Maria Miller debates involving the Department of Health and Social Care during the 2019 Parliament

International Health Regulations 2005

Maria Miller Excerpts
Monday 18th December 2023

(3 months, 1 week ago)

Westminster Hall
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Cat Smith Portrait Cat Smith (Lancaster and Fleetwood) (Lab)
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I beg to move,

That this House has considered e-petition 635904, relating to the International Health Regulations 2005.

In March 2021, a group of world leaders including the then UK Prime Minister Boris Johnson announced an initiative for a new treaty on pandemic preparedness and response. The initiative was taken to the World Health Organisation and will be negotiated, drafted and debated by a newly established, intergovernmental negotiation body. This is the second time that the Petitions Committee has scheduled this issue for debate. In April this year, a petition that called for the Government to

“commit to not signing any international treaty on pandemic prevention and preparedness established by the World Health Organization (WHO), unless this is approved through a public referendum”

was debated after it reached the threshold of 156,086 signatures. Today’s e-petition calls on Parliament to

“Hold a parliamentary vote on whether to reject amendments to the IHR 2005”.

The Government have responded to the petition, explaining that the UK supports strengthening the IHR and the amendment process.

Having met the petitioner, I know that she would like the Minister to address the concerns of the petitioners in his response, specifically which amendments, if accepted, would require changes to UK domestic legislation; who represents the UK; if the information will be publicly available; the Government’s position on the amendments that change language in the regulations from “may” to “shall”; and if the UK will vote against those changes. What is the UK’s position on whether the regulations should be binding or non-binding, and has it proposed any amendments? I hope that the Minister will be able to address those issues in his remarks when we get to that stage of the debate.

In the March 2021 joint article, the group of leaders said:

“The main goal of this treaty would be to foster an all of government and all of society approach, strengthening national, regional and global capacities and resilience to future pandemics. This includes greatly enhancing international co-operation to improve, for example, alert systems, data-sharing, research and local, regional and global production and distribution of medical and public health counter-measures such as vaccines, medicines, diagnostics and personal protective equipment.”

Given the weekend news coverage of the fallout from some of the challenges faced in the procurement of PPE, it is perhaps timely that we debate the petition today. When the next pandemic happens, I hope that any future Government will have learned the lessons from the past.

On specific questions of UK sovereignty and amendments relating to restrictive measures, the UK Government have explained in their response to the petition that

“we have been clear that the UK will not sign up to any IHR amendments that would compromise the UK’s ability to take domestic decisions on national public health measures. There are currently no plans to hold a vote on IHR amendments. Should the UK Government wish to accept an IHR amendment, then depending on the content of the respective IHR amendment, changes to domestic law considered necessary or appropriate to reflect obligations under the IHR amendment, may be required. The Government would prepare such draft legislation before Parliament in the usual way. In all circumstances, the sovereignty of the UK Parliament would remain unchanged, and the UK would remain in control of any future domestic decisions about national public health measures.”

Finally, I take the opportunity to thank all our healthcare workers who worked through the pandemic. As we go into the Christmas period, many of them will be working while we are enjoying turkey dinners with our families, so I pay tribute to their commitment and to all others who work in our healthcare systems. The pandemic affected us all differently, and I hope that in this season of good will we are mindful of all those who are more vulnerable than ourselves. With that, and on behalf of the Petitions Committee, I thank all members of the public who have engaged with e-petitions, including this one in 2023. I look forward to hearing the well-informed contributions of hon. Members.

Maria Miller Portrait Dame Maria Miller (in the Chair)
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Before I call the first speaker, I remind Members that if they wish to contribute, they should bob. I remind those sitting in the Public Gallery that there should be no applause and no photographs at any time.

