Oral Answers to Questions

Debate between Mike Freer and Jim Shannon

Tuesday 28th March 2023 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

Has the Minister made an assessment of the number of wills and estates that are disputed over assets each year in the United Kingdom? What discussions has he had with the devolved Assemblies about the timescales for solving such issues?

[Mike Freer]

I am not aware of any particular statistics on the number of wills that are contested, but I will write to the hon. Gentleman and ensure that we liaise with the devolved Assemblies.

Oral Answers to Questions

Debate between Mike Freer and Jim Shannon

Thursday 3rd March 2022 Commons Chamber

[Jim Shannon (Strangford) (DUP)]

In Northern Ireland, there are 123,000 SMEs. What steps is the Secretary of State taking to ensure they are awarded the same trade opportunities as those in the rest of the United Kingdom, and has the Northern Ireland protocol hindered trade opportunities for SMEs?

[Mike Freer]

I will raise that with my colleagues in the Northern Ireland Office to make sure that they have full access to all the trade support mechanisms that I outlined previously to ensure that all Northern Ireland businesses are fully aware of all the support packages available to them.

Oral Answers to Questions

Debate between Mike Freer and Jim Shannon

Thursday 2nd December 2021 Commons Chamber

[Mike Freer]

The Department for International Trade is always looking to protect our own industries and sectors, including the agricultural sector, while ensuring that they are able to exploit new markets. In terms of beef and lamb, our teams are working hard to ensure that the new markets we are opening up will be available to Scottish farmers. Again, if the hon. Lady would like to know more about the support we are able to offer, I am very happy to facilitate that discussion.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his responses, but bearing in mind the fears of our farmers and farmers’ unions following the New Zealand deal, will he outline what steps have been taken with the Department of Agriculture, Environment and Rural Affairs at the Northern Ireland Assembly to promote our British produce exports to global markets affected by the New Zealand deal?

[Mike Freer]

My understanding is that there are regular and frequent conversations between the Department for Environment, Food and Rural Affairs and DAERA. I am more than happy to ensure that the hon. Gentleman gets details of those discussions if he has any specific concerns he wishes to have addressed.

Psychoactive Substances Bill [Lords]

Debate between Mike Freer and Jim Shannon

Wednesday 20th January 2016 Commons Chamber

[Jim Shannon]

I mentioned the closure of the head shops, which is really good news—good stuff. I also referred to the detective sergeant in the Drugs and Organised Crime Bureau. He outlined an issue that the Irish are now trying to address. It is good to be able to refer to other examples of hard and fast legislative change to address such issues. In the Republic of Ireland, they have been partially successful in relation to online sales—they are almost there—but we must also do that.

I commend the Minister and the Government on what they have introduced. This is the sort of legislation that I and my constituents, as well as people from across the whole of Northern Ireland, want. I look forward to supporting the Minister when it comes to a vote—if it comes to a vote.

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

I thank the shadow Minister for a balanced speech that contained some well-judged comments. I also thank my right hon. Friend the Minister for his courtesy when I took a delegation to him from the National AIDS Trust, Stonewall, Millivres Prowler and Boyz magazine to discuss this topic.

It is clear not just from this debate, but from the debate that has been raging in the gay press over the past few months, that there is considerable concern over the need to ban poppers. What has come to the fore over the past few months while I have been working on the topic is the complete lack of empirical data one way or the other. I appreciate that the Home Office believes—I have no reason to think that this belief is not genuine—that deaths have occurred from the use of poppers. However, that evidence has never been forthcoming.

I therefore decided to do a bit of research of my own. I would like to draw attention to some American research, particularly that of Dr Thomas Hall of the University of California in Los Angeles, who gave evidence to the Gay Times for a report on the effects of isopropyl nitrite. I will not quote the whole document, you will be pleased to know, Madam Deputy Speaker, but he said:

“There is very little specific research on the health effects of alkyl nitrites other than amyl nitrite.”

He went on to say:

“My summary statement would be that in the grand scheme of drugs of abuse, the risks from nitrite poppers are fairly benign… Isopropyl nitrite and other nitrite poppers appear to be far less harmful to the body in general than chronic alcohol consumption.”

I then looked at The New England Journal of Medicine, which stated in 2010:

“To our knowledge, over the past 10 years, there have been only two case reports of visual loss after inhalation of poppers, and the anatomical basis of this injury remains elusive.”

