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House of Commons Hansard
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Commons Chamber
24 July 2018
Volume 645

House of Commons

Tuesday 24 July 2018

The House met at half-past Eleven o’clock

Prayers

[Mr Speaker in the Chair]

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On today’s Order Paper it is noted that on 27 July 1918, Major Francis Bennett-Goldney, Royal Army Service Corps, Member for Canterbury, died from injuries sustained in a car accident while serving as honorary assistant military attaché in Paris; and that on 22 August 1918, Captain the hon. Oswald Cawley, Shropshire Yeomanry and 10th (Shropshire and Cheshire Yeomanry) Battalion The King’s Shropshire Light Infantry, Member for Prestwich, was killed in action near Merville, France. We remember them today.

Oral Answers to Questions

Health and Social Care

The Secretary of State was asked—

NHS Services: Online Access

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1. What recent progress has been made on providing patients with online access to NHS services. [906605]

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It is a great honour to be here, Mr Speaker.

There is good progress in patients using online services in the NHS—about a quarter of patients are now registered to access general practitioner online services, up from about a fifth a year ago—but there is much more to be done to use technology in the NHS for the benefit of patients and clinicians alike.

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I congratulate my right hon. Friend on his appointment. Healthcare delivered by app is increasingly popular with patients in Havant and across the country. Will my right hon. Friend reconfirm his Department’s commitment to the first ever NHS patient app, and update the House on the timetable for its roll-out?

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The roll-out of technology right across the NHS and, indeed, social care is good for patients and good for clinicians. I have seen countless examples of that in just my first two weeks in this job. I pay tribute to the Centre for Policy Studies report, which was launched by my predecessor and authored by my hon. Friend, which demonstrates how apps can be useful for making healthcare easier to access for patients. Apps are popular with patients, and I cannot wait to drive that forward.

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22. May I congratulate the Secretary of State on his new appointment? Another new technology that really matters is MRI scanners. We have had a big fundraising campaign in Bishop Auckland for ours, but the problem with such fundraising campaigns is that they are of course easier in wealthy areas than in poor areas. Will the Secretary of State pay attention to evening out this uneven distribution of resources? [906629]

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Yes, of course I will. I pay tribute to the hon. Lady for her work to raise funds for the MRI scanner in Bishop Auckland, which benefits from great levels of philanthropy in some areas. The whole purpose of having a national health service is that, wherever people live in the country, they can get high-quality healthcare, free at the point of delivery, according to need. I stand by that principle, and I honour it.

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I welcome the Secretary of State to his post. He will know that no regulator is prospectively examining the safety and effectiveness of diagnostic apps in use in the NHS. I wrote to his predecessor recently following concerns that were raised with me about Babylon’s apps, which could be missing symptoms of meningitis and heart attack, for example. What steps will the Secretary of State take to ensure that, as these technologies are rolled out, patients have can have absolute confidence that they have been properly evaluated for safety and effectiveness? Will he set out how he will take that forward?

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The Chair of the Health and Social Care Committee makes a really important point. There is no greater enthusiast for technology than me—as you well know, Mr Speaker—but the thing about new technology is that the rules sometimes need to be updated to take changes in technology into account. The response when there are challenges such as the one my hon. Friend raises is not to reject the technology, but the opposite: to keep improving the technology so that it gets better and better, and to make sure that the rules keep up to pace. I spoke to Simon Stevens at NHS England about this only this morning—we have had a series of conversations in the past couple of weeks since I have been in post—and he is reviewing this exact question. I am absolutely sure that we will get to the right answer.

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Is the Secretary of State familiar with the “GP at hand” online service? It is a partnership between a private company and a Fulham GP surgery, and it has poached thousands of profitable patients from GPs all over London, to the alarm of the British Medical Association and of GPs generally. My clinical commissioning group is investigating it, and in the meantime CCGs have blocked Babylon’s expansion to Birmingham on safety grounds. This is creating a two-tier system for GPs, so will the Secretary of State investigate it?

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I am acutely aware of the question that the hon. Gentleman raises, not least because I am a user of the Babylon service myself—it is my GP. The important thing is to ensure that the rules are kept up to date so that we can get the benefits of the new technology, but make sure that it works in a way that ensures everybody gets high-quality primary care.

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Warm congratulations to the Secretary of State.

Whether it is online consultations or more traditional, face-to-face ones, will the Secretary of State join me in thanking all the NHS staff who do fantastic work in taking care of my constituents in Chipping Barnet?

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I certainly will. I pay tribute to the NHS workforce and the social care workforce who, every day of their working lives, give up their time to serve their community, to serve their fellow man and woman, and to ensure that we have the healthiest nation we possibly can. I love the NHS, as does everybody in the House. Almost everyone is touched by the NHS at some of the most difficult times in their lives. I pay tribute to the workforce.

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I, too, welcome the Secretary of State to his new position. I note his intention to extend online NHS services, but I hope that he will provide more detail about how he intends to guarantee patient safety, given that the Care Quality Commission reported this year that 43% of online GP and pharmacy services are currently unsafe. Will he reverse the cuts to capital funding so that safe technology can be installed? Furthermore, what steps will he take to ensure that elderly and vulnerable patients, who find it difficult to access online services, will still have the certainty of sustainable community surgeries?

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Those are really important questions. On funding, I announced only last week £487 million to improve technology and technology services to ensure that they can be as high quality as possible. On patient safety, the key is to keep improving technology so that it gets better and better. On universal access, we must use technology in such a way that patients who want to access services through technology can do so, as that frees up resources so that more can be done for those who do not want to use technology, meaning that we preserve universal access.

Drug-related Harm

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2. What recent discussions he has had with the Home Secretary on policies to tackle drug-related harm. [906606]

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I attended the most recent cross-Government board meeting, which was held in June and chaired by the Home Secretary, to discuss the implementation of the drugs strategy. We know that drugs can devastate lives and damage our communities. The Government’s approach remains clear: we must do everything that we can to prevent drug use and support people through successful treatment and recovery.

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Given the recent statistics showing that drug-related deaths in Portugal are three per million, compared with the UK figure of 64 deaths per million, does the Minister agree that the UK Government should follow Portugal’s example and make drug policy reform a matter primarily for Health and Social Care, rather than the Home Office?

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The truth is that we work together. In July 2017, the Government published a comprehensive new drugs strategy, setting out what we think is a balanced approach that brings together the police, health, and community and global partners to tackle the illicit drugs trade, and to protect the most vulnerable in our societies who are struggling with drug dependency and help them to recover and turn their lives around. I know the hon. Gentleman takes a very different view, but that is our approach.

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My nine-year-old constituent is currently having up to 400 epileptic seizures every week, and his family believe that medicinal cannabis may be beneficial. Will my hon. Friend update the House on what progress is being made regarding the use of medicinal cannabis for epilepsy sufferers?

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Obviously, our thoughts are with my hon. Friend’s constituent. A two-part review is going on. In the first part, the chief medical adviser considered the evidence available for the medicinal and therapeutic benefits of cannabis-based medicinal products, and found conclusive evidence of the benefits of those products. Part 2, which will be led by the Advisory Council on the Misuse of Drugs, will provide an assessment, based on the balance of harm and public need, of whether we need to do anything regarding the misuse of drugs regulations. While the review is under way, we have established, as an interim measure, the expert panel of clinicians to advise Ministers on any licence applications from senior clinicians, which helped Alfie Dingley, for example.

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What action is the Minister taking with colleagues in the Home Office in respect of the drug Xanax, which is reputedly freely available at very low prices, and is more addictive than heroin? What action is he taking to raise awareness and deal with rehabilitation?

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We are very aware of this drug and its dangers. A few months ago, I responded to an Adjournment debate on the matter that was secured by the hon. Member for Enfield, Southgate (Bambos Charalambous). We are watching the issue very closely. I will find out some more details and write to the right hon. Gentleman. I know that he takes a close interest in this, and we will speak about it.

Maternity Care

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3. What steps he is taking to improve safety in maternity care. [906607]

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Our national ambition is to halve the rates of stillbirths, neonatal and maternal deaths, and serious birth-related brain injuries by 2015. We are working with our partners to implement the maternity safety strategy, and new data shows that the stillbirth rate in 2017 was the lowest since records began in 1927.

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Our three children were all born in periods of extremely hot weather. I ask the House to think of the families of Banbury who have to travel for up to an hour and a half or even two hours, if they are lucky enough to have their own car, to Oxford to give birth in a full obstetric unit. May I encourage the Minister, in her drive to ensure that maternity care is safe, kind and close to home, to ask the new Secretary of State to visit us in Banbury soon so that he can assess the situation for himself?

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I completely understand my hon. Friend’s concerns. She has been an incredibly strong advocate and campaigner on this very issue. As she knows, no permanent changes will be made until the work is carried out by the independent review panel, which is looking at attempts to recruit obstetric staff for her local services. I thank her very much for the offer of a visit; I am sure the Secretary of State will look at it very closely.

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Dr Neal Russell volunteered to help in the fight against Ebola. Today he has returned his Ebola medal in protest at the healthcare hostile environment for migrants caused by a new charging regime, which has led to vulnerable pregnant women here in the UK being too afraid to get maternity healthcare. Will the Minister suspend her Department’s charging regime, pending the completion of a thorough and independent public health assessment?

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That is incredibly sad news. We hate to hear of anybody who has done such incredible service in the pursuit of great healthcare around the world taking such drastic steps. We have an incredibly strong departmental ambition for NHS maternity to provide the safest, highest quality care in the world. That is something we will continue to aspire towards.

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The maternity unit at Harrogate Hospital is award winning due to the skills and compassion of its fantastic team. What action is my hon. Friend taking to encourage more people into maternity care and midwifery careers?

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The Department’s maternity safety ambition plans are to train more than 3,000 extra midwives over the next four years. As part of that, we will be working with our partners to develop new training routes to become registered midwives so that, along with other roles in the NHS, maternity and midwifery can attract the best and retain the most talented staff.

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According to the Royal College of Midwives, the national shortage of midwives is running at nearly 4,000 and is particularly acute in areas like mine in east London, with its very high property prices and rising birth rates. How does the Minister intend to address that?

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There are in fact 2,300 more midwives in the NHS than there were in 2010, but the hon. Gentleman makes a very good point. We want to continue to attract the best people into midwifery, which is why we are providing an extra £500,000 to the NHS to cover the clinical placement costs for 650 additional students in 2019-20.

Childhood Obesity

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4. What steps he is taking to reduce rates of childhood obesity. [906608]

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14. What steps he is taking to reduce rates of childhood obesity. [906620]

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We published the second chapter of our world-leading childhood obesity plan on 25 June. It builds on the progress we made since the publication of chapter 1 in 2016, particularly on the reformulation of products that our children eat and drink most. We will continue to take an approach that is based on evidence and we are determined to act.

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I warmly welcome the Secretary of State to his post. I am sure that he was as alarmed as I was to learn that the proportion of 11-year-old children who are obese is now greater in the UK than the US. What more can we do to educate children and their parents about the benefit of a balanced diet and healthy life start?

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I pay tribute to my hon. Friend’s work at the Department for Digital, Culture, Media and Sport on this matter. It is critical that we have a cross-Government approach. The obesity plan is led by the Department of Health and Social Care, but it is a cross-Government plan. There is a whole range of actions we need to take—from education through to culture and broadcasting—to make sure we get it right.

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One of the reasons why tackling obesity in children is so important is the fact that it has such long-term detrimental effects on health. Now that the Government have published chapter 2 of their childhood obesity strategy, will the Secretary of State outline how it will have a long-term impact on children’s health and tackle issues such as diabetes and heart disease?

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My hon. Friend is absolutely right that obesity, especially in children, is one of the underlying conditions that often leads to much worse long-term health conditions. Some 22% of children aged four and five in reception are overweight or obese; that number is too high and we have to act.

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I welcome the Secretary of State to his new post, which is one of the toughest jobs in Parliament. Having worked with him on other things in the past, I am sure that his energy will come through in the Department.

I have a vested interest in the welfare of young children as we are expecting our 11th grandchild in October. Will the Secretary of State look closely at the relationship between obesity in later childhood and the diet of mothers during pregnancy? Early research shows that there is a link, so will he look at it carefully?

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A veritable football team of Sheermans.

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I am sure that they will grow into that, Mr Speaker.

I pay tribute to the work that the hon. Gentleman has done, which I have watched with admiration from elsewhere. I will certainly look at the point that he raises, which is very important, and we will take a fully evidence-based approach.

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I, too, welcome the Secretary of State to his new job. Today’s figures show that levels of severe obesity in children are at a record high, so will the Government speed up their childhood obesity strategy to tackle this urgent public health challenge?

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We published chapter 2 less than a month ago. There is further work to do, because that sets out a whole series of areas in which we are going to take action, and I am already working on pushing it faster.

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I know that the Secretary of State has a track record of evidence-free, nanny-state policies from his time in DCMS. Can we expect more of the same in his new Department, or is he going to try out some Conservative principles, such as individual freedom, and individual and parental responsibility?

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I am delighted to see that the teamwork between my hon. Friend and I is going to continue. You might be surprised to know, Mr Speaker, that there are some things on which my hon. Friend and I agree. One is the importance of individuals taking responsibility—a critical part of public health and tackling obesity—supported by an enabling state.

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The Secretary of State is working extremely hard. I hope that he will take it in the right spirit if I say that I do not think he has yet quite secured the Shipley vote.

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Sarah, who runs the Devonport Live café in Devonport, one of the poorest parts of the country, used to provide cookery classes for local young mums, but she cannot do that anymore because of a lack of funding to provide the support, facilities and food to help young mums—especially those on low incomes—to get the skills that they need to cook healthy meals for their children. What support can the Secretary of State give to young mums and to people such as Sarah who want to provide cookery lessons to support tackling childhood obesity?

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The hon. Gentleman makes an important point. Funding is available from lots of sources, not just taxpayers. Nevertheless, he will have noted that I have already started talking about the importance of getting funding out into the community, whether that is through social prescribing or wider public health efforts, to make sure that we try to tackle health problems at source and keep people out of hospital as much as possible, rather than spending all the money on sorting things out later in hospital.

HPV Vaccine

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5. What assessment he has made of the potential merits of extending the provision of the HPV vaccine to boys. [906609]

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Our expert group, the Joint Committee on Vaccination and Immunisation, issued its final advice on HPV vaccination for boys on 18 July. I have carefully considered its advice, and I wanted to tell the House first that the Government will introduce a nationwide HPV vaccination programme for adolescent boys. This will bring clear health benefits for boys, providing them with direct protection against HPV infection and associated disease, including a number of cancers.

