Oral Answers to Questions
Debate between Cat Smith and Baroness Laing of Elderslie(1 year ago)
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Madam Deputy Speaker (Dame Eleanor Laing)
Order. We have been here 20 minutes and have covered only two questions. We have a huge amount of business to get through, so can we please go faster? I would like brief questions and brief answers.
Cat Smith (Lancaster and Fleetwood) (Lab)
Independent Medicines and Medical Devices Safety Review
Debate between Cat Smith and Baroness Laing of Elderslie(3 years, 5 months ago)
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Cat Smith (Lancaster and Fleetwood) (Lab) [V]
As I am chair of the all-party parliamentary group on valproate and other anti-epileptic drugs in pregnancy, my comments are on that issue. However, I just want to note the harm done, the hurt caused and the justice needed for victims of surgical mesh and Primodos, who are in a similar position to those who have been harmed by sodium valproate.
One of the common threads that runs through all three campaigns is the way in which, more often than not, it is women who are the victims and it is women’s concerns that have been dismissed. Justice, frustratingly, always seems just out of reach.
One year on from the report’s publication, we really are not much further forward when it comes to sodium valproate. NHS England wrote recently to all women and girls aged 12 to 55 who are currently prescribed sodium valproate, reminding them of the risks of taking it while pregnant. That is a step in the right direction, but it has taken a year. One letter is not going to resolve the issue. The Government really must explain what further action will be taken and over what timescale.
Baroness Cumberlege’s report included nine general recommendations, in addition to a number of specific recommendations on sodium valproate. In January, the Minister provided the Government’s initial response to the recommendations. However, she only responded to the general recommendations and not the specific recommendations on sodium valproate. The Government have since stated on a number of occasions that they will respond in full later this year. Do the Government still plan to make a full response this year and will they address the report’s specific recommendations on sodium valproate?
I have a few brief comments about recommendations 3, 4, 5 and 9 of the report, before turning to the specific recommendations on sodium valproate. I would appreciate an update from the Minister.
Recommendation 3, which is for a new independent redress agency for those harmed by medicines and medical devices, has not been implemented, and it appears that the Government are unwilling to do so. May I express how hugely disappointing that is, given the avoidable harm that so many families have experienced? The case for an independent redress agency remains strong. Other countries have successfully set up an agency without such a mechanism, and people who have suffered avoidable harm following healthcare treatment have no option but to go to court, which is such a lengthy, expensive, confrontational and stressful process.
On recommendation 4, although the Government have stated that they are carefully considering a redress scheme for those harmed by sodium valproate, no further progress has been made. Again, I feel so disappointed, and I know that the families affected share that feeling. Patients who have suffered avoidable harm need help and support now, and actually we owe it to them. That may take the form of additional financial support, above and beyond that to which they are already entitled via welfare benefits and respite care. The frustrating thing is that many have already waited decades for help. What progress is being made to establish a redress scheme for those affected by sodium valproate?
On recommendation 5, again there has been no progress on establishing any specialist centres for those adversely affected by medicines taken during pregnancy. The Department of Health and Social Care appears to take the view that such centres are not needed. I therefore call on the Government to commit to introducing a network of such specialist centres, in recognition of the additional support and care that those affected require.
Recommendation 9 is that the Government should immediately set up a taskforce to implement the review’s recommendations. The Government have been quite clear that they have no plans to establish such a taskforce. The 14-person patient reference group that has been established had a series of meetings this year and will publish its findings shortly. I look forward to reading them, but the group is only able to provide feedback on proposals, whereas a taskforce would have been able to implement the recommendations. The Government really need to explain how they intend to keep patients fully involved as they move forward with full implementation of the report.
On the sodium valproate recommendations, the Government have not responded directly to any of these recommendations, and quite frankly they need to. More importantly, they need to implement them. On the recommendation that a clear process should be agreed to ensure that women can receive counselling related to their epilepsy treatment and contraception choices, at the moment it is a postcode lottery, so what progress is being made to ensure that women and girls with epilepsy have access to pre-conception counselling on epilepsy medicines and contraception?
On the recommendation that information should be collected to identify those already affected by exposure to valproate to ensure that they have access to diagnosis and support and plan their service provision, it is still not sufficient, especially without the redress scheme in place. May we have a response to that recommendation, please?