Finally on medical research, I turned to the US Department of Health and Human Services report of January 2014. It stated:

“To date, use of alkyl nitrites as a psychoactive substance among MSM”—

men who have sex with men—

“has received little attention in addiction textbooks, where they are subsumed among other inhalants.”

We have heard about that today. The report continues:

“This is unfortunate, because lumping these disparate agents together based on mode of administration”—

that is, inhalation—

“obscures substantial differences in both mechanism and typical risk between alkyl nitrites, which act on a specific…pathway, and inhaled solvents and propellants”

that have other effects. That is about the sum of the medical evidence that I could find.

In the absence of medical evidence or hard facts in the UK, I wrote to the Advisory Council on the Misuse of Drugs. The chairman could not have been more blunt. He said that poppers were

“not seen to be capable of having harmful effects”.

There has been talk of a medicinal benefit to poppers, which I thought was an interesting turn of phrase until I received an email. I have to bow to the knowledge of our SNP colleagues, because it was from a gentleman from Croy in Inverness. He said: “Alkyl nitrites are carried, used and, when the need arises, shared by many people who work in the countryside as the first line of treatment if one is bitten by an adder.”

I confess that adders are not common in Finchley and Golders Green. Mr Joyce of Croy went on to say:

“A substantial number of people are bitten each year in Britain and the bite is rarely fatal, but whether that is because the venom is not particularly powerful against modern healthy humans or because treatment, with Alkyl nitrite or one of the eight known anti-venoms, is almost always administered very quickly is a question that is open to debate.”

That email shows that there is a conflict between the views that are held and what limited information and fact are out there in the public domain.

I support the view that there is a need to provide up-to-date empirical evidence. There also needs to be proportionality. Everything that we do carries a risk, whether it is smoking or anything else. If one drinks bleach, one will be harmed, but we are not proposing to ban bleach. When we seek to control, regulate or ban anything, we must deal with it in the round and consider the proportionality of doing so.

I welcome the response to the Home Affairs Committee report, because it states that an investigation will be under way shortly into the impact of the ban on the relationships of gay men and women. I am told that this issue affects not just gay men, but gay women. The Chairman of the Home Affairs Committee, whom I would like to call my right hon. Friend, talked about anal sex. That is quite a crude way of saying that poppers can facilitate sex, through the relaxation of muscles. However, this is not just about the physical side of a relationship. If people want their relationship to be as intimate as possible and poppers facilitate that, they are an important element in the emotional wellbeing of that couple. Therefore, if we are talking about the medicinal benefits, we have to include the emotional and mental health benefits that the use of poppers in a relationship can bring.

When we are talking about risks—I have mentioned proportionality—it is important that we do not start banning things on the basis of one or two incidents. There has to be a significant risk of significant harm to a significant number of people, otherwise we would be banning cigarettes and alcohol tomorrow.

I say to the Minister that the investigation and report must be as open and transparent as possible. I ask him to give an assurance when he responds that evidence will be taken not just from organisations such as Public Health England, elements of the NHS and the ACMD, but organisations such as the National AIDS Trust, the Terrence Higgins Trust and Stonewall. It should also be taken from organisations such as Millivres Prowler, which I believe is the largest retailer of poppers in the UK, because it has a strong, relevant and up-to-date evidence bank of how poppers are used and how they are sold. Because it is a reputable retailer, it also has an enormous amount of data on the illegal import of the more dangerous poppers that are coming in through the internet. I hope that the Minister will also say that evidence will be taken from the international bodies, a few of which I mentioned earlier, that have done medical research into the benefits or disbenefits of the use of poppers.

Finally, if the Home Office decides that there is a risk that needs to be mitigated, but that an outright ban is not necessary, I urge it to consider licensing poppers for sale through sex shops. That would allow some level of control, regulation and protection, without the need for an outright ban, which might lead people to be exposed to all sorts of underground drugs.

There is a lot of work to be done. I welcome the swift action of the right hon. Member for Leicester East (Keith Vaz). Members might think that my conclusion will be that I will support Opposition amendment 5, and I have to say that the Opposition have spoken a lot of sense. However, I will support the Government because I want an exemption based on empirical evidence. If poppers are exempted by the summer recess, as outlined in the response to the Home Affairs Committee report, that exemption could not be easily overturned on the whim of a future Home Office Minister, because it would be based on empirical evidence, whatever it says. On that basis, I will support the Government on this issue.

