Diabetes: Artificial Pancreas

Debate between George Howarth and Keith Vaz

Wednesday 12th December 2018 Commons Chamber

[Mr Howarth]

I am glad that the right hon. Gentleman, who has a background in these matters, has drawn attention to the distinction between type 1 and type 2 diabetes. That is not to say that one is superior to the other, but they are two entirely different conditions brought about by entirely different circumstances. As I said in opening my speech, type 1 diabetes is an auto-immune condition. Nobody is entirely sure what triggers it in some people, but those in whom it is triggered have some predisposition towards the condition.

[Keith Vaz (Leicester East) (Lab)]

Will my right hon. Friend give way?

[Mr Howarth]

I have not quite finished answering the right hon. Member for Hemel Hempstead (Sir Mike Penning). It is particularly important to draw the distinction for young people because, often, young people with type 1 diabetes are bullied very cruelly on the basis that their peers in school accuse them of having brought it on themselves by eating too many sweets or too much sugar. Of course, that is complete nonsense, but that does not stop that kind of bullying taking place.

[Keith Vaz]

I congratulate my right hon. Friend on securing the debate and on being a champion for those with diabetes throughout his parliamentary career. Can I take him back to the issue of structured education, which is one of the great pillars of diabetes care? We do not do it well enough and we do not give those with type 1 diabetes enough support. Does he agree that it is important to ensure that all CCGs give proper consideration to who delivers that kind of education? It should not be delivered by anyone other than those with the expertise to deliver it.

[Mr Howarth]

Yes. I pay tribute to my right hon. Friend, who does a massive amount of work as chair of the all-party group on diabetes. He is very knowledgeable on the subject and the issues involved, and he is of course right. I think I had already said more or less the same thing as he just said, but obviously I agree with myself and with my right hon. Friend.

Let me move on to the digital solutions, such as apps, which could offer platforms to deliver education in a convenient and personalised format. I should add the rider that mobile apps need to be safe, reliable and accredited to be clinically safe. It worries me that some apps out there are produced commercially but do not contain wholly accurate information. It is unsafe to rely on apps that are not properly accredited and that have not been assessed and evaluated by experts who know what they are talking about.

In addition to the low uptake of structured education, the number of specialists working in diabetes care is falling. Between 2010 and 2012, there was a 3% fall in the number of NHS sites that employ any diabetes specialist nurses. Anyone who has any experience of dealing with young people with diabetes will know that nurse specialists are often the very best possible source of advice.

In the light of this shortage, a national network of centres—possibly between eight and 10 expert diabetes technology centres, supported by virtual clinics—could well be a potential platform for the development of more effective structured education for patients, and for professionals as well. I shall say more about that in a moment. Such a network would be helpful for training future generations of diabetes clinicians effectively to provide artificial pancreases, and in the development and evaluation of new technologies.

One of the problems that type 1 diabetes sufferers tell me that they experience is the merry-go-round of different services that they have to access. They may have a problem with neuropathy, or a foot or eye problem, but they cannot access all those services in one place. Many diabetologists, although brilliant at dealing with the diabetes side of the problem, are not equipped to deal with young people who have, for example, psychological problems. All the services need to be better integrated.

Debate on the Address

Debate between George Howarth and Keith Vaz

Wednesday 21st June 2017 Commons Chamber

[Keith Vaz (Leicester East) (Lab)]

It is a pleasure to follow the hon. Member for St Albans (Mrs Main). I congratulate her on her fourth election victory. I am glad, because she will continue the outstanding work that she does for the all-party group on Bangladesh.

Congratulations to you, Mr Deputy Speaker, on your seamless elevation to the Chair. We welcome you to your position. I am honoured again to be returned—

[Mr Deputy Speaker (Mr George Howarth)]

Order. May I say, for the sake of completeness, that it is a purely temporary phenomenon?

[Keith Vaz]

I hope I get an extra minute for that.

