Mental Capacity (Amendment) Bill [Lords]

Kevin Foster Excerpts

Ping Pong: House of Commons
Tuesday 2nd April 2019 Commons Chamber

[Caroline Dinenage]

My hon. Friend makes an incredibly important point. This issue has been a huge burden for local authorities: they have had to carry out multiple deprivation of liberty safeguards often for the same people and often when those people move from one setting to another. That involves a huge amount of bureaucracy and does not offer any better protection for the individuals concerned. The new service will enable local authorities to do this in a much more streamlined and efficient way. It will save them money and, at the same time, offer better protection for the individuals about whom we all care.

Lords amendment 1B was tabled by Baroness Tyler of Enfield to set out the meaning of a deprivation of liberty positively, rather than by using the exclusionary approach set out by the Government. Noble lords are, of course, absolutely right to want to ensure that any definition is understood by people and practitioners. However, a positive definition of a deprivation of liberty is likely to be subject to a legal challenge as article 5 case law evolves, and it would become unfit for purpose incredibly quickly. This is a view not only shared by the Government, but highlighted beautifully in the other place by the esteemed legal experts Lord Mackay and Lord Hope.

Lords amendment 1B does not link the definition of a deprivation of liberty to article 5 of the European convention on human rights, so creating a risk of the definition set out in statute diverging from the convention. This would mean that people who fall outside Parliament’s concept of deprivation of liberty but within the article 5 definition could not have their deprivation of liberty authorised under the Mental Capacity Act 2005. For those people, only the High Court would be available to authorise such a deprivation of liberty, which, in turn, would give rise to excessive delays in accessing vital safeguards.

That is precisely the situation that this piece of legislation looks to address—there are already too many people subject to delays when accessing safeguards, and we cannot introduce a provision that would further risk this.

Given that the Government have these concerns, we cannot agree with the noble lords in their amendment 1B. However, we know that concerns in the other place are reflected by many across the sector and we have taken that on board. We have listened carefully to the views of MPs, peers and other stakeholders and decided not to insist on amendment 1. Instead, I propose that the meaning of a deprivation of liberty will still be as defined under article 5 of the convention, as it is under section 64(5) of the Mental Capacity Act, but there will not be a clarification of the meaning of a deprivation of liberty in the Bill. The Bill will work alongside the rest of the Mental Capacity Act, so it does not impact on the existing definition.

I reassure the House that the Government are still absolutely committed to providing clarification regarding the meaning of a deprivation of liberty for both people and practitioners. We will use the code of practice to lay out in very clear terms and provide details of when a deprivation of liberty is and is not occurring, and this guidance will reflect existing case law. We will set out the meaning of a deprivation of liberty in a positive framing and in a way that is clearer for people and practitioners. We will also include case studies in the code to help bring this to life. Government amendment (a) in lieu of Lords amendment 1B will prescribe that the code of practice must contain guidance on what kind of arrangements amount to a deprivation of liberty.

[Kevin Foster (Torbay) (Con)]

I thank the Minister for giving way and I am reassured by what she says. It would not be appropriate, for example, to put case studies on the front of a piece of primary legislation. Will she outline the timescale for bringing that code of practice forward?

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[Mr Deputy Speaker (Sir Lindsay Hoyle)]

I call Kevin Foster.

[Kevin Foster]

Thank you, Mr Deputy Speaker. It is a particular pleasure to called by you to speak in the Chamber. It is also a pleasure to speak in this debate to reflect briefly on a bit of the background as to why we need this Bill. Some 125,000 people are effectively subjected to this procedure but without the appropriate legal safeguards, so I welcome the fact that both Houses are now looking to support the Bill.

I welcome the Government amendments that have been tabled in lieu of the Lords amendments, and they take on their main thrust and spirit. As I touched on in my intervention on the Minister, it will be interesting to see the timescale for bringing in the code of practice. I accept that it needs to be done properly and be consulted on and that there must be appropriate case studies, but one of the reasons for supporting this Bill is to see that come forward relatively quickly so that there is certainty. Perhaps the Minister will put a letter in the Library that sets out the timescale.

I would not expect to hear a date picked out of the air and stated on the Floor of the House—that would be unreasonable and inappropriate—but it would be useful to get a sense of the timescale, because I assume that we are talking about months, not weeks or years. It would be inappropriate to include specific examples on the face of the Bill, but it is right that the amendments look towards the creation of a clear code of practice and review, providing the opportunity for the House to consider any reviews and hold Ministers to account, because this legislation relates to our most basic right: the right to choose where we live and what we do with our time.

