Assisted Dying

Steve Brine Excerpts

Monday 29th April 2024 Westminster Hall

[Steve Brine (Winchester) (Con)]

Thank you, Sir Robert, for calling me to speak. The “Assisted Dying/Assisted Suicide” report by the Health and Social Care Committee —the Committee that I chair, as you said—has been tagged to this debate. It was published on 29 February and all Members of the House have received a copy of it from me. By complete coincidence, we received the Government’s response to the report just this morning; hon. Members can find that on the Committee’s website now.

Our report is a pretty big piece of work. It includes roundtables with people who have lived experience; we talked to health and care workers from across the NHS and social care, including people who on a daily basis provide care to people at the end of their lives; and we went on a number of visits, including to the US state of Oregon, where assisted dying has been legal for over 20 years, and to the Royal Trinity Hospice in Clapham. We received just shy of 68,000 responses to our online form, which is the largest number of responses of that type to any engagement from a House of Commons Committee. We held five evidence sessions with witnesses from across the world and received close to 500 written evidence submissions.

As we set out to conduct the inquiry, we were very clear that we did not want to weigh in on whether assisted dying should be legalised or whether the law should remain unchanged. That seems to have disappointed just about everybody, which tells me that we got things just about right and, more importantly, in line with the terms of reference that we published at the very start. All that has produced a weighty reference for MPs and peers to draw from in the future.

Our aspiration was for Parliament to have a broad and well researched basis for further consideration, whether sooner or later. Obviously, today’s debate makes it sooner, but I predict that this issue will come back again. We can be crystal clear that this debate is a general one, not a piece of draft legislation. I just implore the campaign groups that encourage people to contact their MPs about this debate to be clear and accurate about what it is. It is not fair to mislead people about what we are doing today. This is a general debate.

In their response to us this morning, including evidence that they gave us, the Government made it clear that they will not bring forward legislation in this area and that it was more possible that a change in law would be sought through a private Member’s Bill; that is indeed what has happened in other jurisdictions where assisted dying has become the law. In producing our report, it was very interesting to look at the international jurisdictions, although the evidence is quite limited about their track record on this issue. In the majority of jurisdictions that have it, this law has come in only quite recently.

As I said, we visited Oregon, and there has been such legislation there for two decades. Its legislation comes into the category whereby a person receives an established terminal diagnosis, which means that they are likely to die within a prescribed period—six months. In the Netherlands, however, the legislation applies a much wider set of criteria: the person seeking to access assisted dying can do so on the basis of “unbearable suffering”, subject to their own experience. That point was made by the right hon. Member for Knowsley (Sir George Howarth). I take the rather old-fashioned view that MPs should vote to change the law based on a clear and concise understanding of exactly what we are changing it to, but that is not the purpose of today’s debate.

We did not find any evidence that the quality of palliative and end-of-life care deteriorated after the introduction of assisted dying in those jurisdictions; in fact, there is some evidence to suggest that there has been an increase in the funding of palliative care services, which I think is interesting. I hope that colleagues follow up the point that some hon. Members have already made: there will probably be legislative changes elsewhere in the UK, and certainly in the Crown dependencies in the coming months. Ministers need to be ready to respond to that, whatever their intention for the law in England.

Three or so minutes is not enough time to set out much detail, but I hope colleagues will reference our report. In the time that I can be here today, I look forward to listening to them and the Minister.

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[Ruth Cadbury (Brentford and Isleworth) (Lab)]

It is a pleasure to serve under your chairship, Mrs Latham, and an honour to speak for the official Opposition in this e-petition debate that calls on the Government to allocate parliamentary time for a debate and a vote on assisted dying. The debate follows the campaign by Dignity in Dying, the Daily Express and Dame Esther Rantzen, and the petition signed by more than 200,000 UK residents, including over 200 of my own constituents.

I thank my hon. Friend the Member for Gower (Tonia Antoniazzi) for her considered opening speech. I also thank members of the Select Committee for the work that they have done in informing this debate.

I should start by making my own view clear. I support reforming the law in favour of assisted dying. I voted for reform in the private Member’s Bill debate in 2015 and I have spoken in previous debates on the subject in this Chamber.

Today we have heard powerful, deeply held views from many right hon. and hon. Members, some supporting change, some not, and some still with an open mind. This has been a truly cross-party debate in the very best traditions of this House. As I speak from the Opposition Front Bench, I can reiterate that both the Leader of the Opposition and the shadow Secretary of State for Health and Social Care have said that, if elected, a future Labour Government would provide parliamentary time and a vote on changing the law.

The process in issues of conscience means that it would be for a Member of Parliament rather than the Government to introduce the change in law. It would be debated and refined on a cross-party basis with each Member free to speak and vote according to their own conscience. Any Government must ensure that any proposal carries with it proper and strong safeguards. It damages the cause if such reforms are rushed through with inadequate consideration. If any reforms do not recognise the concerns that many people have, including those who support reform in principle, we will not receive the consensus that any change must have.

The right hon. Member for Haltemprice and Howden (Sir David Davis) addressed the concern that in Canada and the Netherlands, issues of cognitive impairment or mental illness might be reasons for people to consider assisted dying. We must listen to those concerns. We must also listen to those who are or who represent the elderly, people with disabilities and those who face life-changing conditions.

[Steve Brine]

There has been a lot of talk about Canada today, so I just want to place something on the record. It is true that Canada did extend the MAID—medical assistance in dying—provisions to include those who are suffering from a mental illness. However, on 29 February this year, Bill C-62, as they name them there, received Royal Assent, postponing that eligibility until 17 March 2027. My point is that lawmakers can change the law; that is what we are here for. The slippery slope argument is often made, but actually, the slippery slope would have to be engendered by politicians and by this Parliament.

[Ruth Cadbury]

I thank the Chair of the Select Committee for that very helpful contribution.

