House of Commons
Wednesday 20 June 2018
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Business Before Questions
Gosport Independent Panel
That an humble Address be presented to Her Majesty, That she will be graciously pleased to give directions that there be laid before this House a Return of a Paper, entitled Gosport War Memorial Hospital: The Report of the Gosport Independent Panel, dated 20 June 2018.—(Christopher Pincher.)
Oral Answers to Questions
The Secretary of State was asked—
Leaving the EU
I meet the political parties in Northern Ireland regularly to discuss a range of issues including the UK’s decision to leave the European Union. As I have said repeatedly, these conversations are no replacement for a fully functioning, locally elected and accountable Executive.
During my discussions with political parties, I do need to ensure that we discuss a range of issues, such as the appointments that cannot be made in the absence of Northern Ireland Ministers. I am actively considering the issue of those public appointments, including assessing what action could be taken to address the problem. I will return to the House before the recess to set out my course of action in more detail.
May I thank the Government for their engagement at the highest level with the Democratic Unionist party here on these Benches on a continuing and intensive basis? In the absence of devolution, it is important that Northern Ireland’s voice is heard here, in the corridors of power. I ask the Secretary of State to bear in mind that Monsieur Juncker and Monsieur Barnier go to Dublin tomorrow and that we are likely to hear a lot of harsh rhetoric. Will she encourage them to bear in mind the principle of consent in the Belfast agreement and its successors, and not to take a one-sided approach to this issue in Northern Ireland?
I have been clear, as have all Ministers in this Government, that we are committed to the Belfast agreement and all its principles, including the principle of consent. I hope that the political leaders that the right hon. Gentleman referenced have also heard that message.
The Secretary of State referenced the absence of devolution. Of course, one of the issues is the absence of funding for the Commonwealth youth games in 2021. Will she look carefully at what might be done to bring forward funding for this prestigious event? It should not be stopped as a result of Sinn Féin refusing to form a Government.
I met the Commonwealth Games Federation last week and I am aware of the concerns about this matter. I urge political leaders across Northern Ireland to make clear their support for the Commonwealth youth games in order that the Northern Ireland civil service can release the funds.
There is already a border, which is a tax border, an excise border and, as my right hon. Friend will know very well, a security border. The Government have made some very sensible proposals that whatever the final arrangements are on the border, there should be more authorised economic operators. What discussions has my right hon. Friend had with local parties in Northern Ireland and parties in the Republic of Ireland about extending the use of authorised economic operators?
My right hon. Friend is very aware of and knowledgeable about the border, having been my predecessor in this role as Secretary of State. I can assure him that I have discussed with all political parties—both north and south of the border—the matter of the border and the practical ways in which we can overcome the problems that some people put forward as being an issue.
The EU has been instrumental in helping Northern Ireland to address its legacy issues and in promoting economic development. What are the Stormont parties—or, indeed, the Government—saying needs to be done to address the deficiencies there once the UK leaves the EU?
Many people bear credit for the developments that have happened since the signing of the Belfast agreement and the economic development of Northern Ireland. I say gently to the hon. Lady that perhaps the fact that Northern Ireland is part of the United Kingdom has more of a bearing on its economic strength than many other matters.
The technical note published on 7 June spoke of free trade agreements that could be entered into that would not affect any temporary customs arrangements. What discussion has the Secretary of State had with the parties on specifically what form those free trade agreements might take and who they might involve?
My right hon. Friend the Secretary of State for International Trade is of course responsible for those free trade agreements. However, my hon. Friend alludes to the very important point that for Northern Ireland, leaving the European Union as part of the United Kingdom means that it will have access to those free trade arrangements with the rest of the world and a land border with the European Union. That puts Northern Ireland in a unique, privileged situation.
Brexit is the most fundamental issue that our generation faces. The voice of Scotland is heard through its Parliament and the voice of Wales through its Senedd; the voice of Stormont is silent. What urgent initiatives is the Secretary of State now going to take that will make a material difference in getting Stormont back to work?
The hon. Gentleman is right. In the absence of a functioning Executive, the normal processes—the Joint Ministerial Council meetings, for example—do not have Northern Ireland representation. I am working, together with my officials and Ministers in the Department, to ensure that all Northern Ireland parties are fully apprised of the situation. As he says, the important point is that if an Executive were in place, a full voice for Northern Ireland would be heard in all the normal structures that enable it to be heard.
But it is not just Brexit: there are many urgent decisions now piling up in Northern Ireland. Those decisions cannot be made by civil servants—the High Court has decreed that—and cannot be made by devolved Ministers because there are none. The case of Billy Caldwell is urgent enough for the Home Secretary to act here in England for the Secretary of State’s constituents and mine, so what will she now do to make sure that Billy is not an unwitting victim of this constitutional crisis?
The hon. Gentleman is right: there are a number of matters that are pressing. I have already referred to public appointments. I can also confirm that I will bring forward legislation before the summer recess to put the budget on a statutory footing for 2018-19.
The use of medicinal cannabis is of course a matter for the Home Office for the whole United Kingdom. That is why I welcome the decision by my right hon. Friend the Home Secretary to have a review of the use of medicinal cannabis. I assure the hon. Gentleman that during the whole of last week, officials from my Department were in close contact with health officials in Northern Ireland, and that, across Government, we pressed to make sure that the case of Billy Caldwell was dealt with with suitable respect and dignity for the little boy.
Northern Ireland Economy
This Government are delivering a fundamentally strong economy for Northern Ireland, with unemployment down to 3.3% from over 7% in 2010. Nearly 19,000 new jobs have been created over the last year, the highest number on record, meaning that more people have the security of a regular pay packet for themselves and their families.
Redditch has a proud history of manufacturing businesses that trade with Northern Ireland. One such business is Trimite, which manufactures specialist coatings for the defence and aerospace industries. What assurances can my right hon. Friend give to my constituents at Trimite and other businesses that there is a prosperous global outlook after Brexit?
My hon. Friend makes a very important point about the opportunities for United Kingdom manufacturers—those in her constituency of Redditch and those based in Northern Ireland. The Trade Bill will enable the UK to continue with existing trading arrangements, and that will provide certainty, continuity and reassurance for businesses such as Trimite.
Northern Ireland benefits substantially from being part of the world’s fifth largest economy, with access to an internal UK market of about 65 million people—the most significant market for Northern Ireland businesses, worth £14.6 billion in sales and supporting thousands of jobs. This Government have built a strong economy that can invest in services such as the NHS and deliver public spending. On Monday, I visited Omagh to see the Strule shared education campus, which is benefiting from £140 million of funding from this Government.
In welcoming the progress in the economy in Northern Ireland, does the Secretary of State realise that sport plays an important part in that? On Friday, the Commonwealth Games Federation will meet to decide whether Belfast will get the youth games. It is a small amount of money. Birmingham is getting a huge amount for the Commonwealth games the following year. The permanent secretary has said no, so will she step in?
We know that the greatest roadblock to economic growth in Northern Ireland is the lack of an Assembly being in place. That economic difficulty is being created because no decisions can be made. What measures are the Department and the Secretary of State taking to allow that to happen, so that we can go forward?
The hon. Gentleman will know that there is an appeal against the Buick judgment, which I think is what he was referring to. That appeal will be heard on Monday, and we await the outcome of it, but the Government stand ready to take whatever decisions are necessary.
Leaving the EU: Border Policing
Clause 43 of the December joint report makes it absolutely clear that there will be no physical infrastructure or related checks and controls on the border. As for the use of technology, the hon. Gentleman will be aware that the details of a potential solution have yet to be worked out.
I thank the Minister for his response. He will be aware that the Government’s own assessment shows the economy being damaged by the Government’s plans and that the least worst option is staying in the customs union and the single market. Is that the case, or does he have alternative economic advice that he could publish?
I do not accept the hon. Gentleman’s analysis. The fact is that the Northern Ireland economy is doing very well, with the lowest unemployment rate in the country, and exports are increasing. On the single market and the customs union, let me be absolutely clear: the people of the United Kingdom collectively voted to leave the EU, and that includes the customs union and the single market.
In recent discussions with the political parties in Northern Ireland, was the issue of the European arrest warrant raised? Will the Secretary of State come to the House and make a statement on the serious implications for the Police Service of Northern Ireland if the availability of the European arrest warrant were closed down to the Chief Constable?
I can assure the hon. Lady that my right hon. Friend the Secretary of State spoke to the Chief Constable this morning about the European arrest warrant. We very much hope to have, as the Prime Minister has suggested, a UK-EU security treaty that will be all-embracing and bespoke. As the GCHQ director Jeremy Fleming said this morning, it is important to recognise that four European countries have benefited directly from our intelligence in the past year.
With regard to the border, throughout Operation Banner and the troubles in Northern Ireland, the military and the police desperately tried to get a hard border between the north and south. We would blow up crossing points and the following morning they would be open again. With the automatic number plate recognition that we have now, there should be no hard border, and I cannot see how it could be possible.
