Public Health

Lord Mackinlay of Richborough Excerpts

Tuesday 6th October 2020 Commons Chamber

[Mr Steve Baker (Wycombe) (Con)]

May I begin by thanking my hon. Friend the Minister, the other Ministers in the Department and officials? They are obviously working extremely hard, and I completely accept their good faith in extremely difficult circumstances. I particularly want to pay tribute to the drafters of these very complex regulations. I know from my time as a Brexit Minister that when there are a lot of statutory instruments to do it is extremely hard work for them, and they do not get anything like enough thanks, so I want to put all of that on the record.

It remains the case that this is a dangerous disease for people with risk factors, and I certainly see why the Government wish to introduce measures. My friend and constituent, the epidemiologist Dr Raghib Ali, has written in The Telegraph that both the REACT—real-time assessment of community transmission—and Office for National Statistics studies

“showed that the levels of infection have increased in all age groups, including the most vulnerable older age groups, and also in all regions, but with much larger increases in the North, Midlands and London.”

However, he goes on later in the article to state:

“They all show this is not a repeat of the first wave as infections are rising much more slowly, doubling roughly every 11 days now vs. three days then. And crucially, they also show that the rate of increase is slowing down significantly.”

He goes on, it has to be said, to say that the Government are getting it broadly right.

I have real concerns about the very high cost of the measures. The hon. Member for Westmorland and Lonsdale (Tim Farron) gave some examples, and the hon. Member for Twickenham (Munira Wilson) talked about the need for two families to meet, making eight, but what about two parents and three children? They can meet only one grandparent under the rules.

Elsewhere, we have other stories that are out of the scope of the statutory instrument. If I can get away with one anecdote, there was a story on the BBC website of a wife talking about springing her husband in his 80s out of the care home so that they can spend some time together at that late stage. People are bearing an absolutely appalling set of costs, and anecdotes of poor compliance are rising. Indeed, there seems to be a gap between people’s intentions to comply and what they actually do, as was revealed in the King’s College London research that the Government commissioned.

It is not clear now that the benefit of lockdown outweighs the costs. Although the report fell rather flat, The Telegraph covered some Department of Health and Social Care analysis that seemed to show that in quality-adjusted life years, adjusting for co-morbidities, the cost of the first lockdown was greater than the cost of the disease. In a spirit of good will, where we all mean to minimise harm and maximise human flourishing in the fullest sense, we have to ask whether this set of circumstances is really what we want.

Time and again in our own constituencies, and talking to colleagues in the Tea Room, we hear about people who are being destroyed by this lockdown. Strong, confident, outgoing, gregarious people are being destroyed and reduced to repeated episodes of tears on the phone—all around the House, people are agreeing with me about that. The situation is having a devastating social impact on our society. I believe people would make different choices were they able to take responsibility for themselves, so I have really quite deep concerns about this statutory instrument.

[Craig Mackinlay (South Thanet) (Con)]

My hon. Friend is making the powerful point that there are other health issues and other effects of such draconian rules. Does he agree that the Government should now be publishing what those other effects are? Rather than just the bald figures on infection rates, hospital rates and deaths attributed to covid alone, there should be broader figures on mental health, cancer and all the other treatments, and the deaths that we are not seeing yet but are simply stocking up for the future.

[Mr Baker]

I do agree. I call on Ministers to publish robust data about the balance of costs and benefits. I understand that there is no impact assessment to go with this statutory instrument—I was certainly told that when I picked it up. We really should now be looking extremely carefully at the balance of cost and benefit to overall human flourishing. I am certainly not currently persuaded that the benefit is net positive.

I pay tribute to 66 GPs, led by Dr Ellie Cannon, who have written to the Secretary of State to say that it is now time for him

“to consider non-covid harms and deaths with equal standing as the reported deaths from covid”.

They have suggested that there be a GP on SAGE; I suggest that we also have some economists on SAGE and have made some other proposals about competitive scientific advice, devil’s advocates and other measures that could improve things. The letter from GPs is extremely important. It is time to listen to GPs.

As I reflect on this statutory instrument, I have to say that it is also time to start to think about another way. The Government’s strategy is clearly to suppress the virus, through instruments such as the one we are discussing, pending a vaccine. But what if a vaccine does not come? What if a vaccine, when it comes, does not achieve the ends aimed at? What if we still need some kind of measures alongside a vaccine? I have talked to specialists in this area, and it seems to me—with great sadness—to be pretty clear that we might be in those circumstances, in which case the Government will need a plan B.

For that reason, I was very glad to sign the Great Barrington declaration and to encourage parliamentarians of all parties and both Houses to sign it to show that there is political consensus in both Houses and across all parties for another way. This is plan B, authored by Dr Martin Kulldorff, Dr Sunetra Gupta and Dr Jay Bhattacharya and signed by 1,120 medical and public health scientists, 1,241 medical practitioners and more than 19,000 members of the public, including me. I commend it to the Government.

--- Later in debate ---

[Helen Whately]

I appreciate that my hon. Friend did not take the “let rip” position, but some have done so. The majority of those who have spoken this evening have absolutely supported the fact that we need to have restrictions in place, which is good to hear.

[Craig Mackinlay]

Will the Minister give way?

[Helen Whately]

May I just finish responding to my the point made by my hon. Friend the Member for Wycombe (Mr Baker)? He says that for the vast majority this is a mild illness and that the deaths have particularly been among those with underlying health conditions. It is true to say that the majority of those who have died were older and with underlying health conditions, but, sadly, some have died who did not have known underlying health conditions and were younger. I well remember reading about a nurse not far from my constituency, in Kent, who had three young children and was only slightly younger than me but who died early in the pandemic. So it is not true to say that this affects only older and unwell people, although we should also mourn the older people whose lives have been taken before their time, many of whom were in receipt of care.

The other point is that among those who have had mild illness we are seeing increasing evidence of the condition known as “long covid”, where, sadly, there are long-term health consequences of covid. We are learning about those all the time; they are making it materially difficult for people to lead their lives some weeks and even months after they had the illness, even if they had it mildly in the first place.

--- Later in debate ---

[Helen Whately]

If my hon. Friend would allow me, I would like to make a little bit of progress, otherwise I will have remarkably little time left.

We have a clear strategy, which is to control and suppress the virus while doing all we can to protect the economy, people’s work, schools and the NHS, so that it, in turn, can care for us.

Let me turn to some of the points made by hon. Members. Various reasons have been suggested for the rapid introduction of the regulations. In fact, the shadow Minister made some suggestions. The Government have had to act fast. When we see the rates of increase—particularly when we take away the average across the country, and look at specific areas and parts of the population where the doubling rate can be going up really quickly—it is clear that we need to act fast. The alternative is to act slowly—and if we did that for several days, it would be inaction. That just means that the virus would be left to spread further and faster.

Colleagues have asked for further information about the impact and effectiveness of measures. I get the sense that some Members would like to hear, “If you do x, you get y,” in a very mathematical way. We are dealing with a new disease that simply is not known to the level of “A leads to B exactly.” We look at a huge amount of evidence, including at what is happening overseas, the difference made by local lockdowns and evidence from the test and trace system. All that evidence informs the decisions that are made. We know that social contact is a particular cause of the spread, so we must reduce social contact.

[Craig Mackinlay]

Will the Minister give way?

[Helen Whately]

I am really sorry, but I have so little time.

We have seen reduced levels of socialising since introducing the rule of six, but that is against a backdrop of rates rising in particular parts of the country, which are now under further restrictions. We will continue to look at the evidence and ensure that we are putting in place effective interventions.

The measures that we are debating today are clearly coupled with the vital rules such as hands, face and space. We all have our part to play. We will continue to assess the effectiveness of the measures, but we need restrictions in place until covid rates come down.

Coronavirus Act 2020 (Review of Temporary Provisions)

Lord Mackinlay of Richborough Excerpts

Wednesday 30th September 2020 Commons Chamber

[Sammy Wilson]

Well, of course, that is an issue that the Government will have to address in the future, if ever a vaccine is found.

The important thing is the frustration that many in the public are experiencing at present. It might not have been totally wiped out, but I believe there certainly would have been far more scrutiny if this House had not just had the ability to listen to statements or ask questions, but had actually had the real sanction that if the Minister did not make a consistent and competent case for the measures that he was introducing, they could be voted down. That is why the demand that there be effective scrutiny by this House is important.

We have listened to what the Minister has said, but I am not convinced that we will see that effective scrutiny; because if I heard him right, first, it would only be for matters that are significant. Now, who will make the judgment on whether the issue is significant? I can tell the Minister that, if I own a business and it is decided that it could be closed down, that is significant; yet we do not know who will make that final decision.

