Breast Cancer Screening

Lord Harper Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

I thank the hon. Lady for her comments. We have many other occasions to have a broader discussion about resourcing of the NHS, but I recognise what she says: in the specific situation we are in now, with the people who will need additional scans and additional treatments over and above what the NHS would have otherwise done, we will need to find additional resources to make sure others are not disadvantaged.

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

May I add my words of support to the Secretary of State for the way he has approached this issue, and to Opposition Members for their approach too?

On the scope of the independent review, will it look at other screening programmes? It might be the case that this particular issue is not replicated, but I think people will want assurances about other screening programmes. Also, as the NHS looks to use IT as a powerful way to combat illness and disease, will the Secretary of State make sure that appropriate checks are in place so that there are proper assurances in the system and these kinds of problems do not arise in the future?

[Mr Hunt]

My right hon. Friend is absolutely right, and I assure him that the review being done by Lynda Thomas, one of the most senior cancer campaigners in the country, and Professor Gore, one of the most senior oncologists in the country, will look at what lessons can be learned for the entire cancer programme, and not just at the specific issue of why this particular IT problem occurred.

Oral Answers to Questions

Lord Harper Excerpts

Tuesday 20th March 2018 Commons Chamber

[Caroline Dinenage]

The hon. Gentleman is right to say that the integration of health and social care is vital, and I think that the renaming of the Department is a symbol of how seriously the Government take our commitment to it. I am keen to talk to him about funding, given that the figures for Liverpool show that it is raising £7.4 million from the social care precept and has received approximately £21 million in grant from the Government.

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

I agree that the social care system needs more funds. In recent Budgets, the Chancellor of the Exchequer has found those funds and put them into the system. May I urge my hon. Friend, as she looks at the Government’s proposals in the Green Paper, to ensure that the Dilnot proposals are included? Those proposals, for which we have already legislated, will give us the best chance of a sustainable system in the current Parliament.

[Caroline Dinenage]

The Secretary of State was with Andrew Dilnot yesterday, and we are looking carefully at his proposals. My right hon. Friend is right: although 81% of adult social care providers are registered as good or outstanding, it is unacceptable for levels of care to fall below the standards that we would expect, and in preparing the Green Paper, we will look closely at how we can improve the system.

Oral Answers to Questions

Lord Harper Excerpts

Tuesday 6th February 2018 Commons Chamber

[Mr Hunt]

Public money is public money, and Members have a right to know how it is being spent, so we will absolutely ensure that those contracts are signed in a fair way.

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

As the Secretary of State carries out his social care funding review, I urge him to look carefully at whether we should look again at implementing the Dilnot commission’s proposals. Given that we legislated for them, they are the only way that we are going to tackle the issue with the sufficient urgency.

[Mr Hunt]

At the heart of the Dilnot proposals was the idea of risk pooling—that there is a randomness in the illnesses that affect us in the later years of our life that we would want, as a society, to do something about. I will confirm what the Prime Minister said in the election campaign: we will consult on a cap on social care costs.

Social Care

Lord Harper Excerpts

Wednesday 25th October 2017 Commons Chamber

[Barbara Keeley]

I will come on later to discuss how we should proceed and whether we should proceed on a cross-party basis. The hon. Gentleman’s point about carers and family carers is important. The plain fact of the matter is that there was nothing for carers in his party’s manifesto. We had announced that we were going to lift carer’s allowance at least to the level of jobseeker’s allowance. That is the only improvement that was discussed during the general election. He should turn to his own Minister and his own party and ask them what they will do for carers.

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

I welcome the hon. Lady’s tone in this debate. It is very valuable. I know that she has taken an enormous interest in this subject, even when it has not fallen within her Front-Bench responsibilities. These debates are very helpful in educating people about difficult issues. I am happy to accept that we did not handle this issue well in the general election. The mistake that we made was not being clear about the current system, which is why her reference in the motion to our proposal without setting out the current system in which people can potentially lose all but £23,000 of their assets is disappointing. Such information would have helped to contribute to the public debate.

[Barbara Keeley]

We will come on to that. If the right hon. Gentleman wants to get into the mess that his party made, the truth is that we legislated a number of years ago to lift the asset floor to £118,000. What his party did during the election was drop that to £100,000. At the weekend, we learned that there was an intention to make it only £50,000. He should be clear about what his Front-Bench colleagues were trying to do. Since then, all we have heard is a deafening silence.

