(11 years, 3 months ago)
Commons ChamberI, too, congratulate my hon. Friend the Member for Woking (Jonathan Lord) on introducing this excellent private Member’s Bill. I am delighted to be here to speak in support of it, just as he was kind enough to be here to support my private Member’s Bill. The Minister, who is my neighbour, as he represents Forest of Dean, was also in the Chamber that day. Since then, he has been promoted to his current role, so I hope that the fact he is sitting on the Front Bench today augurs well for the Bill.
The Bill is an extremely worthwhile piece of legislation, but, as we were just hearing from my hon. Friend the Member for Gainsborough (Sir Edward Leigh), it is incredibly important that we scrutinise these pieces of legislation in great detail. Although the Bill appears short, containing few clauses, my scrutiny of it has found that it raises many questions in this important area, on which I seek the Minister’s clarification. I wish to ask him about the time an individual is required to spend, and where they are required to spend it, before the process of naturalisation can begin. I want to explore the Secretary of State’s discretion in these matters, which is clearly outlined in the Bill, and to ask the Minister further questions about the territorial extent clause. I also want to clarify whether the naturalisation provisions added to our general citizenship legislation since the 1981 Act—specifically the requirement to pass a citizenship test and how the test has been changed—would continue to apply in this case. Given that this is a Second Reading debate, I hope that you will regard all those areas of questioning as in order, Mr Speaker.
As I understand it, the provisions on timing relate only to the starting point of the application for naturalisation. As things stand at the moment, the individual making the application needs to be in the United Kingdom at the point at which the clock starts ticking for the five-year period. I would like that clarified.
I also want clarification on the territorial extent of the Bill. My interpretation is that clause 2(3) would extend the Bill to England and Wales, Scotland and Northern Ireland, which all seems very logical, but also to the Channel Islands, the Isle of Man and the British overseas territories. It is on the British overseas territories that my questions begin to multiply. It is worth putting it in Hansard that they are Anguilla, Bermuda, the British Antarctic Territory, the British Indian Ocean Territory, the Cayman Islands, the Falkland Islands and its dependencies, Gibraltar of course, Montserrat, Pitcairn, Henderson, Ducie and Oeno Islands, St Helena and its dependencies, the sovereign base areas of Akrotiri and Dhekelia, the Turks and Caicos Islands, and the British Virgin Islands.
On the 300th anniversary of the treaty of Utrecht, my hon. Friend has mentioned Gibraltar. She may recall that it was taken under British command, but with the aid of Dutch and Austrian troops.
The question is whether those troops settled in Gibraltar and what the rules were for their naturalisation as British citizens prior to 1981. I can honestly say that I do not have the faintest clue, but that is an interesting historical point.
I was evacuated to the British sovereign base of Dhekelia as a child when, as a British citizen, I was growing up in Cyprus. We were living in Nicosia at the time, and we were often under threat of invasion by Turkish forces. I remember being evacuated to Dhekelia, and feeling incredibly safe and secure there, on British sovereign territory. My father, however, had to remain behind in Nicosia to do his job. He put a Union flag on the roof of our house, and we sincerely hoped that the Turkish air force would be able to spot it from the air should it decide to bomb Nicosia. However, I digress, Mr Speaker.
I am trying to find out how my hypothetical examples would be affected by the Bill. My hon. Friend the Member for Woking told us that the provision would probably apply to a citizen of Fiji. Let us imagine that that citizen of Fiji joins Her Majesty’s armed forces, does exemplary service and decides—I do not know what the residence requirements would be—that he or she wants to remain in the British Indian Ocean Territory. Does the territorial extent of the Bill mean that the first date of the five-year period includes residence in one of the territories I have listed? That is my interpretation.
In relation to the questions asked by my hon. Friend the Member for Gainsborough, a situation might arise in which, as we heard, a Jamaican citizen who joined our armed forces abroad and served with great courage with them in other parts of the world decides to settle in Gibraltar, or perhaps closer to Jamaica, in the Cayman Islands. From there, could that person apply for naturalisation as a British citizen, without ever having resided in what we might more naturally think of as the United Kingdom? I particularly want clarification on that point. I understand that the 1981 Act requires people to spend five years resident in the UK, but does the territorial extent in the Bill define the UK more widely? I look forward to hearing from the Minister about that.