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I declare an interest as a very, very part-time dentist.

I am delighted by the response, but given the importance of head and neck cancer prevention for both sexes, but especially for males, who are twice as susceptible, will the Minister supplement this programme with a catch-up programme, as was done for girls in 2008, to make the vaccine available for 14 to 18-year-old boys?

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I thank my hon. Friend for welcoming this. The British Dental Association has been key in lobbying on this issue, as has—I give credit where it is due—The Mail on Sunday, which has campaigned on it for a long time. I have asked NHS England and Public Health England to work together to advise me on the implementation of the programme, including with regard to the issue that he raises, which makes a lot of sense and for which there is precedent from the girls’ programme. I will of course consider the advice and confirm the implementation plan as soon as possible.

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I congratulate the Minister on that announcement. The vaccine also plays its part in protecting against sexually transmitted disease. Will he saying something about the fact that syphilis is now at its highest rate since the second world war and that there are strains of gonorrhoea resistant to treatment? What are the Government going to do about this?

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They are linked but separate issues. Yes, the HPV vaccine is very important for adolescent boys, for men who have sex with men and for people before their sexual debut. Sexual health is of course a huge challenge. We work closely with local authorities—top-tier local authorities are all public health authorities—and, through the ring-fenced public health grant, which is £16 billion during this spending review period, we are providing those services.

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Cancer survival rates are now at an all-time high thanks to the brilliant and dedicated work of clinicians, including at Cheltenham General Hospital, but prevention is better than cure. Will the Secretary of State direct his customary energy towards prevention work, including vaccinations, but also tackling risk factors such as obesity?

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Yes, he will. I am pleased to say that prevention is one of the Secretary of State’s three key priorities. The HPV vaccine is a key prevention measure, while one of the drivers behind the child obesity plan was Cancer Research UK’s very clear advice that being overweight was one of the big risk factors, alongside diabetes, in cancer. Yes, prevention is always better than cure.

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I welcome the Government’s acceptance of the JCVI’s recommendation to extend the vaccination programme to adolescent boys, but the Minister will know that there are huge regional differences in the take-up of the vaccination among girls. What steps will he take to tackle these regional differences before and during the roll-out to boys?

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The shadow Minister is absolutely right to raise this issue, which she also raised with me in the Westminster Hall debate on the same subject introduced by my hon. Friend the Member for North Thanet (Sir Roger Gale), who has done a lot in this area. I have already spoken to Public Health England about this in respect of the girls’ programme, and I will be speaking to it again now that we have announced the boys’ programme, because the equality of doing the dual programme must be matched by the equality of its taking place in her constituency as much as in mine in Hampshire.

BAME Blood, Stem Cell and Organ Donors

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6. What steps his Department is taking to increase the number of BAME blood, stem cell and organ donors throughout England. [906610]

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We urgently need more black, Asian and minority ethnic donors to save lives through the gift of organ donation. That is a priority for the Government. Last week, I launched a national campaign to address myths and barriers and bring attention to the life-saving power of organ donation. It is crucial that these messages be properly tailored to enable everyone to participate.

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In 2017-18, only 1 33 people from the BAME community in this country donated an organ. While they are still living, BAME people make up a third of the people on transplant waiting lists and have to wait over a year longer than white patients. I know that the Government announced a new campaign, following NHS Blood and Transplant’s annual report on organ donation, within the BAME community, but it fails to address many of the recommendations in my report “Ending the Silent Crisis”, published in June. I sent a copy to the Minister, along with a request for a meeting, but I have yet to receive a response. Will she agree to meet me after the recess to discuss the recommendations in my review?

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I am sorry the hon. Lady has not received a response, because I instructed my office to say I would agree to meet her. I commend her work in this area, because it is very important that we tackle this injustice. Central to that is reaching out to those communities and engaging with them in a way that inspires them. We have found in our work over the last year that there is a sense of distrust among some minority ethnic communities towards health providers. I will be bringing out some tools in the autumn and would encourage all Members to reach out to their minority ethnic communities to tackle the fact that, as she says, a third of people on transplant waiting lists are from black and Asian communities and that we need more donors.

Adult Eating Disorders

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7. What steps he is taking to improve access to NHS adult eating disorder services. [906612]

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The Government are committed to improving eating disorder services for adults. The National Institute for Health and Care Excellence has updated its guidelines, and NHS England recently completed a national review of provision and is considering next steps. We will also be ensuring that people remain properly served as they transfer between children’s and adults’ services.

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Two thirds of adults wait more than four weeks and one third wait 11 weeks for treatment. What are the Government going to do about it, in the light of the review that the Minister has just mentioned?

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As I have said, NICE has published its new clinical guideline on the recognition and treatment of eating disorders in people over the age of eight, including adults, and we will make clear to NHS organisations what we expect of them. We are ensuring that we meet the waiting times for eating disorder treatment, and we are delivering against those standards.

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Data from NHS Digital show that the number of beds for people with serious mental health conditions, such as eating disorders, has fallen by nearly 30% since 2009. The Government say that they are committed to ensuring that everyone with an eating disorder has access to timely treatment, but according to the hon. Member for Central Suffolk and North Ipswich (Dr Poulter)—who I believe is also an NHS doctor—there is often a long wait for patients with eating disorders who need beds for urgent in-patient care. Does the Minister agree with him?

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The hon. Lady’s starting point was “since 2009”. It is certainly true that there was a decline then, for a number of reasons, not least the fact that we are improving treatment in community settings rather than acute in-patient beds. Our Five Year Forward View began in 2014, and we have been delivering improvements in the number of beds and staff since that date.

Leaving the EU

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8. What recent assessment he has made of the effect on the health and social care sector of the UK leaving the EU. [906613]

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The Government are undertaking a wide range of analysis in support of our EU exit negotiations and preparations. Our overall programme of work is comprehensive, thorough and continuously updated.

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Brexit poses major challenges for the NHS and, in particular, the beleaguered and neglected hospitals of East Kent. Can the Minister reassure me—and the Royal College of Midwives and other bodies—that we will be able to recruit much needed migrant worker staff to the health and social care sector and will encourage them to stay after March 2019?

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We will remain committed to attracting the brightest and best. The hon. Lady says that her area is “beleaguered”; I remind her that the Kent and Medway sustainability and transformation partnership received £101.2 million more than it received in the previous year.

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Nearly 10,000 EU citizens work in the social care sector, caring for some of the most vulnerable people in society. What steps is my hon. Friend taking to ensure that there will be no shortage of people working in that sector once we have left the EU?

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My hon. Friend has raised an extremely important point. The Home Secretary recently announced a settlement scheme to enable those staff from the European economic area to remain. However, it is also important for us not to scare EU nationals, and to point out that there are now 4,500 more non-UK EU nationals working in the NHS than there were two years ago, at the time of the referendum. There is often a sense that there are fewer, but that is not the case.

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20. The number of vulnerable adults in Newcastle is rising by 20% each year. The over-85 population is set to rise by 60% in the next decade, and additional cost pressures will mean £30 million in extra costs over the next three years. How is Newcastle City Council supposed to meet the adult social care budget, given the cuts that have been made in it? I ask the Minister please not to mention the adult social care precept, because it does not even begin to cover those costs. [906627]

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I would have expected the hon. Lady to welcome the additional funds that have been announced—not just the £2 billion for social care, but the extra £20.5 billion a year, in real terms, that will be delivered through the long-term funding settlement. Instead of criticising that funding, the hon. Lady should welcome the Government’s commitment to increasing funds for the NHS and ensuring that it remains fit for the future.

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Does my hon. Friend agree that one of the big benefits of our leaving the European Union is that we will not be sending billions of pounds a year to Brussels, and can instead spend that money on our health service, as per the new funding settlement?

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My hon. Friend is right to draw the House’s attention to the fact that there are a number of benefits from leaving the EU, not just in terms of the dividend to which he refers, but in terms of flexibility, for example in—[Interruption.] Labour Members do not seem to want to hear about the opportunities: opportunities on life sciences for example, in terms of getting medicines through in shorter timescales; opportunities on immigration; opportunities on professional qualifications; opportunities even on food labelling. It is important that we take those opportunities, as my hon. Friend says.

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I too welcome the Secretary of State to his place. Membership of the European Medicines Agency has enabled early access to new drugs for UK patients through a single Europe-wide licensing system for a population of 500 million. Can the Minister clarify whether it is still the Government’s intention to remain a member of the EMA, and perhaps explain why on earth they voted against the EMA amendment last Tuesday?

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As the hon. Lady will be aware, we accepted the amendment, and it is our intention to work as closely as possible on that as part of taking that forward—[Interruption.] To correct the—[Interruption.]

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Order. To be fair, it is a speedy correction.

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This is a near instantaneous correction, Mr Speaker, to recognise that what I should have clarified is that, following the vote in the House, it is our intention to work as closely as possible with that, and we recognise the point the hon. Lady makes.

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It is still rather hard to understand why the Government voted against it in the first place. There is no current associate membership of the EMA for the UK to re-join as a third country, so if it is not possible to stay in the EMA what is the plan to avoid delays of up to a year in the licensing of new drugs for UK patients?

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There are a number of things that can be taken advantage of. We can use the flexibilities we have in terms of assessments with shorter timescales so that we can prioritise UK drugs that are bespoke to the UK market. There will be opportunities as part of this, as well as our working closely with European colleagues.

NHS Workforce

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9. What steps he is taking to tackle workforce shortages in the NHS. [906614]

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17. What steps he is taking to tackle workforce shortages in the NHS. [906623]

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We now have more professionally qualified clinical staff working in the NHS: over 41,000 more since 2010, including over 14,000 more doctors and over 13,000 more nurses on our wards.

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The majority of NHS staff in Scotland will benefit from a 9% pay rise over the next three years; their equivalents in England will get a much lower increase, and we do not even know if the funding for that is secured. Does the Minister have any concerns that nurses in England may choose to relocate to Scotland where they could be paid almost £1,000 more and work for a health service whose Government actually value its work?

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It is interesting that the hon. Gentleman asks that question, because it is worth looking at some of the facts. Over the five years to 2017 health spending increased by 20% in England but by only 14% in Scotland. As a consequence, people are 30% more likely to wait 18 weeks for treatment in Scotland than in England, and the increase in the number of nurses and doctors in England has been higher than in Scotland. Perhaps the SNP should look at how we have been performing in the NHS in England and learn from that.

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In that case, perhaps the Secretary of State will join the Royal College of Nursing in welcoming the action by the Scottish Government to enshrine safe staffing levels and ratios in law. Given that there are over 36,000 vacant nursing posts in the NHS in England, when will he follow the Scottish Government’s lead and bring forward legislation on safe staffing levels?

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I have seen what has happened, and maybe the reason why the SNP has had to do that is that in England we have increased the medical workforce faster than in Scotland. When the performances improve in the Scottish NHS, we in England will start to take lessons, but until then I will concentrate on making sure we get the very best NHS right across the country.

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Barely two years after the shock closure of Deer Park medical centre in Witney, the people of Witney are now deeply concerned over the future of Cogges medical centre. Please will Ministers explain what they are doing to help with recruitment and retention of GPs in rural areas, and will the Secretary of State meet me to discuss the provision of GP services in our market towns?

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I or the Minister of State would be delighted to meet my hon. Friend. Making sure that our GP services are of high quality and can respond to the health needs in the local community is absolutely mission-critical to getting prevention right, and I hope that my hon. Friend’s insights will feed into the long-term plan to guarantee the future of the NHS.

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I congratulate the Secretary of State and remind him that when he tours the high streets of Britain he will find an increasing number of acupuncturists, herbal medicine practitioners, reflexologists, yoga practitioners and many more, and they all have one thing in common: none of them is available on the health service. Will he introduce a review that takes into account patient experience and practitioner experience?

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I pay tribute to my hon. Friend’s long campaign in this area, and I very much look forward to working with him on it to ensure that we get the right evidence-based approach to using all kinds of medicines and technologies for the benefit of patients.

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I welcome the new Secretary of State to his post. He has said that the whole workforce of the NHS and social care should have the chance to fulfil their potential, but the care workforce has an annual turnover of 27% and a vacancy rate of 7%, and, sadly, care staff learned last week that they would not even be paid the national minimum wage for sleep-in shifts, which will potentially drive even more people away from working in social care. Will the Secretary of State demonstrate the leadership that this Government have lacked on this issue and ask the Chancellor to change the regulations on the national minimum wage for sleep-in shifts, to show care staff that they matter?

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I value every person who works in the NHS and in social care, because everybody plays a part in improving the wellbeing and the health of the nation. I care deeply about that. On the question of sleep-in shifts, I saw the decision by the court and I have already had conversations with the Department for Business, Energy and Industrial Strategy, which leads on this regulation, to ensure that we can get the rules right for the future.

Alcohol Dependency

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10. What plans the Government have to improve support for the children of alcohol-dependent parents. [906615]

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Alcohol addiction has a devastating impact on individuals and their families, and it is unacceptable that children bear the brunt of their parents’ condition. That is why we are investing £6 million over three years to support vulnerable children living with alcohol-dependent parents. I pay tribute to the former Secretary of State and to the shadow Secretary of State for their leadership in making this happen.

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I thank the Minister for his answer, but this is obviously a much wider problem, affecting more than just the children of alcohol-dependent parents. Will he tell the House what more can be done to ensure that people in the wider community can access that kind of help?

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We are working on an alcohol strategy, which is being led by the Home Office, and I have spoken to a number of stakeholders in the last two weeks at the various roundtables I have been holding. On the question of alcohol-dependent parents with children, we are working through local authorities, which is important, but as part of the investment that I have mentioned, there is also £500,000 going into expanding the helpline provision for children who find themselves in this position. I have heard time and again when talking to children affected by this that being able to say that they are not alone in this is often a great place to start. The helpline will be very important in that regard.

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I welcome the comments made by the Public Health Minister today. I also welcome how open he has been to cross-party lobbying on this issue, including from my hon. Friend the Member for Leicester South (Jonathan Ashworth), the shadow Secretary of State. The £6 million is welcome news. Just to put it in perspective, more than 4,000 children phone Childline each year about alcohol use—it is the biggest concern that children have about their parents when they ring that service. We have something in Doncaster called the Family MOT—Moving On Together—and I hope the Minister will take the opportunity to see some of the good practice that is going on around the country. Will he tell us more about how that £6 million is likely to be spread around the country?

