(5 years, 5 months ago)
General CommitteesIt is a pleasure to serve under your chairmanship this morning, Mr Wilson.
I am genuinely pleased to see the Minister in his place this morning—he knows that I mean that sincerely, because I also know how strongly he feels about the perils of no deal. I thank him for bringing the two draft statutory instruments before the Committee today and for summarising them so well for us.
On Tuesday, we were in Committee to scrutinise some other SIs, and I said that that was a very important day for our country but, as it turns out, the whole week is a very important week for our country. I am pleased that yesterday the House voted to take no deal off the table, although I am aware that does not guarantee it will not happen. However, we are only 15 days away from 29 March, and I am concerned that we are still hurtling towards leaving the European Union without a deal. I hope that tonight article 50 will be extended in order to give the Government more time to prepare, negotiate and provide those affected by these SIs, and all the others we have considered—such as industry and business—with more information about the impact that the changes will have on their day-to-day work.
As I have mentioned in my remarks in each SI Committee—I know that the Minister is probably sick of hearing this, although I try to say it differently each time—I regret that the Government are in this position and that they have run down the clock, achieving very little, as we have seen so far. We are now squeezing through very important legislation in such a short period—although, again, I recognise that that might be extended tonight—but as legislators, which we all are, we have a duty to scrutinise legislation effectively in order to protect the public. However, the Government have not given us enough time to do so effectively.
As the Minister is aware, Labour Members do not have access to the hordes of experts to whom the Government are privy, so I am literally drowning under the weight of all the SIs. I am sure he is, too, but he has a little more help than I do. Another batch of such SIs have been laid before the House this morning, to be dealt with on Monday, so there goes my weekend, and that of my small team. I know what we will be doing most of the time. That is another reason why an extension to article 50 would be welcome.
The health and safety of the public are of the utmost importance, which is why, although I recognise the need to transfer EU law into UK law, I have some questions for the Minister. I am sure that he will answer them in Committee if he can. I apologise in advance if he has already done so in his opening remarks, in which case he can skip answering them again. I have of course written my speech in advance, although I did try to cross out anything that he has already answered.
The draft regulations are a consequence of the UK’s decision to leave the EU, which will also result in our departure from the European Atomic Energy Community, or the Euratom treaty, which covers civil nuclear policy and legislation across the EU, including emergency response to nuclear incidents. Euratom reports to the International Atomic Energy Agency. Have the Government decided what the UK equivalent of Euratom will be, and how it will report to the IAEA?
The explanatory memorandum to the draft regulations on Chernobyl and Fukushima says:
“Where necessary, functions currently undertaken by for instance the European Commission...will be replaced by references to domestic risk management authorities.”
Who will the domestic risk management authorities be?
I am pleased that both explanatory memorandums to the SIs state that all rules will remain the same and that the maximum levels for radioactive contaminants in food will remain as they are now. Will that be kept under review? Will the UK continue to have conversations with the EU to keep the UK’s restrictions in line with the EU’s? If there is another incident—God forbid—on the same scale as Chernobyl and Fukushima, will the UK work with EU countries to mitigate the consequences for the public in this country?
The Minister has mentioned some dates: the retained EU legislation relating to food and feed from countries affected by the Chernobyl incident will expire on 31 March 2020, and the retained EU legislation relating to food and feed from Japan, following the Fukushima nuclear incident, will be reviewed by the Government before 30 June 2019. Will the Minister tell us if his Department has already made an assessment of whether the regulations should be extended? I am particularly concerned about legislation relating to food and feed from Japan, given how close that deadline is—it is only a couple of months away. If the legislation is to be extended or amended, will the Minister tell us how that would happen? Will it take place in a Delegated Legislation Committee such as this one?
The draft regulations on Chernobyl and Fukushima have an associated direct cost to businesses of £5.7 million. Will the Minister justify and explain that high cost? The explanatory memorandum also states that there will be no additional burdens on enforcement bodies. Does the Minister think that is a realistic assessment? Any changes must be clearly and effectively communicated to enforcement bodies, industry and businesses, to ensure that any changes are carried out smoothly. Protecting public health is of great importance and we must ensure that the changes protect members of the public. Any failure to do so may be a risk to UK consumers. I know that the Minister takes that point very seriously and wants to avoid such a risk, and that he will do all he can to mitigate that. I support him in that endeavour and I look forward to his response.
(5 years, 5 months ago)
General CommitteesIt is a pleasure to serve under your chairmanship this morning, Mr Wilson.
I am genuinely pleased to see the Minister in his place this morning—he knows that I mean that sincerely, because I also know how strongly he feels about the perils of no deal. I thank him for bringing the two draft statutory instruments before the Committee today and for summarising them so well for us.
On Tuesday, we were in Committee to scrutinise some other SIs, and I said that that was a very important day for our country but, as it turns out, the whole week is a very important week for our country. I am pleased that yesterday the House voted to take no deal off the table, although I am aware that does not guarantee it will not happen. However, we are only 15 days away from 29 March, and I am concerned that we are still hurtling towards leaving the European Union without a deal. I hope that tonight article 50 will be extended in order to give the Government more time to prepare, negotiate and provide those affected by these SIs, and all the others we have considered—such as industry and business—with more information about the impact that the changes will have on their day-to-day work.
As I have mentioned in my remarks in each SI Committee—I know that the Minister is probably sick of hearing this, although I try to say it differently each time—I regret that the Government are in this position and that they have run down the clock, achieving very little, as we have seen so far. We are now squeezing through very important legislation in such a short period—although, again, I recognise that that might be extended tonight—but as legislators, which we all are, we have a duty to scrutinise legislation effectively in order to protect the public. However, the Government have not given us enough time to do so effectively.
As the Minister is aware, Labour Members do not have access to the hordes of experts to whom the Government are privy, so I am literally drowning under the weight of all the SIs. I am sure he is, too, but he has a little more help than I do. Another batch of such SIs have been laid before the House this morning, to be dealt with on Monday, so there goes my weekend, and that of my small team. I know what we will be doing most of the time. That is another reason why an extension to article 50 would be welcome.
The health and safety of the public are of the utmost importance, which is why, although I recognise the need to transfer EU law into UK law, I have some questions for the Minister. I am sure that he will answer them in Committee if he can. I apologise in advance if he has already done so in his opening remarks, in which case he can skip answering them again. I have of course written my speech in advance, although I did try to cross out anything that he has already answered.