The threat from Northern Ireland-related terrorism continues to be severe in Northern Ireland, meaning an attack is highly likely. The Government provided the Police Service of Northern Ireland with £230 million between 2010 and 2016, and we are providing a further £160 million in this Parliament. Our response to terrorism and paramilitary activity is co-ordinated, effective and fully resourced.
I welcome what my right hon. Friend says, but how can it be right that loyal octogenarian veterans now have to look over their shoulders as a result of spurious and vexatious complaints in relation to allegations of which they have already been cleared? Is it not time for a statute of limitations to back our servicemen and women?
My hon. Friend is a doughty campaigner for his constituents on this matter. I am sure he will agree with me that the current mechanisms for investigating the past are not delivering either for victims or for veterans. Right now, too many cases are not being investigated, including hundreds of murders by terrorists.
The Chief Constable in Northern Ireland has expressed some concerns about cross-border security in today’s Belfast Telegraph. Will the Secretary of State give us some assurances about what discussions she has had with the Irish Government to allay the concerns that the Chief Constable has raised?
Some of those responsible for ensuring the peace in Northern Ireland during the days of the troubles are now being summoned to court again. Many of these individuals are suffering from all kinds of post-traumatic stress disorders and are terrified about going back to Northern Ireland. Will my right hon. Friend ensure that anyone called back to court will be wrapped around with a package that makes them feel safe and secure?
My right hon. Friend, who has served in the Northern Ireland Office, knows a great deal about this matter. He is right that the current situation simply is not working—it is not working for victims and it is not working for veterans—and that is why we want to deal with it.
With viable devices being found in County Down as recently as the start of this month, will the Secretary of State outline what discussions she has had with the Chief Constable to ensure there are sufficient resources and sufficient police officers on duty in stations throughout County Down to make sure that terrorists do not succeed?
Further to the question of the hon. Member for North Down (Lady Hermon), Michel Barnier has said this week that the United Kingdom could not remain in the European arrest warrant system post Brexit. What plans does the Secretary of State have to meet this concern, and to address the issue of the 300 additional PSNI officers for which there will be a vital need post Brexit?
Article 50 Negotiations
There is regular engagement by the Secretary of State for Exiting the European Union with the EU’s chief negotiator, and my right hon. Friend the Secretary of State for Northern Ireland hopes to have a meeting with the chief negotiator for the EU very soon.
I am grateful to the Minister for that answer. Will the Minister therefore enlighten the House about the timetable for publishing the Government’s policy on the backstop for the Northern Ireland border, and as I say, with the discussions ongoing, will the Secretary of State discuss that with the chief negotiator?
Does the Minister agree that threats from the European Union about having a hard border in Northern Ireland are simply unhelpful, and that what we need is co-operation in the use of technology so that things can continue to flow just as they do today?
May I just say that the European Commission has agreed, in the joint report it signed in December, that there will be no hard border—no physical infrastructure on the border? It is also incumbent on us to make sure that the details of the Belfast agreement are met, which means ensuring that there is not a hard border.
As I said earlier, we will not be giving an ongoing commentary on all our meetings. However, I can assure the hon. Gentleman that we have the implementation period until the end of December 2020, and then the backstop agreement, but only if that is required under specific circumstances, and no more.
Leaving the EU: Agricultural Sector
I recognise how fundamental agriculture is to Northern Ireland economically, socially and culturally.
The Secretary of State and I are fully committed to ensuring that, as negotiations progress, the unique interests of Northern Ireland are protected and advanced. We want to take the opportunities that leaving brings to reform the UK’s agricultural policy and ensure we make the most of those for our farmers and exporters.
Bagged salad, seed potatoes and beef are the high-quality products that make up around a third of Northern Irish farmers’ exports. Those farmers rely on the EU for around 90% of their income, and they would see animal and plant health tariffs and produce checks as a nightmare. How can the Minister guarantee those farmers a future income and a market while also guaranteeing environmental standards?
The hon. Gentleman is right: agriculture and farming is a massive industry in Northern Ireland. Some 49,000 people are employed in the sector and there are 25,000 farms. What I will say to him is that if we can get that overall economic framework with the EU through negotiations, the tariffs he refers to will not apply.
Armed Forces Veterans: Legacy Investigations
I have regular discussions with the Secretary of State for Defence about a number of issues relating to Northern Ireland.
This House knows that, were it not for the bravery of the British Army, the Ulster Defence Regiment and the Royal Ulster Constabulary, George Cross, there would never have been a Good Friday agreement. Yet the Secretary of State's proposals include legacy investigations into veterans—in some cases going back 50 years. Will she agree to give evidence to the Defence Committee inquiry into this matter so that we can ask her how her proposals are compatible with the principles of the armed forces covenant?
I agree wholeheartedly with my right hon. Friend. As I said at the recent Police Federation conference in Northern Ireland, we owe all those who served an enormous debt of gratitude. Without the contribution of our armed forces and police, there would quite simply have been no peace process in Northern Ireland. I want to reassure my right hon. Friend that we are consulting on how to address the legacy of the past. This is a consultation.
Chester is a garrison city, and numerous constituents who have retired from the services are affected by uncertainty. I have no problem with crimes being investigated where there is evidence, but what comfort can the Secretary of State give those servicemen and ex-servicemen in my constituency who have served honourably and are living under a cloud of suspicion and uncertainty?
Those people are living under that cloud of uncertainty under the current system, and I want to see an end to the disproportionate focus on our veterans that is happening under that current mechanism. There is widespread agreement that the current system is not working. I urge the hon. Gentleman and all his constituents to respond to the consultation—we are consulting.
An end to disproportionate focus is not the answer we need. What we need is for a line to be drawn, and the way to draw that line is to have a statute of limitations and a truth recovery process. Why has the Secretary of State excluded that from the consultation when it was supposed to be included?
Our armed forces and security forces served bravely and valiantly during the troubles. What action has the Secretary of State taken to ensure that no one who served is unnecessarily dragged into the criminal justice system for actions that have already been investigated?
The consultation entitled “Addressing the Legacy of Northern Ireland’s Past” launched on 11 May and will run until 10 September. We are determined to provide a better outcomes for victims and survivors, and to ensure there is not a disproportionate focus on former soldiers and police officers.
Even though it is absent from the legacy consultation, and further to the questions asked by my right hon. Friends the Members for Rayleigh and Wickford (Mr Francois) and for New Forest East (Dr Lewis), will the Secretary of State reconsider promoting a statute of limitations so that veterans are protected from legal assault and are not hounded into old age?
The Prime Minister was asked—
Yesterday marked one year since the attack on the Finsbury Park mosque. That truly cowardly attack was intended to divide us, but we will not let that happen. We have been joined today by the imam of the mosque, Mohammed Mahmoud, and I am sure that Members from across the House will join me in paying tribute to his extraordinary bravery and dignity. [Hon. Members: “Hear, hear.”]
Friday is the 70th anniversary of the arrival of the MV Empire Windrush at Tilbury docks. It is right that we recognise and honour the enormous contribution of the Windrush generation and their descendants. That is why we have announced an annual Windrush Day, which will keep alive their legacy for future generations and ensure that we all celebrate the diversity of Britain’s history.
This morning I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.
I concur with the Prime Minister’s remarks concerning the terrorist attack on the Finsbury Park mosque. One year on, it is right that we remember it.
Following the agreements to which the UK signed up at the Paris climate change summit, will the Prime Minister now commit to a new UK climate change target of zero net emissions before 2050?
The United Kingdom has been leading the way in relation to dealing with climate change. The United Kingdom was, I think, the first country to bring in legislation relating to it, and the Government have a good record in dealing with these issues. Crucially, we have ensured that we remain committed to the Paris accord. I pay tribute to my right hon. Friend the Member for Hastings and Rye (Amber Rudd), who played a key role in ensuring that the Paris accord was agreed to and that everybody signed up to it.
I reassure my hon. Friend that I agree with him: upskirting is a hideous invasion of privacy. It leaves victims feeling degraded and distressed. We will adopt this as a Government Bill. We will introduce the Bill to the Commons this Thursday, with Second Reading before the summer recess, but we are not stopping there. We will also ensure that the most serious offenders are added to the sex offenders register, and victims should be in no doubt that their complaints will be taken seriously and perpetrators will be punished.
I join the Prime Minister in welcoming my friend, Imam Mohammed Mahmoud, here today. He showed enormous humanity and presence of mind on that terrible day a year ago, when he prevented violence from breaking out on the streets of my constituency. I thank him and all the religious leaders in the local community who did so much to bind people together. As a country, we should be bound together in condemning racism in any form wherever it arises.