The scrutiny will only be for issues that are national. Sixteen million people are currently affected by a range of local decisions and local restrictions. That, to me, is as bad—half the nation, half the country, is affected—yet according to the Minister’s definition today that would not be covered because it would not be a national decision. And, of course, scrutiny will happen where possible. I suppose if the Government wished to escape scrutiny they could always say, “But this has suddenly emerged,” even though the data could have been collected days and days before. So who will decide whether it is possible to have the time to do this?

[Craig Mackinlay (South Thanet) (Con)]

As ever, my right hon. Friend makes the most powerful points. Does he agree that perhaps a special committee to decide what is significant—do lots of locals make a national?—would be a good way forward, so that we can decide what should be debated in this House and what can be left properly to Ministers to decide on a regular and rapid basis?

[Mr Speaker]

Order. It is significant to me to try and get as many Members in as possible. Please let us try to make sure we leave time for others.

Public Health

Lord Mackinlay of Richborough Excerpts

Monday 15th June 2020 Commons Chamber

[Tim Farron]

I am grateful for that relevant intervention. The point is that we need to do what is safe and compensate those people who are unable to go about their normal business if it is not safe. I am not one of those people who says, “We just follow the science.” A judgment still needs to be made on the basis of the science, but we need to have the guidance up front and early. As the hon. Member for Strangford (Jim Shannon) said, Northern Ireland is opening up on 3 July and perhaps England will open on 4 July, but we need the information on which to base those decisions.

In the Lake District national park—the most populated national park in the country—80% of the working-age population works in tourism and hospitality, an industry that has basically closed down for the past three months. It is not the case in every part of the country, but the tourism in the national parks and in the coastal zones of the UK is largely cyclical. Visitors rely on the feast of the summer to see them through the famine of the winter. Lockdown turned our summer to winter. Even if businesses are permitted to open in a limited capacity, the restrictions on customers will continue to prevent them from making up all that lost income. If the tourism economy is able to fully reopen only in the autumn, we condemn people to three winters in a row: three winters of making a loss; three winters of financial hardship. As the Government ease the lockdown restrictions, it is entirely sensible for the Chancellor to begin the slow unwinding of the furlough scheme for many businesses. After all, there is light at the end of the tunnel and hope for the future—but not for everyone. We must not fall into the trap of thinking that the ending of the lockdown will mean that business can begin to make profit again; being open for business is no guarantee of having business. A business cannot pay its staff even 10% if it is not making any income to pay them with, and that is going to be the case for a good number of businesses in the tourism and hospitality sector. If the Government insist on no exemptions to the phasing out of the furlough from August, many businesses in Cumbrian towns and villages will be forced to lay off huge swathes of their staff or to fold altogether.

As well as the huge increase in job losses on my patch, 37% of the working population are now on furlough—that is the fourth highest level in the country and the highest by far in the north of England. If we do not recognise that the tourism and hospitality industry is in a unique and precarious position, we will simply end up killing hundreds of otherwise healthy businesses in the autumn, in which case, what would have been the point of the Government’s expenditure so far? The furlough scheme would just become a waiting room for unemployment, and I will not settle for that.

[Craig Mackinlay (South Thanet) (Con)]

The hon. Gentleman is making a powerful point about tourism. It is worth £3 billion to Cumbria, and £320 million lands in Thanet—North Thanet and South Thanet as a whole—because of it. Would he now consider it appropriate that people should be able to sleep on their boats, and use their caravans and campervans, because these family units could be spending money on things locally, although not in the pubs and restaurants, obviously? Would he consider that to be sensible at this time?

[Tim Farron]

The hon. Gentleman makes a good point, which is that we should be considering intelligent ways of unlocking. The industry could reopen in phases, and I have been encouraging people involved in the hospitality industry in the lakes and the dales to get the breakdown of what is possible for their business and their industry to the Government early, so that it informs the Government’s decision making. Many of the things he suggests should be considered, and I am sure they are being. As I will discuss in a moment, we could have done with the guidance on what is permissible significantly sooner—that is, we do not have it at all, even with only 19 days to go.

It is not right for us to simply accept that for many people in hospitality and tourism the furlough scheme may just end up being that waiting room for unemployment, if no support is provided to take them beyond the autumn, because of the cyclical and seasonal nature of our hospitality and tourism industry. I will not settle for that. I am sure I speak for dozens of colleagues from right around the country, from all parties, who recognise this problem in their own communities. I urge us all to work together to make sure the Government see the need for a special package for the hospitality and tourism industry, in Cumbria and across the whole country.

In Cumbria, we pride ourselves on our warm welcome to visitors and the strength of our communities. Not only will the impact of this on hospitality and tourism be catastrophic for those directly involved, but untold damage and hardship will be caused to other industries and businesses that are tied into and utterly inseparable from the tourism economy. I am talking not only about the restaurants, pubs and attractions, but about the retail industry, entire supply chains, the maintenance industry, and those involved in furnishings and fittings. We provide a first-class welcome for our visitors and we are proud of it. From the awesome pubs and vibrant retail industry to the fantastic hotels and cosy homestays, our communities are a credit to the awesome part of the world we get to call home, but our visitors experience only the tip of the iceberg. Below the surface an enormous amount of work goes on to maintain and supply the visit that people enjoy; these are the businesses caught in the tension of being both desperate to get back to work and concerned to keep themselves, their families and their customers safe. Keeping restrictions in place is absolutely right to protect lives and prevent a second spike, which would be even more damaging to our economy, but we also have a responsibility to protect Cumbria’s families from hardship and destitution.

There is still no sign of the Government guidance, which it was promised would arrive last Friday, on the reopening of some of the tourism and hospitality industry. There is still no clarity on which parts of the hospitality industry will be able to open from 4 July in England or what the timetable for any gradual reopening might be. We are now just 19 days away from 4 July, and the tourism industry is still completely in the dark. Businesses not only need the guidance to ensure that they are meeting all the Government criteria; they also want to know how they can market with confidence to attract customers safely ahead of time. The lack of clarity from Government on which parts of the industry will be able to open from 4 July continues to hamper business planning, prevent bookings and stifle potential income opportunities.

There are three simple things that the Government could do to ensure the survival of the tourism industry through to the spring of 2021. The first is to publish the guidance today. Thousands of people are living in considerable anxiety day to day, having been robbed of even the small amount of certainty that a road map would provide. If the restrictions are to be eased in a way that will maintain health protection, businesses need the maximum time available to prepare and put appropriate measures in place.

Secondly, the Government must be flexible in their phasing out of the furlough scheme for tourism and hospitality and recognise that if they phase out the scheme for businesses with no income at this stage, they will needlessly kill off many of our local businesses that would otherwise be able to thrive and prosper in the future.

Thirdly and finally, the Government must introduce a bespoke support package for the tourism and hospitality sector, to see it through to the spring of 2021. Our lakes economy exists on feast and famine. The lockdown came at the end of the winter famine, and then the feast was cancelled. If they dump us out in the cold on our own as we approach the next winter famine, they will kill an industry and plunge thousands of my constituents into hardship. I am not having that—not when a support package through to next spring could see us come out fighting, ready to bounce back as the high season begins.

We take seriously our responsibility to care for the lakes, the dales and the whole of Cumbria’s spectacular landscape. We cannot wait to welcome visitors back to enjoy the fells, the food and the finest places on the earth, from Dent to Coniston, Grasmere to Kirkby Lonsdale and Windermere to Kendal, but without financial support there could be barely any tourism and hospitality sector there to welcome them. Will the Minister and her colleagues show that they are serious about protecting lives and livelihoods by announcing those measures to protect the tourism industry today?

[Mr Mark Harper (Forest of Dean) (Con)]

It is a genuine pleasure to follow the hon. Member for Westmorland and Lonsdale (Tim Farron), because my area, like his, has a number of tourism and hospitality businesses. I have met a number of those businesses virtually, and they too will be waiting to see the guidance on how they are able to open their businesses in a way that is profitable and sustainable. They no doubt look forward to seeing that guidance.

I want to cover two things. The first is the process of how the Government make these regulations and the House debates them. The second is the amendment to regulation 7, on gatherings, and pertains specifically to an event proposed in my constituency.

My first point relates to one that I touched on in my interventions on the Minister and in response to my hon. Friend the Member for Broxbourne (Sir Charles Walker). I note that on social media, one of our colleagues has clipped my remarks and used them as an explainer for the rather complicated set of amendments that we are debating. I have not yet had a chance to look at it, because that would have been inappropriate and difficult in the Chamber, but I will see whether my explanation has clarified things.