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[Barbara Keeley]

In the example I gave, residents who had lived in a care home for a long period had a manager who did not keep their care plans or any documentation, and they suffered terrible abuse. Such things do go on, and I am still concerned that we are giving responsibility to people who are already overstretched and may not be doing or may be unable to do a good job.

[Kevin Foster]

I accept the point. However, the hon. Lady’s example is not just about standards being ignored, because there was a raft of, bluntly, criminal behaviour and abuse. If we were having a longer debate about care homes and the regulatory system, we could look at whether having the Care Quality Commission cover such a wide range of areas is the best way of ensuring that such things do not happen, but Mr Deputy Speaker is always keen for us to stick to the topic of the debate.

The amendments relating to Lords amendment 1B are appropriate and slightly better than the original, and the amendments relating to Lords amendment 25A make eminent sense. It makes sense to record why something has not happened, because if there are concerns about the management of a care home, there should be a duty to record why something was not done, not just to review it. The management could in theory say, “I’ve reviewed it, but I didn’t record what I’ve concluded,” or try to come up with a conclusion later.

[James Morris (Halesowen and Rowley Regis) (Con)]

On recording things, one issue that arose when we were in Committee related to fluctuating conditions. For example, if somebody were subject to a DoLS, but then medical evidence demonstrated that they could be released from it, that makes it even more important to ensure that records are kept and that there is absolute clarity around the reasons for deprivation of liberty.

[Kevin Foster]

My hon. Friend makes a strong point. We should not just assume that once a DoLS is in place it will be there for life. For some people, it may apply during a particular period of treatment or time, and things will fluctuate for some people if they recover to a point at which a DoLS is no longer appropriate because they are able to make their own decisions. As he says, the appropriate records must be kept to ensure that that is properly reviewed and borne in mind, so that a decision cannot be made that someone should be subject to this forever. There should be a rolling review, to ensure that those in charge of caring for a person and those overseeing the care are satisfied that it is still the appropriate measure, given its impact on the person’s life.

I do not wish to prolong the debate, given that there is consensus across the House, which is welcome. The Bill will be better for having these substitute amendments, inspired by the Lords amendments, and on that basis, I hope the House will endorse them.

[Jim Shannon (Strangford) (DUP)]

It is always a pleasure to follow the hon. Member for Torbay (Kevin Foster), as I do on many occasions. I agree with what he said. First, I thank the Minister for her commitment, for our comprehensive discussions and for making herself available for each and every person who wished to have input into this process, and hopefully the changes that the Government want to see will be passed.

The Government have gone to some lengths to ensure that this Bill replaces and improves existing legislation surrounding the deprivation of liberty as a matter of pressing urgency. The current system is not fit for purpose—many people in this Chamber and outside it feel that—and this legislative change by the Government is what we want to see.

The Bill implements the Law Commission’s recommendations, introducing a new system for people who lack capacity and need to be confined for care and treatment, ensuring that the system protects vulnerable people, is person-centred and includes a strong role for carers and families. I have had a chat with the Minister about this, and the Bill will also ensure that supported people and their families are supported and included throughout the process. That is very positive.

The supported person will be afforded their rights throughout the process by an appropriate person. The appropriate person will normally be a family member. Carers and families will be given a stronger role, with an explicit duty to consult them and the supported person. As someone who cares, along with my mother and son and others, for my brother Keith, who was in a motorbike accident some 15 years ago, I know the importance of the carer’s role across the whole process.

Healthcare (International Arrangements) Bill (Changed to Healthcare (European Economic Area and Switzerland Arrangements) Bill)

Kevin Foster Excerpts

Ping Pong: House of Commons
Tuesday 26th March 2019 Commons Chamber

[Stephen Hammond]

It absolutely is my job to tell my constituents and the whole of the country the truth, and I did that yesterday in Committee and will do it again now. If the hon. Gentleman votes for the withdrawal agreement and it passes, the EHIC will remain in place, as I said yesterday. As I also said yesterday it has always been the Government’s advice that people should purchase travel insurance. None of that has changed and that is exactly what I said yesterday and it is exactly what I am saying today.