I was pleased that the Prime Minister mentioned the Windrush generation. I, too, join her in commemorating that event, when the Windrush generation arrived in this country. I hope that the hostile environment will be put behind us, and that we will take a special moment today to welcome a daughter of the Windrush generation as a new Member of this House. My hon. Friend the Member for Lewisham East (Janet Daby) brings to this House enormous experience of dealing with the problems of poverty and dislocation in her borough, and she will make a great contribution to the House.
Today marks World Refugee Day—a time to reflect on the human misery of 65 million refugees displaced across the globe. There is a responsibility on all political leaders both to aid refugees and to act to tackle the crises and the conflicts that drive this vast movement of people.
The Prime Minister said—[Hon. Members: “A question?”] Thank you. The Prime Minister said that extra funding for the national health service will come from three sources: Brexit, economic growth and the taxation system. Well, there can be no Brexit dividend before 2022. Economic growth is the slowest since 2009, so which taxes are going up?
The right hon. Gentleman mentioned a number of issues in his opening question. First, I take this opportunity to say that when I visited Finsbury Park mosque after the attack, I was struck by the very close work that was being done by a number of faith leaders in that community. I commend them for the work that they are doing—they were doing it then, and that I know they continue to do it. We see such work in other communities, including in my own constituency of Maidenhead.
The right hon. Gentleman ended up by asking a question, I think, on the national health service, so can I be very clear about this? We have set out a long-term plan for the NHS. That is securing the future for the national health service. We have set a five-year funding settlement. That will be funded. There will be money that we are no longer sending to the EU that we will be able to spend on our NHS—[Interruption.] Hon. Members may shout about this, but I know that that issue is not the policy of Labour Front Benchers. In relation to money that we are no longer sending to the EU being spent on the NHS, the shadow Housing Secretary called it “bogus”, and the shadow Health Secretary said it was a deceit. Perhaps I can tell them what another Labour Member said a few weeks ago:
“we will use funds returned from Brussels after Brexit to invest in our public services”.
That was the right hon. Gentleman, the Leader of the Opposition.
I am very pleased that the Prime Minister is reading my speeches so closely. I said that the money sent to the EU should be ring-fenced to replace structural funds to regions, support for agriculture and the fishing industry, and funding for research and universities.
May I remind the Prime Minister that my question was about taxation to deal with the NHS promises she made at the weekend. Last year—she might care to forget last summer, actually—she wrote in the Conservative manifesto:
“Firms and households cannot plan ahead”
with the threat of unspecified higher taxes. By her own admission, households and businesses need to plan, so can she be straight with people? Which taxes are going up and for who?
As I said on Monday, my right hon. Friend the Chancellor will set out the full funding package. We will listen to people and he will set it out properly before the spending review. I am interested that the right hon. Gentleman has now confirmed that the Labour party thinks there will be money coming back from the European Union. I think there is one circumstance in which there would be no money coming back from the EU: if we adopted Labour’s policy of getting a deal at whatever price.
At the weekend, the Prime Minister said that
“about £600 million a week more in cash”
would be spent on the NHS. She continued:
“That will be through the Brexit dividend.”
Our net contribution to the European Union is about £8.5 billion a year, but £600 million a week is more than £30 billion a year. Her figures are so dodgy that they belong on the side of a bus. We expect that from the Foreign Secretary, but why is the Prime Minister pushing her own Mickey Mouse figures?
The right hon. Gentleman thanked me earlier for reading his speeches. I suggest that he or perhaps his researchers spend a little more time carefully reading and listening to what I actually say. He claims that I said that by 2023-24 there would be £600 million more in cash terms per week spent on the NHS from the Brexit dividend. No, I did not say that. I said the following: there will indeed be around £600 million more spent on the NHS every week in cash terms as a result of a decision taken by this Conservative Government to secure the future of the NHS. That will partly be funded by the money we no longer spend on the European Union. As a country, we will be contributing a bit more. We will listen to views on that, and my right hon. Friend the Chancellor of the Exchequer will bring forward the package before the spending review. If the right hon. Gentleman is so concerned about people’s taxation, why, when we increased the personal allowance, thereby taking nearly 4 million people out of paying income tax altogether, did he and the Labour party oppose it?
Last night, the Prime Minister sent an email to Conservative party members telling them:
“The money we now send to the EU will go to the NHS”.
The Government’s own Office for Budget Responsibility says we will not see any dividend until at least 2023. The Prime Minister talks about a strong economy, but our economic growth last year was the slowest of any major economy, and it has already been downgraded this year. If growth does not meet expectations, does that mean—this is the question—extra borrowing or higher mystery taxes?
It is the balanced approach that this Government take to our economy that has enabled us—[Interruption.] Oh, they all groan! They do not like to hear that there is a fundamental difference between us and the Labour party. We do believe in keeping taxes low, we do believe in putting money into our public services, and we also believe in dealing with our debt and making sure that we get debt falling. What would the Labour party do? The Labour party would not have money to put into the national health service, because the Labour party would bankrupt our economy. And yes, if we are talking about the amount of money that is being put into the NHS, let us just look at what the Labour party offered at the last election. The Labour party said that 2.2% more growth for the NHS would make it
“the envy of the world”.
Well, I have to say to my right hon. and hon. Friends that I chose not to listen to that. We are not putting in 2.2% more growth; we are putting in 3.4% more growth.
Under Labour the NHS increase would have been 5% this year, and the Institute for Fiscal Studies confirmed that this year there would be £7.7 billion more for the NHS. What is the Prime Minister’s offer? She has promised £394 million per week without saying where any of it is coming from, apart from those mysterious phantom taxes that the Chancellor is presumably dreaming up at this very moment.
There is a human element to all issues surrounding the national health service and public spending. Let me give an example. Virginia wrote to me last week. She said:
“my diabetic daughter has fallen down on 4 occasions in the last month. She has both legs in plaster and is being told there isn’t enough money for the NHS to give her a wheelchair”.
The IFS says that the NHS needs 3.3% just to maintain current provision, which I remind the Prime Minister is at crisis levels. Does she think that standing still is good enough for Virginia, or for anyone else who is waiting for the treatment that they need and deserve?
We are putting in extra money to ensure that we see improved care in the NHS. Let me remind the right hon. Gentleman what the chief executive of NHS England, Simon Stevens, has said of our announcement. He said:
“we can now face the next five years with renewed certainty. This multi-year settlement provides the funding we need to shape a long-term plan for key improvements in cancer, mental health and other critical services.”
If the right hon. Gentleman wants to talk about what the Labour party does in relation to the health service—and that is where he started—let us look not at what it says, but at what it actually does. For every £1 extra that we spend on the NHS in England, Labour in Wales spends only 84p. Typical Labour: say one thing and do another.
Health spending grew by 5% in Wales last year, rather more than in England. The Prime Minister’s 3.4% is actually just 3%, as it is only for NHS England. There is nothing for public health budgets, nothing for community health, and, vitally, nothing for social care. That is less than is needed just to stand still.
After the longest funding squeeze in history, A&E waits are at their worst ever, 4 million people are now on NHS waiting lists, and the cancer treatment target has not been met for over three years. Nurse numbers are falling, GP numbers are falling, and there are 100,000 staff vacancies. NHS trusts are £1 billion in deficit, and there is a £1.3 billion funding gap in social care. The Prime Minister is writing IOUs just to stand still. Until the Government can be straight with people about where the money is coming from, why should anyone, anywhere, trust them on the NHS?
I will tell the right hon. Gentleman why people should trust us on the national health service. Over the 70 years of the NHS, for 43 of those years it has been under the stewardship of a Conservative Government. Despite taking difficult and necessary decisions on public spending in 2010 as a result of the deficit left by the last Labour Government, we have consistently put extra money into the NHS. We have now announced a national health service plan that gives it certainty of funding for the next five years, and, working with clinicians and others in the NHS, we will see a 10-year plan to improve services and to improve care for patients. The right hon. Gentleman can stand up here all he likes and talk about the Labour party’s plans for money, but what we know is that the Labour party’s plans would bankrupt this economy. The IFS has said:
“Labour would not raise as much money as they claim even in the short run, let alone the long run.”
In short, its plan “absolutely doesn’t add up”: Conservatives putting more money into the national health service; Labour losing control of the public finances and bankrupting Britain.
I thank my hon. Friend for continuing to highlight this important issue of family support and family relationships, and we are determined to do as much as we can to support families. That is why we are providing for high-quality relationships education, helping children to be equipped and prepared to maintain healthy and respectful relationships in their adult lives. The Department for Work and Pensions is providing relationship support services to families through the voluntary sector, and, backed up by up to £39 million, the reducing parental conflict programme will help councillors across England integrate support for family relationships into the local services for families. As my hon. Friend says, and as she has said before, children who are exposed to frequent, intense and poorly resolved conflict can experience a decline in their mental health; we understand the importance of supporting families at an early stage.
May I associate myself with the remarks of the Prime Minister on the incident a year ago at the Finsbury Park mosque?
