Leaving the European Union

Debate between Chris Heaton-Harris and Sarah Wollaston

Monday 1st April 2019 Westminster Hall

[Chris Heaton-Harris]

I hear what the hon. Lady says. We have a Speaker who believes in the evolution of parliamentary process at a very speedy rate, so I am sure there is a way that very popular petitions could get time on the Floor of the House. I do not think anybody would necessarily disagree with that. The process might be slightly more interesting behind the scenes, but that is one for those who deal with those matters.

I thank the hon. Members for York Central (Rachael Maskell), for Bath (Wera Hobhouse), and for Dulwich and West Norwood (Helen Hayes). I will spar one day with the hon. Member for Streatham (Chuka Umunna) on no-deal preparation. Actually, no-deal preparation has gone well—much better than he might care to make out.

[Dr Wollaston]

On no-deal preparation, one thing that has been quite frustrating is the use of non-disclosure agreements—gagging clauses. It is very difficult for the Health and Social Care Committee to assess the extent to which no-deal planning for medicines supplies has been a success, as people have had to sign those agreements. Is the Minister prepared to sweep those out of the way so that we can see whether there is adequate planning for supplies of vital medicines and medical equipment in the event of no deal?

--- Later in debate ---

[Chris Heaton-Harris]

Perhaps the hon. Lady missed the email update last week to 19,000 doctors by Professor Russell Viner, president of the Royal College of Paediatrics and Child Health, who said:

“I know that many of you will have been watching the news about Brexit…with feelings of uncertainty and increasing alarm…I have been considerably reassured by governments’ preparations relating to medicines supplies…governments, the Medicines and Healthcare products Regulatory Agency and the NHS have been working hard behind the scenes…and we believe that our medicine supplies are very largely secured”.

His biggest concern was panic buying. As far as I am aware—I will happily take this up with the hon. Lady offline—NDAs have not been a practice of no-deal preparation for quite some time. I will happily correspond or have a conversation with her afterwards about that, because if she has concerns I would like to bring them into the open a tiny bit.

[Dr Wollaston]

Is the Minister saying that everybody who has been asked not to disclose any issues to do with the supply of medicines is now at liberty to disclose them?

[Chris Heaton-Harris]

I have said what I have said in public, and I will happily take that up with the hon. Lady after the debate.

I also thank the hon. Members for Swansea West (Geraint Davies), for Linlithgow and East Falkirk (Martyn Day), for Hornsey and Wood Green (Catherine West), for Stockport (Ann Coffey), for East Lothian (Martin Whitfield) and for Totnes (Dr Wollaston). The hon. Member for Totnes cited a whole host of reasons why she is allowed to change her mind. I will not go back and quote all the things she said to her electorate in the 2017 general election. I also thank the hon. Member for Bermondsey and Old Southwark (Neil Coyle), and the hon. Member for Edinburgh North and Leith (Deidre Brock), who missed the point that wages are rising ahead of inflation at this point in time, and obviously I thank the hon. Member for Darlington, who informed us about Labour’s whipping.

More importantly, I thank the number of people who have expressed themselves to the Government in the three petitions we have debated, which ask us to reverse the 2016 referendum result, whether by revoking article 50 or holding a second referendum, as well as the exact opposite: that the Government ensure that we deliver the outcome of the 2016 referendum no matter what. The Government’s position remains clear: we will not revoke article 50 and we will not hold a second referendum. We remain committed to leaving the European Union and implementing the result of the 2016 referendum.

Parliament’s position is now also clear. In the series of indicative votes on 27 March, Parliament voted on the options of revoking article 50 and holding a second referendum. Neither option achieved a majority in the House. Indeed, the House voted, with a majority of more than 100, against revoking article 50.

The Government really do acknowledge the substantial number of signatures that these petitions have amassed. We also recognise the hundreds of thousands of people who marched in London on 23 March in favour of a second referendum. In particular—I do not think anyone has done this—I congratulate Margaret Anne Georgiadou, the creator of the revocation of article 50 petition, for starting a petition that, at current count, has attracted more than 6 million signatures. That is a considerable achievement in anyone’s terms.

I want to take a moment to note that I, the Government and, I am sure, everyone in the Chamber, were disgusted to hear the reports that Ms Georgiadou has received threats and abuse for starting a petition. That is utterly unacceptable. Everyone should feel and be able to express their opinions and participate in political discourse without fear of intimidation or abuse. That is integral to our democracy and it should be at the front and centre of our minds when we debate and discuss all issues, including Brexit. It is those democratic values that underpin the Government’s commitment to uphold the result of the 2016 referendum.