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Danny Kruger Portrait Danny Kruger (Devizes) (Con)
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I am very pleased to be able to speak in this debate. I thank all the petitioners and members of the public who are interested in the debate, and the hon. Member for Lancaster and Fleetwood (Cat Smith) who introduced it. It is worrying that so few Members are present. I am always proud to act in concert with my band of brothers here—we happy few who seem to fight on multiple fronts. This is a fringe issue in Parliament, as demonstrated by the empty Benches, but significant numbers of the public have a real interest in this topic, so what is going on?

I think the explanations are partly that it is a complex matter. It requires significant delving into pretty abstruse documentation and websites. As the debate goes on, it is not always thrilling. It is also that we debate issues of principle, such as the abstractions of sovereignty and individual rights, that often fail to get traction in the media. Although occasionally generating headlines, they do not generate proper attention in Parliament or the media.

The fundamental reason why the topic and the proposed regulations and treaty from the World Health Organisation have not generated the sort of disquiet that we few Members feel among our colleagues, the wider public and the media is that we want, as individuals and citizens, to trust in the Government when it comes to healthcare. We really do. That is why we have such a commitment to the NHS in our country. We want the state to be trusted, authoritative and capable when it comes to our health. We instinctively recoil at suggestions that there is a problem when it comes to the management of healthcare, and yet, as we have heard today from colleagues who put the details very well—I will not reiterate the points that have been made—there is clearly a difficulty, a challenge, a problem with the proposed regulations and treaty.

It is suggested by the World Health Organisation and the Governments who are contributing to the design of the regulations and the treaty that the WHO should move from being responsible for identifying pandemics on behalf of countries, and towards taking responsibility for co-ordinating the response to pandemics. That is an enormously significant change. It would co-ordinate the response of nation states and how they managed their health care. We have heard expressed very well the threat that that represents; it could mean enforced mandates, forced lockdowns and so on. I echo the call on the Minister to address the question whether the World Health Organisation will be able to impose a lockdown, or any other intervention, without the consent of Parliament.

I would also like the Minister to reflect on the provision in the proposed regulations that suggests that the World Health Organisation would require countries to tackle misinformation and disinformation. We must remember that in January 2020, the organisation aspiring to this power denied that there was human-to-human transmission of covid-19. For many months, it denied the possibility that the virus had a human origin and originated in a Wuhan facility. This is the organisation that we propose giving the power to intervene in national debates, and to close down discussion about the origins and appropriate response to pandemics under the guise of tackling misinformation and disinformation.

We should be concerned about the value of the World Health Organisation, given its record, and we should, I am afraid, have the same scepticism about our Government’s role. The trust that we all desperately want to have in healthcare has been badly tested by the experience of recent years. I echo many of the points made by my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) about radicalisation; we both experienced that radicalisation over the course of the covid experience. We went from a position of trust in the state to profound scepticism.

I want to call attention to a new book that has come out, to which I contributed the afterword.

Maria Miller Portrait Dame Maria Miller (in the Chair)
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Order. I do not think that we do advertising in here.

Danny Kruger Portrait Danny Kruger
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Okay. Forgive me. I will not advertise the book, although I derive no benefit from it, I should emphasise. It is written by the campaigners UsforThem, who did such good work in calling attention to the effect of the lockdowns on children, and who became radicalised through the experience of covid. UsforThem has written a very good book about the lack of accountability for the response to covid. I do not share some of its concerns about particular decisions made by particular officials or Ministers, but I absolutely share its concerns about the failure of accountability in the system as a whole.

The inquiry into the whole covid episode, which we are all watching, is performing a fairly useful function in identifying misdemeanours, confusions, and, in a rather whodunnit way, which Ministers, officials and advisers deserve individual blame. What we are really getting out of it, however, is evidence that the system as a whole failed. There is no point in identifying the culpability of individuals when the fundamental problem that the inquiry, and the experience of us all, demonstrates is that the British state failed.