Many of us in this House will be aware of the deeply distressing audio and images of children separated from their parents in US detention centres. Infants as young as 18 months are being caged like animals, babies of eight months are being left isolated in rooms, and last night the former head of US Immigration and Customs Enforcement said he expects hundreds of these children never to be reunited with their parents—lost in the system, orphaned by the US Government. Is the Prime Minister still intending to roll out the red carpet for Donald Trump?
May I first of all say to the right hon. Gentleman that I am pleased to see him in this Chamber to be able to ask his questions? But on the very important issue he has raised of what we have seen in the United States, the pictures of children being held in what appear to be cages are deeply disturbing: this is wrong; this is not something that we agree with. This is not the United Kingdom’s approach; indeed, when I was Home Secretary I ended the routine detention of families with children. We have a special, long-standing and enduring relationship with the United States and there will rightly be a range of issues that I will be discussing with President Trump about our shared interests, and it is important that we make sure that when we welcome and see the President of the United States here in the United Kingdom we are able to have those discussions, which mean that when we disagree with what they are doing we say so.
I have to say that that is a disappointing answer from the Prime Minister. We should all be unreservedly condemning the actions of Donald Trump, and I ask the Prime Minister to do that. On the issue of immigration, while the US Administration call it a zero-tolerance policy, the Prime Minister calls it a hostile environment. We know that this Government detain children in detention centres here in the UK. The UK is the only EU country to detain people indefinitely. Will the Prime Minister today, on World Refugee Day, show some leadership and end her policy of indefinite detention?
First, in relation to the right hon. Gentleman’s question about what is happening in the United States, I clearly, wholly and unequivocally said that that was wrong. On the issue of the detention policy here in the United Kingdom, he referred to the detention of families with children and, as I have said, we ended the routine detention of families with children early after 2010. We do, on occasion, need to detain people, but we take their welfare extremely seriously. That is why, when I was Home Secretary, I commissioned Stephen Shaw, the former prisons and probation ombudsman, to look at this issue. As a result of his report, we introduced the at-risk policy, which means that we have a clear presumption that adults who are at risk should not be detained, along with better mental health provision for them. We have asked him to go back and look at this issue again, and he has reported. We are carefully studying that report and will publish in due course.
My hon. Friend is absolutely right to say that care proceedings should be a last resort. They should be undertaken only after other steps have failed, because we want every child to be in a stable, loving home that is right for them. The sector-led review that she mentions is an important contribution to work that is being done across the family justice system to address the pressure caused by rising public law volumes in family courts, and we are carefully considering the report’s findings and recommendations.
First, I have just said in response to questions about the pictures and the behaviour that we have seen in the United States and about the way children are being treated, that is clearly, wholly and unequivocally wrong. On the wider issue of the President of the United States coming here to the United Kingdom, there are many issues that Members of this House—including the hon. Gentleman’s right hon. Friend the Leader of the Opposition—consistently encourage me to raise with the President of the United States. We do that: when we disagree with the United States, we tell them so. We also have key shared interests with the United States, in the security and defence field and in other areas, and it is right that we are able to sit down and discuss those issues with the President. He is the President of a country with which we have had, and will continue to have, a long-standing special relationship.
I completely understand my hon. Friend’s concerns and have dealt with issues of contaminated land sites and development on them in my constituency in the past. We take local residents’ safety seriously in relation to contaminated land, and we ensure that the guidance is regularly updated. Developers are already required to ensure that they comply with a host of legal and regulatory safeguards before they build on contaminated land, and we also require that they work in conjunction with the Environment Agency and meet building regulations to ensure residents’ safety.
I offer my deepest sympathies to those suffering from severe conditions where other treatments have not been effective and where cannabis-based medicines have the potential to help. I recognise that people suffering from such issues will of course want to look to alleviate their symptoms, but it is important that medicines are carefully and thoroughly assessed to ensure that they meet rigorous standards, so that doctors and patients are assured of their efficacy, their quality and their safety
My right hon. Friend the Home Secretary announced a two-part review yesterday. We see from recent cases that we need to look at this carefully, and the first review will be carried out by the chief medical officer followed by a review from the Advisory Council of the Misuse of Drugs. My right hon. Friend is also acting to set up an expert panel of clinicians that can advise Ministers on any applications to prescribe cannabis-based medicines.
I am happy to join my hon. Friend in commending the work of the groups in her constituency that she referred to, such as Brightlife and Age UK. She is right that Saturday marked the two-year anniversary of the death of Jo Cox, but she is also right that Jo Cox’s legacy lives on every day in the work on the issues that she cared about, particularly loneliness. I was pleased that we were able to announce £20 million to combat loneliness, and that will be used to help bring people together, to explore the use of technology to connect people in remote areas and to improve transport connections to make face-to-face contact easier. Jo was passionate about seeing a step change in how we deal with loneliness in this country, and we are determined to support the continuation of her work after her sad and tragic death.
There are many good examples of mutuals and co-operatives that operate in our economy, and they do well and provide services to individuals. There is no limit on the number of mutuals and co-operatives that could be set up. We want a mixed economy, and they play an important part.
As my hon. Friend says, he has been a consistent campaigner on this particular issue. We have announced over £3.9 billion of new additional capital funding for the NHS up to 2022-23, and the majority of that is to support the implementation of the local sustainability and transformation partnership plans. Major projects are under consideration across the country, and we intend to announce one large-scale scheme the size of the Shrewsbury and Telford plan every year going forward. They will be based on high-quality plans, but they will arise from local NHS leaders. It is important that such plans are driven by the local NHS, but they will ensure better care for patients.
I thank the hon. Gentleman for raising this important issue. Our sympathies are with the family.
We take the teaching of water safety very seriously, which is why we are supporting the National Water Safety Forum’s national drowning prevention strategy, which aims to achieve a 50% reduction in drownings by 2026 by encouraging people to stay safe while enjoying themselves. We have made sure that swimming and water safety is compulsory in the national curriculum for physical education at primary level, but we recognise there is more to do. We have established an implementation group, and we are reviewing the recommendations of the report, which is part of the Sporting Future strategy that aims to improve the swimming curriculum.
I can absolutely give my hon. Friend that assurance. We do not want to see money going to the NHS and being wasted or spent on bureaucracy, and not actually getting to patient care. That is why it is so important that, alongside the extra money, as part of the 10-year plan we will be working with the NHS on making sure not only that we see better outcomes for patients as a result of this extra money but that the money is spent wisely and in the interest of patients.
The hon. Lady refers to documents that she describes as having been leaked from the Department for Transport. No Government respond from the Dispatch Box to leaked documents they have not seen. In advance of the timetable changes for both Northern and Govia in May, a separate independent panel was set up by the DFT to reassure the Department about the nature of those plans.
Is the Prime Minister aware that Birmingham airport will have 15% fewer international flights than otherwise, and that Manchester airport will have 11% fewer, Newcastle 14% will have fewer and Bournemouth will have more than 40% fewer, by 2030 as a result of Heathrow expansion? How do we help investment in our regions by suffocating the regional airports’ growth?
My right hon. Friend asks about expanding Heathrow and the impact it is going to have on regional airports, so may I just tell her one anecdote? When we made our first announcement about the in principle decision on the third runway at Heathrow, I went down to Cornwall and visited Newquay. People there were very pleased and welcomed the announcement, because of the ability it was going to give them to improve their local economy and expand their tourist industry, in particular.
I recognise the value of community pharmacies. I think everybody across this House recognises the valuable work they do in communities, and indeed we have recognised it with our £100 million contribution to a health transformation fund. We have done and will continue to do what we can in the absence of an Executive to protect the delivery of vital public services. The Secretary of State’s budget for 2018-19 addresses the key pressures across public services, including the Northern Ireland health service, and she will be bringing forward legislation to put the budget position on a legal footing. I know that she will be more than happy to meet the hon. Gentleman to discuss this issue further.
May I join the Prime Minister and the Leader of the Opposition in paying tribute to the bravery of the imam from the mosque in Finsbury Park? May I also pay tribute to two people who are also in the Gallery today and who have shown dignity, bravery and integrity: the parents of Alfie Dingley? Alfie got the licence yesterday so that he will not have so many fits, which is what we know this treatment will do. I thank the Prime Minister and, in particular, the Attorney General for their input into this, but I want us to try to work with the family so that we can speed this up for other families. I know that is the most important thing the family want now.
I say to my right hon. Friend that I, too, welcome the parents of Alfie Dingley and commend them for the dignity they have shown in dealing with this difficult issue of ensuring that what they wanted to see for their son was available. As my right hon. Friend has said, a licence has now been issued, but it is right—this is the point of the reviews that my right hon. Friend the Home Secretary has set up—to make sure that our process of considering these drugs to ensure that they are going to be efficacious and safe for patients is not a long drawn-out one, because the length of process, as, sadly, Alfie’s parents found, can be deeply distressing.