Legal Migration

Steve Brine Excerpts

Monday 4th December 2023 Commons Chamber

[James Cleverly]

An inability to speak English would hamper anybody, and it really is entirely reasonable to expect people coming here to work to be able to do so.

[Steve Brine (Winchester) (Con)]

This year, vacancies in adult social care fell a little—the figure now stands at a “mere” 152,000—which was due to a large increase in the number of care workers coming to this country as part of the shortage occupations list. The Library tells me that, as of September, there were 121,000 vacancies in the NHS. What exact changes does the Home Secretary envisage making to the shortage occupations list? Can he please show the workings-out of the changes to family arrangements, for which he said that he has crunched the numbers with the Immigration Minister? Above all, who did Ministers consult in the health and care sector ahead of today’s legal migration announcement?

[James Cleverly]

We asked the Migration Advisory Committee to look into these things—that it why it exists—however my hon. Friend makes a very important point, which speaks to why we are tightening the system to prevent abuse. Anyone looking at the numbers will see that a significant number of people have come through the health and social care visa system over the last couple of years, yet we have lost them from health and social care. That is not what any of us needs or wants. The right thing to do is to ensure that those who come are genuinely employed in that sector, which is where we need them—that is the promise that they have made to us, and that we have made to them. Ensuring that that is the case is the right and fair thing to do.

International Doctors: Visas

Steve Brine Excerpts

Wednesday 2nd November 2022 Westminster Hall

[Matt Warman]

I absolutely agree with my hon. Friend that increasing all those routes is hugely important. Of course, we would all like to see more doctors trained in this country, and the Government have gone some way towards doing that, but where people want to work abroad, Britain should be as attractive a place as we can be. That is why, on the GP point specifically, the Government should be removing every single barrier in that visa process.

The most straightforward thing we could do, which would remove the need for a practice to register as a visa-sponsoring practice, is simply to say that when a GP qualifies in this country, they get the indefinite leave to remain that other doctors get. These are people in whom the UK has already invested. They are already here; they already have a visa. The extension of that visa into another form seems simply to be a bureaucratic hoop that we are putting in their way as doctors and in the way of GP practices. We are putting extra bureaucracy into a system, while on the other hand the Government say, “We desperately need people to come to this country to work in the NHS, and we will try to do everything we can.” The health service does hugely good work to try to recruit such people and specifically encourages them to train as GPs, but then we put an additional barrier in their way.

The response from the Government in the past has been, “Actually, the visa process registration is not terribly onerous and GP practices can do it.” They point to the numbers that have and do, which is fine as far as it goes, but it does not answer the question of why we put a barrier in the way in the first place. It should not be a cost of doing business when we say that we really want to make it as easy as possible.

Equally, it should not be a reasonable thing to put different sorts of doctors on different sorts of levels. It is not reasonable to say to people that, just as they have gone through the most stressful part of qualifying with exams, they should also be thinking about their immigration status. That calls into question their probity when we have things such as the General Medical Council making sure that they are upstanding members of our communities, and many of them have tens of thousands of patients to testify to that.

I do not think it really washes when the Government say that we need to put barriers in place, and I do not think that the Department of Health, where the Minister was previously a Minister of State, would agree, in an ideal world, with the Home Office stance. We could work together across Government to try to secure a sensible outcome.

I have talked about GPs, but there are broader issues around visas for doctors, many of which come back to the Home Office backlogs that I know my right hon. Friend the Minister is working really hard to address. There is a good argument for simply scrapping visa fees altogether for people coming to work in the health service. That is an argument for another day, but when it comes to GPs I think that lowering the five-year limit for indefinite leave to remain to three years is the neatest way to address the issue.

On the broader issues, ultimately this comes back to how many doctors we are training in the UK. We all want, as I said to my hon. Friend the Member for Mid Derbyshire (Mrs Latham), to see more people trained in this country. That is what we are doing and that is what the Government continue to pursue, but until we reach that moment—the NHS has never reached entire self-sufficiency in the UK—we should make it as easy as possible for doctors, dentists, nurses, people working in social care, and all those who work in different parts of the health service, to come to the UK. It is not primarily a question about backlogs; it is a question about process. At the moment there is a degree of bureaucracy that simply does not need to exist.

[Steve Brine (Winchester) (Con)]

It is great to hear my hon. Friend making such an eloquent case, as always—more so than I can. The issue matters for all the reasons he has set out, but would he agree that because of the retention challenge in the health service, the more we pour in at the top is sometimes, in part at least, offset by those who go out at the bottom? There is a wider picture here to do with pension pots—the whole retention piece is part of the wider jigsaw, which I appreciate is not the remit of this Minister, but perhaps was in his previous job.

[Matt Warman]

I thank my hon. Friend for that intervention. It is always tempting to ask the Minister to go and have a word with his former self, but we cannot do that. I think he has read the last couple of points that I want to make.

There are a number of relatively low-hanging pieces of fruit that the NHS has repeatedly asked for. I want to thank the RCGP, the British Medical Association, the radiologists, the British Dental Association, and also groups such as EveryDoctor, which have helped me with this debate and have identified the fact, as my hon. Friend implied, that there are a small number of things that could and should be sorted as quickly as possible. Busting the barriers around pensions and the bureaucracy around visas are things that would make a real difference to recruitment and retention across the health service. There are plenty of things that are difficult when it comes to addressing the NHS’s challenges, particularly as we approach winter. On the narrow point of GP provision, we have a visa process that puts pressure on, in particular, small GP practices, where the added burden of registering as a visa sponsoring practice is even greater now as they are under such huge pressure. It is also a burden on GPs at what is a particularly stressful point in their careers.

I know the Minister will make entirely legitimate points around putting a process in place, but the reality is that there is a political choice to be made to ease some of those burdens. There is a powerful, compelling case to be made for doing a small number of easy things that could address the GP crisis in particular, which, as my hon. Friend the Member for Winchester (Steve Brine) alluded to, is acute.

