NHS Commissioning (Pre-Exposure Prophylaxis)

Debate between Mike Freer and Jane Ellison

Tuesday 7th June 2016 Commons Chamber

[Jane Ellison]

No, that is not the case. There has been an important study—the PROUD study—but that looked at clinical effectiveness. There is a wider piece of work to be done—of which the pilot programme that we have announced is part—to enable us to understand where PrEP fits in in terms of clinical and cost-effectiveness, and how it fits into the HIV prevention landscape more broadly, alongside other HIV interventions that are commissioned. There is work yet to do, but we are not standing still. We have announced this important pilot and committed money to it, and we have asked NICE for an evidence review. All this will go into our consideration.

[Mike Freer (Finchley and Golders Green) (Con)]

I agree with the shadow Minister apart from on one thing, which is his asking my hon. Friend the Minister to show leadership. Having campaigned on many male sexual health issues as chair of the all-party parliamentary group on HIV and AIDS, I can say that this Minister has been unfailingly supportive in addressing many of the issues facing not just men’s sexual health, but particularly gay men’s sexual health. I therefore take issue with that call for leadership.

Having said that, I have lost too many friends to AIDS over the years not to challenge NHS England’s decision not to fund PrEP. HIV infection rates in this country are on the increase and existing strategies are not working. It is not acceptable to suggest that we simply continue to do the same. I have a meeting with the Minister on 13 June. Will she agree to widen that to other stakeholders?

[Jane Ellison]

I thank my hon. Friend for his kind words. I take this issue extremely seriously. He is right to say that we face a challenge in relation to HIV rates, and particularly, as I said, STI rates in the high-risk MSM community. I stress again that while it will no doubt have an important part to play, PrEP is not a silver bullet for sexual infections, particularly in some of those high-risk groups. It is important to understand that. We have to continue to look at a whole range of measures. When I recently met the chief executive of the Terrence Higgins Trust, we touched on this.

As my hon. Friend says, we have a meeting coming up. I apologise for not responding to the shadow Minister’s question about meeting stakeholder groups. Of course I will meet all the key stakeholder groups. I have already had some formal and some informal discussions on this, but of course I am very open to having further such discussions. Stakeholders were involved in the process that NHS England has been involved in. NHS England has made its position clear, and there is a matter due to go before the courts on which I will not comment further. Yes, I will engage on this. Yes, of course I accept that we need to do more, and of course we all share the concerns about rising HIV infection rates, particularly among the MSM community. I too lost friends to the AIDS epidemic that my hon. Friend mentions. I take this issue extremely seriously, but we have to follow a sensible process, and that is what the Government are doing.

Oral Answers to Questions

Debate between Mike Freer and Jane Ellison

Tuesday 22nd March 2016 Commons Chamber

[Jane Ellison]

NHS England’s senior specialised commissioning management team made that decision, and I think NHS England recognises that it could have been made earlier. However, it is also recognised that NHS England has already done valuable work. Some important lessons have been learned, and we do not want to lose that. We must now work with both NHS England and Public Health England to understand how we can continue to learn from, for example, the test sites.

[Mike Freer (Finchley and Golders Green) (Con)]

I share some of the concerns expressed by the hon. Member for Hornsey and Wood Green (Catherine West) about the roll-out of PrEP, but it is only one tool in HIV prevention. Will my hon. Friend update the House on the progress of the HIV prevention innovation fund?

[Jane Ellison]

My hon. Friend is right to draw the House’s attention to the fact that PrEP is only one part of prevention, although obviously we understand its importance. He is also right to mention the innovation fund, which, of course, he championed. We have invested up to £500,000 in new and innovative ways to tackle HIV. Some excellent organisations have come forward with some very innovative approaches, and we have also established the first national HIV home sampling service.

HIV Prevention

Debate between Mike Freer and Jane Ellison

Thursday 12th March 2015 Commons Chamber

[Mike Freer]

I am grateful to the Minister for that announcement. Is she able to give us any indication of how quickly the expert panel will report?

[Jane Ellison]

I am sure we would all want the panel to do that work in a timely fashion. I am not able to provide a date tonight, but I will convey the sense of urgency here in the Chamber to NHS England.

Hon. Members made important points about stigma and discrimination. I can only support everything they said. There is some encouragement: in the latest Ipsos MORI poll in 2014, the National AIDS Trust reports that overall public support for people with HIV is higher than ever, with 79% agreeing that people with HIV deserve the same level of support and respect as people with cancer. That is up from 2010. There is room for improvement, however, and a need for engagement across the spectrum. The NHS, local authorities, the Government, community and faith groups, the media—everyone has a part to play in eliminating HIV-related stigma. I note the comments about the role of schools—I will convey them to my right hon. Friend the Secretary of State—and the intervention about homophobic bullying. The Government have invested money in tackling such bullying and take it extremely seriously. It remains a concern for all of us.

