Oral Answers to Questions

Philip Davies Excerpts

Tuesday 24th February 2015 Commons Chamber

[Jane Ellison]

I am certainly very happy to talk to my hon. Friend about his particular constituents. I am aware of the work that he has done in his local area. He will be interested to know that in 2013 the Government published “The UK Strategy for Rare Diseases” precisely to address such issues and the complexities around them, and aspects of that strategy speak directly to the challenges that he has just outlined. May I also take this opportunity to mention that there is an event tomorrow in Parliament organised by Rare Disease UK to mark rare disease day, at which the Under-Secretary of State for Women and Equalities, my hon. Friend the Member for East Dunbartonshire (Jo Swinson), will be speaking?

[Philip Davies (Shipley) (Con)]

15. What estimate he has made of the number of admissions to A & E in the last three years for patients with palliative care needs in (a) areas with a 24-hour palliative care helpline or palliative co-ordination centre and (b) areas that do not offer such services; and if he will make a statement.

[The Minister of State, Department of Health (Norman Lamb)]

We know from local examples that areas that offer 24/7 community palliative care services have been able to reduce the number of A and E attendances and inappropriate hospital admissions, including emergency admissions, for people with palliative care needs. I would encourage all areas to offer these services in line with the NICE quality standard.

[Philip Davies]

A poll conducted by Sue Ryder shows that 82% of people expect advice to be available 24/7, yet only 8% of CCG areas have a dedicated around-the-clock palliative care helpline and co-ordination centre. As I am sure we all agree, carers do wonderful work and need as much support as possible. Will my right hon. Friend’s Department work with Sue Ryder and others to ensure that there is a dedicated 24/7 palliative care service, which would certainly help to take the strain away from A and E, which is already under great pressure?

[Norman Lamb]

I pay tribute to the professionals in my hon. Friend’s area, which is one of the leading areas for providing strong support in the community, which prevents unnecessary hospital admissions. I am very happy to work with Sue Ryder and others to try to get the message across that if this can be provided throughout the country we will improve the experience of people at the end of life, but critically also save costs further down the line by stopping inappropriate hospital admissions.

Health and Social Care (Safety and Quality) Bill

Philip Davies Excerpts

Friday 9th January 2015 Commons Chamber

[Jacob Rees-Mogg]

My hon. Friend makes an interesting point. It is possible that that is taken care of by other parts of the Bill. Clause 1 contains the fundamental commitment that unreasonable risks should not be taken, and language could be seen to be part of that. The reason I like the new clause is that it makes it absolutely clear that language is fundamental.

It is very hard to think of a circumstance where a lack of communication could possibly be safe. There may be cases where a patient cannot speak, or absolutely dire emergencies where there is no alternative form of treatment, but in the ordinary course of events language skills must be essential for somebody who looks to work in this country for any length of time.

I hope that the Government will think about this new clause very seriously, and perhaps consider whether a “notwithstanding” aspect is necessary, and that if they do not accept it today, they will look at the matter again in another place.

[Philip Davies (Shipley) (Con)]

I apologise for not being here when my hon. Friend the Member for Stone (Sir William Cash) opened the batting on this new clause.

I very strongly support the sentiment behind the new clause. It should go without saying that people who are practising medicine should be able to communicate properly in English. It is a sad state of affairs when we have got to a point where we feel the need to introduce legislation in this regard. Whatever the rights and wrongs of the matter, sufficient examples have been reported around the country to indicate that we do have a problem. It may not be widespread—it may only occur in pockets—but it is perfectly clear that in some areas there is a problem that needs to be addressed. If the Government do not intend to accept the new clause, I would like to know what they intend to do about this genuine problem that people have identified.

My hon. Friend the Member for Stafford (Jeremy Lefroy) made a reasonable point about the measures that were put in place, partly by the previous Government, relating to new doctors and people who are currently going through training. The problem with that, however, is that it does not deal with the people who are already practising.

[Jeremy Lefroy]

My hon. Friend makes an extremely important point. Does he accept—perhaps the Minister will comment on this as well—that the revalidation process that doctors now have to go through should include, if it does not already, as I am sure that it must, language and, indeed, communication skills?

[Philip Davies]

I take my hon. Friend’s point. I am not entirely sure, though, how robust that process is or whether the same test is applied for people who are currently practising as for those who are starting out on their training. I suspect that there may well be a slight difference in the standard that is expected. I hope that I am wrong and he is right; it will be interesting to hear what the Minister says. I would be interested to know how many people have been struck off because they are unable to communicate effectively—if it is hardly any, or none, that would indicate that the current regime is not working effectively—and how often the measures that my hon. Friend mentions have been invoked.

As ever, my hon. Friend the Member for North East Somerset (Jacob Rees-Mogg) made an interesting point about the European Union. I do not intend to get bogged down in that today, but it would be interesting to know what the Minister’s understanding of this is. If he will not accept the new clause, is my hon. Friend’s point a factor in that, or is it his position, and that of the Government, that nothing in EU law would prevent such a provision from being introduced?

Although I agree with the sentiment behind the new clause, I wonder whether its wording is deficient and could lead to some unintended consequences. My hon. Friend the Member for Stone made great play of the need for people to be able to communicate effectively in English, and he is absolutely right, but unfortunately there is no mention of English in his new clause. That seems to be a rather glaring omission that could lead to unintended consequences at a later date. The new clause merely says that people who practise medicine should

“have appropriate language skills to communicate effectively with their colleagues and patients.”