It is worth reminding ourselves that this set of regulations are the biggest restrictions on the liberties of British people since the second world war, and potentially even including some of the wartime restrictions. The first set of regulations were made on 26 March and came into force immediately. They were clearly very significant, and they were made under the emergency provisions. Although the regulations were made under the Public Health (Control of Disease) Act 1984, the substance of them had been debated quite fully as part of the debate on the Coronavirus Bill, which got Royal Assent that week. To be fair, although the original regulations themselves had not been debated, the substance of them had been debated at length by the House as part of the passage of the Coronavirus Act 2020, so they were properly debated in the House. Since then, though, they have been amended by the different sets of amendment regulations—I shall not trouble the House by reading out all the titles.

I note that although the amendment No. 2 regulations were debated in a Delegated Legislation Committee, as the Minister said, they are going to be approved by the House only today—they are on the Order Paper—and we are now debating the coronavirus No. 3 regulations which, as set out in the exchanges, have in some cases already been superseded by the No. 4 regulations, which were laid before the House on Friday and in some cases came into force almost immediately afterwards, with some regulations coming into force on Saturday.

My hon. Friend the Member for Broxbourne put his finger on it when he noted that the regulations are actually quite complicated and not everybody will understand them in great detail, but because they are the law a breach of them is actually an offence. We are creating criminal offences here, and when we do that it is important that we let people know what the offence is and how they can make sure that they remain within the law. I suspect that if we were to do a survey among Members of Parliament, even they probably would not get all the regulations correct. They are quite difficult to follow, given that they start off with a set of regulations that is then amended over and over again. It is quite a challenge to work out what the current legal position is. Given that sanctions are involved, that is difficult.

If I were to explain to the public—who are, after all, the people we represent and the reason why we are here—why they should care about what might seem like a piece of esoteric processology, I would say that it is because we are debating laws that they have to live under and that place enormous restrictions on their liberty and how they live their lives and, as my hon. Friend the Member for Broxbourne said, have really quite significant impacts on their livelihoods, as was clearly illustrated by the hon. Member for Westmorland and Lonsdale when he recounted the impact on his local tourism sector, as there has been an impact on mine. The regulations include detailed provisions about what businesses can trade, how they can trade and how they can make money or not make money, so it is important that we debate them seriously.

It is worth my briefly going through how we have ended up with these regulations. As I said, the first set of regulations were in effect debated as part of the debate on the Coronavirus Bill. There were then some amendments that were largely minor and technical, so people could probably live with the fact that they were not debated in detail. The second set of amendments—those that are not being debated by the House today, because they were debated in Committee, but will, I suspect, be approved by the House today—contained some important changes and significantly increased the maximum penalty from £960 to £3,200. Admittedly, that is the maximum after a number of offences, but it is a significant penalty increase, and they have not yet—until this evening—been approved by the House. So far, that criminal offence or sanction has been imposed only by the stroke of a Minister’s pen, not by the approval of the House.

The amendment No. 3 regulations, which we are debating, contain some significant changes. They changed fundamentally the structure of the regulations from restrictions as to whether we could leave our homes and the reasons why we could do so towards in effect saying that we could leave our homes whenever we liked but just could not stay away overnight. That is a significant change in the way the regulations are structured and, again, that has not been properly debated by the House until today.

The other significant change in the regulations was that they altered the rules about gatherings. Originally, more than two people were not allowed to meet in a public place. These regulations change the rules on gatherings to cover both public and private places and put a restriction on gatherings to be of no more than six. I will come onto that a little later in my remarks, because it is relevant to my particular constituency case.

The final thing that these regulations do that I want to focus on—the Minister touched on this in her remarks—is to extend the review period from 21 days to 28 days. I am not sure I quite follow the logic that the Minister set out, because I was happy with the shorter period on the basis that the regulations are very significant restrictions on liberty, and therefore I think reviewing them more frequently is better. On the Minister’s point that the length of time for the review has been extended to allow changes to come into force and an assessment to be made of the impact of those changes on, presumably, the R number and the level of infections before we make another set of changes, I understand the logic behind that, but that does not really seem to be exactly what we are doing. The review period as set out in the regulations is 25 June, which is nine days before the point in the Government’s plan at which we will potentially open up the leisure, tourism and hospitality sectors. That nine-day gap will not leave people a lot of time to prepare, because 25 June is only 10 days after the very significant and welcome changes to open up the non-essential retail sector, which have only taken place today.

If those changes today were to have an adverse impact on the spread of the virus— I do not think they will, because businesses are operating in a covid-secure way—we probably would not know about that in 10 days’ time because of the period that the virus takes to show up and feed through into the data. So we would not be in a position on 25 June to know whether the changes that have taken place today have had any impact. We would not know, therefore, when we were potentially going to announce the opening up of the hospitality, leisure and tourism sectors, whether the changes today have had any impact or not, and whether we need to make a course correction. I am not sure that the extension of 21 days to 28 days for the review period makes a lot of sense, because we are not debating the regulations at the time when they come into force or ahead of that, so the timetables are completely out of kilter.

My final point before I come to the specifics of the regulations is on the amendment (No. 4) regulations, which deal with linked households. I will touch on them only briefly, because they are not the regulations we are debating today. I have read those regulations, and they are quite complicated. There is such a level of detail about family structures and the rules on which households can link to other households means, and I am not really sure that trying to put that level of detail into the law makes a lot of sense. That is both because it is complicated—I am not sure how anybody makes head or tail of it—and because realistically I cannot see how anyone can practically enforce the regulations. I do not see how a police officer, without carrying out the most extraordinary amount of surveillance, can possibly know whether various households are appropriately linking to each other, particularly if one of the households has multiple adults in it.

We may have reached the point where the Government should think—particularly because there has been such high compliance with even the parts of the rules that are guidance only—about whether we want to set out our thinking, publish the advice and guidance to people, and allow them to implement it themselves without having legal sanction underpinning it.

These regulations expire at the back end of September anyway. It may be worth the Minister saying what the Government are doing: whether they are going to keep the legal framework in place until then, or whether, at an earlier point, there may be some sense in moving to a model where we deal with this through guidance and advice, not the power of the criminal law. That would be a tribute to the British people. They have largely followed the rules very, very fully and the evidence is that they can be trusted to follow the guidance pretty comprehensively, even if it is only guidance and not backed by criminal sanction.

On the specifics in the regulations we are debating today—this is my final point, Madam Deputy Speaker—regulation 7 makes it very clear that a gathering of more than six people outdoors is unlawful and that somebody attending such a gathering is committing an offence. I mention that because there is a proposal in my constituency to hold a demonstration this coming weekend on the subject of black lives matter. Now, I am very firm in my view that I abhor racism of any kind. In normal circumstances, I would welcome people demonstrating that they, too, were against racism of any kind. I hear people say we have a right to protest in this country, and normally we do. However, under the regulations, which I suspect the House will approve this evening, we actually do not have a right to protest if there are more than six people—it is an offence. The Home Secretary made it very clear that it is an offence. She was very clear, in her exhortations this past weekend, that people should not come to London and should not protest, because the regulations are in force because we are trying to deal with a pandemic.

That is very much the view of most of my constituents about this particular demonstration. My own view is that I would welcome such a demonstration to take place in the future when the coronavirus regulations are no longer in force and we are no longer trying to deal with the pandemic, but it would be an offence at the moment. There is a decision taking place this evening. The local trust that runs the recreation centre is having to make a decision about whether to approve the demonstration. I have been very clear that people attending the protest would be committing a criminal offence, which is punishable by a fine, and it should not take place. If it were to take place, my advice to people would be not to turn up but to express their views in other ways—there are plenty of ways that people can express their views on social media and so forth—and to hold over a protest until it is lawful.

In any other circumstance, if a Minister proposed abolishing the right to protest, people would be outraged. We would think that this House would absolutely have to vote, debate and decide on such a provision, but that right to protest was effectively extinguished by the stroke of a Minister’s pen and has been significantly changed in the regulations again by the stroke of a Minister’s pen. It is only today that the House will take a decision. I would say to Ministers that it is in their interests to bring the measures to the House, have them debated and then have the House give its backing, so that it is Parliament that has approved them and not just them. Until the regulations are approved, the ban on protests is purely on the basis of the signature of the Secretary of State for Health, as the Minister said. I am sure that he does not really want to have all to himself the fact that he personally has abolished the right to protest in England. That is actually what he has done without the sanction, yet, of this House, because the regulations have not yet been approved.

[Craig Mackinlay]

As ever, my right hon. Friend is making a forensic analysis, particularly of the timeline, to which I think we will all refer over the days ahead. He makes the very good point that we are considering regulations that are backed up by criminal records and fines, and that we are doing that rather rapidly and belatedly. Would he hazard a guess as to how many people will actually be fined for having a barbecue with seven people next week, when they see that there will be no fines or sanctions for big gatherings of people who are passionate about what they stand for? I wonder if he might hazard a guess.

