Earl of Devon Portrait The Earl of Devon (CB)
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If the noble Viscount listens to my next paragraph, I will clarify that point.

I should also note, for the record, that we have a recent precedent for a grandchild of a sovereign seeking to join your Lordships’ House as an elected hereditary. In 2018, when I stood for a Cross-Bench vacancy upon the retirement of Earl Baldwin, one of the other 19 hereditary Peers to stand against me was the second Earl of Snowdon, previously Viscount Linley, who is a grandson of His late Majesty King George VI. I believe he withdrew his candidacy before the voting took place—obviously cowed by the strength of the other candidates. The publicly proffered reasoning for his withdrawal was that, as a member of the Royal Family, he should not sit in Parliament by convention—a reason which may indeed render my amendment dead in the water.

This aside reminds us that the only Members of your Lordships’ House that have any democratic legitimacy whatsoever happen to be the hereditary Peers. While we may be tainted by our hereditary privilege, we have at least vanquished multiple highly qualified competitors in transparent elections to obtain our seats. Indeed, I think we fulfil the second sentence in Labour’s 1997 manifesto, highlighted by the noble Lord, Lord Parkinson, by increasing the democratic legitimacy of this House. It is, I submit, a pity that we cannot fill other seats in your Lordships’ House by equivalent means.

I look forward to the debate on this topic. I am particularly interested to hear the views of the Front Benches of each of the main political parties, including the Minister, as this offers an opportunity for them all to clarify for posterity exactly how they view the role of the hereditary principle in the context of our monarch and how they expect to protect and support His Majesty the King in this House once we hereditary Peers have left the building.

In parting, I note that in earlier debates on this Bill, both the Government and the Liberal Democrats have pointed to the King’s legitimacy being based not upon the hereditary principle but upon his popularity and how well he does his job. This is transparently not the case. The monarch is not a competitor in a reality television show; he is our sovereign Head of State. He is born to his position and anointed, for those with Anglican faith, by God by the Archbishop of Canterbury. We all watched the Coronation, and I hope that is a fact we can all agree to. I beg to move.

Baroness Meyer Portrait Baroness Meyer (Con)
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My Lords, I will speak in support of the amendment from the noble Earl, Lord Devon. This Bill is about not just the future of hereditary Peers but the stability of our entire constitutional order. Hereditary Peers are not relics of feudal privilege, as the Government claim; they are a vital link between our past, present and future. Remove them and we take another step towards dismantling the traditions that have kept this country stable for centuries.

Make no mistakes: this Bill disregards our history, weakens the House of Lords and ultimately paves the way for abolishing the monarchy itself. If hereditary Peers are obsolete, how long before the same argument is made against the Crown? For generations, hereditary Peers have served the Crown, upholding duty, service and continuity. Strip them away and the Lords becomes a Chamber of political appointees. Once it loses its independence, the monarchy loses its natural defenders.

Britain has never been a nation of radical upheaval. We have adapted, not abolished; we have evolved, not revolted. That careful, deliberate reform has kept our constitutions intact. Contrast and compare this with Russia and France, the two nations of my heritage. Both believed that radical change would bring stability, but instead they have suffered instability and disorder. In Russia’s case, it led to a regime even more oppressive than the one it had overthrown, including my grandparents. Why would we throw the baby out with the bath-water?

This Bill is ill-judged: it overturns the 1999 constitutional settlement; it ignores consensus; and it disrupts the balance that has protected us from political chaos. The path from abolishing hereditary Peers to dismantling the monarchy may not happen overnight, but it will set a precedent. Let us be clear: those who cheer the removal of hereditary Peers today will be the same voices calling for the end of the monarchy tomorrow. This Government reassure us that they support the monarchy, but how can we trust them? If they can remove hereditary Peers today, what stops them targeting the monarchy tomorrow?

History teaches us that, once safeguards are eroded, they are rarely restored. The monarchy is not just a symbol of our national unity but a powerhouse of soft diplomacy and economic strength. It generates billions for the UK. What greater demonstration of its soft power than the Prime Minister presenting the King’s invitation to President Trump—a move that could actually place Britain apart from the European Union in negotiations over tariffs, despite Brexit.