I think what he is really trying to say is that they should have appropriate English language skills to communicate effectively with their colleagues and patients. As drafted, the new clause would place an onus on people practising medicine to have appropriate language skills in general to communicate effectively with their patients. In the case of a patient who speaks no English whatsoever and speaks Urdu, for example, would the new clause insist, in effect, that their doctor must be able to communicate effectively with them in the only language that they are capable of speaking? That would seem to be a possibility, because the crucial word that has been omitted is “English”.

[Jacob Rees-Mogg]

I have just checked the territorial extent of the Bill, and parts of it apply to Wales as well, so we should not forget the need perhaps to be able to communicate in Welsh where appropriate.

[Philip Davies]

My hon. Friend makes a good point. That enhances the complication that could arise as an unintended consequence. I agree wholeheartedly with the sentiment of the new clause and the intention behind it, but I wonder whether its wording may lead to unintended consequences in relation to languages other than English that were not foreseen when it was tabled.

[Sir William Cash]

As my hon. Friend will appreciate, the new clause says:

“The Secretary of State shall by order make regulations enabling the General Medical Council to ensure that all doctors…have appropriate language skills to communicate effectively”.

I am not prejudging this—I will be interested to hear what the Minister says, if he can take advice on the matter, and of course there is the House of Lords to come—but it may well be that the regulations can identify how my hon. Friend’s points, which I completely understand, can be addressed.

[Philip Davies]

I am grateful to my hon. Friend. He may be right that the points I make can be overcome in one way or another, whether through his existing wording, which may well work, or perhaps a slightly amended version in another place. I just wanted to flag up this issue because I would not want any unintended consequences to come about as a result of the new clause. The whole point is that the onus should be on everybody to be able to speak English, and I would not want anything to allow for a loophole that prevented that from happening.

I wholeheartedly support the sentiment underlying the new clause. Integration is essential in this country and speaking the language is one of the key forms of integration. I do not see how it is possible to integrate into society if one is not competent in speaking English. I support the idea that people who come to this country should be able to speak English, whether they are patients or doctors—the requirement should apply to both equally. I shall be interested to hear the Minister’s view.

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[Philip Davies]

I welcome what the Minister has said and commend him for that initiative. In order for us to be able to see how robust the revalidation process is, can he tell us how many people have been through it and how many have failed as a result?

[Dr Poulter]

The revalidation process is ongoing and is reviewing everybody on the medical register. It is very easy to revalidate someone who is training to be a specialist as a surgeon or in some other hospital position, because they are assessed annually as part of their specialist training. The revalidation process for the consultant and general practice work force—which kicked off as a five-year programme—is ongoing. Some people have volunteered to come off the medical register, including retired doctors who have not practised for some time. I would be happy to write to my hon. Friend to update him on the revalidation process. It will not be completed for another couple of years, but once we have gone through the first cycle of revalidation the process will be easily repeated. I stress that doctors will be revalidated on a maximum of a five-yearly basis. It is possible for the GMC to seek reassurance with regard to certain specialties by requesting more regular competency tests as part of the annual appraisals.

The revalidation process is an important new power that is being implemented effectively. We need to keep it under review because it is important that all doctors, regardless of the proposed new clause on language testing, are competent, keep up to date with medical practice, able to communicate effectively and empathetically with their patients, and work as part of a multidisciplinary team for the benefit of patients. That applies to general practitioners, hospital specialists and those working in mental and physical health. It is an important step for which the GMC has been asking for many years and in which other health care professions are taking an interest. The Nursing and Midwifery Council is considering revalidating nurses in a similar way in future. It is a welcome measure that will help protect patients and the public. It is making good progress and I will write to my hon. Friend with further details in due course.

Medical revalidation is the process by which the GMC evaluates whether doctors can keep their licence to practise in the UK. In addition, a doctor wanting to work in general practice in the UK must also be on the national medical performers list, which is managed by NHS England. To be included on the list, the doctor must hold a licence to practise from the GMC and, as a consequence of the revalidation programme, he or she must have effective communication skills.

As I outlined earlier, the key step to improving checks on language competency for EEA doctors was the Medical Act 1983 (Amendment) (Knowledge of English) Order 2014, which made changes to the Medical Act 1983. My hon. Friend the Member for Shipley will be pleased to hear that the title of the order refers to English. After all, the General Medical Council regulates doctors on their ability to speak primarily that language, and I hope that that reassures him.

The order gave the General Medical Council the power to refuse a licence to practise to a medical practitioner from within the EU who is unable to demonstrate the necessary knowledge of English. It created a new fitness to practise category of impairment relating to language competence to strengthen the General Medical Council’s ability to take fitness to practise action where concerns are identified.

For example, if I, as a doctor, worked with a doctor about whose language competency I had concerns, or if a doctor was not able to communicate effectively in their day-to-day work, I, fellow health care workers and patients could report the doctor to the GMC, which—in addition to the existing initial point-of-entry language testing powers and the revalidation process—now has new powers to take action specifically in relation to such language concerns. That is another important measure that the Government have introduced to strengthen the GMC’s powers on language testing.

The change enables the GMC to require evidence of English language capability as part of the licensing process in cases where language concerns are identified during registration. Just as doctors from outside the European economic area can be tested on their language competency, the same competency tests now apply to doctors coming to work in the UK from within the European economic area, thanks to the new regulations. We hope that the wrongs identified following the dreadful Daniel Ubani case and the tragic death of David Gray have now been righted through very strong legislation to ensure the competency and ability to communicate in English of all doctors coming to work in the United Kingdom. As I have outlined, additional measures are now in place to enable the GMC to take action if concerns are raised during the ongoing medical practice of any doctor about their ability to speak English and to communicate effectively with their patients.