[Sir Peter Bottomley]

On a point of order, Mr Deputy Speaker. Do you or your Clerk know whether an intervention by the occupant of the Chair adds a minute to the time of the Member speaking?

[Mr Deputy Speaker]

I am lost for words, and that is most certainly not a point of order.

[Keith Vaz]

Lost for words for the first time, I think, Mr Deputy Speaker.

I am honoured to be returned yet again—for the eighth time—to the House. I am delighted to be joined, representing the city of Leicester, by my hon. Friends the Members for Leicester South (Jonathan Ashworth) and for Leicester West (Liz Kendall). I stand here today having listened to a number of excellent speeches. Looking back on my three decades in this House, I do not remember a time of such political instability. I hope that the Gracious Speech and the scrutiny that this House will give it will enable us to get at least some legislation through in the next two years.

Terrorism has hit the streets of Britain three times since the House was last in session: in Manchester, at London Bridge and only this week in Finsbury Park. The commitment that has been made by the Prime Minister, and supported by the Opposition, that we put communities at the heart of dealing with counter-terrorism is the right approach. The Prevent strategy, which has been in operation under successive Governments, does need to be reviewed. We clearly need a strategy, but unless we put our communities at the forefront of trying to deal with terrorism, we cannot hope to succeed. It is important, especially at this time, that we choose our words very carefully indeed.

I pay tribute to the chief constable of Leicestershire, Simon Cole, for his work on counter-terrorism. He is the Prevent leader for the police. We in Leicester are a city of many cultures, races and religions. We live in harmony, apart from a small disorder last Sunday: after Pakistan beat India there was much activity on the Belgrave Road, but I hope very much that that was a one-off. Normally, however, all communities work very well and closely together.

In the context of counter-terrorism, it is important to raise the issue of policing. The threat to policing mentioned by the head of counter-terrorism, Mark Rowley, in his letter to the Home Secretary today is an important point. It is right that the Government have protected the counter-terrorism budget over the past few years but, as we all know, information is gathered at a local level and it is vital that the Government publish the police funding formula, for which we have been waiting for over a year.

In Leicestershire, we have lost 547 police officers since 2009—that is a reduction of 23%. In 2006, there was one police officer for every 430 people; now we have one for every 599 people. Despite the excellent work of the chief constable and his team, the police and crime commissioner, Willy Bach, and his deputy Kirk Master, they are still awaiting the formula, but without that formula, they simply cannot plan.

I join other Members in recognising the tragedy of the Grenfell flats fire and the fact that that obviously has an implication for all our constituencies in which we have high-rise accommodation. The Government must act quickly to deal with these issues so that people can be reassured that something is being done to protect them. I join the Leader of the Opposition and others in commending my hon. Friend the Member for Kensington (Emma Dent Coad) on the work that she has done.

Brexit will, of course, dominate proceedings over the next two years. I hope that, as a matter of urgency, we will clarify the position of EU citizens. Some 3 million EU citizens live in the United Kingdom. My constituency has 10,000 people who have come from the EU—the majority hold Portuguese passports—and they are very anxious about whether they will be allowed to remain in the United Kingdom. Of course the Government have said they want them to stay, but unless we get that in writing, it will not satisfy them.

There are practical difficulties, too. I am glad to see the former Immigration Minister, the hon. Member for Scarborough and Whitby (Mr Goodwill), on the Front Bench, because this was raised by the Home Affairs Committee in the last Parliament. Some EU citizens have arrived with identity cards but without passports, while others have passports. When they make their applications for indefinite leave, it will be important that the practicalities are taken into consideration. We in this place have suggested that the registration should perhaps be done at a local level through local authorities, rather than through a process of writing to the Home Office because, as we know, it takes a great deal of time for it to reply.