This is not outdated tradition; it is a vital asset for our future. We must stand firm against this misguided attack on the traditions that define our nation. That is why this amendment is crucial. It will protect the delicate balance of our constitution and safeguard the stability, continuity and integrity of our institution. That is why I support this amendment.

Lord Moore of Etchingham Portrait Lord Moore of Etchingham (Non-Afl)
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My Lords, I rise to support the amendment tabled by the noble Earl, Lord Devon, which is very creative and imaginative. For anybody who thinks this is beside the point, I certainly would not want to press the issue too hard—it is somewhat absurd to suggest that the removal of 92 hereditaries will turn the British constitution completely upside down—but the point is important.

It is said by those who call for the abolition of the remaining hereditaries that the hereditary principle is indefensible. That is often said, and then not really argued—it is simply stated. If it is indefensible, that must apply to other aspects of the hereditary principle, of which the monarchy is the most prominent. One point I would make to the noble Viscount, Lord Hailsham, is that he is, in fact, mistaken. The present King did make a speech in the House of Lords, when he was Prince of Wales: he made his maiden speech here and was entirely entitled to do so. I remember no parliamentary crisis arising from it.

I agree with the noble Lord, Lord Wallace of Saltaire, that this must be quite annoying because there are so many things flying around; could it not all be grouped? This is the problem with the Bill: it raises a very big issue and then tries to make it very narrow. Masses of issues come out of this which we need to think about, and heredity is one of them.

Heredity is a very important principle in life. It is for our monarchy, which is much respected around the world and here, for all the reasons the noble Earl, Lord Devon, said. It is also very largely the principle on which our citizenship and all families are based. What are families other than hereditary? It answers a very important aspect of people’s way of thinking about things. It may well be appropriate in modern times to remove that from a parliamentary chamber, and that is what is very likely to happen. But we need to understand that this may reflect badly upon us if we get it wrong; that it may expose this House to lots of questioning about what we really are and whether we deserve to be here; and that it may make people feel that our history and our understanding of ourselves is diminished.

Last week I was in Ukraine. I was taken out to Zaporizhzhia, right by the front, by a very nice Ukrainian driver who had previously been a rock star, or at least in a rock band, but harder times had come upon him—as they often do with rock stars. As we parted, he said, “I am so pleased. First time I ever meet real Lord”. I felt very ashamed because I am not a real Lord: I am a Boris creation. I said that to him, but that only made me rise in his estimation, because in Ukraine, Boris is an immensely popular figure. It is interesting that over there in that snowbound, war-torn place, the idea of a Lord means something to an ordinary person. It is a universal idea, and it is an idea which is essentially British and retains a certain importance. All that can be done away with, and it probably will be in legislative terms, but let us think about the way this is being done and be cautious.

Andrew Marvell, the great poet—who was a Parliamentarian, by the way, not a Cavalier—wrote a famous poem about Oliver Cromwell’s return from Ireland. He warned Cromwell about the danger of ruining what he called

“the great work of time”.

That is something we need to think about. This Bill is Cromwellian, and therefore is dangerous.

Baroness Meyer Portrait Baroness Meyer (Con)
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I just want to say that that was then and we are where we are now. The situation is different. Why do we want to evict a lot of people who the noble Baroness’s party admits are doing good things, with just a click of the fingers? Is that not too cruel?

Baroness Smith of Basildon Portrait Baroness Smith of Basildon (Lab)
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The noble Baroness has made her point. There are times in life when you have to seize opportunities to make things happen and, sometimes, if you fail to take that opportunity, that time passes. The party opposite is suggesting this now only because an alternative proposal came forward. Had the noble Lord come forward before our manifesto, I would have bitten his hand off and gone with it. It is a shame that he did not.