The European Union and Michel Barnier say that they do not want a hard border on the island of Ireland, and we agree with that, but in his remarks yesterday on security co-operation he seemed to be erecting barriers in the way of the best possible co-operation between the UK and the rest of the Europe. The Belfast Telegraph, in its editorial today, says that this brinkmanship by the EU is a boon to terrorists. Will the Prime Minister make it clear that that kind of approach is completely wrong? It appears that the EU wants to make Brexit harder for the UK but easier for those who want to cause damage across Europe.
The future security partnership we want with the EU is an important part of the deal that we are negotiating with it. I set out our intentions on that security partnership in the speech I gave at the Munich security conference. I fully recognise the importance of this, and in particular, of some of the instruments we have been able to use within the European Union, to the working of the police across the border of Northern Ireland and Ireland, and to ensuring that those who would seek to do the people of Northern Ireland harm are apprehended, prevented from doing so and brought to justice. I am absolutely clear that that security partnership is a key, important and essential element of what we are negotiating.
In the Gallery today are two young men from my Cleethorpes constituency, Callum Procter and Oliver Freeston, both of whom won seats on North East Lincolnshire Council at last month’s elections. Oliver is just 18 years old and is perhaps the youngest councillor in the country. Will the Prime Minister congratulate Callum and Oliver? Does she agree that it is this country that provides the policies that allow young people to prosper and be successful?
I am very happy to welcome Callum and Oliver and to congratulate them on their important success in the May local government elections. The fact that it is under this Government and this party that we see an 18-year-old taking a seat on the council shows that, as my hon. Friend says, it is this Government who are ensuring that young people have the opportunities to prosper and to pursue their hopes.
The conclusions of the Gosport independent panel, which I set up with the Secretary of State’s support when I was a Minister, are truly shocking, not only because of the fact that 456 people lost their lives following the inappropriate prescribing of opioids, but because there was a closing of ranks that prevented families from getting to the truth. Does the Prime Minister agree that there now needs to be an independent and thorough police investigation by another force? Will she agree to meet me and family representatives to discuss the report’s implications? Does she agree that we must never again ignore families in this way and that there must be a mechanism whereby when allegations of wrongdoing are raised, they are investigated immediately, and that that mechanism must include the family?
My thoughts, and I am sure those of everybody in the House, will be with all the families of the patients who died as a result of what happened at Gosport War Memorial Hospital. The events there were tragic and deeply troubling, they brought unimaginable heartache to the families concerned, and they are a matter with which the whole House should be concerned. The right hon. Gentleman raised the way in which the public sector often, in his terms, closes ranks; that is an issue that we have to deal with across the public sector.
I pay tribute to the right hon. Gentleman for establishing the inquiry when he was a Minister. I am sorry that it took so long for the families to get the answers from the NHS. I thank Bishop Jones and his fellow panel members for what they have done, and I would be happy to meet the right hon. Gentleman with Bishop Jones. This case shows why it is absolutely right that my right hon. Friend the Secretary of State for Health and Social Care has been putting such a focus on patient safety and transparency in the NHS, because we need to ensure that we do not see these things happening in future. The findings are obviously distressing and deeply concerning. Of course, measures have been put in place to deal with issues, and my right hon. Friend the Secretary of State will make a statement on the report shortly.
Peak hurricane season is due to hit Bangladesh and the Rohingya in the camps there. The UK is leading in the provision of aid to the Rohingya; other countries pledge aid but do not deliver. What more can the Government do to put pressure on those countries that renege on their pledges of aid for the Rohingya?
My hon. Friend raises an important point: this country not only says what it is going to do but actually puts its money where its mouth is and goes out and helps people around the world, including the Rohingya in the circumstances to which she referred. We will continue to put pressure on all those countries that say they will do something but do not actually deliver the money, to ensure that they do.
I want to return to the broader context of the question asked by my hon. Friend the Member for Luton South (Mr Shuker). This has been a chilling week for those of us from right across the House who believe in the values of tolerance and diversity. It is not just President Trump: Viktor Orbán has proposed a new tax on organisations that defend refugees and the Italian Government are targeting the Roma people. It is good that the Prime Minister said that President Trump’s policy is wrong, but I want her to do more, and I think that the House wants her to do more. What is she going to do proactively to defend those values? What work is she going to do with Chancellor Merkel and President Macron to make it clear to the rest of the world and to the European Union that these other values, which are so inimical to our country, cannot stand?
We do work with Governments across Europe, particularly with the French and German Governments, on these issues of migration in relation to Europe. We expect all members of the international community to adhere to international law and commitments to human rights. As a Government, we oppose extremism in all forms, including when such extremism threatens to damage ethnic and community relations. We believe in the fundamental values of liberty, of democracy and of respect for human rights. We will continue to work with others to ensure that it is those values that are pre-eminent in everything that we and they do.
The Prime Minister’s renewed commitment to the NHS is extremely welcome. Recently, the Health and Social Care Committee visited the Larwood House GP surgery in Worksop where, generally, all patients are seen by the doctors the same day. What more can the Government do to make sure that this best practice among GP practices is spread across the whole country so that all of our constituents can get in to see a doctor when they need to?
My hon. Friend raises a very important point. One principle underpinning what we will be looking to the NHS to do across its 10-year plan is to ensure that the best practice that we see in many parts of the NHS is indeed spread across the whole of the NHS so that patients are able to get the access and the same standards that they need across the NHS. I commend the work that has been done in the GP surgery to which he has referred in his constituency. This is very important. I also commend work that is being done elsewhere to bring services together to ensure that patients see an improvement in the care and treatment that they receive.
The last Labour Government oversaw a 5.9% increase in spending on the NHS. The Thatcher and Major Governments managed 3.6%. So far, the Prime Minister’s predecessor, David Cameron, and the right hon. Lady herself have managed 1.9%. Why, therefore, are we meant to be happy and amazed by her unfunded pledge to deliver an increase of 3.4%, which is under the annual average achieved since the NHS was first created?
As was recognised by the chief executive of NHS England, this is the funding that the NHS needs. Crucially, giving a multi-year funding settlement based on a long-term 10-year plan will give the NHS the stability and the certainty that it needs to be able to introduce the transformation that we all want to see in patient care. We will also ensure that, unlike what happened under the Labour party, this money will be seen in improved patient care.
Gosport Independent Panel: Publication of Report
This morning, the Gosport Independent Panel published its report on what happened at Gosport Memorial Hospital between 1987 and 2001. Its findings can only be described as truly shocking. The panel found that, over the period, the lives of more than 450 patients were shortened by clinically inappropriate use of opioid analgesics, with an additional 200 lives also likely to have been shortened if missing medical records are taken into account.
The first concerns were raised by brave nurse whistleblowers in 1991, but then systematically ignored. Families first raised concerns in 1998 and they, too, were ignored. In short, there was a catalogue of failings by the local NHS, Hampshire constabulary, the General Medical Council, the Nursing and Midwifery Council, the coroners and, as steward of the system, the Department of Health.
Nothing I say today will lessen the anguish and pain of families who have campaigned for 20 years for justice after the loss of a loved one. But I can at least, on behalf of the Government and the NHS, apologise for what happened and what they have been through. Had the establishment listened when junior NHS staff spoke out, and had the establishment listened when ordinary families raised concerns instead of treating them as “troublemakers”, many of those deaths would not have happened.
I pay tribute to those families for their courage and determination to find the truth. As Bishop James Jones, who led the panel, says in his introduction:
“what has to be recognised by those who head up our public institutions is how difficult it is for ordinary people to challenge the closing of ranks of those who hold power...it is a lonely place seeking answers that others wish you were not asking.”
I also thank Bishop Jones and his panel for their extremely thorough and often harrowing work. I particularly want to thank the right hon. Member for North Norfolk (Norman Lamb), who, as my Minister of State in 2013, came to me and asked me to overturn the official advice he had received that there should not be an independent panel. I accepted his advice and can say today that, without his campaigning in and out of office, justice would have been denied to hundreds of families.
In order to maintain trust with the families, the panel followed a “families first” approach in its work, which meant that the families were shown the report before it was presented to Parliament. I, too, saw it for the first time only this morning, so today is an initial response and the Government will bring forward a more considered response in the autumn.
That response will need to consider the answers to some very important questions. Why was the Baker report, completed in 2003, only able to be published 10 years later? The clear advice was given that it could not be published during police investigations and while inquests were being concluded, but can it be right for our system to have to wait 10 years before learning critically important lessons that could save the lives of other patients? Likewise, why did the GMC and NMC, the regulators with responsibility for keeping the public safe from rogue practice, take so long? The doctor principally involved was found guilty of serious professional misconduct in 2010, but why was there a 10-year delay before her actions were considered by a fitness to practise panel? While the incidents seemed to involve one doctor in particular, why was the practice not stopped by supervising consultants or nurses who would have known from their professional training that these doses were wrong?