Diabetes Care

Debate between George Howarth and Keith Vaz

Thursday 3rd March 2016 Commons Chamber

[Keith Vaz (Leicester East) (Lab)]

Thank you, Mr Deputy Speaker, for giving me the opportunity to debate this important matter. I begin by declaring my interests as a type 2 diabetic and chair of the all-party parliamentary group for diabetes. In 2007, I founded the diabetes charity Silver Star, and I am an active and passionate supporter of Diabetes UK and JDRF—the Juvenile Diabetes Research Foundation—both of which provide secretarial services to the APPG. I would argue that we currently have the best diabetes Minister we have ever had, and I am glad to see her on the Front Bench today. I would like to thank her and her diabetes tsar, Jonathan Valabhji, for all the work that they do.

Diabetes is one of the most important health challenges facing the NHS and indeed the world. Sometimes we get immune to the facts, even though they are so devastating: 3.5 million people in the UK have been diagnosed with diabetes; 700 people a day are diagnosed with the illness; by the end of this debate 15 more people will have been diagnosed with diabetes—that is one every 2 minutes; and it is estimated that by 2025 some 5 million people in the United Kingdom will have diabetes.

Despite the good intentions of the Government, the passion of practitioners and the interest of many Members of this House, I am worried that the prevention, diagnosis and treatment of diabetes is not high enough on the agenda. One in five hospital admissions for heart failure, heart attack and stroke are people with diabetes. Diabetes is responsible for more than 135 amputations a week, four out of five of which are avoidable. Diabetes is the leading cause of preventable sight loss and the most common cause of kidney failure. Every year, more than 24,000 people die prematurely due to diabetes.

[Mr George Howarth (Knowsley) (Lab)]

I echo my right hon. Friend’s comments about the Minister. He cites statistics, and on the amount of money that is spent on diabetes, £7 billion of the NHS budget is spent on dealing with the avoidable complications to which he has just referred. Yet Department of Health spending on research into diabetes through the UK’s Medical Research Council is just £6.5 million, which is by far the lowest level of almost any developed country. Does he think there is a connection between those two things?

[Keith Vaz]

My right hon. Friend, who is a great campaigner on this issue, is right to have raised this, because we need to spend much more on diabetes research. One way of doing that is to make sure the funds are available for the excellent researchers and academics we have in this field, because research has indicated that there is an unacceptable and unexplained disparity in diabetes care in our country. We are failing the very people we are trying to help. Secondary complications are largely avoidable through better care, and we need to ask why this is not being provided. Although the NHS currently spends approximately £10 billion on diabetes, it is estimated that 80% of these costs are spent on dealing with complications. The time for conferences, seminars and good words is over—it is time for a new deal for diabetics.

Earlier this year, the Public Accounts Committee published a report on the “Management of adult diabetes services in the NHS”, and I would like to thank those on the Committee for their very hard work. The report found that astonishing variations still exist across clinical commissioning groups: the percentage of patients receiving all the recommended care processes ranged from 30% in some areas to 76% in others; and the percentage of patients achieving three treatment targets ranged from 28% to 48% in different areas between 2012 and 2013. As well as this postcode lottery, the figures were even worse for type 1 diabetic patients.

In response to my recent written question, the Minister acknowledged that there is no specific budget allocation for public health services related to diabetes. It is up to local authorities to

“assess local needs, prioritise and deploy available resources accordingly.”

I believe that is wrong. My own health and wellbeing board was unable to tell me how much it has spent on diabetes awareness. It should be able to do so. I welcome the Government’s inclusion of diabetes in their proposed clinical commissioning group improvement and assessment framework. That is a vital step in the development of a cohesive national diabetes strategy.

There has been much discussion about how effective the framework will be, and whether it will be released on time. We are already disappointed that the publication of the childhood obesity strategy has been delayed, a pertinent issue of concern for me and many other Members, including the Chair of the Health Committee, the hon. Member for Totnes (Dr Wollaston). We need an assurance from the Minister today that both the framework and the childhood obesity strategy will be published before the start of the summer recess.

