and re-assert once more that the Rock is British and will remain so. Brexit provides us with an opportunity to build further on our relationship and further protect the Rock’s rights and interests. That is best guaranteed by a closer electoral bond, which would also send a clear message to Madrid about the perpetuity of that bond.
Unlike other overseas territories, Gibraltar does not have the option of formal independence, which, however unlikely, would be available to others should they so wish it. The 1713 treaty of Utrecht ceded Gibraltar to Great Britain in perpetuity. The treaty had a sting, in that Gibraltar can only be British or Spanish. Its own unilateral independence is not an option. Whereas most overseas territories have their own currencies or shared currencies—the Eastern Caribbean dollar, under the Eastern Caribbean Currency Union—or use the euro in some cases or the US or New Zealand dollar, only the Falkland Islands, Gibraltar and St Helena, with Tristan da Cunha and Ascension Island, share sterling as their domestic currency.
Gibraltar’s truly unique feature, however, is that it already has electoral links with the UK, via its attachment to the South West region for representation in the European Parliament. That will disappear upon Brexit. The way to protect that attachment is for this Parliament to allow the people of Gibraltar direct representation in this House. There was a cogent argument given then that Gibraltar should be connected to the UK through electoral representation, and there is a clear argument now. Gibraltar’s population is a little light numerically to qualify as a constituency. It has a population of 33,000, with an electoral roll of 23,000. However, this is in the same ball park as—I may need help pronouncing this—Na h-Eileanan an Iar in the Outer Hebrides, a constituency with 21,260 voters.
Of course, we will always respect the devolution of powers that are in place, and having a Gibraltar MP in this House should not be an impediment to Gibraltar’s future constitutional development. Gibraltar’s constitution of 2006 is a tribute to the fact that it has a vibrant and responsible democratic system of government. That is why my Bill would not change the devo-max settlement of its 2006 constitution. If taken further, it would not impose a Westminster MP on Gibraltar. The decision whether to take up the offer of an MP in Westminster for Gibraltar must be made by the residents of Gibraltar alone and decided by their own internal procedures. The mechanics of how that might work would need to be discussed with Gibraltar’s leaders, but I reiterate that it would be for the people of Gibraltar to decide whether to have such representation here in our Parliament, which would become their own.
There is a local campaign group in Gibraltar, called the Representation in Westminster Group, that has been arguing for a number of years that a democratically elected MP in Westminster can only strengthen the Rock’s link with Britain and act as a permanent counter to any Spanish claims. The campaign says that it has already collected almost 9,000 signatures in support of UK Parliament representation, which it will deliver here once 10,000 signatures have been amassed. That is an impressive number—close to half the eligible voters.
As we leave the EU and forge a new global Britain, and given the Rock’s unique constitutional position with its membership of the sterling zone and rich historical links to Britain, there has never been a more appropriate time to cement our relationship with Gibraltar by offering it this constitutional bond. It would signal a perpetual and lasting link of shared interests. Gibraltar may be small, but its success is a matter of pride for the British people. Gibraltar’s constitution gives its citizens full powers of self-governance, other than over foreign affairs, defence, internal security and interest rate monetary policy. Gibraltar has always been and will continue to be a good and true member of the great British family. I very much hope that with this Bill we can reward the Gibraltarian people for their steadfast and loyal support for Britain.
Question put and agreed to.
That Craig Mackinlay, Sir Graham Brady, Maria Caulfield, Sir David Crausby, Tim Farron, Daniel Kawczynski, Priti Patel, Andrew Rosindell, Sammy Wilson and Nigel Dodds present the Bill.
Craig Mackinlay accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 26 October, and to be printed (Bill 231).
[14th Allotted Day]
Confidence in the Secretary of State for Transport
I beg to move,
That this House has no confidence in the Secretary of State for Transport, the Rt Hon Member for Epsom and Ewell; notes the failed implementation of the May rail timetables which has left thousands of commuters without services and has drastically affected their everyday lives; believes Northern and Govia Thameslink Railway should have their franchises terminated; and regrets that the Secretary of State for Transport has failed to strategically manage and oversee the UK railway and take responsibility for his role in the crisis on England’s railways, whilst officials at other organisations have resigned and forgone bonuses.