I appeal to the Minister and the Government to work as closely as they can with the Department of Health and Social Care to understand these challenges and see what can be done, and I urge my right hon. Friend to take seriously the suggestion that if someone qualifies as a medical doctor in this country, and in particular as a GP, they should have indefinite leave to remain. At the moment, it effectively comes with that if they qualify in a hospital but not in general practice. That is an inequality that the Minister can look to fix, and I hope he will do so as soon as is practicable.

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[Stuart C. McDonald (Cumbernauld, Kilsyth and Kirkintilloch East) (SNP)]

It is good to see you in the Chair, Mr Stringer. I also start by welcoming the Minister to his place. I wish him good luck; he probably needs it, as much as any Minister in Government, because his is an incredibly challenging post. We will, of course, have significant political differences on this topic, but it is an important issue, so if there is an opportunity for constructive and positive engagement, I am up for that, wherever possible. I thank the hon. Member for Boston and Skegness (Matt Warman) not just for securing the debate but, as ever, for his expert introduction to the topic and advocacy.

Moving to the subject at hand, like other Members I will start by recognising the extraordinary contribution of non-UK nationals to all parts of our NHS. I suspect everybody in the room has benefited from that, never more so than in recent times. GP practice is no different, and nationals of other countries will continue to play an important part, both now and in the future. As the hon. Member for Boston and Skegness alluded to, figures suggest that 47% of new GP trainees in England in 2020-21 were international medical graduates.

Another important context for this debate is the extraordinary pressure that our NHS is under, particularly in the light of covid, but also for all sorts of other reasons, which we could perhaps touch on in another debate. High vacancy rates are among them. As has been mentioned, challenges in recruitment and retention affect GP practices as well as everywhere else.

Against that background, the hon. Member identified what at first seems to be a technical problem in the operation of the immigration system, but one which, when examined, is significant. A failure to solve it leads to some absurd and harmful consequences. As he pointed out, the pain will ultimately be felt by patients. He explained that the three-year GP training regime for IMGs leaves them, on completion, two years short of being able to apply for settlement. That is unlike other specialisms, which have longer training periods.

That requires IMGs to find a GP practice that has become a tier 2 sponsor, which is not easy. The hon. Member for Rutherglen and Hamilton West (Margaret Ferrier) alluded to statistics highlighting that, with half of all IMGs having struggled with the visa process, 30% having considered moving away from GP practice and 17% thinking about leaving the United Kingdom.

The Minister’s predecessors appeared to dig their heels in and say, “We just need more GP practices to become tier 2 sponsors.” I agree with the hon. Member for Boston and Skegness that that prioritises Home Office bureaucracy above the health service. Ultimately, it is the wrong answer for patients who are struggling to access a GP. We are going to lose skilled and dedicated GPs as a result.

There is one issue where I do have some sympathy for the Minister’s predecessors, and that is the rejection of the idea that a route to settlement should simply be shorter. Settlement is an important and significant thing. There are aspects of that where I am open to persuasion on the case to shorten routes generally and in some specific cases, for example, family members. However, an argument to shorten the route to settlement simply because a training course lasts a certain time is perhaps not the most persuasive. It is not one that I am closed to, but it is not one that I immediately find the most persuasive.

However, the Home Office should be pragmatic about other possible solutions that have been put forward. Its current insistence that 8,166 GP practices right across the UK should just invest time—and over £4 million—in becoming tier 2 sponsors on the off chance that they might want to recruit an IMG is simply not realistic. The £4 million in fees from those GP practices would go to the Home Office—I wonder if that has something to do with its intransigence at the moment.

The alternative approach of a practice only becoming a sponsor once it has already had an application for an IMG is also far from ideal. The delay that that causes is bad for all affected, and the pressure on IMGs to find a tier 2 sponsor to satisfy immigration requirements prior to their existing visa expiring means that they cannot wait. As evidence given to the Health and Social Care Committee earlier this year highlighted, newly qualified GPs have received removal letters from the Home Office soon after their qualification. That is absurd, because we not only need them but have spent tens of thousands of pounds on training them to do a job that we urgently need them to do. I hope good sense will prevail over the Home Office’s current intransigence.

I now turn the other solutions, which I think are perfectly reasonable, that the Royal College of General Practitioners has put forward. The first solution is to create a new post-medical training visa that works in the same way as a graduate visa. The second is to create umbrella bodies that could operate as a sort of super-sponsor. That could be the NHS or whichever training body had already sponsored the first three years of the IMG’s presence here. Who knows—it could be the Royal College of General Practitioners itself. I do not have the answer as to which option would be best, but any of them would clearly be better than the absurd situation we find ourselves in.

[Steve Brine]

I have a suggestion, at least for England: the primary care networks or the new integrated care boards could quite easily act as an umbrella sponsor, thereby taking the bureaucracy away from the practices, which is part of their purpose.

[Stuart C. McDonald]

That is a valid proposition, and we could do the same with health boards in Scotland. If we knock our heads together, we can come up with a way to fix this. It just requires a little bit of pragmatism.

There is a second issue I wanted to raise—when I saw the motion for this debate, I wondered if the hon. Member for Boston and Skegness would raise it. That issue relates to recent reports from the BBC flagging complaints of poor treatment and conditions for international doctors in private hospitals, as well as highly questionable recruitment practices. I will touch upon it briefly because it has not been raised, although it is important to draw it to the House’s attention and to see if the Minister will investigate and respond. There were reports from 11 October suggesting that doctors from some of the world’s poorest countries were being recruited, by Nuffield Health in particular, to work in private hospitals under conditions prohibited in the NHS. There are reports of doctors being on call 24 hours a day for a week at a time, not being able to leave the hospital grounds and, unsurprisingly, suffering from extreme tiredness, putting both patients and doctors at risk.