The burden of care for diabetes is currently left overwhelmingly to one group: the GPs. It is unrealistic to expect GPs alone to manage this. We acknowledge that GPs are under increasing pressure, and the demand for their services far outweighs the supply. In some places, it takes weeks to get an appointment. The financial incentives given to GPs are clearly not working. Some 16% of GPs’ contracts is supposed to be spent on incentives, with 15% of this sum being directly allocated to diabetes testing. That equates to £94 million, yet an estimated 549,000 people have type 2 diabetes, but remain undiagnosed. A recent study by Pharmacy Voice found that 40% of GPs would like more support for their patients in managing diabetes. We need an action plan from NHS England that will assess the practical support that clinical staff need to care properly for their patients.

We are often told that it takes a village to raise a child. That phrase was recently given re-emphasis by Hillary Clinton. In my view, it takes a whole town of healthcare professionals to deal with the diabetes tsunami. Instead of placing the entire burden on GPs, we need to utilise a network of different professionals to attack the diabetes epidemic on all fronts in an efficient and cost-effective way.

At an international conference organised by the all-party group last month, we heard evidence to that effect from specialist GP Dr Paul Newman, endocrinologists Dr Sam Rice and Dr Abbi Lulsegged, diabetes nurse Sara Da Costa, diabetes specialist dietician Julie Taplin and lifestyle expert Emma James. However, we did not have time to hear from other parts of the network—the podiatrists, ophthalmologists and pharmacists. Their enthusiasm knows no bounds, but they are limited by the availability of funds and the lack of specialist staff. We must mobilise our political will to give them the support that they so desperately need.

Diabetes specialist nurses are vital in the fight against diabetes. Evidence shows that these nurses are cost-effective, improve clinical outcomes and reduce the length of patient stays in hospital. I am extremely concerned that the number of trained diabetes specialist nurses has stagnated. The latest national diabetes in-patient audit stated that one third of hospital sites still have no specific diabetes in-patient specialist nurses. With the predicted increase in diabetes cases to 5 million by 2025, it is alarming that forward-thinking plans to train such nurses are not being put in place now. We need a commitment from the Minister that there will be future provision for diabetes specialist nurses.

Community pharmacies are ideally placed to provide care at a time and in a place convenient to patients. The NHS diabetes prevention programme could be a great opportunity to get community pharmacies involved in supporting GPs and other healthcare providers. Janice Perkins, the pharmacy superintendent of Well Pharmacies, advised me that this could be done as part of a care plan package, where appropriate tests are provided to the patient based on their personal need, without their having to access numerous sites.

The proposed cuts to the community pharmacy budget could see the closure of up to 3,000 sites. My local pharmacist, Rajesh Vaitha of the Medicine Chest in Leicester, informed me that up to 60 out of 227 sites could close in Leicester alone. The closure of these pharmacies will have an adverse effect on patients and will place greater pressure on our already strained health infrastructure. Pharmacies are on the high street, and no appointment is needed to see the pharmacist. Like many patients, my late mother Merlyn, a type 1 diabetic, had great faith in her local high street pharmacist. I believe that the cuts to community pharmacies could be shelved if pharmacies were properly utilised in diabetes care.

Last Friday I visited the Steno Diabetes Centre in Copenhagen. Steno is a world-leading out-patient facility that cares for 6,500 diabetics a year. It is a one-stop centre for diabetics, with the main focus on prevention and secondary complications. The Steno centre is run by a team of remarkable diabetes specialist nurses led by Professor John Nolan. This is extremely cost-effective—the centre has an annual clinical budget for 6,500 patients of £9 million. Steno has reduced avoidable blindness in its patients by 90%—a service that is provided by a team of just six nurses and one ophthalmologist. The centre’s foot clinic has reduced avoidable amputations in the past 10 years by 82%. The savings from avoiding just two amputations funds the entire foot clinic’s annual budget. The Steno centre is an ideal model of how diabetes care should be facilitated. I urge the Minister—not that I want her to spend too much time abroad—to look at the incredible work that is being done there and bring a network of such centres to the United Kingdom.