The process for determining whether a person has the necessary knowledge of English is set out in the General Medical Council (Licence to Practise and Revalidation) Regulations Order of Council 2012. The GMC has published guidance setting out the evidence required to demonstrate that a person has the necessary knowledge of English. With regard to the fitness to practise changes that have been introduced, a new category of impairment relating to English language capability has been created, which allows the General Medical Council to request that a doctor about whom concerns have been raised undertakes an assessment of their knowledge of English during a fitness to practise investigation.

The changes have hugely strengthened the General Medical Council’s ability to take fitness to practise action where concerns about language competence are identified in relation to doctors already practising in the UK. We are in the process of bringing in similar powers for the Nursing and Midwifery Council, the Pharmaceutical Society of Northern Ireland, the General Pharmaceutical Council and the General Dental Council to ensure that the health care professionals they regulate—nurses, midwives, pharmacists, pharmacy technicians, dentists and dental care professionals—will also have appropriate language skills for the roles that they perform. The consultation on our proposed legislative changes for those four regulators closed on 15 December, and we will publish the outcome shortly with a view to immediate legislation.

I want to pick up the good point made by my hon. Friend the Member for North East Somerset about the need for primary legislation. I hope that he is reassured that the existing legislation, and the ability to bring in regulations underpinning that through section 60 orders underpinning the Medical Act 1983 and other Acts, provides the ability to bring in strong regulations to protect patients and the public in respect of language competency. The Government have done exactly that. There will be future opportunities to legislate in the form of a Law Commission Bill, which would make it possible to neaten up the already very robust and strong regulation on language testing that we have introduced. I am sure that we will consider doing so at the first opportunity.

I hope that such measures will reassure my hon. Friend the Member for Stone. Thanks to this Government, strong laws have been passed, and very strict new rules are now in place to ensure that doctors practising medicine in the UK can do so only if they can communicate with patients using a high standard of written and spoken English. With that reassurance, I hope that he will withdraw his new clause.

National Health Service (Amended Duties and Powers) Bill

Philip Davies Excerpts

Friday 21st November 2014 Commons Chamber

[Clive Efford]

It is just not realistic to compare what went on under the previous Labour Government with what is going on now. Yes, the contract in Cambridgeshire, at Peterborough, was won by an NHS bidder, but what was the cost? How much money was diverted from patient care into running that tendering process? That is an increasing cost to the NHS that we cannot allow to continue. By the way, I unreservedly withdraw my accusation that the hon. Gentleman voted in favour of the 2012 Act, because that is a calumny I would not use against my worst enemy.

Through the House, the Secretary of State would be accountable—

[Philip Davies (Shipley) (Con)]

Will the hon. Gentleman give way?

[Clive Efford]

Yes, I will, because I have lost my place.

[Philip Davies]

I am delighted to help the hon. Gentleman out. Helpful as ever! He talks about stopping what he calls privatisation and about putting the Secretary of State in charge. At the moment, there is a cap on the amount of private income that a hospital trust can gain, but does he agree that clause 7 of his Bill would remove that cap, giving discretion to the Secretary of State? Does he acknowledge that the amount of private income a hospital could receive could actually go up under his Bill?

[Clive Efford]

There are a number of provisions relating to the Secretary of State which state that everything that is decided has to put patients first, rather than competition. That is the key difference in this Bill. The Secretary of State will have to be satisfied that every penny raised from private income serves the needs of patients. The Secretary of State will set the limit, which can be variable, but it will have to come down because this House will demand that.

--- Later in debate ---

[Clive Efford]

I am grateful for my hon. Friend’s kind words and for the support of all the thousands of people, particularly health service staff, who have supported the Bill.

[Philip Davies]

Will the hon. Gentleman give way?

[Clive Efford]

I hope the hon. Gentleman does not mind, but I am going to make some progress.

Never before have we had market tendering of the health service as we have today, and it is breaking down our NHS. The Bill is not a solution to all the mistakes that this Government have made in their top-down restructuring of the NHS, but it is an important block on enforced privatisation. The argument can be simplified into two distinct sides. If people believe the NHS should be a pure market, open to competition regulations, where the interests of competition are put before those of patients, they belong on the side of the Government. If people believe the NHS is a public service that should be free of competition rules, where the interests of patients are put first, they should vote for the Bill today.

We know that No. 10 did not understand what was going on in 2012. The Chancellor was asleep at the wheel, and the Liberal Democrats, suffering from some form of terminal Stockholm syndrome, were led by the nose to turn the NHS from a public service into a free market. My Bill takes a scalpel to cut the heart out of the hated 2012 Act and put right the worst of the Government’s mistakes. It will remove the sections that require the tendering of NHS services for competition with the private sector, the result of which has been millions of pounds being diverted from patient care into the pockets of lawyers and accountants through the tendering process. NHS bodies are spending millions either bidding or managing bidding processes, and that is all money being diverted from patient care. That must stop, and this Bill will end it.

--- Later in debate ---

[Clive Efford]

Absolutely. It is the capacity of the NHS to continue to provide services in the future that is under threat. Eventually and inevitably, with continuing privatisation of all its services, the NHS will end up as just a patchwork of contracted-out services, and that will put us at the mercy of the private sector.

[Philip Davies]

The hon. Gentleman talks about money being diverted away from patient care and about extended privatisation, but will he comment on the private finance initiatives that the previous Labour Government imposed right across the NHS, bankrupting many of its institutions and taking money away from patient care?