Looking at other points that were made, the noble Earl, Lord Caithness, was someone who had lots of amendments, as I recall, to the Grocott Bill, although he did not speak to them. It is a shame. I actually stopped coming to the Chamber to listen to the debate because it was the same thing time and again—there were so many amendments. So, here we are now because 25 years ago, the principle was established that hereditary Peers would no longer have the right to sit and vote in the House of Lords. That is what has brought us to this point now.

To answer some of the questions, the noble Baroness, Lady Finn, talked about some of the characteristics of hereditary Peers and the work that they do. The same applies to life Peers, as I am sure she will readily admit. There has always been scrutiny in this House, not just from hereditary Peers but from across the House. This House has always discharged its duties and will continue to do so.

The noble Lord, Lord Newby, asked the noble Lord, Lord True, for his response, which he received. I have always said that there is no barrier to Members of your Lordships’ House who have hereditary peerages receiving life peerages. That does not have to wait until the end of the Bill. If peerages were offered tomorrow by the political parties, they could be made life Peers. It is different for the Cross Benches. I do not think it is for me or the Government, if there was to be a proposal for other Members of other parties, to say who they would be, but there is a way of working this out and I will discuss this with the relevant parties. I accept that the Cross Benches are in a different position and would need different arrangements as well.

The noble Lord, Lord True, talked about his four-stage plan, some of which I had heard before but some of which was new to me as well. He says that this is a way of offering greater security for the Government to get their business through. I am sure that with his normal courtesy it would not be, but I hope that is not a suggestion that, if we do not do this, we will not get our business through. I just want to confirm this. Because he is aware of the conventions of the House—and I hope I understand him correctly—I think he is looking to seek further protections in terms of ping-pong, but if he could confirm that to me at some point, that would be very helpful, because I am sure he does not mean it to sound in any way as a threat. I am sure that is not what he intended, but it did come out a little bit like that. I will read Hansard, or we can talk further on that to make sure we have got it absolutely clear.

I have to be honest with the noble Lord. I understand why he has put this through, but I wish he would have come to this conclusion earlier—I really would have welcomed it—and I ask at this stage that he withdraw his amendment.

Baroness Meyer Portrait Baroness Meyer (Con)
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My Lords, I too congratulate my noble friend Lord Brady for his maiden speech, and the noble Baroness, Lady Quin, for her valedictory speech.

This Government claim that this Bill aims to modernise the House of Lords, break away from feudal traditions and fulfil a manifesto pledge. It promises to replace the House with a Chamber that is representative of the regions and nations. Yet hereditary Peers represent diverse regions better than any other group of noble Lords. Today’s hereditary Peers are not a relic of feudal privilege. They bring diverse political views, professional expertise and unparalleled knowledge of the constitution and our nation’s history. Their contribution goes far beyond their “accident of birth”, and their historical ties mean that they are directly involved with rural community, ensuring that the countryside is represented. The fact that this Bill targets non-Labour Peers reveals, as many Lords have mentioned, the true intent of this Bill.

Forcing major constitutional changes without cross-party agreement undermines the delicate balance between tradition and evolution, a balance critical to Britain’s political success since the Civil War. We can contrast and compare that with the histories of France and Russia. Since the revolution in 1789, France has experimented with two empires, a monarchy and five republics in search of stability, and they are still searching. In one short century, Russia demolished an empire and got rid of its aristocracy, replacing it with a communist tyranny after a civil war which claimed 8 million lives and displaced several million more, including my grandparents. This was not modernisation; it was a step backwards. They replaced the Tsar’s regime with a worse form of autocracy. Today, the new Tsar, Putin, exerts more power than the Tsar ever did.

The UK’s unwritten constitution has evolved through adaptation rather than revolution. In times of great change, we have managed to adapt and modernise without having to resort to violence. The lesson is clear: change masquerading as progressive politics rarely delivers improvement, particularly when there is no consensus on what shape that change should take.

This Bill threatens our national identity and sets a dangerous precedent. It allows Governments to remove Members they dislike, transforming the House into a political, powerless body. Imagine if a future Prime Minister decided there were too many former Members of Parliament, and he or she applied the same principle. I am not sure that this House would welcome that.