On the recommendation that a prospective registry should be established for all women on anti-epileptic drugs who become pregnant, and to include them in mandatory reporting of data relating to them and their children, such a registry could be expanded to collect data on paternal effects as well, but at the moment we are just looking at valproate. The valproate registry has been established, and it has been confirmed that other epilepsy medicines will be included, but that has not happened yet. It needs to be expanded to include those other epilepsy medicines as a matter of urgency, because we already know that anti-seizure medication is causing problems during pregnancy.
On the recommendation about stakeholders continuing to work with the patient groups to monitor and improve the pregnancy prevention plans and look at the next steps, all women and girls of childbearing potential have been written to, as I said at the start of my contribution, but we really need to do so much more to improve the PPP. It is important that a balance be found that allows women to make a choice about their treatment and care, while limiting the number of pregnancies exposed to sodium valproate and other harmful epilepsy medicines. May I ask the Minister what progress has been made in making improvements to the PPP?
The final recommendation on sodium valproate is:
“Clinicians should continue to follow guidance regarding prescribing of valproate and alternatives”.
Although further measures have been introduced to communicate the need for that, it is unclear—perhaps the Minister can shed some light—whether or not it is happening in practice, particularly given past concerns about the lack of communication with women and girls. That is a huge concern for me, as I know it is for many of the campaigners involved.
This is not the first time that I have raised the issue in the House. I put on record my thanks to my constituent Janet Williams and her fellow campaigner Emma Murphy for bringing the scandal to my attention in my first few weeks as an MP. Since then, I have learned so much about sodium valproate and epilepsy. I also put on record my thanks to Daniel Jennings from Epilepsy Action for his support in keeping me abreast of this and other issues that people with epilepsy face.
The challenges that women seeking pregnancy face while managing their epilepsy are not just about sodium valproate. Evidence shows that there are a number of other anti-epilepsy drugs that can cause preventable disabilities in babies when taken by their mothers. We must not forget the women impacted by other anti-epilepsy drugs. We cannot go on seeing history repeat itself. Anyone watching this debate who is in that situation might want to seek out the Epilepsy Society’s “Safe Mum, Safe Baby” campaign.
The Government need to consider funding research into safer epilepsy medicines so that babies will not be born with preventable disabilities caused by their mothers’ life-saving drugs. Some important progress has been made, but there are far too many areas in which we are still waiting for action and further response from the Government. It is deeply concerning that the Government have so far chosen not to respond to the specific recommendations on sodium valproate, because it took six months before they produced their initial response to the Cumberlege report, and after a further six months we are still waiting for their full reply.
Madam Deputy Speaker (Dame Eleanor Laing)
Before we go any further, may I make an appeal to hon. Members who are speaking from home to remember that those who are here in the Chamber still have to get back to their constituencies this evening—and that usually that which can be said in 10 minutes can be said more effectively in five or six?
Elections: May 2021
Debate between Cat Smith and Baroness Laing of Elderslie(3 years, 11 months ago)
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Cat Smith
It is a pleasure to see the Minister respond to the urgent question. I wish her well with her continued recovery.
As the Minister set out, elections have been suspended for more than a year, and a record number of polls are now set to take place on the same day, with every elector able to cast a ballot in one election or another. It is deeply disappointing that the Government have failed to provide clarity on how these polls will be covid-secure.
Clarity is urgently needed by local councils, electoral staff, candidates, campaigners and, of course, the public. This is yet another example of the Conservative Government being too slow to act. Ministers have had many months to make the necessary changes to protect our democratic process. Instead, they are treating these elections like business as usual. Across the world, countries have demonstrated that elections can take place safely with the right safety measures in place. National elections were held in the US, New Zealand, Singapore, Iceland and Lithuania last year. Labour has consistently called for safer voting methods to be introduced, including voting over multiple days and an all-postal ballot. Will the Minister explain why the Government have taken no action so far? Will she also confirm whether the Conservative party chair took advice from Conservative party candidates about the timeframe for a possible delay? The scheduling of elections should come above party political advantage.
Will the Minister confirm, in no uncertain terms, that these elections will not be postponed in an irresponsible, last-minute U-turn? Unless councils are informed of changes in good time, unnecessary expenditure will be wasted on the printing of poll cards and other preparatory work. Given the crippling Government cuts, councils simply cannot afford to be caught on the hoof here. Electoral staff have expressed deep anxiety about running these elections safely without additional funding, so will the Minister produce clear guidance and training for local authorities about how to make polling stations and the count covid-secure?