[Kevin Foster (Torbay) (Con)]

Does my hon. Friend agree that we need to be very clear that, with the EHIC, people will get treated as if they are a local; it is not the NHS on tour, so to speak, so we can still face some charges? Particular note should be taken of repatriation costs. If going abroad on something like a skiing holiday, people would be foolish not to take out full travel insurance.

[Stephen Hammond]

My hon. Friend is right. I made that point yesterday; I made it when I was speaking at the Dispatch Box on Report; and I am happy to make that commitment again today.

It must be our foremost priority to ensure that the Bill receives Royal Assent and is in place so that we can respond to different scenarios. We take this decision with regard for the people who currently rely on the EU reciprocal healthcare arrangements and, only with that in mind, we are choosing not to disagree with the Lords amendments.

--- Later in debate ---

[Kevin Foster]

It is a pleasure to be called to speak in this debate. I do not intend to detain the House long with my observations. I enjoyed the Minister’s introduction.

I welcome the Lords amendments, particularly the ones that change the thrust of the Bill to the EEA and Switzerland, but I hope that right hon. and hon. Members will bear in mind that, in the long run, the goal of having reciprocal healthcare arrangements with other nations is not a negative one in itself. I was disappointed yet again to hear from the right hon. Member for Carshalton and Wallington (Tom Brake) that this is all about opening up the NHS to the US health giants—it is not. It is about having reciprocal arrangements for visitors to other countries, including those on business and those who are travelling.

[Julie Cooper]

I made the point that, in future, there may be a place for such arrangements, but does the hon. Gentleman accept that time is so short, given the urgency of getting something in place to secure arrangements, that now is not the time for that?

[Kevin Foster]

I meant it more as a comment. I accept the Lords amendments. To be blunt, given the pressure of time and the need to get the Bill on the statute book to give people certainty about their healthcare arrangements, if these amendments achieve consensus with Opposition Front Benchers and the other place, I am more than happy to support them.

In relation to the remarks of the right hon. Member for Carshalton and Wallington, who sadly has not stayed for the rest of the debate, this is about making sure that people who go to hospital to access emergency care are not suddenly faced with a bill for the full cost as if they were completely uninsured.

We have arrangements with Australia and New Zealand that are not at the same level as we have with other EU countries, but they could potentially be developed. I do not want to see that aspiration lost, because we want our young people to have the opportunity to travel and work abroad where appropriate. In many countries, as the hon. Member for Central Ayrshire (Dr Whitford) rightly said, people who work will start earning rights under that country’s social insurance system, which would trump the Bill.

[Mr Dunne]

My hon. Friend is generous in giving way. In talking about other Commonwealth nations to which we would like to extend such arrangements, does he agree that the dominions of the Channel Islands, which do not currently have reciprocal status with the UK, should not be ignored and should be a matter of importance once the EU arrangements have been completed?

[Kevin Foster]

As always, I thank my right hon. Friend for his incisive intervention. The Channel Islands might use our currency and, in many ways, fly our flag, but people forget they have a very different constitutional status and are not part of the European Union. For some visitors, it can be a surprise that there is not a reciprocal agreement. There is a reciprocal arrangement with Gibraltar, for example, and it makes eminent sense to try to have such an arrangement between the UK and the Channel Islands, not least given the strong cultural links and the fact that many families split their time between the mainland and the islands.

Looking across the Commonwealth more widely, it might make sense to have arrangements with countries such as Canada and Jamaica in the long run, based on the fact that they have comparable systems of healthcare provision. That is perhaps where the oft-cited example of the United States starts to fall apart, because it is one of the handful of modern, developed countries that do not have a guaranteed system of universal healthcare free at the point of need rather than a system based on insurance schemes for which people may pay.

It is welcome to have ambition, and the Bill is clear about where we are going. I have no problems with the Lords amendments, which are welcome, and I am happy to support them. I am conscious that we are looking to move the debate forward, but I wanted to get those thoughts on the record.

[Dr Whitford]

Obviously, the Bill itself is quite small. It does not extend or protect continuing reciprocal healthcare rights; it is simply an enabling Bill that gives the Secretary of State powers to try to do that. It enables him to pay for overseas treatment in the EEA and Switzerland. We have heard how the Lords removed the powers to extend that worldwide and increase the scope, as well as limiting some of the Henry VIII powers.

