Tobacco and Vapes Bill

Matt Warman Excerpts

2nd reading
Tuesday 16th April 2024 Commons Chamber

[Matt Warman (Boston and Skegness) (Con)]

My dad used to smoke 60 John Player Specials a day. When he died in 2009, the last 20 years of his life had been blighted by heart attacks, by strokes and by dementia—the things that we know now, and we knew then, are exacerbated not by free human choice but by the fact that smoking is an addiction. Nobody chooses to smoke 60 cigarettes a day. Addiction forces them to do so, and it hits the poorest hardest. Tobacco ruins lives. Smoking takes away the rational, free, human choices that so many people in this Chamber have defended today. Defending smoking is not defending rational, free, human choices; it is defending addiction, which is the very opposite.

Every day when we come to this place, we should ask ourselves one question: how can I as a Member of Parliament, how can we as a Parliament and how can the Government do things that make the lives of our constituents better, healthier, happier, freer? Most of the time, I think that Parliament and the Government should get out of the way. There are even days when I think that what we can do most is not say anything. However, we have to ask ourselves: what are the things that government can do? There are some things that only government can do.

I will let you into a secret, Madam Deputy Speaker. The Ronald Reagan quote that

“The…most terrifying words in the English language are: I’m from the government, and I’m here to help”

was a joke. Ronald Reagan was being slightly glib when he said that. The real most terrifying words in the English language might perhaps be that there is no government—that there is no operation above our individual choices to protect us, to give us security, and to fulfil the single most important function of government: security. Security in terms of health is just as important, because the Government exist to make people’s lives happier and healthier.

People might think that Governments are a necessary evil, or that they are a brilliant thing that can expand ever greater, but whatever we think, we do not improve people’s lives by getting out of the way all the time. Tobacco does not have some unique special status. We should ask ourselves why, as a Parliament, we have agreed that it is right to have speed limits, seatbelts and motorcycle helmets yet somehow people make a different argument for tobacco. That just does not make sense.

Some people will say that this Bill is not perfect, and they are right because nothing is, but if people vote against this Bill, or even abstain, they must demonstrate how it would make the current situation worse, and I cannot see a single example of how it would do so. Some might say that it makes some shops unviable; well, if the viability of a business depends on tobacco, I do not think that it is good for this country for that to be a viable business. Some will say that it fuels the black market. That does not seem to me to be an argument at all. We do not legalise crime for fear of it being driven underground; we in the Conservative party put 20,000 extra police officers on the streets. We fund what we need to do to tackle it.

Many have said that the problem is a 34-year-old in a shop being told, “I am terribly sorry, but you’re not 35.” The reality of this approach, and why it is the right approach, is that by the time today’s 14, 15 or 16-year-olds are 34 or 35, it simply will not be viable for those shops to be selling tobacco. It is a way of driving something—a bad thing—out of our society. That can only be a good thing.

An addicted life is not a free life. The spurious grounds cited for objecting to this Bill have not demonstrated what needs to be demonstrated: that this Bill would make things worse. The social contract that gives us legitimacy in this place is a balance. We have done some things recently that have tested that balance, and today we have a chance to show the 60% or so people who support this Bill that we are on their side. Government should not always be allergic to doing things that are popular, because when push comes to shove, yes of course people love freedom, but to exercise that freedom, people need to be alive.

I come back to where I started—to my dad. The last 20 years of his life were scarred by strokes, heart attacks and dementia, all exacerbated by smoking. That was not a free life; it was a life destroyed by addiction for precious little pleasure and a lot of money. We need the freedom to live longer, healthier, happier lives, with fewer people dying needlessly. That is what this Bill can do for us today.

I cannot understand why someone would vote against it. I cannot understand why they would be indifferent to it. What we should do, surely, is answer the question in front of us as best we can. I cannot help but think that if someone is voting against this today, they cannot see the human wood for the ideological trees. We have the answer. For all the high-flown arguments about the nanny state, the beginning and the end of this debate should be very simple: will people live longer, healthier, happier lives? Will they be alive? The Bill will deliver that. I commend it to the House.