High numbers of electoral staff are volunteers, with many in the high-risk category under covid-19 guidance. Does the Minister expect at-risk people to risk their health to support the safe running of these elections? The Welsh Labour Government have been working to ensure that elections can still go ahead safely. What steps have the Government taken to co-operate with the devolved nations? Finally, does the Minister share my concern that the Government’s lack of preparation will force many people to choose between their health and their right to vote?
Madam Deputy Speaker (Dame Eleanor Laing)
Before I call the Minister to answer, let me say that the hon. Lady took rather longer than the time allocated to her. I simply warn everyone taking part in the statement today that I will not allow long questions or speeches from people who are meant to be asking questions. I know that the Minister will give short answers. I am determined that in one hour, we will get all 25 people on the Order Paper in to ask their questions. If we do not, those who do not get to ask their question can blame those who took too long in asking theirs.
Point of Order
Debate between Cat Smith and Baroness Laing of Elderslie
Cat Smith (Lancaster and Fleetwood) (Lab)
On a point of order, Madam Deputy Speaker. I seek your guidance. I am sure you are aware that the Cabinet Office has a role in co-ordinating the cross-governmental response to climate change, including the greening government commitments and the UN sustainable development goals, and is responsible for procurement across Government, which obviously relates to sustainability. We have discovered that in Cabinet Office questions this morning the Cabinet Office decided to unilaterally withdraw from the Order Paper one question that had been drawn four times, each having been submitted by a Labour Member. The question was about what steps the Department was taking to facilitate cross-governmental co-operation on tackling climate change. The Opposition had approached the Table Office, and it confirmed that the question would be in order, but the Department decided to unilaterally withdraw it. I seek your guidance, Madam Deputy Speaker, as to how we can ensure that questions are in order. If the Table Office say they are, is it okay for Departments to unilaterally decide they are not?
Madam Deputy Speaker (Dame Eleanor Laing)
I thank the hon. Lady for her point of order and for having given me notice of her intention to raise it. It is not for the Chair to interfere in such matters, of course, but it is for the Chair to make sure that Members are given proper answers to any question they ask and that Departments are accountable to Parliament and therefore to individual Members of Parliament. [Interruption.] We really do not need commentary from the Back Benches while I am giving a polite answer. I have never known a point of order to be heckled like that.
The short answer to the hon. Lady’s question is that it is perfectly in order for Departments to decide which Department is responsible for any matter a Member raises, be it in a written question, an oral question, a letter to a Minister, and so on. It is quite normal for a Department to say that a matter cannot be properly answered by one Minister but that it could be answered by another. Even where the Table Office might have said that a matter is properly for one Department, that Department has every right to transfer it to another one.
That said, if the hon. Lady or the four Members who tabled questions they thought would be answered publicly this morning do not get answers in a timely fashion, please come back and draw it to the attention of the Chair, because the Chair is concerned that Members have their questions properly answered. I hope that helps the hon. Lady.
Overseas Electors Bill
Debate between Cat Smith and Baroness Laing of ElderslieFriday 23rd February 2018
(6 years, 10 months ago)
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Madam Deputy Speaker (Mrs Eleanor Laing)
Order. The hon. Gentleman has intervened several times. He must talk about the Bill, not about other matters.
Cat Smith
Thank you, Madam Deputy Speaker. My hon. Friend’s intervention was particularly about the capacity of local elections offices. Were the Bill to be successful, the impact on local elections offices in councils up and down the country would be huge, because the process of registering an overseas elector can take around two hours. If those offices were to see a huge increase in the number of overseas electors registering at a time when local councils have had huge funding cuts, the pressure would be absolutely huge.
There was further evidence in June about how under-resourced election staff are. My hon. Friend the Member for Newcastle-under-Lyme (Paul Farrelly) described the issues on polling day as “a shambles”. Significant issues also occurred in Plymouth, with hundreds of voters unable to cast their votes in the June general election. An independent investigation found that 35,000 postal vote holders had received two polling cards—a postal vote polling card and a polling station card. In addition, 331 people who received a polling card that was issued on 5 May were removed from the register after that point.
These failings clearly illustrate that more action must be taken now to deal with the increasing challenges that returning officers face in delivering elections effectively. Those concerns have been raised on multiple occasions by the Association of Electoral Administrators, which has called on the Government for a
“full and thorough review of the funding of the delivery of electoral services…as a matter of urgency”.