Ironically, as many have pointed out previously, most hereditary Peers have more democratic legitimacy than life Peers. There are only 23 excepted hereditary Peers. The majority have been elected in a fair, competitive process. These elections are based on merit and expertise rather than inheritance. Cancelling elections retroactively undermines the very principle of democracy, setting another troubling precedent.

As many noble Lords have noted, if the Government truly want reform, they should address inactive Peers, improve the appointments process and ensure greater transparency in the selection process. This Bill does nothing like this. Instead, it scapegoats a particular group to advance a partisan agenda. Such hostility is misplaced and risks eroding the very foundations of Britain’s constitutional stability and its long-standing ethos of balancing tradition with modernity. The last time we tried that, almost 400 years ago, was certainly not a happy experience.

This Bill is not about evolution but a poorly disguised revolution.

Health and Care Bill

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Lord Sharkey Portrait Lord Sharkey (LD)
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My Lord’s, I shall speak to Amendments 178 and 240, and I remind the Committee of my interest as chair of the Specialised Healthcare Alliance.

Amendment 178 deals with innovative medicines and medicinal products. The debate on this amendment is very timely, given the recent conclusion of NICE’s review of its methods and processes and the current consultation on the innovative medicines fund. Both the review and the IMF consultation are to be welcomed. It is clear that they will result in improvements in the system of assessing medicines and medicinal products, particularly in respect of analysing and addressing uncertainty and incorporating more real-world evidence into decision-making. However, it is also clear that both the IMF proposals and the outcome of NICE’s review are at risk of falling short of the hopes of many patients, clinicians and the life sciences sector more generally in a number of important ways.

First, there is still a lacuna in NICE’s approach to considering treatments for rare disease. For ultra-rare diseases—those affecting fewer than 1,000 people—NICE retains its highly specialised technologies process. For more common conditions—those affecting more than 25,000 people—NICE has its separate technology appraisal process. But for patients with rare diseases—those affecting between 1,000 and 25,000 people—there is no process, and so treatments for these patients have to be considered instead through the unsuitable technology appraisal process. This gap sets us apart from other countries, such as the more generous ASMR system in France and the AMNOG system in Germany for evaluating rare disease treatments.

It was therefore very disappointing to see that the case for the rare disease modifier was again rejected in NICE’s review. It was rejected on the grounds that society does not value treatments for rare disease more highly than those for more common diseases. Those representing rare-disease patients would contend that the fact is that these treatments are inherently costly. The Government accept this in relation to ultra-rare disease, so why do they not do so for rare disease treatments? I would be grateful if the Minister could address that specific question when he replies.

Secondly, NICE’s own consultation looked favourably on reducing the discount rate at which NICE assesses the future costs and benefits offered by a treatment, saying that such a change

“could make a particularly big difference to some treatments, like gene therapies.”

However, NICE has now said that this change would not be possible, due to the views of “system stakeholders”, and this has disappointed many people. When the Minister replies, I would be grateful if he could expand on what “system stakeholders” really means in this context. Who is NICE talking about and why did it assign conclusive weight to their views?

Thirdly, the system in England still fails to formalise the input of patients and clinical experts in the way that, for example, the SMC in Scotland does through its patient and clinical engagement process.

Finally, proposals for the innovative medicines fund now move far beyond the originally planned narrow focus on autoimmune and rare diseases. This causes some SHCA members to worry that rare diseases will get less attention than originally envisaged.

These proposals fall short of the hoped for bridge between the MHRA’s licensing process—which reforms are speeding up in some cases—and NICE’s reimbursement process. Without such a bridge, earlier licensing will not deliver benefits to NHS patients, and ultimately companies will lose interest in making bespoke licensing applications to the MHRA. The Government’s own figures—the life sciences competitiveness indicators, published by the Office for Life Sciences—demonstrate that it is already the case that the per capita uptake of new medicines remains lower and slower in this country than in comparable countries.