The draft regulations are a consequence of the UK’s decision to leave the EU, which will also result in our departure from the European Atomic Energy Community, or the Euratom treaty, which covers civil nuclear policy and legislation across the EU, including emergency response to nuclear incidents. Euratom reports to the International Atomic Energy Agency. Have the Government decided what the UK equivalent of Euratom will be, and how it will report to the IAEA?
The explanatory memorandum to the draft regulations on Chernobyl and Fukushima says:
“Where necessary, functions currently undertaken by for instance the European Commission...will be replaced by references to domestic risk management authorities.”
Who will the domestic risk management authorities be?
I am pleased that both explanatory memorandums to the SIs state that all rules will remain the same and that the maximum levels for radioactive contaminants in food will remain as they are now. Will that be kept under review? Will the UK continue to have conversations with the EU to keep the UK’s restrictions in line with the EU’s? If there is another incident—God forbid—on the same scale as Chernobyl and Fukushima, will the UK work with EU countries to mitigate the consequences for the public in this country?
The Minister has mentioned some dates: the retained EU legislation relating to food and feed from countries affected by the Chernobyl incident will expire on 31 March 2020, and the retained EU legislation relating to food and feed from Japan, following the Fukushima nuclear incident, will be reviewed by the Government before 30 June 2019. Will the Minister tell us if his Department has already made an assessment of whether the regulations should be extended? I am particularly concerned about legislation relating to food and feed from Japan, given how close that deadline is—it is only a couple of months away. If the legislation is to be extended or amended, will the Minister tell us how that would happen? Will it take place in a Delegated Legislation Committee such as this one?
The draft regulations on Chernobyl and Fukushima have an associated direct cost to businesses of £5.7 million. Will the Minister justify and explain that high cost? The explanatory memorandum also states that there will be no additional burdens on enforcement bodies. Does the Minister think that is a realistic assessment? Any changes must be clearly and effectively communicated to enforcement bodies, industry and businesses, to ensure that any changes are carried out smoothly. Protecting public health is of great importance and we must ensure that the changes protect members of the public. Any failure to do so may be a risk to UK consumers. I know that the Minister takes that point very seriously and wants to avoid such a risk, and that he will do all he can to mitigate that. I support him in that endeavour and I look forward to his response.
(5 years, 5 months ago)
General CommitteesIt is a pleasure to serve under your chairmanship again, Ms McDonagh, on this bright windy morning. I thank the Minister for bringing the two statutory instruments to the House today and for ably summarising them.
We are all aware that today is a very important day for our country. We are only 17 days from Brexit, yet MPs are just, tonight, getting the latest meaningful vote on the Prime Minister’s latest deal. I expect that not much, or perhaps not enough, will have changed; as the Minister said, we are waiting on the Attorney General’s judgment. This is all very concerning for millions of people up and down the country—concerns I know the Minister shares.
In the event of a no-deal Brexit—we might know in the next few days if that is what will happen—we need to be prepared, but as I have said throughout our consideration of these SIs, I regret that the Government have waited so long to prepare for no deal, given that it was the fallout position for if we did not get a deal. Regardless of how much scrutiny we give the legislation this morning, it is being rushed through. As legislators, we need two things: information and the time to process and scrutinise that information. Unfortunately, the Government have failed to provide MPs with either. I regret the way in which the Government have processed the legislation, but here we are.
Moving on to the SIs, food and feed law serves to protect public health, as well as animal health and welfare. I appreciate that that is a difficult balancing act, particularly in light of growing public concerns about where our food comes from. What conversations has the Minister been having with his colleagues in DEFRA about animal health and welfare, and its impact on our food?
In addition to ensuring human and animal health, the Government must provide continuity for business operators and trade. The Minister touched on that. Is he confident that the SIs will ensure that continuity? What conversations has his Department had with business operators and trade? Similarly, what conversations has his Department had with the scrutinising bodies that will take over the responsibilities of the EU bodies? Will the Minister please confirm which bodies will be doing that? Is he confident that they have adequate time and resources to provide a check and balance on food standards once we leave the EU?
The explanatory memorandum says that staff will need to familiarise themselves with the amendments. Is the Minister confident that the staff referred to in the memorandum have had all the information they require to do that?
Originally, there was a reading time of less than 30 minutes, but following the consultation it was extended to not more than an hour. That has underpinned the financial implications of the statutory instruments. Does my hon. Friend agree that there seems to be an arbitrary take on the time it will take local authority officials and businesses to read the paperwork? When we have looked at it, it has certainly taken more than an hour to read, process and understand—if one is able to download it.
I agree with my hon. Friend. We debated that very point in some of last week’s Delegated Legislation Committees. I thought that perhaps I was a slow reader, as it took me considerably longer than 60 minutes not just to read it, but to try to understand and digest it. I recall the Minister saying last week that that time was just a guide, but I am sure he will address that point directly.
With that in mind, is the Department offering any support to scrutinising bodies to ensure that queries can be answered quickly and effectively? In the event of a no-deal Brexit, which none of us wants, there will be lots of new changes, so I hope that scrutinising bodies will be properly equipped to ensure that nothing is slipped through—chlorinated chicken, for example—that could cause harm later on. We need experts on the ground who are able to scrutinise and safeguard public health in the event of a no-deal Brexit.
Both statutory instruments cause fragmentation across the nations. Can the Minister tell the Committee when legislation will be made by the devolved Administrations? Has he had discussions with the devolved Administrations about these changes? Colleagues from all regions will be rightly concerned about the disparity that might be caused by the SIs.
The draft Food and Feed Imports (Amendment) (EU Exit) Regulations 2019 include an amendment to the Plastic Kitchenware (Conditions on Imports from China) (England) Regulations 2011. I am sure that there is plastic kitchenware from China in my kitchen and in all our kitchens. It would be difficult for there not to be, considering how much China produces. However, this seems entirely isolated from the rest of the measures in the SI. Will the Minister tell the Committee why those changes are being made in this SI? Is there something about Chinese plastic kitchenware that we need to watch out for? I certainly do not eat it.