Nuffield Health denies those allegations, but a British Medical Association and Doctors’ Association UK questionnaire of 188 resident medical officers adds some credence to the claims. It shows that 81% of respondents were recruited from Nigeria, and most complained of extreme working hours and unfair salary deductions. The conclusion of the Doctors’ Association UK was that we now have a two-tier system: one for the NHS and one for other international recruits in the private sector. I ask the Minister to look into that.

That issue highlighted to me another fundamental problem with how the immigration system operates. We have all sorts of checks and regulations that focus on ensuring that people who come to work here abide by their visa conditions, and they include the doctors we have been talking about—the IMGs—where the Home Office is on their case as soon as they have qualified to see what they are doing next. However, little or no checks are done to protect people who come here. That is not just in the NHS and with doctors; I have been firing off parliamentary questions and freedom of information requests in relation to the agricultural sector. That is a sector wide open to exploitation, but as far as I can see there is no concerted effort to protect people from that exploitation.

As the Minister will appreciate, Nigeria is a red-list country for recruitment. According to both the World Health Organisation and the Government, that is not where we should be finding doctors.

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[Stephen Kinnock (Aberavon) (Lab)]

It is a pleasure to serve under your chairship, Mr Stringer. I thank the hon. Member for Boston and Skegness (Matt Warman) for securing this important debate. His speech was an excellent example of a constructive critique of where his own party is on the issue, and he put forward some practical and thoughtful ideas. I hope the Minister has taken note. I suspect there is more chance he will take note of the hon. Member’s comments than he will of mine, but we never know. This debate is a great example of the cross-party discussion that we can have in this place.

Let me start by setting out the Labour party’s position on work-based migration in Britain, as it is important to set the context before drilling down into the specifics of the issue we are discussing today. In a nutshell, we support the points-based immigration system for migrant workers; it was of course the Labour Government in 2008 that introduced that system for immigration from outside the European Union. We are clear that there will be no return to the European Union’s freedom of movement. We want to build on and improve the points-based system currently in place. It is a very blunt, one-dimensional instrument that could be significantly improved.

Our long-term ambition is to make sure that every employer across the private and public sectors is recruiting and training more home-grown talent to fill vacancies before looking overseas, but we recognise that simply turning off the tap of labour from other countries without having the appropriate workforce structures, plans, training, skills and productivity strategies in place, our private sector and our public services will deteriorate, our businesses will struggle to meet the Labour party’s ambitions to make, buy and sell more in Britain, and we potentially risk jobs disappearing overseas.

We cannot have a situation like the one we have had in the farming sector over the past year, where 30,000 pigs were slaughtered and £60 million-worth of crops were burned. Indeed, we cannot have a situation in the NHS where we are short of doctors, all because our immigration system puts up red tape and barriers that prevent, or at least severely discourage and disincentivise, doctors who have come to the UK from overseas to do their three years of general practitioner training from staying on to fill critical vacancies in the job market. That is utterly counterproductive, not least because 47% of new trainees in England in 2020-21 were international medical graduates. Labour’s shadow Health Secretary, my hon. Friend the Member for Ilford North (Wes Streeting), has been clear that it is madness for the NHS to lose GPs whom the British taxpayer has paid to train.

Successive Conservative Governments have already cut 4,700 GPs over the last decade, meaning that patients are finding it next to impossible to get an appointment. There is a chronic lack of doctors, nurses and healthcare staff in the NHS. Staff shortages are reaching dangerous levels, when the need for NHS treatment is incredibly high, with huge backlogs and millions of people forced to wait for treatment. Patients are finding it impossible to get a GP appointment in many cases, and GPs are leaving the health service at an alarming rate. Last year, one in six people who tried to speak to a nurse or GP were unable to get an appointment at all. The hurdles placed in front of international medical graduates are a barrier to our NHS filling vacancies and providing the medical care that the British public deserve.

A survey by the Royal College of General Practitioners found that around 30% of all IMG trainees consider not working as an NHS GP because of all the difficulties and red tape with the visa process. The first of those difficulties is that IMG GPs are not eligible to apply for permission to stay permanently until two years after completing their training. GP training takes three years to complete, and it is only after five years that IMGs can apply for indefinite leave to remain, in line with wider UK visa rules. That problem is unique to general practice: other medical specialty training takes a minimum of five years to complete.

The second difficulty is that international GPs must find employment with a GP practice with a visa sponsor licence before their existing visa expires in order to be eligible for a visa that allows them to stay and work as a GP after their training, and ultimately apply for permission to stay permanently. However, practical and bureaucratic obstacles can make that extremely difficult, because GP practices may struggle with the costs and bureaucracy associated with obtaining a licence to sponsor a foreign worker. The Royal College of General Practitioners warns that the cumulative effect of visa difficulties on IMGs is that some are

“feeling forced to take roles elsewhere in the NHS and others considering leaving the NHS, and in some cases the UK, altogether.”

The Government have so far been utterly intransigent on the issue of IMGs, and on tweaking the visa system to remove the red tape. Labour would look closely at the issue as part of our wider improvements to the points-based system. Those improvements would involve the Government working hand in hand with employers, trade unions and other key stakeholders to ensure that we have a properly planned, sector-by-sector approach, with a proper strategy that works for businesses, workers, the public sector, customers and patients alike. As part of that, we will review the length of work visas, processing times and the existing path to citizenship to ensure that they are all working for our economy and for the public.

Labour already has a long-term workforce plan for the NHS. That involves doubling the number of medical school places, which in turn will deliver more home-grown GPs. At the heart of the plan is the doubling of medical school places—an increase of 7,500—which means we will double the number of doctors trained in a year. Our shadow Health Secretary will also produce long-term workforce plans for the NHS for the next five, 10 and 15 years, which will ensure that we always have the NHS staff we need to get patients treated on time. The plans will not only provide good jobs for British workers and fill shortages in our NHS, but prevent us from having to do dirty deals, as mentioned earlier, with some of the poorest countries in the world—those on the WHO red list—and from recruiting medical professionals from impoverished communities that desperately need that medical knowledge locally. That is exactly what the British Government have done recently with Nepal.