[Mr Harper]

My hon. Friend has a point. The reason why I have been clear in the view that I have expressed in my constituency about these protests is that I fundamentally believe that we live in a country governed by the rule of law, and one thing about the rule of law is that it applies to everybody in the country. Of course, one of the arguments that many of the people attending these protests are making is that they want everyone in our country, whatever their race, to be treated equally under the law. We already have laws in this country that protect the way people are treated and guarantee, under equality legislation, that we treat people of different races the same. It is difficult for someone to argue that they want the law to be applied to protect people of different races and guarantee their rights if, at the same time, that person is conducting a protest that in itself breaks the law. It is not a very consistent position to have.

Coronavirus

Lord Mackinlay of Richborough Excerpts

Tuesday 3rd March 2020 Commons Chamber

[Matt Hancock]

I have been absolutely clear about the legal position, and I have said that we are keeping the area under review.

[Craig Mackinlay (South Thanet) (Con)]

As cases escalate, and we have to assume they probably will, even a well-prepared NHS will become stretched, with health professionals likely to be affected. Self-help will become important, and we are already seeing a national shortage of hand-sanitising gel. Will my right hon. Friend work with the manufacturers to ensure basic products such as paracetamol, ibuprofen and cough medicines remain widely available on the high street?

[Matt Hancock]

My hon. Friend is completely right and, in fact, our no-deal planning and our no-deal stockpiles are playing an important part in making sure we are fully prepared and ready.

Coronavirus

Lord Mackinlay of Richborough Excerpts

Wednesday 26th February 2020 Commons Chamber

[Matt Hancock]

I abhor any racist attacks that people might say have resulted from this situation. The circumstances do not matter—racism does not help; it hinders any response. I can assure the hon. Lady that 111 staff have the support they need and we have back-up plans. That is all part of the plan and 111 is responding brilliantly. Thank goodness we have 111. It is only a couple of years old and it is absolutely delivering in these circumstances. Everybody in the country knows that if they are worried that they have coronavirus they should call 111.

[Craig Mackinlay (South Thanet) (Con)]

I pay tribute to the Secretary of State at this very difficult time. His statement was very measured. He mentions four means: containment, delay, research and mitigation. Containment and delay come with serious economic and social disruption, and we are seeing that in the markets at the moment. I would say that what we must be doing the most is mitigation. This is a very strange virus with a very long period between infection and symptoms. The number of interactions people make during that two-week period—perhaps even longer—will be innumerable, and that makes thermal testing, which is often the first way forward, difficult to analyse. Will the Secretary of State, the chief medical officer and other international experts look seriously at whether this is simply A. N. Other flu virus that is difficult and problematic, but recoverable from?

[Matt Hancock]

I thank my hon. Friend; I will certainly do that. I agree with him on the importance of mitigation. The mitigation strand is really about what would happen should this become a full-scale pandemic, and the very significant impact that that would have on the country— including, of course, on the NHS. On the purpose of the delay strand of this work, even if we do not succeed in containing the virus, we want to delay its arrival so that it does not all arrive in one big peak, but arrives over time so that we can better cope with it. Of course, the contain strand is about trying to stop that from happening at all.

NHS Funding Bill

Lord Mackinlay of Richborough Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Craig Mackinlay (South Thanet) (Con)]

I am delighted to see you in your place, Mr Deputy Speaker; it is the first time we have been in the Chamber together since you were elected—congratulations to you.

I am pleased to support the Second Reading of the Bill, which displaces any doubt that the Conservatives’ commitment to the NHS is absolute. It will be cast in legislation, and the budget will rise way into the future. The Bill reflects what we have: an ageing population; even more advanced, very expensive machines, which one has only to go round a modern hospital to see; procedures that were not even thought about just a generation ago; and pharmaceutical products that are advancing and by their very nature expensive. In the future, the NHS will be even more important. As we advance into an age of gene and DNA mapping, insurance providers will know the conditions that we are likely to have in 40 to 50 years’ time—we may not want to hear about some of them. The NHS will be much more at the heart of everyone’s healthcare.

However, I have concerns about throwing money out unless there is proper administration and great care about looking after it. I fear that NHS trusts may simply reach out again for the locum hotline and that the money will not be spent where it ought to be on the frontline. In South Thanet, we have an issue with GP numbers—just one GP per 2,500 of population. That is among the worst figures in the country: the average is one per 1,600. It is little wonder that our A&E departments find themselves under stress. The GPs issue is complex: it is about retention, early retirements and morale. We have tried to implement an international recruitment scheme, but it has not gone as well as many of us would have hoped.

I am particularly worried about procurement. A couple of years ago, I launched an extensive freedom of information request aimed at NHS trusts and clinical commissioning groups, police and fire authorities, and even universities, across the entire country. I published the results with The TaxPayers’ Alliance in January 2018. I asked a simple question: how much did they pay for a ream—500 sheets—of 80 gsm photocopy paper, which every institution uses by the pallet load? Any one of us could probably go to the high street and pick up a ream for £2.50. The average NHS trust procures 25,000 reams a year.

I found that the highest price paid by a CCG was Wokingham CCG at £5 a ream; the lowest price—very well done—was paid by Haringey CCG at £1.62. The lowest price paid per ream by an NHS trust was £1.40, by Colchester Hospital University NHS Foundation Trust; the highest was £4.65 by Portsmouth Hospitals NHS Trust. That was a simple issue to ask questions about, and one wonders what else is being procured badly. How much are trusts paying per kilowatt-hour for electricity? What do they pay for their telecommunications, their medicines and everything else?

[Dean Russell]

One of the big challenges as we move into the digital economy is the procurement of advertising, especially social media advertising. Facebook, Google and so on all take huge amounts but in small pockets across the country—not just from NHS trusts, but from all aspects of Government and businesses as well. I would love that issue to be looked at.

[Craig Mackinlay]

My hon. Friend makes a good point. How much do trusts spend on recruitment consultants? There is a whole panoply of expenditure on other things that the NHS, as a very big procurer, could get at competitive, keen prices.

My hon. Friend the Member for North Dorset (Simon Hoare) made a good point about the cost of medicines and repeat prescriptions. That has to be a major issue: across the country, £20 billion a year—nearly one sixth of the NHS budget—is spent on medicines, many of which are on free, repeat prescription. My wife, a pharmacist in the community, far too often sees bags full of expensive drugs come back to the pharmacy after the demise of a loved one. They have to be thrown away, and the money is completely wasted. We need to ask some difficult questions about the NHS. Let us not try to throw more money at it in the hope of a better outcome, because we need to be rather more clever. Great as it is—it has become a national institution, greatly loved—the NHS does not always do things perfectly.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I thank the hon. Gentleman for giving way, and I have been listening with great interest to the excellent contributions of new Members.

There is some evidence that NHS provision in Scotland is somewhat rackety. The hon. Gentleman has described the cost of bits of paper, and so on. Would it not be a good idea to apply the same tests to the delivery of NHS services in Scotland?

[Craig Mackinlay]

Obviously the hon. Gentleman takes a great interest in Scotland. This is a debate about England, but I think there should be a serious debate in every part of the country about whether the NHS is operating as we would operate if this were our own business, and I think that in many areas of procurement, whether the item in question is paper, telecommunications or power, the answer will be “Probably not.”

I have benefited from a couple of interventions adding to my time, but I will end by saying this. As I said earlier, the NHS does not always do things perfectly, and in that regard I reflect on the death of young Harry Richford at the Queen Elizabeth the Queen Mother Hospital maternity unit, and on what the coroner said last week. The coroner said that the death of young Harry—who died after a week, following a very difficult Caesarean—had been “wholly avoidable” and “contributed to by neglect”, and that “Harry was failed”.

We cannot just keep saying that we will learn from these things. We need to embed improvements so that our healthcare system in this country is much the best on the planet, and I am sure that the Government will deliver that.

[Several hon. Members rose—]

DRAFT GENERAL FOOD HYGIENE (AMENDMENT) (EU EXIT) REGULATIONS 2019 DRAFT CONTAMINANTS IN FOOD (AMENDMENT) (EU EXIT) REGULATIONS 2019 DRAFT SPECIFIC FOOD HYGIENE (AMENDMENT ETC.) (EU EXIT) REGULATIONS 2019 DRAFT GENERAL FOOD LAW (AMENDMENT ETC.) (EU EXIT) REGULATIONS 2019

Lord Mackinlay of Richborough Excerpts

Tuesday 5th March 2019 General Committees

[Mrs Hodgson]

I do apologise. If we leave with a deal, all this will have been for naught. We have some of the highest food standards and regulations, and they would continue to exist. That is all the more reason why it is such a disappointment to us all that we are at the eleventh hour and the 58th or 59th minute and we still do not have a deal. I sincerely hope that one is brought before the House next week that a majority of the House can vote for.