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I probably cannot do all of that without trying Mr Speaker’s patience, but I should like to thank the right hon. Lady, who is one of my predecessors, for the work that she does through the all-party parliamentary group on children of alcoholics, and with the charity Adfam. Charities and other third sector organisations will play a key part in putting in bids to work with local authorities, as part of the £6 million. Public Health England is leading on that, and I look forward to having ongoing discussions with her and with other Members who I know have a deeply held personal interest in this matter.

Pregnancy: Smoking Rates

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11. What steps he is taking to help reduce the rates of smoking during pregnancy. [906616]

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Smoking rates are at their lowest ever, but we need to make more progress on tackling smoking in pregnancy, as I outlined in the general debate last Thursday. We are determined to redouble our efforts in this area, because smoking is still the biggest preventable killer in our country today.

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I thank my hon. Friend for his answer. Smoking rates among pregnant women are still stubbornly high. What steps can he take to encourage the partners of pregnant women to give up smoking so that both partners play a part in preventing damage to the unborn child?

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My hon. Friend makes a good point, which he made in last week’s debate. Public Health England and NHS England will continue to work with local areas in our constituencies to promote evidence-based ways of identifying and supporting pregnant smokers to quit. The overall ambitions in the tobacco control plan, which I published a year ago last week, will touch the general population, which of course includes the partners of pregnant women.

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Has the Department carried out investigations into the effects of vaping during pregnancy? If so, what are the results?

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Vaping and e-cigarettes were part of the Stoptober campaign that we ran last October through Public Health England. I am often criticised for not promoting vaping enough, and I am sometimes criticised for promoting it too much, which possibly gives me a steer. The advice is clear that the best thing to do, whether someone is pregnant or otherwise, is not to smoke.

Mistakes in Healthcare

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12. What steps his Department is taking to support families and patients affected by mistakes made in the healthcare system. [906618]

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Families and patients are at the heart of our work to improve patient safety, which is why all NHS organisations are subject to a statutory duty of candour and should be open and transparent with patients and families when things go wrong. Last week, the National Quality Board published new guidance for NHS trusts to help them better support, communicate and engage with bereaved families and carers.

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I thank the Minister for that response, but since I was elected three years ago I have come across several examples of families who have lost loved ones who went to hospital for repeat interventions from the health service, yet died from undiagnosed conditions, many of which could have been avoided. The problem is that those families have found getting answers and finding anyone to accept responsibility fruitless, so what more can the Department do to help them?

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My hon. Friend is right to raise that issue. Those who have lost loved ones in that way need answers when things go wrong. The recent bereavement guidance is clear that, when notified of a death, families and carers should be told that they can comment on the care of the person who has died and raise any concerns. From next year, medical examiners will offer greater scrutiny for the bereaved, increasing transparency and offering them the opportunity to raise concerns.

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In a recent report, Healthwatch Greenwich drew attention to the fact that many local GP practices are still wrongly refusing to register patients, often vulnerable ones, unless they have ID or proof of address. What more can the Minister do to ensure that each and every GP practice is following the Department’s guidance?

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I am grateful to the hon. Gentleman for that question, and I will certainly look more closely at the issue.

Draft Human Fertilisation and Embryology Act 2008 (Remedial) Order

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13. What assessment he has made of the extent to which the draft Human Fertilisation and Embryology Act 2008 (Remedial) Order 2018 meets his Department’s policy objectives on equality. [906619]

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The revised remedial order laid last week addresses the potential inequalities that were identified by the Joint Committee on Human Rights, but it also goes further, ensuring that a sole applicant biologically related to the child will always be able to apply for a parental order regardless of their relationship status. That is a step forward for equality.

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On behalf of the all-party parliamentary group on surrogacy, I thank the Minister for meeting us recently and for laying the order, which removes an inequality. Surrogacy helps to build families, be they heterosexual, same-sex or individuals, so what more can she do to promote it?

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My hon. Friend is right. There has been considerable growth in surrogacy arrangements in recent years, but I am unsure whether the law has kept pace with the changing practice. We have been revising the guidance to ensure that everyone can approach the matter with greater certainty but, more specifically, I have commissioned the Law Commission to have a good look at the law in the area so that we can ensure good practice in this country without driving people overseas.

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What action is the Minister taking to ensure that the National Institute for Health and Care Excellence guidelines on equal access to IVF are adhered to, so that people such as my constituent Rebekah Hambling, who sadly lost her IVF baby to group B strep, are not denied further rounds of IVF in North East Lincolnshire because they would still have been eligible in other CCG areas?

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I agree with the hon. Lady. It is unacceptable that seven CCGs offer no IVF treatment at all, which is establishing a postcode lottery. We keep reminding NHS England and CCGs of the NICE guidelines and we expect them to follow them.

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I call Bim Afolami. Not here. This is a rum state of affairs. I hope the fellow is all right. He was here earlier, but he has beetled out of the Chamber at a most inopportune moment. Well, there is nothing to be done, and the grouping breaks down, but I hope Bim’s okay. Reports would be welcome.

Cancer Strategy

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16. What steps the Government are taking to ensure that the recommendations of the cancer strategy will be implemented by 2020. [906622]

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I, too, hope my hon. Friend the Member for Hitchin and Harpenden (Bim Afolami) is okay.

Saying that gave me a crucial few seconds. [Interruption.]

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It is very good of the hon. Member for Hitchin and Harpenden to drop back in on us. Unfortunately, he beetled out of the Chamber at a most inopportune moment, just before his question was reached. If he sits there, and if he is a good boy, we might get to him in due course. We have moved on now, which is most unfortunate.

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We are very clear that achieving the 62-day standard is not a prerequisite for transformation funding, but the better the performance against the standard, the more funding alliances will receive. Most have now received 75% to 100% of the funding requested. This is taxpayers’ money, so we must ensure alliances are operationally strong and ready to achieve transformation.

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I welcome the new Secretary of State to his post.

There remains the inconvenient truth that, despite all Governments bombarding the NHS with process targets in recent decades, cancer survival rates are not catching up with international averages. The last Government’s estimates suggested that that needlessly costs 10,000 lives a year as a result. Will the Minister work with the new Secretary of State, in drawing up the next cancer strategy, to put outcome indicators at the very heart of the process? For example, holding the local NHS accountable for its one-year figures would encourage initiatives to promote earlier diagnosis, cancer’s magic key.

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I thank my hon. Friend for his work chairing the all-party group on cancer over many years, as I know he is about to step down. He has two answers in one here. Yes is the answer. Improving cancer patient outcomes will be the seam that runs through the centre of the NHS’s long-term plan, like the proverbial stick of rock.

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Only 5% of the NHS cancer budget, about £385 million a year, is spent on radiotherapy, and that underinvestment is affecting patient access to advanced modern radiotherapy and outcomes. Is it not time to make the cancer drugs fund a cancer treatment fund and extend those opportunities?

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We are looking at the future of the cancer drugs fund as part of the new 10-year plan. There is a radiotherapy review at the moment, as the hon. Gentleman will be aware. Knowing him, he will be engaging with the review in his area. He talks about the latest radiotherapy and, of course, we have the new proton beam therapy treatment coming online in London and Manchester, for which children and patients are currently sent overseas. That is a great step forward, but there is an awful lot more to do, which is why the 10-year plan will have cancer at its heart.

Artificial Intelligence

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18. What assessment he has made of the opportunity for artificial intelligence tools to improve the provision of healthcare. [906624]

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The Government believe that artificial intelligence and other digital technologies have the potential to transform health and care services. Our work on that includes investing over £400 million in tech transformation, which I announced last week. There is much more to do.

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I also welcome my right hon. Friend to his new role. He will bring tremendous energy and enthusiasm, particularly into the information advantage that we know is needed to transform the NHS. Does he share my view that not only will this transform patient outcomes but we can use artificial intelligence to improve patient treatments? What are his initial views of the obstacles standing in the way of rapid uptake of such technologies?

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There are huge opportunities for AI to improve patient outcomes and to make life easier for staff. In answer to the second part of my hon. Friend’s question, it is all about getting interoperable data rules and standards in place so that different systems can talk to each other in a secure, safe and innovative way.

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rose—

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When we were at university together there was nothing, in my judgment, about the hon. Gentleman’s intelligence that was artificial.

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Thank you, Mr Speaker. It is not just artificial intelligence. The development of other life sciences and new technologies can have a massive effect on improving people’s healthcare, such as the development of treatments like Orkambi for people with cystic fibrosis. Will the Secretary of State make it an important priority to cut through the impasse between NHS England and the manufacturer, Vertex, so that people with cystic fibrosis can finally get access to the drugs they need?

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As the Clerk advises—his is the intellectual copyright—the hon. Gentleman has used his intelligence artificially to shoehorn his preoccupation into a question to which it has no other relation. But he has got away with it on this occasion, as it is the last day and we are all in a summer mood.

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I welcome the power of new technologies to bring new drugs to the table. NHS England has made a very generous final offer to the manufacturer of Orkambi. Having spoken to those involved again over the past couple of days, I understand that a meeting has been offered to the company but not taken up. The company can break this impasse by accepting the very generous offer on the table.

Children's Mental Health: Social Media

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19. What steps his Department is taking to help protect children’s mental health from the harmful effects of social media. [906625]

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Our chief medical officer is leading a systematic review of international research to improve our understanding of social media use and children’s mental health. We are also working with the Department for Digital, Culture, Media and Sport to consider what more can be done to reduce potential harm to children’s mental health from social media. This is being done through the Government’s upcoming internet harms White Paper, which is due later this year.

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The longer people spend online, the more likely they are to experience cyber-bullying. Research by Childline, a service of the National Society for the Prevention of Cruelty to Children, shows that the number of young people seeking counselling as a result of online bullying has increased by 88% in just five years. What are the Government doing to improve research on this issue and to better understand the potential harms?

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My hon. Friend is right to highlight this, but it is worth bearing in mind that there are also positive effects from engagement on social media. The relationship between social media use and its impact on mental health is not conclusive. That is why the chief medical officer is carrying out a review of all the evidence in this area, so that we can understand and shape future policy. That report will be due next year.

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The Government acknowledge that we are seeing an increase in the number of children suffering with their mental health. We have only to look at the figures on the number of children turning up at accident and emergency in a crisis to know that that is the case. This is a serious state of affairs. Why then are the Government releasing their response to the consultation on the Green Paper on young people’s mental health later this week, when we are in recess, and thus avoiding scrutiny in this House?

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Respectfully, I say to the hon. Lady that this is a response to the consultation on the Green Paper, which has had considerable debate in this House. The suggestion that we have avoided scrutiny really does not pass.

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Thank you for calling me, Mr Speaker; news of my death has been greatly exaggerated, Sir.

I thank the Minister for her previous reply. She will be aware that there is considerable concern about certain images on social media, particularly those relating to self-harming, and the effect they have on young people’s mental health. Will she set out the Government’s response in dealing with this issue?

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I know the hon. Gentleman, who has returned to the Chamber in rude health, is in fact deeply grateful to me for my generosity in accommodating him, notwithstanding his rather eccentric disappearance, and the fact that he did not mention it was a mere oversight.

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I can confirm that the Government will be publishing their online harm White Paper by the end of this year to address the very subject my hon. Friend mentions.

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I have asked the previous Secretary of State whether he would agree to engage in my all-party group inquiry on social media and the impact on young people’s mental health. May I ask this Minister to go a step further and engage in our oral evidence sessions, which are starting when the House returns in September, about how we can find solutions to the problems that the impact of social media causes to young people’s mental health?

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I would be more than happy to engage with the hon. Gentleman and the all-party group on this issue, because it is important we do as much as we can to learn and to get as much evidence as possible in this area.

South Tees CCG

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21. If he will ensure that funding for services commissioned by South Tees clinical commissioning group will not be reduced as a result of that group being placed in special measures. [906628]

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I reassure the hon. Lady that the level of funding allocated to South Tees CCG will not change as a result of the group being placed in special measures.

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I appreciate the Minister’s reply, but does she agree that, instead of dismissing this as a failure of bookkeeping, as her colleague in the Tees Valley has done, she should look carefully again at the rising demand in our area and at the unique challenges we face as a result of high levels of deprivation, ageing demographics and the economic shock we suffered three years ago? Will she look again at a fairer funding allocation to make sure that we can serve everyone’s needs in the Tees Valley?

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The hon. Lady is absolutely right to raise this issue. Prevention is a key aspect of the new Secretary of State’s focus as the Department moves forward. NHS England will support all CCGs that are in special measures to return to financial balance. It also provides a bespoke package of support, along with a higher level of monitoring and oversight, to ensure that the money is always spent wisely.

Topical Questions

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T2. If he will make a statement on his departmental responsibilities. [906632]

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We have proposed £20 billion more funding for the NHS to guarantee its future, and I am looking forward to working with everyone in the NHS and the social care system on a long-term plan to ensure that that money is well spent. Today, we have published for the House the 2018-19 pay settlement for doctors and dentists. It represents the highest pay settlement since 2008. I regard it as a first step and look forward to a wider conversation on pay and improvements to help to make the NHS the best employer in the world.

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Will the Secretary of State update the House on the progress of Baroness Cumberlege’s review of the use of mesh implants? Will he confirm whether the inquiry will liaise with the Scottish Government and whether it will hold any evidence sessions in Scotland? There are plenty of women, including some in my constituency, who had operations in England but now live in Scotland. Their voices must be heard in the inquiry.

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Yes, the hon. Gentleman is absolutely right. We published information on this issue just last week. We absolutely will consult the Scottish Government and all interested stakeholders. It is a very important matter to get right.

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T5. Last year, 7.3 million people were prescribed antidepressants, including more than 70,000 children. That is an increase of more than 500% in the past 20 years. In welcoming the Secretary of State’s announcement on social prescribing, may I, as co-chair of the all-party group on mindfulness, ask him what part mindfulness and other evidence-based non-drug options will play in the strategy? Would he like to undertake a mindfulness course, and in doing so join the now more than 150 other MPs and Lords who have done so at Westminster? [906636]

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I would be absolutely thrilled to. I have previously participated in mindfulness training. In fact, the former chairman of my local Conservative association became a mindfulness instructor, which shows how much we take it seriously locally. I pay tribute to my hon. Friend’s work on this issue. He will have seen that, even in my first two weeks in this role I have already spoken out in favour of moves towards social prescribing and the broader prescribing of less intervention and less medicinal methods, where possible, because medicines do of course have their place. The work that he has done on this issue over many years is to be applauded.