We need to focus on the crisis in social care now. We on the Labour Benches have raised many times just how fragile the care sector is after years of swingeing budget cuts by the Government. A survey by the Association of Directors of Adult Social Services reported that more than two thirds of councils had reported closures of care providers in the first five months of the financial year. Nearly half those councils had had homecare providers handing back contracts.

--- Later in debate ---

[Jackie Doyle-Price]

My right hon. Friend is indeed correct.[Official Report, 3 November 2017, Vol. 630, c. 3MC.]

The ageing population presents one of our nation’s most profound challenges. It raises critical questions as to how, as a society, we enable all adults to live well into later life, and how we deliver sustainable public services that support them to do so.

[Mr Harper]

In a spirit of cross-party consensus, may I add my support to the issue raised by the hon. Member for Stretford and Urmston (Kate Green) by urging that when we bring forward our consultation we cover the nearly 50% of social care spending that is spent on adults with disabilities? I share the view that we must make sure that they are properly supported and able to live full lives, including, where they are able, moving into work. That sometimes gets lost in the debate when we completely focus on people towards the ends of their lives. We must deal with everybody. The hon. Lady made a really important point.

[Jackie Doyle-Price]

I could not agree more. I share my right hon. Friend’s support for the hon. Lady’s comments. There are still many opportunities to get working-age adults with disabilities into work. We have set ourselves a target of getting 1 million more people with disabilities into work, and we are very committed to doing that.

In response to the point made by the hon. Member for Worsley and Eccles South in her opening remarks, yes, much of the debate has focused on how we care for the elderly, but, as she and the whole House will be aware, support for working-age adults is becoming an increasingly big proportion of local authority spending in this area, and it is very important that we focus on it. Alongside the preparations we are making for consultation in the new year, we have a parallel work stream looking specifically at working-age adults, because some of the solutions will be similar and some will be different.

[Jackie Doyle-Price]

There needs to be a separate work stream because it is connected to the desire to get more people into work, but the two programmes are working in parallel. As I said, today is a great opportunity to get that on the record. Certainly, it has been very much a focus of my conversations with voluntary groups in the sector.

[Mr Harper]

Picking up the point about the work being separate but parallel, in thinking about how we are going to fund the care, it is really important to make sure that we do not inadvertently put in place any barriers to work, whereby somebody would find that moving into work would increase the cost of their care to the extent that working was of no consequence. That would not be an issue of funding care for older people, where there are some different challenges. A separate but parallel structure may well be the right one to go for.

[Jackie Doyle-Price]

Again, I agree with everything that my right hon. Friend says.

To reassure the hon. Member for Worsley and Eccles South, we will have plenty of opportunity to discuss all these issues in the new year. We want to progress this by building a real consensus, because it is a strategic challenge facing us all. Not only are we all living longer, but working-age adults with disabilities are living longer. That is a matter for celebration, and we must do everything we can to make sure that we can meet all our obligations to them.

--- Later in debate ---

[Jackie Doyle-Price]

I think it matters a great deal that we have made £9.25 billion available.

[Mr Harper]

Will the Minister give way on the funding issue?

[Jackie Doyle-Price]

I need to make progress. I apologise to my right hon. Friend.

On delayed transfers of care, the Government are clear that no one should stay in a hospital bed for longer than is necessary. Doing so removes people’s dignity and reduces their quality of life. It leads to poorer health and care outcomes, and it is more expensive for the taxpayer. I will set out in more detail the work we are doing to reduce delayed transfers of care. That is critical, because a well-functioning social care system enables the NHS to provide the best possible service.

We are clear that we must make much faster and more significant progress well in advance of winter to help to free up hospital beds for the sickest patients and reduce pressures on overcrowded A&E departments. Last year, there were 2.25 million delayed discharges, up 24.5% from the 1.81 million in the previous year. Just over a third of those delays were attributable to social care. The proportion of delays attributable to social care increased over the last year by four percentage points to 37% in August 2017.