[Craig Mackinlay (South Thanet) (Con)]

I am sure the hon. Lady is aware that the pages of regulations that we are trying to transpose into UK law have never had parliamentary scrutiny. They are regulations, so as soon as the ink is dry in Brussels, they become the law of the land whether we like it or not, with no debate in this place. Uniquely, in future, we will have the opportunity to shape our regulations.

As the hon. Lady is aware, the EU operates a precautionary principle. Many think that the standards that come out of Brussels are somehow gold-plated holy writ, but she will be aware of the problems that we have faced in past years, such as the Fipronil scandal in August 2017, which affected eggs. That happened under the regulations that are meant to be the gold standard, but I certainly hope that the UK will be able to do better in future. Can she comment on the fundamental principle that it is better that this place decides food safety, rather than it being decided by regulations over which we have no authority?

[The Chair]

Order. I would like us to concentrate on the detail of the regulations, rather than straying into the territory of whether we should be leaving the EU.

[Mrs Hodgson]

With that advice in mind, Ms McDonagh, I would say that, given that the hon. Gentleman had quite a lot to say, perhaps he should have considered making a full speech and graced us with his further thoughts on these matters. I am sure that we would all have enjoyed that immensely. However, I disagree with the fundamental principle of what he said, which is that these regulations were passed in Europe with no scrutiny here.

As a new MP, as I am sure a number of us were at one time or another, I had the huge pleasure of serving on the European Scrutiny Committee. Week in, week out, we would be sent reams of documents containing EU directives and regulations that our esteemed Clerks would have rated as politically or financially sensitive. They gave us advice, but we had to read all those documents and sit and scrutinise them all, week in, week out. We could then refer them for further debate in a European Standing Committee or on the Floor of the House, if we thought something needed scrutiny. I know for a fact that we scrutinised all EU directives that came to this House. Nothing was passed without proper scrutiny. It is a shame the hon. Gentleman has not had a chance to serve on that Committee, because he might never get a chance.

[Craig Mackinlay]

I have.

[Mrs Hodgson]

Oh, he has; because I was going to say, the hon. Gentleman has missed a treat.

I hope the Minister will respond to my concerns, either now or in a letter. I know he always sends a letter if he is unable to respond on the day. I know, too, that many others, not only in this room but across the country, will be looking forward to his response.

Oral Answers to Questions

Lord Mackinlay of Richborough Excerpts

Tuesday 19th February 2019 Commons Chamber

[Jackie Doyle-Price]

I will always welcome any research designed to improve the treatment of asthma. Certainly, from a public health perspective, we must do much more to prevent asthma and reduce the likelihood of life-threatening attacks.

[Craig Mackinlay (South Thanet) (Con)]

4. What steps the Government are taking to improve mental health service provision.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

Under the NHS long-term plan, there will be a comprehensive expansion of mental health services, with at least an additional £2.3 billion in real terms by 2023-24. That builds on our ambitious targets for improving community and crisis care, with extra treatment for 370,000 adults per year, and for 345,000 children and young people by 2023.

--- Later in debate ---

[Mr Speaker]

I would not want the hon. Gentleman to feel any sense of social exclusion.

[Craig Mackinlay]

One of my constituents, Mark Verrion, is a patient of Kent and Medway NHS and Social Care Partnership Trust. He was first admitted on a temporary basis following an unfortunate but mild episode. He has now been institutionalised for 11 years, and he has been moved over 100 times during that period, often out of area. The trust has 289 out-of-area placements for adult mental health services, which is an increase of 100 over the past year, and the cost to local health budgets is obvious. Does my hon. Friend agree that my constituent and all the other out-of-area patients deserve local health provision to enable them to remain within the trust area?

[Jackie Doyle-Price]

I quite agree with my hon. Friend. Frankly, I am horrified to hear the account he has just given. We have made a priority of getting rid of out-of-area placements, because we know that patients do better when they are among family and friends. Clearly the case he has just outlined, which has lasted the past 11 years, is totally unacceptable. I will give it my personal attention and meet him to discuss it.

Department of Health and Social Care and Ministry of Housing, Communities and Local Government

Lord Mackinlay of Richborough Excerpts

Monday 2nd July 2018 Commons Chamber

[Craig Mackinlay (South Thanet) (Con)]

We have heard some fantastic speeches from Members on both sides of the House about adult social care. I am not sure that we have been given the solution, but I think we have realised that there is a problem that needs to be solved.

Housing represents, potentially, a great asset for people in later life, which can help to pay for adult social care and other services that people need as they age. My worries are about house-price-to-earnings ratios and house price inflation. In 1996 the Nationwide house-price-to-earnings ratio was just 2.8, which means that 2.8 times someone’s earnings could buy that person the average house in the United Kingdom. Over the past 40 years, house price inflation has averaged 5% a year. That affordability gap is now extremely wide throughout the country. It is bizarre. One would have thought that the areas with the highest house prices would have the lowest ownership, but the reverse is the case. In the north-east, 60% of people are owner-occupiers, and the house-price-to-earnings ratio is just over 5. In the south-east, where house prices are obviously higher, 70% of people own their homes, but the ratio is now close to 10. That does not quite follow the pattern that we might expect.

Back in 1995, it would have cost first-time house buyers 17.5% of their incomes to service their mortgages. According to the figures that are available, in late 2016 the proportion was 33%. At the peak in 1989, base rates were approaching 14%, and it was costing 56% of income to maintain a mortgage, so we are not living in unusual times.

Thankfully, we are narrowing some of the gap between housing requirement and provision. It has been running at an estimated rate of 230,000 a year for some years, and will continue into the future. We built 217,000 houses last year, which is all to the good, but we have a fundamental problem: we do not seem to want to live together as generations any more. We seem to want independent living, and that can often lead to lonely living. There is a potential solution there, which might also solve some of the adult social care problems.

Is it time that we had a debate about a further loosening of planning law? Let me put some questions—not solutions—on the table. Are we allowing a degree of timidity in relation to development? Are we just trying to add little bits to existing conurbations, thus increasing pressure? Are we not thinking clearly enough about the building of completely new towns, with proper infrastructure—road, rail, health provision and schools—as part of the plan, rather than simply adding to the edges of existing communities?

Should we be trying to unlock brownfield sites? I can think of a perfect 5-acre derelict site that used to be the gasworks in the middle of Ramsgate. No one wants to develop it because of the remediation costs. Should legislation be introduced to force what are often utility companies to regenerate on pain of, perhaps, an additional business rate charge, or should the Government provide loans with a clawback provision to inject the seed capital to get developments moving?

We do have an existing stock, and I think that two measures would be helpful. Capital gains tax and inheritance tax are a problem, particularly for older people with holiday homes. Let us suppose that an elderly couple have had a holiday home for many years. One of them might become a widow or widower. They have fond memories, and do not want to rent out the property because of the aggravation that it would involve. Most people will not face an inheritance tax charge. Why on earth would they want to sell an asset that is hugely pregnant with gain, paying capital gains tax at 18% or 28%? They would rather leave it in their estate until they die, and perhaps pay nothing at all. As for those with a chargeable estate, why should they pay a 28% capital gains tax charge, and then a 40% inheritance tax charge on the £72 that is left in cash after that tax has been paid, which would represent a total tax charge of 57%?

The second measure I present is downsizing relief for stamp duty. Often, again, this would affect the elderly person, perhaps on becoming widowed. There is a north-south divide in this of course: in parts of the country it will be perfectly possible to buy that downsized smaller property for within the £125,000 stamp duty threshold for paying zero, but for many in the south, particularly in London, there will be a huge stamp duty to pay. My proposal is that we should have a downsizing relief for people moving to a smaller floor-area property—the threshold could perhaps be 75%. The Treasury might say it would lose money, but it forgets that for every seller there would be a new purchaser, so we would be creating stamp duty on purchases that might not otherwise have happened at all.

[Liz Twist (Blaydon) (Lab)]

Does the hon. Gentleman agree that housing is also a key determinant of health and that is an additional aspect that we must think about, especially in housing for older people? We must see housing as part of that bigger picture in creating a healthy nation.

[Craig Mackinlay]

Older people often stay stuck in a house that is not right for their future needs and is further from help they would so desperately require in their later years.

To conclude, housing is a scarce resource, particularly in some parts of the country, and we must maximise its use and maximise mobility.

Drug Addiction

Lord Mackinlay of Richborough Excerpts

Wednesday 22nd November 2017 Westminster Hall

[Craig Mackinlay (South Thanet) (Con)]

I beg to move,

That this House has considered the human and financial costs of drug addiction.