Oral Answers to Questions

Matt Warman Excerpts

Tuesday 6th June 2023 Commons Chamber

[Neil O’Brien]

I have already noted that we have increased the number of doctors in general practice by nearly 2,000 since 2019 alone. The number of direct patient-facing staff in general practice is 50% higher in total than in 2019, and that is up right across the country. However, of course we will go further and grow the number of clinicians in general practice, building on what we have already done.

[Matt Warman (Boston and Skegness) (Con)]

The primary care recovery plan includes excellent measures to extend visas for international medical graduates, but can my hon. Friend say whether that extension will be automatic, answering the concerns of the Royal College of General Practitioners, and whether it will be in place for the 1,000 or so graduates coming this June and August?

[Neil O’Brien]

My hon. Friend modestly does not mention his role in advocating for that important reform, which will help to increase the number of highly qualified GPs coming from other countries to work in the NHS. We will ensure that that extension is automatic, so that people have extra time to make sure they get the right placement in general practice.

Dental Services: East of England

Matt Warman Excerpts

Tuesday 16th May 2023 Westminster Hall

[Matt Warman (Boston and Skegness) (Con)]

I congratulate my hon. Friend the Member for South Norfolk (Mr Bacon) on securing the debate. Although my constituents use the facilities of the east of England, I welcome his hospitality in the debate as well. This is a shared issue, especially for many in the southern part of my constituency.

I wanted to speak today because, as we have heard from many other hon. Members, this is not just a top issue, but the top issue, in the postbag and particularly on social media. We all feel the immense frustration of our constituents on this important issue. In Lincolnshire, nearly a quarter of five-year-olds are suspected to have tooth decay. Last year, a dozen Boston children had teeth removed. The problems we have heard about in the east of England are present in my part of the world too, and the burden of that partly falls on the services provided in the east of England, which is why it is relevant for me to speak today. These are real problems.

I asked my office to do what I called a secret shopping exercise because, like my hon. Friend the Member for South West Bedfordshire (Andrew Selous), I did not trust the data NHS England had provided. On that secret shopping exercise, we see that just a single NHS practice is offering access to new patients and, even then, only to children. There are huge problems with local provision. When I spoke to the ICB, which has recently taken on the responsibility, it said that there are particularly acute issues in coastal and rural areas and, as we have heard, that there are no silver bullets. However, it raised a few issues, which I will use to augment previous speakers’ excellent contributions.

First, there is the enormous backlog in the General Dental Council exams. I gather that 1,700 people are seeking to take the part 1 exam and that the GDC website does not even say when it plans to put another one on. When it does, it is likely to put just 150 people through it. I know that the GDC is an independent body, but will the Minister do all he can—I know he is already doing so—to encourage the GDC to pull its finger out?

Secondly, on the issue of having a dental school in the east of England, there is a medical school in Lincoln; if it were to train dentists, that would benefit the broader area. As we have heard, there is a clear need for many more dentists to be trained across the country, so perhaps we could do something for East Anglia and see benefits for the whole region from having Lincoln-trained dentists.

Thirdly, the issue of fluoridation affects my constituents as well. I do not think anyone, except those on the outer edges of the internet, could possibly argue against fluoridation, and we should encourage it as quickly as possible. On the outer edges of the internet, I give way to my hon. Friend the Member for Broadland (Jerome Mayhew).

[Jerome Mayhew]

I try not to inhabit that area. Does my hon. Friend not think that it is surprising that only 10% of the country’s drinking water is fluoridated?

[Matt Warman]

It is a surprising number. As I am sure my hon. Friend knows, the water companies have raised issues that are legitimate to some extent, but the overall public good from increasing that number is obvious and would pay real dividends relatively quickly. It would be public money well spent.

[Peter Aldous]

In this place, fluoridation is recognised, but the feedback I get from water companies is that conspiracy theories on the internet cause them concern. Does my hon. Friend agree that there is a need for the Government to lead a public awareness campaign on the benefits of fluoridation to dispel these urban myths?

[Matt Warman]

I was the Minister responsible for 5G during covid, and we all remember that, apparently, 5G caused covid—I should be very clear that it did not. However, there is a clear dilemma for the Government as to how much they engage with genuinely fringe conspiracy theories and risk giving them a degree of salience and credibility that they simply do not deserve. I encourage the Minister and his colleagues in the Department for Environment, Food and Rural Affairs simply to get on with it and engage, where necessary, with people who are genuinely worried. However, we sometimes have to acknowledge that the extremities of the internet are not a place where rational debate can always be had, be it on 5G and covid or on fluoridation and tooth decay.