The Bill will allow the Secretary of State and his team to negotiate healthcare agreements with the EEA and Switzerland as a group through the EU system or, failing that, to make bilateral agreements. Unfortunately, that would mean having bilateral agreements with 31 countries, which would inevitably be more complex, more bureaucratic and more expensive.

Clause 4 allows data exchange, which most Members would recognise is absolutely critical not just for collecting payments or swapping money, but for accessing medical health records if someone goes for treatment in another country. It is important that that will be handled only by an authorised person who is part of a statutory body—a public body.

I welcome the new clause in Lords amendment 11, which says that the devolved Governments must be consulted, because it is the three devolved Governments who deliver healthcare in Wales, Northern Ireland and Scotland. It is critical that they are involved in any agreements.

This legislation is needed whether there is a deal or no deal. As came out of the points of order exchange earlier, the withdrawal agreement would extend through the transition period, but we have all seen how the last three years have melted away like snow off a dyke. The next 20 months will also disappear, so legislation is required for the long-term protection of those who already live in Europe and want to stay there, particularly those who have been there only a few years and do not have five years-worth of residency rights in the country they have chosen to settle in. After the Bill is passed, it is therefore important that the Government hope to negotiate the continuation of reciprocal healthcare.

The problem is that reciprocal healthcare is not a free-standing thing on its own; it is there simply to enable freedom of movement. People cannot exercise their freedom of movement rights if they simply cannot afford healthcare where they choose to live, work, love, settle or retire. We have had the right over the past few decades to retire and settle anywhere. People are well aware of my husband’s situation as a German citizen who lives here and has spent virtually all his adult life working in our health system. That was certainly his first concern after the Brexit vote, and I am sure it is a concern for all 5 million people who have either settled here from Europe or settled in Europe from the UK.

The problem is that, as the Government reject freedom of movement and talk merely about a mobility framework, any reciprocal arrangement is likely to be proportional to that mobility framework, as is described in the impact assessment. The Government are not offering visas of over a year for unskilled workers. They are demanding that people be high skilled, possibly that they earn more than £30,000 a year and that they are economically active and are contributors. Will pensioners still be able to retire elsewhere, since they are not necessarily contributors in a major sense and are certainly not necessarily economically active?

People highlight the difference between what the UK has to pay into the European system and what we get back from Europe. A lot of that difference is quite simply because of the number of UK pensioners who choose to retire to sunnier climes—who can blame them?—and the general lack of obsession with retiring to the drizzle and moving in the other direction. Living in Scotland, I can vouch for that. Who would choose to leave the south of France and come to live in the mist, fog and drizzle? That is why the number of European pensioners retiring to the UK is considerably smaller than the number of UK pensioners who retire to the south of Spain and the south of France. That is simple logic.

Services for People with Autism

Kevin Foster Excerpts

Thursday 21st March 2019 Commons Chamber

[Kevin Foster (Torbay) (Con)]

It is always a pleasure to follow the hon. Member for Strangford (Jim Shannon) after a rare opportunity to hear him contribute to a debate. His contributions are always well thought out, passionate and well structured on behalf of his constituents. I definitely agree with him about the need at some point to get the Northern Ireland Assembly back up and running, doing its job again and tackling the issues that need to be tackled on behalf of Northern Ireland. Just ramming business through this place in a day is not what any of us really wants to see. We want to see the politicians who were elected to serve Northern Ireland doing so.

Let me come to the main substance of the debate. I pay tribute to my right hon. Friend the Member for Chesham and Amersham (Dame Cheryl Gillan) and to my hon. Friend the Member for Bexhill and Battle (Huw Merriman) not only for securing this debate, but for the passion that they bring to this issue. Obviously, our best wishes go to my right hon. Friend, who is facing a family situation.

This is an interesting debate. When I was about 12, I sat the Mensa IQ test and got a reasonable rating.

[Paula Sherriff (Dewsbury) (Lab)]

Division!

[Kevin Foster]

Yes, thank you—and I like the shadow Minister, too!

That was interesting, because at that rating you are not that far off the autism spectrum. A lot of people forget that the dividing line is not very big. Many people around that mark will show some traits. For example, if we go to a talk on this matter and find someone very interested in politics, when we ask them what party they support, they say, “I don’t really support a party, but I love analysing election nights, with all the statistics.” I asked such a person to reel off election results in the local area—I was in Coventry at the time on the city council, and they were absolutely able to do that, because that was their special interest. They were very passionately interested in politics, but when they were asked, “Which party are you thinking of joining with all this interest?”, the answer was, “Well, I’m not really into that. I’m into the analysis of politics.” That was their special interest.