In my own constituency, we are very fortunate to have not only the best football team in the country—many thanks to West Ham, Swansea and Liverpool for what they did last night—but the Leicester Diabetes Centre, a centre of true excellence in diabetes care. It is one of the largest facilities in Europe for clinical research into diabetes. Run by the dynamic duo of Professor Melanie Davies and Professor Kamlesh Khunti, it provides an innovative partnership between the NHS and academia—the very people in whom we should put more faith and behind whom we should put more funds, as my right hon. Friend the Member for Knowsley (Mr Howarth) said. We are extremely fortunate to have such experts, but we need more centres of excellence.

We need an holistic approach to public health, tackling the medical complications of diabetes and the contributory lifestyle factors that increase the prevalence of type 2. Other countries have taken a lead on this issue. Dr Francisco George, director general for health in Portugal, told me that data sharing is one thing we can do. I have also heard from Dr Pablo Kuri Morales, the Minister responsible for health promotion in Mexico, that a sugar tax actually works. Press speculation is that the Prime Minister has shelved the sugar tax until after the European Union referendum. In my view, the two matters are entirely separate, so why can we not have a sugar tax now?

I have been vocal in my support for a sugar tax and for clearer labelling of sugar content. Industry leaders such as Waitrose and Asda have made commitments to reduce sugar in their products, but I am afraid that the Government’s responsibility deal, which pledged to do all kinds of things, has not had much effect in reality, as recent reports by Professor Graham MacGregor and Action on Sugar have shown. We are, however, fortunate to have an NHS chief executive—Simon Stevens—who has imposed his own 20% sugar tax across the NHS, and that is an important start. I call on the Minister, when she returns to Richmond House, to ban high-sugar products from the canteens in her own Department.

I recently visited a brilliant juvenile diabetes centre in Tangiers, which was based in the Centre de Santé Saïd Noussairi. I nearly wept when I saw young type 1 diabetics having to rely on charitable funding just to get their daily insulin injection—something we can get absolutely free from our NHS. Yet, astonishingly, even in our country, whose healthcare system is the envy of the world, we have stark variations in diabetes treatment and unfocused resources.

We have world-leading medical professionals, nurses, healthcare professionals and researchers who are capable of doing, and willing to do, so much more, provided they get the funding and are backed by an iron political will. That is why we need to achieve a new deal for diabetics, and now is the time to start.

Diabetes

Debate between George Howarth and Keith Vaz

Wednesday 8th September 2010 Commons Chamber

[Mr George Howarth (Knowsley) (Lab)]

I congratulate my right hon. Friend on choosing this subject for debate. Will he also pay tribute to the work of the Juvenile Diabetes Research Foundation for the work that it is doing to try to highlight the difficulties of young people with diabetes?

[Keith Vaz]

I certainly will. As the House knows, my right hon. Friend has a debate next Wednesday in which he will explore the issue of young people and diabetes. I know that his own daughter is a sufferer of type 1 diabetes. I certainly pay tribute to the work that that organisation does. These voluntary organisations are of great importance in raising awareness.

It is not just diabetes itself that causes problems, it is also the complications and other conditions that arise from having it. For example, diabetes is the leading cause of blindness, amputation, renal disease and cardiovascular disease. Some 4,200 people in England are blind due to diabetic complications, and that number increases by 1,280 a year. Some 100 people a week lose a toe, foot or lower limb due to diabetes, and cardiovascular disease is a major cause of death and disability in people with diabetes, accounting for 44% of fatalities among people with type 1 diabetes and 52% among people with type 2. Diabetes is also the single most common cause of end-stage renal disease. It is evident that suffering from diabetes is detrimental to a person’s general health, especially when it is not managed effectively.

