(2 years, 11 months ago)
Commons ChamberLike my hon. Friend the Member for Heywood and Middleton (Chris Clarkson), I served on the Bill Committee. It was my first time on a Bill Committee on a major piece of legislation. I do not know how often there is a change in Minister, PPS and Whip during a Bill Committee, but I congratulate my hon. Friend the Minister, and my hon. Friends the Members for Devizes (Danny Kruger) and for Castle Point (Rebecca Harris), on getting up to speed on the Bill so quickly and taking us through the Committee.
Bill Committees can sometimes be sleepy affairs, but that one, like this debate, certainly was not. We had vigorous debates on various parts of the Bill, including the measure on voter ID, which I fully support, as it closes a vulnerability in our electoral system. We discussed a number of points surrounding voter ID, including many examples from abroad—countries such as Ireland and the Netherlands. We are now, through this Bill, introducing a form of legislation that will make us more European, in many ways, than we were. It is interesting that the Opposition parties that would have had us remain members of the European Union are so resistant to a system that is more in line with our continental friends than what we have at the moment. It will be a more secure system. I accept that there is a lot of work for Government to do in order to popularise and inform voters of these measures, and also to roll out the electoral ID card that will be introduced, but if the measures are introduced properly, there is no reason why anybody should be left out.
It is said that these are solutions in search of problems, but problems have been identified in places such as Tower Hamlets, Slough, Wycombe and Birmingham, among others, and this Bill will finally address them.
In an earlier speech, reference was made to an electoral judge suggesting that personation was neither here nor there, but does my hon. Friend recall the evidence to the Bill Committee where that electoral judge, in a judgment during the Labour Administration of 2005, said, “If you don’t look for fraud you won’t find it”, and described the Government as “having its head in the sand” on this issue?
My hon. Friend is absolutely right. One of the key problems is not only not looking for it—it is a matter of training. There is a big problem that needs to be addressed in terms of making sure that the police are aware of electoral law issues and getting them out there to go and investigate. He is completely right that a lot of this goes undetected.
I am pleased to see that the clauses on undue influence remain. I spoke on Second Reading about having to run the gauntlet of people trying to use intimidating behaviour on election day by thrusting leaflets into people’s faces. The central thrust of many of these measures is to protect the security of the ballot. I appreciate that I may be slightly testing the limits of what I am allowed to say on Report, but I have seen today an email from Scotland Yard to somebody I know who has reported an alleged breach of the secret ballot, but advice from the Electoral Commission and the local authority concerned is that the onus is on the individual who cast their vote to claim that secrecy has been breached. I would suggest that that is contrary to section 66 of the Representation of the People Act 1983, which says that every returning officer, presiding officer, clerk, candidate, election agent and polling agent
“shall maintain and aid in maintaining the secrecy of”
the vote. So if this legislation is to be reformed further in the other place, it should not be by removing the parts that we have introduced, but by giving some consideration as to whether the need to maintain a secret ballot is restated in primary legislation.
We have heard the argument for votes at 16, which I will not support. We have raised the age of marriage to 18, we have raised the age at which people have to be in education or training from 16 to 18, and the age at which you can smoke was raised by the Labour Government to 18. We have raised the age at which people can buy a lottery ticket from 16 to 18, I am sure with the Opposition’s support, as well as the age at which people can buy alcohol. Voting is an adult activity; it is something that adults do—if we want to encourage younger people to vote, I see no reason why we cannot introduce votes at 12. I think all the arguments advanced by Opposition Front Benchers could also apply to 12-year-olds.
I support the measures in this Bill. I look forward to its going on to Third Reading and the other place, and to seeing those measures come on to the statute book as soon as possible.
(4 years, 3 months ago)
Commons ChamberMy hon. Friend neatly explains the consequences of delayed diagnosis. A recent systematic review of the available literature found that, overall, patients with a delayed diagnosis of AS had worse clinical outcomes, including higher disease activity, worse physical function and more structural damage compared with patients who had an earlier diagnosis. Those with a delayed diagnosis also had higher healthcare costs and a greater likelihood of work disability, as well as a worse quality of life, including a greater likelihood of depression. Those are the consequences of not giving a prompt diagnosis.
We spoke earlier about the National Axial Spondyloarthritis Society, or NASS, which has identified four factors that contribute to delay: a lack of awareness among the public that AS might be the cause of their chronic pain; GPs failing to recognise the features of AS; referral to non-rheumatologists who might not promptly recognise AS; and failure by rheumatology and radiology teams to optimally request or interpret investigations. AS cannot be cured, but reducing the eight-and-a-half-year average delay in diagnosis will lead to better outcomes for those living with the condition.
The all-party group for axial spondyloarthritis, of which I am a vice-chair, suggests three steps that would help to reduce the delay in diagnosis. The first is the adoption of a local inflammatory back pain pathway to support swift referral from primary care directly to rheumatology. Low levels of referral to rheumatology from primary care represent one of the key barriers to achieving an early diagnosis of AS, and a national audit by the APPG found that 79% of clinical commissioning groups do not have a specified inflammatory back pain pathway in place, despite NICE guidelines recommending that.
My hon. Friend makes reference to the NICE guidelines and the quality standard on spondyloarthritis not being implemented by 79% of clinical commissioning groups. Does he agree that that simply relates to primary carers referring directly to rheumatology departments, which is not a cost issue but one of professional education?
My hon. Friend is absolutely right, and that neatly leads me on to the APPG’s second proposal. I appreciate that the NHS is rather busy at the moment with public health messaging of one kind or another, but awareness of AS remains low and support for an awareness campaign would help to significantly raise the visibility of the condition not only among the public, but for example among GPs.
Thirdly, the APPG suggests encouraging the routine adoption of minimum service specifications across the NHS to help to reassure patients, particularly in the context of covid-19 and the difficulties many patients face in accessing key services during the recent lockdown. I would welcome any opportunity to meet Ministers separately to discuss those proposals in detail, if that were possible.
I will leave the last word to Zoë Clark, who addressed the APPG’s last physical meeting in January. She told attendees how, after getting AS symptoms aged 20, incorrect diagnoses and the impact of her condition left her socially isolated and unable to live independently, at a time when she was trying to complete a demanding four-year master’s degree in osteopathy. She said that living with undiagnosed AS was a frightening time and she ended up having to largely sacrifice her social life, due to the difficulties of balancing her degree with the pain and fatigue she regularly experienced.
No one should have to wait eight and a half years to find out what is wrong with them. I hope that we can begin to put that right.