This is an expansive subject, with a huge number of facets, and is covered by a huge amount of UK and international data. Pleasingly, two Members raised drugs issues at Prime Minister’s questions today. They probably sought to steer us towards their views about liberalisation and legalisation, which I must say are somewhat the opposite of mine.

I thank the Minister for being here to respond to the debate. This issue cuts across many Departments. It is not just a health issue; it cuts across policing, justice and home affairs, health, border matters and education, and it is even an issue for the Treasury. I thank the many organisations that supplied data and their interpretations in advance of this wide-ranging debate, including the Royal College of Psychiatrists, Release and the House of Commons Library, which has considered data from a huge variety of sources.

[Mr Gregory Campbell (East Londonderry) (DUP)]

I congratulate the hon. Gentleman on securing this debate. He talks about data. Does he agree that the information from the Library about the increase in male mortality from drug misuse, particularly in the past five years, is alarming and demonstrates the urgent need not only for this debate but for action to be taken after it?

[Craig Mackinlay]

The hon. Gentleman highlights one of the key tenets of my speech. I am most concerned about death rates.

I thank the Library for its diligent service; it is an invaluable source of information. I also received information from Smart Approaches to Marijuana, or SAM, a US agency that has done a lot of work on how decriminalisation of cannabis in particular has affected various states in the United States. I consulted papers by the National Treatment Agency for Substance Misuse and by the Advisory Council on the Misuse of Drugs, and the National Audit Office evaluation of the Government’s 2010 drugs strategy, which is a seven-yearly document. I also consulted the Government’s July 2017 drugs strategy.

The real trigger for me calling this debate was the rising death toll in the USA due to the use of opioids and their derivatives—notably fentanyl, with which I am sure many hon. Members are familiar—whether they are legally obtained or illicitly produced. Some 64,000 drug-related deaths were recorded in the US in 2016, an increase of just over 21% from the year before. There was a 33% rise in one year in the state of Ohio alone. There were 4,050 deaths in Ohio, which has a population of just 12 million. To give Members an idea of scale, the entire US military losses over the 20 years of the Vietnam war were a fraction under 60,000. Scaled up to the UK population, Ohio’s current death rate would represent 22,000 deaths in the UK each year. Thankfully, the figure here is lower; according to the last reported data, there were 2,677 deaths in 2015.

[Liz Saville Roberts (Dwyfor Meirionnydd) (PC)]

Does the hon. Gentleman share my concern that Wales is disproportionately represented? Wales’s population is 5% of the United Kingdom’s, but 10% of those drugs deaths took place in Wales. Will he join me in asking the Minister whether changes to UK legislation are needed to allow devolved Governments to introduce harm-reducing measures, such as safe injecting facilities, in areas with a high concentration of injecting drug users, such as Wrexham?

[Craig Mackinlay]

I thank the hon. Lady for that intervention. She has put that issue on the record, and I am sure the Minister will address it later. I will provide some data for Wales that may assist her.

My concerns are somewhat summed up by that old adage, which is usually used in relation to financial markets: when the US sneezes, the UK catches a cold. I am concerned that we may be on the brink of a fentanyl epidemic here in the UK. I want to highlight both the human costs and the financial costs of drug addiction to the UK economy and to the people of this country.

The human costs are fairly obvious. Everyone will have their own points to add to this list, but they include: physical and mental health issues; disruption to families; the effects on children and their life chances, including the increasingly clear link between drug use during pregnancy and various autism spectrum conditions and physical deformities in children; the obvious spread of disease; the often desperate measures that people take to try to raise cash, resulting in prostitution and all manner of human degradation; forgone opportunities and the essence of all that someone could be in life being extinguished; and, of course, premature death.

[Jeff Smith (Manchester, Withington) (Lab)]

The hon. Gentleman is right to highlight the fact that our drugs policy in this country is failing. Does he not think that now might be the time for a shift in drugs policy and for us to focus not on criminalisation but on care and health? Should that not be the focus of our drugs policy?

[Craig Mackinlay]

The hon. Gentleman is right. I have an expansive speech to make, which I think will cover all the issues well. Perhaps he would like to come back in with those points later.

I chair the all-party parliamentary group on the harmful effects of cannabis on developing brains and have a long interest in that topic. The APPG’s principal aim is to raise awareness of the continued and growing danger to children, teenagers and their families of cannabis use in particular but also of wider drug use. I will publish a detailed paper on that subject later. The effects of the early use of skunk cannabis on youngsters’ mental health are increasingly recognised, as is the additional human cost of the significant rise in other effects, such as traffic-related deaths, in some of the US states that have gone down the route of decriminalisation.

I do not just take an abstract, desk-based approach to this topic. I have been a magistrate in Kent for 12 years. For too long, I have seen people go through the same revolving door of committing crimes, coming to court and going to prison. The same drug-related issues come up time and again. On one occasion, someone’s appearance in court arose from offences committed on the day of their release from a custodial sentence. That revolving door has to stop. Too often, I have seen youngsters in their late teens or early 20s who are on employment and support allowance or similar disability benefits and are incapable of holding down work brought to court after bouts of acquisitive crime. Nearly all of them are on long-term anti-psychotic drugs to deal with schizophrenia and bipolar disorders. In my experience, practically every one of those people gives the same mitigation in court: “I’ve had a long-term addiction to cannabis from an early age”—often from the age of 13.

The 2014 NHS National Treatment Agency for Substance Misuse paper was particularly useful in advance of this debate. It highlights that there are 306,000 heroin and crack users in England, with disproportionate heroin and crack use in lower-income areas compared with wealthier parts of the country. Drug use and poverty are linked. More than 1 million people are affected by family members’ or friends’ links to drug addiction. The Advisory Council on the Misuse of Drugs found a substantial increase in the number of people dying from drugs in the UK in recent years. That is mainly down to opioid substances, which, as I mentioned, caused 2,677 deaths in 2015. Opioid-related deaths have increased year on year. A massive increase in the 1990s followed a marked increase in heroin use. Thankfully, the number of deaths flattened and declined in the late 1990s and early 2000s—that was often put down to lower grade and more highly cut heroin being sold—but it has risen markedly since 2004.

Let me move on to fentanyl and various synthetic opioids, which are cited as the reason for the increase in deaths in the US. Fentanyl is a fairly normal pharmaceutical product. It is widely used, often in operations. It was first created in the early 1960s as a pain management drug, and it is very effective at that. It has a fairly easy formulation, but illicit supply increasingly comes from China, hence its street name of China white.

The epidemic of drug overdoses in America is killing people at almost double the rate of both firearm and motor vehicle-related deaths. Between 1999 and 2015, it is estimated that fentanyl and derivatives killed about 300,000 people in the US—the numbers are of virtually biblical proportions.

We regularly hear the argument for legalisation of cannabis, with those demands often coming from our Liberal Democrat friends—I see the right hon. Member for North Norfolk (Norman Lamb) in his place. Let us examine a real case study. In November 2012, Colorado and Washington states voted to legalise the private use of marijuana. In those two states, marijuana use exceeds the US national average and has risen significantly post-legalisation—more rapidly than in states where it is still illegal. We have also seen increases in teen arrests, accidental ingestion by children, marijuana-related poisoning, teenage admissions to treatment, and crime.

According to the Associated Press:

“In Washington, the black market has exploded since voters legalized marijuana…with scores of legally dubious…dispensaries opening and some pot delivery services brazenly advertising that they sell outside the legal system.”

Rather than putting a lid on matters, legalisation has taken the lid off. Marijuana-related traffic deaths—where a driver tested positive—have more than doubled, from 55 in 2012 to 123 in 2016, and there has been a 72% increase in marijuana-related hospitalisations since legalisation.

With that backdrop, let us look at the UK. The Library suggests that drug misuse in England and Wales has fallen in the past decade. That has got to be good news. However, I view some of those figures with a little scepticism; I will refer to such matters later on. Of course, 95% of heroin on the streets originates from Afghanistan, and cocaine invariably comes from Peru, Colombia and Bolivia; it is not manufactured in the UK. For that reason, I very much hope that as we leave the European Union and exercise more diligent control of our borders, we will be able to implement a more rigorous approach to border security, particularly on the smuggling of drugs.

The number of people in drug addiction treatment in the UK is at just a little under 300,000, with opiate dependency involved in more than 52% of cases. More than 100,000 under-18s are living with people in drug treatment. Those are some of the human costs. What are the financial costs?

[John Howell (Henley) (Con)]

I thank my hon. Friend for introducing the debate. Before he moves on to financial costs, will he say something about another side of the human cost—the extent to which prisoners are taking drugs and the efforts being made to try to stop that in prisons?

[Craig Mackinlay]

My hon. Friend makes a good point. We in the judiciary often feel that we put people in prison as a last resort and hope that that is a place where they may seek relief from drugs and get the treatment they need. However, all too often we hear of many examples where that is far from the case.

