Doctor Training

Will Quince Excerpts

Tuesday 17th January 2023 Westminster Hall

[The Minister of State, Department of Health and Social Care (Will Quince)]

It is a pleasure to serve under your chairmanship, Sir George, and I am hugely grateful to my hon. Friend the Member for South Cambridgeshire (Anthony Browne) for raising this important issue and for his hugely constructive proposals and suggestions.

The workforce are the beating heart of everything our NHS does and stands for, and doctors make up an important part of the workforce and are invaluable to our NHS. I am hugely grateful for the incredible work they do day in, day out. I also thank all those who have contributed to the debate. I will try my best to respond to as many of the themes raised as possible in the time available to me.

Let me turn first to workforce pressures, which were raised by a number of hon. Members. We know, and I certainly recognise, that the workforce remain under sustained pressure having worked tirelessly through the covid pandemic to provide high-quality care to those who need it. I recognise, too, the huge and important role that doctors play in supporting our NHS. That role is as important as it ever was, which is why I am passionate about supporting our doctors, particularly in challenging times.

As the hon. Member for Strangford (Jim Shannon) rightly said, it is vital that we support the workforce not just now, but in the future. I recently met with the British Medical Association, the Hospital Consultants and Specialists Association and other unions to discuss, among other things, what we can do to ensure that NHS staff continue to feel valued in their work, but also how we can improve such things as their working environment and working conditions, which are really important. I look forward to continuing those discussions.

The crux of the debate is growing the workforce. What have we seen in the past year? We have seen record numbers of staff, including record numbers of doctors working in our NHS—since October 2021, 4,700 more doctors, representing a 3.7% increase—but I recognise that demand for NHS services continues to grow, which is why we have done a significant amount already to invest in training additional doctors and our future workforce.

As my hon. Friend the Member for South Cambridgeshire said, the Government have created and funded 1,500 more medical school places each year for domestic students in England. That is a 25% increase over three years, and the expansion was completed in September 2020. It has delivered five new medical schools for England. My hon. Friend mentioned levelling up, which of course was part of the motivation behind that expansion, hence the new medical schools in Tyne and Wear, west Lancashire, mid-Essex, Lincolnshire and Kent.

My hon. Friends the Members for Gloucester (Richard Graham) and for Redditch (Rachel Maclean) mentioned the Three Counties Medical School. I know some of the issues around that, some of which I think are specific. I would be happy to meet my hon. Friends, and my hon. Friend the Member for Worcester (Mr Walker), who has also raised the matter with me, to discuss this further.

In addition—I am conscious of the fact that we are talking about medical places—we temporarily lifted the cap on medical places for students completing A-levels during the pandemic, in 2020 and 2021. That resulted in an intake of nearly 8,500 in each year, which was significantly above the planned figure of 7,500.

My hon. Friend the Member for Newton Abbot (Anne Marie Morris) asked what we are doing to look at new routes into medicine. That is an important point: yes, we have the traditional routes, but what are we doing to consider other ways in? I am delighted that, only last week, Health Education England announced funding for the first 200 apprentices to begin training as doctors over the next two years. That marks an important step in making a career in medicine more accessible. My hon. Friend the Member for Wantage (David Johnston) made a similar point: we have to make medicine more accessible. I am really excited about those apprenticeships and what can be done in that space.

Turning to the long-term workforce plan, I heard what my hon. Friend the Member for South Cambridgeshire and others said in calling for us to be bolder and more ambitious, and I know that we need to do more to ensure that the NHS has the workforce that it needs for the future. I heard my hon. Friend’s call for a feasibility study on doubling the number of places, and I will take that away and look at it. I also heard his call for an increase of circa 1,000 places next year. That would have a significant financial implication, which would not sit within our spending review allocation. Again, I will have to take that away and look at it, and have those conversations with the Chancellor.

We have commissioned NHS England to develop a long-term plan for the NHS workforce for the next 15 years. That high-level, long-term NHS workforce plan will look at the mix and number of staff required across all parts of our country, and it will set out the actions and reforms needed to reduce supply gaps and improve retention. My hon. Friends the Members for Bolsover (Mark Fletcher) and for Torbay (Kevin Foster) eloquently set out why we need a workforce that will reflect the changing nature of medicine and technology, and demographic changes. That is vital, and those will be key parts of the NHS long-term plan.