Diabetes currently costs the NHS 10% of its annual resources, and in the next 15 years the costs will continue to escalate significantly as the prevalence of diabetes increases. The NHS cannot allow or afford the diabetes explosion to continue. Diabetes and its complications cost the NHS about £9 billion each year, which, as I have said, equates to £1 million an hour. About 7% of that is attributable to the cost of prescription medicines, and a significant proportion is made up of the costs of treating serious long-term complications of the condition.

How do we avoid those costs, both human and financial? Early identification is the key. The later the diagnosis of diabetes, the higher the human and financial price that we have to pay. It is estimated that there are currently 1 million people living with diabetes in the UK who are simply not aware of having the condition. A fundamental problem is that type 2 diabetes is more often than not an asymptomatic condition. It is thought that many people with type 2 diabetes may have had it for nine to 12 years before diagnosis. As I said, it was sheer chance that I turned up in my doctor’s surgery that morning to be told that I had type 2 diabetes. Raising awareness of diabetes and making testing available is therefore essential if we are to get a grip on the problem.

I could mention a number of organisations, including Diabetes UK, and I pay tribute also to the Silver Star organisation, which was established in Leicester some years ago and continues to campaign among the south Asian community in particular. Such organisations are vital because the NHS cannot do it all on its own.

Diagnosis does not necessarily mean that a sufferer is getting the care and help that they need. It is thought that approximately 40% of people in the UK with diabetes are in poor diabetic health, which means that their condition is not being effectively regulated. Of all the reasons why people are liable to diabetes, obesity has been identified as having the strongest association with type 2 diabetes. Almost two in every three people in the UK are overweight or obese, and the National Audit Office suggests that 47% of type 2 diabetes cases in England can be attributed to obesity. That puts an extremely high number of people at risk of contracting it.

The most deprived people in the UK are two and a half times more likely than average to have diabetes at any given age. That is surely symptomatic of the inequalities that exist not just in our health system but in our society. Type 2 diabetes is up to six times more common in people of south Asian descent and up to three times more common among people of African and Afro-Caribbean origin. Although we must raise awareness in all sections of society, it is clear that knowing which groups are at the highest risk gives us an advantage in targeting campaigns and prevention programmes.

I welcome the Minister to the Dispatch Box. Whenever I have raised the issue with him, he has been extremely helpful and listened very carefully to what I have had to say. I am sure that when he responds, he will tell us about the programmes that currently exist, some of which were started by the previous Government. If there is one thing that I wish to stress to him, it is the need to prevent the condition rather than treat it. With the inevitable changes in our NHS—there will be reductions in some areas in the context of the coalition Government’s overall commitment to keep health expenditure at last year’s levels—the more we can spend on preventive work, the better it is in the long run. If we spent the £1 million an hour that we currently spend on treating diabetes on preventing it, in the long run, some of those in the Chamber tonight who are younger than me, and their children and grandchildren, will benefit greatly.

I shall conclude by raising one local constituency issue. About a year ago, I had a meeting with the then Health Secretary and the chief executive of the local primary care trust, Mr Tim Rideout, who recently informed me that he is leaving Leicester to go to London to work on the commissioning programme. I thank him and the PCT staff for their work, and I am sure that when the Minister meets him, he will find that he is an excellent officer of the NHS. Leicester was promised a state-of-the-art diabetes centre of excellence. In fact, when we went to see the then Health Secretary, we did not even ask for money—it was in the budget, so very unusually, a delegation led by an MP did not ask for money. We were told by the PCT that £6 million was in the budget and that a centre of excellence would be created in Leicester, principally because of the high calibre of diabetes experts in the city, and obviously because the diaspora who live there mean that it is the best place to conduct such research.