The draft food and feed imports regulations state that functions currently undertaken by the European Commission on food controls will be the responsibility of the Secretary of State. Can the Minister provide information on how decisions on food controls will be made and managed? Who will advise the Secretary of State on those decisions? Imported food can be susceptible to known or emerging risks linked to specific food or feed of animal and non-animal origin. It is therefore important for human health and consumer trust that we get this right. Equally, consumer trust and consciousness mean that we cannot see a reduction in animal ethics.
I hope that the Minister can allay some of those concerns today, and I look forward to his response.
(5 years, 5 months ago)
General CommitteesIt is indeed a pleasure to serve under your chairmanship this morning, Ms McDonagh; I hope I give you no trouble.
I thank the Minister for providing a summary of these statutory instruments and for his letter in advance of the Committee, which gave me further details about them. As he has heard me say many times before, this is not the first group of no-deal SIs that we have debated. We are just 24 days away from Brexit day and are yet to agree a deal with the EU. I wonder when the Government might start to become concerned about the clock ticking down. I am greatly concerned, and I know that many others across the country are too. We do not have a deal yet, but we are rushing through so many statutory instruments in such a short period of time that it is deeply concerning for accountability and proper scrutiny. As legislators, we have to get it right, and I deeply regret that we have been put in this position by the Government, but here we are again.
The safety of our food is of the utmost importance to our health and wellbeing. We cannot get it wrong; food safety must be protected at all costs. There is also the element of consumer trust. We must not allow that to break down in any event, particularly if there is any relaxation of regulations, which I hope will not happen. I share the Government’s commitment to ensuring no change in the high-level principles underpinning the day-to-day functioning of the food safety and feed safety legal framework. Ensuring continuity for business and public health bodies is important in the interests of the public. As the Minister would expect, I have questions and concerns about these statutory instruments, which I will set out for the Committee.
When food is found to be unsafe for human consumption, we need a quick and effective mechanism to ensure that it is withdrawn from the market. In 2017 alone, the rapid alert system for food and feed issued more than 3,800 “original notifications”, of which 942 were classified as an alert. It is crucial that any food warnings are communicated quickly and effectively. Will the Minister revise the explanatory memorandum for the General Food Law (Amendment etc.) (EU Exit) Regulations 2019 and ensure that alternative arrangements are made to receive food safety warnings that are quick, clear and effective?
As a result of these regulations, the Food Standards Agency will have additional responsibilities in the result of a no-deal Brexit. I am aware of additional funding being made to the FSA, but is the Minister confident that it will have enough funding and staff to take on those additional responsibilities? Will he outline how many additional staff have already been recruited, when they started work and what roles they are currently undertaking? Will the FSA have the ability to work and communicate with European bodies to ensure that information and intelligence is shared?
Regulation 19(c) of the general food law regulations assigns the Secretary of State for Health and Social Care the power to make provisions considered “necessary or expedient”. Will the Minister say whether there will be any oversight over such decisions and whether the Secretary of State will justify any decisions made under those powers in the House?
All the regulations must be easily amendable, if and when necessary, to respond to any emerging threats or changes in safety standards, but I hope that any changes will be justified and overseen by the relevant bodies. What will the arrangements be for collecting data, monitoring the effectiveness of the regulations and regularly reporting? What bodies will be able to scrutinise performance and delivery, and what assessment has been made of their capacity to take on such work?
Concerns were expressed in the public consultation on these statutory instruments about the additional burden on industry and enforcement authorities to communicate changes. Will the Minister reassure me and the Committee that communications with respect to the proposals outlined in these SIs will be delivered with sufficient time to make the necessary preparations to minimise the impact of any changes?
Businesses and food business operators have raised concerns about the lack of information given to them, as well as about their own understanding of the information. Will the Government make their information clear to the public, and if so, when will they do this by? Sufficient transition periods will be required for these statutory instruments. Can the Minister provide some clarity on the transition periods that will be in place to assist businesses and industry in complying with any changes? The explanatory memorandum states that there will be
“an Equivalent Annual Net Direct Cost to Business…of…£600,000.”
Can the Minister explain how those costs will be accrued and by whom, and if they have been communicated to those affected?
Respondents to the consultation on the Specific Food Hygiene (Amendment etc.) (EU Exit) Regulations 2019 raised concerns about the cost of changing their labels. Some respondents estimated that that could cost between £200,000 to £500,000. Has the Minister made any assessment of the impact that that could have on businesses?
In the public consultations, local authorities expressed concerns about the need for them to make the required updates to legal references in official documents and online, which will take significant time and effort and will naturally have cost implications for local authorities, which is concerning in the light of budget cuts. Can the Minister confirm whether the Government will fund any additional burdens on local authorities, especially in the event of a no-deal Brexit?
It is estimated that it will take local authorities less than 60 minutes to read and familiarise themselves with the new regulations and to disseminate them to staff and keyholders—they must be able to read a lot faster than me. Is the Minister convinced that that is a realistic assessment?
Is the Minister confident that, from day one of Britain’s exit from the EU, the high standards of food safety will be maintained? Can he explain what implications a no-deal Brexit would have on the future monitoring of food safety standards and legislation in this country? As I have said, the safety of our food is hugely important and we cannot get it wrong.
Does my hon. Friend agree that if we agree a deal, there will be no change to any of the systems that we currently share and enjoy? Does she also agree that more should be said publicly about how many of the regulations that we enjoy and support in the House—I have sat on many of these Committees—will continue to be in place as we leave the EU?
I do apologise. If we leave with a deal, all this will have been for naught. We have some of the highest food standards and regulations, and they would continue to exist. That is all the more reason why it is such a disappointment to us all that we are at the eleventh hour and the 58th or 59th minute and we still do not have a deal. I sincerely hope that one is brought before the House next week that a majority of the House can vote for.
I am sure the hon. Lady is aware that the pages of regulations that we are trying to transpose into UK law have never had parliamentary scrutiny. They are regulations, so as soon as the ink is dry in Brussels, they become the law of the land whether we like it or not, with no debate in this place. Uniquely, in future, we will have the opportunity to shape our regulations.
As the hon. Lady is aware, the EU operates a precautionary principle. Many think that the standards that come out of Brussels are somehow gold-plated holy writ, but she will be aware of the problems that we have faced in past years, such as the Fipronil scandal in August 2017, which affected eggs. That happened under the regulations that are meant to be the gold standard, but I certainly hope that the UK will be able to do better in future. Can she comment on the fundamental principle that it is better that this place decides food safety, rather than it being decided by regulations over which we have no authority?