Joint Committee on Vaccination and Immunisation

Debate between Mike Freer and Jim Shannon

Wednesday 8th January 2014 Westminster Hall

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

It is a pleasure to be here today under your chairmanship, Mr Gray. I am grateful to Mr Speaker for granting this debate on the work of the Joint Committee on Vaccination and Immunisation. I requested this debate following the JCVI’s decision on the 2 October 2013 to undertake further work on key issues surrounding the human papillomavirus, or HPV, vaccination programme. I understand that some colleagues may wish to comment on other aspects of the JCVI’s work. I want to focus particularly on the Committee’s decision to consider—I use its word—“urgently” vaccinating men who have sex with men, on attendance at sexual health services, and adolescent males. I intend to focus my remarks on that work now being undertaken with regard to the HPV vaccination programme, specifically in terms of exposure to HPV-related cancers, which are increasing in boys who have sex with females and the MSM community.

The decision of the JCVI to prioritise consideration of vaccinating MSM is noteworthy, not least because the minutes of its October meeting accept that a full economic model might not be necessary where sexual health clinicians can develop independent guidelines. Historically, the JCVI has often rejected vaccination of adolescent boys and MSM on economic grounds, so it is a major step forward for it to say that heath clinicians with expertise—particularly at sexual health clinics—can take such a decision on clinical grounds. That is welcome.

It is important—I have no doubt that my hon. Friend the Minister will need to ensure it—that any decision on extending vaccinations is clinically and financially sound. I do not seek to undermine that decision. I wish to stress the economic benefits of extending the vaccination swiftly, rather than stress other issues of equality, which I raised in an Adjournment debate last year.

[Jim Shannon (Strangford) (DUP)]

I thank the hon. Gentleman for bringing this important health matter to Westminster Hall for consideration. There have been significant positive results from vaccinating women and girls for HPV, so clearly there is an advantage shown in doing that. That consolidates the hon. Gentleman’s request for the same vaccination to take place in men and boys as well. Does he agree that the same should happen with regard to men as has happened for women and girls?

[Mike Freer]

The hon. Gentleman makes a good point that repeats some of the discussion we had in last year’s Adjournment debate. The success of the vaccination programme among girls has had a dramatic impact on HPV-related cancers among women. However, the flaw was that it assumed herd immunity for boys who were having sex either with girls or within the herd. But of course, not all boys have sex with girls: some—shock, horror!—have sex with other boys, and not all boys have sex within the herd. Increasingly, in a global economy, and particularly in Europe where the vaccination programme is not the same, adolescent boys in this country are exposed to women who have not been vaccinated. It is important to close the loophole for adolescent boys having sex with unvaccinated girls and those having sex with unvaccinated boys, who, obviously, grow to be unvaccinated men.

If the JCVI has agreed to urgently review the economic case for extending the vaccination programme, why is this debate needed? Before I discuss that, it is worth reminding ourselves what health problems we are trying to prevent. I recall, during the Adjournment debate, seeing the duty Whip sink ever further on the Bench as we discussed certain topics and cancers. This is not a pleasant subject, but I would rather discuss an unpleasant subject than have to deal with it in our hospitals.

Nine out of 10 cases of genital warts are HPV-related; oral-related HPV infections—men are six times more likely than women to have oral infections—increase the risk of cancers of the mouth, throat, neck and head cancers; and there are HPV-related penile and anal cancers: HPV is associated with 80% to 85% of anal cancer in men. In 2009, just after the HPV vaccination programme started, there were more than 6,500 cases of these cancers, with 47% of penile cancer and 16% of head and neck cancers thought to be HPV-related. The latest incidence data show that in 2010 there were 437 incidences of anal cancer and 5,637 of oropharyngeal cancer, 515 instances of penile cancer and 180,000 instances of genital warts. Rates of HPV-related cancers are on the rise in the UK. Throat cancer has overtaken cervical cancer as the leading HPV-related cancer. I am pleased that the JCVI has accepted that there is an urgent need to review the clinical and economic case for extending the programme to adolescent boys and MSM.