Why did Hampshire constabulary conduct investigations that the report says were
“limited in their depth and range of offences pursued”,
and why did the Crown Prosecution Service not consider corporate liability and health and safety offences? Why did the coroner and assistant deputy coroner take nearly two years to proceed with inquests after the CPS had decided not to prosecute? Finally and more broadly, was there an institutional desire to blame the issues on one rogue doctor rather than to examine systemic failings that prevented issues from being picked up and dealt with quickly, driven, as the report suggests it may have been, by a desire to protect organisational reputations?
I want to reassure the public that important changes have taken place since these events that would make the catalogue of failures listed in the report less likely. These include the work of the Care Quality Commission as an independent inspectorate with a strong focus on patient safety, the introduction of the duty of candour and the learning from deaths programme, and the establishment of medical examiners across NHS hospitals from next April. But today’s report shows that we still need to ask ourselves searching questions as to whether we have got everything right. We will do that as thoroughly and quickly as possible when we come back to the House with our full response.
Families will want to know what happens next. I hope that they and hon. Members will understand the need to avoid making any statement that could prejudice the pursuit of justice. The police, working with the Crown Prosecution Service and clinicians as necessary, will now carefully examine the new material in the report before determining their next steps, in particular whether criminal charges should now be brought. In my own mind, I am clear that any further action by the relevant criminal justice and health authorities must be thorough, transparent and independent of any organisation that may have an institutional vested interest in the outcome. For that reason, Hampshire constabulary will want to consider carefully whether further police investigations should be undertaken by another police force.
My Department will provide support for families from today, as the panel’s work has now concluded, and I intend to meet as many of the families as I can before we give our detailed response in the autumn. I am also delighted that Bishop James Jones has agreed to continue to provide a link to the families, and to lead a meeting with them in October to allow them to understand progress on the agenda and any further processes that follow the report. I commend the role played by the current MP for the area, my hon. Friend the Member for Gosport (Caroline Dinenage), who campaigned tirelessly for an independent inquiry and is unable to be here today because she is with the affected families in Portsmouth.
For others who are reading about what happened and have concerns that it may also have affected their loved ones, we have put in place a helpline. The number is available on the Gosport Independent Panel website and the Department of Health and Social Care website. We are putting in place counselling provision for those affected by the tragic events and who would find it helpful.
Let me finish by quoting again from Bishop Jones’s foreword to the report. He talks powerfully about the sense of betrayal felt by families:
“Handing over a loved one to a hospital, to doctors and nurses, is an act of trust and you take for granted that they will always do that which is best for the one you love.”
Today’s report will shake that trust, but we should not allow it to cast a shadow over the remarkable dedication of the vast majority of people working incredibly hard on the NHS frontline. Working with those professionals, the Government will leave no stone unturned to restore that trust. I commend this statement to the House.
Just before I call the shadow Secretary of State—the Secretary of State made reference to this point in passing—I think that it is only fair to mention to the House that a number of colleagues whose constituencies have been affected by the events at Gosport Hospital are unable to speak in these exchanges because they serve either as Ministers or, in one case, as Parliamentary Private Secretary to the Prime Minister. It should be acknowledged and respected that a number of those affected individuals are present on the Front Bench. I am of course referring to the Minister for Care, the hon. Member for Gosport (Caroline Dinenage); the Secretary of State for International Development, the right hon. Member for Portsmouth North (Penny Mordaunt); the Under-Secretary of State for Exiting the European Union, the hon. Member for Fareham (Suella Braverman); and the hon. Member for Meon Valley (George Hollingbery).
I thank the Secretary of State for the advance copy of his statement. I welcome the tone of his remarks and the apology that he has offered on behalf of the Government and the national health service.
This is a devastating, shocking and heartbreaking report. Our thoughts must be with the families of the 456 patients whose lives were shortened. I, like the Secretary of State, pay tribute to the right hon. Member for North Norfolk (Norman Lamb), whose persistence in establishing this inquiry in the face of a bureaucracy that, in his own words, attempted to close ranks, must be applauded. I know that other Members have also played an important part, including the hon. Member for Eastbourne (Stephen Lloyd), who is in his place, and the Minister for Care, who is understandably and properly in her Gosport constituency this afternoon. I also thank all those who served on the inquiry panel, and offer particular thanks for the extraordinary dedication, calm, compassionate, relentless and determined leadership—yet again—of the former Bishop of Liverpool, James Jones, in uncovering an injustice and revealing a truth about a shameful episode in our nation’s recent history.
As the Secretary of State quoted, the Right Rev. James Jones said:
“Handing over a loved one to a hospital, to doctors and nurses, is an act of trust and you take for granted that they will always do that which is best for the one you love.”
That trust was betrayed. He continued:
“whereas a large number of patients and their relatives understood that their admission to the hospital was for either rehabilitation or respite care, they were, in effect, put on a terminal care pathway.”
Others will come to their own judgment, but for me that is unforgivable.
This is a substantial, 400-page report that was only published in the last hour or so, and it will take some time for the House to fully absorb each and every detail, but let me offer a few reflections and ask a few questions of the Secretary of State. Like the Secretary of State, the question that lingers in my mind is, how could this have been allowed to go on for so long? How could so many warnings go unheeded?
The report is clear that concerns were first raised by a nurse in 1991. The hospital chose not to rectify the practice of prescribing the drugs involved. Concerns were raised at a national level, and the report runs through a complicated set of back and forths between different versions of health trusts and successor health trusts, management bodies and national bodies about what to do and what sort of inquiry would be appropriate. An inquiry was eventually conducted and it found an
“almost routine use of opiates”
“almost certainly shortened the lives of some patients”.
It seems that that report was left on a shelf, gathering dust.
I am sure that many of the officials and players acted in good faith but, taken as a whole, there was a systemic failure properly to investigate what went wrong and to rectify the situation. In the words of the report, serious allegations were handled
“in a way that limits the impact on the organisation and its perceived reputation.”
The consequence of that failure was devastating.
To this day, the NHS landscape understandably remains complex and is often fragmented. How confident is the Secretary of State that similar failures—if, God forbid, they were to happen again somewhere—would be more easily rectified in the future? Equally, as the Secretary of State recognises, there are questions about Hampshire constabulary. As the report says,
“the quality of the police investigations was consistently poor.”
Why is it that the police investigated the deaths of 92 patients, yet no prosecutions were brought? The report has only just been published, but what early discussions will the Secretary of State be having with the Home Secretary to ensure that police constabularies are equipped to carry out investigations of this nature, if anything so devastating were to happen anywhere else?
What about the voice of the families? Why did families who had lost loved ones have to take on such a burden and a toll to demand answers? It is clear that the concerns of families were often too readily dismissed and treated as irritants. It is shameful. No family should be put through that. I recognise that the Secretary of State has done work on this in the past and I genuinely pay tribute to him, but how can he ensure that the family voice is heard fully in future? He is right that we must be cautious in our remarks today, but can he give me the reassurance that all the relevant authorities will properly investigate and take this further? If there is a police investigation, can he guarantee that a different force will carry it out?
I also want the Secretary of State to give us some more general reassurances. Is he satisfied that the oversight of medicines in the NHS is now tight enough that incidents such as this could never be allowed to happen again? What wider lessons are there for patient safety in the NHS? Is additional legislation now required? Does he see a need for any tightening of the draft Health Service Safety Investigations Bill to reflect the learnings from this case?
The Right Rev. James Jones has provided a serious, devastating, far-reaching service in a far-reaching report. Aggrieved families have had to suffer the most terrible injustice. In the next few weeks, we will rightly acknowledge 70 years of our national health service. The Secretary of State is right to say that this must not cast a shadow over the extraordinary work done every day by health professionals in our NHS. But on this occasion, the system has let so many down. We must ask ourselves why that was allowed to happen and dedicate ourselves to ensuring that it never happens again.
I thank the shadow Health Secretary for the considered tone of his comments. I agree with everything he says. Members across the House will understand that we are all constrained in what we can say about the individual doctor concerned—because that is now a matter for the police and the CPS to take forward—but we are not constrained in debating what system lessons can be learned, and we should debate them fully, not just today but in the future. The big question for us is not so much, “How could this have happened once?”—because in a huge healthcare system we are, unfortunately, always occasionally going to get things that go wrong, however horrific that sometimes is—but, “How could it have been allowed to go on for so long without being stopped?”
Reflecting the hon. Gentleman’s comments, the poor treatment of whistleblowers, the ignoring of families and the closing of ranks is wrong, and we must stop it. We must go further than we have gone to date. In a way, though, it is straightforward, because we know exactly what the problem is and we just have to make sure that the culture changes. The more difficult bit is where there were process issues that happened in good faith but had a terrible outcome.
In particular, this report is a salutary lesson about the importance of transparency. Obviously I had only a couple of hours to read it—so not very long—but it looks as though the Baker report was left to gather dust for 10 years, for the perfectly straightforward and understandable reason that people said that it could not be published in the course of a police investigation or while an inquest was going on. I am speculating here, but I am pretty certain that had it been published, transparency would have prompted much more rapid action, and some of the things that we may now decide to do we would have done much, much earlier. That is an incredibly powerful argument for the transparency that has sadly been lacking.