It is positive that the number of new HIV infections overall continues to fall, and I believe that the Government can be proud of their record in this area, but the rise in the number of new MSM infections and the high levels of late diagnosis among black African populations are of great concern. Today I have set out how we will be more bold and innovative with the HIV prevention programme, including through a new national home sampling programme—one of the first of its kind in the world—increased use of social and digital media platforms and the setting up of an innovation fund to trial new approaches. Importantly, we are working in partnership with local authorities in taking this work forward. I see this as a transition to a long-term plan for HIV prevention and sexual and reproductive health promotion, and it is our ambition to see infection rates falling, not rising, and late diagnosis becoming a much rarer event. I thank all right hon. and hon. Members for their contributions to this excellent debate.

Question put and agreed to.

Shaker Aamer

Debate between Mike Freer and Jane Ellison

Wednesday 24th April 2013 Westminster Hall

[Jane Ellison (Battersea) (Con)]

Good morning. I am pleased to open the debate under your chairmanship, Mr Robertson, and to welcome colleagues here to support this important debate. I thank everyone who signed the e-petition that helped to secure it and I am glad that we were able to do so so quickly after the e-petition hit the 100,000 signature threshold. I thank everyone who made that happen, including the hon. Member for North East Derbyshire (Natascha Engel), Chair of the Backbench Business Committee, the Speaker, and the Under-Secretary of State for Foreign and Commonwealth Affairs, my hon. Friend the Member for North East Bedfordshire (Alistair Burt).

Guantanamo Bay, extraordinary rendition and the practice of effectively interning detainees without due process are wrong, and worse, a foreign policy disaster for our important ally, the United States. However, I am not here today to try to solve the problems of Guantanamo Bay or make general criticisms of US foreign policy—those debates are for another time. I am leading the debate with the sole aim of understanding what more the British Government and the US authorities can do to make the release of Mr Shaker Aamer, my constituent, and his return back to his family in London—the clearly stated policy of the British Government—more likely.

The debate has been given greater urgency by reports of a new round of hunger strikes, which started on 6 February, and conflicting information about Mr Aamer’s health. His US lawyer, Clive Stafford Smith, and the Foreign and Commonwealth Office have confirmed that Mr Aamer is one of at least 63 detainees involved in the hunger strike. From previous legal declarations made by Mr Stafford Smith following visits to his client in Guantanamo Bay, I understand that Shaker Aamer’s health was already poor and declining, even before the current round of hunger strikes began. Mr Aamer now fears that he will die in the camp, and his family and I, and many others, are extremely concerned for his physical and mental well-being. The US Under Secretary of Defence for Policy, James N. Miller, wrote to me on 26 February stating that Mr Aamer was in “good health”. The Minister wrote to me on 17 April telling me a US official had stated:

“Mr Aamer is in a stable condition”

and that

“he is being offered medical treatment”.

Mr Aamer’s lawyers have a long-standing request that the Foreign Office persuades the US authorities to allow an independent doctor to visit Mr Aamer in Guantanamo. It was arranged at Britain’s request for Binyam Mohamed, a former detainee and British resident. Will the Minister consider reinforcing that request?

Further to that, recent reports of US troops in riot gear assaulting the minimum security wing of the facility with batons and rubber bullets are particularly troubling. Mr Aamer reports to his lawyer that he is being “assaulted”, as he puts it, by the so-called forcible cell extraction team when he asks for anything, including his medication. I am concerned, and Parliament should be concerned, about the apparent disconnect between the various reports from Guantanamo Bay and what the US authorities say to our Government. Will the Minister comment on that?

Many people here will be aware of the details of Mr Aamer’s case, but for those who are not, a bit of background might be helpful. Shaker Aamer is a 46-year-old Saudi national and a permanent resident of the UK. He had permission to live in the UK indefinitely, based on his marriage to a British national. Mr Aamer has been held by the US Government, without charge, in the Guantanamo Bay detention camp for more than 11 years. He met his wife, Zinneera, in 1996 and started a family in London. His wife and four children, Johina, Michael, Saif and Faris—all of whom are British citizens—live in Battersea and are my constituents. His father-in-law, Mr Siddiqui, who started the e-petition, lives in Tooting, as do many of his supporters. The right hon. Member for Tooting (Sadiq Khan) is in his place; he cannot speak because he is a Front Bencher, but I am grateful for his support for the debate and for the ongoing campaign to free Mr Aamer.