I should like to put on record my thanks to the Minister’s predecessor, my hon. Friend the Member for Broxtowe (Anna Soubry),for her support in this matter and for facilitating a teleconference, which she and I and representatives of the Terrence Higgins Trust had with the Chairman of the JCVI, which I believe gave some impetus to this change of heart and the speeding up of the work by the JCVI. That was a significant breakthrough.

The key point in this debate is that although the JCVI’s urgent report is due at some unspecified point later this year, the procurement of the next round of HPV vaccinations will commence in October or November this year. I am concerned that if the JCVI does not report in time and this procurement round is missed, we may have to wait four more years—I believe it is a four-year procurement round—before the HPV vaccination programme is extended to adolescent boys and MSM, if that is the recommendation.

HPV Vaccine

Debate between Mike Freer and Jim Shannon

Tuesday 2nd July 2013 Commons Chamber

[Mike Freer]

Yes, I will raise the cost-effectiveness of the vaccine as compared with the treatment costs of many cancers, including oral or pharyngeal cancer, which is throat cancer.

In 2009, just after the HPV vaccination programme started, there were over 6,500 cases of these cancers, with 47% of penile cancers and 16% of head and neck cancers thought to be HPV-related. Today, however, overall rates of HPV-related cancer and warts should—should, I stress—subsequently come down in heterosexual men, because of so-called herd immunity.

Herd immunity is where men have sex with vaccinated women and thereby get protection against warts, as well as other cancers including penile, anal, oral and pharyngeal cancers. However, they get such protection only if they have sexual contact with UK-born women who have been vaccinated, or with Australian women or those of the very few countries that have had a mass vaccination programme.

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing this debate. Does he agree it might be better if we had a regional vaccination programme not only for England and Wales, but for Scotland and Northern Ireland as well, so we can address issues of education and intervention UK-wide first, and also globally?

[Mike Freer]

The hon. Gentleman makes a good point. On a small island such as ours it is important that men who are having sex with women, or men having sex with men, are having sex with partners who are vaccinated, and I believe that is a matter not just for England and Wales, but for the whole of the United Kingdom, and we would also then be setting an example for the rest of the world.

Herd immunity is valuable, but it is not foolproof for heterosexual men. I have mentioned that it is valuable where heterosexual men are having sex with vaccinated women, but men who have sex with men are not subject to herd immunity, and that is another element of inequality. Evidence from other countries suggests herd immunity will eventually prevent most, but not all, cases of HPV-related cancer in heterosexual men. There is still work to be done, therefore, on all men having vaccinations against HPV-related cancers.

Some HPV-related cancers are on the rise in the UK, despite the vaccination programme. Throat cancer has overtaken cervical cancer as the leading HPV-related cancer in the UK. Men who have sex with women who are not vaccinated remain at risk. This is of concern to men who, for example, have sex while on holiday or while living outside the UK, or who have sex with unvaccinated migrants to the UK—but men, straight or gay, remain at risk.

The current programme is inequitable, as those men who “stray from the herd” by having sex with unvaccinated women or men will remain at risk. That is why I am seeking a commitment for the HPV vaccination programme to be widened.

The key issue I wish to press is the health inequality in respect of gay men and anal cancer, an inequality perpetuated by the current vaccination policy. Gay men already experience poorer sexual health as a group; they are at an increasing and far higher risk of HIV and other sexually transmitted infections compared with the wider population. Rates of anal cancer in gay men are now equivalent to those for cervical cancer in women before the cervical cancer screening programme was introduced in 1988. HPV is associated with 80% to 85% of anal cancer in men, yet it is not yet possible to screen for or effectively treat anal pre-cancer, as it is for cervical cancer; HPV vaccination is the only effective form of prevention, and it is being denied to men.

Gay men with HIV are particularly susceptible to HPV-related anal cancer and as the number of gay men with HIV continues to rise year on year, so will cases of anal cancer, other HPV-related cancers and warts. In addition to having a disproportionate effect in HIV-positive men, HPV can increase the risk of HIV transmission. HPV can increase skin fragility and overt anal warts can bleed, which enhances the risks of acquisition or transmission of HIV infection. This health inequality between gay men and the general population will continue to widen as long as gay men remain unprotected against HPV. I stress this point as it relates to gay men, but it also affects heterosexual men who are equally unprotected.