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I welcome the Secretary of State to his post. May I take a moment to thank all the NHS and social care staff who are caring for vulnerable patients in this intense summer heat?

The new Secretary of State inherits waiting lists at 4.3 million, with more than 3,000 patients waiting more than a year for an operation. He inherits a situation in which 1,700 patient requests for hip and knee operations have been refused, and in which patients in Sussex are now expected to endure “Uncontrolled, intense, persistent pain” for six months before they receive hip or knee treatment. Does he consider such increased rationing to be fair?

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I am grateful to the hon. Gentleman for his welcome. Like him, I pay tribute to the work of NHS and social care staff in this summer heat. There are of course pressures on the NHS—I fully acknowledge that—and he raises a couple that I have already raised with NHS England. What he did not mention was that since 2010 there are 6,000 more operations every day and 1,800 more emergency admissions every day.

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Since 2010, the NHS has suffered the biggest financial squeeze in its history, and the rationing that I referred to is a consequence of that squeeze.

Let me ask the Secretary of State about general practice, which he will know is facing a severe workforce crisis, with GP numbers down by 1,000 and many GPs worried about the patient safety implications of the Babylon app, which we have already discussed this morning, and its funding implications for their model of practice. When Babylon itself admits that it is still testing it out, when Hammersmith and Fulham CCG says that

“there is evidence of concern regarding the risk to patient safety”

of expanding the service, and when Birmingham and Solihull CCG questions whether Babylon can operate in an effective and safe manner, why does the Secretary of State dismiss concerns about patient safety and say that the rules simply need to be updated? Will he tell us what specific rules will be updated to allay concerns about patient safety?

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It is almost as if it was not just my hon. Friend the Member for Hitchin and Harpenden (Bim Afolami) who popped out, but the shadow Secretary of State, who obviously was not here for the earlier discussion. Getting more resources and increased resources into primary care and to GPs in particular is absolutely mission critical to the long-term sustainability of the NHS. I am delighted that there is record GP recruitment at the moment and that the work that has been done to increase GP training is bearing fruit. On the question of new technology, as we discussed over a series of questions earlier, yes, it is important to make sure that it works well and that the rules are right but, if we turn our backs on new technology, we are turning our backs on better care.

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I congratulate my right hon. Friend on his new position. Despite having incredible NHS staff, our hospital in Harlow, the Princess Alexandra Hospital, is not fit for purpose in terms of its building. We desperately need a new hospital. Will he visit Princess Alexandra Hospital as Secretary of State and will he please make sure that we get the new hospital that we urgently need in the constituency of Harlow?

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I pay tribute to the work that my right hon. Friend has done over many years making the case for his hospital, which I have heard loud and clear. I always enjoy visiting Harlow, especially when I am his guest. I hear the case that he puts and look forward to visiting soon.

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T3. Last month, a constituent contacted me about the care of her adult son who needed to be admitted to hospital under the Mental Health Act 2007. She was told that no beds were available anywhere in the country. The following day, a bed was identified but when, after three hours’ wait, the ambulance had not arrived, the bed was filled by another patient. Three days later, he was finally admitted to hospital. The head of mental health at Nottingham City Council told me that this is not an infrequent occurrence. Secretary of State, how is this an acceptable standard of mental healthcare? [906633]

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Clearly, the sequence of events that the hon. Lady has outlined is completely unacceptable. We have obviously set out clear expectations on NHS England to commission sufficient beds to enable local placements where possible and specialist care where a more acute service is required. It is up to NHS England to ensure that sufficient services are commissioned and I will readily take up that case with NHS England.

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I welcome my right hon. Friend to his new position.

On Friday, a retired NHS consultant visited my surgery to talk about carpal tunnel syndrome. It appears that some of the operations are not going to happen now, and he said that they can happen at general practice level for about a third of the cost that they happen at hospital level. Is there an opportunity, yes, to save money but also to do things better by moving surgery out to community facilities? Can we explore such opportunities before these decisions are taken?

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My right hon. Friend raises an important point about ensuring that procedures are done in the right place at the right cost, but primarily in a way that is best for the patient. I am happy to meet her to discuss the specifics of that and to see whether a change can be made.

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T4. Despite previous reassurances from Health Ministers, I continue to receive reports from constituents of waiting times for referrals to child and adolescent mental health services in excess of nine months and, with an extremely high threshold for support, many are turned away. The Government spend less than 1% of the NHS budget on children’s mental health. When will the Department stop failing our children and gives CAMHS the investment that it desperately needs? [906634]

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The hon. Lady will be aware of the proposals that we have in the children and young people’s mental health Green Paper. We have very ambitious plans to roll out a whole new workforce to work in schools to support children at an earlier stage of mental ill health. Why we have these proposals is that we readily admit that an insufficient number of children are able to access services at present, and that is why we are making this investment.

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My constituent, Aaron Winstanley, from Barton-upon-Humber is currently in Germany receiving immunotherapy treatment for a rare form of cancer. The local community has reacted magnificently, raising around half of the £300,000 that this treatment costs. Could the Minister outline what is being done to introduce this treatment into England?

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I wish my hon. Friend’s constituent well and pay tribute to the money that the local community has raised. I will connect my hon. Friend to the office of Cally Palmer, the national cancer director. As we write the new long-term plan for the NHS—to which the cancer stream is so central—we will ensure that innovative new technologies and treatments that were not thought of even a few years ago are also at its centre.

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T6. Three times more people die by suicide each year than in road accidents. Today, Samaritans volunteers across the UK are taking part in its awareness campaign, “The Big Listen”. What action is the Secretary of State taking to ensure that local agencies are encouraged and resourced to carry out awareness-raising work to get out the message that suicide is preventable, not inevitable, in line with NICE’s draft guidelines? [906638]

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I thank the hon. Lady for her dedicated work on this issue. She is right to pay tribute to the work of the Samaritans, and the Department is pleased to do everything that we can to support the Samaritans in this area. Our real tool for tackling suicide is to ensure that the local suicide prevention plans are up to spec to deliver a reduction in suicides. We will be taking steps properly to interrogate the quality of the plans so that we can deliver against the guidelines.

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I welcome the Secretary of State to his position, especially given his background in data and digital. What is he going to do to improve NHS data management to enable its use to develop the next generation of drugs and medical technologies to deliver better health outcomes?

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That is a great question. Not only can technology improve in health settings; there are even greater opportunities on the research side. Getting the data structures right is mission critical, but there is so much more that we can do.

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T7. To help to reduce childhood obesity, 76% of people support a ban on junk food adverts before 9 o’clock, but the consultation on this is going into the middle distance. Critics would say that the Government are dragging their feet. By when will we see this ban finally put into place? [906639]

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We announced that we will be consulting less than a month ago. I have been closely involved in this in my previous role, as well as in this one. We will ensure that we take an evidence-based approach, but I am determined that we proceed.

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Will the Secretary of State come down to East Sussex to view the Better Together partnership, which puts health and social care together?

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How could I say no? The integration of health and social care is vital and long awaited, and there is so much to do.

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As someone who is about to have a knee operation, may I tell the Secretary of State that it is a painful thing to wait for and that people should not have to stay on waiting lists for long periods of time? My question is about hospital medical staff. Western Mail carried out a survey to look at the effect of EU nationals leaving the national health service because of Brexit. It found one health board saying that there were 1,200 more nurses than there were four years ago, and another saying that there were 1,400 fewer. No one seems to be able to tell us with absolute certainty the numbers of these staff in the health service.

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I listened carefully to the right hon. Lady because she has long been a campaigner on health issues, and I very much take her point about knee operations. Of course, the number of EU nationals working in the NHS in England has risen by over 4,000 since the referendum. I know that there are concerns in specific areas, but I hope that we can all take reassurance from the fact that that number has continued to rise. We are determined to ensure that the NHS has the workforce that it needs.

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I welcome the Secretary of State to his place. I encourage him to visit the most rural part of England, up in Northumberland, to see for himself the challenges to healthcare provision due to the lack of a real rural financial formula. Will he update my constituents and the Save Rothbury Hospital campaign on how the review for that community hospital is going? That sort of low-level care is what makes the difference.

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I am happy to discuss with my hon. Friend how we provide support. Addressing the fact that 43% of patients in acutes do not actually clinically need to be in hospital is a key objective of the long-term plan to ensure that we get the right community services and relieve pressure from acutes.

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I am sorry, but as in the national health service—under Governments of whichever colour—demand massively outstrips supply. I have tried to extend the envelope, but we must now move on. [Interruption.] I heard the shadow Chancellor’s observation from a sedentary position, which may well be recorded in the Official Report. We now move on to the urgent question.

Public Sector Pay

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(Urgent Question): To ask the Chief Secretary to the Treasury if she will make a statement on the public sector pay announcement.

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I am delighted to have this opportunity to discuss today’s announcements of public sector pay rises.

Last September, I informed the House the we would scrap the cap, and now we are delivering on that commitment. What we are announcing today amounts to the biggest pay rise in almost 10 years for about 1 million public workers across Britain, including teachers, armed forces personnel, prison officers, police, doctors and dentists. This comes on top of the positive news we were able to announce in March that 1 million nurses, midwives, porters and other NHS staff would receive a 6.5% pay rise over three years. That deal was a benchmark example of where high pay awards are agreed in return for modernisation of terms and conditions.

We were able to announce these pay rises thanks only to the hard work of the British people, which has brought down the deficit by over three quarters and allowed us to reach the point where the debt will begin to fall this year. We did not listen to the siren calls from the Opposition for damaging splurges, and that is why today we are able to scrap the cap and increase public sector pay. These new pay deals represent what this Government are about. They are affordable and responsible, while making sure that we continue to provide the public with world-class public services. They also reward our hard-working public servants.

It is great, on the final day of this Session of Parliament, that we are able to give every person who works in the public sector positive news on which to enjoy their summer.

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These uninhabited proposals will do nothing to repair the damage done to our brilliant public sector workers by this Government’s slash-and-burn policy in relation to public sector pay. Over the past seven years, our teachers have lost £2,500, our firefighters £3,000, our prison officers £4,000 and our paramedics £4,000 in real-terms pay cuts. Even the armed forces have been affected by this stingy Government.

Yet the Government think it is enough to announce to the press—to the press, Mr Speaker, yet again—an uncosted proposal that will, at best, leave workers just about breaking even on their austerity-slashed pay, while civil servants and others continue to see their pay cut. This is a mendacious PR exercise. Based on today’s announcement, after eight years of real-terms pay cuts for employees in the public sector, our police officers, junior doctors, some specialist doctors, GPs and dentists are all being offered a further real-terms pay cut.

Will the Minister now confirm what the additional cost of each announcement is to Departments? Will she also confirm that this cost is being siphoned from existing departmental spend, with no new money made available? This will have a disastrous effect on Departments already close to ruin from austerity; they will be forced to cut staffing levels and services to cope. Can she guarantee that there will be no reductions in staffing levels across the public sector because of this unfunded increase in pay? Can she guarantee that public services will not be adversely affected by her failure to provide proper funding? Will she explain why civil servants continue to see real-terms pay cuts? They are always at the back of the queue when it comes to pay. How much additional social security expenditure has resulted from seven years of cuts to public sector workers’ pay? Does she agree that it has been this Conservative Government’s policy for the past seven years to force thousands of public servants on to social security by cutting their income?

The Conservative party should be ashamed. The Government’s announcements today leave public sector workers treading water. These proposals will force threadbare Departments to make further cuts to vital services and to reduce staffing levels, and what for? All so that the Prime Minister can get a cheap PR hit to try to cling on to power. We do not buy it. Labour demands that public sector workers get the pay that they deserve.

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Yet again, we hear from a Labour Front Bencher not a positive welcome of the news today, which will mean hundreds of pounds more in the pay packets of public sector workers, but yet more complaints and no solutions.

We have scrapped the cap, and we are making sure that public sector workers get a decent pay rise. Let me tell the House what that will mean for workers in the public sector. For teachers earning under £35,000, it will mean a 3.5% pay rise, earning them an extra £800 a year. Police will see a 2% rise, with the average police constable on a £38,000 salary seeing a £760 pay rise. Prison officers will see a 2% rise and a 0.75% bonus, with extra for those who are new recruits. Junior doctors will get at least a 2% pay rise, and the hard-working people in our armed forces will receive a 2% pay rise and an additional 0.9% bonus, to reflect the brilliant work they do for our country.

The hon. Gentleman asks me how these pay rises are funded. Unlike the profligate Labour party, we have worked to support every Department to ensure that these pay rises are affordable within their budgets. In the case of the Department for Education—[Interruption.] The hon. Gentleman asked me the question. Does he want to hear the answer or not? [Interruption.] He obviously does not.

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Order. I think the hon. Member for West Ham (Lyn Brown) is the author of a newly published book entitled “Summer Rage”, but if I may say so, the launch party can wait until after today.

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I was diligently trying to answer the hon. Gentleman’s question, and I hope that he will listen to the answer.

We will be allocating a further £500 million from central Department for Education budgets to schools, to make sure they are able to give these pay rises to our hard-working teachers. In every other case, Departments have been able to find savings in their central budgets to make sure those pay rises are affordable. It is a bit rich getting lectures from the Labour party about affordability when its purported policy, along with overthrowing capitalism and making business the enemy, is to create a run on the pound. I do not know whether the hon. Gentleman can explain how his party could afford public sector pay rises with a run on the pound, but I would like to hear his answer.

The pay rises we are announcing today represent the highest pay rises for almost a decade for public sector workers. We have been able to achieve them because of our management of the economy, because we have seen employment reach a record level and because we are spending less in areas such as welfare, whereas people under the Labour Government were left on the scrapheap. Please can the Labour party welcome the fact that public sector workers are getting a pay rise and that we have scrapped the cap, rather than continuing with their usual Eeyorish nonsense?

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Like my right hon. Friend, I am rather surprised to hear the noise from the Opposition Benches. If we were to follow the policies of the right hon. Member for Hayes and Harlington (John McDonnell), we would see inflation of 1,000,000%, such as they have in Venezuela—a country that he suggests we all follow the example of. I welcome the pay rises that we will see for teachers in my schools in Redditch. Can my right hon. Friend tell me again how much teachers will receive, and can she emphasise the fact that those on the lowest incomes will receive the most?

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My hon. Friend is right; teachers on the lowest incomes will receive the largest rises. All teachers earning less than £35,000 will receive a 3.5% pay rise, and the Secretary of State for Education is making sure that schools have the money to afford that. Teachers in the upper pay range will receive a 2% pay rise.