How confident can I be that this would not happen again? I do think that the culture is changing in the NHS, that the NHS is more transparent and more open, and that interactions with families are much better than they were. However, I do not, by any means, think that we are there yet. I think that we will uncover from this a number of things that we are still not getting right.
As the hon. Gentleman will understand, it is not a decision for the Government as to which police force conducts these investigations. We have separation of powers and that has to be a matter for the police. One of the things that we have to ask about police investigations is whether forces have access to the expertise they need to decide whether they should prioritise an investigation. When the medical establishment closes ranks, it can be difficult for the police to know whether they should challenge that, and it does appear that that happened in this case.
In terms of wider lessons on the oversight of medicines and the Health Service Safety Investigations Bill, we will certainly take on board whether any changes need to be made there.
The culture of closing ranks and ignoring whistleblowers in the NHS is gravely worrying. Even as a new MP, I have had constituency cases where people have alerted me to this, and I feel that it could still happen today. What implications will the report have for the wider health service, particularly for elderly care and people who have family members in these situations?
There is one very important point that the shadow Health Secretary mentioned that it is important to understand from this report. We very often have a problem where people in an end of life situation are not treated in the way that we would want for our own relatives or parents. To put it very bluntly, the worry is that someone’s end may be hastened more quickly than it should be. We have made a number of changes, including scrapping the Liverpool care pathway, which happened under the coalition Government. But in this case, these patients were not in an end of life situation. They were actually going to the hospital for rehabilitation and expecting to recover—but they were old. One of the things that we will have to try to understand—all of us—is how this could have been allowed to happen and how this culture developed. I am afraid that the report is very clear that, inasmuch as the doctor was responsible—I have to be careful with my words here—lots of other people knew what was going on.
I am very grateful to the Secretary of State for an advance copy of his statement. There is much in it that I agree with, both in tone and content.
These are truly horrific events, and our first thoughts must always be with the families of those who have been affected by this scandal. It is deeply distressing to lose a loved one in any circumstances, and the circumstances in this case, with all the press coverage, will only have amplified that distress for everyone concerned.
When the inquiry was originally announced, it was expected to take two years, and it is extremely disappointing that it has stretched out until now. There has no doubt been a catastrophic failure of monitoring and accountability, not only with regard to the doctor concerned but those who failed to investigate these actions. The Government are also included in this failure. However, I am grateful to the Secretary of State for issuing the apology that he has today, and welcome the fact that the Government will bring forward more considered responses in the autumn.
I sincerely hope that this will be the beginning of justice, and ultimately closure, for the families affected. I hope that the Secretary of State will support the opening of criminal investigations into the events following the report’s findings. The public find it very difficult to have faith in health regulators who act both as investigators and prosecutors—and even the judge—in complaints. I hope that he will look at this aspect to ensure public confidence and faith in the healthcare regulation system in the future.
I thank the hon. Gentleman for his comments and agree with what he says. Of course, if the police decide to bring forward criminal prosecutions, that would have the support of the Government, but the police must make that decision independently. If a family feel that an injustice has been done, who can they go to if they feel that ranks are being closed? I think we have made progress on that question, but we need to reflect very carefully on whether it is enough progress.
The events at the hospital and the panel’s report are of significant interest to me and my constituents, and those of my hon. Friend the Member for Meon Valley (George Hollingbery), on whose behalf I am also speaking. His constituents and mine have asked whether the families can be confident that the report’s findings will be acted on and that people will be held accountable for what happened.
My hon. Friend is right to ask that question. The best parallel is the Hillsborough process, which was also led by Bishop Jones. A similar report was published that put documents into the public arena, essentially enabling people to understand truthfully what happened. On the basis of that, inquests were reopened, criminal prosecutions happened and so on. We are at that stage of the process. I hope that the transparency and thoroughness of the report will give families hope that they are at last being listened to.
May I first thank the Secretary of State for backing and trusting my judgment in 2013, without hesitation, and proceeding with this panel inquiry? I join him in paying tribute to the work of Bishop James Jones and the whole panel. Bishop James Jones is a remarkable man who has shown extraordinary clarity of thought that has, in a very impressive way, built the trust of families who have been involved in this process.
I am not sure that I share the Secretary of State’s confidence that an earlier publication of the Baker report would have resulted in the transparency he called for, bearing in mind that I had to intervene in 2013 to stop a statement being made that there would be no public inquiry even after the publication of that report. Does he agree that we have to find a way of overcoming the problem of having different inquiries through inquests, through the police and through regulators, because, together, those stopped the vital information getting out into the public domain and stopped proper investigation into these issues? Does he also agree that we need a mechanism to ensure that in future families are never ignored again, and that when legitimate allegations of wrongdoing are made, they are investigated properly and families are involved in that process?
First, I again pay tribute to the role that the right hon. Gentleman played. One of the most difficult things for any Minister is knowing when to accept advice, which is what we do most of the time, and when to overrule it. His instincts have been proved absolutely right. It is not an easy thing to do, and it causes all sorts of feathers to be ruffled, but he stuck to his guns, and rightly so. Bishop James Jones, who is a truly remarkable public servant, talked in the Hillsborough panel report about the
“patronising disposition of unaccountable power”.
That is what we have to be incredibly on guard against.
The right hon. Gentleman is right: at the heart is the problem that we did not listen to families early enough and we did not listen to whistleblowers inside the NHS early enough. My reason for saying that all these things need to see the sunlight of transparency much sooner is frankly that if they had come to light sooner and if proper attention had been given to this in 2001—we all know that Mid Staffs started in 2005—how many other lessons and tragedies throughout the health service could have been avoided? That is why I think it would be the wrong reaction today to say that we are getting there on patient safety and that transparency problems are solved: there is a lot further to go.
Within the last few hours, I have learned that I have a constituent whose grandmother had recovered from successful hip surgery without the need for any drug interventions and was sent to Gosport War Memorial Hospital for rehabilitation, only to be given a lethal cocktail of drugs that killed her. The matter was reported to Gosport police when it happened in 1998. Does the Secretary of State agree that if people are found wilfully to have administered lethal drug doses unnecessarily, they deserve to lose their liberty, and that if people are found wilfully to have covered up such crimes—for that is what they are—they deserve to lose their jobs?
On behalf of my constituents, I thank the Secretary of State for the apology and the statement today. Can he confirm that all families affected have been contacted and say a bit more about the support that will be available to those who have lost loved ones?
I am happy to do that. All the families who think they had a relative affected have been part of the panel process, and they were all invited for a briefing by Bishop Jones this morning in Portsmouth. We will provide ongoing support and counselling if necessary through the Department of Health and Social Care, which was a specific request of Bishop Jones. We are also conscious that when people read the news, they may suddenly decide that they or a loved one were affected by this. We have set up a helpline so that people can contact us and we can help them to trace whether they too have been affected.
Does not every instance of people being scared to speak out and relatives finding it too difficult to complain underline the importance of the Healthcare Safety Investigation Branch, which the Secretary of State has established? I remind him that I am chairing the Joint Committee of both Houses that is carrying out prelegislative scrutiny of the draft Health Service Safety Investigations Bill. When we report on 24 July, will my right hon. Friend undertake to bring that into law as quickly as possible? That will afford the safe space that people need to report such matters without fear or favour.
Absolutely. I commend my hon. Friend for his work and for being one of the colleagues in this place who have thought and talked about the importance of getting the right safety culture in the NHS. The Healthcare Safety Investigation Branch matters because in situations such as this, it could have been called in, done a totally independent investigation, got to the truth of what was happening quickly and prevented a recurrence of the problem. That is one of a number of things that we need to think about.
Ten years ago, a constituent came to see me called Mrs Gillian McKenzie. She told me a story that sounded so far-fetched that I struggled to believe it. In her opinion, her mother and many other elderly people had effectively been killed before their time at a hospital in Gosport. I found it staggering. I then read the hundreds of pages of documents that this amazing woman, Mrs McKenzie, had put together over the weekend, and I came to the harrowing conclusion that there could be a chance of a significant number of early deaths at the Gosport War Memorial Hospital.
I was a candidate then, not the MP. I contacted my good friend, my right hon. Friend the Member for North Norfolk (Norman Lamb), and I took Mrs McKenzie and relatives up to London to meet him. He agreed that this could be something wicked beyond compare. Over the next few years, there was continual campaigning and lobbying, and continual pushback. Finally—I pay tribute to my right hon. Friend—we got this commission off the ground. By the way, Mr Speaker, Mrs McKenzie is now 84. I saw her on Saturday evening, wished her luck and gave her a hug. Twenty years later, we are talking about the deaths of more than 450 and possibly 600 elderly people. The relatives today got the truth.