On the regulations, as I said in April, during the last debate we had on this subject in this place, the problem during the whole covid episode was not the lack of international co-operation; there was a very high, remarkable, degree of that. Almost every country did exactly the same thing, following China’s example. What we did not have enough of was independent decision making at nation state level. The bits that worked at nation state level were times when individuals and communities on the ground, local government, local public services and local businesses took the initiative to collaborate and develop their own responses, and took responsibility for supporting communities. That is what we needed at the national level, too—more independent decision making, while obviously collaborating and sharing information about what works.

I recognise the point made by the hon. Member for Lancaster and Fleetwood. I hope that the Minister will say that the Government are committed to ensuring that British national sovereignty is reflected in the wording of any new treaty. I am afraid—we are familiar with this from current debates—that peppering legislation with the language of sovereignty is not sufficient. What we really need is the practice of sovereignty and the declaration of principles. Principles are only valid in so far as they are put into practice. We want actual practice of the principle of sovereignty through the treaty that emerges, and in any amendments to the regulations.

I conclude with four questions for the Minister, who I hope will be able to answer them. First, when will we see the next iteration of the draft regulations? I had understood that they were expected now. Secondly, which Minister is responsible for negotiating the treaty and the regulations? Is it him or a colleague? I would also be interested to know which civil servants are involved. We knew who the civil servants negotiating Brexit were. I wonder who has been delegated to the WHO and is working on our behalf there.

Thirdly, colleagues raised the issue of the WHO mandates potentially imposing a very significant bill on the taxpayer. Has work been done to quantify the potential cost to the taxpayer of implementing the requirements of the treaty? Finally, I appreciate that the Minister is probably not in a position to do so today, but will the Government commit to publishing their red lines—what they will and will not accept? Vague commitments to preserving sovereignty are not sufficient. What exactly will be acceptable and not? I appreciate that the negotiations are going on with other states, but I think it would be appropriate for our Government, at this advanced stage of the negotiations, to declare publicly what they are and are not prepared to cede, by way of our independence.

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Christopher Chope Portrait Sir Christopher Chope
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Absolutely; I agree with my right hon. Friend. We do not want to withdraw; there is no need to withdraw from a voluntary organisation that is confined to giving us advice and providing data and information. Who would resent having access to data and information? Indeed, the essence of the relationship between a responsible society and its Government is that the Government should provide information to enable individuals to decide for themselves whether they want to take particular medicines, go on trips to particular countries, be vaccinated in a particular way, or whatever.

I see the proper role of the WHO as providing information to Governments across the globe. Those Governments can then decide for themselves what they like and do not like, having regard to the fact that the WHO’s chairman seems to have been imposed on it by the People’s Republic of China, and was strongly opposed by our Government. It seems very much as though the whole WHO is too beholden to China. The WHO is also beholden to some of its big donors; if one analyses how the WHO is funded, one sees that organisations such as the Bill & Melinda Gates Foundation are significant supporters. He who pays the piper calls the tune. I think that is a good starting point when looking at these things. In the case of the WHO, there is too much evidence that the people paying the piper are calling the tune to too great an extent.

Once bitten, twice shy. Let us remind ourselves what happened during the pandemic. As others have mentioned, the WHO went into the pandemic with a policy of saying that lockdowns were not, and could not be, the right answer to a pandemic for all sorts of reasons. We can now see the adverse consequences that flowed from our country’s decision to have a lockdown, and we can compare that with what happened in Sweden. Then, during the early part of the pandemic discussions, and without any evidence being brought forward, the WHO suddenly changed its advice. Why? There is a suspicion that it was because of undue influence from the pressures that I have been describing. We will never know why it changed its advice. All we know is that somebody who changes their advice like that, without any evidence, should not tell us what to do. We should say, “If you want to change your advice, fine, but why do you change it? We don’t have to follow it.” However, under the proposed treaty amendments, we would have to follow it. That is obviously of great concern, because people can see what happened in the past, and that is potentially a guide to the future.