However, I understand that that money is no longer available because the PCT is to be scrapped. I know that budgets are very tight indeed, but I hope that the Minister will consider whether there are any resources that will allow Leicester PCT to fulfil its ambition of creating a centre of excellence, not just for the people of Leicester, but for the people of our country, so that we can be a leading part of diabetes prevention in Europe and the rest of the world.

I ask people in every country that I visit about their diabetes figures. I was recently told in the Gulf that 20% of the population of Dubai have diabetes or are susceptible to diabetes. Sometimes, people have the condition but do not realise that they have it. I was also recently in Kenya, where the figures were very high indeed. When I was there, I was told that you, Mr Speaker, will be leading the delegation next week to the Commonwealth conference. People in Kisumu, which is my wife’s place of birth, told me that it, too, has a diabetes explosion. They need not so much medicines, but food to enable them to change their diets. As in the Gulf, many of the community eat dates and, in the Asian community, sweets, especially at festival times. We could control diabetes if people changed their diets.

I know that this is an Adjournment debate and that it is not in prime time, but I am delighted to see so many right hon. and hon. Members here. If we act now, we can save the health service a huge amount of money and save lives. I hope that the Minister agrees.

Prevention and Suppression of Terrorism

Debate between George Howarth and Keith Vaz

Wednesday 14th July 2010 Commons Chamber

[Keith Vaz]

I understand that; it is exactly the point that Ian Blair, now Lord Blair, made to the Select Committee. However, as we have heard today from the Home Secretary, this power has not been used very often. I am sure that she was in the Chamber when the Attorney-General spoke on the issue—it was one of the best speeches that I have ever heard here—and opposed what the last Government were going to do. To be perfectly frank, if one has a power that one does not use, why have it?

It is important to consider who supported the longer detention period. Only the police came before the Committee and said that they supported it. Ken Macdonald—now Lord Macdonald—who is conducting the review had no reservations when he was Director of Public Prosecutions, but had reservations after he ceased to be DPP. He brought those reservations—

[Mr George Howarth (Knowsley) (Lab)]

Will my right hon. Friend give way?

[Keith Vaz]

I will not, because time is very short and I know that lots of people want to speak. I have great admiration for my right hon. Friend—oh, all right, then.

[Mr Howarth]

I am grateful to my right hon. Friend for reluctantly giving way. Does he recall that when those debates were going on, the claim was never that these powers would be used frequently, but that they might be necessary in very exceptional circumstances?

[Keith Vaz]

My right hon. Friend is right, but we now have the facts and some evidence that we did not have before. The hon. Member for Esher and Walton mentioned the security services. The security services have never said, on or off the record, that they wanted an increase in the detention period. When they met the Select Committee, they were very clear that they were not taking a position on this, and that was echoed in the statements made by the head of MI5. In their view, it was a decision to be made by politicians.

My next point concerns the impact on the community. I listened to what my right hon. Friend the shadow Home Secretary said, and I have great admiration for him. However, I do not believe that the so-called independent research conducted by officials at the Home Office—or consultants, or whoever did it—truly reflects the views of the community. This matter impacts on the community, and that includes the ethnic minority communities of this country, specifically the Muslim community. There was huge disquiet about these powers being sought by the last Government. I have 10,000 people of the Muslim faith in my constituency; others have more. It was not only the Muslim community but the entire ethnic minority community that was concerned, although they may not have wanted to relate their views to consultants for a research document.

The Home Secretary is coming before the Select Committee tomorrow morning—I hope she has not forgotten, because we are all turning up and it would be terrible if she were not there—and we will of course probe her about her review. I am sure that she will deal with all the points that we raise in the competent way she has done since becoming Home Secretary. However, in answer to the hon. Member for Perth and North Perthshire (Pete Wishart) she said that she was personally in favour of 14 days. She had me until that point. If she believes that 14 days is the right limit, how can she come before the House and ask for 28? On that point alone, and having been convinced by right hon. and hon. Members, I will vote against the motion.