Order. I would like us to concentrate on the detail of the regulations, rather than straying into the territory of whether we should be leaving the EU.
With that advice in mind, Ms McDonagh, I would say that, given that the hon. Gentleman had quite a lot to say, perhaps he should have considered making a full speech and graced us with his further thoughts on these matters. I am sure that we would all have enjoyed that immensely. However, I disagree with the fundamental principle of what he said, which is that these regulations were passed in Europe with no scrutiny here.
As a new MP, as I am sure a number of us were at one time or another, I had the huge pleasure of serving on the European Scrutiny Committee. Week in, week out, we would be sent reams of documents containing EU directives and regulations that our esteemed Clerks would have rated as politically or financially sensitive. They gave us advice, but we had to read all those documents and sit and scrutinise them all, week in, week out. We could then refer them for further debate in a European Standing Committee or on the Floor of the House, if we thought something needed scrutiny. I know for a fact that we scrutinised all EU directives that came to this House. Nothing was passed without proper scrutiny. It is a shame the hon. Gentleman has not had a chance to serve on that Committee, because he might never get a chance.
Oh, he has; because I was going to say, the hon. Gentleman has missed a treat.
I hope the Minister will respond to my concerns, either now or in a letter. I know he always sends a letter if he is unable to respond on the day. I know, too, that many others, not only in this room but across the country, will be looking forward to his response.
(5 years, 5 months ago)
General CommitteesIt is indeed a pleasure to serve under your chairmanship, Mr Evans, and to be here discussing this draft amending regulation. I thank the Minister for writing to me in advance and for his summary this morning. However, I have started all of my speeches on Brexit SIs with a caveat, and I will do so again this morning. I apologise for any repetition.
We are now just 29 days away from Brexit day, 29 March, as I am sure everyone is well aware. It is deeply concerning that we are still planning for a no-deal scenario when we are so close to the deadline. I know that we have many, many more public health SIs to get through in that time, and I am worried that we simply will not have enough time to prepare properly. I hope the Government will take no deal off the table.
I thank the Minister for his letter asking for my support on the regulations. He does have my support, but as always I have some questions, and as always I know he will try to answer them. The explanatory memorandum says that there will be a low level of impact on businesses, but no impact assessment has been made. It admits that there will be some additional administrative burden on businesses, but that it will only be an extra 30 minutes of additional paperwork for applications to make health claims in both the UK and the EU. Is the Minister convinced that that is a realistic assessment? The consultation response document says:
“Some respondents raised concern that the consultation under-estimated the additional burden caused for submitting a new claim.”
Has the Minister made any assessment of that since the consultation document was published?
The consultation document was published sooner than anticipated, and I thank the Minister for that, but I am concerned about how short the consultation period was—only 10 working days. I know that we are fast approaching Brexit, but allowing such a short time for businesses, stakeholders and the public to participate in a consultation is alarming, particularly when legislation is drafted as a result. If we are going to get no-deal planning right, we need more time and expertise to look into such detailed legislation.
Throughout the consultation response paper, it is clear that respondents wanted more detail from the Government. We need more detail on risk assessments, management processes and on how mirroring EU regulation would work in practice. The devil really is in the detail and the Government have failed to provide any detail at all. Will the Minister tell us when we will have that crucial detail at our fingertips? Concerns were also raised about integrated supply chains, particularly if the UK failed to be aligned with EU lists on product labelling. Will the Minister address those concerns?
The UK has a long tradition of collaboration with the European Food Safety Authority. Does the Government have a commitment to working with EFSA in the event of a no-deal Brexit? I know the Government are in the process of establishing the UK nutrition and health claims committee, the UKNHCC—not a very catchy acronym or easy to say. What relationship will EFSA have with the UKNHCC in the event of a no-deal Brexit?
The hon. Lady is painting a grim picture of a no-deal Brexit. Surely it is within her power to vote for the deal on 12 March and take the instruction that 61% of the people in Sunderland gave her at the referendum?
I think the former Prime Minister, who has a very fancy hut where he is writing his memoirs, may be the one who started it, but perhaps it goes even further back than that. I will follow your advice, Mr Evans, and not get drawn into such a fascinating debate on who started it, and what we might be asked to vote for on 12 March, because we still do not know what that will be. I will tell the right hon. Gentleman my decision when I know what we are voting for.
There has been a recruitment process for that catchily-named organisation, the UKNHCC. If somebody could come up with a way to say that, that would be helpful, seeing as we could be talking about it in the future. When will the names of the members be made public? What will their expertise be? Will they be subject to any scrutiny?
Finally, I understand that we are only half implementing the Commission delegated regulation 2016/128. Most of that regulation, which relates to foods for special medical purposes, came into force in February 2019 and will be transferred into UK law, but the part that relates to food for special medical purposes developed to satisfy the nutritional requirements of infants will not apply until 22 February 2020. As a result, the UK will not implement that part of the regulation. Can the Minister confirm whether that is the case?
Page 35 of the regulations makes no reference to infants. Is that intentional, and can the Minister elaborate on what will happen to infants who need food for special medical purposes? If the UK does not implement that law, we will have different standards from the rest of the EU. Will that gap be bridged immediately?
Any changes to the legislation must be communicated effectively and in a timely manner to the agencies affected by the SI. As I said earlier, I am concerned that the clock is ticking much quicker than we would like. I hope therefore that the Minister will work urgently to ensure that any changes are made quickly and communicated clearly. With that, and without being drawn into a whole debate on Brexit, I look forward to hearing the Minister’s response.
Maybe it is set in stone. Members can work out what I mean by that.
The hon. Lady asked lots of different questions. About the impact on business, we appreciate that there may be an additional administrative burden on companies that would have to submit claims to the UK and the EU if they wish to make the claim in both areas, but our intention is that procedures for submitting claims in the UK will closely follow those already in place for the EU. We have been in that family for some 40 plus years.