This is about having a real understanding of autism. What started changing some of my perceptions about people with autism was when I had a volunteer activist who struggled slightly socially in certain scenarios. However, when we were carrying out—of all things—a telephone canvassing session with an automated dialling system, this guy was an absolute star. The rest of us were struggling. The rest of us were finding the whole process very difficult, but he absolutely engaged with it. It was pushing his mind to run slightly faster, and he had ability enough for the whole team. He was given a script, which enabled him to engage brilliantly with people on the phone. That was where his ability came through. In fact, what would normally be seen as a disability became a huge ability. That is why, as a Member of Parliament, I became very keen to challenge perceptions—for example, as has already been touched on in this debate, when someone is seen as naughty. We need to make it clear to employers that, when it comes to people with autism, it is about how they are supported when they enter employment.

I remember doing some work on this with a team when I was deputy leader of Coventry City Council. We looked at why people had left particular jobs—in programming or in engineering. Their skillset was there, their knowledge was there and their strengths were all in that area. What we found was that they were struggling with things such as the lunch room and the office environment—places where they had to interact with people. Everyone else assumes that such interaction is quite simple, but the perceptions of how these people would deal with them were different.

I welcome the fact that support is being provided, but I would be interested to hear from the Minister how much further we can go. We are talking not just about an employer doing a favour, but about an employer sometimes bringing in an absolutely unique talent who may be able to address a job in a way that, bluntly, most of us in this Chamber would struggle with. Sometimes the way an autistic mind works can become a massive advantage in engaging in areas such as IT and tech.

That all means that we need the appropriate levels of support. I do have some concerns over the pressure on higher needs funding in Torbay. I recognise that the Government recently provided some extra funding, but there has been an issue in Torbay. I do not think that we are unique in this, as some of the other smaller coastal unitaries face an issue with the deficit. Traditionally, their funding levels are lower than other areas, which makes it harder for them to deal with such issues. They are paired up with larger—bluntly, more wealthy—counties.

We also need to be clear that this issue is not just about learning, but about having fun. I welcome the fact that support services are available in the Bay. For example, the ASRUS Group meets at the YMCA in Dartmouth Road, Paignton. It is not just about providing education support, but about providing social support to build skills.

This has been a worthwhile debate. I have enjoyed sitting through most of it and listening to the contributions. It will be interesting to hear from both Front-Bench speakers what their thoughts are on this subject. Some people who have absolutely unique talents and some of the greatest minds on this planet may be just on the autistic spectrum, or only just below it. That is where we need to change our perception. It is not about someone with a disability, but about someone who may have a unique ability that we could unlock with the right support.

Eurotunnel: Payment

Kevin Foster Excerpts

Monday 4th March 2019 Commons Chamber

[Matt Hancock]

Frankly, I do not think we should really pay much heed to such a statement, rather than a question, unless the hon. Gentleman is going to vote for the deal as well.

[Kevin Foster (Torbay) (Con)]

It is always a bonus to see my right hon. Friend the Secretary of State for Health and Social Care at the Dispatch Box answering questions, particularly today. On the deal and making sure that we have a secure supply of medicine, will he reassure me that he will continue to ignore some of the noise and party political point scoring and focus on making sure that the NHS can function in whatever circumstances it faces after 29 March?

[Matt Hancock]

There is a notable difference in tone, is there not, between those who care about ensuring that people get the supply of medicines in future, and those who want to make political points out of it but do not oppose the decision we are discussing.

Mental Capacity (Amendment) Bill [Lords]

Kevin Foster Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Tuesday 12th February 2019 Commons Chamber

[Norman Lamb]

That is clearly insufficient when it comes to the vital task of playing a role in the protection of people’s civil liberties and human rights. That is what the Bill envisages.

Sue Bott, the deputy chief executive of Disability Rights UK, says:

“Given the rare unanimity across the health and social care sector and disabled people’s organisations we urge the Government to delay the Bill and look again at its provisions. It is better to have a co-produced piece of legislation that works for everyone than rush through a new law that, in its current form, will seriously undermine the human rights of disabled people.”