We have put in place an agile and supportive improvement infrastructure, and I have been very clear about priorities. First, in this year’s mandate to NHS England we set out a clear expectation that delayed transfers of care should equate to no more than 3.5% of all hospital beds by September. Those in the system have worked extremely hard to agree spending plans and put in place actions to make use of the additional funding, and they deserve real congratulation for their efforts. Since February, there have been significant improvements in the health and care system where local government and the NHS have worked together to tackle the challenge of delayed transfers of care, with a record decrease in month-on-month delayed discharges in April 2017.

NHS and Social Care Funding

Lord Harper Excerpts

Wednesday 11th January 2017 Commons Chamber

[Jonathan Ashworth]

My hon. Friend has had one bite of the cherry, so if he does not mind I shall make a little progress and then I will do my best to get as many people in as possible.

Does the Secretary of State agree—

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

rose—

[Jonathan Ashworth]

I will give way in a few moments.

Does the Secretary of State agree that the four-hour standard is a reasonable proxy for patient safety? Does he agree that every breach of the four-hour standard can be regarded as a potentially elevated risk?

--- Later in debate ---

[Jonathan Ashworth]

I pay tribute to the hon. Lady for the work she is doing on tackling loneliness. I know that all Labour Members very much appreciate the work she is doing on that, along with my hon. Friend the Member for Leeds West (Rachel Reeves). The Government amendment is conspicuous in not referring to all patients.

The Secretary of State did distinguish between “urgent” and “minor”—[Interruption.] The hon. Member for Beverley and Holderness (Graham Stuart) says I should get a haircut. Did he say that? No? I beg his pardon, but he heckles so much it is sometimes difficult to hear what he is saying. Can the Secretary of State tell us how he would define the difference between urgent and minor care for instances relating to this four-hour standard? Can he tell us what will be the minimum severity of physical injury or other medical problem which will be needed for a patient to qualify for access to an A&E? How will we determine these new access standards? How quickly will they be available? Will patients with visible injuries be exempt from a new triage system? If so, which injuries will qualify? If the Secretary of State is not moving away from this four-hour standard, he needs to clarify matters urgently, because the impression has been given that he is doing so. [Interruption.] Not by me, but by his own remarks in the House on Monday. If he is not moving away from that standard, will he guarantee that he will not shift away at all from it throughout this Parliament and that it will remain at its current rate?

[Mr Harper]

rose—

[Jonathan Ashworth]

I will give way to the former Government Chief Whip.

[Mr Harper]

I, too, was in the Chamber on Monday and I listened carefully to the Secretary of State then. He was challenged by the right hon. Member for Exeter (Mr Bradshaw) on the target and was asked whether he was watering it down. He said explicitly that “far from watering down” he was recommitting the Government to it. He was generous to the Labour party in saying that it was one of the best things the NHS did. I think that was very clear.

[Jonathan Ashworth]

Let me say to the former Chief Whip that the Secretary of State said that

“we need to be clear that it is a promise to sort out all urgent health problems within four hours, but not all health problems, however minor.”—[Official Report, 9 January 2017; Vol. 619, c. 38.]

The Secretary of State did not need to come to the House to make those remarks and set these various hares running, so the right hon. Member for Forest of Dean (Mr Harper) should make his objections not to me, but to the Secretary of State—

--- Later in debate ---

[Mr Hunt]

I will give way on funding one more time.

[Mr Harper]

We had the debate at the election about the need for a strong economy to pay for the NHS, and the public decided that the Conservative party won that argument. May I give my right hon. Friend another example, from yesterday, from his friend Jeremy—the Leader of the Opposition? He proposed to cap high pay, but the top 1% of taxpayers pay 27% of income tax revenues. That proposal would cut the funding available to the NHS and damage the services that hard-working members of staff produce.

[Mr Hunt]

My right hon. Friend is right. That is the worst kind of gesture politics, because it may get the Leader of the Opposition a few votes or a few more Momentum supporters, but it would damage the NHS.

--- Later in debate ---

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

I am very pleased to follow the hon. Member for Liverpool, Riverside (Mrs Ellman). I am sorry that the hon. Member for Central Ayrshire (Dr Whitford) is no longer in her place. I particularly enjoyed her remarks, in which she set out a number of constructive policy suggestions, drawing on experience in Scotland, and suggested that we could reflect on them and improve the situation here.