Leaving the European Union is a complex process, to put it mildly. It is not just about trade deals, reciprocal healthcare and citizens’ rights. It is about complex supply chains at every level of business, and there is a complex supply chain around nutrition regulation. It would be an act of foolishness on our part to diverge too far and we do not intend to do that. We estimate that the application paperwork should take only 30 minutes to complete, and rightly so.
In terms of future divergence with the EU, we will make sure that we continue to review the situation to make sure we stick to regulatory alignment with the EU, as deemed appropriate by the Government and ultimately by this House, which holds the Government to account. I am content, as is the Government, that the SI maintains regulatory standards and nutrition policy in a no-deal scenario, and therefore an impact assessment is not required. I have already said that businesses will have to spend a short time on administration.
We completed an equalities impact assessment. We found that the measures set out in the instrument do not have an impact on any of the protected characteristics as defined in the Equality Act 2010.
The hon. Lady asked why the consultation period was just 10 days. To be factual, it was not. It was 11 days—[Laughter.] That is #factualnews. A consultation’s duration is generally determined by the proposals it contains, and in this case we are proposing to mirror the existing regulatory regime as closely as possible, ensuring minimal disruption to business. With that in mind, we consider the consultation period to be entirely appropriate and in line with Cabinet Office consultation principles.
We received 31 responses to the consultation—a case of quality over quantity. We are pleased that they included responses from a broad spectrum of groups, including manufacturers, trade bodies, members of public and one local authority. The response was supportive of the proposals to mirror the existing regulatory framework, as I have already said. We are working with the Department for Business, Energy and Industrial Strategy’s business insight group—now there is a catchy title—to sight the industry on proposed guidance and to obtain its feedback.
Infants are deliberately not mentioned in the SI, because the issue does not apply on exit day. Our current policy intention is to make domestic legislation that is consistent with regulation 609/2013. That includes requirements for foods for special medical purposes developed to satisfy the nutritional needs of infants and for infant and follow-on formula, which are important. The Department will issue further advice on that once the EU exit position is clarified, which clearly is yet to happen.
I was asked whether the UK will continue to be a member of EFSA after we leave the EU. I have said no. The nature of our future relationship with EFSA will be subject to negotiation with the EU, and that is not just in terms of the withdrawal agreement. The SI provides for the appropriate expert committee—I appreciate that the acronym is not ideal—to assume EFSA’s functions in a no-deal scenario, which will guarantee certainty.
The hon. Member for Glasgow South West asked what will happen in relation to products banned in the EU after exit day. As I said in my opening remarks, products that EFSA approves after exit day will be for it to approve for the remaining member states. In terms of the relationship between our new committee and EFSA, we have a long tradition of close scientific collaboration with EFSA in this country. We value it greatly and very much hope and intend that to continue in the future. If EFSA makes a decision on a product, it would be most unlikely that our new committee, whatever it is called, would not take notice of that. We want to continue close regulatory alignment in this policy area so that the public have confidence and so that, returning to my first point, businesses do not face an undue burden in getting products covered in both areas.
Public Health England is in the process of recruiting specialist members for the UKNHCC, including the chair. The recruitment was open and transparent: it was advertised on gov.uk from 8 November to new year’s eve; high-calibre applications were received and the shortlisted candidates were interviewed last week. The committee is ready to come into effect if required. I do not have the names here, but I know that recommendations for appointments to the committee have been shared with the devolved Administrations. They have confirmed that they are content with the calibre and experience of the recommended individuals. Appointment letters will be issued shortly; once accepted, they will be published. I have already said I will publish that to members of the Committee.
Finally, guidance is being developed and tested with industry to ensure that it is fit for purpose, is closely aligned and clearly communicates to business any changes in the process that would occur in a no-deal scenario. That guidance will be published shortly—certainly before exit day, which we still hope will be 29 March.
On a point of clarity on the lack of mention of infants, I heard what the Minister said, but there is a lack of clarity on whether there will be a gap between the situation in the EU and the regulations here. Will that gap exist? Will there still be a difference? I know he is sort of saying that he cannot say what the position will be at the moment, but will he seek to ensure that there is no gap?
Not only will I seek to ensure that there is no gap, but I will very much take that as feedback from Her Majesty’s Opposition on the regulations and ensure that it is fed through to the new committee as it is formed. I understand the concerns expressed by the hon. Lady and the Scottish National party spokesman in that regard.
Question put.
(5 years, 6 months ago)
Commons ChamberI thank the Minister for bringing this legislation to the Floor of the House and for providing us with a summary of it, which helped immensely. We are expecting many more health SIs in the weeks to come, so I must make it clear again, as I will in future, that it is incredibly concerning that we are now only 38 days away from 29 March and are still preparing for a no-deal Brexit. I hope that it does not come to that, but this has taken up a considerable amount of Parliament’s time and resources. My preferred scenario would have been one in which the Prime Minister did not run down the clock for two years, and especially now when we are getting closer and closer to Brexit day. I understand the need for “just in case” legislation, but we should have secured a deal by now.
Moving on to the legislation, clinical trials will probably not be in the forefront of people’s minds, but they are crucial for the safety and efficacy of medicines, as well as for our health and wellbeing. Medicine is not something that we should get wrong, but when we do, as in the case of Primodos, valproate and vaginal mesh as a surgical procedure, we must hold up our hands and take urgent action.
While this may not be the most eye-catching statutory instrument, it is hugely important. It is about patient safety and confidence. It would mean that in a no-deal scenario, the Medicines and Healthcare Products Regulatory Agency would be able to operate as a regulator outside the EU system and would therefore take on roles formerly conducted by the European Medicines Agency and through the wider EU regulatory framework. I must put on record my disappointment that the EMA is relocating from the UK to the Netherlands next month because of Brexit. Our loss is the Netherlands’ gain, but we should not have let it come to this. However, this SI means that in the event of a no-deal Brexit, the MHRA will be able to regulate clinical trials to ensure that they continue to operate effectively.
I want to ask the Minister for clarification on a few points. The new EU clinical trials regulation was introduced in April 2014 and was expected to come into force in October 2018. I understand that owing to technical issues that has now been delayed. The Government’s no-deal guidance says that
“we’ll align where possible with the CTR without delay when it does come into force in the EU”.
Will the Minister please restate that commitment to the House today?