Not only is that impacting on voters, but it might also be having a significant impact on the health and wellbeing of electoral administrators and the public servants who work in local elections offices. Following the 2017 general election, the Association of Electoral Administrators wrote that
“we have collectively been concerned for the health and well-being of…our members”.
As a result, the AEA contracted the Hospital and Medical Care Association to provide members with free-of-charge access to confidential counselling services. That is not an indication of healthy elections offices up and down the country.
In the context of austerity, we cannot allow the Government to dismantle our electoral system any further. The existing provision of checking registration against electoral registration officer records within 15 years is already a challenging and resource-intensive process. Some applications contain vague or incorrect previous addresses, which can cause problems in checking the register—so much so that the Association of Electoral Administrators has estimated that it takes roughly two hours to register one overseas elector. Because overseas electors fall off the register after 12 months, the vast majority of registration applications occur immediately ahead of a general election, when the pressure on electoral administrators is at its most intense.
Abolishing the 15-year rule, and therefore presumably increasing the number of British citizens overseas who can register to vote, would completely overstretch electoral administrators, who are already being pushed to the limit. In addition, the requirement to keep copies of previous revisions of registers for more than 15 years, whether in data or in paper format, will have a resource implication in the form of increased ICT server capacity or physical storage area.
In the light of those concerns—
Paul Flynn
On a point of order, Madam Deputy Speaker. As we appear to have passed the point at which it would have been possible to consider the next Bill, I want the House to know that there will be a public demonstration outside in which democracy will work, and we will have a debate on the cruel effects of the present law on young children and those in serious health difficulties, including a young boy who is suffering, and whose parents are suffering, in a terrible way. What has happened here today has been a filibuster organised by one party, and I am ashamed to say that I am a member of that party—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. I allowed the hon. Gentleman to make a point of order about his Bill—although he knows that it was not a point of order—because I appreciated that he had a point to make, and I allowed him to make it. However, I will not take from him criticism of the Chair through the use of the word “filibuster”.
Cat Smith
Let me return to the Bill. I want to ask the Government three questions. Have they any indication of how many of the estimated 5 million Britons living abroad would apply to be overseas electors in the run-up to a UK parliamentary election or national referendum if the 15-year rule were removed? How do they intend to fund EROs for the additional costs incurred by these proposals? What steps will they take to ensure that election teams have the resources and the capacity to manage the increased volume of electors?
The devil is also in the detail, which the Government have failed to provide. According to the Bill, an overseas voter will qualify as a resident if
“the person has at some time in the past been entered in an electoral register in respect of an address at a place that is situated within the constituency”.
However, many questions remain unanswered.
If an overseas elector was registered at a previous address but then moved to a different address before leaving the UK where they did not register, at which address should they register to vote? As time goes by, potentially over several decades, it could be very difficult for EROs to check previous revisions of registers owing to ever-changing localities. Problems include local government reorganisation, polling district and ward boundary reviews, the demolition or redevelopment of properties, street renaming, house renumbering, and limited availability of local authority records. Can we seriously expect someone who has not lived in this country for 40 years to remember the exact date on which they were last registered to vote, and the precise address at which they lived? I think not.
I also question whether the current deadline to apply to register as an overseas elector and make absent voting arrangements is sufficient, in the context of abolition of the 15-year rule. The Association of Electoral Administrators has urged the Government to consider bringing forward the voter registration deadline for overseas electors to allow sufficient time to process and check previous revisions of registers. What steps will the Government take to address those concerns?
Not only is the likelihood of error extremely high, but we are leaving our democracy wide open to potential fraudulent activity. In response to the Cabinet Office policy statement about overseas voters, the Association of Electoral Administrators warned that scrapping the 15-year rule would increase the potential for electoral fraud. Under the Government’s proposals, applicants who cannot provide a national insurance number or UK passport could have their identity verified by another registered overseas elector using an attestation. That would be a signed written statement from another British citizen who was registered to vote in the UK. Can we honestly expect this to be sufficient security to prevent fraudulent applications? When the attester as well as the applicant live abroad, what is the likelihood of a false declaration resulting in prosecution proceedings? My guess is, very low.
There is also no way of checking whether an overseas voter is living at the stated address abroad. Overseas voters who owned and lived in more than one home could register more than once and we would have no way of knowing whether people were registered multiple times.