It was disappointing to hear not a single policy suggestion in the shadow Secretary of State’s 33-minute contribution. He might reflect on that because the debate will not move forward otherwise.

The hon. Member for Central Ayrshire drew upon her clinical experience, but I also enjoyed the contribution of the right hon. Member for Doncaster Central (Dame Rosie Winterton) who, after a period of enforced silence as Opposition Chief Whip, drew upon her ministerial experience, demonstrating the value of ex-Ministers contributing from the Back Benches and bringing something to the debate.

I have reflected on the Labour motion before us today, which specifically talks about the four-hour target and funding issues, which I will touch on in my inevitably brief speech. As I said in an earlier intervention, I was in the House on Monday when the Secretary of State was clear in what he said and I do not understand why Labour Members fail to see that. He did not in any way water down the target. The right hon. Member for Exeter (Mr Bradshaw) challenged him and the Secretary of State specifically “recommitted the Government” to the target. He was actually generous in paying tribute to the Labour Government for having introduced it, saying that it was

“one of the best things about the NHS”—[Official Report, 9 January 2017; Vol. 619, c. 46.]—

and in no way resiled from it.

Indeed, I think the shadow Secretary of State said in his remarks that the Secretary of State had somehow talked about ensuring that the target applied only to those with urgent health problems and that he had somehow said that secretly outside the House. However, I have looked carefully at the Secretary of State’s oral statement, given in the House just two days ago, and he was explicit about ensuring that the four-hour standard related to urgent health problems. He specifically referenced Professor Keith Willett, NHS England’s medical director for acute care, and said that

“no country in the world has a”—

four-hour—

“standard for all health problems”.—[Official Report, 9 January 2017; Vol. 619, c. 38.]

The target is for urgent health problems, and if we are to protect vulnerable patients, that is what we need to ensure—it is incredibly valuable.

The motion also relates to social care funding, so I want to talk about the charge that the Opposition keep making about local authority decisions. It is entirely true that the coalition Government had to make savings from local government budgets in the previous Parliament owing to the previous Labour Government’s lack of preparation following the dramatic financial crisis. We inherited a budget deficit of 11% and had to make such savings, but local councils had choices in the decisions they made about where the cuts fell. Gloucestershire County Council prioritised spending on adult social care, stating that it was the single most important service that it delivered. The budget related not only to older people; a third of it went on provision for adults with disabilities, including learning disabilities. The council protected that budget in cash terms, which is one reason why we are one of the best performers in the region and have low delayed patient discharge from the acute sector. While I do not pretend that there are no problems—of course there are challenges—the hard-working health and social care staff do an excellent job.

[Toby Perkins]

I am grateful to the right hon. Gentleman for giving way, but his comments about local government are ludicrous. The cuts that local government faced were far greater than those to any Department. The Government cannot introduce that level of cuts and then say to local government, “You have to decide what you cut.” Of course that was going to lead to social care cuts.

[Mr Harper]

The point that I was making is that my local authority also faced significant cuts and had to make choices. It chose to prioritise adult social care as the single most important service that it delivered, so it had to make difficult cuts in other areas. However, the choice to put adult social care at the top of the list of priorities was the right choice six years ago and remains the right choice today. If councils chose to put adult social care at the bottom of their list, that was not the right decision.

There is no acute A&E department in my constituency, but it is served by A&E departments in Gloucester and Cheltenham. I visited the new chief executive at Gloucestershire Hospitals NHS Foundation Trust and met some of the staff in the A&E department—the hospital has had its challenges—and she is working hard with her management team on turning around the performance of A&E, which has not been up to scratch. I talked to her about the processes they are putting in place, and I am confident that, with the hospital’s hard-working staff and improved leadership, they will be able to hit the targets that the Government have asked them to meet.

[Alex Chalk (Cheltenham) (Con)]

I joined Gloucestershire police on a night shift last Saturday, and I went to Gloucestershire royal hospital A&E, too. I saw professional and compassionate staff offering care in no doubt pressured circumstances. Does my right hon. Friend agree that the current STP process in Gloucestershire must be the occasion to enhance capacity elsewhere in the county and that that must include bolstering and enhancing A&E provision at Cheltenham general hospital?