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The key test of whether the public sector pay cap has been removed is how the Government treat their own civil servants. Can the Chief Secretary to the Treasury confirm that each UK Department was given funding for a 1% increase in civil service pay? Can she confirm that the pay remit guidance issued by the Cabinet Office for civil service pay allows pay rises of 1% to 1.5%? Can she tell us what pay rises civil servants who are not covered by a pay review body can expect this year? Finally, will the 220 Ministry of Defence staff in Scotland who are not being paid the living wage finally get £8.75 an hour?

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My right hon. Friend the Minister for the Cabinet Office has made the decision to award civil servants a 1.5% pay rise. That represents an increase on previous years, but we need to make sure that all public sector pay awards are affordable within Government budgets and that we are able to recruit and retain the highest possible quality civil servants.

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Order. I am keen to accommodate the interests of colleagues, but I remind the House that there is a further urgent question after this and then two ministerial statements and a debate on a motion appertaining to standards, before we get to the summer recess debate, in which no fewer than 30 colleagues wish to take part. I will try to accommodate people now if they pledge in advance to ask a single-sentence question, and preferably a short one, with a commensurately brief reply.

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The public sector workers in Morecambe and Lunesdale will welcome this announcement. Can my right hon. Friend confirm that those in the public sector are now getting £30,630 on average compared with £27,977 in the private sector?

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The figures that my hon. Friend quotes about public and private sector workers are right. My job as Chief Secretary is to make sure that we are properly rewarding public sector workers and that in areas where we are struggling to recruit and retain, pay rises are commensurate, to retain those people. We are also making sure that those pay rises are affordable within our Government budgets, which I think is what taxpayers expect.

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Can the Chief Secretary tell me how much extra funding has been provided for schools, to pay for the increase in teachers’ pay? Will that pay increase be fully funded?

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As I mentioned already, £500 million is being provided over two years to put into schools’ budgets. We have been working with the Department for Education. This is affordable for schools, but most importantly, it is fair for teachers, and those who are earning under £35,000 will get a 3.5% pay rise.

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Thanks to the decisions that have been made in Essex, we will see 150 new police officers on our streets. Can the Chief Secretary confirm that those new police officers will benefit from today’s announcement?

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My hon. Friend is right. I am delighted to hear the news about the police force in Essex. Those police officers will receive a 2% rise and, in addition, they will get increments as they move up the pay scale, so many will see a rise in excess of that.

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Cuts to school budgets have meant that some schools have had to make cuts to payments for support staff such as lunchtime assistants, for example, including by removing their holiday pay. How will today’s announcement benefit those lowest paid workers who have already suffered?

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Last year we announced that we were putting £1.3 billion more into schools’ budgets to help them to cope with the issues they were facing. That represents a real-terms increase from 2015. Today we have announced an additional £500 million to support these pay rises for teachers. I say to the hon. Lady: let us look at the school results, such as the fact that our nine-year-olds are now among the best in Europe at reading. It is because of this Government’s reforms that we are seeing better results.

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I strongly welcome the extra money for lower-paid teachers. May I ask my right hon. Friend where the £500 million will come from within the Department? The Department has already had to make efficiency savings, given the extra £1.3 billion that has gone to schools.

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It is important that schools receive the extra money so they are able to afford those pay rises. The money is coming from central DFE budgets—underspends in central DFE budgets—and it will be allocated to schools. My right hon. Friend the Education Secretary will talk about the allocation in due course.

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The Chief Secretary says that our armed forces will receive a 0.9% one-off payment, but there is no clear timeframe. Will she tell us exactly when armed forces personnel will receive that payment?

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Personnel will receive that payment alongside their 2% pay rise this year. Many armed forces personnel will also receive pay increments—we saw an average of 1.3% last year—on top of the bonus and the pay rise.

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What assessment has my right hon. Friend made of the announcement’s impact on the recruitment and retention of prison officers?

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My hon. Friend makes a very important point. Prison officers will receive a 2% rise and a 0.75% bonus. Prison officers who were newly recruited on fair and sustainable terms will receive additional progression pay to make sure that we retain those really important workers.

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Why have the Government announced that school leaders’ pay will continue to be cut in real terms, given that the School Teachers Review Body said that a 3.5% increase was needed across all pay ranges to prevent “deteriorating” trends in teacher retention?

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It is very important that we focus the pay rises on the lowest-earning teachers, which I think would be supported across the education system. Where there are specific shortages in education or in schools, there is of course the flexibility to increase pay, and I know that that happens for a number of headteachers.

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I welcome the news of the 3.5% pay rise for lower-paid teachers in Torbay. Will the Chief Secretary commit to work with the DFE to publish how the funding will be broken down by local authority so that we can clearly see how this is being funded?

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I thank my hon. Friend for his question. How the additional funding will be allocated will certainly be announced in due course by my right hon. Friend the Education Secretary. I welcome my hon. Friend’s welcoming of the good news, unlike Labour Members, who are still looking extremely gloomy.

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I am delighted that the Chief Secretary and the Government have finally seen sense and dropped the cap. However, there is already a £20 billion black hole in the MOD budget. How exactly is it going to pay for this?

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The hon. Lady is the first Opposition Member to welcome the pay rise, so I thank her for her support for public sector workers and for the pay rise we are giving them. I am working very closely with the Justice Secretary to make sure the pay rise is affordable within the Ministry of Justice budget. [Hon. Members: “Defence!”]

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The budgets of West Sussex schools are hugely under pressure and will be completely shot unless this pay award is completely funded centrally. Will the Chief Secretary guarantee that it will be completely funded centrally? What assessment has she made of the impact on the DFE’s budget for children’s social care, which is already facing a predicted shortfall of £2 billion by 2020?

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My hon. Friend mentions the funding for teachers’ pay rises. Beyond the 1%, the pay rise will be fully funded centrally, as will be announced by my right hon. Friend the Education Secretary.

I thought the hon. Member for Stoke-on-Trent North (Ruth Smeeth) referred to the MOJ, but apparently she was talking about the Ministry of Defence. The modernising defence review is going on at the moment, and I am working on that very closely with my Defence colleagues to make sure that this remains affordable.

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The Chief Secretary talks about putting more money into people’s pay packets, so will she tell us when under-25s will be paid the national living wage?

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This Government have achieved some of the lowest levels of youth unemployment for years. Under the Labour party, people were left on the scrapheap and we had rising youth unemployment, with up to 20% of our young people unemployed in 2010. What is important is that while people are training and gaining skills, it remains affordable for companies to take them on.

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I very much welcome these pay awards. Will the Chief Secretary say a little about the difference that taking millions of people out of income tax altogether will make in tandem with these pay awards?

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My hon. Friend makes a very good point. We have seen disposable incomes—the money people have to spend—increasing under this Government because we have cut tax for basic rate taxpayers by £1,000 a year. We know that the Labour party wants to raise tax to the highest peacetime levels, and the reality of that would be less money for hard-working public and private sector workers.

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Not one of the examples that the Chief Secretary announced is above the consumer prices index inflation rate of 2.4%. This is a real-terms cut for public sector workers. The secretary of the Unison branch at my town hall wants to know the Chief Secretary’s message for his branch members. How are they meant to survive when they are facing yet again—as they have year on year, for the past eight years—a real-terms pay cut?

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The vast majority of the numbers that I announced are above inflation, but the hon. Gentleman clearly did not hear that. I would point out that these pay awards are for the period 2018-19. We are seeing inflation fall, and many of the awards represent increases significantly above that.

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I asked the Chief Secretary and the Secretary of State for Education to ensure that the well-deserved pay rises for teachers did not come from the existing budget increases, so may I thank them both for ensuring that? My teachers deserve a pay rise, but they do not want school classrooms to suffer. May I also ask whether headteachers will be in receipt of the 2% increase mentioned for higher-rate teachers?

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As we have said, pay rises above the 1% that was previously budgeted for will be funded from central DFE budgets. [Interruption.] To the hon. Member for Wythenshawe and Sale East (Mike Kane), who is shouting from a sedentary position, I say that the funding will be not from schools budgets, but from central DFE budgets. We are moving this money to the frontline to make sure that teachers are properly supported. The rate for headteachers is 1.5% but, as I have already said in answer to the hon. Member for Bath (Wera Hobhouse), there is flexibility where there are recruitment issues.

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If these pay rises are from departmental cuts, this will mean no new money, which will result in further public services being lost and redundancies to follow. Does the Chief Secretary agree?

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I think that the fastest way to have redundancies is to create a run on the pound and overthrow capitalism.

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This pay award comes on the back of 10 years of pay freezes, which are fundamentally cuts. What can the Minister say to reassure people that, under this pay award, they will not actually see a pay decrease in the years to come?

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We have gone through a tough period in the aftermath of the financial crash, and the public sector has made a contribution. We are now at a turning point, with debt falling as a proportion of GDP. It is because of the hard work that has been done that we are now able to afford these pay rises, which are well deserved.

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The Chief Secretary talks about this alleged increase, yet she fails to discuss where it is coming from. What guarantee can she give to my constituents, who expect two new schools to be built in Reading East, that those schools will not be raided to pay for the pay rise?

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Our programme of spending £23 billion on schools capital will continue. This is about finding efficiencies in our central Government budgets. I know the Labour party does not understand value for money, but that is what we are doing, so that we can put more money into schools and teachers’ pay.

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The Minister will be aware that an aspect of our confidence and supply discussions with the Government involved raising the pay cap; we welcome the statement that she has made. However, given the fact that there is no Assembly functioning in Northern Ireland, what discussions has she had with the Secretary of State for Northern Ireland to ensure that the money is made available from departmental budgets and, secondly, that the decision is made to award these payments to teachers and nurses?

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As usual, the money for this pay will be allocated through the Barnett formula, but the money is coming from the central DFE budget.

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How exactly will further education colleges be able to give their staff an uplift?

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The hon. Lady will understand that we are conducting a review of further and higher education, and that is among the issues that we will be looking at.

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Teachers’ pay is not devolved to Wales until September 2019, so can the Chief Secretary confirm that the British Government will make the appropriate transfers to Welsh local education authorities to pay for the increase?

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I understand from my colleagues in the Department for Education that this will also apply to Wales.

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Past announcements on school budgets have unravelled within days, so is the Chief Secretary guaranteeing that every single penny to fund the teachers’ pay increase will come out of central budgets, with not one single penny falling on school budgets? Does the Chief Secretary accept that this does not change the grim reality of 351 out of 354 Birmingham schools facing real-terms pay cuts and budget cuts over the next two years?

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I have been very clear that the additional £500 million over two years will be coming from central DFE budgets. It will be allocated to schools. My right hon. Friend the Secretary of State for Education will be announcing exactly how that allocation will work in due course.

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Last week I was speaking to headteachers in my constituency who were very frustrated that they were breaking up for the summer unable to finalise their budgets. Now that they are able to do so, can the Chief Secretary guarantee today—I think that she has dodged this question a little bit today—that they will not have to find a penny from their existing budgets to fund the pay award?

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I think that many Opposition Members are missing the point that headteachers have significant flexibility in terms of paying their staff. Last year there was an average rise of 4.6%, including promotions. The point I am making is that above the 1% pay award that was already baked in, the DFE is providing extra funding to the tune of £500 million. My right hon. Friend the Secretary of State will be announcing the allocations in due course.

Syria

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(Urgent Question): To ask the Foreign Secretary what steps he is taking to save civilian life in the conflict in Syria.

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My right hon. Friend the Minister for the Middle East is travelling. I hope that the House will appreciate that Syria does not fall within my ministerial responsibilities, but I will of course endeavour to answer the urgent question and the questions that follow as best I can.

The situation in Syria is of course a humanitarian catastrophe. Over 400,000 people have been killed, and half of Syria’s 11 million population have been displaced. In these appalling circumstances, the UK has been taking all steps possible to save civilian life, and as the second-largest bilateral donor to the humanitarian response there since 2011, the UK is at the forefront of the response, by providing food, healthcare, water and other lifesaving relief. So far, we have committed £2.71 billion in response to the Syria conflict, which is our largest ever response to a single humanitarian crisis. Through our £200 million Syria Conflict, Stability and Security Fund, the UK has also provided a range of support to Syrian civilians and their communities to help save lives, bolster civil society and counter extremism. This includes our support to the White Helmets.

The White Helmet volunteers have played a particular role in saving over 115,000 lives during the conflict, at great risk to their own. They have faced particular protection risks as a result, with many killed while doing their work. It was for that reason that, as the Foreign and International Development Secretaries set out on Sunday 22 July, the UK has worked with our international partners to facilitate the rescue and relocation of a group of White Helmets volunteers and their families from southern Syria. We continue to call on all parties to protect civilians in the Syrian conflict. That includes using the multilateral organisations, including the United Nations Security Council, the UN Human Rights Council and the International Syria Support Group. The UK has also been at the forefront of efforts to strengthen global norms on chemical weapons and, of course, to deter their use.

Ultimately, there needs to be a political settlement to end the conflict. Syria’s future must be for Syrians to decide. The UK will be pragmatic about the nature of that settlement, and we will continue to support the UN process to achieve it.

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Thank you, Mr Speaker, for granting this urgent question.

Yesterday, the Foreign Secretary and the International Development Secretary announced that the Government will help to provide safe passage for the White Helmets, as the Minister has said. They will come to UK and other safe countries via Israel and Jordan. This is the latest development in a conflict that has been going on for seven years. We have watched as Assad’s barbaric regime bombards helpless civilians with barrel bombs and chemical weapons. The White Helmets are some of those who choose not to fight and it is correct, therefore, that we give them sanctuary. But before I ask about that specific announcement yesterday, I want to ask the Minister what more we will do, because the situation is urgent. There are three major problems that the Government need to give attention to.

First, there are several million people in the northern city of Idlib today. Hundreds of thousands of people have been pushed there by the Syrian regime, following the siege of Aleppo and the bombardment of other towns. These internal refugees are all now waiting for what comes next, and if Idlib is a repeat of Aleppo, the consequences for life—of children particularly—will be utterly horrific. I would like the Minister to explain what discussions are going on inside Government to respond specifically to that threat. As a member of the UN Security Council and one of the biggest aid donors to civilian protection in Syria, what efforts will the Government make now to deter Aleppo-style attacks on hospitals and schools, and how will we prevent further use of chemical weapons?

Many expect the Syrian Government to repeat its previous barbaric use of its bombs and its chemical weapons on Syrian civilians over the summer. I am simply asking the Government to do something to try to protect people.