In the short term, Labour has consistently pushed for a fix to punitive doctors’ pension rules. The fix would do away with the cap above which NHS workers incur additional tax burdens. That would support short-term recruitment and prevent the exodus of workers. The Government are yet to deliver on that.

The Labour party is committed to making the points-based system work, and to our NHS workforce plan. The current system is simply not fit for purpose, and at this time of crisis we risk losing newly qualified GPs because of unnecessary red tape. The Conservatives have broken promise after promise on GPs. Their 2019 manifesto promised to deliver 6,000 more GPs by 2024-25. The former Health Secretary, the right hon. Member for Bromsgrove (Sajid Javid), admitted that the Government are not on track to deliver that.

In contrast, the next Labour Government will put patients first, ensuring that they are able to get a face-to-face appointment when they want one, bringing back the family doctor to deliver continuity of care and implementing our workforce plans. The current Government are out of ideas, and we need practical solutions.

[Steve Brine]

It is interesting that the hon. Gentleman mentioned continuity of care, because he will be aware that that came up yesterday during Health questions. Would the Opposition introduce direct management of lists back into the GP contract from when it is next renegotiated? That is how we achieve continuity of care.

[Stephen Kinnock]

The key piece of our plan is to cancel non-dom status, which is estimated to generate approximately £3.2 billion for the Exchequer, and to use that money to invest in more GPs, doctors and nurses—indeed, doubling the numbers. We can have the best plans and legislation in the world, but we need the resources to deliver them. That is how we will pay for our plans and generate the kind of care that we need for our public. It is time for that Labour Government, so that we can clear the backlogs holding our country back, which we see right across Government, and get Britain’s public services back on track.

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[Robert Jenrick]

The hon. Gentleman makes a valid point. Of course, one could apply that to a number of other regulated professions, whether that be lawyers, nurses or others making significant contributions to the United Kingdom. It is an important step to obtain indefinite leave to remain, and not one that we should give away lightly. Asking an individual to spend five years here in order to demonstrate that level of commitment to the UK feels to me about the right length of time, but I am open and interested to hear other contributions on that point. At the moment we do not have plans to reduce the length of time that skilled workers would need to complete in the UK in order to apply for settlement.

The SNP spokesperson, the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), raised a number of cases that I am aware of from my former role at the Department of Health and Social Care about allegations of the mistreatment of foreign workers—including doctors and nurses—coming to the UK. That is something we take seriously, and the Department of Health and Social Care and NHS England are investigating. If I receive further information from the Ministers in the Department of Health and Social Care, I will be happy to write to the hon. Gentleman.

On the broader question of the ethics of recruiting healthcare professionals internationally, the NHS takes that responsibility seriously. We have ethical guidelines nationally that are set by NHS England and individual trusts in England—that may well be the case in Scotland as well—and of course we take heed of the red lists, which give a strong indication of countries from which we should not be recruiting healthcare professionals because they clearly need them to satisfy their own healthcare requirements. The NHS proactively works with countries that have an excess of doctors and nurses, or that train individuals specifically for export. In fact, one of the last meetings I had as Health Minister was with the Chief Minister of the state of Kerala, which specifically trains nurses to be exported to other countries around the world.

That sort of arrangement is sensible and defensible by the UK, although it is not a sustainable answer in the very long term because we live in a globally ageing society; there will be competition from other states to recruit professionals. That is one of the many reasons we should be training more doctors and nurses in the UK and considering measures such as raising the cap on medical school places, if we are able to do so. That, of course, is a matter for the Treasury and the Department of Health and Social Care, not my Department. It is worth saying that it is an extremely expensive measure over time, and that the Opposition’s proposal would cost several billion pounds to deliver. That is not to say that it is not an important step, but it is worth bearing in mind the significant outlay.

[Steve Brine]

The Minister is responding very clearly to the points raised. What we really need is an independent health workforce assessment, supported by the Treasury. He will be aware that that was called for by some Members who are no longer on the Back Benches. Dare I say that he could encourage that through his good offices, because only once we have the answer will we get to a better place. If we ask the NHS what we need it will answer with what we can afford. Those are not the same questions.

[Robert Jenrick]

For a long time I have believed that one of the virtues of a national health service is that it should be able to plan for its workforce needs long into the future. My hon. Friend raises the specific campaign of our right hon. Friend the Member for South West Surrey (Jeremy Hunt), when he was Chair of the Health and Social Care Committee. I am sure that he will consider that carefully now that he has his hands on the controls as Chancellor of the Exchequer.

Nationality and Borders Bill

Steve Brine Excerpts

Consideration of Lords amendments
Wednesday 20th April 2022 Commons Chamber

[Tom Pursglove]

I profoundly disagree with the hon. Gentleman. He and I debated these matters many times in Committee and it is fair to say that the approach he advocates is in essence a charter to do nothing. I do not think it is acceptable to stand back, throw our hands in the air and say that this is all too difficult. We have to take action. The new plan for immigration is delivering meaningful change and I genuinely believe it will make a difference. Of course, such considerations often require consideration of the number of people who come here, the flow and all the pertinent and relevant issues. It is difficult to predict the number of people who will come at any given point in time. I believe we are introducing meaningful changes that will dramatically shift the dial and, ultimately, help to preserve lives.

[Steve Brine (Winchester) (Con)]

The Minister knows, because we have discussed the matter several times since the announcement, that a lot of my constituents are very concerned about the Rwanda partnership deal, as am I, but the truth is that how we will operate the scheme is as yet unknown. Many have conflated the issue in respect of last week’s announcement with this Bill. Will the Minister assure me that the legislation that enables the partnership predates this Bill and this Government? Will he also reassure me and my constituents in respect of the screening programme and specifically how LGBTQ people will interact with it? There are many concerns about that and our friends in Rwanda.