[Mr Harper]

The whole point of the STP process is to ensure that we have capacity across the health sector. One important thing that the Secretary of State talked about is the other changes to the health and social care system—indeed, that is mentioned in the Prime Minister’s amendment, which is why I will support it. In that I agree completely with the Chair of the Select Committee. We have to look at the two things together.

Unlike what the hon. Member for Central Ayrshire (Dr Whitford) said, in Gloucestershire we are lucky to have a single CCG and a single county council, which work well together with lots of joint working, and they increasingly want to bring health and social care together. That is exactly what the Chair of the Select Committee said, it is the right thing to do and it is what the hon. Member for Central Ayrshire said is being done in Scotland to help deliver a better service.

My hon. Friend the Member for Cheltenham (Alex Chalk) is right that, the more we can improve capacity in the system to ensure that people can access primary care where they need it and can access social care where they need it, we will take pressure off the accident and emergency system. Indeed, when I visited the A&E department, it had a good triage system in place, with general practitioners based in the department to ensure that people with conditions that can be treated by general practice are signposted and treated in an appropriate setting, rather than damaging the service’s ability properly to deliver acute care to those who really need it. We need to consider such steps, going forward.

[Dr Murrison]

Would those people fall within the four-hour target? That lies at the heart of the debate. Should the four-hour target cover both urgent and more elective problems that people present to casualty departments?

[Mr Harper]

I do not know the detail of how the statistics are measured, but the important thing is to ensure that people who walk through the front door of an A&E department but who do not need urgent care receive care in the appropriate setting and are properly signposted, whether to community pharmacies, general practice or the information services that the NHS provides online or on the telephone. It is about making sure that people go to the right setting. The Government acknowledge that that is not perfect at the moment, and they are doing a lot of work to improve it in the future.

Finally, the Government’s moves to devolve spending power and decision making to local areas, particularly given what will happen in Greater Manchester, to bring health and social care together is the way forward, and I have certainly encouraged my local authority, as it leads the formulation of our devolution proposals, to make an ambitious ask of the Government on health. I hope the Government will look at that very seriously in the months ahead.

Mental Health and NHS Performance

Lord Harper Excerpts

Monday 9th January 2017 Commons Chamber

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

I welcome the Prime Minister’s announcement and the Secretary of State’s confirmation of extra support for mental health. I particularly welcome the review to be led by Lord Stevenson and Paul Farmer. As they carry out that review on improving businesses’ ability to support people with mental health problems, will they particularly look at how we can help smaller businesses—those that perhaps do not have the human resource expertise that larger businesses may have—to make sure that people with mental health problems stay in work and are able to get back into work when they fall out of it? They are the biggest single category of disabled people not currently working, and we could make a huge difference.

[Mr Hunt]

My right hon. Friend will of course know that from his distinguished time as a Minister in the Department for Work and Pensions. He is right. The central problem we are trying to address is that if someone, for example, stops going to work and is signed off work because of severe depression, that is bad for the individual and also bad for the business. Too often, what happens at the moment is that it then becomes entirely the NHS’s responsibility to get that person back to work; the business says, “Well, it’s not our responsibility anymore because they’re not turning up.” With a little bit of help from the business, we could get the person back to work much more quickly, meaning that they recovered more quickly and the business would not lose someone important. That is what Dennis Stevenson and Paul Farmer will be looking into.

CQC: NHS Deaths Review

Lord Harper Excerpts

Tuesday 13th December 2016 Commons Chamber

[Mr Hunt]

I thank the hon. Lady for her contribution. I recognise the progress made in the Scottish patient programme, and particularly the inspirational leadership of Jason Leitch, who has done a fantastic job in Scotland and some very pioneering work.

The hon. Lady made some good points that I will take in reverse order. On whistleblowers, I asked Sir Robert Francis to look at this in his second report. He concluded that it would be very difficult, if not impossible, to go back over historical cases, because the courts have pronounced and it is very difficult to create a fair process where legal judgments have already been made. However, I take on board what she says, and I do not think that that means that we cannot learn from what has happened in previous cases; they are very powerful voices.

The hon. Lady is absolutely right about near misses, and we will include that issue in the “learning from mistakes” ambition.