Secondly, the Minister mentions the aid we have given, but we need to make sure it is getting into Syria. Last week, the hon. Member for Isle of Wight (Mr Seely) and I visited southern Turkey, where we met 20 or so Syrian doctors who had escaped Syria for a short while to receive training from British trauma surgeon David Nott. These doctors have a target on their backs just for doing their job—which is an impossible job to do but made immeasurably harder simply because they lack the basic supplies that British taxpayers have paid for to get to them. We need to make sure that we carry out diplomatic efforts to get that aid across the border.

The hon. Member for Isle of Wight and I brought back a letter from those doctors. They say in this letter that they are bracing themselves for a summer of death, so whether it is by doing all we can to deter the bombardment of Idlib, or simply using our influence, as I have said, to get supplies across the border to these doctors, we must help.

Finally, please can the Minister tell the House what support the White Helmets will now be offered? What will the scale of that help be? Will other vulnerable humanitarians in Syria be offered similar assistance? There are others from international NGOs trapped in Syria who require safe passage out. Can we guarantee resettlement for all of those who need it, and work with border countries to get them out and to the UK?

I know this is difficult. I know that there are many in this House who will simply say there is nothing we can do. But I think that with political will there is a way to help, and it will cost us very little to try. Surely, saving one life alone would be worth the attempt.

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I absolutely commend the hon. Lady, both for her question today and for the fact that she recently personally visited the region, along with my hon. Friend the Member for Isle of Wight (Mr Seely). She has thus seen at first hand what is going on, and speaks with authority in asking this urgent question.

There is no difference, I think, across the House; we all share a deep, basic human concern for the horror of this conflict, which has gone on for seven years. I recall its start when I was a DFID Minister, and was in the forefront of many of the fundraising conferences we had to try to turn as much as £1 billion on a sixpence at the beginning of the 2010 to 2015 Government, in order to focus on this sudden, ghastly—and now long-standing —conflict. We completely share the hon. Lady’s attitude and indeed much of her analysis.

First, on the White Helmets, this is a very important opportunity for us to issue our thanks and appreciation. They have been extremely brave. They are community-based civil society people, who put themselves at risk to do basic things, such as be first responders, clear the rubble and rescue the injured. They do so having been demonised in particular by the Russians, who have even accused them of carrying out chemical weapons attacks themselves.

It has been an absolutely remarkable feat of extraction to take the White Helmets out of southern Syria. We give enormous thanks to the Israelis for the efforts they made once requested by us, our international partners and the Americans. My right hon. Friend the Foreign Secretary, who had only been in the job for two days, was absolutely significant in discussing this with President Trump, when he was with the Prime Minister at Chequers, to try to persuade him to put a request to the Israelis to do it. Clearly, that has worked, and as a result many of hundreds of White Helmets and their families have been extracted from southern Syria.

The broader issue the hon. Lady describes is of course much more challenging. I totally understand what she says about the need, as she would put it, “to do something”. We are all frustrated at the difficulty of getting access for humanitarian purposes in territory that is increasingly controlled by the Syrians, the Russians and the Iranians. The delivery of the humanitarian aid we have on offer is perhaps more difficult now than it was when the conflict was at its height, because there are fewer pockets through which we can actually and easily deliver the aid we want to deliver. We are, for instance, talking to the hon. Lady’s former colleague David Miliband and the International Rescue Committee, which has its own people there, separate from the White Helmets. Wherever there are people delivering humanitarian aid, we want to give them maximum access and maximum protection.

On spending, we remain the second biggest donor in the conflict, and this is the largest budget we have ever given to a single cause of this sort. Our efforts will continue, and I am sure that the Minister for the Middle East will be making further statements in the House once we resume after the summer.

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Thank you, Mr Speaker, for granting this urgent question, which the hon. Member for Wirral South (Alison McGovern) so eloquently set out.

It is clear that there is a further catastrophe looming for the millions of people who live in Idlib. As the Minister said, the UK Government have the outstanding record on supporting those caught up in this catastrophe through humanitarian relief. Will the Minister assure the House that, with others, he will continue to liaise and seek assistance not only for the hundreds of thousands of brave people caught up in this looming crisis, but in particular for the many very brave humanitarian workers and actors who have often put their lives on the line to support those caught up in this situation? As with the work done with the Israeli Government, they urgently need to be able to rely on the international community to help them specifically in the coming days and weeks.

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My right hon. Friend is absolutely right. He of course was at the forefront of the initial aid effort in Syria, when he was Secretary of State for International Development and I was his hard-worked minion in that Department, at the beginning of the conflict. He is absolutely right that we have to maintain access for humanitarian efforts. We have so far committed £2.71 billion in response to this crisis. We have provided over 27 million food rations, 12 million medical consultations, 10 million relief packages and over 10 million vaccines. We are going to continue with our efforts. At the Brussels conference in April, we pledged to provide at least £450 million this year and a further £300 million next year to help to alleviate the extreme suffering in Syria and to provide vital support to neighbouring countries, which have taken up so much of the consequential effects of this horrid conflict.

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Thank you, Mr Speaker, and I apologise for my lateness.

Before I say anything else, I am sure the whole House will join me in sending our thoughts to those affected by the fires in Greece and the floods in Laos. We send our best wishes to the authorities in those countries which are responding to those tragedies.

Mr Speaker, thank you for granting this urgent question. I congratulate my hon. Friend the Member for Wirral South (Alison McGovern) on securing it and on bringing to the House such important and impassioned insights from her recent visit to the Turkish border, along with the hon. Member for Isle of Wight (Mr Seely). I can only endorse what she says in terms of the need to increase flows of medical supplies and equipment to those doctors and first responders working to save civilian lives in Syria. I thank the Minister for his response on that point, but I would like to reiterate one specific question asked by my hon. Friend, about the safety of the doctors. She talked about doctors feeling as though they had targets on their backs. I think that is something we need to respond to specifically.

As we all know, no amount of medical supplies and equipment will be sufficient if we reach the point in coming weeks where Assad and his foreign backers seek to capture not just Idlib but northern Latakia. If the assaults go ahead, the loss of life in those areas will be catastrophic, and the humanitarian crisis from civilians fleeing the violence will be just as devastating. The question is: what are we doing, in this country and as an international community, to prevent that from happening? I believe, as most Members do, that the only solution guaranteed to stop that loss of life and to end the suffering of the Syrian people is a peace deal brokered between all parties and predicated on the withdrawal of all foreign powers.

That, however, raises another grave question: who will broker such a deal? It simply cannot be left to the Russians, the Iranians and the Turks to stitch up an agreement between themselves, and it cannot be left to Vladimir Putin and Donald Trump to decide Syria’s fate in a room by themselves. We need the resumption of the Geneva peace process. We need all parties around that table and we need to protect the interests of all communities, including our Kurdish allies. against Daesh; otherwise, they risk being sold down the river once again. I therefore ask the Minister what progress is being towards the urgent resumption of those talks?

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I echo the right hon. Lady’s expressions of concern about the fires in Greece and the floods in Laos. She is of course absolutely right. We are all very saddened to learn that a country to which so many of our own citizens go at this time of year has already suffered 50 deaths as a result of raging fires in this period of very dry weather.

I omitted to respond to the hon. Member for Wirral South (Alison McGovern) on the question of the 21 doctors who had written to the Foreign Secretary. The letter has been received and has been passed to the Secretary of State for International Development, who will answer in due course in consultation with my right hon. Friend the Foreign Secretary.

The right hon. Lady is right that there can only be a political settlement, but there is no magic wand that the UK can wave on its own to try to solve the problem. It has been one of the most protracted and insoluble conflicts I have ever seen, as someone who has watched the middle east and the near east for over 30 years. It is the one to which there is no obvious answer, compared with so many of the difficult protracted differences that exist in the region. More territory is controlled now by Mr Assad and his associates than before. The right hon. Lady is absolutely right to say that Idlib and the north-west is now particularly vulnerable. We are perhaps seeing movements towards the foot of the Golan Heights near Quneitra where, if there is a conflict with the Israelis, it would obviously be very serious indeed. Ultimately, the solution is a political one. That means the United Nations and engagement of a sort with Russia, which I am sorry that Russian actions have put into reverse over the past few months. But a political effort with all responsible and interested countries is the only way to overcome this conflict.

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I am saddened to hear the Minister say that this will take a political solution, because, sadly, the solution we are seeing is not a political one. The solution we are seeing is being bought by ammunition on the battlefield, by violence and by force. Sadly, we are seeing it spread not just from the population centres we have seen in the past, but to areas like Idlib and down to the border.

The truth is that, if we are not willing to engage in a balance, if we are not willing to stand up to Russian and Iranian violence and to close off the routes for weapons to the Syrian regime, the political solution of which we speak will be bought on the battlefield and not around the table. Will my right hon. Friend at least concede that we should now be doing an awful lot to help the Turkish Government, who will be taking on vast numbers of refugees from Idlib, and the Jordanian Government, who are already bearing far more than their share of the burden?

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First, I pay enormous tribute to Jordan not only for helping with the extraction of the White Helmets, but for being prepared to take some of them, along with many tens, even hundreds of thousands of Syrian citizens, who, over the last few years, have gone to the likes of Jordan and Lebanon. Without the generosity of such neighbours, many, many people would be caught in the conflict by having to stay there. Those countries having admitted so many—actually, millions of—Syrian citizens is something that the world will be able to look back on over the years as a great humanitarian act. I totally agree with my hon. Friend about the necessity of trying to stop the flow of weapons, but in terms of doing anything on the ground or from the air, I hope that he will appreciate that it is not my role today to commit to any such action in the way he hints at in his question.

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Thank you for granting this urgent question, Mr Speaker, and I add my congratulations and thanks to the hon. Member for Wirral South (Alison McGovern) for the thoughtful, compassionate and very well-informed way in which she asked her questions. About 2.7 million refugees are in and around Idlib right now. They have all fled from other parts of Syria and have nowhere else to go. If Idlib turns into carnage, many of those 2.7 million people, including possibly 1 million children, will be left with no hope. As we have heard often enough, the situation is becoming desperate, and it is more desperate now than it has ever been.

I have often criticised Israel here and elsewhere in this building, so I have no hesitation on this occasion in commending and thanking Israel for the speedy and effective way in which they got so many of the White Helmets, and vitally, their loved ones, out of the danger zone. However, we should be under no illusions as to why the White Helmets and medics in Syria are in such danger: they will be the witnesses who bring Assad and his colleagues to account for crimes against humanity when, at some time in future, this horror on earth begins to settle down. It is so important to protect the witnesses who will hold the killers to account, so that those who commit mass murder will always know that they will be brought to justice sooner or later.

I have two questions for the Minister. First, a number of countries have established their own national mechanisms for the prediction and prevention of mass atrocities, either at home or elsewhere. The UK Government to date have not. Do they have any plans to join countries such as the USA in implementing such a strategy? Secondly, in December 2015, when the House was asked to agree military action in Syria, we were told that this would help to establish a provisional civilian Government in Syria, hopefully within six months. We are now two years past that expected date and a civilian Government of any kind is further away than ever. Have the Government done any assessment to establish why the predictions that they made in December 2015 were so catastrophically off-target, and what are they doing to make sure that similar predictions will be a bit more reliable?

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The hon. Gentleman is slightly unreasonable in saying that our predictions have to be reliable, in the way that he describes, as if it were entirely in our gift. We are dealing with a horrid, ghastly international conflict in which we are a player, in some ways, but we are not there on the ground in a way that can influence things as he wants. However, there is one area on which I strongly agree with him—that is, the question of accountability. We are absolutely committed to supporting efforts to pursue accountability for human rights abuses and war crimes in Syria, and there undoubtedly have been such.

We strongly support the work of the United Nations’ IIIM—the International, Impartial and Independent Mechanism—which investigates and collects evidence of the most serious crimes committed in Syria. We have contributed £200,000 to the start-up costs of that organisation, and we are funding non-governmental organisations that collect evidence for future prosecutions. We are also supporting the important work of the independent UN Commission of Inquiry, which is reporting on violations and abuses, and we have been in the lead on successful diplomatic efforts to strengthen the capability of the Organisation for the Prohibition of Chemical Weapons to prevent the further use of chemical weapons and to attribute responsibility to those who might use them.

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The £2.71 billion contribution to the Syrian aid effort is the single biggest act of humanitarian assistance in our nation’s history. Will my right hon. Friend continue to ensure that a suitable proportion of that support goes to countries such as Jordan and Lebanon, which are doing such important work on the ground to provide life-saving support?

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My hon. Friend is absolutely right. From the very beginning of this conflict, when we were looking at so many displaced people, a significant fraction of the humanitarian aid—or at least, the DFID budget spending—went to surrounding countries that were so generously accommodating to those who had fled, so it is inevitable that a large part of that budget will continue to go to such countries. Of course, in an ideal world, we would like to see Syrians return to their homes, but those have been so devastated that people would be going back only to rubble in many cases. It is inevitable that a lot of displaced Syrians will remain outside their former country for a long time to come.

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I also congratulate my hon. Friend the Member for Wirral South (Alison McGovern) on bringing this matter to us today. Is it not a fact that what the Russians and the Assad regime are doing is driving out moderate forces, forcing them away and, as a result, increasing the territory that is under the control of Daesh affiliate Jaysh Khalid Ibn al-Waleed? Does that not indicate that this is not an agenda that we could in any way support in any negotiated process? Is it not time that the international community as a whole called the murderers and liars in the Russian regime and the Assad regime to account?

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The hon. Gentleman is very well experienced in this area and speaks with authority in the House. A lot of what the Russians have done is absolutely contemptible. They have continued close military co-operation with the regime, in spite of the atrocities committed by it, including the use of chemical weapons. To go back to what we were discussing earlier, they have demonised the White Helmets as bad people and agents of the west, and as people who have committed atrocities themselves, when in fact, they are the most generous-spirited, decent citizens that we could ever hope to find anywhere in the world, in many ways. The hon. Gentleman is absolutely right to draw the difference between what is right and what is wrong in this conflict.

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The war in Syria has haunting similarities to past conflicts when the international rules-based order was unable to deal with the parties taking part in them—including, in particular, the Spanish civil war. What reassurances can my right hon. Friend give me that, as rebel forces and refugees are driven towards Idlib, work will be done to ensure that we do not see that city become another Srebrenica?

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My hon. Friend, like other right hon. and hon. Members, is absolutely right to point out the dangers that face Idlib if, as it were, the forces of evil drive towards it and we see renewed conflict there. The international community has to focus very heavily on Idlib and make sure that it is not subjected to the kind of military assault that we must at all costs work together to avoid.