Although I have elaborated on this process before, let me do so again, to reinforce exactly why it is that we must uphold the result. In 2015, Parliament voted overwhelmingly to give the British people a choice on whether to remain in or leave the European Union, allowing them to express a clear view to Government. Before we asked them to vote, the Government wrote to every household, committing to implement whatever decision they made.

On 23 June 2016, the British people expressed their view to Government. With nearly three quarters of the electorate taking part, 17.4 million people voted to leave the European Union. That is the highest number of votes cast for any single course of action in UK electoral history. More British people than ever before or since amassed in agreement on a single, clear outcome: they wanted the Government to deliver the UK’s withdrawal from the European Union.

Of course, Parliament also made a commitment to uphold the result of the 2016 referendum. In the 2017 general election, the British people cast their votes again, and more than 80% of voters voted for parties who committed in their manifestos to uphold the result of the referendum.

--- Later in debate ---

[Dr Wollaston]

rose—

[Chris Heaton-Harris]

I will happily give way to all three hon. Members, beginning with the hon. Member for East Lothian.

--- Later in debate ---

[Chris Heaton-Harris]

I do not think that I was blaming hon. Members collectively. I was just making a point about what people might well have expected. It is not just the Government but many colleagues who stood on manifestos promising to uphold the result of the referendum who have an obligation and mandate to do so.

[Dr Wollaston]

Does the Minister agree that it was the publication of the manifesto that was the tipping point for the Conservatives, and it was all going quite well until then, when things fell off a cliff? That was my experience.

[Chris Heaton-Harris]

The problem is that people sometimes do not like it when politicians say one thing and do another. We all recognise that, and it is a difficulty that we all might have at some point in the future. What if a Member goes round during a general election campaign saying

“this constituency voted by 54% to leave. I think this is one of the things that annoys people, is telling them that they didn’t know what they were voting for. That was the purpose of the referendum, we accept the result…We have to go into this, absolutely understanding that the principle here is that we respect the outcome of the referendum and I think it would be a huge mistake to go into this promising that I’d be prepared to vote to actually overturn the deal and send us back into Europe”?

That is what the hon. Lady said to her constituency.

No-deal EU Exit Preparations

Debate between Chris Heaton-Harris and Sarah Wollaston

Wednesday 20th March 2019 Commons Chamber

[Chris Heaton-Harris]

Yes, I can confirm that we have signed a whole suite of aviation agreements and that is the case.

[Dr Sarah Wollaston (Totnes) (Ind)]

There is a good reason why this House has resoundingly objected to and rejected a no-deal Brexit: because Members here have looked at the evidence of the real-world harms. Just one such area of concern is the position of healthcare for British citizens who are pensioners who have retired to countries across the European Union. The Minister will know that a reciprocal arrangement could not be made with the EU as a whole but would have to be made with 27 individual countries. Can he set out in how many of those 27 countries our fellow citizens who have retired to the EU now have the absolute certainty that in nine days’ time they will have reciprocal healthcare arrangements in place?

[Chris Heaton-Harris]

Actually, a whole host of countries are now enacting legislation through their processes to do exactly as the hon. Lady says. The hon. Lady is completely correct in the fact that health in general terms is tied up in social security policy in nearly all EU member states. This needs legislation in individual EU member states, and I believe—I will write to the hon. Lady later today to clarify this—that pretty much every member state has started that legislative framework process.

Oral Answers to Questions

Debate between Chris Heaton-Harris and Sarah Wollaston

Thursday 19th July 2018 Commons Chamber

[Chris Heaton-Harris]

I am afraid that I do not recognise the basis for the hon. Gentleman’s question—I do not believe that in the slightest. I can only point out to him that a group of people called the “cybernats” were not particularly pleasant in the run-up to the Scottish referendum.

[Dr Sarah Wollaston (Totnes) (Con)]

Crashing out with no deal looks increasingly likely, particularly as former members of the Government have stated that they intend to undermine a deal. What is needed now is a plain English guide to the consequences of no deal for individuals, families, communities and businesses. Will the Minister commit himself to publishing such a guide so that people can see the consequences and step away from the edge of the cliff?

Access to Medical Treatments (Innovation) Bill

Debate between Chris Heaton-Harris and Sarah Wollaston

Friday 16th October 2015 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

Would my hon. Friend accept that such a database could be set up anyway, without this Bill, and that what is really needed if we are to record medical innovations is adequate funding? This does not require legislation.