My hon. Friend the Member for Wantage rightly said that those going into medicine understandably want a portfolio career. General practice is still an attractive option and we have more people wanting to be GPs, which is a great thing, but I wonder how many people would want to be Members of Parliament if they were just doing surgeries, which is part of the role, all day every day. In medicine, a portfolio mix involves some time in the hospital and some time in general practice. It is really important that people have the ability to develop their skills and have a specialism, but they should not lose their generalist skills. I think we will see more people wanting to be GPs but also to spend time in hospitals and other settings, and our NHS long-term plan must reflect that.

We have committed to publishing the plan this year. As the Chancellor set out in the autumn statement, it will include independently verified forecasts for the number of doctors, nurses and other professionals needed in five, 10 and 15 years’ time, taking full account of the improvements that we need in retention and productivity. The plan will ensure that we have the right people with the right skills to transform and deliver high-quality services fit for the future.

The hon. Member for Strangford asked about Northern Ireland. He is absolutely right to do so, because a plan cannot work in isolation. NHS England is looking at the NHS long-term plan, but it could not do so without having those all-important discussions with the devolved Administrations around our United Kingdom. There are a number of plans, but there is commonality of interest because of the nature of our United Kingdom, and inevitable join-up. I know that NHS England is having those conversations, and I will ensure that we have them at ministerial level too.

We have touched on international recruitment. As we grow the domestic workforce, ethical international recruitment remains a key element of achieving our workforce commitments, and we are ramping up efforts through targeted support for NHS trusts with recruiting from overseas. My hon. Friend the Member for South Cambridgeshire mentioned our code of practice for international recruitment, which aligns with the latest advice from the World Health Organisation. It guarantees stringent ethical standards when recruiting health and social care staff from overseas, and ensures that we can work collaboratively with other Governments around the world. Although it restricts active recruitment from particular countries, which my hon. Friend correctly referred to as the red list, he rightly pointed out that an individual still has the right to migrate. Therefore, we will still see individuals applying independently for vacancies in our NHS in the UK, which is known as direct recruitment. We are not actively recruiting, but people can nevertheless apply.

Our long-term NHS workforce plan is about ensuring that we get the balance right between international recruitment and domestic training places. As health systems develop around the world, we have to build our domestic resilience to ensure that we are training enough doctors here in the UK. Having said that, internationally trained staff have been a key part of our NHS since its inception in 1948, and they continue to play a vital role. Let me put on the record that we value hugely their contribution to providing excellent care.

Retention was another issue raised. I do not underestimate the importance of staff retention, which is as important as recruitment. As well as training more staff, which is vital, we have to ensure that we keep those highly qualified, experienced clinicians. We have to ensure that they feel supported and valued within in our NHS, not just at a national level, but at a local, individual trust level. We have the actions set out in the 2020 NHS people plan, which are helping us to build that culture and will help support us to ensure we get it right. They include a much greater focus on health and wellbeing, strengthening leadership and increasing opportunities for flexible working, which I know is important in a modern workforce.

A number of hon. Members mentioned pensions, and I understand that challenge. I meet the senior clinicians we need to retain in our NHS. We announced a package as part of our plan for patients in the summer, continuing the temporary retirement-return easements. We also announced the intention to introduce a number of permanent retirement flexibilities from 1 April this year. I know the Chancellor and the Secretary of State for Health and Social Care are acutely aware of the issue and are exploring what more can be done.

In the short time I have, I will cover specialty training. My hon. Friend the Member for South West Bedfordshire (Andrew Selous) rightly raised the important issue of GP training places. One challenge with more funding for medical schools is to ensure that there are specialty places for people to go into. It pains me when I hear that people want to train as GPs but there is not the space in GP practices for those specialty places. I know my hon. Friend has met my fellow Minister, my hon. Friend the Member for Harborough (Neil O’Brien). I am also happy to meet him to discuss this issue from a workforce perspective.

I was pleased when, only last week, Health Education England announced the creation of nearly 900 more specialty placements. That is hugely important, especially because there is a focus on areas such as mental health and cancer, where we know we have shortages. It pains me to hear of anyone wanting to be a GP but not having access to specialty training, because I know we need more of them.

Conscious of the fact that I intend to leave a little time for my hon. Friend the Member for South Cambridgeshire to respond, I thank all hon. Members for their constructive contributions to this morning’s debate. It has given me, the Department and, dare I say it, the Treasury some food for thought about the long-term future of medical training places.