[Clive Efford]

There are issues about PFI, which we need to sort out. I must say, though, that the hon. Gentleman has picked on the wrong Member of Parliament. I have one of the very first PFIs in my local hospital. When was it advertised in the European Journal? In March 1995. It was a Tory PFI and it is one of the most expensive in the national health service; it is costing millions of pounds for my local hospital. Both Governments have something to answer for when it comes to PFI. There are issues that need to be put right, but people must understand that that will not happen under a Tory Government.

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[Sir Tony Baldry]

The point I am making, which I shall develop, is that the Bill is completely unnecessary. I also want to make the point that all Opposition Members seem to wish to deny that there has been any involvement of the NHS with the private sector. It is important to remind the House of the fact that it was the Labour party, and a Labour Government, who introduced the private sector into the NHS, and the 2012 legislation in no way significantly changed that relationship.

[Philip Davies]

Does my right hon. Friend agree that those people who support the Bill would be supporting the removal of the cap on the amount of private income that hospitals can receive? Does he think that, when 38 Degrees was encouraging people to write in about the Bill, it made that clear to the people who signed its petition?

[Sir Tony Baldry]

My hon. Friend makes a good point. I think the Labour party will regret signing up to every 38 Degrees campaign, because if 38 Degrees starts drafting the Labour party manifesto rather than the Labour party, the Labour party will never sort out whether it is new Labour, old Labour or any other sort of Labour, which is why it did so incredibly badly yesterday in the Rochester by-election.

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[John Healey]

Patients say exactly the opposite of what the hon. Gentleman has just argued. However, I understand that he feels he has nothing to apologise for. If he fundamentally believes that the NHS should be a system based on full-blown competition, delivered by the private sector, then of course he would want to legislate in that way.

[Philip Davies]

While the right hon. Gentleman is going back to fighting some 1980s ideological warfare, I think most constituents are bothered about what happens in practice. Is he really asking me to apologise to my constituents for the fact that there are now 9% more professionally qualified clinical staff at Bradford teaching hospital and 42% fewer senior managers, or that there are 7% more professionally qualified clinical staff at Airedale NHS Foundation Trust and 14% fewer managers, or, I might add, for the brand spanking new, state-of-the-art A and E department at Airedale hospital? Does he really think that is something to apologise for?

[John Healey]

The hon. Gentleman normally finds a common touch in the way he makes his points. I have to tell him that if he tries to trot out those sorts of figures on the doorstep in the next five months, he will find that they cut no ice with the public, because they know what is happening to their NHS day to day, and we will make sure they understand why it is happening.

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[John Pugh]

If the hon. Member for Eltham (Clive Efford) wished to talk about that, we could happily move away from the internal market where local circumstances required and demanded it. That would be an entirely sensible policy. I see no reason, though, why health boards should not procure goods and services based on simple best-value principles without all the competition legislation that has been vilified in the debate. They should be funded—as most services are—by capitation and according to local need, and they should be in some way democratically accountable, and I think we can get a genuine public service element back into the NHS. However, not every political party is advocating that at the moment, and some are steering in quite the opposite direction.

[Philip Davies]

The hon. Gentleman is making a thoughtful speech, as is typical of him. Does he agree that what we are dealing with today is an Opposition party in desperate straits that knows exactly what it is doing in using the word “privatisation”? It knows that people out in the country associate it with having to buy private health care, but actually nobody is proposing to change the fundamental ethos of the NHS, which is that treatment is free at the point of need. The Labour party is conflating the two as a desperate political tactic.

[John Pugh]

The hon. Gentleman is not altogether wrong, but if we are to continue to deliver, in stressed circumstances, a service that is free at the point of need, we cannot run the NHS as an internal market for ever. In fact, the NHS is already trying to morph into something different. We now have health and wellbeing boards, which mean that commissioners and providers get together to try to agree a local plan. They are struggling in every way to behave like a health board, but they do not have the executive powers to do so. There has been the move away from tariffs, which have been used to try to adjust the market, and we are now talking about whole-treatment costs. There is also talk about integration.

What is clearly entirely disruptive, though, is the intrusion of competition where it is not needed—where it is simply dogma; where it is seen as a panacea for producing good results, whether or not there is a good case for saying that; where it derails sustainable services; or where it becomes a central operating principle of the NHS. None of those things is particularly helpful.

I do not want to comment on TTIP, because I do not think it is well understood at the moment, but we will certainly need to look at how it plays into the competition agenda.

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[Mark Reckless]

That is an excellent website, which I recommend to all Members. The Minister has said that my hon. Friend made those observations when most of the Committee stage of the Bill had been completed. Was that during the “pause” that had been invented as a new mechanism for Parliament? My hon. Friend is not here at the moment, but I think he would agree with me that the 2012 Act is not as it was billed to us by those on the Government Front Bench. It has led to an extraordinary degree of additional complexity in the NHS, and the introduction of competition bodies—and, in particular, European competition law—into the NHS is not welcome.

[Philip Davies]

Will the hon. Gentleman give way?

[Mark Reckless]

No, I will continue for a bit, if I may.

I do not think that the extent of the difficulties that doctors and others would encounter as a result of section 75 of the Act and the bureaucratic, market-based—or quasi-market-based—commissioning rules that it requires was any more apparent to my hon. Friend the Member for Clacton than it was to other Members, although some Opposition Members may have had premonitions of it. I thought that the Bill was intended to allow the various local bodies to get on with running the NHS in their areas. Some would run it better than others; there would be local decision-making and discretion, and people would learn from each other. Now, however, there are centrally determined rules that force everyone into, in particular, commissioning or contracting behaviour, but do not make sense in the context of the service that is being delivered.