I will make two other points before I end my jaunt to the east of the England. The first is that I know the Minister is looking—as we do with GPs and the NHS more broadly—at what work can be done by people who are not fully qualified dentists to help the nation’s oral health. Along with the expansion of people who have trained abroad, I think that would be welcome and could make a difference, but it is not a silver bullet either.

My final point is that, although my secret shopping exercise was valuable and instructive, it is a huge sign of failure, because the data about which dentists are accepting patients should be freely and easily available so that constituents can easily see which practices are offering help. Given the structure of NHS dentistry, we will always have some dentists with open lists and some with closed lists, even in a healthy system. Easy access to that information would benefit our constituents and NHS England.

I know that the Secretary of State is a huge fan of data and is making such information as open and as easily available as possible, and I hope it can form part of the eagerly anticipated dentistry plan, which is coming “soon”—I think that is the current Government parlance. In a world where the autumn runs into February, I would hope that “soon” is well before the summer. I know it will make a difference in the medium term, but the biggest frustration for all our constituents is the fact that there is no silver bullet.

I hope the dentistry plan includes, for instance, the experimental ways of employing dentists that some trusts are using up and down the country, because that will provide some of the interim measures that I hope will come before the opening of the three dental schools that we have secured in this debate alone. Those will make a huge difference, but it takes time to train dentists, and constituents need solutions as quickly as possible. In pursuing that, we will save people from turning up at A&Es and emergency dental appointments, which will come as a consequence of failing to deliver the basic services I know the Minister is keen to offer as quickly as possible.

Recovering Access to Primary Care

Matt Warman Excerpts

Tuesday 9th May 2023 Commons Chamber

[Steve Barclay]

I join the hon. Lady—as I did the other colleagues from across the House who have done this—in paying tribute to the primary care staff in her constituency for the work they do. We have touched a number of times on the fact that there are both more pharmacies and more pharmacists than there were in 2010, so there is more capacity. However, we also recognise the scope to better use the expertise within pharmacy, which is why an additional £645 million of investment—new funding—is going into pharmacies over the next two years.

[Matt Warman (Boston and Skegness) (Con)]

I am married to a trainee GP, so I have read all 46 pages of this excellent plan—reading it makes me different from those on the Opposition Front Bench. Importantly, the plan is littered with examples of brilliant practice up and down the country, with case studies that should be adopted more widely. Almost all of them come back to the use of technology. Will the Secretary of State say that he will target the help needed to adopt that technology at the practices that need it most, which are so often those in coastal constituencies such as mine?

[Steve Barclay]

My hon. Friend is right about the opportunity that tech offers to deliver changes at scale and the fact that this is proven technology that is working and already up and running in many primary care settings. So often within the NHS the challenge is not the initial innovation—we get pockets of wonderful innovation—but how we industrialise it across the wider NHS. This recovery plan focuses on that, looking at how we scale the case studies to which he refers. About half of primary care does have digital telephony. The opportunity here is to target that funding at the other half; that is often the smaller GP practices, as well as those in coastal communities, because they find the transition to tech more difficult. That is why a key part of this recovery plan is about the investment in not just the tech, but in locums, to provide cover so that staff can make the transition to that new way of working.

NHS Strikes

Matt Warman Excerpts

Monday 17th April 2023 Commons Chamber

[Steve Barclay]

As I have said, we need to see meaningful movement from the BMA. The 35% demand that it has set out is not affordable, which is a point that is recognised by most colleagues across the House—certainly, Opposition Front Benchers recognise it. We need to see significant movement from the BMA to be able to have constructive and meaningful engagement.

[Matt Warman (Boston and Skegness) (Con)]

I welcome the Secretary of State’s acknowledgement that junior doctors deserve a pay rise, and not just because my wife is a junior doctor, and his focus on non-pay issues. For all the talk about ACAS from Opposition Members, is it not the case that so long as the BMA leadership maintain that their starting point is 35%, there is no point in going to ACAS, because the BMA is not prepared to negotiate? It is setting its face against the interests of doctors and patients. The only way to get through this is to get around the table with a meaningful starting point, and that cannot be 35%, as the Leader of the Opposition has said.