If the UK does leave with a deal, which I hope we do, what will the arrangements be for the CTR and the UK? Could the UK, no longer being a part of the EMA, delay the availability of new medicines in the UK? I am aware of concerns raised that, because the UK will be seen as a smaller market for new drugs than the EU, companies will be more likely to prioritise the authorisation of new drugs in the EU rather than in the UK. Has the Minister made any assessment of this risk?
Will the Minister please tell the House what the implications of a no deal would be for clinical researchers who are EU nationals? Will the UK also be eligible for EU funding for clinical trials under a no-deal scenario? The UK is currently one of the largest recipients of funding for clinical trials, and I am concerned about the implications for future trials and opportunities. The MHRA will have the power to publish its own guidance on clinical trial applications and applications for an ethics committee opinion, as well as declarations of the end of clinical trials and the content of documents forming trial master files. Could the MHRA continue to work with EU states in order to keep regulation in line with the EU? Will the Minister review important details, such as ethics, where concerns are raised?
In July 2017, the then Health Minister, Lord O’Shaughnessy, said that in the event of a no deal the Government would ensure that any system put in place would not impose additional bureaucratic burdens. Can the Minister reaffirm this commitment today? I know that this instrument was subject to consultation and that because of concerns raised amendments were made. Will she please say whether any further amendments are expected and whether there will be further consultation? Finally, will she please confirm that any changes made by the instrument will be communicated effectively to stakeholders in a timely manner?
(5 years, 6 months ago)
Commons ChamberIt is being implemented as we speak. I am very happy to talk to my hon. Friend about when it will be rolled out in Colchester.
I welcome the Government’s commitment to end the transmission of HIV in England by 2030. However, HIV reduction was not mentioned in either the prevention plan or the long-term plan. How will the Government reach that ambitious goal without a concerted and fully costed strategy?
We do have a concerted and fully costed strategy. Indeed, I have given the commitment of ending new AIDS cases by 2030 with a plan around that. The long-term plan goes into detail about new ways of commissioning sexual health services. This is a very important area, and, as the hon. Lady says, it is an important part of the prevention agenda, and we will make sure that we get it right.
(5 years, 6 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Mr Hosie. I thank the hon. Member for Mid Derbyshire (Mrs Latham) for her passionate and excellent speech and for so bravely sharing her own experience with melanoma, which makes it all the more delightful that she is with us in such fine health this morning. I am very sorry to hear about her brother, but I am pleased that her diagnosis was found early and was successfully treated. I also thank the hon. Members for Ayr, Carrick and Cumnock (Bill Grant) and for Linlithgow and East Falkirk (Martyn Day) for their excellent contributions.
It is fair to say that the health implications of using sunbeds once dominated public consciousness. Almost 10 years ago, when the Sunbeds (Regulation) Act 2010 was introduced by the former Labour MP for Cardiff North and passed by a Labour Government, the health risks that came with using sunbeds were well known and well talked about. I remember a parliamentary reception with celebrities such as Nicola Roberts from Girls Aloud speaking out loud and clear about the dangers of sunbeds.
Roberts spoke as someone in the public eye who felt compelled to be tanned—despite being of ginger complexion and very fair skinned—and to constantly use tanning products. She bravely said that she was coming to a point in her life where she wanted to be her natural colour. However, that was 10 years ago, and we should have come a lot further, but owing to vanity or whatever, everyone still goes in search of that elusive tan. As the hon. Member for Mid Derbyshire says, we do not need a tan; it should not be something that we desire.
The issue has certainly not been talked about in a long time, not least in the House, where between January 2011 and February 2019—more than eight years—the word “sunbeds” has been said only 16 times. It is therefore very welcome that the hon. Lady has brought this issue to the fore once again, because there is a generation of young people who will not really understand the risks of sunbed use. They will not know that the short, high-intensity exposure to UV radiation provided by sunbeds is dangerous and can dramatically increase the risk of skin cancer. Looking tanned might seem desirable when we are young, but I doubt, as the hon. Lady said, that looking aged with skin damage several years along the line will be as desirable. I invoke the dried-up prune analogy once again: we have all seen them on the beaches, haven’t we?
It is important that we get the message about the health risks across to young people, particularly because people frequently exposed to UV rays before the age of 25 are at a greater risk of developing skin cancer later in life. I have to admit that that statistic greatly worries me. I confess that, as a young woman in the 1980s, before we knew what we know now, I used sunbeds, although not as often as some. It was obvious that they could not be that good for me, but I did not realise how bad they were for me. I often used them to get a base tan before going on holiday, because we all believed that we would look after our skin better if we got a base tan before going abroad. As the hon. Lady said, that is a total fallacy. Has the Minister therefore made any assessment of how many young people know the risks of sunbed use, and does he have any plan to address the issue?
All the Government information on sunbed use dates back to 2009 and 2010, despite more relevant information being published since. For example, the WHO published a 2017 report entitled “Artificial Tanning Devices: Public Health Interventions to Manage Sunbeds”. The IARC also assessed UV-emitting tanning devices as “carcinogenic to humans” based on consistent evidence of a positive association between their use and the incidence of melanoma.
As we have heard, melanoma is on the increase in the UK, and it is estimated that the NHS will spend £465 million on treating skin cancer patients by 2025. I pay tribute to charities such as Melanoma UK and MelanomaMe., which was set up in my constituency in 2017 by Kerry Rafferty and Elaine Taylor—I met them in 2017 when opening an awareness event for them in Sunderland—after one of them suffered from melanoma and the devastation it wreaked on her life and body. Charities such as Melanoma UK and MelanomaMe. support patients and their families and raise awareness of skin cancers and the risks of sun exposure and, of course, sunbed use.
The Minister knows how strongly I feel that the Government have an obligation to prevent cancers, and I know he is passionate about doing so. That is why I believe that the Government must look at sunbed regulations again, to assess whether they need to be updated almost 10 years on since they were first published. It must be a priority for the Government to ensure that people know the risks of sunbed use before using them, as well as during and after their use. For example, people are told that smoking is harmful before they take it up, but guidance does not disappear once they have started smoking or even once they have stopped. Even though they may carry on smoking, everyone who smokes will admit to knowing the health risks. We are not at that stage with sunbed use.