[Tom Pursglove]

My hon. Friend always raises pertinent issues on behalf of his constituents in Winchester. As the Home Secretary set out yesterday, the legal basis for the policy is the new Labour—I know it is not fashionable to talk about new Labour on the Opposition Benches—policies of 1999, 2002 and 2004, when the Labour party had a genuine and thorough position on these matters that I am afraid is not in place today, when we hear a lot of criticism but no meaningful alternative is brought forward to address the issues. For the reasons I have set out, I argue that we have to take action to address the terrible criminality that puts lives at risk. That argument underpins the legislation.

Ukraine: Urgent Refugee Applications

Steve Brine Excerpts

Tuesday 8th March 2022 Commons Chamber

[Kevin Foster]

I thank the hon. Gentleman for that example. We are conscious that people are leaving without the normal proof they might have of family relationships. It would clearly be inappropriate to insist that people try to get a marriage certificate or something like that if they have fled from their home. We have provisions that allow travel without passports and other documents, obviously once certain checks and nominations are done. Again, that is part of the process that is being established.

We are conscious that, even where people have access to documents, they might not have the full documents. We are also conscious that people will potentially have left in a hurry, so they may not have had time to bring particular documents. Not having a passport will not be a bar, but we will need to use other processes to identify them, which is not unusual in situations where we are moving people at pace.

[Steve Brine (Winchester) (Con)]

So much about this does not feel right, and my constituents know what they see. All of this is far too robotic. As the hon. Member for North Antrim (Ian Paisley) said, very little Christian compassion is being shown at the moment. Surely we are past the UK saying that we are going to have a generous scheme; it is time to deliver a generous scheme.

The family scheme is too slow and the humanitarian sponsorship scheme, as I raised with the Secretary of State for Levelling Up, Housing and Communities yesterday, is still being designed at the Department for Levelling Up, Housing and Communities. I do not want to hear the Minister say that that is another Department, as he is the Minister at the Dispatch Box. At the very least, can we have a simple online gateway up and running tomorrow so that constituents who want to help can at least register their interest? There is so much compassion and desire to help, but people are not able to do so.

[Kevin Foster]

I recognise my hon. Friend’s concern. The vast majority of councils in this country, including my own, took part in the Afghan resettlement scheme, and many are already offering to take details and offers of help in preparation for the launch of the humanitarian sponsorship route. I encourage my constituents to do it, and I know he will be encouraging his constituents to think of what offers they can make. The compassion of this country is shown by the fact this will be an unlimited scheme, on top of the family scheme, and could potentially be one of the biggest movements into communities in the UK since the evacuations of the 1930s.

Ukraine

Steve Brine Excerpts

Tuesday 1st March 2022 Commons Chamber

[Priti Patel]

I was not aware of that, and I recognise the tone of the hon. Lady’s comment. I will pick that up, absolutely—[Interruption.] Yes, I need to find out what has happened. Had she notified me of this before, I could have looked into it. However, she is raising it now and I will look into it. As for the point on Europe, I have commented that it is still working through what it is going to do.

[Steve Brine (Winchester) (Con)]

My constituent writes in the past few hours:

“My only brother with his two small children and wife are hiding in the shelter under their home not knowing what the next hour will bring, gradually running out of food and basic supplies”.

For those of us with small children, that is unimaginable. The Ukrainian family scheme is really good news for that family, and I thank the Home Secretary and the Prime Minister for listening to their Back Benchers on that. The UK is big-hearted and generous, as always. Will the Home Secretary say a bit more about the humanitarian sponsorship pathway? A church in the Chandler’s Ford bit of my constituency has been in touch during her statement to say that it wants to help. How can it even express an interest at this stage to get the ball rolling?

[Priti Patel]

First, if my hon. Friend sends me the details of the church, the Department for Levelling Up, Housing and Communities will pick that up through the sponsorship group. We are working in fast time on all this and things are moving very quickly. As he said, he has been contacted during this statement. We want to take up every single sort of offer and a lot of co-ordination is taking place in Government.

Nationality and Borders Bill

Steve Brine Excerpts

Report stage
Tuesday 7th December 2021 Commons Chamber

[Tom Pursglove]

It is probably fair to say that those on the Benches of the right hon. Member for Islington North (Jeremy Corbyn) quite regularly try to reinterpret his comments. In the end, it is highly unacceptable for anybody to get into a small boat for this purpose. I think it is fair to say that this House speaks with one voice in saying that people should not be making dangerous crossings, and we perhaps just disagree about how to render the route unviable.

The Government have brought forward a comprehensive Bill as part of the wider package of measures that we are seeking to introduce to address this issue. It is disappointing that some of us in the House seem to have quite a lot to say in complaining about our approach, but do not actually have a viable alternative to our policy.

[Steve Brine (Winchester) (Con)]

I have sat through hours of this debate and have been shocked—although I should not be surprised—by some of the smearing and scaremongering that we have heard. Is it any wonder that we receive some of the communications that we do? There is much to support in the Bill. As the Minister says, the immigration system is clearly not working. I am struggling on one point around resettlement, on which we may be able to take more people with us. The Government have rightly promised that the Bill will provide new, safer routes that can help to address the channel crossings. Will the Minister tell us whether the Home Office now has plans, and can provide more detail on those plans, for more resettlement schemes through safe routes?

[Tom Pursglove]

I am grateful to my hon. Friend. One of the things we have been very clear about is that we want to expand community sponsorship in particular, but a number of schemes that are already being delivered are making a considerable difference. We should not forget that 15,000 people were airlifted out of Afghanistan over the summer. Nor should we forget that the BNO route in relation to Hong Kong is a valuable and important route that is helping to provide sanctuary to many individuals. That is an ambitious offer that we have made.