Through the programme of work that I outlined and the long-term planning that NHS England has under way, which will be published this year, we are ensuring that the NHS has the robust and resilient workforce that we know it needs for the future. Doctors are, of course, an integral part of that. We are working to ensure that we have the right people with the right skills in the right places. We are working to ensure that they are well supported and looked after so that they, in turn, can look after those who need our great NHS services, and so that they can keep delivering that great standard of care that people need now and in the future.

Oral Answers to Questions

Will Quince Excerpts

Monday 1st April 2019 Commons Chamber

[Mr Hurd]

I am genuinely sorry that this is taking much longer than I would like, and I am more than happy to meet Mr and Mrs Studley and other victims. However, bearing in mind that we have some of the toughest regulation in the world, we have a range of issues to look at in relation to firearms safety—we have committed to consulting on them in the Offensive Weapons Bill—and we are determined to consider them in the round.

[Will Quince (Colchester) (Con)]

Does the Minister share my concern about the easy availability of air and imitation firearms? Given that there were 1,300 offences relating to imitation firearms last year, does he agree that it puts our police officers in a particularly difficult position if they do not know whether a weapon is real or an imitation?

[Mr Hurd]

I understand my hon. Friend’s point, but the broader point is that it is absolutely right to look again at the regulations on air weapons. They are already tight in terms of ownership and possession, but we have undertaken to look again particularly at what we can do to tighten up the safety regime, and that is exactly what we intend to do.

Prevention and Suppression of Terrorism

Will Quince Excerpts

Tuesday 26th February 2019 Commons Chamber

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. It underpins why the decision that the Government are putting before us this evening is, if overdue, very strongly welcome.

[Will Quince (Colchester) (Con)]

I listened very carefully to the words of the Opposition Front-Bench spokesman. Does the hon. Gentleman agree that not opposing the order is just not good enough? We cannot be neutral in the face of an antisemitic terrorist organisation.

[Wes Streeting]

I agree with the hon. Gentleman. I have not seen a parliamentary Labour party briefing on this topic, which is regrettable. It means that I do not know the lines to take, so I have just had to come up with my own. I say plainly, simply and unequivocally that it is not good enough simply to say, “We won’t be opposing.” We should be making it clear that we would troop through the Lobby and vote for the motion if there is a Division. That is what people across the country and in my constituency want to hear.

Finally, I welcome the fact that Hezbollah flags will not be flown on the streets of our capital city, and I strongly support the Mayor of London’s leadership on this issue, but let us not lose sight of what Hezbollah is doing right now in Syria. Syria Solidarity UK is quite right to say that it is not just about flag waving and what is going on here; we must not lose sight of what is happening in Syria, too. For as long as my constituents send me to this place, I will sit here proudly as a Labour MP from a strong social democratic tradition, standing up for the values that our party was founded to champion.

Oral Answers to Questions

Will Quince Excerpts

Monday 25th February 2019 Commons Chamber

[Will Quince (Colchester) (Con)]

Given the dangers our children are exposed to on social media platforms, does my right hon. Friend agree that those platforms should look to fund education seminars in schools on how to stay safe online?

[Mr Wallace]

My hon. Friend makes a really good point. Some of the large companies already do that: Google, for example, goes to many constituencies and makes presentations in primary schools. I would recommend that all hon. Members approach the company and ask it to come to their constituencies. I went to a session in my constituency which made a difference for young people in staying safe online. But there is a lot more that companies could do, and that is what we will push for in the online harms White Paper.

Knife Crime Prevention Orders

Will Quince Excerpts

Monday 4th February 2019 Commons Chamber

[Victoria Atkins]

I note in passing that the reserves of Leicestershire police have risen by £3.8 million since 2011, so just a fraction of the £27.6 million currently in reserves may go a very long way. I hope the hon. Lady will vote with the Government tomorrow to give Leicestershire police and other police forces up to a further £970 million on top of last year’s increases, with the help of police and crime commissioners.

[Will Quince (Colchester) (Con)]

I welcome this initiative, which I think will make a difference, but we must go further. The Minister knows that since entering this House I have campaigned for both first aid education and weapons awareness education to be on the national curriculum. We are halfway there, with first aid entering the curriculum. What steps can she take to ensure that weapons awareness appears on our national curriculum?