It is easy to shrug off health warnings when it comes to sunbed use, because the symptoms of skin damage may not appear for up to 20 years. However, skin damage can have very serious implications, as we have heard, so the warnings must not be shrugged off. The hon. Member for Mid Derbyshire called for a ban on sunbeds across the UK, like in Australia and other countries. Although I can see why she calls for a ban, I feel that we must first allow the Government to look at all the most recent evidence and make an assessment. They should definitely update the regulations if necessary and ensure that younger generations are made aware, at the earliest stage, of the risks of sunbed use.
As I said at the beginning of my speech, this issue was very much in the public consciousness almost 10 years ago, and perhaps it is time to ensure that it is again. I am sure the Minister will take on board all that he has heard this morning, and I look forward to his response.
(5 years, 6 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Sir Christopher. I start by thanking the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) for securing this timely debate, and the other hon. Members for their excellent contributions: my hon. Friends the Members for High Peak (Ruth George), for Lincoln (Karen Lee) and for Coatbridge, Chryston and Bellshill (Hugh Gaffney), and the hon. Members for Strangford (Jim Shannon) for Ayr, Carrick and Cumnock (Bill Grant), and for Central Ayrshire (Dr Whitford).
World Cancer Day gives us an opportunity to come together and celebrate how far we have come in cancer diagnosis, treatment and care. It also gives us a chance to reflect on what more needs to be done to fight cancer. The Minister and I have previously worked closely together as co-chairs, as we often say in debates, on breast cancer, as I also have with the hon. Member for Central Ayrshire. That shows that all the main parties’ spokespersons are committed to working together on this issue.
Cancer is a very emotive issue, as we have heard in this debate in some passionate contributions. One in two of us will be affected by it in our lifetime. Most of us in this Chamber will be here today because of the personal effect that cancer has had on our or our family’s lives. In the UK alone, more than 360,000 people are diagnosed with cancer every year. That figure is expected to rise to more than half a million cancer cases every year by 2035. That is equivalent to one new case every minute. That makes the Prime Minister’s commitment to diagnose three in four cancers at an early stage by 2028 all the more ambitious.
Our NHS workforce do a fantastic job every day in caring for us and our loved ones, but as we have heard, there are chronic staff shortages across the NHS. There are vacancies for 102,000 staff, including 41,000 nurses. That makes it harder and harder for them to do the jobs that they want to do. I agree with my hon. Friend the Member for Lincoln, who as a former nurse powerfully made the point about the effect that the lack of the bursary has on the situation. Cancer Research UK has also pointed to the chronic shortages in the diagnostic workforce, with over one in 10 positions unfilled nationally. This is a worrying trend, as more people are expected to be diagnosed with cancer over the years and the NHS cancer workforce are already struggling to keep up with demand.
We covered a lot of this ground with the Minister in the debate earlier this month, in which we also discussed the long-term plan. The Minister said that,
“we must ensure that we have the right staff with the appropriate skills and expertise to ensure that patients receive the best care.”—[Official Report, 8 January 2019; Vol. 652, c. 60WH.]
I agree with him. Therefore, will he tell the House when he plans to publish the workforce implementation plan and when the budget for Health Education England will be set? Patients have a right to the best possible care and it is crucial that the NHS workforce are able to provide that. That is why I believe the Minister should consider it—as he probably does—a top priority.
It will be World Cancer Day on Monday, and I am proudly wearing my wristband. We must recognise the contribution the UK in particular has made to cancer diagnosis, care and treatment around the world. For example, Cancer Research UK has played a role in developing eight of the world’s top 10 cancer drugs. More than a quarter of the clinical trials that Cancer Research UK funds involve at least one other country. Cancer Research UK’s international grand challenge scheme brings together researchers from the UK, Europe and around the world on three five-year programmes, to take on some of the toughest challenges in cancer research. Cancer is an international challenge, which is why we should all unite together against cancer.
It is not just about surviving cancer. As we have heard today, it is about living well with cancer. According to Macmillan, 70% of people with cancer are living with one or more other serious health condition, often as a result of cancer and its treatment. Similarly, a third of people who have completed their treatment in the last two years say that their emotional wellbeing is still affected. As we have heard, during and after treatment, the cost of cancer can be a major issue with regard to not just loss of earnings, but travel and transport costs, and the increasingly expensive parking charges.
I have supported Macmillan’s Cost of Cancer campaign for over 10 years now. It is sad that we still need to debate and discuss this, but it is still a major issue. The issue of parking could be very easily solved. The cost of cancer also includes access to benefits, as we heard from my hon. Friends the Members for High Peak and for Lincoln. That can also be solved easily by some joined-up action across Government. That is why, when thinking about cancer, we must not forget about after-care, advice and support, especially when it comes to further symptoms that could become secondary cancer. In this regard, I believe that it is vital important that GPs are aware of all symptoms of secondary cancer, so that it can be picked up as soon as possible.
Finally, in this World Cancer Day debate, I want to pay tribute to all the NHS cancer workforce for all the hard work they do, day in, day out. Whether diagnosing, treating, caring or advising, they do a difficult but fantastic job, which we are all very grateful for. I also pay tribute to the scientists and researchers who discover the groundbreaking new treatments and information. Finally, I thank the campaigners and volunteers. We cannot beat cancer alone, which is why we must all come together to do so. As always, I look forward to working with the Minister to do just that.
(5 years, 6 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Sir Roger. I begin by thanking my hon. Friend the Member for Warrington North (Helen Jones) for introducing this debate on behalf of the Petitions Committee. I, too, pay tribute to Natasha Sale, who started this important petition. As others have said, it is so sad that she did not live to see this debate take place. Her family, I am sure, are very proud of her.
I thank all hon. Members who have spoken in the debate: the hon. Member for Henley (John Howell), and my hon. Friends the Members for Rotherham (Sarah Champion), for Darlington (Jenny Chapman), for City of Chester (Christian Matheson), and for Kingston upon Hull West and Hessle (Emma Hardy), whose speech was excellent and we will not forget any time soon. I thank the hon. Members for Livingston (Hannah Bardell), and for Lanark and Hamilton East (Angela Crawley), who spoke on behalf of the SNP. It has been an excellent debate with very good contributions and lots of sharing. I am a classic oversharer, but I will try to resist the urge. Finally, I thank the 167,000 people who have signed the petition so far.