Police, Crime, Sentencing and Court Bill

Steve Brine Excerpts

Report stage
Monday 5th July 2021 Commons Chamber

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

I will speak to amendment 1, which has cross-party support, and amendments 2 to 7, which would remove the provisions in the Bill that affect the right to protest.

In passing, I point out that a number of other issues are in play today, and goodness only knows what such a debate must look like to those looking in from the outside, but that is the consequence of the inadequacy of the time that has been made available to us. I will therefore limit my remarks strictly to the amendments that stand in my name.

Essentially the objection that many of us have to the proposals is that, first, the Government have got the balance badly wrong, and, secondly, their language in trying to strike that balance is among the vaguest and most imprecise I have ever seen as either a legal practitioner or a parliamentarian.

To ban protest on the basis that it would be noisy or cause serious annoyance may appeal to many parents of teenagers up and down the country, but we have to do rather better when fundamental issues of free speech are in play. Many years ago, it was said—the hon. and learned Member for Edinburgh South West (Joanna Cherry) may have heard the same thing—that in Scots law, a breach of the peace was almost anything that two cops did not quite like the look of. It seems to me that what the Government want to do here, in regulating not the conduct of a few drunks on the high street on a Saturday night but the fundamental right to protest, is to take the law back to that imprecise state of affairs. The risk is that that serves only to pit the police against the protesters. It will not be the Home Secretary who makes a decision about what is noisy and causes serious annoyance, but police officers, often those on the ground at the time. That risks undermining the fundamental principle of policing by consent, which has always underpinned the way in which we police protest and, indeed, all behaviour in this country.

I remain of the view that the provisions will be ineffective and have a chilling effect. I do not believe for one second that, if the Bill becomes law, Extinction Rebellion will look at it and say, “Oh well, we can’t possibly go out and protest on the streets of the capital. We’d maybe better just go home and email our Members of Parliament.” Although I have heard some in the House say that even that is seriously annoying sometimes. The Bill will not stop Extinction Rebellion protesting.

However, communities throughout the country who face a challenge to hospitals, schools, traffic management and so on will look at the Bill and think, “Actually, it’s not safe for us to use our voice and to protest against what is being done to our community.” For that reason, as in so many other cases, I believe that this is a fundamentally mistaken provision. The only amendments we can seek to introduce are those that would excise it from the Bill, where they should never have been in the first place.

[Steve Brine (Winchester) (Con)]

Will the right hon. Gentleman give way?

[Mr Carmichael]

If the hon. Gentleman can intervene in nine seconds.

[Steve Brine]

I am listening to what the right hon. Gentleman says. He does not want Conservative Members to smear Opposition amendments, so in that spirit, I point out that the Bill does not ban protest. Is he not tempted by new clause 85, which my hon. Friend the Member for Huntingdon (Mr Djanogly) spoke about, and which provides for a code for the policing of protest?

Police, Crime, Sentencing and Courts Bill

Steve Brine Excerpts

3rd reading
Monday 5th July 2021 Commons Chamber

[Steve Brine]

There is much in this Bill that I welcome—I have spoken before about driving offences reform—but of course parts of it are controversial. That is what happens with legislation: some people do not agree with parts of it. However, on balance, it is a Bill worth backing, and that is why I did so on Second Reading.

New clause 90 seems entirely logical to me. I have been well lobbied on the subject, and I hope to hear something from the Minister. Being able to do their job without abuse is surely the least that our shop workers can expect.

On protest, we should be careful not to be misled about what is in the Bill and what is not. I actually agree with some of what my right hon. Friend the Member for Haltemprice and Howden (Mr Davis) said. The parts of the Bill on protest are not right just yet, and I predict that they will have a challenging time in the other place. I look forward to hearing what the Minister has to say on that. Surely new clause 85, in respect of a code for the policing of protest, is worth a look.

I think that new clause 55, in the name of the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), is poorly drafted. I saw a tsunami of contacts this weekend from constituents who are against it. I wish it were going to a vote, if only so that I could vote against it and the House could show its will on the subject.

Finally, I oppose new clauses 51 and 52 in respect of illegal Traveller encampments. My constituents have an illegal encampment on the Cattle Market car park in the centre of Winchester just today, which is inconveniencing their lives. I oppose those two new clauses.

[Victoria Atkins]

This Bill delivers on our promise to the British people to keep them safe and to crack down on criminals. This Bill backs the police, recognising the unique and enormous sacrifices they and their families make to protect us all. This Bill imposes a legal duty on local councils, the police, health services, schools and prisons to work together to prevent serious violence in their neighbourhoods.

This Bill balances the rights of protestors to demonstrate with the rights of residents to access hospitals, to go to work, to let their children sleep at night. And, despite some of the claims from the Opposition, this Bill includes measures that will help to protect women and girls, but that go further than that and protect the whole of society from some of the most dangerous offenders that are sentenced. This includes managing sex offenders before and after conviction and, importantly, providing clarity on the extraction of data from victims’ phones, in line with the rape review that the Government published only a few weeks ago.

Let me briefly address the Government amendments in this group. In Committee, I undertook to consider further whether the reporting duty in respect of the police covenant should be extended to apply to the British Transport police, the Ministry of Defence police and the Civil Nuclear Constabulary. Having reflected further, we agree. We want the wider policing family to be included in the covenant, and amendment 34 does exactly that, covering not only these three forces but the National Crime Agency. They do essential work for us, and we want them and their families to be looked after.

Government amendments 35 to 45 standardise the traffic offences in clauses 4 and 5, and clauses in relation to serious violence reduction orders, for the British Transport police—again, consistency in how we deal with these important matters.

Let me turn to the non-Government amendments. I will not be able to deal with them all, but I will pick out the ones that have been talked about most frequently. First, I thank the right hon. and learned Member for Camberwell and Peckham (Ms Harman), my right hon. Friend the Member for Basingstoke (Mrs Miller) and many other Members across the House for raising the issue of sexual harassment, not just in the context of this Bill but in our wider work.