The hon. Lady is most right of all about people with learning disabilities. The heart of the problem is deciding when a death was expected and when it was unexpected. About half of us die in hospitals. As she rightly says, the vast majority of those deaths are expected, but when a person has a learning difficulty it is very easy for a wrong assumption to be made that they would have died anyway. That is a prejudice that we have to tackle, and one that Connor Sparrowhawk’s mother talks about extremely powerfully. We have to make sure that this is not just about lessons for the whole NHS, but particularly about ensuring that we do better for people who have learning disabilities.

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

As chair of the all-party parliamentary group on learning disability, for me the most chilling phrase in the foreword of the report was when Mike Richards and his team said:

“We found that the level of acceptance and sense of inevitability when people with a learning disability or mental illness die early is too common.”

Will the Secretary of State put on the record what Mike Richards says in the report, namely that there can be no tolerance of treating the deaths of people with learning disabilities with any less importance than the deaths of any other patient in the national health service?

[Mr Hunt]

I am happy to put on the record the fact that those words have the Government’s wholehearted support. I credit my right hon. Friend for his work leading the APPG. I commissioned the CQC report because a year ago we had a report by Mazars on what happened at Southern Health, which said that only 19% of unexpected deaths were investigated and that that fell to 1% for people with learning disabilities. That cannot be acceptable, and it is why it is so important that we act on today’s report.

Oral Answers to Questions

Lord Harper Excerpts

Tuesday 15th November 2016 Commons Chamber

[Nicola Blackwood]

Current restrictions on the advertising of less healthy food and drink in the UK are among the toughest in the world, so I am pleased to reassure the hon. Gentleman and his constituents on that fact.

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

May I draw the Minister’s attention to some excellent leadership from the private sector? Lucozade Ribena Suntory, which is based in my constituency, announced last week —rather buried in the news from the United States of America, I am afraid—that it was going to take 50% of sugar out of its soft drinks by reformulating all its new and existing products. That demonstrates really good leadership and is an example to other companies.

[Nicola Blackwood]

I welcome my right hon. Friend’s question. He is absolutely right. We very much welcome the actions of not only Lucozade but Tesco in cutting the sugar in their drinks. It is proof that doing so is possible and meets the expectations of many consumers.

Care Homes

Lord Harper Excerpts

Thursday 1st May 2014 Commons Chamber

[Mr Speaker]

Nobody could accuse the fastidious Minister of excluding from the answers any consideration that he thinks might in any way be material. If he can combine that with reasonable economy, the House will be even more grateful to him than it is.

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

On the Minister’s last point, I am pleased that Gloucestershire county council, notwithstanding the financial pressures on it, has prioritised spending on adult social care for elderly people and those with learning disabilities. From his conversations with the CQC, is he confident that its culture is not just that of a tick-box regulator, but that of an organisation that sees itself as the champion of those who are receiving care and their families, such that if it sees the sort of abuse that was highlighted on television last night, it will act to ensure that it comes to an end and that the perpetrators are dealt with swiftly?

Tobacco Products (Standardised Packaging)

Lord Harper Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

I welcome those comments by the Chair of the Home Affairs Committee. I know that his Committee is undertaking work on illicit tobacco, and it would be very welcome and helpful if it put its draft report or final evidence into the consultation. If he has not already had the opportunity to do so, I urge him to look at the chapter of the report that Sir Cyril devotes to this matter, which I think he will find of great interest. This is one of the wider issues on which the final short consultation will enable people to put their concerns on record so that they can be weighed in the balance.

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

I listened very carefully to my hon. Friend’s statement. I am slightly surprised by Labour Members’ response, given that when in government they said that they needed

“strong and convincing evidence of the benefits to health, as well as…workability”.––[Official Report, Health Bill [Lords] Public Bill Committee, 25 June 2009; c. 305.]

Their response was therefore a little churlish. The right hon. Member for Leicester East (Keith Vaz) made some sensible points on the risks of smuggling. I will look at Sir Cyril’s report carefully, including the section on that subject, before I study the regulations when the decision is put to the House. I thank the Minister for her careful and thorough statement.

[Jane Ellison]

I thank my hon. Friend for those comments. The issue is looked at in some detail, and as I said, Sir Cyril said that he was not convinced by the arguments in this respect.