This is a very timely debate, because Cervical Cancer Prevention Week concluded only yesterday. The age to start screening is a very emotive issue. Every year in the UK, more than 3,000 women are diagnosed with cervical cancer. As we have heard, 15% of those women are under 30. Last year, 12 of those under 30 died from cervical cancer. The number of cervical cancer deaths has fallen in recent years, but it remains the most common cancer in women aged 35 and under. That is why I welcomed preventive measures such as the introduction of the HPV vaccination, which was offered to adolescent girls in secondary school.
My daughter was one of the first to receive the vaccination when she was 13. I was very pleased to give that permission; I would not have hesitated for a second to give it, although as my hon. Friend the Member for Warrington North said, a number of people do not give permission. That is very concerning; genuine concerns will have led them to that decision, but we must do what we can to allay their fears. We heard about the catch-up programme at the time, to ensure that all girls up to the age of 18 were vaccinated.
At that time, I looked extensively into this policy area, following a campaign by Washington constituent, Claire Walker Everett, and her family. Claire led the campaign before her untimely death at the age of 23 in 2008, and her family continued it for some time afterwards. I called for a further catch-up programme to address what I called the “seven-year gap”, so that women between 18 and 25 could be vaccinated until they were eligible for smear tests. I said that the gap would close each year until almost all under-25s had been vaccinated, as is now the case. That was 10 years ago, so that gap has closed. Many of those first vaccinated are approaching 25 and are eligible for a smear test, so we should have a whole generation of young women and girls who mostly have been vaccinated against the HPV virus, to help protect them from cervical cancer.
The vaccination programme has been very successful on the whole, with a high national uptake of around 85%. However, I have previously raised with the Minister the significant regional differences in the uptake of the HPV vaccination, which need to be addressed. The lowest uptake for the two doses is in Stockton-on-Tees, at 48.3%; the highest uptake is in East Renfrewshire, at 95.6%. That is curious, and flies in the face of the screening statistics cited by hon. Members, which show that the north-east reached higher rates than others. Perhaps the differences are in pockets rather than whole regions.
I therefore ask the Minister what steps he is taking to investigate and address the regional inequalities in HPV vaccinations and screening. How do the Government ensure that the HPV vaccinations are taken up by the vast majority of girls? Otherwise, the reassurance of my earlier statement that a whole generation of women and girls approaching 25 have been vaccinated falls short in certain areas, which is extremely concerning. Cervical smear tests are available to women aged 25 to 64, yet cervical screening is at a 21-year low. Last year, it was discovered that more than 40,000 women had missed out on crucial information about cervical screening appointments and test results. Has the Minister made any assessment of the impact that has had on uptake? Can the Minister give assurances that this issue has been solved?
According to Jo’s Cervical Cancer Trust, which I commend for its tireless work and campaigning, one in four women across the UK do not attend cervical screenings. That proportion increases to one in three among those aged 25 to 29, when they are first eligible for screening, and to one in two in some of the most deprived regions in the UK. That decline can be for a host of reasons, such as fear or embarrassment.
I pay tribute to TV shows that show the medical equipment involved in a smear test; the “Victoria Derbyshire” show even showed a smear test live on the show on Friday, in an attempt to address those reasons. There was no wincing or obvious cries of pain, so it will have been reassuring to someone who has not had one, although I am sure some viewers complained that it was not suitable daytime viewing. Aside from doing more of that, will the Minister tell me what steps he is taking to increase take-up? Additionally, what steps is he taking to educate women on the need for cervical smears and what the tests are for? I understand that some women believe that a cervical smear will also detect ovarian cancer—as he knows, that is not the case.
As I mentioned, most women under the age of 25 have received the HPV vaccination, giving them excellent protection from the HPV virus. That means that the reason that once may have existed to lower the screening age no longer does. However, I say again, that reason falls down in low take-up areas. Additionally, I worry that lowering the eligibility age for a cervical smear test to 18 would cause additional problems and worries for young patients, as my hon. Friend the Member for Warrington North detailed so well in her excellent speech. False positives are more likely in younger women, as they often undergo natural and harmless changes in the cervix that a smear test would identify as cervical abnormalities. In most cases, those abnormalities resolve themselves without any need for treatment.
Treating false positives as cancer can damage the neck of the womb, which can cause a woman to give birth prematurely in any future pregnancies. In women under 25, therefore, the risk is deemed to outweigh the benefit. However, as my hon. Friend said, women should be provided with that information, to make judgments for themselves. Wider education should start in school; my hon. Friend the Member for Kingston upon Hull West and Hessle called for that to start as early as possible, to tackle the fear and embarrassment as soon as possible. I also believe that much more research should be done on the age so a decision can be made that is best for all women.
Cervical cancer is very rare in women under 25, with under three cases per 100,000 women. However, every such case is an awful ordeal for the woman and her family, and sometimes it becomes a tragedy, as it did in the case of Natasha Sale. That was also true for Claire Walker Everett from Washington in my constituency, who died at 23 and whose case first brought this issue to my attention, and more recently for Amber Rose Cliff from the neighbouring Sunderland Central constituency, who died in 2017 at the age of 25. If a young woman has abnormal bleeding or symptoms that she is concerned about, she should be taken seriously by her GP and offered a smear test as soon as possible as part of the health investigations into what is causing her symptoms.
I believe that is part of current guidance and best practice, but we have heard clearly that that guidance is not always followed. That was the case in the short life of Amber Rose Cliff. Between the ages of 18 and 21, she went to the doctor around 30 times, complaining of worrying symptoms and asking for a smear test, only to be told 30 times that she was too young and sent away. When she was 21, her mum paid for her to have a smear test privately. The results were devastating. It was cancer, and the cancer had spread. She died just four years later, aged 25. Young women should not be excluded from a valuable screening service just because of their age if they have symptoms, as Amber obviously did. GPs should be aware of cervical cancer symptoms and know that they should refer young patients who present with such symptoms for smear tests as part of wider investigations.
With all I have said in mind, I conclude that the age for cervical smear tests should remain at 25, on the condition that further research and debate is conducted and tests are offered to those under 25 who present with symptoms. The Government must also ensure that preventive measures such as the HPV vaccination are taken up as fully as possible, and that women who are eligible for a cervical smear test attend their appointments when they are invited or as soon as possible thereafter. I know the Minister cannot drag them all there personally, but I look forward to his response.