In the summer of 2001, Mr Aamer went with his wife to Afghanistan. Shortly after, coalition forces entered the country. He managed to get his wife and children safe passage out of Afghanistan and they eventually arrived home. He had to separate from his family to protect them because, like many other foreign nationals, particularly Arabs, Mr Aamer was picked up by Afghan warlords and sold to the American forces, who were apparently paying thousands of dollars in bounties for anyone suspected of being an enemy combatant. After a short time at the detention facility in Kabul, he was transferred to the US Bagram airbase and then to the US Kandahar base, before being rendered to Guantanamo. He arrived at Guantanamo Bay on 14 February 2002, the day his youngest child, Faris, the son he has never met, was born in London. The explanation of why he was in Afghanistan is, in my view, beside the point. I have never met Mr Aamer and have never taken a view on why he was there. The fact remains that he languishes in Guantanamo Bay and has been there for more than 11 years without a charge being brought against him associated with his time in Afghanistan or any other period.

Shaker Aamer is one of the last 166 detainees still held at the facility, out of a total of 779 brought there from around the world from January 2002 onwards. He is Detainee 239. He has been cleared for transfer on two separate occasions by the US Government: in June 2007, when the Bush Administration conceded they had no evidence against him; and again in 2009, following the review of detainees initiated by President Obama’s Executive Order 13492, called “Review and Disposition of Individuals Detained at the Guantánamo Bay Naval Base and Closure of Detention Facilities”. It was headed by Special Envoy Daniel Fried and was one of newly elected President Obama’s first executive orders. The transfer clearance document issue to Mr Aamer in November of 2009 was explicit:

“On January 22, 2009, the President of the United States ordered a new review of the status of each detainee at Guantanamo. As a result of that review, you”—

that is, Shaker Aamer—

“have been approved for transfer out of Guantanamo. The United States Government needs to make appropriate arrangements for your transfer and this will require negotiation with countries where you could be possibly transferred. We cannot at this time give you a specific time for your transfer. The United States Government intends to transfer you as soon as appropriate arrangements can be made.”

The meaning of the document is clear: he was allowed to go to “countries”—plural, which is important—and it should happen as “soon as appropriate arrangements” could be made. The US now apparently says he has only ever been cleared for transfer to Saudi Arabia. That is not Mr Aamer’s wish, not least because it would mean abandoning his family in London. Three years on, of course, he has not been transferred anywhere: Mr Aamer remains in Guantanamo Bay. Rupert Cornwell, in The Observer, summed up the situation well when he said that

“even George Orwell would have been pressed to conceive the plight”

of Shaker Aamer and other detainees in his situation,

“cleared for release, but denied freedom”.

[Mike Freer (Finchley and Golders Green) (Con)]

I congratulate my hon. Friend on securing the debate, which is on a subject on which she has campaigned hard. I apologise that I need to step out for a meeting, but I will return for the rest of the debate. Does she agree that this detention without trial is a stain on a democracy? To hold an individual for that period without bringing charges is not acceptable and is akin to the treatment in Soviet gulags, which the Americans criticised throughout the cold war.

[Jane Ellison]

I could not agree more; it is exactly that. It is one of the distinguishing lines that we should draw between our mature democracies and those we have criticised over many years. For many decades, the west criticised the gulags of the Soviet era, yet we seem to have replicated them.

Oral Answers to Questions

Debate between Mike Freer and Jane Ellison

Monday 13th September 2010 Commons Chamber

[Mike Freer (Finchley and Golders Green) (Con)]

4. What his most recent assessment is of the security situation in the Gulf region; and if he will make a statement.

[Jane Ellison (Battersea) (Con)]

11. What his latest assessment is of the security situation in the Gulf region.

[The Minister for the Armed Forces (Nick Harvey)]

The security situation in the Gulf remains delicately balanced, with Iran’s nuclear ambitions, Arab-Israel relations and the risk of Yemen becoming a failed state being the most destabilising factors. We are working closely with our allies in the region as well as key partners such as the US to find a diplomatic solution to all these issues, but it is clear that they will not be resolved quickly. I welcome my right hon. Friend the Foreign Secretary’s Gulf initiative, which recognises increased engagement in the region as a key foreign policy priority. It makes it clear that there are significant economic as well as national security interests in the Gulf, and that the presence of UK forces there is vital in order to reassure our allies and act as a stabilising influence.