The first residence requirement in the 1981 Act is that applicants must have been resident in the UK for at least five years, and I am again interested in the Minister clarifying the territorial extent of the United Kingdom in that regard. The second requirement is that they must have been present in the United Kingdom five years before the date of application, which is the provision that we are tackling; the third is that they are free of immigration time restrictions on the date of application; and the fourth is that they are free of immigration restrictions for a period of 12 months before making the application. Will that remain in force when the Bill is passed?
The fifth requirement is that the applicants have not spent more than 450 days outside the United Kingdom during the five-year period. I understand that that is covered by the Secretary of State’s discretion with regards to serving members of the armed forces. The sixth is that they have not spent more than 90 days outside the United Kingdom in the last 12 months of the five-year period. The final requirement is that they have not been in breach of the immigration rules at any stage during the five-year period. Can the Minister confirm that all those aspects of the residency requirements in the 1981 Act will continue to apply, and that the Bill will change only one particular area?
Since the 1981 Act, there has been one major modification to what it takes for someone to be naturalised as a citizen of the United Kingdom. I refer, of course, to the UK citizenship test. I do not know whether you have ever had the chance to see whether you can pass it, Mr Speaker, but in preparation for this debate, I thought that I would see whether I could do so. I looked at some sample tests, and I regret to inform the House that in the first sample test I failed to reach the necessary 75% required to pass.
Let me give some examples of questions that I did not answer successfully. I will not put you on the spot, Mr Speaker, although I know you are an encyclopaedically knowledgeable man. The following question stumped me: in which year did married women get the right to divorce their husband? To help the applicant there are four possible answers, and I am happy to take an intervention from anyone who can answer the question correctly. The options are 1837, 1857, 1875 or 1882. I do not know the correct answer, but I know I got it wrong. I am glad to say that I did know that it is not the Prime Minister who calls a by-election and that we have two Chambers in our national Parliament, so I sailed through some of the questions.
Here is another question that I failed miserably to pass: what is the number of children and young people up to the age of 19 in the UK? Again, Mr Speaker, I will help you out, but I will not put you on the spot. I will take interventions from colleagues who know the answer. The four possible answers are 13 million, 14 million, 15 million and 16 million. I failed on that one and I can see that the House has also failed on that measure of citizenship. I was getting rather depressed with my results from the test until I discovered a crucial fact. I compliment my hon. Friend the Minister on any involvement that he may have had in this crucial fact, which is that this Government have now introduced a much more sensible citizenship test. Those examples were taken from the citizenship test that can only be described as a new Labour fantasy about the level of knowledge that we would all have about our country.
I will not go on with further examples of questions that I failed—
Mr Speaker, I shall have that speech of yours printed and engraved. It is so eloquent that I can only—
May I draw my hon. Friend back to the Bill? Surely the point is that this country, whose virtues she is extolling, has a long history of support by overseas troops and forces to win key battles. Waterloo would not have been won without the Prussians, Wellington famously crying, “Where is Blucher?” I presume General Blucher could have applied, were he willing to change from Prussian to British, to become a British citizen.
My understanding is that he would have had to have been resident in the territories outlined in the Bill for a considerable period of time before applying.
I will bring to a conclusion this line of discussion, but I am pleased to report to the House—you will forgive me, Mr Speaker—that I was able to get 100% on the new citizenship test. I expect that all the people who go through the process will, as a result of these changes, be able to demonstrate not just the narrow technical points that we define on a page in legislation, such as the number of days, but the wider cultural and historical aspects of what it means to be a British citizen.
My next line of questions for the Minister relates to the Secretary of State’s discretion, which I understand is a crucial part of the legislation. That discretion is vital because someone serving in our armed forces might get into trouble with the law, either civilian or military, and might—I am sure that the numbers are very low—have to go through the ignominy of a dishonourable discharge. If a member of the armed forces has been dishonourably discharged, would that almost invariably mean that they would not meet the new criteria for applying for naturalisation? Perhaps the Minister will confirm that from the Dispatch Box.