Our Amendment 178 suggests that the Government review the situation by the end of the year, when we will have a good half year of experience of the changes to NICE and the operation of the IMF, and when we will be able to see that the hoped for improvements have materialised. I hope that the Minister will consider this suggestion.

I now turn to Amendment 240, which seeks to probe the Government’s actions to improve awareness of rare diseases among healthcare professionals. There are more than 7,000 rare diseases, and it would clearly be impossible for every healthcare professional to receive training on every single one of them. However, as the Government’s rare disease framework notes, healthcare professionals can improve their awareness of rare diseases more generally, be more alert to considering them and be provided with the educational resources that help them recognise rare diseases in patients. Healthcare professionals can also be better supported to help signpost patients with rare disease to information about their condition and to help them understand it.

In a 2016 survey by Rare Disease UK, it was found that 70% of patients were not provided with sufficient information on their condition following diagnosis, and that 35% of patients given information did not understand the information that they were given.

More recent surveys demonstrated that these challenges continue. The Government’s national conversation on rare diseases in 2019 found that almost one in five people living with a rare condition reported that a lack of healthcare professional awareness of their disease was the number one challenge that they faced, and healthcare professionals themselves identified it as the second biggest challenge they faced behind only the well-known difficulties in obtaining an accurate diagnosis. I accept that healthcare professional regulators can do only so much to make improvements, but it would be helpful to understand from the Minister what steps they might be able to take to help better embed rare disease content in training frameworks.

Finally, there is a wider question of how the Government currently track progress in increasing awareness of rare diseases among healthcare professionals. How do the Government do that? I look forward to the Minister’s reply.

Baroness Meyer Portrait Baroness Meyer (Con)
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My Lords, in speaking to Amendment 266, I shall not speak for long because everything has been said. The noble Baroness, Lady Finlay of Llandaff, explained the problem very clearly as did other speakers.

The only reason I want to speak is that in April last year I spoke in favour of the Private Member’s Bill introduced to this House by my noble friend Lady Wyld which sought to prevent cosmetic procedures being performed in England on people aged under 18 unless under the direction of a medical practitioner. The Bill was passed with cross-party and government support. As a result, children are now better protected. It is high time that we protected the population at large. When one hears of all the side-effects and that people can buy a product online and inject it into themselves or somebody else, it feels like the wild west, and the consequences can be quite dramatic, as we have heard. I very much hope that the Government will be able to support this amendment. This is not complicated and needs to be done quickly.

Baroness Pitkeathley Portrait Baroness Pitkeathley (Lab)
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I want to follow the noble Lord, Lord Sharkey, because I am former chair of the Specialised Healthcare Alliance. I shall speak very briefly in support of Amendments 164 and 178 in his name and that of my noble friend Lady Wheeler.

Every reorganisation of the NHS leaves patients who have a rare or less common condition anxious about how their particular needs will be assessed, how they will be met and even how they will be noted. It is sadly true that the rarer or more specialised a condition, the more it comes down to a postcode lottery whether the patient will be able to access care in spite of established national standards. Not only is it harder to access care, it is also harder for these patients to access the support groups or information networks which are vital when finding out the sometimes rare information about these conditions. The suggestion in Amendment 164 that the CQC assess the provision by ICBs of care for those with rare or less common conditions would provide the assurance that is so badly need.

House of Lords (Hereditary Peers) (Abolition of By-Elections) Bill [HL]

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Baroness Meyer Portrait Baroness Meyer (Con)
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My Lords, much as I like and admire the noble Lord, Lord Grocott, I hope that he will forgive me for disagreeing with him on this occasion. One thing that I have always admired about this country is its stability based on an ancient monarchy, ancient Parliament and ancient traditions. Since the Civil War, this country has known instinctively how to find the right balance between preserving tradition and allowing evolution. Contrast and compare that with the two countries from which my parents come: France and Russia. Since the revolution in 1789, the French have experimented with two empires, a monarchy and five republics to find the secret of stability. I would argue that they were still searching for it. In one short century, Russia demolished an empire and got rid of the aristocracy, replacing it with a communist tyranny. It is now an autocracy disguised as a democracy.