[Steve Barclay]

I very much agree with my hon. Friend, and he is right to highlight the wider issues that we want to discuss. The previous negotiation with the junior doctors included, for example, setting up a higher pay band, which has meant that there has been a cumulative increase of over 24% over four years. It included targeted action such as a £1,000 a year allowance for junior doctors who work less than full time, and targeted action around unsocial hours and weekend work. Those are the meaningful discussions that we want to enter into with junior doctors, but that has to be on the basis of a realistic and deliverable discussion, and 35% is not that.

Health and Care Bill

Matt Warman Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Matt Warman (Boston and Skegness) (Con)]

When I spoke on workforce issues on this Bill last time, I said I was prepared to support the Government’s position on the basis of what the Minister and the Secretary of State had said. The Whips do not need to worry too much, because that remains the case, but I feel a huge amount of sympathy for my right hon. Friend the Member for South West Surrey (Jeremy Hunt) and Lords amendment 29B. Fundamentally, if the Government are not prepared to accept what the House of Lords has proposed, they are making their relationship with NHS staff and those associated with the NHS somewhat more difficult.

I ask the Minister to ensure that he doubles down on the commitment he made previously to engage relentlessly, publicly and as extensively as possible with that workforce. If the Government do not do that, there will never be that sense that the cavalry is coming over the hill.

When my right hon. Friend the Member for South West Surrey was Secretary of State, we established a new medical school in Lincoln—a huge achievement of his, and one I continue to try to take as much credit for as possible. However, saying to doctors in my local constituency, who are working so hard at the Pilgrim Hospital in Boston and in Skegness, that we are recruiting more people locally who will be able to make a difference is a challenge, because they do not yet see it on the wards. Part of that, as has been said, is because it takes such a long time to train people and bring them to fruition.

[Richard Graham (Gloucester) (Con)]

A number of us have been successfully lobbied by the Royal College of Nursing in our own constituencies, showing us the figures—a shortage of 250 nurses in our A&E at the hospital in Gloucester—and staff surveys showing that morale is not where it should be. Does he agree that those things are influencing why some of us are not happy with the Government’s position?

[Matt Warman]

I agree that the Government need to continue to address that issue in the way I have described, through more extensive engagement to try to demonstrate some of what is happening.

That brings me to my second point—I will try to stick to the original time limit—which is that these issues are about trust. We need trust with the NHS workforce. As my right hon. Friend the Member for West Suffolk (Matt Hancock) said, with reconfiguration it is very often the case, as it is in my constituency, that even though the data says we will save lives by moving a service from Boston to Lincoln or vice versa, we need to engage with local communities, because right now they simply do not believe that a service that is further away may yet save lives. That does not ring true, and often the data is not yet there.

I simply appeal to my hon. Friend the Minister to deliver on what he said at the Dispatch Box about engaging with the profession, because that is essential to try to improve the morale that the pandemic has damaged so much. I also appeal to him to ensure that local NHS organisations engage with local people, because only that will win public support for the reconfiguration that is so essential for our NHS both locally and nationally.

[Edward Argar]

With the leave of the House, I would like to thank right hon. and hon. Members who have spoken in this debate. I am grateful to the shadow Minister, the hon. Member for Bristol South (Karin Smyth), and indeed to the hon. Member for Ellesmere Port and Neston (Justin Madders), with whom we spent many happy hours over many weeks in Bill Committee.

I also put on record my gratitude to the amazing Bill team in the Department, with whom it has been a pleasure and a privilege to work on this piece of legislation. They have done an amazing job.

I thank my right hon. Friend the Member for West Suffolk (Matt Hancock), under whose leadership we saw the genesis of this Bill, and whom it was a pleasure to work with and work for over a long period of time.

On reconfigurations, and on tackling modern slavery and supply chains, I hope and believe that these measures attract support across the House, and therefore will not reprise the case for them here.

In respect of workforce planning, I join my hon. Friend the Member for Boston and Skegness (Matt Warman) and many others who have spoken in highlighting our gratitude to the NHS workforce and our recognition of the pressures they have faced, particularly over the past two to two and a half years, but also more broadly. That is why we have not only put in place the measures I outlined to deliver an assessment through Health Education England of the needs of the workforce and the framework for growing it, but rather than waiting for that, already put in place measures to continue to significantly increase the workforce.