Even more sinister than the change in advice on lockdowns was the WHO’s approach to finding a treatment for covid-19 patients. There was a lot of evidence to suggest that ivermectin—it was not the only such drug—could be used to really good effect to improve outcomes for patients suffering from covid-19. Strong evidence suggested that treatment with ivermectin might improve someone’s chances of survival by as much as 81%, but the WHO intervened at the behest of certain pharmaceutical companies that were in competition with the producers of ivermectin. It gave very dubious advice, to the effect that ivermectin should be used only in clinical trials.

To those who are not familiar with too much of the detail, I commend a book by Dr Pierre Kory, a distinguished physician and epidemiologist—I think he is an epidemiologist. He certainly deals with pulmonary and critical-care medicine; he is a specialist in that. He was in charge of the Front Line COVID-19 Critical Care Alliance, and produced a book called “The War on Ivermectin”. It was a war, organised by the WHO, against a remedy for covid-19, because, obviously, the whole vaccine development programme was premised on there being no cure for covid-19, and no effective treatment for it. In the absence of such treatment, it was legitimate for experimental vaccines to be brought into play without undergoing the full process set out in the Licensing Act 2003, because there was there was nothing else. We were in the desperate situation of there being no other way out. Actually, however, there was a lot of evidence to suggest that ivermectin—

Maria Miller Portrait Dame Maria Miller (in the Chair)
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Order. I am sure that the hon. Member is not intending to use a prop. Let us leave it to Amazon to sell books.

Radiotherapy: Accessibility

Maria Miller Excerpts
Tuesday 18th July 2023

(8 months, 2 weeks ago)

Westminster Hall
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Maria Miller Portrait Dame Maria Miller (in the Chair)
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Before we start, may I point out that there will be some videoing by the education department? Please do not be distracted. The Doorkeepers are aware and the video will simply be used to illustrate how a Westminster Hall sitting works, so just ignore it.

Selaine Saxby Portrait Selaine Saxby (North Devon) (Con)
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I beg to move,

That this House has considered the accessibility of radiotherapy.

It is a privilege to serve under your chairmanship, Dame Maria. I thank the Backbench Business Committee for granting this important debate, all colleagues who supported the application, and Professor Pat Price for her tireless work in supporting the all-party parliamentary group for radiotherapy and championing this vital treatment.

We all know that the cancer backlog was affected by the pressures of covid-19, but in May this year there were 7.47 million people waiting for cancer treatments and 3 million of those have been waiting for over 18 weeks. Only 61.7% of patients receive their first treatment within two months, far below the operational standard of 85%. Radiotherapy is a key part of cancer care. It is the second most effective treatment for cancer and is needed in four out of every 10 cancer cures.

Radiotherapy targets the cancer with radiation. The cancerous cells are more affected than the healthy cells, which are better at repairing themselves. Modern radiotherapy has come on leaps and bounds, and within the last 10 years breakthroughs have increased the accuracy and focus of the treatment to within millimetres, significantly reducing collateral damage to healthy cells.

Surgical treatments require intensive care, with all of the hospital resources and emotional trauma that that entails, and chemotherapy has a significant impact on the immune system. In contrast, radiotherapy is an out-patient treatment that requires fewer patient visits to care centres. It only costs between £3,000 and £7,000 per patient, despite being incredibly high tech.

The international recommendation is that 53% to 60% of cancer patients receive radiotherapy treatments. However, in the UK only 27% of cancer patients received radiotherapy treatment in 2019. In my North Devon constituency, only 4.7% of my constituents live within the recommended 45-minute travel time for radiotherapy treatment. The other 95.3% are among the 3.4 million people in England for whom distance from a radiotherapy service effectively limits the availability of treatment.

Oral Answers to Questions

Maria Miller Excerpts
Tuesday 11th July 2023

(8 months, 3 weeks ago)

Commons Chamber
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Neil O'Brien Portrait Neil O'Brien
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We absolutely recognise the need for patient safety, which is why there will be clear patient group directions and clear pathways about what pharmacists do. They are not taking on the role of GPs, but are providing additional services that will make things more convenient for all of our constituents.