[Chris Heaton-Harris]

I shall come to that point in a moment.

When this idea was introduced during the passage of Lord Saatchi’s Bill, it was not a novel one. Several of the royal medical colleges, among others, had already called for such a database. The Academy of Royal Medical Colleges has recently stated that it believes that there should be

“an explicit requirement for the results of an innovation to be properly recorded with the outcomes made available to clinical colleagues for scrutiny and learning…The Academy believes that this is an essential requirement.

The Association of Medical Research Charities has said of data collection:

“This is a key aspect of innovation since new interventions require an evidence base to demonstrate safety and efficacy and to ensure effective uptake in practice.”

[Chris Heaton-Harris]

I will continue, if my hon. Friend will allow me, because in the depths of my speech I shall come to that point and go into detail about how this will work. I am simply proposing to confer on the Secretary of State the power to establish this process, and I hope to be able to give my hon. Friend a detailed answer to his question in due course.

The Royal College of Surgeons has stated:

“The value of innovation is severely diminished if we cannot learn from it. Registration of the results of an innovative treatment, whether positive or negative, ensures that clinicians can consider the data to learn from mistakes or spread instances of good practice.”

[Dr Wollaston]

My hon. Friend has quoted a number of organisations. Does he accept that all those organisations oppose the Bill? He needs to make that explicit to the House. It is not fair to quote the Royal College of Surgeons, for example, without making it clear that it has explicitly opposed this Bill.

[Chris Heaton-Harris]

I would like to think I am making the point that although we all recognise that we need to encourage innovation in the NHS, and there is tons of it going on, it is not captured in a way that is easily spread throughout the NHS. All the royal colleges I am citing, which do not like parts of this Bill, do accept the concept of spreading innovation, which is something I am trying to do through this Bill.

The Royal College of Psychiatrists has said that

“a register that is available to other doctors would allow sharing of knowledge about a potential innovation and this would be beneficial.”

The Royal College of Physicians add to the list, by stating:

“Innovation relies on a culture of knowledge sharing and a collaborative environment that stimulates ongoing improvement.”

The concept of innovation being spread is welcome throughout the medical community, and I hope to capture it in this Bill. A way of encouraging and recording innovation, and spreading knowledge about it throughout medicine, is widely recognised by most of the royal colleges as being a solidly good thing.

That is also recognised by individual doctors, patients and families. It seems that most people know and understand that there is a need for a culture change in knowledge-sharing and the reporting of success and failure. In researching for my Bill, I was told a story by a dad named Alex Smith, and it is as follows:

“Four years ago, my wife Donna and I were told by a paediatrician to take our son Harrison, who had been diagnosed with Duchenne Muscular Dystrophy, home, love him, give him a good life, there’s nothing we can do, he’s going to die.

How is it possible that our specialist doctors and GPs were, AND STILL to this day are, not willing to try something to help save our son’s life?...every day something we all take for granted as simple as opening a jar is taken away from him, in the last month alone his ability to get off the floor unaided has almost left him and one day in the not-too-distant future his ability to breathe and his heart to beat will be taken away and we will lose him, way, way too soon.”

Mr Smith believes:

“With a robust framework to allow our doctors to innovate safely and responsibly and share that data, the chance to save this generation could become a reality.”

It therefore should come as no surprise that an idea that has been called for by so many worthy and excellent minds, including people such as Alex, Donna and Harrison, who are facing such horrendously difficult times, should be taken up by a legislator, especially given that for decades this simply has not happened.

--- Later in debate ---

[Dr Wollaston]

As my hon. Friend the Member for Daventry pointed out, many of these bodies would like to have such a register, but they would also like to be able to guide how it should look and to have it within the existing research framework.

The Bill suggests that doctors are not already innovating, and that this is about fear of litigation. The original Bill was based on the premise that fear of litigation was stopping innovation. In fact, the position is very clear if we read what a number of bodies have said. My hon. Friend quoted some individual examples, but the vast majority of opinion from the medical community and the research community is that, genuinely, it is not fear of litigation that stops innovation. Every aspect of this Bill is based on a false premise, I am afraid. I do not want to detain the House by reading out all the various quotes on why the fear of litigation does not stop innovation, but he will know that that is the case.