[Philip Davies]

I congratulate the hon. Gentleman on his victory in last night’s by-election. It was an excellent result for him and it would be churlish not to point that out. I know that he is a long-standing believer in localism. Is he not worried by the British Medical Association’s concerns that the Bill would give much wider powers to the Secretary of State, thereby centralising powers and taking the day-to-day running of the NHS away from clinical staff and putting it in the Secretary of State’s hands? As a champion of localism, is he not worried by that?

[Mark Reckless]

I am grateful to the hon. Gentleman for his congratulations; that is very decent of him. I am not a fan of quasi-autonomous bodies, of great amounts of regulators or of overlapping layers of bureaucracy; they rarely work. Given the degree of complexity that has now been brought into the NHS, I think it is possible—although I am not certain—that the centralisation of power in a single Secretary of State who is at least accountable to the House might be better than the current diffusion and fragmentation of powers, which does not seem to be working effectively. My party would like to replace the alphabet soup of regulators and the overlapping layers of bureaucracy with a single, elected health board for each county area. That would give a degree of clarity to the oversight and management of the NHS.

[Mark Reckless]

There is an argument for doing that, and a judgment has to be made. It might be possible, depending on the different areas of the countries—particularly in the devolved Administrations—that the solution to that question might be different. My general view is that it is much better to have democratic accountability than not to have it, and in many areas I would prefer that to be local. My party wants to see health boards elected on a county basis.

My party also wants European competition law to be taken out of the NHS, and the Bill is exemplary in that regard. I strongly support that provision.

I have signed a pledge on TTIP, along with most other candidates in the by-election, except for the Conservative—[Interruption.] No, not the Liberal one—that was not a good one to sign—although I did vote against tuition fees, along with most Opposition Members. I would like to see the NHS excluded from TTIP. There are arguments as to whether it will be or not, but those arguments should be settled in the House as per this Bill, rather than being left to the unpredictability of future legal actions.

[Philip Davies]

Will the hon. Gentleman give way?

[Mark Reckless]

I am just reaching my conclusion, if I may.

The hon. Member for Eltham made a mistake in talking about the UK negotiating on TTIP. That is an area of exclusive competence for the European Community, and it is therefore the EU Commission that will negotiate with the United States on that matter. When I first heard about TTIP, it sounded as though it would be all about free trade and I thought that it would be broadly a good thing. The more I looked into it, however, the more it seemed to be not about free trade but about the creation of a single set of transnational regulations between the US and the European Union, and that it would be illegal for anyone not complying with them to sell goods and services. I am therefore very sceptical about TTIP and I am not sure it is something that I would want to support. I certainly do not want to see the NHS included in it.

I congratulate the hon. Member for Eltham on his Bill, and I look forward to supporting him in the Lobby.

Oral Answers to Questions

Philip Davies Excerpts

Tuesday 21st October 2014 Commons Chamber

[Mr Hunt]

As I said earlier, we welcome the fact that Labour is now interested in cancer policy. If we look at the reason for those delays, which we are working hard to address, it is because the number of cancer referrals—[Interruption.] Labour left this country with the worst cancer survival rate in western Europe; we are doing something about it. The reason for the delays is that the number of people being referred for cancer tests has gone up by 50% since 2010. We are treating record numbers of people with cancer because we want to do something about that survival rate.

[Philip Davies (Shipley) (Con)]

T2. The Public Health Minister is pursuing a long list of nanny state proposals that we might have better expected from the Labour party, including plain packaging of tobacco, outlawing parents smoking in cars and having higher taxes on alcohol. Will she give us a list of which policies, if any, she is pursuing that have a Conservative flavour to them?

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

Following on from the Secretary of State’s previous answer, tobacco control is an integral part of tackling cancer. I am delighted to let the House know that smoking prevalence among adults in England fell to 18.4% in 2013. This is a record low, which means that the Government have hit their tobacco control plan target for 2015 two years early. I am sure that even my hon. Friend would welcome that news.

Oral Answers to Questions

Philip Davies Excerpts

Tuesday 15th July 2014 Commons Chamber

[Philip Davies (Shipley) (Con)]

7. What lessons his Department has learned from the Born in Bradford research study.

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

By tracking the lives of 13,500 children and their families, the Born in Bradford research study is providing information that will help us to understand the causes of common childhood illnesses, and to explore the mental and social development of a new generation.

[Philip Davies]

In the Born in Bradford study, 63% of Pakistani mothers are married to cousins, and within that group there was a doubling of the risk of a baby being born with a congenital anomaly. The report also found that “a larger number” of children born to cousins

“will have health problems that may lead to death, or long term illness for the baby.”

How much do health issues related to first-cousin marriages cost the NHS, and, given those findings, is it not time that such marriages were outlawed?

[Dr Poulter]

We do not have any financial information, but it is important to point out that the Born in Bradford study showed that there was an increase in the risk of birth defects from 3% to 6% in consanguineous marriages. However, that clearly highlights that not all babies born to couples who are related have a genetic problem, and the key issue is to help women to make an informed choice before they get pregnant and to direct them to genetic counselling where that may be required.