That former member of the armed forces might have lived a blameless life for many years since, their dishonourable discharge having been some time in the past, so to what extent will the Secretary of State’s discretion be used in that example? Would it be the case that, however much time had elapsed and however honourable the person’s life had been since, the fact that they had been dishonourably discharged would be sufficient to count against their application for naturalisation?
Will the Minister, when he responds, clarify exactly how the Secretary of State’s discretion might be used in other situations? What other aspects of that discretion might be required? For example, if the person had had a magnificent period of service, left the armed forces, lived in one of the overseas dependencies I listed earlier and was then perhaps convicted of rape or murder, would that be something the Secretary of State would see automatically as a red line? My understanding is that it would, because being of good character is a requirement.
The other area of discretion I would like clarified relates to the requirement to be able to communicate to an acceptable degree in English, Welsh or Scottish Gaelic. Someone might have exemplary military service and fulfil all the conditions, and they might be one of the people who will be helped by the Bill, because at the beginning of their process of naturalisation they were on active service overseas, but perhaps their command of English, Welsh or Scottish Gaelic is not quite at an acceptable level. To what extent will the Secretary of State be able to use his or her discretion in those circumstances? It is a question of how discretion will be used to define good character. Similarly, how will discretion be used to define the ability to communicate in English, Welsh or Scottish Gaelic?
(13 years, 1 month ago)
Commons ChamberThank you, Mr Deputy Speaker, for giving me the opportunity to raise this matter in the House. Bowel cancer affects men and women, and it is the second-highest killer after lung cancer. The debate is, I suggest, both timely and genuinely needed.
I have personal experience of the NHS that is probably too long to list. When I was a jockey, I was saved by a gastro-surgeon at Warwick hospital. I hoped I was riding the winner at Stratford races, but we turned over and the horse ruptured my spleen, perforated my left kidney and broke nine bones in my ribs. I can assure the House that it hurt a great deal. The surgeon saved my life on that occasion. Subsequently, it is well known that I had a meningioma in April and was recently given the all clear by Mr Neil Kitchen and the amazing staff at Queen Square hospital in north London.
My grandmother was an NHS matron and I have had bowel cancer screening. Certain family members have had this cancer, so I had the colonoscopy that was medically advised in those circumstances. I would certainly not be an MP were it not for the campaigns I waged on behalf of Savernake hospital in Wiltshire, where I was born; that hospital also saved my mum’s life.
I would like to declare an interest as a taxpayer. The NHS’s approach to individual screening is surely an issue in which we should all be interested—from the point of view of prevention of loss of life and the maintenance of good health, but also in respect of how NHS funding, which is clearly finite, is spent on preventing future problems.
I pay tribute to the Beating Bowel Cancer regime, to Cancer Research UK, to the British Society of Gastroenterology, and to Professor Wendy Atkin, her funders and the 170,000 volunteers who took part in her definitive study of flexible sigmoidoscopy, which is known as a flexi-scope. I also pay tribute to Imperial College London, University College London, the University of East Anglia and St Mark’s hospital, and to the variety of doctors, constituents, charities and members of the public who have worked so hard to combat this problem and have helped me to prepare for the debate—including the clinicians, particularly Dr Colin Rees.
As a Member of Parliament representing a constituency in the north-east, I am proud to say that the north-east leads the way in bowel cancer screening. It was the first to complete coverage of an entire region in April 2010.
Before I embark on the substance of my argument, I also make an apology on behalf of my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), who sponsored the Beating Bowel Cancer reception in the House last year. Much to his regret, he cannot be here tonight. He is a good friend of mine, but he is well known in the House—and, indeed, throughout the world—for having worn the Beating Bowel Cancer tie, which I am now wearing, in the Chamber after that reception. My hon. Friend, who has quite a generous build, was attempting to restrain that generous build with his suit when he accidentally touched a button on the tie, setting off a melody that lasted for nearly two minutes. Madam Deputy Speaker virtually extracted him from the Chamber. I understand that the incident was reported in 25 countries, and did more for the screening of bowel cancer worldwide than anything that anyone has said since.