Maria Miller Portrait Dame Maria Miller (Basingstoke) (Con)
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I warmly welcome the Government’s commitment to investing £645 million to enable pharmacists to provide for far more common conditions. I have already visited one of my own local surgeries, the Shakespeare Road medical practice, and seen at first hand how pharmacists are already working in GP surgeries to try to reduce waiting times. Surely, more surgeries should be doing the same, involving pharmacists with enhanced roles in order to cut waiting times in a manner that is safe.

Neil O'Brien Portrait Neil O'Brien
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My right hon. Friend is completely correct. That £645 million, of course, comes on top of the £100 million that we have already put in. We have grown the pharmacy workforce hugely—there are 82% more pharmacists now than in 2010—and we are also enabling those people with their high-end skills to do more by reforming regulations. That is not just the blister packs issue; we are enabling them to do convenient things such as hand out bagged medicines even if the pharmacist is not present.

New Hospitals

Maria Miller Excerpts
Thursday 25th May 2023

(10 months, 1 week ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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The announcement and the manifesto commitment were to build by 2030. The hon. Lady touches on the engagement with industry; Lord Markham has been engaging with industry. We have had a significant team, both within the Department and in NHS England, working on the standardised designs. The whole point is that we have seen in other sectors how standardisation allows us to construct much more quickly. It will also allow internal processes in government to be much quicker because we are not looking at each scheme in a bespoke way; we will have much more standardisation. That is how we will move at a much quicker pace. It has required us to take a little more time over recent months as we have finalised the plan, but now that we have that plan and clarity about the RAAC hospitals in particular, we will be able to move with much more pace.

Maria Miller Portrait Dame Maria Miller (Basingstoke) (Con)
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I warmly welcome my right hon. Friend’s statement and the confirmation that the new Hampshire Hospitals NHS Foundation Trust hospital in Basingstoke is one of the cohort 4 hospitals due for completion in 2032-33. It will serve residents in my constituency and those of a number of right hon. and hon. Members. We have a plan, a preferred site and an amazing team on the ground, so how can my right hon. Friend work with me and other colleagues to speed up this new hospital? It is badly needed to replace the current hospital, which was built in the 1970s to last 50 years. We have one of the biggest maintenance backlogs, and we really need the new hospital to meet the needs of our growing population. We have some of the highest levels of house building in the south-east. What can he do to help?

Steve Barclay Portrait Steve Barclay
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My right hon. Friend has assiduously and passionately led the campaign on this. I stand ready to have further discussions with her. She is right about the trust going into the rolling programme; that is how it will be taken forward. As I touched on in response to the Chair of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine), there are some questions that we are keen to work through—not least around junction 7, the land acquisition, and the service design—and I know that she will be at the fore in making representations on those points.

Urgent and Emergency Care Recovery Plan

Maria Miller Excerpts
Monday 30th January 2023

(1 year, 1 month ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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First, I thank the hon. Lady for recognising the steps that we have taken on transparency. That has been an area of challenge and it is part of my wider commitment to transparency.

The ambition of the targets has to be realistic, and targets are not a ceiling but a floor. It is about saying, “How do we set a target that is realistic?” Of course, we will aim to do better than that, but it is about setting something that the system feels is achievable, because that in turn gets much more buy-in.

On beds, we are increasing capacity, as my right hon. Friend the Member for Wokingham (John Redwood) alluded to. What it is really about is freeing up patients who are fit for discharge from hospital, who should not be there and would actually prefer to be getting care at home. It is about looking at the end-to-end bed capacity, not simply at beds within the acute sites.

Maria Miller Portrait Dame Maria Miller (Basingstoke) (Con)
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I welcome my right hon. Friend’s statement. In the pandemic, the use of local private hospitals by the NHS, particularly in places such as Basingstoke, kept services such as cancer care going uninterrupted. Could the NHS be using more private facilities more widely to relieve some of the pressures that he so eloquently outlined in his statement?