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I commend the Government for their part in evacuating many White Helmets from dangerous areas. Will the Minister tell the House what action he will be taking in the coming days, weeks and months to locate, communicate with and evacuate many of the humanitarian workers in Syria who are trapped and at very high risk? Will he also commit today in this House, before we break up for the summer recess, that the UK Government will look very seriously at providing resettlement places in the UK for those aid workers?

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We have already offered places to some of the White Helmets and, in the past, if I am right, we have offered 20,000 Syrians resettlement opportunities in the UK. We are working, and will continue to work, with non-governmental organisations that will, as the hon. Gentleman rightly points out, have vulnerable people delivering humanitarian aid in Syria. It is essential that we know where they are and what they are doing and that we do everything we can on the ground, however limited it might be, to work with others to make sure they and their lives are protected.

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This country’s resettlement scheme is good and well respected, and last year 6,200 Syrian refugees were resettled here, but 50% of the United Nations High Commissioner for Refugees’ estimated 1.2 million refugees worldwide are Syrian, and we can do so much more. We are one of the states parties signatories to the New York declaration of 2016. Sections 77 to 79 state our intention to expand resettlement and encourage other countries to do the same, but last year only 35 countries accepted resettled refugees, so will the Minister please commit to doing all he can both to expand our very good resettlement programme and to encourage others to do likewise so that more refugees come through safe and legal routes?

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The House and our voters can be rightly proud of what we have done since the beginning of this conflict seven years ago. Up to the end of March this year, we had resettled more than 11,000 refugees through the vulnerable persons resettlement scheme. We will also resettle up to 3,000 children and their families from the middle east under the vulnerable children resettlement scheme; up to the end of March, we had resettled more than 700 refugees through the scheme. This is the cause to which we have given the largest ever amount from our own budgets, and we are the second-largest multilateral donor. Our original intention was to help people in and around Syria, so that they did not need to come here, but that has turned out not to be the case, which is why the UK is doing both. We can be proud that we are doing both to a considerable degree.

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May I press the Minister about Idlib? What specific initiatives are the UK Government involved with now to try to ensure that, even if Idlib is not a safe zone, at least some protection is provided to civilians there, given we know they will soon be subject to a final assault that will involve barrel bombs or, worse, chemical weapons?

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We will work with our international partners to do whatever we can. The right hon. Gentleman is absolutely right about barrel bombs and chemical weapons. We have condemned their use and, as I said, have been at the forefront of strengthening the authority, power and reach of the OPCW in attributing any use of chemical weapons. This is not an easy issue to address. We agree that Idlib is looking very vulnerable, but I will be discussing this with my right hon. Friend the Minister for the Middle East, who is primarily responsible for these issues, and I have no doubt that there will be suitable occasions, when the House resumes in September and then again after the party conference season, to explain our policy in detail, as the right hon. Gentleman requests.

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I want to thank the Minister for the Middle East, whom I met last week, with Lord Glasman, to talk about northern Syria in particular. It was a very fruitful meeting. We talked about the importance of getting medical attention to Kurdish fighters, particularly here in the UK. Will the Minister follow up and make sure that the Kurds are involved in any deal made around Idlib and Syria generally? They have not been included in some of the talks so far.

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I hear what the hon. Gentleman says about the Kurds and I will convey his views straightaway to my right hon. Friend, who I am sure will be in touch with him, as he has been already in the past.

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I thank the Minister for his response this afternoon. Our Government have not been found wanting when it comes to aid, but can he outline the humanitarian aid currently going from the UK and who is monitoring how it is administered to ensure it gets to those who need it most?

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I have already explained to the House the quantum, if you like, which over the past few years has totalled £2.71 billion. It takes all sorts of forms—medical, vaccines, relief packages of food, water and so on to meet the basic needs of any human life or existence—but as always with humanitarian aid in a conflict, rather than a famine, the problem is access and humanitarian aid workers being attacked, blocked or prevented, or, even worse, accused of being parties to the conflict when quite clearly they are neutral humanitarian aid workers doing their best for human beings in difficulty. We will work with the UN and other countries and with the many brave organisations inside Syria that manage to get the necessary supplies to people who are desperately starving, thirsty and ill.

EU Withdrawal Agreement: Legislation

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With permission Mr Speaker, I would like to make a statement on the White Paper published today setting out the Government’s plans for legislating for the withdrawal agreement and implementation period.

On Friday 29 March 2019, the UK will leave the European Union, giving effect to the historic decision taken by the British people in the 2016 referendum. The Government are committed to delivering a smooth and orderly Brexit. That is why we have already passed the European Union (Withdrawal) Act 2018—[Laughter.] The shadow Foreign Secretary is laughing. She and her party voted against the Bill, thereby undermining her commitment to give effect to the referendum. We are ensuring that the statute book functions after exit, whatever the outcome of the negotiations. I am grateful to this House and the other place for the many hours of scrutiny devoted to that vital piece of legislation. We are now embarking on the next step in the process of delivering that smooth Brexit for the people and businesses of this country.

Since last June, the UK has been negotiating with the EU to decide on the terms of our withdrawal. We have made substantial progress—on protecting the rights of EU citizens in the UK and UK citizens in the EU, deciding the terms of the financial settlement and agreeing a strictly time-limited implementation period. Most of the withdrawal agreement—about 80%, according to the EU—has now been agreed with our EU partners, and we have isolated outstanding issues for further focused negotiation. I will be meeting Michel Barnier again on Thursday to take forward the negotiations at this critical time.

We have already agreed a financial settlement, estimated at between £35 billion and £39 billion, which is well below the figures bandied around by some when we started this negotiation. The implementation period will be finite and will allow for the negotiation and conclusion of free trade deals. Many of these arrangements will of course require new domestic legislation to deliver them into UK law. That is why, last November, we announced our intention to bring forward a new piece of primary legislation to implement the withdrawal agreement in UK law.

Today, we are publishing a White Paper setting out our proposals for this important legislation, which will be introduced once the negotiations have concluded and Parliament has approved the final deal. Our expectation is to reach agreement in October.

Under the terms of the European Union (Withdrawal) Act, Parliament will then have its say on the final deal. If it is approved, will we bring forward the legislation so that it can be in place for when we leave the EU on 29 March 2019. In setting out our proposals today, we are giving Parliament the opportunity to scrutinise our plans well ahead of the Bill’s introduction, given the need to enact the legislation in the time available and mindful of the importance of maximum scrutiny in this House.

By publishing the White Paper today, the Government are providing further certainty to people and businesses here in the UK and across the EU. It also sends a clear signal to the European Union that the United Kingdom is a reliable, dependable negotiating partner, delivering on the commitments it has made across the negotiating table. Of course, while we are making good progress, discussions are still ongoing in various areas, so some parts of the Bill will only become clearer as we settle the remaining parts of the withdrawal agreement. In the light of that, today’s White Paper focuses on those parts of the withdrawal agreement where the text is already agreed. I will take them in turn.

The UK’s first priority in negotiating its withdrawal from the EU was to reach agreement on the rights of citizens, including the 3.5 million EU citizens who live in the UK and who are valued members of their communities and play an integral part in the life of this country. Likewise, the approximately 1 million UK nationals who currently live in the EU are equally valued by their host countries and communities.

The agreement reached on citizens’ rights will allow EU citizens in the UK, and UK nationals in the EU, to live their lives broadly as they do now and enable families who have built their lives in the EU and the UK to stay together. The most important next step will be to provide a continued right of residence for those citizens. EU citizens lawfully residing in the UK on 31 December 2020 will be able to stay.

This month, the Home Office published further details about how EU citizens and their families can obtain settled status in the UK. That statement confirms that the settlement scheme will make it simple and straightforward for citizens and their families to secure long-term status in this country. The Bill will ensure that EU citizens can rely on the rights set out in the withdrawal agreement and can enforce them in UK courts. It will also establish an independent monitoring authority to oversee the UK’s implementation of the deal on citizens’ rights, thus providing further reassurance for citizens.

All EU member states must implement the agreement in full and provide certainty for UK nationals on the continent. As the Home Secretary stated recently, we now need to know more of the details of how each member state will fulfil its obligations and implement its side of the agreement. We will be pressing further for those details over the summer.

The next chapter of the White Paper deals with the strictly time-limited implementation period that the UK agreed with the EU in March. The UK will leave the EU on 29 March 2019. After that, the implementation period on which we have agreed will ensure that people and businesses will have to plan for only one set of changes as we move towards our future relationship. From 30 March 2019 until 31 December 2020, common rules will remain in place, with EU law continuing to apply, and businesses will be able to trade on the same terms as they do now. During that period, we will not be a member state and will have the flexibility that we need to strike new trade deals around the world—something that many argued we would not be able to achieve in the negotiations.

To legislate for the implementation period, we must ensure that the UK statute book continues to reflect the relevant provisions of EU law, as it applies to the UK during this time-limited period. As the House will know, the current mechanism for bringing EU law into UK law is the European Communities Act 1972. Under the European Union (Withdrawal) Act, the ECA will be repealed on 29 March 2019. As set out in the White Paper, the EU withdrawal agreement Bill will contain a time-limited provision so that parts of the ECA are saved until 31 December 2020. Those changes will ensure that our statute book functions properly throughout the implementation period, in accordance with the agreement that we have made with the EU.

Let me now turn to the financial settlement, the structure of which was agreed in December on the basis that it would sit alongside our future partnership. As we have said from the start, nothing is agreed until everything is agreed. That is in keeping with article 50, and in keeping with the guidelines that have been given to the EU for the negotiation. We will have a framework for our future relationship with the EU, alongside the withdrawal agreement, and our approach to that future partnership is set out in the White Paper that we published earlier this month. There must be a firm commitment in the withdrawal agreement requiring the framework for the future relationship to be translated into legal text as soon as possible. It is one part of the whole deal that we are doing with our EU partners. Of course, if one party fails to honour its side of that overall bargain, there will be consequences for the whole deal, and that includes the financial settlement.

In addition, we have agreed an obligation for both parties to act in good faith throughout the application of the withdrawal agreement. The White Paper published today explains that the EU withdrawal agreement Bill will include a standing service provision to allow the Government to meet the commitments of the financial settlement. In the interests of transparency and oversight, the White Paper also includes proposals to enhance the existing scrutiny arrangements for the payments made to the EU.

The White Paper sets out our approach to delivering the withdrawal agreement and the implementation period into law, and I look forward to discussing all its proposals with Members in all parts of the House. It is a necessary part of leaving the EU and ensuring a smooth and orderly departure. It gives EU citizens living here, and UK nationals abroad, clarity and certainty that their rights will be properly protected; it will enact the time-limited implementation period, giving businesses greater certainty and giving the public finality with respect to our relationship with the EU; and it provides for the appropriate means for paying the financial settlement. Above all, with 80% of the withdrawal agreement settled with our EU partners, the White Paper is another key milestone on the United Kingdom’s path to leaving the EU. I commend this statement to the House.

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I thank the Secretary of State for providing advance copies of his statement and the White Paper. I am glad to say that that was two hours ago, and it is much appreciated.

We will of course scrutinise the White Paper closely, but a quick reading reveals a number of important points. First, the gimmick of fixing exit day as 29 March 2019 in the European Union (Withdrawal) Act has already come unstuck. We warned at the time that it would not work and would need to be rubbed out and that large parts of the European Union (Withdrawal) Act would need to be amended. Here is the proof.

Paragraph 56 of the White Paper states that

“EU law will continue to have effect in the UK in the same way as now”

for the implementation period—that is, until December 2020—but section 1 of the European Union (Withdrawal) Act, which took 18 months to get through Parliament and received Royal Assent only 28 days ago, repeals the European Communities Act on exit day, 29 March 2019. The implementation Bill will amend section 1 of the withdrawal Act by saving the ECA, as the White Paper makes clear in paragraph 60. So the ECA is repealed, and before that comes into force, it is amended and saved. The Secretary of State says that just “parts of the ECA” are saved until 30 December 2020, but that is a huge understatement. Almost all of it is saved, with amendments not to the applicability of EU law, but to collateral issues.

However, not just section 1 of the withdrawal Act now needs major surgery. The other big ticket item in the Act was the much-vaunted “conversion of EU law” into our law—again, fixed by the gimmick of the date of 29 March 2019. We warned that that would not work, because the gimmick gets in the way, so it is going to be rubbed out. Paragraph 69 of the White Paper makes it clear that the conversion exercise is now not needed until December 2020.

Then, of course, there is the European Court. Just a few weeks ago, many Brexiteers cheered section 6(1) of the withdrawal Act, which would extinguish the role of the European Court on the fixed date of 29 March 2019. But not so fast: as we said at the time would happen, paragraph 80 of the White Paper preserves the full role of the European Court until December 2020. Again, the withdrawal Act will need major surgery.

I cannot remember legislation that has needed such great revision and amendment before the relevant parts have even come into force. Of course, the provisions of the withdrawal Act that have come into force relate to delegated powers. During the 18-month passage of the European Union (Withdrawal) Bill through the House of Commons, it was acknowledged that it contained sweeping provisions packed with Henry VIII powers. They were supposed to be strictly limited by a two-year sunset clause. The White Paper now proposes that those clauses should be extended: sunset is now December 2022. On the face of it, paragraph 75 of the White Paper suggests that if there is no deal, the huge exercise of amending what will be hundreds of legislative provisions will be carried out through delegated legislation. I hope that that is not true, and I look to the Secretary of State for reassurance that that is not the implication of paragraph 75.

Then there is the elephant in the room: if there is no deal, there is nothing to implement. Can the Secretary of State tell us what is the legislative plan, to be in place by March next year, if there is no agreement on citizens’ rights—the Secretary of State said a lot about them—on the financial settlement, on Northern Ireland and on many other issues? If there are not to be sweeping delegated powers, what legislation will there be, and when, between now and March 2019?

There was no mention of Northern Ireland in the Secretary of State’s statement, and there is just a brief reference to it in the White Paper. I appreciate that elements of the Northern Ireland agreement are still being discussed, but with nothing substantive on Northern Ireland, the White Paper contains a huge gaping hole.

There are proposals on the financial settlement. The Secretary of State now seems to be saying that the EU will have to fulfil its side of the bargain, or we will not pay up. We have been down this track before. The Chancellor has previously dismissed that approach by saying:

“That is not a credible scenario. That is not the kind of country we are. Frankly, it would not make us a credible partner for future international agreements.”

So which is it: has it been agreed, or are we back to conditionality?