I have no future as a surgeon, and I assure the House that I have removed the bottom half of my own tie so that there is no possibility of my being extracted from the Chamber for being too musical.
Let me now make some serious points about the clinical position. Traditional bowel cancer screening involves the faecal occult blood test, known as the FOB. In the last few years 11 million people in the country have been offered the test, 6 million have accepted it, 120,000 scopes have followed, and 12,000 diagnostic findings of cancer have resulted. It is clear from the statistics that lives have been saved. Previously those screened were aged between 60 and 69, but screening has now been extended to those aged between 60 and 74. It should be noted that the north-east—leading the way, as it does so often in a medical context—was the first region to extend the age group.
Tragically, take-up of that vital free NHS screening is only 54%, whereas take-up of breast cancer screening is 74% and take-up of cervical cancer screening is 79%. However, the situation is changing. Professor Wendy Atkin and her team have brought flexible sigmoidoscopy to the forefront of bowel cancer screening. The results of their 16-year study were definitive. Their randomised trial, which followed 170,432 people, established that the flexi-scope examination reduces the incidence of bowel cancer in those aged between 55 and 64 by a third. Mortality was 43% lower among that group than it was in members of the control group.
The flexi-scope test works by detecting and removing growths on the bowel wall, known as polyps, which can become cancerous if left untreated. It can prevent cancer from developing by removing polyps before they become cancerous, and provides long-lasting protection from bowel cancer.
I congratulate my hon. Friend on securing this very important debate. Does he agree that screening for certain kinds of hereditary cancers, such as non-polypsosis colorectal cancer, should begin at a much earlier age, and should take place relatively frequently throughout the lives of those who are screened?
I do indeed. I welcome the fact that the guidelines from the National Institute for Health and Clinical Excellence have changed to allow screening to become considerably more frequent in such cases. I am sure that the Minister will comment on that.
Flexi-scope screening will undoubtedly save thousands of lives. FOB screening saved 700 to 1,000 lives a year, and flexi-scope screening will save about 3,000 lives a year. To confirm that, the Government implemented a pathfinder project in three areas. Unsurprisingly, two of those areas were in the north-east, this country’s leading medical region. The three areas were South of Tyne and Wear and Tees, along with Derby. The pathfinder findings are with the Department of Health and have not yet been published, but I can assure the House that, in broad terms, they accord with Professor Atkin’s findings. Last October, the Prime Minister announced a proposal to pilot the scheme nationally in 2012, but there are clinical and funding issues that need to be addressed.
First, when is the Department of Health going to invite bids for the follow-on pilot process, given that that was supposed to be done in 2011 and it is now 23 November?
Secondly, clinicians raise the specific concern that the flexi-scope system is only manageable if we have a sufficiency of trained nurse endoscopists, so where are we in respect of this crucial training? Even with the most amazing piece of equipment, if we do not have the people to operate and interpret it, it is useless. Under this scheme, several hundreds of thousands of endoscopies will have to be carried out, with colonoscopies to follow in about 10% of cases. Therefore, everything will depend on training.
Thirdly, how does the Department of Health plan to assess its age groups? My understanding is that the current group of 60 to 74-year-olds will have FOB testing, and those aged 55 will have a flexi-scope. That is relatively clear, but what will happen for gentlemen and ladies in the 56-to-60 age group is not at all clear. Will they be offered the flexi-scope as well, or is that to be based solely on GP referral? Trusts need guidance on what they are to do with such a large and unknown number of people, as they need to plan budgets, staffing and much more besides.
Fourthly, we need to assess what we are going to do with those who have a flexi-scope at 55 and receive the all-clear and then reach the age of 60. Will we rescreen? Anyone who has ever worked in the health industry will know that there is “health speak”, and in this case the following question would be asked: “What is the parallel screening modality for the future?” As always, “health speak” is gibberish, but the simple question here is: are we going to rescreen people who are fine at 55?