I want to mention the financial cost, because it is hugely relevant to our economy. Figures I have put together suggest that the financial cost now amounts to a fairly reasonable chunk of our annual deficit. It is very difficult to pull figures together, but one that I have derived from headline data is £20.3 billion a year. That does not include some of the more unknown and abstract costs, such as opportunity costs of lost economic output from a potential workforce who are economically inactive due to drug dependency and the physical and mental effects of drug use.

To break the figure down, drug-related crime is estimated at a fraction under £14 billion a year. The cost to the NHS of ongoing health issues resulting from drug addiction is half a billion. The benefits and treatment cost is estimated at £3.6 billion—£1.7 billion in direct benefits, £1.2 billion in the cost of looked-after children of drug addicts, and £700 million in addiction treatments such as methadone and Subutex. The cost to the courts, the Prison Service and the police in 2014-15 was £1.6 billion. An addicted person not in treatment and committing crime costs on average £26,074 a year. A somewhat dated Daily Telegraph report shows that a problem drug user could cost the state £843,000 over their lifetime—and that was in 2008.

Some of the other human costs are obvious, such as depression, anxiety, psychosis and personality disorders. Some 70% of those in drug treatment suffer from mental health problems. We might ask which follows which, but I think there is a clear link between drug use and psychotic episodes. Cardiovascular disease is also an issue after a lifetime of drug misuse. Muscular and skeletal damage are commonplace among injecting drug users. Lung damage following the smoking of various drugs and derivatives is also prevalent. Poor vein health and deep vein thrombosis is common among injectors. Then there is liver damage, which is expensive to treat, with hepatitis C causing cirrhosis, liver failure, liver cancer and death.

Deaths can come in many forms, including through accidents, suicides, assaults and simple overdose, as well as misadventure from drug poisoning, and drug abuse and drug dependence. Figures from the Office for National Statistics show that 2016 saw the highest number of deaths down to illegal drug use since records began in 1993. That fact is worth bringing to the table. Fewer than 1% of all adults in the UK are using heroin, but about 1% of heroin addicts die each year—10 times the equivalent death rate of the general population—and those deaths are predominantly from heroin and opioid use.

I will give the hon. Member for Dwyfor Meirionnydd (Liz Saville Roberts) some figures for the UK. Between 2012 and 2015, opioid-related deaths in England rose by 58%. She will be pleased to know that in Wales the rise was only—if that is the right word—23%; in Scotland it was 21% and in Northern Ireland, 47%. We now see an ageing cohort of drug users who began their drug-taking lives in the ’80s and ’90s coming through the system with increasingly complex health and social care needs, which have contributed to a recent spike in deaths.

A typical heroin user is likely to spend £1,400 a month on drugs—two and a half times an average mortgage. More than half of all acquisitive crimes—crimes including shoplifting, burglary, robbery, car crime, fraud and drug dealing, whether at a lower or higher level—are down to those on heroin, cocaine or crack. Those crimes have victims. To bring that down to a micro-level, figures from Kent County Council’s road safety team show there were 59 incidents of known drug-driving on Kent roads in 2016, with 16 resulting in serious injury and three in road accident deaths. Those figures are rising. In the last 10 years, Kent has seen 18 fatal, 70 serious and 142 slight accidents due to drug-driving incidents.

When budgets are stretched nationally and locally, the temptation is to reduce treatment, but that is entirely the wrong approach. NHS figures suggest that for every £1 spent on drug treatment, there is a saving of £2.50 to general society. We have a good record on drug treatment in the UK, far better than many other countries in the world. In England, 60% of heroin users are in treatment, compared with only 45% in Italy and 37% in the Netherlands. We have fewer injectors now than we did some years ago. We have an advanced needle-sharing procedure, and that is improving. As I say, it is far better than other countries: 1.3% of drug injectors suffer from HIV, compared with 3% in Germany and 37% in Russia, so we are doing some things very well.

What can drug treatment do to help outcomes for society? Obviously, it stops emergency admissions, as A&E is often the first call, it prevents suicide, self-harm and accidents, and of course it reduces reoffending. Estimates in the NHS document suggest that a city the size of Bristol could cut 95,000 offences a year through effective treatment. The benefit of that to society is some £18 million a year. It is not just the financial effect, however; there are other societal effects: reduced crime, less drug litter and less street prostitution. The area that I used to represent as a councillor in the Medway towns was plagued by street prostitution in the middle of Chatham. With that came the drug litter and sexual paraphernalia literally dumped in the street, costing the council money and being a potential source of infection to others.

Troubled families can be stabilised through effective drug treatment. We can reduce drug-related deaths and blood-borne viruses. I repeat: £1 spent can represent a saving of £2.50 to society.

[Jeff Smith]

The hon. Gentleman is rightly making the case that it is a false economy not to invest in addiction services. Does he share my disappointment that funding for addiction services has fallen by half and that, under this Government, public health budgets are also falling, with councils struggling to fund the addiction services we need?

[Craig Mackinlay]

I could not agree more with the hon. Gentleman: I feel there is a false economy in cutting that type of service. Obviously, they are the sorts of services where we cannot always see what sort of bang we are getting for the pound spent, because the savings come about in a rather disparate way. The hon. Gentleman brings a very powerful case to the table.

The Government have spent vast sums of money over the last few years on the Frank initiative. I do not know whether hon. Members will remember it—“Call Frank”; “Tell Frank”. I have asked many youngsters of late whether they have heard of “Frank”, and they do not have a clue who he is, so I question somewhat the effectiveness of the Frank initiative, which is particularly aimed at teenagers and adolescents. I will be reporting in a detailed paper shortly, so hon. Members should look out for that.

Almost in closing, I want to look at the July 2017 drug strategy. It is a good strategy with recovery at its heart. It looks at the threats and at the actions we can take to reduce homelessness, domestic abuse and mental health issues. The strategies are the usual strategies, which I think are common sense: reducing demand through deterrence and the expansion of education and prevention information, obviously restricting supply through law enforcement responses, supporting recovery and driving international action to reduce the amount of foreign-produced drugs hitting our streets—of course, that does little to stop the ever-increasing rise of cannabis grown in the UK. I believe it is clear that drug misuse destroys lives. It has a devastating effect on families and communities.

[Ronnie Cowan (Inverclyde) (SNP)]

The hon. Gentleman is coming to his conclusion. He seems to be saying that we are spending all that money trying to penalise people for drug use and trying to cut off the international supply. He has put horrific figures in front of us today. What will he do to change and affect that outcome?

[Craig Mackinlay]

The hon. Gentleman will hear that in my conclusion.

[Ronnie Cowan]

I was too soon.

--- Later in debate ---

[Craig Mackinlay]

I am sure that, as any of these debates progress, there is often a clarion call: “Let’s just liberalise. Let’s just legalise.” I am very pleased that, from what I have heard so far from the Government, they have no intention of doing that, and I massively support them. Drugs are illegal for a reason, because of the clear evidence that they are harmful to human health and associated with the wider societal harms of family breakdown, poverty, crime and antisocial behaviour.

[Ronnie Cowan]

What does the hon. Gentleman say to the Portuguese Government, who decriminalised and legalised and have seen a reduction by half in heroin addiction? What does he say to John Marks, who ran a very successful clinic in Liverpool, where the local crime rate dropped by 90%?

[Craig Mackinlay]

Again, if the hon. Gentleman will hold on for a moment, I will address that point. Where we have big experience areas such as Colorado and Washington, we have not seen just a stabilisation, reduction or more sensible use. We have seen increased rates and an increase in deaths and consequential accidents and results. To address his point, in an operation in Switzerland, which I think was also replicated in London, Brighton and Darlington in 2009, an unresponsive minority of heroin users who seemed not to be affected by normal drug treatment methods were given pharmaceutical-grade heroin under daily clinical conditions. I am not averse to that; it is a way forward for a very hard core of users, to keep their criminality off the street, get them clean drugs at the right time and help them off their addictions.

We often say, “Why should we criminalise the user?” In my experience of the court system, I have never seen somebody go to prison for the use of drugs. They tend to go to prison because of the criminality that results from drugs. There is one country, Sweden, that is very stiff on these things. Sweden has probably one of the most penal criminal codes for even personal use of drugs. It is interesting that it enjoys one of the lowest rates of drug use in Europe.

I have concerns that we are facing a general institutional downgrading of possession, particularly of class B drugs, and for that reason I am not sure that we see the full spectrum of what is happening out there in real drug use, based on the figures we receive from the police. If we were to see those, we would see reductions. Arrests for cannabis possession have apparently dropped by 46% since 2010. Cautions are down by 48% and numbers of people charged are down by 33%.

