Julian Lewis

A wide variety of medicines are used for the purpose of pain-relief, and they have differing levels of regulation. Some items can be bought off-the-shelf without a prescription, whilst others require authorisation from a medical professional. The Human Medicines Regulations 2012 set out the responsibilities which certain medical professionals may undertake regarding the supply and administration of regulated medicines. The Misuse of Drugs Act 1971 sets out the legal framework for the prevention of misuse of controlled drugs.

Decisions about what medicines to prescribe and administer are made by the doctor or other qualified medical personnel responsible for that part of the patient’s care. They must always satisfy themselves that the medicines they consider appropriate for their patients can be safely prescribed and administered, and they must take account of appropriate national guidance on clinical effectiveness. Clinicians are responsible for the decisions they make regarding the administration of medicines, and they are regulated by the relevant regulatory body for their profession.

Professional regulators are responsible for setting and enforcing their own standards for the healthcare professionals that they regulate. The General Medical Council (GMC) is the regulator of all medical doctors practising in the United Kingdom, and the Nursing and Midwifery Council (NMC) is the regulator of nurses and midwives in the UK. Both the GMC and the NMC are independent of the Government, are directly accountable to Parliament, and are responsible for operational matters concerning the discharge of their statutory duties.

Following the Shipman Inquiry's Fourth Report, published on 14 July 2004, the Government introduced tighter controls on the procurement, storage, supply and prescribing of controlled drugs, and established national and regional monitoring by the Care Quality Commission (CQC) and a network of regional NHS Controlled Drug Accountable Officers. The CQC is responsible for making sure that health and care service providers, and other regulators, maintain a safe environment for the management and use of controlled drugs in England. The CQC does this under the Controlled Drugs (Supervision of Management and Use) Regulations 2013. These regulations strengthened system governance to monitor the safe use and prescribing of controlled drugs, and require greater co-ordination between the health system and police, to investigate and take action, to protect patients and the public against the misuse and diversion of controlled drugs. Further information on these regulations is available at the following link:

https://www.legislation.gov.uk/uksi/2013/373/contents/made

Individual universities are responsible for the courses that they offer. We have launched a 10-Year Health Plan to reform the National Health Service. A central and core part of this plan will be our workforce, and how we ensure we train and provide the staff the NHS needs, including doctors and nurses, to care for patients across our communities.

Under the Care Act 2014, local authorities in England have a legal duty to support people with sight loss to develop practical skills and strategies to maintain independence.

The Care Quality Commission (CQC) is now assessing how local authorities are meeting the full range of their duties under Part 1 of the Care Act 2014. These assessments identify local authorities’ strengths and areas for development, facilitating the sharing of good practice and helping us to target support where it is most needed.

Therefore, although the CQC is not currently required to assess vision rehabilitation services as a regulated activity, under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, this does mean that sensory services, including vision rehabilitation, form part of the CQC’s overall assessment of local authorities’ delivery of adult social care. In that context, the CQC will report on sensory services when there is something important to highlight, for example, something being done well, innovative practice, or an area for improvement.

The CQC’s reports and ratings of local authorities are made public on their website.

The Medicines and Healthcare products Regulatory Agency (MHRA) is aware of concerns regarding modular neck hips and the risk of cobalt poisoning. We are investigating the issue with our stakeholders including the British Orthopaedic Association, British Hip Society, and the National Joint Registry to support.

The term modular neck covers a broad range of designs, and adverse incident reports of this sort typically include descriptions of symptoms rather than a definitive diagnosis of cobalt poisoning. In addition, it is not possible to uniquely identify cobalt poisoning from hip replacements in the ICD-10 coding scheme currently used in Hospital Episode Statistics.

The UK Medical Devices Regulations provide clear requirements for manufacturers to undertake post-market surveillance activities to ensure safety action is taken, when appropriate. The MHRA is working towards implementing a future regime for medical devices regulation. This will put in place strengthened legal requirements for how manufacturers monitor and report on their devices once they are being used in the real world.