Before I come to the topic of today’s debate, I would like to express my condolences to the families and friends of those who so sadly died as a result of being struck by a train at Loughborough Junction in south London yesterday. I also pay tribute to all the railway staff who attended in response, in particular the British Transport police. Despite the challenges we face, we can never forget the outstanding public service that tens of thousands of men and women provide every day. We owe it to them to do our very best for the industry.
I regret having to table the motion, but given the totally unacceptable state of the railway I felt that I had a duty to passengers. The latest chaos follows meltdown on the east coast, resulting in a £2 billion bail-out and huge cuts to promised electrification in Wales, the north of England and the midlands. This is not shaping up to be a distinguished legacy. In his resignation letter to staff, Charles Horton, the outgoing chief executive of Govia Thameslink Railway, said:
“In my view, this was an industry-wide failure of the timetabling process. But with leadership comes responsibility and so I feel it is only right that I step down”.
Why is it that the chief executive of a train company who is responsible only for the travel disruption on one part of the railway is able to recognise the responsibility that comes with his leadership role and resign, yet the person who is truly responsible, the Transport Secretary, remains in post?
Does my hon. Friend agree that, ever since the collapse of the west coast main line franchising competition under a predecessor of the Secretary of State, the entire franchising system has become increasingly ridiculous and unworkable, and that the way in which we run our railways needs to be changed entirely?
I could not agree more. We are seeing instance after instance. It is evidence, if any more were needed, that the system has completely and utterly failed and needs to be completely revised. Why are train companies allowed to retain their franchise despite repeated failures? Northern and GTR should be stripped of their contracts. Labour said very clearly that franchise failure should mean forfeit. It is clear that the Department for Transport has failed to ensure that train companies fulfil the terms of their contracts.
Does the hon. Gentleman agree that it is not only GTR that should lose its franchise? The Secretary of State should have his office removed as well because this is a façade of a franchise. We know that Ministers are behind it, and it is Ministers who should be held accountable for the fact that passengers in places such as Preston Park in Brighton are losing their jobs, cannot spend time with their kids in hospital and are having their lives wrecked.
I agree entirely. The Government seem to want to have control and intervene, but they do not want to take responsibility. GTR should have been stripped of its contract years ago for running the worst rail service in modern times. The company has repeatedly been found in breach of its contract as well as overseeing toxic industrial relations and poor customer service. Had the Government heeded Labour’s call to strip the company of its franchise, the recent disruption could have been avoided.
I will give way to the hon. Gentleman.
I thank the hon. Gentleman—he is always kind and courteous with his time. A month ago, I believe that he said at the Dispatch Box that the rail professionals should be allowed to get on and run the industry, but in this instance he is being critical of the Secretary of State for not intervening and stopping that very eventuality occurring. I would like some clarification.
I will come on to that. As an excellent member of the Select Committee on Transport, the hon. Gentleman knows that the DFT sits on those bodies—it has a presence—yet it did nothing when it was given those alarms or warnings that he knows all about.
I shall give way briefly, as I want to make progress.
It is not many months since we had a problem with Southern, as has been mentioned by the hon. Member for Brighton, Pavilion (Caroline Lucas). From time to time there are problems on the west coast main line, yet the Secretary of State sits there like Pontius Pilate and abdicates responsibility.
My hon. Friend make the point wisely and accurately.
My hon. Friend is making a good speech. Yesterday, members of the Transport Committee sat for many hours interrogating leaders of the industry, both train operating companies and Network Rail, trying to find out who runs the railways. After all those hours, answer came there none. Does my hon. Friend agree that there are two scenarios? First, the Secretary of State is in charge, in which case he should take responsibility; or even worse, he is not, in which case he should be sacked?
My hon. Friend makes the point very well. We are talking about a dysfunctional railway that is completely and utterly fractured, and that has to be resolved.