Tobacco Products (Standardised Packaging)

Philip Davies Excerpts

Thursday 3rd April 2014 Commons Chamber

[Jane Ellison]

As I said, I want to publish the draft regulations alongside the short final consultation to look at any final points people want to make about the wider aspects of the policy. It is important that we do that to move forward in a way that is robust and sensible and that shows that we have considered everything in the round. I want to do that this month; then, if we decide to proceed, we will move to give the House a final decision before the summer recess. There is no reason why the legislation could not be brought before the House before the end of this Parliament.

[Philip Davies (Shipley) (Con)]

The Minister’s nanny state instincts do not come as a great surprise. Can she tell us why she set up the review in the first place? Is it because she was not capable of assessing all the evidence herself and making a decision, or because she had already decided what she wanted to do but did not have the guts to announce it and so wanted to use taxpayers’ money to hide behind a review? Whichever it is, it does not inspire confidence. Such decisions should not be farmed out to someone who is unelected and totally unaccountable.

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[Sir Paul Beresford (Mole Valley) (Con)]

I obviously have an interest in this particular area. May I say to those hon. Members who are protesting that if I could arrange for them to come into an operating theatre and see the damage that oral cancer does to people, they might actually change their mind?

[Philip Davies]

Ban it then. Ban smoking.

[Sir Paul Beresford]

I am ignoring the interruptions. I am particularly pleased by what the Minister has said and I thank her for it. I encourage her to move this nation ahead first, as I hope she will, rather than to wait for the Australians.

Children and Families Bill

Philip Davies Excerpts

Monday 10th February 2014 Commons Chamber

[Luciana Berger]

I am not going to take any more interventions, because many Members have prepared speeches and wish to contribute to the debate.

The proposal has the overwhelming support of royal colleges, health experts and leading authorities on public health from across our country. In the past week alone, 700 doctors have written to the British Medical Journal in support of a ban on smoking in cars with children. YouGov polls have shown that the measure enjoys the support of up to 80% of the public. It also has the support of the Liverpool Schools’ Parliament, which voted for such a ban unanimously. Many colleagues who have visited schools in recent days have encountered similar enthusiasm from young people.

To those who say that this law would be unenforceable, unworkable or a dreadful infringement of civil liberty, let me offer this thought: 38 years ago this month this House debated a law that would make a certain behaviour in a car illegal, and Government Members were granted a free vote. There was general agreement about health and safety, but Members raised concerns about whether it would be enforceable or a step too far. One Member said that it was a mark of the fact that

“as a society we are becoming over-governed and over-regulated.”—[Official Report, 1 March 1976; Vol. 906, c. 1006.]

Despite that, the proposal passed that night with a convincing majority and eventually became law. More than 30 years on, no one is arguing that we should repeal the law that made it compulsory to wear a seat belt. In the same way, few people would argue that we should bring back smoking in enclosed public spaces or on the London underground. In the meantime, the proportion of motorists wearing a seat belt has risen from around 25% to over 90%. It shows just how powerful the effect can be when Parliament unites and sends a signal. We have such an opportunity before us today. This is a matter of child protection, not adult choice.

Members across the House will be familiar with the words of the great liberal philosopher John Stuart Mill. He prized liberty above all else, but even he accepted that a civilized society should exert influence over an individual in order to prevent harm to others. This is a simple and straightforward measure that would make a world of difference to hundreds of thousands of children across our country, reducing the misery inflicted by passive smoking, saving millions of pounds for our NHS and protecting children who do not have a choice and do not have a voice, and who in 20 years’ time, I am sure, will wonder how it was ever allowed in the first place. I sincerely hope that Members on both sides of the House will support the measure today.

[Philip Davies (Shipley) (Con)]

I have no quibble at all with the hon. Member for Liverpool, Wavertree (Luciana Berger), who represents the smug, patronising excesses of new Labour. They think that the only reason they came into Parliament was to ban everybody else from doing all the things that they happen not to like. What perturbs me is that Conservative Ministers appear not to have grasped the concept, even though they claim to be Conservatives, that we can disapprove of something without banning it. This is just another in the long line of triumphs for the nanny state.

I will not give way because I want to rattle through what I have to say in order to give other Members an opportunity to speak. I believe that parents are much better placed to decide what is best for their children than the state is. If we want to encourage parents to take responsibility for their children, we have to give them that responsibility. We will never get parents to do that if the Government say, “Don’t worry about taking responsibility for your children, because we will make all the relevant decisions for you. You don’t have to worry about anything.” That is not something we should be encouraging.

The Conservative party used to believe in the rights of private property, and that people could do as they pleased in their own private property. Their private vehicle is their own private property. If people wish to smoke in a car with children, that is a decision for them to take. As Conservatives, we should not interfere with that.

Members have talked about small and confined places and about restricting the proposal to private vehicles, so why not caravans? I know that Labour Members are not going to ask their friends in the Gypsy community to stop smoking in caravans, so we will never have the prospect of that happening. What is the difference between a caravan and a small car? What is the difference between a small, confined flat and an open-top car? Why is it worse for people to smoke in an open-top car than in a confined flat or a caravan? Why is one much more of a danger to health than the other? This in no way reflects the fact that most car journeys are very short. Why do Labour Members think it is an absolute outrage and terribly dangerous for somebody’s child if they smoke in a two-minute car journey but absolutely fine for them to smoke for hour after hour in a caravan that is, in many cases, just as much of a confined space? The whole thing is absolute nonsense.

--- Later in debate ---

[Mr Winnick]

rose—

[Philip Davies]

I have said I am not going to give way. The hon. Gentleman can listen for once.