I urge the Minister to listen carefully to that—the “rare unanimity” across the sector. When I was responsible for taking the Care Bill through Parliament, we ensured that by the end pretty much everyone was on board, although it was a slow and sometimes frustrating process.

The Minister will be applauded if she now recognises that these concerns about the amended Bill are not past ones but current ones. If we are to get people on board and ensure that everyone agrees that we are properly protecting the human rights of very vulnerable people, the right thing to do now is pause, before the Bill goes back to the House of Lords, to ensure in particular that the provisions on conflict of interest of care home managers and the rights of advocacy are properly addressed. If the Minister can do that, she will go a long way towards bringing people on board. I am sure that that is what she wants.

[Kevin Foster (Torbay) (Con)]

Given the restrictions on time, I will curtail my speech and take out remarks I might have made; I am conscious that colleagues would also like to speak.

I always agree with the passion of the right hon. Member for North Norfolk (Norman Lamb) on these issues, but I do not agree with his conclusions on aspects of the Bill. I am reassured by the Government amendments, particularly in relation to independent hospitals: such a hospital might have a potential business interest in keeping someone in its service, so it will not at any time judge whether that person needs to be under the deprivation of liberty safeguards.

It is important that we have a modern system; as has been mentioned, the backlog of 125,000 people under the existing system is utterly unacceptable. What standards there are will need to be changed. When I look at the Opposition amendments, particularly amendment 49, I take the Minister’s point that the consultation—actually talking to someone about their views and their care—is part of what we would expect a care provider to be doing. There must be clear, independent safeguards around deprivation of liberty, and the ability to have an independent check. In some cases, it would be better for someone who works with the individual every day to do the consultation, rather than someone literally turning up from the local authority or health board, who may not have had any contact with them. We are talking about people with issues when it comes to interacting and understanding some of the engagement, so I do not see why there should be consultation in all cases. We are talking about consultation, not decision, and I do not see what the issue is with that.

I turn briefly to the amendments moved by the hon. Member for Rhondda (Chris Bryant). The attention he brings to the issue of acquired brain injury is always welcome—particularly in the football world, on the day when an England 1966 hero passed away. The hon. Gentleman mentioned that those from that era often acquired head injuries as a result of heading heavy leather balls, particularly when wet. That is still an issue in football today. I join the hon. Gentleman in saying that the rules should be looked at. If that can be done in rugby without affecting the flow of the game, there is no reason why it cannot be done in football. Similar arguments were advanced in relation to video referees and they are now in place.

I am conscious of the time remaining for others to have their say, so I will just say that I support the Bill and that I do not see the need for the amendments tabled by the Opposition.

[Several hon. Members rose—]

Appropriate ME Treatment

Kevin Foster Excerpts

Thursday 24th January 2019 Commons Chamber

[Kevin Foster (Torbay) (Con)]

It is a pleasure to be called to speak in this debate, and particularly to follow the hon. Member for South Shields (Mrs Lewell-Buck) and her comments. I thank the constituents who contacted me ahead of the debate not only to encourage me to attend but to make clear their concerns about this issue. Several Members have picked up a point on which I shall reflect as well: ME can have such an impact on someone’s life, but at the same time they sometimes have to battle for recognition that that is what is affecting them. Of course, there is no specific test for the condition, which leads on to the fact that there is no specific cure for it. As we heard in the previous speech, that can lead to scepticism rather than someone being supported.

As several Members have already said, this condition has a £3.3 billion impact per year, in terms of healthcare costs, the related welfare payments, productivity losses and unpaid informal care, as well as, of course, the wider lost opportunity because those who suffer from this condition are not able to live life to the full or as they would wish. It will be interesting to hear from the Minister about the review of the NICE guidelines. For the reasons that other Members have already gone into, it is welcome that we know what is being looked at, but it would be particularly welcome to hear whether we might be able to bring forward some updated guidelines earlier than the stated timeline of 2020. It would be interesting to hear the Minister say that when he responds to the debate.

As has also been touched on already, when one considers the impact of ME, it is quite remarkable to see how little is spent on research. I think something like only 0.02% of all active grants given by UK mainstream funding agencies goes towards research in this area. Clearly, without research, there will not be the hope of improved treatment or of a test being developed so that people can move away from scepticism and get support from their medical practitioners. Ultimately, we will hopefully find a cure, or a treatment that at least mitigates some of ME’s effects.