[Victoria Atkins]

I am grateful to my hon. Friend, who has indeed campaigned so much, not just on serious violence in general, but on county lines in particular, representing as he does an important town in Essex. The Government’s work through the serious violence taskforce has included sending out lesson plans before last year’s summer holidays, because we listened to youth workers who said to us, “Before children go off on their summer holidays, please can we help teachers teach them about the risks of carrying a knife?” We also support the work of charities such as the St Giles Trust, which goes a very long way to helping children. The Department for Education plan to introduce relationship education in schools will, of course, help, because it is about ensuring that children are not exploited and know what behaviour they should expect from their friends and older mentors. That is all part of a joined-up package.

Oral Answers to Questions

Will Quince Excerpts

Monday 21st January 2019 Commons Chamber

[Mr Speaker]

Order. The hon. Member for Colchester (Will Quince) was focused intently upon his electronic device, and I am sure he found it thoroughly captivating, but I gently point out to him that he has a question that is not unadjacent to that with which we are dealing now, and that he might care to shoehorn his inquiry into the present.

[Will Quince (Colchester) (Con)]

No. 21, Mr Speaker.

[Mr Speaker]

No. What I mean is blurt it out now man!

[Will Quince]

21. Will the Minister join me in welcoming the £664,000 allocated to Essex from the Home Office early intervention youth fund? Will the Secretary of State keep the situation under review while ensuring that Essex police have the resources required to continue to tackle this issue?

[Victoria Atkins]

I am delighted that Essex is one of 29 projects across the country that have received money under the early intervention youth fund. The project in Essex will help to support the violence and vulnerability project. As we know, it is the vulnerability of young people that often places them so starkly in the path of those gangsters who want to exploit them.

Oral Answers to Questions

Will Quince Excerpts

Monday 3rd December 2018 Commons Chamber

[The Minister for Immigration (Caroline Nokes)]

I thank the hon. Gentleman for his question, which I know he raised at the Home Affairs Committee last week and again with me in Westminster Hall last week. Both the Home Secretary and I have undertaken to raise that with the Chancellor, who is obviously, as the hon. Gentleman will have noticed, on the Front Bench this afternoon.

[Will Quince (Colchester) (Con)]

Last month, I attended the Centre for Action on Rape and Abuse “Reclaim the Night” march in Colchester, along with hundreds of my constituents, in protest against sexual violence against women. What steps is my right hon. Friend taking to ensure that the police have the resources they need both to prevent these crimes and to bring those who commit these horrific offences to justice?

[Sajid Javid]

My hon. Friend raises a very important issue. It is about resources—that is why we saw an increase in police resources last year; and there will be a police settlement statement soon, which will look at resources going forward—but it is also about powers, and I remind him that we will shortly be bringing forward a draft domestic abuse Bill.

Civil Partnerships, Marriages and Deaths (Registration Etc.) Bill

Will Quince Excerpts

3rd reading: House of Commons & Report stage: House of Commons
Friday 26th October 2018 Commons Chamber

[Tim Loughton]

I am grateful to the hon. Lady because she pre-empts my clause 4 moment. The fourth, and very important, component of this Bill, which is addressed in clause 4, is coroners’ investigations. She participated in earlier debates and worked very helpfully with me and others to move this important issue up the agenda. I am grateful for her contribution.

Clause 4 will allow part 1 of the Coroners and Justice Act 2009 to be amended. That is not easy, and the matter is slightly complicated by the fact that it falls under the jurisdiction of both the Ministry of Justice, which is responsible for coroners, and the Department of Health and Social Care, which is responsible for healthcare in relation to baby loss. I must pay tribute to some very helpful and proactive support for this measure by MOJ officials. I had a very helpful meeting with the Under-Secretary of State for Justice, my hon. Friend the Member for Charnwood (Edward Argar), who I am glad to see is present on the Front Bench. He was a great champion of many of the Bill’s provisions when he was just a commoner on the Back Benches and added his name to many of the measures I have been trying to get through today.

The Minister has confirmed that an immense amount of work has gone on at the Ministry of Justice. There are issues still to be resolved, such as whether coroners should have the power to investigate all stillbirth loss or should concentrate, which I think is practically the better approach, on full-term baby loss, when there are the fewest excuses or reasons for stillbirths to happen. Also, should this be mandatory or effectively subject to parental veto? There are serious problems with that, as there are some cases in which a stillbirth may have been connected to domestic violence and some sort of cover-up may be wanted, so I think we are coming to the view that the scheme should be mandatory. Should there be specialist coroners or should all coroners have the ability to investigate? Of course, there are also capacity constraints. The fact that a lot of work has been going on in the Department in the last few months shows that this can be done.