I have heard what the Secretary of State says about the withdrawal agreement being reached by October this year, but he knows that he is in a minority here and in Brussels. If agreement is not reached until November or December, how will the Secretary of State ensure that there is proper scrutiny of the implementation Bill, and will he guarantee that it will not be packed with wide-ranging Henry VIII powers?

We have a White Paper and we have time to scrutinise it, but we also have serious questions that now fall to be answered.

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I thank the right hon. and learned Gentleman for his welcome to the White Paper in general. He will appreciate that the decision to publish it now was a finely balanced one because the negotiations are ongoing, but ultimately it was deemed more important and more respectful to this House to provide the information and consult as early as possible.

On the right hon. and learned Gentleman’s point about the date of departure, I presume he welcomes and supports the implementation period. I have not heard any substantive suggestion how he might have done it differently; perhaps as he reflects he will have some, but otherwise calling the implementation period a gimmick when businesses have called for it and welcomed the certainty it provides is, I think, rather an indication that the Labour party is reverting to type.

The right hon. and learned Gentleman had nothing to say on citizens’ rights, nothing to say on welcoming the mechanism to secure the rights of EU nationals here and nothing to say on welcoming the mechanism to make sure UK nationals have their rights abroad protected. In relation to no deal, we will be prepared regardless of the outcome, as he knows. This is not the legislation being provided to that effect, as we are focused on getting the right deal for the UK and the EU.

In relation to Northern Ireland, the right hon. and learned Gentleman will have seen the White Paper on our future relationship with the EU and the arrangements for frictionless trade, which are not just important for businesses but will avoid any return to a hard border. Our position is that that provides a clear, workable model that maintains our commitments under the Belfast agreement and avoids any friction at the border, but also frees us up to strike free trade deals abroad.

On conditionality, the right hon. and learned Gentleman is a learned lawyer, but I have to say to him that as a matter of basic general international law, whether through the interpretation of treaties under the Vienna convention or customary international law, when countries sign up to a treaty, both sides must commit to the obligations on both sides; there is reciprocity. Of course, if one side fails to live up to its commitments, it is open to the other side to take proportionate measures, including in relation to financial means, to make sure good effect is given to the whole deal. That is what it takes to stand up for the interests of the United Kingdom; if the right hon. and learned Gentleman would roll over, it is a good job Labour is not handling the negotiations with the EU.

This White Paper is about delivering a smooth and orderly Brexit and one that respects the referendum. I gently say to the Opposition that it is not entirely clear that it is Labour’s overriding objective to give effect to the referendum. Straight after the referendum, the leader of the Labour party demanded the immediate triggering of article 50; with a similar lack of strategic foresight, Labour Members repeatedly voted against the EU withdrawal Bill, whose sole purpose was to deliver a smooth and orderly Brexit, including on Second Reading; and now the Labour party will not rule out a second referendum. It is clear that Labour Members are taking the opportunistic political low-ground, rather than rallying together to try to secure the best deal for the UK with our EU partners. The withdrawal agreement Bill is essential, and I hope that all who wish to see a smooth and orderly Brexit will support it and engage seriously on the substance.

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Order. As expected, a very large number of Members are seeking to catch my eye. I would like to accommodate as many as I can, but I remind the House that there is a further ministerial statement to follow, another piece of business that may be short but is uncertain in length, and then a very heavily subscribed summer Adjournment debate. There is therefore a premium on brevity, now to be brilliantly exemplified by Mr Steve Baker.

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The least worst of the negotiable mechanisms to deliver the implementation period was the one in the White Paper of repealing the European Communities Act 1972 but saving its effect with modifications to the end of the implementation process. Will the Secretary of State confirm that he is going to ask this Parliament—this House—to agree to that mechanism in the same vote that we are asked to sign up to the future relationship through that political statement?

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I can assure my hon. Friend that that will all be part of the same process, and I am happy to work with him on the detail and substance, as we move forward.

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I am grateful to the Secretary of State for his statement, for advance sight of it and the White Paper, and for notice yesterday that the White Paper would be published today. It is nice when a White Paper is handed to Members in the Chamber in ways that do not involve the risk of decapitation, as was the case last week.

I am left wondering what would have happened if the Government had had their way and the House had risen five days ago. Would we have been left without a White Paper? Would the White Paper have been announced in a written statement to add to the 40 or so that have been sneaked out over the past few days without any attempt to allow for scrutiny by Members? The Minister says that publishing the White Paper now gives Parliament time to scrutinise it before the Bill is brought forward but, by my reckoning, there might be eight parliamentary sitting days before the intended date for publishing the Bill, and Parliament might well want to undertake other business in that time, too. Although there is a lot of time between now and the Bill’s publication, the odd timetable that this place sets for itself means not a lot of time for parliamentary scrutiny is being allowed.

I look forward to questioning the Secretary of State on the White Paper in more detail when he attends the Select Committee later today. Paragraph 23 of the White Paper refers to discussions with existing EEA countries about the UK’s future relationship with them. Do the Government hope to establish a unique and unprecedented relationship with those countries that is different from the unique and unprecedented relationship that we are going to have with the EU? If so, why should the EEA countries agree to that?

Paragraph 30 refers to the likely use of the immigration rules, rather than primary legislation, to ensure the ongoing rights of EU nationals living in the UK. Anything that gives legislative impact to the continuation of those rights sooner rather than later is to be welcomed, but does using that method mean that Parliament will not be able to amend the Government’s proposals? If we think they do not give sufficient protections to citizens, and this is being done under immigration rules rather than through primary legislation, will Parliament have the opportunity to strengthen that protection if it sees fit?

The Secretary of State has acknowledged that primary legislation will be needed to give effect to the financial settlement, but one or two members of the European Research Group might not be too keen on that settlement. What are the Secretary of State’s contingency plans if they rebel in the way they did last week? Will the Government just cave in? If not, what concessions do they expect to have to make to the hardliners to get this essential legislation passed?

I welcome the assurance in a number of passages of the White Paper that the usual conventions regarding the devolved Administrations will apply. Can we have an assurance from the Secretary of State now that this legislation will be normal, and that we will not need to appeal that it is abnormal, so that his Government do not ride roughshod over the rights of the devolved Parliaments simply because their assessment of what our people need is a bit different from that of those Parliaments? Or is this another situation in which if the devolved Administrations disagree with the UK Government, they will take us to court, rather than seeking a political agreement?

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I thank the hon. Gentleman for his comments. I think that the initial part of his statement was a backhanded way of welcoming the fact that we have got this out now so that Members of not just this House but all the devolved Administrations have a proper chance to scrutinise the terms of the withdrawal agreement Bill and the implementation period.

The hon. Gentleman asked about EEA nationals. We are engaged in diplomacy with our EEA partners and separate provision will be made for them. We hope to be able to conclude that reasonably soon.

I take on board the hon. Gentleman’s points about consultation with the devolved Administrations. We have been working closely with the devolved Administrations at official and ministerial level to prepare this White Paper. Ministers discussed proposals for the Bill at the last meeting of the Joint Ministerial Committee on 5 July. Of course, we will respect the Sewel convention, although I accept the hon. Gentleman’s point that there are different views about how that will apply, and that is difficult to judge until we have the entire withdrawal agreement.

The hon. Gentleman asked about the immigration rules. The changes will be made by statutory instrument—that is the swifter, more flexible way to proceed in accordance with the White Paper—but the process will allow for the scrutiny of those rules in the normal way.

I hope that I have given the hon. Gentleman some reassurance. I look forward to engaging with him, and all the devolved Administrations and those representing them, as we go through this process.

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It is becoming increasingly fashionable to criticise the Northern Irish backstop as either a tactical blunder that we have made, or some kind of dastardly trick that the EU is playing on us, so will my right hon. Friend confirm that the backstop remains important precisely because we are a Government who take our obligations towards Northern Ireland seriously, who value Northern Ireland, and who will do nothing to undermine peace there or the integrity of the whole United Kingdom?

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My right hon. Friend is absolutely right. There are two distinct issues at play here. We are absolutely committed to the Belfast agreement and to peace and stability in Northern Ireland. At the same time, it is unacceptable for a customs border to be drawn along the Irish sea, as that would be a direct threat to the territorial integrity of this country. I am sure that that is not what our European partners intend—there may be similar pressures in countries within the EU—but we are absolutely clear about our position on this.

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Paragraph 24 states that

“all EU citizens lawfully residing in the UK”

by 31 December will be able to stay. Can the Secretary of State give the House and those 3.5 million European citizens an assurance that that commitment from the Government will still hold in the event of us leaving without a deal? Yes or no?

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I apologise for the disruption that this is causing to the right hon. Gentleman’s evidence session, which I look forward to joining later.

We are very clear that, in the event of no deal, there would be no wholesale removal of rights of EU nationals in this country. We are absolutely committed to providing the reassurance and security that they need. That is the point of agreeing these aspects of the withdrawal agreement up front and publishing this White Paper—so that EU nationals here and UK expats abroad can see precisely not only the substance of their rights, but how they will properly be protected.

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May I commend my right hon. Friend for restating so robustly that the payment of any financial settlement will be conditional on an agreement on the future relationship with the EU? Will he confirm that the necessary flexibility to accommodate that conditionality will be built into the Bill?

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My right hon. Friend heard what I said in my statement. The most important thing is that we are clear that there is no deal until the whole deal is done, and it will be important to establish that linkage in the withdrawal agreement directly.

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I am still unclear about the Secretary of State’s plans for the Northern Ireland backstop. If that is part of the withdrawal agreement, will it be legislated for in the legislation referred to in this White Paper—yes or no?

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The Government are still maintaining that no deal is preferable to a bad deal. Over the summer, the Secretary of State will be going round the European Union selling the Government’s White Paper policy document, and in that he has my full support. However, if he were to fail, for whatever reason, would he accept the clear evidence that a customs union-based approach is still preferable to no deal?

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I appreciate the way in which my hon. Friend tries to tempt me down that particular path, but I think that it is only right to prepare for all eventualities in relation to the money, to the operational contingency planning that we are doing, and to the legislative steps. Obviously our overriding focus is on getting the best deal, and I shall be spending the weeks and months ahead in Brussels, talking to Michel Barnier and his team, and focusing on that. I shall be out there again on Thursday, looking to achieve the best deal.

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The Secretary of State said that the withdrawal agreement was 80% agreed, but he did not mention the biggest and toughest outstanding issue, which is that of the Northern Ireland border and customs arrangements. Will he tell us whether, in his discussions last week, Mr Barnier agreed to new clause 36 to the Taxation (Cross-border Trade) Bill, which was passed by this House last week and requires reciprocal differential collection of tariffs before the agreement can be put in place?

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I have already mentioned our approach to the Northern Ireland issue. We believe that the proposals in the “Future Relationship” White Paper provide a sustainable, deliverable approach, and we want to make sure that we are aiming to achieve that. In relation to Michel Barnier, the negotiations are of course ongoing, and I will protect the integrity of the negotiating room, if the right hon. Gentleman will forgive me. Of course, there is nothing in the legislation that was passed previously—last week or otherwise—to prevent us from achieving the goals in this White Paper or, indeed, the previous one.

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I welcome what the Secretary of State is doing to get the UK ready for Brexit. Will he confirm that as he travels around the EU this summer, he will be pressing EU member states to ensure that they are also ready so that we can leave the EU without disruption to those relationships?

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My hon. Friend is absolutely right, particularly in relation to the protection of UK nationals abroad in the same way as we are protecting EU nationals under UK law. We are setting up a monitoring authority, and the Commission will perform that function in relation to UK expats abroad. None the less, we want to ensure that the legislation and mechanisms are in place to give that security to UK expats.

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The Secretary of State has said that the Government are committed to delivering a “smooth and orderly Brexit”. To that end, are they going to issue a White Paper and Bill to cover a no deal scenario, given that he and his colleagues say that that is a real and increasing possibility? Presumably such a Bill will be needed to cover all eventualities, from compulsory purchase orders to the creation of lorry parks and to establishing emergency warehouses for medicines and food.

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I do not think that I have ever said that this is an increasing risk, but it is certainly a real risk. As the time for the deal approaches, the only responsible thing for us to do is to ensure that we are ready for all eventualities. Without going into some of the more hair-raising examples that the right hon. Gentleman has highlighted, I think it is right to ensure that we are ready for all eventualities by having the logistical infrastructure and legislation in place. I hope that we will have his support.

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I thank the Secretary of State for coming to the House at the earliest opportunity to give us the chance to scrutinise the White Paper. I have not had a chance to read it myself, so will he confirm that the Prime Minister’s principles of ending the free movement of people, of not giving billions of pounds each and every year to the EU, and of making our own laws in our own country, judged by our own judges, are not broken by the White Paper?

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My hon. Friend is absolutely right to get back to the key overarching objectives. I believe that, with this White Paper and the previous one, the full strategy can be seen in the round. Yes, we have had to take a pragmatic as well as a principled approach, but it is faithful to the referendum in the three key areas that he describes.

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The Government have promised that the House will have all the information and data that it needs to make an informed choice when we take the critical vote in the autumn. Will they therefore produce an impact assessment on the political declaration on the future relationship between the UK and the EU well in advance of our taking that critical vote?

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I thank the hon. Gentleman for his question; he has raised this matter a few times. We will ensure that the appropriate analysis is done on all aspects of all elements on both sides of the deal.

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I wish the Secretary of State a productive summer—it could be a very interesting one. The EU has a poor track record when it comes to trade deals generally, which is why we trade with the majority of the rest of the world on World Trade Organisation terms. What assurances can he give us that, in the run-up to the publication of the White Paper, we will be meaningfully preparing to leave on no trade terms and that the White Paper’s proposals will have the dexterity to ensure that the preparation is in place in time?

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My hon. Friend is right to raise that aspect of the arrangements. We are working closely with all the other arms of Whitehall, including the Department for International Trade, and we are ensuring that we have the right flexibility. The advantage of the implementation period in the White Paper is that it is finite, so that those who want to see an end to the eternal haggling with the EU and want some clarity about the end-state relationship will have that provided. During the implementation period, we will be free to negotiate and to conclude free trade deals with other countries beyond the continent.

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Is the Secretary of State aware that he has just set alarm bells clanging in the homes of around 3 million EU citizens living in this country? When he answered the question about what would happen in the event of no deal by saying that there would be no wholesale removal of rights of EU nationals in this country, what did he actually mean? Will he put in writing what he means in the next 24 hours so that those people do not have a horrendous summer thinking the worst about what could happen in the event of no deal, with their rights not being protected?

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