Steve Barclay Portrait Steve Barclay
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My right hon. Friend makes an important point. Again, within that is patient choice and how we empower more patient choice—providing services that are free at the point of use—to use what capacity there is within the system, including in the independent sector. I absolutely agree that we should be maximising capacity. At Downing Street with the Prime Minister, we had a very useful roundtable with the independent sector about how we can make more use of its capacity. That is certainly an area that we are exploring.

Oral Answers to Questions

Maria Miller Excerpts
Tuesday 1st November 2022

(1 year, 4 months ago)

Commons Chamber
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Neil O'Brien Portrait Neil O’Brien
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The hon. Lady asks a powerful question. As well as the reforms that we started this summer and I announced in our plan for patients, as we start to think about the next dental contract, we are thinking about all the different things we can do to incentivise dentists to work in particularly poorer areas where there is difficulty accessing services. We are also working with the General Dental Council to review the processes that overseas dentists have to complete before they start to provide NHS care, which are sometimes more arduous than those for doctors. We are also thinking about the internal market of the UK and making it easier for dentists in Scotland to practise in England as well.

Maria Miller Portrait Dame Maria Miller (Basingstoke) (Con)
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I welcome the shift in responsibility for NHS dental services in my area to my local Hampshire integrated care board. That will bring a real improvement by focusing on local priorities, rather than the previous regional approach. Will my hon. Friend join me in encouraging ICBs to ensure that they adequately fund dental services, especially for elderly people and children? Dental health is as much of a priority as any other aspect of our health.

Neil O'Brien Portrait Neil O’Brien
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My right hon. Friend is absolutely right. The shift to ICBs is right and it is an opportunity to integrate services in a way that has not been done before. She is right to stress the important preventive role that dentistry can play, which also reduces demand on other services, including accident and emergency.

Health and Social Care

Maria Miller Excerpts
Monday 5th September 2022

(1 year, 6 months ago)

Ministerial Corrections
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The following is an extract from the statement on 20 July 2022.
Maria Miller Portrait Dame Maria Miller (Basingstoke) (Con)
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I welcome my right hon. Friend’s statement and its recognition of the need to have specific strategies to make sure that women have equal access to services. However, it is silent on the biggest healthcare injustice that women face in our country—that abortion is still treated under Victorian criminal law, with the most draconian laws in the world. Seventeen women in the past eight years have been subject to criminal investigation, including simply because they suffered the appalling issue of stillbirth. This strategy should stop that by expanding the Government’s own change in the law in Northern Ireland to ensure that abortion is an issue between women and their doctors, and that every woman is protected from criminal investigation at a time when what they need from us is care and compassion.

Women’s Health Strategy for England

Maria Miller Excerpts
Wednesday 20th July 2022

(1 year, 8 months ago)

Commons Chamber
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Steve Barclay Portrait Steve Barclay
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The hon. Lady says that she is not being listened to, but my understanding is that she is co-chair of the menopause taskforce, which has been set up to look at these issues. Indeed, she has also had meetings with officials on the subject of HRT. It is slightly remiss of her to suggest that she is not being listened to when Health Department officials are meeting with her and when we have a taskforce under way. There is much consensus around the points that she raises. She has highlighted, quite rightly, the importance of HRT, and we have acted on that. Part of the reason for the delay until April is that the IT systems need to be put in place. I well recall, when I was a Treasury Minister, being asked to move at pace in response to covid, because of the cash-flow pressures on businesses, and sometimes having the same colleagues complaining that forward controls and other issues had not been put in place. We need to put the right IT in place. We will do that for April, and the work is under way. The issues that she raises are being addressed, but in an effective way.