I am not being flippant, but I see that, in each of these countries, the constitutional baby has been thrown out with the bathwater several times, often in circumstances of extreme violence. In Britain, in times of great change, we have managed to keep the baby and successfully replace the bathwater without having to resort to violence. There is a lesson to be learned here. I am well aware that, for many people, Lords reform is long overdue. Many have spoken about it today. However, there is a difference between modernising an ancient regime and extinguishing centuries of tradition. Change, often masquerading as progressive politics, does not always produce improvement, particularly when there is no consensus on what shape that change should take and how it might affect our long-held values as a consequence.

Removing all hereditary Peers would fundamentally change the nature of your Lordships’ House. Their numbers have already been reduced to barely 11% and there is no reason to cull them into oblivion. Why should their presence be considered more objectionable than that of, say, those Peers who have been politically appointed? I may not have been a Member of this House for very long, but one thing I have observed is the quality of the hereditaries’ contributions, their grasp of a wide range of subjects and the variety of their expertise and experience. At a time when levelling up between north and south is a major plank of the Government’s strategy, we should recognise that the hereditaries are less urban as a group than any other group of Peers in this House. One issue often raised is the absence of female hereditary Peers. That needs to be addressed, there is no doubt, but surely this is not a matter for this Bill.

While we can all agree that change is needed, it should not be done in this way. It would be pure constitutional vandalism simply to wrench out of our ranks one small group which contributes so positively to our proceedings, out of proportion to their number. If this were to happen, I very much fear that we would find ourselves on a slippery slope at the bottom of which we would find a republic waiting for us. The last time we tried that, almost 400 years ago, was certainly not a happy experience.

EU Council

Baroness Meyer Excerpts
Monday 17th December 2018

(6 years, 3 months ago)

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Baroness Meyer Portrait Baroness Meyer (Con)
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My Lords, how much taxpayers’ money would be spent if we had a second referendum? A second referendum would be a complete disaster. As the Prime Minister said, it would damage the core of a democracy that we took 1,000 years to achieve, and this Parliament is part of it. If you do a second referendum, why not a third or a fourth? Actually, why not govern by referenda and get rid of Parliament altogether? It is madness.

Baroness Evans of Bowes Park Portrait Baroness Evans of Bowes Park
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I understand that the Electoral Commission has recently published figures showing that the referendum in 2016 cost around £150 million or £160 million. If that is incorrect then I will write to my noble friend, but I think those are the figures that were published. We are not considering a second referendum. We are working to ensure that this deal is passed by the House of Commons.

Leaving the European Union

Baroness Meyer Excerpts
Monday 26th November 2018

(6 years, 3 months ago)

Lords Chamber
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Baroness Evans of Bowes Park Portrait Baroness Evans of Bowes Park
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We are absolutely committed to ensuring a deal that works for the entire UK family, including Gibraltar. Our position on Gibraltar sovereignty has not changed and will not change.

Baroness Meyer Portrait Baroness Meyer (Con)
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My Lords, given that the head of HMRC, Jon Thompson, has again confirmed that, in the event of no deal, no hard border will be built in Northern Ireland; given that the Prime Minister of Ireland offered the same assurance last month; and given that the backstop remains the main source of dispute in this country over the Prime Minister’s deal, can the Leader of the House help us to understand why there is any need for a backstop at all?

Baroness Evans of Bowes Park Portrait Baroness Evans of Bowes Park
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As we have repeatedly made clear, this is an insurance policy no one wants to use. It is needed in case the future relationship is not ready at the end of the implementation period to ensure that there is no hard border. However, as we have also made clear, it is not the only option. There is a possibility of a short extension to the implementation period. It has also been made clear in both the withdrawal agreement and political declaration that both sides will consider how facilitative arrangements and technologies can be used to avoid a hard border on the island of Ireland. There are other options that we will all be exploring rather than the backstop.