Health and Care Bill

Matt Warman Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Sir Edward Leigh (Gainsborough) (Con)]

Obviously, abortion is a deeply emotional issue and we probably all know where we stand, but this is not a debate about abortion. At-home abortions were brought in as a purely temporary measure to defend women’s health. It was always the understanding that the measure would continue just as long as the pandemic continued.

There are many different arguments about this issue. I could go through the statistics that have been given to me that some people might deny, but it is undoubtedly the case that more than 10,000 women who took at least one abortion pill at home provided by the NHS in 2020 needed hospital treatment. There is therefore an issue around safety and women’s health and we need a proper debate. This amendment was brought in in the House of Lords at night-time. Barely a seventh of the Members of the House of Lords actually took part in the Division. We need a proper, evidenced debate on this issue. There is nothing more important when a human life is at risk.

Of course, we all support telemedicine; I chaired a meeting yesterday on atopic eczema and we are making wonderful steps, but as important as curing atopic eczema is, it is nowhere near as important as a situation where a life is at stake. I know that there are different views about coercion, but surely the whole point of the Abortion Act, for those who supported it, was to get abortions into a safe medical location and to get them away from the backstreets. People surely did not want them to be done at home, where there is risk. The hon. Member for Upper Bann (Carla Lockhart) spoke about the case of the 16-year-old girl who delivered a foetus who, apparently, was 20 weeks old. That is why, as my hon. Friend the Member for Congleton (Fiona Bruce) said, the National Network of Designated Healthcare Professionals for Children welcomes the Government’s stance, and why children and young people will be provided with protections.

I urge hon. Members, whatever their view, to think, to consider the evidence and not to rush in. The amendment goes completely against the whole spirit of the Abortion Act. Whatever we think of that Act, the amendment would be a huge new step that I believe would put more women’s health at risk and possibly lead to coercion—we need more evidence on that. I therefore support what the Government are doing today.

[Matt Warman (Boston and Skegness) (Con)]

I rather think that men should enter the debate on abortion with a degree of trepidation and humility. In that spirit, I will make three simple points.

First, it strikes me as absolutely right that parliamentarians in this place and in the other place should seek to use every vehicle before them to enact the improvements in our constituents’ lives that we all want. It is right and fair to say that the measures were temporary and were brought in only for a certain purpose, but it cannot be right to say that now that we have done that extraordinary experiment, seen how many women have benefited from the change in telemedicine and got the data, we cannot let the vehicle of the Bill pass us by without trying to make this improvement.

Secondly, the reason that all the expert bodies—including the Royal College of Obstetricians and Gynaecologists, Women’s Aid and the Academy of Medical Royal Colleges, where I have to declare that my wife works—support this approach is that they have seen the evidence. They look at that evidence as organisations that have the safeguarding of their patients absolutely at the heart of every single thing they do. They have looked at what we have done and the evidence we have gathered, and they say it is right to continue with the measures brought in for the pandemic. That is why Wales and Scotland have continued them.

We have to trust the evidence; we have to trust the science. We have to understand that we are in the position that we are in as a result of the covid vaccine programme because we trusted the science. Today, we have an opportunity to trust the science yet again. That seems to me an incredibly powerful argument.

We are not making telemedicine compulsory; we are making it a choice. Yes, we are putting a huge burden on doctors to say that the person on the other side of the screen is not someone who should have pills by post, so to speak. We are saying that they should make that calculated judgment. We ask the professionals, be they in charities or in hospitals, to make those judgments every day. We do so because they are the experts.

I say simply to hon. Members that there are issues on which we profoundly disagree—of course there are; these are fundamentally ethical issues—but if we are in favour of abortion, we should be in favour of the choice that is provided by the very safest options. We can see today from the evidence of the past couple of years that it is safer for women who are at their most vulnerable to have the option that we are talking about today. It is not compulsory; it is an option. For me, supporting that today is the definition of being pro-choice.

[Bob Blackman]

I have had more correspondence on Lords amendment 92 than on any other in the past 12 years. I shall vote accordingly, against Baroness Sugg’s amendment and against the Government’s amendment in lieu.