Order. I have the very highest respect for the hon. Gentleman and for his keen interest in and experience of this issue, and I am exercising some latitude for Back Benchers and for the Secretary of State on this extremely sober matter, but I hope that the hon. Gentleman is at least approaching something that has a question mark at the end of it.
I am, Mr Speaker. I appreciate the latitude.
This has been a 10-year battle. Today, the relatives got the truth. The relatives and I demand justice. I urge the House, the Government and the police to do everything necessary to ensure that the individuals named in the report are brought to justice.
There can be no justice unless the truth is put on the table. That is the crucial first step, and now justice must proceed. I thank the hon. Gentleman for his campaign for Mrs McKenzie. Perhaps the best words I can use are these of the panel in the report:
“Yes, we have listened and yes, you, the families, were right. Your concerns are shown to be valid.”
I echo the tributes to the work of Bishop James Jones and the integrity and diligence that he and the panel have shown in conducting this inquiry. The Secretary of State has rightly focused on the impact on families, and I was pleased to hear in his statement that there will be a helpline for families who suspect that they have been affected—not least because the immediate catchment area around Gosport includes a lot of retirement homes, and many families whose elderly relatives went to the area to retire may live some distance away. Given the publicity that the report has given rise to, a considerable number of people may need to get in touch. Will he ensure that the helpline is adequately resourced?
Yes, I will absolutely do that. I ought to say that I know my hon. Friend met many families and relatives during his time as a Minister in my Department, and he always dealt with those cases with a huge amount of compassion. The facts of the matter are, according to the report, that 650-plus people had their lives shortened, but we are in touch with only about 100 families, so we are expecting more people to come forward.
I, too, join in the comments that have made about the remarkable work of Bishop James Jones—not only in this important report, but on Hillsborough and on mediating with the Government last summer about moving the contaminated blood inquiry away from the Department of Health. I seek an assurance from the Secretary of State about the approach that Bishop Jones has put forward, which is the “families first” approach. Is there now a commitment from the Government to making that approach—families first—the hallmark of any inquiry that is ever held in the future?
I think actions speak louder than words. Such an approach is what Bishop Jones requested on this occasion, and we have done that. We obviously need to think through some process issues, because when a Minister wants to report to the House, they need to be a little bit informed as to what they are talking about. However, I think we have found a way to do that with this report and with the Francis report, so I think it is a good template.
May I commend the diligence and determination of the right hon. Member for North Norfolk (Norman Lamb), without whose efforts we would not be hearing the truth today, as grim and disturbing as that truth might be? Does my right hon. Friend agree that this raises further questions about the way in which doctors’ performance and patient safety are monitored? With the GMC, doctors are in effect policing themselves. Is it not time to say that this system has to change?
We do have to ask those questions, and we have to be able to respond to the concerns of my hon. Friend and his constituents about how we can be absolutely certain there will not be a closing of ranks. My experience, however, is that doctors are very quick to want to remove those of their number who are letting the profession down because this damages everyone’s reputation. There are some very difficult questions for the GMC and for the NMC. Because their processes took so long, I do not think they can put their hand on their heart and say that they have kept patients safe during that period.
The legislation regulating both doctors and healthcare professionals is now 35 years old. It is inefficient, outdated and—as I know from a constituency case in which the individual concerned is into the fifth year of her complaint to the GMC—not user-friendly for the complainant. The GMC and other healthcare professionals want change and the Secretary of State’s Department has already consulted on change, so will he give a guarantee that he will bring forward legislation to ensure that the system is not only effective, but effective for patients who make complaints?
The right hon. Gentleman is absolutely right: we have a regulatory landscape that is very complex, does not achieve the results we want, and forces regulators to spend time doing things they do not want to do and does not give them enough time for things they do want to do. Obviously, because of the parliamentary arithmetic, if we are able to get parliamentary consensus on such a change, that would speed forward the legislation.
There are many “if onlys”, but one of them is: if only the junior doctors and others who spoke up had been listened to. I know my right hon. Friend is committed to making sure that people and whistleblowers are listened to and that he is committed to transparency. Will he say a bit more about what he is doing to make sure that everyone involved in patient care—from consultants to healthcare assistants, porters, patients and families—are listened to and that their concerns are acted on?
I think we have made progress when it comes to whistleblowing because every trust now has a “freedom to speak up” guardian—an independent person inside the trust whom clinicians can contact if they have patient safety concerns. That is a big step forward, which was recommended by Robert Francis. Where I am less clear that we have solved the problem is in relation to having someone for families to go to if they think that everyone is closing ranks, and we now need to reflect on that.
I refer the House to my entry in the Register of Members’ Financial Interests and my history of working in the NHS.
A brave nurse came forward all those many years ago to highlight a concern, but the concern was not taken forward adequately at that time. Often in these circumstances, the NHS closes ranks, management remove the individual who raises the concern—the clinician in this instance—and allows the system to continue. Is there some way of monitoring the types of concerns raised by clinicians, ensuring that the staff who raise these concerns are not themselves penalised and that the system then takes accountability forward?
The hon. Lady is absolutely right to raise that matter. The nurse concerned, Anita Tubbritt, talks in the report about her concerns and the pressure that she was put under, and it was a brave thing to do. When the hon. Lady reads the report, she will see that nurse auxiliaries and others who were not professionally trained clinicians also came forward with concerns and were also worried about the impact that doing so would have on their own career. That is what we have got to stop because, in whatever part of the UK, getting a culture in which people can speak openly about patient safety issues is absolutely essential.
I was a junior doctor at the Royal Hospital Haslar in Gosport, which is just around the corner from the Gosport War Memorial Hospital, so I know that hospital fairly well, and I also know that the people of Gosport will be disappointed and distressed by this, since they very much value their community hospital.
Does the Secretary of State agree with me that there is an issue about the governance of smaller institutions, as we have seen in the past? I in no way wish to disparage the excellent work done by community hospitals, of which I have been a champion for many years, but will he look specifically at the pages in the report that touch on this? There is an issue about governing and ensuring safety in small institutions—whether in general practice or in hospitals?
I think that that is actually an excellent point, and we should definitely look at it. Big hospitals have clear lines of accountability—boards, chief executives—but those often do not exist in community hospitals and there is no one who can say they are the boss of that trust, so we should look at that.
The grandmother of one of my constituents died in Gosport War Memorial Hospital in January 1999—in other words, after concerns were being raised by families and by staff at the hospital. The family believe that her morphine dose was well above that needed for her reported pain. I thank the Health Secretary for the tone of his statement, and I also thank Bishop Jones for the work he did on this inquiry. Does the Secretary of State believe that this report shows a need for tightening the draft Health Service Safety Investigations Bill?
I thank the hon. Lady for her comments. I do not want to jump to a conclusion about any changes to the draft Bill. However, we should definitely reflect on any legislative changes that might be needed as a result of this report, and that Bill could be a very powerful vehicle for doing so.
My right hon. Friend has mentioned trust, and as a doctor myself, I am very aware of and humbled by the fact that people come to me with their children and put their trust in me to look after them. When events such as this occur, trusts can be shaken, and it is therefore important that these things are dealt with quickly. In this case, the investigation, since complaints were first received, has been going on for far too long. What will my right hon. Friend do to reassure people that any such complaints will be dealt with much more quickly in future, and that opportunities to save lives will not be lost in the meantime?
That is the big question we have to answer for both the House and the British people. However, I would say to the hon. Lady that I am confident that, where there is unsafe practice, it is surfaced much more quickly now in the NHS than it has been in the past. I am less confident about whether we have removed the bureaucratic obstacles that mean the processes of doing such investigations are not delayed inordinately so that the broader lessons that need to be learned can be learned.
One of the reasons for the growing success of the “Getting it right first time” programme is the creation of clinician-agreed datasets. Will the Secretary of State give the House an assurance that there will in future be proper analysis of the data on the excess number of deaths and the use of this particular type of drug in excessive amounts? Such analysis would have shown this hospital as an outlier, so questions could have been asked, as is now happening successfully with the GIRFT programme.
I thank my hon. Friend for his championing of the GIRFT programme, which is incredibly powerful and successful. He will have noticed that we announced last week that we are expanding it into a national clinical information programme, which will cover more than 70% of consultants. What is disturbing in this case, though, if I may say so, is that the data was really around mortality, and we have actually had that data for this whole period. There is really nothing to stop anyone looking at data, and we can see a spike in the mortality rates in this hospital between 1997 and 2001. They go down dramatically in 2001, when the practices around opiates were changed. That is why we have to ask ourselves the very difficult question about why no one looked at that data or, if they did, why no one did anything about it.
I congratulate the Secretary of State and the right hon. Member for North Norfolk (Norman Lamb) for getting us to this point. I was deeply concerned to hear in the Secretary of State’s statement that Ministers had been given advice not to proceed with this independent panel. Is the Secretary of State convinced that Ministers are now receiving better advice?