The UK is committed to working multilaterally and bilaterally to defend Freedom of Religion or Belief around the world. In Mozambique, the UK regularly engages with authorities and religious leaders both in the capital (Maputo) and northern Mozambique (Cabo Delgado and Nampula) to address the problems of violence and to tackle the ongoing humanitarian crisis, including several times this year. The UK is supporting efforts to counter the ongoing IS-Mozambique insurgency in Cabo Delgado, through programmes aimed at building local resilience to violent extremism and security and human rights training of Mozambican Armed Forces, as well providing humanitarian assistance to those displaced. Ongoing challenges for religious communities remain, as Christian and Muslim places of worship continue to be affected.

The Autumn Budget 2024 announced a government grant funding uplift for the BBC World Service in 2025-26. The uplift is for the BBC World Service only, ensuring it can continue to operate in 42 languages and helping to maintain its crisis response capability. The BBC is operationally and editorially independent and sets its own budgets.

The Government continues to call for the human rights of all Afghans to be protected, including the freedom of religion or belief, and we regularly press the Taliban on this through our Doha based UK Mission to Afghanistan. Ministers and officials also engage regularly with a range of Afghans, including religious and ethnic minorities, to ensure our policy and programming reflect the needs of the entire population. In October, we co-sponsored a Human Rights Council resolution extending the mandate of UN Special Rapporteur, Richard Bennett, to monitor and report on the human rights situation in Afghanistan for another year, including that of minority groups.

In order to repair the public finances and help raise the revenue required to increase funding for public services, the Government has taken the difficult decision to increase employer National Insurance.

HMRC recently published on 13 November a Tax Information and Impact Note that covers the impact of employer NICs changes.

The Government has protected the smallest businesses and charities from the impact of the increase to Employer National Insurance by increasing the Employment Allowance from £5,000 to £10,500, which means that 865,000 employers will pay no NICs at all next year, more than half of employers will see no change or will gain overall from this package, and all eligible employers will be able to employ up to four full-time workers on the National Living Wage and pay no employer NICs

More broadly, within the tax system, we provide support to charities through a range of reliefs and exemptions, including reliefs for charitable giving, with more than £6 billion in charitable reliefs provided to charities, CASCs and their donors in 2023 to 2024.

To repair the public finances and help raise the revenue required to fund public services, the Government has taken the difficult decision to increase employer National Insurance.

The Government will provide support for public sector employers, including fire and rescue authorities, for the additional costs of Employer National Insurance Contributions. This is in line with the approach taken under the previous government’s Health and Social Care Levy. Further details will be set out in due course.

There have been 31 tragedies, since August 2019, where 97 people are confirmed to have died and at least 14 people have been reported as missing at sea, presumed dead, as a result of or linked to attempting these dangerous crossings.

Numbers of fatalities

A total of eight minors are reported to have died in the fatal incidents that have occurred this year. Prior to this, the only known minor fatalities occurred as a result of an incident in October 2020 when an entire family group, including 3 children, died following the capsizing of a migrant vessel.

Almost all fatalities have occurred in French Territorial Waters (TTW). There has been one incident (on 14 December 2022), involving the deaths of 4 people, which undoubtedly took place within UK TTW. However, an earlier tragedy – the loss of 27 people in a single incident in November 2021 – was proven after investigation to have partially occurred within UK TTW. It is subject to an ongoing Art.2 Human Rights Inquiry led by Sir Ross Cranston.

A suspect arrested on suspicion of murder may be held in custody before charge where the custody officer a) is determining whether he has before him sufficient evidence to charge them with the offence for which he was arrested and b) has reasonable grounds for believing that the suspect’s detention is necessary to obtain evidence (for example, witness statements, interview, or medical examination) (PACE section 37). There are statutory limits on the time for which suspects can be held in custody without charge (section 41).