Moreover, this is totally and utterly unenforceable. What on earth are we doing saying to the police, whose resources are already stretched, that all of a sudden this should be a new priority for them to undertake? Have they got nothing better to do than go up as close as they can to a moving car to see whether there happens to be a small child in the back seat? Of course, this is not just about small children but all children. How on earth does the driver prove that the person in the back of the car is over 18 rather than under 18? What happens when the driver throws the cigarette away and the police have to try to prove whether they were smoking when they were pulled over? The whole thing is completely unenforceable. It is gesture politics of the worst kind, with Ministers and shadow Ministers trying to flex their health zealotry at all these health organisations and saying, “We’re tougher on these matters than the others.”

Standardised packaging—it is not plain packaging, as some people say—is also nonsense. In many cases, the standardised packaging is more colourful than the existing packaging, so this measure will not do anything for the people who say that all the colourful packaging encourages people to smoke. It is already the case that cigarettes cannot be displayed in large shops. What on earth is the point of having plain packaging for products that are already behind a counter and cannot even be seen? Again, the whole thing is complete nonsense.

All these arguments are arguments for banning smoking altogether. If people had the courage of their convictions and said, “We should ban smoking altogether”, I would at least have some respect for them, but they dare not say that that is what they want to do, even though we know it is their real agenda. While cigarettes are a legal product, brands should be free to use their own branding on the packs. Standardised packaging would simply be a triumph of the nanny state that would presumably soon be followed by plain packaging for alcohol, sweets, crisps, and all the foods that supposedly lead to obesity. Once we have gone down this road for one thing, why would we not have plain packaging for everything? We know, particularly given the current Ministers and shadow Ministers, that that is what it would quickly lead to.

I have tabled three amendments to Lords amendment 124 to try to make it more sensible. The Lords amendment states that the Secretary of State can make regulations if he believes that they

“may contribute at any time to reducing the risk of harm to…the health or welfare of”

children—I repeat, “may” contribute. This gives the Secretary of State the authority to make a decision on a whim just because he happens to think that it might make a difference. My first amendment would change “may” to “will” so that he would need to have some evidence for making a change rather than just doing it on a whim.

The second amendment relates to regulations. Under Lords amendment 124, the Government are saying that they can make lots of provisions and as long as some of them are capable of having a positive effect, that is fine. They can propose 10 ridiculous things and two sensible ones, and the regulations allow them to do it as long as some of them are sensible. My amendment says that “each” provision that they want to bring in should be capable of making a difference, not just the odd one or two in a whole series.

The Minister said that it would be a constraint on the Minister’s power to accept my amendments. Well, I make no apology for trying to constrain the Minister’s power. That is what the House of Commons is all about—trying to make sure that sensible decisions are taken based on evidence, not just on the latest whim of the nanny state brigade whom she has listened to. We are supposedly here to try to defend the freedoms of people in this country. This Government want to trample over every single one of those freedoms. It makes me wonder what is the difference between having Labour or this Government in charge. I expect no better from Labour, but I did expect an awful lot better from a supposedly Conservative-led Government.

[Kevin Barron (Rother Valley) (Lab)]

Listening to this debate, I could have heard the same things said in 2006 when the House came to a decision on smoking in public places. That is public health legislation which the Prime Minister says is good legislation, although he did not vote for it at the time. I hope that Members will bear that in mind.

I hope that Members will also bear in mind, as we always must when considering such legislation, that currently in the UK over 100,000 people a year die prematurely from smoking tobacco. I support the amendment, which will, I hope, further restrict the use of tobacco not just by young people but, in turn, by adults. As the Minister said, two thirds of people who start smoking are young when they do so, and it is addictive.

One of my points relates to what the Minister said about e-cigarettes not being sold to people under the age of 18. Some people argue that e-cigarettes are a gateway to tobacco use, but the organisation that I have worked with on this over many years—Action on Smoking and Health, which the hon. Member for Shipley (Philip Davies) clearly admires—says that there is no firm evidence for that at this stage; it is doing another survey this year. The important thing is that over 2 million people are using e-cigarettes, some of them so that they smoke less tobacco and some so that they smoke no tobacco. I agree with the Minister that we should view them as a medicinal product—as part of the family of nicotine replacement therapies. That should be our approach in stopping these awful deaths from smoking. VAT on nicotine replacement therapy products is currently 5%. If e-cigarettes were also licensed and charged at the same rate, that would benefit everybody.

I support what the Minister said about proxy purchasing. This has not yet been addressed and it should have been. Alcohol and tobacco are harmful, depending on how they are used, although alcohol is not as bad as tobacco.

We have debated standardised packaging many times in the House and heard the arguments about printers being affected, and so on. The hon. Member for Shipley said that standardised packages are very complicated, and of course they are. I hope that we will have better safeguards to stop people engaging in contraband activities. There is no way that this measure will do anything other than stop people advertising on cigarette packets the products that cause all these premature deaths.

I support the Government and the Opposition on banning smoking in cars with children. Enforcement is always an issue, and we accept that. When I first started driving, people had to have seat belts in cars but did not have to wear them, and only one person in four did so. When the law was changed, 90% of people started wearing them practically overnight. This is about changing habits. We could not have a worse situation than somebody in a confined space like a car smoking cigarettes when children are there.

Everybody said that the ban on smoking in public places would never be enforced. I was on the Health Committee when we had that debate and we went to Dublin to look at what had happened in Ireland. A guy there tried to get publicity by saying, “I’m going to be smoking in this pub tonight. Will you come down and get me?” However, there were very few problems with enforcement and the same is true of us now. We have not seen all the details, but, as far as I am concerned, the provision is a further step towards protecting young people and future generations from premature death as a result of ill health, and we should support that.