We face the danger of confusing the existing legal framework. Many have expressed their concern that we will end up with a sort of Heaton-Harris defence for those who have undertaken perhaps rather dangerous experimental treatments billed as innovation. My hon. Friend cited the case of the children who suffered from Duchenne muscular dystrophy, and that is very sad, but the Bill has an underlying assumption that all innovation is a good thing whereas the lesson of history is that it can be extremely dangerous and harmful. We need to be very careful about what we mean by innovation, and to accept that there are also very dangerous innovations. If, as a result of this well-intentioned Bill, we inadvertently end up with people being, in effect, experimented on by irresponsible doctors who are able to get off scot-free, we will have to come back to this place and amend it.

I would like to give my hon. Friend an example based on the case of somebody from my constituency who wrote to me to say that he was concerned that the Government were not doing enough with regard to experimental treatments. His specific example was a bogus treatment called GcMAF. The company promoting this entirely bogus treatment—it has a number of clinics in Europe and Guernsey—is very concerned that it cannot use it in this country because it is prevented from doing so by the current legislative environment. Well, jolly good. It puts out literature saying

“we state that if you have terminal stage 4…cancer, have not had chemotherapy, and you do the GcMAF protocol, you have an 80% chance of being cancer free in a year.”

That is the kind of claim that such doctors put out. In other words, the company is not only promoting its own product, but actively discouraging people from having a treatment that could help.

[Chris Heaton-Harris]

My hon. Friend is surely making the case for the database because successes and failures would have to be recorded. She would therefore be able to benchmark and see the evidence behind such a claim. A company cannot choose just to record successes on the database.

[Dr Wollaston]

I must say that I do not think my hon. Friend understands how this works. Companies will simply direct people to their successful treatments. Yes, they may have to record their failures as well, but it is only by comparing the results for bodies of patients having such treatments that people can see whether treatments are entirely bogus. This company cannot currently operate in the UK—quite rightly—and I am afraid that we would see this kind of bogus treatment.

My hon. Friend’s Bill would require doctors who want to undertake so-called innovative treatments to consult at least one other doctor. Seven doctors operate in the clinic concerned. We can see how, if a doctor is working in a clinic with others who are profiting from bogus treatments, it will be very easy for them to pop down the corridor and get one to agree that their bogus treatment is an absolutely fantastic treatment for cancer.

I am afraid that the Bill is based on a false premise, and such a randomly searchable database of unconnected treatments is very dangerous. In addition, if someone wants to start a trial of a new product but there are one or two examples on the database of the treatment not working, the Bill might inadvertently end up killing off a potentially useful treatment. Such things need to be established as part of a research trial. Databases that are randomly searchable by the public will be an absolute quacks charter.

--- Later in debate ---

[Chris Heaton-Harris]

My hon. Friend will know—in fact, we had a meeting about this just before the Bill was first drafted—that I do not tackle research in the Bill; it is specifically excluded. She will know that learning from failure is one of the most important things people can do. She will know that she is describing doctors not acting responsibly, but my Bill does nothing to change the current position: if a doctor acts irresponsibly, the full weight of medical negligence legislation will still come down on top of them. She is painting a picture that simply will not and could not exist if the Bill comes into force.

[Dr Wollaston]

I am afraid that I disagree. My hon. Friend’s Bill would not allow us to learn from failure. We learn from failure through medical research. He says that it will not undermine medical research, but I have read him a long list—I am happy to read it out again—of members from across the entire research community who are deeply concerned that it will undermine research for the reasons I have set out.

If someone was absolutely desperate—as in the very tragic case of the family my hon. Friend cited—and was persuaded not take part in a clinical trial by an unscrupulous doctor, why would they do so? They would mortgage their house to go to such a clinic if it persuaded them to do so, thinking that it was their best hope of a cure. The fact is that that hope is likely to be dashed. They are best off going to an established research community.

The Bill will undermine recruitment to clinical trials. Although my hon. Friend does not mention medical research, very vulnerable people will end up circumventing genuine medical research. He will set back the progress of science, and when that comes to pass we will have to come back to the House to amend the legislation. I very much regret that he has been persuaded to take up this Bill. He knows of the long list of members of the research community who are profoundly opposed to it, for the reasons I have set out.

I urge the Government to be very clear that they support medical research and that they want genuinely to move forward on that basis. My hon. Friend the Minister is right to be looking at the accelerated access review. Let us use that review to look genuinely at the barriers to research and to getting products rapidly into use for NHS patients.

I urge colleagues to read the briefings on their desks from the entire research and medical community, and robustly to reject the Bill.