The murders that, sadly, we have heard so much about in this Chamber—the murders of Nicole Smallman, Bibaa Henry, Sarah Everard and PCSO Julia James—have caused millions of women and girls to share their own experiences and fears of walking in our towns and cities. We have also heard girls’ stories about their experiences at school through the social media platform Everyone’s Invited.

We are listening to women and girls. In March, we reopened the survey on violence against women and girls and received more than 180,000 responses in terms of the survey as a whole. Each of those responses is helping to shape our work developing this vital strategy. We therefore recognise the shocking extent of street harassment and the strength of feeling concerning the need for a new offence.

While it is the case that there are already offences available to address sexual harassment behaviour, the right hon. and learned Member for Camberwell and Peckham, whom I have met recently to discuss this, can rest assured that we remain open-minded on this issue and are continuing to examine the case for a bespoke offence. As part of the commitment, the new strategy on tackling violence against women and girls will focus on the need to educate and to change cultural attitudes. A new offence can do so much, but we need to go further than that, and that is our intention.

As I announced in Committee, I am pleased that as part of the cross-government work and work across agencies, the College of Policing intends to develop advice for police forces to assist them to use existing offences in the most effective way to address reports of sexual harassment, and the CPS will be updating its guidance to include specific material on sexual harassment.

Moving on, new clauses 26 and 27 have been tabled by the right hon. Member for Kingston upon Hull North (Dame Diana Johnson)—indeed my hon. Friend the Member for Wycombe (Mr Baker) has spoken to me about this—and they come out of the very tragic circumstances of the rape and murder of Libby Squire. As a constituency MP near the Humber, I very much join both the right hon. Lady and my hon. Friend in paying tribute to Libby and her family.

--- Later in debate ---

[Sir Iain Duncan Smith]

I thank my right hon. Friend for his intervention. The truth is that I have had a lot of discussions with my right hon. and learned Friend the Lord Chancellor about this, and I feel that he is very sympathetic. I am sure that he can speak for himself, but I hope that he will give an undertaking that the Government will return to this matter in this Bill, at least by the time it is in the other place, and make whatever changes are necessary to the laws and regulations in terms of criminal justice. I have a high hope that that will be the case, but I will leave it to my right hon. and learned Friend to make his position clear when he gets to his feet.

[Steve Brine]

I want to back up my right hon. Friend, having put my name to these amendments. The reason that this measure needs to be in this Bill is that we have seen such a huge rise in the number of pet owners during the pandemic. I have not seen the amount of casework on this issue in 11 years that I have seen in recent months.

[Sir Iain Duncan Smith]

I thank my hon. Friend for that intervention. He is right, and that is the point I was trying to make earlier. There has been a huge upwelling of anger and concern about the theft of dogs in particular, but pets in general. These three new clauses highlight that particular issue. It is not a simple thing or something that can be ignored, and it is quite interesting to look at what has happened to prosecutions.

Police, Crime, Sentencing and Courts Bill

Steve Brine Excerpts

2nd reading & 2nd reading - Day 1
Monday 15th March 2021 Commons Chamber

[Nick Thomas-Symonds]

My hon. Friend is absolutely right about the importance that is being put on statues over women, and the Government should be ashamed. This comes at a time when—

[Steve Brine (Winchester) (Con)]

Will the right hon. Gentleman give way?

[Nick Thomas-Symonds]

In one moment, because I need to deal with the issue of the rape statistics that has been raised. We are seeing fewer people being prosecuted and convicted for rape than at any time since records began, and that is at a time when the number of reported rapes is increasing. What message do the Government think that that sends to victims about coming forward? As I said to the Minister—he is a Justice Minister; he really should be concentrating on trying to deal with this problem—99% of reported rapes do not even get near a court. That is absolutely shameful. I say to the Home Secretary: think again about the Government’s priorities on this, make changes, such as end-to-end support for victims pre-trial and post-trial, and fast-track these trials through our system, instead of the two years that there have to be at the moment.

[Steve Brine]

If the desecration of our war memorials does not move the right hon. Gentleman, can I check this one with him? Two of my constituents lost their daughter when somebody impaired by the incorrect use of prescription drugs careered across the carriageway and hit her car head-on at high speed, killing her outright. In part 5 of the Bill, on road traffic, we introduce clause 64, on increased penalties for causing death by dangerous driving. Does the shadow Home Secretary support that and will he vote for it?

[Nick Thomas-Symonds]

I do absolutely support that and I will come to it in a moment but, to deal with the first part of the hon. Gentleman’s question, he seemed to imply that I did not understand the value of war memorials. I absolutely do. The difference is that this Bill has now been extended to every form of memorial, including statues of slave traders. It really sums up the problem with the Government’s approach. If they genuinely wanted to introduce proportionate measures to protect war memorials, they could have done so and not introduced the measures that they actually have.

I come to the sentencing elements of the Bill. It is of course right to extend whole-life orders to cover the premeditated murder of a child. The tragic murder of Ellie Gould on 3 May 2019 highlights the failure of the justice system to impose strict enough sentences on those who murder in a domestic setting and the issue of the age of the killer. But this measure is insufficient. The current approach to sentencing seems to forget the context in which many female victims are killed—in the home, with a weapon taken from that location. The minimum tariff in such cases is 15 years, but it is 25 if the weapon is brought to the scene of the crime. That is a systemic problem; violence against women and girls seems to be seen as less serious than other forms of violence. This has to be addressed.

The Opposition also say that tougher sentencing on its own is not enough. We know that wider change across our society is needed, and we know that the Government who have decimated our public services over the past 11 years have totally lost sight of addressing the causes of crime as well, with the sadly predictable consequences of rising violent crime in every single police force area of England and Wales. The Bill is shamefully short of measures to address the unacceptable violence women and girls face. In that, it fails woefully to meet the urgent need for change.