As chairman of the all-party parliamentary group on smoking and health, I support Lords amendments 85 to 88, which require the Government to have a consultation on the polluter pays levy on tobacco manufacturers. The levy was the central plank of our recommendations to the Government to deliver their smoke-free 2030 ambition. We had other recommendations, but that was the central one because funding for smoking cessation and tobacco control has been reduced every year since 2015 and has not been reinstated in the spending review or the recent spring statement.

Additional funding is vital to reducing smoking rates among the most disadvantaged in society and particularly among pregnant women. The current target to reduce the national prevalence of smoking in pregnancy to 6% by 2022 will be missed, and I think we should be clear about that. Last year alone more than 50,000 women smoked during pregnancy, which caused damage to them and to their unborn children. If we want to create a smoke-free society for the next generation, we must step up our efforts now.

Health and Care Bill

Matt Warman Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Mr Deputy Speaker (Mr Nigel Evans)]

I have three people indicating that they wish to speak. I ask people to make really short contributions, because I want to give the Minister six minutes to wind up and we will then go into the votes at half past.

[Matt Warman (Boston and Skegness) (Con)]

I will be brief, Mr Deputy Speaker. I should declare that I am married to a doctor.

Staff are the No. 1 priority for the health service, and have been historically for this Government, so I will support the Government today, but somewhat through gritted teeth. I implore the Minister to include a few things in his 15-year review. I ask him to engage with the feeling of staff, which we have all heard about: if there are fundamentally not enough staff within the system, it is impossible for them to feel that they can do the job they went into medicine to do as well as they possibly can. I know his plans in this 15-year review will address some of that, but I hope he will also address the fact that there is a huge role to play for technology and for the increasing integration between health and social care. If more patients are stuck in hospitals because they cannot be sent on to the social care system, then we need more doctors to staff those hospitals.

I hope the Minister will consider those multiple facets in the review, and also consider that perhaps more important than anything else is how we retain staff. Even if we are putting more and more people into the beginning of a career pipeline, we will never be able to fill up that pipeline sufficiently if people, whether for pension-related reasons or a whole host of other reasons, are leaving more rapidly than we currently imagine they will in the planning.

That retention aspect has to be a hugely important part of the review. I hope that the possibility of addressing all those multiple factors will be core to what the Minister has been talking about. As others have said, I also hope he will be as transparent as possible within that, and that he or his Department will come to the House to make those plans transparent. Fifteen years is good, and transcends the political horizon that so often derails good intentions for the NHS, but the more transparent we can be, and the more support we can give to recruitment, retention, technology, social care and a host of other issues, the less my teeth will be gritted as I support the Government today.

[Mr Holden]

I shall keep my comments very brief. I apologise to the Minister for not having been here for his speech, because I was with one of his colleagues in my constituency earlier today.

I welcome what the Government are doing today in new clauses 36 to 48. There has been a huge campaign for a long time by people from so many different organisations, particularly Natasha Rattu of Karma Nirvana, Sara Browne and Payzee Mahmood from IKWRO, Halaleh Taheri and Natasha Feroze at the Middle Eastern Women and Society Organisation, Rosie Walworth and Zoe Russell from the Royal College of Obstetricians and Gynaecologists, who have worked closely with me over the past few months, Janet Fyle from the Royal College of Midwives, barristers Dr Charlotte Proudman and Naomi Wiseman and consultant gynaecologist Dr Ashfaq Khan, who did some excellent briefing for us in earlier stages of the process. I also thank Adam Mellows-Facer and Huw Yardley from the Public Bill Office, who did some excellent work with my office manager, Robbie Lammas, who has kept going on this throughout.

I am pleased that the Government are coming forward with the amendments on virginity testing today. I particularly welcome the fact that they are UK-wide and have had support from scores of Members, including the hon. Member for Richmond Park (Sarah Olney), the former Health Secretary, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), and many other hon. Members from across the House who I can see here today.

It is excellent that the Government have listened so much and responded so thoroughly. I would like to hear the Minister talk about new clause 22, which I tabled today, on hymenoplasty. I know we are on Report, but I want his assurance that, if all goes well, we should see those amendments to this Bill in the House of Peers before too long. It is vital that banning hymenoplasty and banning virginity testing go hand in hand.