[Will Quince (Colchester) (Con)]

I congratulate my hon. Friend on introducing this important Bill, which is, in effect, enabling legislation in this regard. It is worth reiterating something he has already mentioned, so will he join me in thanking the Under-Secretary of State for Justice, my hon. Friend the Member for Charnwood (Edward Argar)? It is one thing to have enabling legislation, but given the complex nature of what my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) is trying to introduce, a Minister who is so supportive is worth their weight in gold?

[Tim Loughton]

Give my hon. Friend the Member for Colchester (Will Quince) a job—I am sure that will happen shortly. We should be paying tribute to him, too, because although many other Members have been part of this crusade, including my hon. Friend the Member for Banbury (Victoria Prentis), who is sitting next to him, he has probably done more than anyone to put stillbirth absolutely on the parliamentary and national radar.

It is because of the Minister’s empathy, understanding and preparedness to work with parliamentarians that we are in a position in which, if this enabling legislation is enacted, we can have practical measures in fairly short order, perhaps even ahead of the first civil partnership for opposite-sex couples happening in this country before the end of 2019. This enabling clause gives a good deal of discretion to the Minister, and there is no other Minister I have greater faith in to make sure that something actually happens. Now that we have praised him to the rafters, we will expect a very early announcement on when the change will happen.

This is a complicated Bill, as I have said, and that is my own fault, but it contains four really important measures that have widespread support across the whole House and across the country.

--- Later in debate ---

[Will Quince]

It is a pleasure to follow my hon. Friend the Member for Copeland (Trudy Harrison).

I thank and pay tribute to my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) for bringing forward the Bill. I congratulate him on getting it to this point with Government support, which is significant. I applaud him for the parliamentary dexterity with which he has incorporated into the Bill so many issues that he has seen as wrongs and injustices over his career in Parliament—I am sure it has a long way to go—since 1997. It is certainly a lesson for us all that we can squeeze a huge number of issues into one private Member’s Bill and still get it through Parliament.

It is a great honour to co-chair the all-party parliamentary group on baby loss, and it is the parts of the Bill relating to baby loss that I would like to focus on briefly in my contribution. The group exists only really for two purposes: to reduce miscarriage, stillbirth and neonatal death; and to ensure that we have world-class bereavement care and support right across our NHS for those who sadly still go through one of those tragic occurrences. The Bill goes a long way to addressing both those objectives.

First, the element of the Bill on coronial involvement is really quite significant, particularly in relation to stillbirth. We still do not know why around 50% of stillbirths happen, and there is a huge lack of research and evidence. Allowing parents, whether it is voluntary or not—that is still to be decided—and whether it is a late-term stillbirth or slightly earlier, to have coronial involvement is really significant. As part of that evidence-gathering exercise, it is so important that when mistakes are made—the NHS and the medical profession are human businesses, and inevitably mistakes do happen—we learn from every single one. That is why the element on coronial involvement is so significant.

I mentioned this in an intervention, but I would like to pay tribute to the Under-Secretary of State for Justice, my hon. Friend the Member for Charnwood (Edward Argar). In respect of coronial involvement, the Bill is just a piece of enabling legislation. As soon as a Department accepts that we are going to do something, it can still take months and in some cases years to introduce legislation, but my understanding is that the work that the Minister and his departmental officials have already done means that a measure could come in as soon as within 12 months. That may strike fear into the hearts of officials, but it is quite incredible when we consider the complexity of this issue. Given my point about ensuring that we have the research and evidence base to look at and some understanding of why stillbirths happen, that will enable us to start implementing the measures that we know need to be introduced and start to address it. Working in tandem with the new Healthcare Safety Investigation Branch, which was introduced by my right hon. Friend the Member for South West Surrey (Mr Hunt), the former Health Secretary, this could have a huge impact, in particular on reducing stillbirth.

The second element, in relation to the registration of pre-24-week baby loss, is part of the bereavement piece and also really significant. I cannot continue my contribution without again paying tribute to the hon. Member for Washington and Sunderland West (Mrs Hodgson), who has spoken so movingly about her personal experience of this issue—a hugely brave thing to do—and campaigned tirelessly. She has been key in both forming and working with the all-party group, including as part of her work as a shadow Health Minister.