A suspect arrested, including on suspicion of murder, may be released within the authorised detention period on conditional or unconditional police bail, pre-charge, a) where there is as yet insufficient evidence to charge a suspect and they are released pending further investigation and b) where the police consider that there is sufficient evidence to charge, but the matter must be referred to the CPS for a charging decision (PACE section 35 and section 37).

Preconditions for police bail include the need to prevent offending by the suspect, the need to safeguard victims of crime and witnesses, the need to manage risks to the public and the need to secure the suspect’s surrender to custody (PACE section 50A). Where the individual’s release is required and no pre-conditions for bail are met, they must be released under investigation or subject to no further action (section 37).

Where a murder suspect is to be released on pre-charge bail, police should seek the views of close family members of the alleged victim, if it is reasonably practicable to do so, when deciding whether the suspect should be released on bail, and if so whether and what conditions should be imposed (section 47ZZA).

Under the Police and Criminal Evidence Act 1984 (PACE) and the Criminal Justice and Public Order Act 1994 (CJPOA 1994), suspects who have been charged with murder are not eligible for police bail pending appearance at court for that offence unless exceptional circumstances apply (PACE section 38(1)(c) and section 25 CJPOA 1994). They must be kept in police custody and brought before a court not later, in most cases, than the first sitting after they are charged with the offence (section 46).

The rules and procedures relating to police bail are governed by PACE and the Bail Act 1976.

This historic agreement protects the long-term secure operation of the UK-US base on Diego Garcia with Mauritius, which plays such a crucial role in regional and international security. We have full Mauritian backing for robust security arrangements, including preventing foreign armed forces from establishing themselves on the outer islands, or otherwise undermining the effective operation of the base, meaning the base is more protected than ever from foreign malign influence in a more insecure world.  This deal has been welcomed by a range of key international partners, including the US and India. It is our intention to pursue ratification in 2025 by submitting the treaty and a Bill to Parliament for scrutiny.

The Ministry of Defence continues to assess and monitor the evolving threat picture in Ukraine, including Russian use of chemicals as a method of warfare. The UK has been at the forefront of international support and assistance to the armed forces of Ukraine and has provided respirators and decontamination kits, as well as other protective measures to enhance Ukraine's protective capabilities against chemical weapons.

Our commitment to Ukraine is unwavering, we continue to work closely with our international partners to coordinate counter-CBRN support and assistance to the Armed Forces of Ukraine.

Both the Ministry of Defence (MOD) and Rolls-Royce Submarines (RRS) investigated a subcontractor's outsourcing of development work for a RRS intranet page; this IT system is separate to the RRS classified systems. The investigation found no evidence that Belarusian nationals had access to sensitive information and concluded that no change to MOD procurement policy was required. No formal sanctions were imposed.

Defence took steps to ensure and confirm that there had been no compromise of classified information. The safety and security of the United Kingdom's nuclear submarines and the Deterrent, including the Service personnel who operate it, remain our highest priority. Our security processes are under constant review to ensure best practice.

As set out in our consultation on proposed reforms to the National Planning Policy Framework, the government supports upward extensions as a route to urban intensification. Planning policy makes clear that local authorities should support upward extensions where the development would be consistent with the prevailing height and form, well designed (including complying with any local design policies and standards), and can maintain safe access and egress for occupiers.

The government will keep recent changes to permitted development rights under review and as per my response to the right hon. Gentleman’s oral question on Monday 28 October 2024 (Official Report HC, Volume 755, Column 524), I will reflect further on the specific concern he has raised.

Future plans for the Freeports Programme are being carefully considered as part of the ongoing Spending Review process.

This does not change the fact that Solent Freeport, alongside the other seven English Freeports and the two Scottish Green Freeports, has had tax sites designated and is open for business. Delivery is - and will continue to be - led by local partners and I thank all those involved for their continued hard work on the project.