[Ronnie Cowan]

Is that not symptomatic of the police force taking a different attitude? Many police commissioners have come out and said, “We have to stop arresting people for personal possession.”

[Craig Mackinlay]

The hon. Gentleman is absolutely right. That has been the outcome. I am not particularly keen on seeing youngsters receive a criminal record for the use of drugs. There is perhaps another way, such as a non-recordable early intervention, rather than a criminal record that could be with them for life and weigh seriously against their potential job opportunities for the future. We are seeing police guidelines saying that no arrests should be made for possession. I am worried that we are seeing a normalisation of drug use. If youngsters feel that that is the new norm, there will be very little deterrent and they will feel that taking cannabis is acceptable. Inquiries I have made for my report have shown that youngsters still feel that they are deterred from going into using cannabis by the threat of criminal sanction.

I will come to my conclusion, which I hope will wrap a few things up. I am particularly fearful that this side of the Atlantic will face a potential onslaught of fentanyl and other artificial opioid derivatives, and I feel the Government need to be prepared for that. Action to rehabilitate that current core of class A drug users now will save their lives in the future, should fentanyl become more of a norm on our streets. I feel that we should be upping our game in three strands of work: education in schools, colleges and universities.

I would like to see significantly increased sentences for drug supply. Under current sentencing guidelines, the maximum sentence for the category A offence of suppling 5 kg-plus of class A drugs, which is right at the high end of drug supply, is 16 years, compared with 35 years for attempted murder. As we cope, or potentially have to cope, with fentanyl and similar lethal derivatives, we should perhaps give some thought to creating a new class—class AA—for these truly lethal drugs.

But to me, rehabilitation is the key, and I would not want to see services or that type of expenditure downgraded, because of the £2.50 saving for every £1 of investment. I would like residential rehabilitation to be the norm. We could call them prisons, if hon. Members would like, but they would be prisons or centres with one primary focus, and I think the judiciary would welcome being able to make that choice. They would be abstinence-based rehabilitation centres; people would go in on drugs and come out clean.

[Mike Gapes (in the Chair)]

I am conscious that we do not have unlimited time, so I would be grateful if hon. Members kept their remarks brief, so that I can allow time at the end for the Minister and the Opposition Front Benchers to speak and, if possible, call everyone who wishes to speak.

[Norman Lamb (North Norfolk) (LD)]

It is a pleasure to serve under your chairmanship, Mr Gapes. I congratulate the hon. Member for South Thanet (Craig Mackinlay) on securing a debate on this really important issue.

I will start with where I agree with the hon. Gentleman. As a father myself, I share the horror at the impact of dangerous drug use; in a sense, my starting point is to be hostile to dangerous drug use, whether legal or illegal. That is a really important point, because according to the evidence the most dangerous drug of all is alcohol, which is used very heavily within these buildings. We must remember that, because there is enormous hypocrisy in the debate on this issue.

For me, the most depressing thing said in the Chamber today was the Prime Minister’s reaffirmation of the commitment to the war on drugs—the catastrophically disastrous war on drugs—in response to a question from the hon. Member for Reigate (Crispin Blunt). He raised a totally rational case, which was rejected with what I would say was a rejection of the evidence and an approach based on stigma and an ignorance of the facts of the disastrous impact of the war on drugs.

It was an enormous pleasure just the other day to meet some parents, together with the hon. Member for Inverclyde (Ronnie Cowan), from the Anyone’s Child organisation. Far from what the Prime Minister said about the families of those who have lost their lives through drug use all rallying around to demand ever-tougher sentences, these brave people are powerfully making the case that the criminalisation of drug use has had disastrous consequences for their families and will leave them distraught for the rest of their lives.

In a way, the great irony I found in the contribution from the hon. Member for South Thanet is that he pointed to a whole series of disastrous consequences of drug use—but drug use under a criminal market. That is the extraordinary thing. I am completely with him about identifying and recognising these disasters, but they are happening here and now. There is a false thinking that suggests that, because there are dangers of drug use, the automatically sensible thing to do is to ban drugs, but we should know by now that that does not work. The Home Office’s own study in 2014 confirmed that banning has no impact on the level of drug use in society, so let us start thinking afresh about this issue.

[Craig Mackinlay]

Will the right hon. Gentleman give way?

[Norman Lamb]

No; I am conscious that time is really tight.

Far from protecting people, the current framework of our drug laws resulted in 3,744 drug-related deaths in 2016—the highest ever level, and a 44% increase over five years. We are not talking only about the United States; it has arrived in this country with a vengeance. Heroin and morphine deaths rose by 109% under a criminal market. It is not working.

On criminalisation, the hon. Member for South Thanet said he does not see many people ending up in prison, but just last year 45,000 people ended up with criminal convictions for possessing drugs, which has a dreadful blighting effect on their careers; we waste human capital in our country. One of the families that talked to us on Monday talked about their son, who is a really clever scientist but who now cannot work as a scientist because of the effect of his conviction several years ago. That is ludicrous, but it is the effect of criminalisation. The Australian study from a few years ago confirms the negative impact of criminalisation on all those people who end up with a criminal record.

Criminalisation also hits many people who self-medicate because they are experiencing mental ill health. It has a massive impact on people who are already vulnerable, and because they choose to use a substance to perhaps take away the pain of what they are going through, we then give them a criminal conviction. It is the most ludicrous response imaginable. There are also those people who suffer from conditions such as multiple sclerosis, and who use cannabis to ease their pain, who we then give a criminal conviction for their trouble. Again, it is a ludicrous way of responding to a real problem.

We hand vast sums of money—billions of pounds in profits—to organised crime, not only in this country but globally. It is the most extraordinary waste of resources and it promotes extreme violence in our communities. Of course, it is always the poorest communities that suffer the most. In the United States, there is very clear evidence that it is poor black communities that suffer the most. In our country, black people are targeted for stop and search, being nine times more likely to be stopped and searched for drugs than white people.

Instead of those awful consequences of criminalising drug use, let us think about an alternative approach that may be more rational and may be based on evidence, not ignorance and stigma. Let us instead regulate the market for cannabis. The data that the hon. Member for South Thanet raised from the states in the US that have legalised cannabis are highly contested data. Very respected organisations such as the Drug Policy Alliance address some of the misclaims about the impacts of cannabis use in Colorado and Washington. One of its conclusions is that teen marijuana use is unchanged, while its overall conclusion on the impact of legalisation is “So Far, So Good”.

A lot of misclaims are being made about the impact of legalisation in the United States, but a legalised, regulated market has the potential to take the trade away from criminals and instead raise pounds in taxes, which can then be used on health and education and supporting people out of addiction, rather than simply criminalising them. Let us treat it as a health issue, not a criminal justice issue. Let us accept across our country the principle of safer drug consumption rooms. They are already saving lives in eight European countries and in Canada and Australia. The principle is endorsed by the BMA. No one dies of an overdose in a drug consumption room. Let us accept that evidence and apply it in this country before we continue the carnage of loss of life that we are experiencing now. Let us accept heroin-assisted treatment where other treatments have failed. I recognise that the hon. Member for South Thanet acknowledged that that may be appropriate in some cases, but it is a policy based on evidence of what works.

Finally, the attitude of this Government. I have mentioned the 2014 Home Office study that was done while the Prime Minister was Home Secretary. Her own Department concluded that there was no international evidence at all to show that tougher drug laws reduce the use of drugs in society, so why do the Government not follow the evidence? Secondly, the evaluation of the Government’s drugs strategy last year raised some extremely serious concerns. It concluded that enforcement expenditure has

“little impact on availability.”

It states:

“Illicit drug markets are resilient and can...adapt to even significant drug and asset seizures.”

Criminalisation does not work. Contact with the criminal justice system for drug offences can

“bring with it potential unintended consequences including unemployment...and harm to families”.

Also:

“Incarceration may also negatively impact on the indirect and unemployment harms that...drug-related enforcement activities”

seek to improve. The conclusion of the Government’s own analysis is that it is not working.

Then there is the real hypocrisy. There will be loads of Ministers in this Government who have used cannabis, and probably other drugs as well, in their younger years, and yet they are prepared to see fellow citizens convicted of offences for something that they themselves did in their younger years, and they have gone on to enjoy good careers. Let us stop the hypocrisy. Let us recognise that we should apply the approach of reduction in harm, not criminalisation, because it has not worked and it has led to awful consequences internationally.

--- Later in debate ---

[Craig Mackinlay]

I thank right hon. and hon. Members very much for their contributions this afternoon—obviously, it is a split debate and a split decision. I will put just one thing on the record now, if I may. We tend to make dangerous things illegal. When firearms are used to commit dreadful offences in the US—

[Mike Gapes (in the Chair)]

Order.

Motion lapsed (Standing Order No. 10(6)).