--- Later in debate ---

[Mr Winnick]

There is the notion that this amendment on the safety of children in cars is an attack on freedom, but as my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger) rightly said, a model society will always need to put various restrictions on what individuals can and cannot do.

Reference has been made to seat belts, and it so happens that I was in the Chamber during the debates on that. I imagine that if the hon. Member for Shipley (Philip Davies) had been present at the time, he would have argued strongly against compulsory seat belts in cars—of course he would have because when I was listening to him today, I heard the authentic voice of primitive Toryism.

[Philip Davies]

Thank you!

[Mr Winnick]

I do not necessarily work on the assumption that whatever the hon. Member for Shipley opposes I should support, Mr Deputy Speaker, but nevertheless that is usually the case.

I was also around when we debated banning smoking in most places, which it was argued at the time was a grave restriction on freedom. Who in the House of Commons today, in 2014, would argue that, apart from the hon. Member for Shipley and a few others? The ban, which was so controversial at the time, has been widely accepted in the country. People said that it would not be accepted and that the law would be broken, but has it been? Where is the evidence that the law on smoking passed in the previous Parliament has been broken?

I accept entirely that it may be difficult to implement the measures that have been suggested on smoking in cars, and I do not underestimate the difficulties. I do, however, say simply that it is worth a try. Every organisation that has been mentioned and is concerned with public health has argued that the amendment should be put into law, as I believe it should be. It provides an opportunity to protect children in the way it describes, and it is likely, however difficult it may be to police, that people will accept that the law has been passed by Parliament, and that there will be a greater desire to ensure that it is observed. This measure is worth a try, and anything that can protect children from the dangers of smoking should certainly be supported tonight.

Tobacco Packaging

Philip Davies Excerpts

Thursday 28th November 2013 Commons Chamber

[Mr Speaker]

Order. We are dealing with an extremely important matter, which I judge as urgent, but we have business questions and two ministerial statements to follow, so the model is what might be called “the Gibraltar model” of Mr Nigel Evans, whereby a good exchange was had, but it was a brief one. I will not be able to accommodate everybody who wants to speak.

[Philip Davies (Shipley) (Con)]

Idiotic, nanny state proposals such as the plain packaging of tobacco are what we expect from the Labour party. What we expect from Conservative Ministers is for them to believe in individual freedom and individual responsibility, and to stand up to the health zealots and nanny state brigade who, if they could, would ban everything and have everything in plain packaging. Will the Minister commit to sticking to those Conservative principles and to ignoring the nanny state brigade of Labour Members?

[Jane Ellison]

I know my hon. Friend feels strongly about this issue, but nobody is banning anything. Were the Government to proceed following receipt of the review, the proposal would be about packaging, not the ability to purchase tobacco. All the sorts of points that my hon. Friend has often articulated were well made during the consultation, which, as he knows, received an enormous response, and all the responses will be made available to Sir Cyril.

--- Later in debate ---

[John Pugh (Southport) (LD)]

The Minister says that this is a complex matter, but I am a bit puzzled. What exactly is the downside of plain packaging, apart from fewer fags being sold?

[Philip Davies]

A left-wing, nanny state wallah like you would not understand.

[Jane Ellison]

The hon. Member for Southport (John Pugh) may be aware that there has been a challenge to the policy in Australia, so it is important to proceed in a measured and evidence-based way.

Tobacco Packaging

Philip Davies Excerpts

Friday 12th July 2013 Commons Chamber

[Anna Soubry]

Well, I could say that the hon. Lady’s party, when it was in government, had 13 years to introduce such legislation. Indeed, I am more than happy to say that. If it was so simple to introduce standardised packaging, why did Labour not do it? It is not as simple as they now try to make out. Most importantly, I believe, Mr Speaker—and I do speak as a lawyer—you always want good legislation that is evidence-based. That is why I am more than content to support a delay, while we wait to see the evidence as it emerges from Australia.

[Philip Davies (Shipley) (Con)]

I congratulate the Government on this decision. The Minister will recall that the last time I raised this subject in the House, she told me that I would see the light, and I am delighted that she and the Government are the ones who have seen the light on this issue. She cherry-picked some numbers of people in favour of and against standardised packaging from the consultation. Could she tell us the figures from the full 688,000 responses? How many of those were in favour and how many against?

[Anna Soubry]

Forgive me; I do not have that information at my fingertips. I am more than happy to supply it to my hon. Friend by way of a letter, or any other mechanism.

The position I have set out is what we now need, and if there is a criticism that I would make, it is that we went to consultation first. All good legislation needs a good, healthy debate, followed by, perhaps, wider consultation. We now need to have that debate, and I am very happy to lead it.

Oral Answers to Questions

Philip Davies Excerpts

Tuesday 11th June 2013 Commons Chamber

[Anna Soubry]

No, it certainly is not, and I have given my views. The hon. Gentleman will know that like many decisions on public health, these are complicated matters. Most importantly, it is vital that we take the public with us. I have said before that I welcome a debate, and perhaps he and the hon. Member for Newport West (Paul Flynn) might come to you, Mr Speaker, and ask for a debate in this Chamber or in Westminster Hall. Let us have the debate, because taking the public with us is always important when we make these sorts of difficult and controversial decisions.

[Philip Davies (Shipley) (Con)]

Does the Minister agree that some of the proposed standardised packaging is more colourful than the existing packaging, and given that we have a display ban on cigarettes, what on earth is the point of having standard packaging for something that cannot be displayed?