Members have already touched on the fact that there is clearly an issue in relation to how those living with this condition are assessed for welfare benefits, particularly because they might be assessed on a good day, which does not then reflect their overall condition. When he sums up, it would be interesting to hear the Minister reflect on some of the conversations that the Department of Health and Social Care is having with the Department for Work and Pensions, although I accept that he is unlikely to get a particularly long time to sum up, given the short length of the debate.

I welcome the opportunity today to highlight this issue on the Floor of the House, and I congratulate the hon. Member for Glasgow North West (Carol Monaghan) and the other Members who applied on securing this debate and enabling us to raise our concerns on a cross-party basis. As has been touched on, 250,000 people live with this condition in the UK. It needs research, support and a change of culture, so that sufferers feel supported and believed and can have some hope of living the sort of normal life that we all expect and deserve.

[Several hon. Members rose—]

Healthcare (International Arrangements) Bill

Kevin Foster Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Monday 21st January 2019 Commons Chamber

[Stephen Hammond]

The hon. Lady is completely correct. We explored that in Committee, and discussed the purposes of the common travel area. Indeed, there was an explicit debate in Committee on the arrangements for Northern Ireland. I am happy to confirm that to her.

Each of the agreements that we are seeking to strike could differ from country to country. Such agreements will have to take into account the operational possibilities and limitations of each contracting party, to ensure the smooth operation of reciprocal healthcare arrangements. This should include how NHS trusts in the UK can evidence eligibility for the treatment of non-UK citizens in the most efficient and least burdensome manner. Only when these technical details are known will the Government be able to speak confidently to the specific measures that we can report on for each country. Regardless of the specifics of any arrangements entered into, and as with all departmental expenditure, reciprocal healthcare costs are and will continue to be authorised by the Treasury supply process and to be included in the Department’s annual estimates, as well as being included in the annual resource accounts, which are audited by the Comptroller and Auditor General. I said in Committee that I hoped that the hon. Member for Ellesmere Port and Neston would be satisfied by that commitment to transparency, and I give that commitment again tonight. With that, I hope that he will feel able to withdraw new clause 1.

Turning to amendment 1, the hon. Member for Ellesmere Port and Neston again raised the important issue of appropriate levels of parliamentary scrutiny. The Government clearly recognise the importance of such scrutiny for this Bill and for secondary legislation made under it. The hallmarks of an effective and responsible parliamentary system are the processes by which we draft, consider and test legislation, and the appropriate parliamentary procedure for the scrutiny of regulations made under this Bill is the negative resolution procedure. The exception to that is where provision within regulations is needed to make consequential changes to amend, repeal or revoke primary legislation. Consequently, the Government are once again resisting that amendment.

As I have said previously, the powers in this Bill provide the Government with both the flexibility and the capacity to implement detailed and complex arrangements concerning healthcare access abroad. The remit of our regulation-making powers is tightly focused. They can be used only to give effect to healthcare agreements or arrange, provide for or fund healthcare abroad. Therefore, the subject matter to which the regulations relate is narrow. I say again that when regulations amend, repeal or revoke primary legislation, they will of course be subject to the affirmative resolution procedure, which is the appropriate level of scrutiny for such powers. However, where statutory instruments do not make changes to primary legislation, and deal with procedural, administrative or technical provisions, they should be subject to the negative resolution procedure, and that is reflected in our approach to this Bill.

We have been clear about our intentions for reciprocal healthcare in the context of exiting the EU. In the short term, our policy is to maintain the current system of reciprocal healthcare with the EU on a transitional basis until the end of 2020. That would happen automatically if there is an implementation period, and it is something that we are seeking to agree individually with member states in the event of no deal.

[Kevin Foster (Torbay) (Con)]

I welcome the Minister’s confirmation of the Government’s intentions behind this Bill. Will he confirm that the nonsense we heard from the shadow Minister about funding hip operations in Arizona is absolute tosh? While the shadow Minister may be enthusiastic about the healthcare system in the United States, will the Minister confirm that we are not?

[Stephen Hammond]

My hon. Friend is right. I said continually in Committee and I say it again now that this Bill is tightly focused in terms of the regulations that can be made under it. We want long-term reciprocal healthcare arrangements with the EU or relevant member states, and that is the Bill’s focus.