As I said to the shadow Secretary of State, we will work with the royal colleges to address the issue of training. It is a perfectly fair point, and I do not think there is disagreement in the House on that. On the wider issue of addressing disparities, that is exactly what the taskforce is about. That is why we have such a relentless focus on data, why we have a women’s health ambassador to give greater voice to these issues, and why we have brought forward specific measures, such as the family hubs and mobile breast screening units, to better address those disparities.

Maria Miller Portrait Dame Maria Miller (Basingstoke) (Con)
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I welcome my right hon. Friend’s statement and its recognition of the need to have specific strategies to make sure that women have equal access to services. However, it is silent on the biggest healthcare injustice that women face in our country—that abortion is still treated under Victorian criminal law, with the most draconian laws in the world. Seventeen women in the past eight years have been subject to criminal investigation, including simply because they suffered the appalling issue of stillbirth. This strategy should stop that by expanding the Government’s own change in the law in Northern Ireland to ensure that abortion is an issue between women and their doctors, and that every woman is protected from criminal investigation at a time when what they need from us is care and compassion.

Steve Barclay Portrait Steve Barclay
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My right hon. Friend is right that there is a need for care and compassion, and she highlights an extremely important point. She will be aware that the sexual health review is currently being conducted. That will report later this year and will look into the issue that she raises.

Oral Answers to Questions

Maria Miller Excerpts
Tuesday 19th April 2022

(1 year, 11 months ago)

Commons Chamber
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Maria Miller Portrait Mrs Maria Miller (Basingstoke) (Con)
- Parliament Live - Hansard - -

My hon. Friend the Minister is right to talk about the contracts with dentists, but should she not also look at how dentistry is structured and the regional nature of the contracting? It sits outside our clinical commissioning groups, which reduces co-ordination and accountability in respect of something that is central to our health. Should this not change?

Maria Caulfield Portrait Maria Caulfield
- Parliament Live - Hansard - - - Excerpts

My right hon. Friend is right. Health Education England is addressing the overall system of where dentists are training and where the gaps in provision are filled in its “Advancing Dental Care” review. It is also working with commissioners at a local level to develop more opportunities in those places that we term dental deserts, where there is currently a lack of provision.

Health and Care Bill

Maria Miller Excerpts
Jess Phillips Portrait Jess Phillips
- Parliament Live - Hansard - - - Excerpts

I have heard similar framing, with some saying people will take the pills after 10 weeks. If we look at the actual data, we see it shows that the change increased from 25% to 40% the proportion of abortions happening before six weeks. Telemedicine has dramatically reduced the gestational period, making it much less. I am afraid to say that these are not a good faith arguments. They are based not on fact, but on the idea that women will lie. Women are concerned about their health. They are frightened about their health. We do not make decisions about our health in the hope that we will be harmed; we do what is best. We should not be treated like children; we should be treated like adults.

Maria Miller Portrait Mrs Maria Miller (Basingstoke) (Con)
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I thank the hon. Lady for giving way and add my condolences to those of others for her sad loss.

The hon. Lady is right when she says that these issues can be entrenched and people have entrenched points of view. When we have that situation as a House, we look at the facts and at what the experts say. The experts who support Government amendment (a) in lieu of Baroness Sugg’s Lords amendment 92 include the vast majority of professionals: the Royal College of General Practitioners, the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the British Medical Association; and the Academy of Medical Royal Colleges. Does the hon. Lady agree that, when it comes to trying to find a way forward through entrenched views, we should look at the experts, and the experts are giving us a very clear way forward, followed by my hon. Friend the Minister?

Jess Phillips Portrait Jess Phillips
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I absolutely agree. It is difficult to be dispassionate. I have never been accused of being dispassionate about anything. I am passionate about what I eat for my breakfast. I am just not a dispassionate sort, but the right hon. Lady is absolutely right that we must look at column A and column B in this instance. Column A is full of experts—medical experts, women’s rights experts, and women themselves—and a huge amount of evidence.

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Diana Johnson Portrait Dame Diana Johnson
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I want to address the issue of safeguarding. Let me be clear: creating more barriers to access does not help women; it helps abusers. The End Violence Against Women coalition and other major VAWG organisations reject the claim that telemedical abortions put women at greater risk of coercive abortions. The fact is that coercive pregnancies are far more common than coercive abortions, and since the introduction of telemedical abortions providers have seen a rise—a rise—in safeguarding disclosures, highlighting that the system provides a safe space for women to come forward if they are being coerced. Nurses are highly trained to assess safeguarding issues, and if concerned they will ask the women to come to the clinic for face-to-face assessment.

Finally and crucially, women themselves strongly favour keeping telemedicine for early medical abortion. A clear majority want it to continue.

As a country, we have an opportunity to be seen to be a shining light for women’s reproductive rights around the globe at a time when those rights are being rolled back elsewhere. The weight of the evidence in favour of maintaining this essential women’s healthcare pathway is overwhelming. I ask Members to support the amendment in lieu.

Maria Miller Portrait Mrs Miller
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First, I apologise for being late to the debate, Mr Deputy Speaker. I appreciate your calling me to speak, and I will be brief.

Amendment (a) in lieu of Lords amendment 92 is all about increasing women’s choice, not about taking choice away from anyone. The basis on which the amendment can be judged is the evidence we have gathered, not in a short period of time, but during two years in which 150,000 women have used telemedical abortion care. Judge the amendment against that backdrop; it is done not on a whim or a fancy, but after two years of intensive analysis.

While I might want to agree with those of my right hon. and hon. Friends who are calling for a reasoned debate in the House of Commons on the broader issues of abortion, the truth is that we do not have those debates because the Government talk about changes to abortion provision coming from Back Benchers when that provision is now so out of date in our country that we need the Government to look at it more broadly. I will support the amendment because it is the right thing to do. The amendment is backed by a huge range of organisations and a significant body of evidence, and it requires the Government to look more broadly at abortion—to take this as a responsibility and to stop shoving it back on to the Back Benches.

Continuing telemedical abortions will be supported and regulated in exactly the same way as face-to-face abortion care, and to suggest otherwise is to be factually incorrect. Members really need to think about the evidence showing that online sales of abortion pills from unregulated providers have decreased since telemedical abortion was made legally available. Rather than push people back into an unregulated market, let us keep what we have, which has worked for 150,000 women over the past two years. But please, please, Minister, let us have a reasoned look at abortion more broadly. Stop saying that this is an issue for Back Benchers. It is not.

Alex Cunningham Portrait Alex Cunningham (Stockton North) (Lab)
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I will speak specifically to Lords amendments 85 to 88 on tobacco control. First, I pay tribute to my hon. Friend the Member for City of Durham (Mary Kelly Foy) who put so much work into tobacco control amendments in Committee but is unable to be here. Like her, I am an officer of the all-party parliamentary group on smoking and health, and I strongly support amendments 85 to 88 on the “polluter pays” levy on tobacco manufacturers. I heard what the Minister said about a levy being complicated and how it might take years to implement, but a way must be found to make big tobacco pay for the crisis that it sustains every day that it remains in business.

Like my hon. Friend the Member for City of Durham, I represent a constituency in north-east England, which is the most deprived region of the country and has high rates of smoking. We have reduced smoking significantly in recent years, but, despite that progress, it is still the leading cause of premature death, killing more than 400 of my constituents a year. In my constituency, smoking costs society more than £62 million, which is money that our community can ill afford. I also worry that nearly 15% of local pregnant women are still smoking at the time of delivery, which is 50% higher than the national average. We all know that smoking in pregnancy significantly increases the risks of miscarriage, stillbirth, sudden infant death syndrome and foetal growth retardation. The levy would raise vitally needed money for investment in deprived areas such as ours in the north-east to break the cycle of addiction, disease and premature death. At current rates of decline, Cancer Research UK has calculated that the smokefree 2030 ambition will not be achieved for our most disadvantaged communities until 2047.