When the UK negotiates an international healthcare agreement in the future, the most important elements setting out the terms of that agreement would, as Members should expect, be included in the agreement itself. Such agreements are likely to contain all the detail of which Parliament should have due consideration, such as who is covered under the terms of that agreement. In contrast, the regulations implementing the agreement would not include anything fundamentally new. They would contain the procedural, administrative and technical details, such as the types of documents or forms to be used. It is therefore right that regulations issued under this Bill be subject to the negative procedure. That is an appropriate use of parliamentary time. Were we to accept amendment 1, it is likely that this Parliament would find itself debating whether the forms required to process reciprocal healthcare arrangements should be changed. That would clearly be a misuse of Parliamentary time.

I once again reassure the House that Parliament will have the opportunity to undertake appropriate scrutiny of future binding healthcare arrangements. Where we strike a comprehensive healthcare agreement with the EU or with individual member states, that agreement would be subject to the appropriate parliamentary scrutiny. Part 2 of the Constitutional Reform and Governance Act 2010 sets out the process under which Parliament can review what are intended to be legally binding healthcare agreements. That provides an opportunity for parliamentary scrutiny in respect of the substance of healthcare agreements. Implementation of such an agreement, if that is by way of regulations under the Bill, will then be subject to its own scrutiny before ratification of the healthcare agreement.

Everyone in this House wants reciprocal healthcare arrangements. Overwhelming support for reciprocal healthcare has been shown throughout the passage of this Bill, including in Committee during the evidence sessions with the expert witnesses. We heard directly from several Members and evidence was presented, and there is a clear desire for current arrangements to continue.

NHS Long-term Plan

Kevin Foster Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

I will take advice and consideration from many people, but not from the hon. Gentleman, who for seven years has run a frankly outrageous campaign based on scare stories about hospital closures that are totally unreasonable, unrealistic and wrong. He will never be somebody I listen to, because I care about improving the future, not political point-scoring.

[Kevin Foster (Torbay) (Con)]

Last Friday, it was a pleasure to meet the chief executive and chair of my local hospital trust to discuss the new A&E department and the new mental health ward that will be built on the site of Torbay Hospital over the next year. Does the Secretary of State agree that it also vital that we have the local services around mental health, in particular, because in the past we have seen far too many people from Devon being sent elsewhere, across the country, and that this investment will now bring that to an end?

[Matt Hancock]

Yes, absolutely. My hon. Friend is a brilliant advocate for Torbay and for the English Riviera, and has made the case so strongly for his local hospital. I was delighted that we could recently find the funding to support the case that he and local clinicians have made, and I look forward to working with him to make it a reality.

Oral Answers to Questions

Kevin Foster Excerpts

Tuesday 27th November 2018 Commons Chamber

[Jackie Doyle-Price]

First, I pay tribute to the work that the police do in dealing with people who are in mental health crisis. They view it as part of their core work, but clearly they should not be picking up the slack where services do not exist. I am working closely with the police service and other interested parties to ensure that we have sufficient crisis care, to enable the police to discharge their responsibilities adequately and in a safe way. We will continue to do that.

[Kevin Foster (Torbay) (Con)]

My constituent Alice Sloman died during what should have been a routine MRI scan, following complications with the general anaesthetic that had been administered to her. Will the Minister agree to meet me and Alice’s parents to discuss the possibility of people, particularly those with existing conditions, having routine heart checks before such procedures?

[Stephen Hammond]

The Government express sincere condolences to my hon. Friend’s constituents. I would of course be happy to meet him and his constituents.

Assessment and Treatment Units: Vulnerable People

Kevin Foster Excerpts

Tuesday 6th November 2018 Commons Chamber

[Caroline Dinenage]

NHS England transferred over £50 million up front to CCGs that are closing beds over the course of the financial year, so that they can invest in community alternatives. In addition, between 2015 and March 2019 it will invest another £50 million in transforming funding to put in place things such as the much needed crisis prevention teams, which are focused on supporting children in the community.

[Kevin Foster (Torbay) (Con)]

The number of people with learning disabilities and autism in secure mental health hospitals is unacceptable and I welcome the commitment to reduce it. Can the Minister confirm exactly how she will monitor that and keep the House updated on progress?

[Caroline Dinenage]

That is the thrust of the whole transforming care and building the right support programme. We know that in some cases during the course of the programme people who have left residential units and gone into the community have gone back in to the units again. We have to keep a very close eye on the figures and ensure that the right package of support and care is provided so that once people leave a secure unit and go into the community, they are able to stay there.