This is really important because it is so difficult for any parent who suffers a miscarriage or a stillbirth, however it is termed, at 23 weeks and a few days or at 22 weeks to go home with no recognition whatsoever. We have an opportunity to give great comfort. Whether it is still classed technically as a miscarriage or a stillbirth, that baby is still born: the mother has given birth and, in many cases, the father is present. Such a recognition, albeit seemingly quite a small element, is important—that life existed; that individual existed. I know that I do not need to make that point to my friend on the other side of the Chamber.

This Bill has probably achieved such an aim, in that the former Secretary of State has set up the pregnancy loss review, which is being spearheaded by Zoe Clark-Coates and Samantha Collinge. This work is already being undertaken, and it is recognised at the highest level of the Department of Health and Social Care. I have no doubt that we are going to find a solution, but again it is very complex. There are lots of different views about exactly how we do it, such as whether it is voluntary and at what point in the pregnancy it applies. I have differing views on that, and I will certainly feed them into the review.

[Fiona Bruce (Congleton) (Con)]

On this very sensitive subject, does my hon. Friend agree that if a baby has to be induced very early due to a foetal abnormality, the parents often experience just as much grief as on the other occasions he mentions, such as natural stillbirth?

[Will Quince]

Yes is the honest answer, and I thank my hon. Friend for that intervention. I have now met many bereaved parents as part of this process, and the reality is that everybody grieves in different ways, and the more ways in which we can provide comfort and support to those bereaved parents the better. She raises a very good point about foetal abnormality—whether there has to be induction, this is classed as a medical termination, or whatever terminology is used. In fact, I find some of the terminology used by medical professionals pretty harsh, and I would love to tone down some of it and use very different language. She is absolutely right in her fundamental point. My personal view, for what it is worth, is that regardless of the point in the pregnancy, if it provides comfort for bereaved parents to have a certificate, a piece of paper or a document that shows that the baby existed, I feel very comfortable about ensuring that such a system is brought in.

I conclude by again thanking my hon. Friend the Member for East Worthing and Shoreham because his Bill will make a huge difference. I have focused on two of its aspects, but I also wholeheartedly support the other provisions. It is fantastic that we have full cross-party support for the Bill, and indeed Government support. The sooner the measures incorporated in the Bill can be implemented, the better.

Immigration: DNA Tests

Will Quince Excerpts

1st reading: House of Commons
Thursday 25th October 2018 Commons Chamber

[Sajid Javid]

I absolutely agree with my hon. Friend. He has again emphasised that providing DNA should be optional, because it can help those individuals, and if they choose to provide it, we should take that seriously, but it should be just that—optional, not mandatory.

[Will Quince (Colchester) (Con)]

I thank the Home Secretary for his statement and welcome the steps that he is taking to put this situation right. Does he agree that it is essential in cases of this nature that the Government act not only quickly, but with openness and transparency?

[Sajid Javid]

I agree, and that is why I decided to publish and put in the Library for the whole House to see the internal review that has already been done and was commissioned within days. That is why I will be writing to the Home Affairs Committee today as well, and no doubt there will be future opportunities to keep the House updated, whether by me, the Minister for Immigration or another Minister.

Offensive Weapons Bill

Will Quince Excerpts

2nd reading: House of Commons & Money resolution: House of Commons
Wednesday 27th June 2018 Commons Chamber

[Louise Haigh]

The right hon. Gentleman need not worry; I will not be put off at all by interventions from Government Members.

[Will Quince (Colchester) (Con)]

The hon. Lady mentions that this is not only a London problem, but a lot of it does emanate from London. The county line operations and many other things start in our big cities, so will she join me in encouraging the Metropolitan police to work far more closely with other forces to make sure we break these county lines? The county lines are now heading across the country, but they largely start in London.

[Louise Haigh]

I completely agree that the county lines emanate from many metropolitan areas, and certainly not just London—they originate with organised criminal gangs in Birmingham and on Merseyside, too. I commend the Government’s approach through the national county lines co-ordination centre. Working between police forces is a nut that we really have to crack, because the county lines business model has been developed to exploit the challenges that police forces and other agencies experience in working together.

--- Later in debate ---

[James Morris]

My hon. Friend is right. The evidence—again, this is from the Government’s serious violence strategy—is that 40% of gang members have been identified with a severe behavioural problem by the age of 12. That significant number allows us to understand how we might address some of the underlying behaviours that lead to violence and the targeted approaches that are necessary to deal with that.

As Members will know, I have been a long-term campaigner for improving mental health care in this country. The Government have made significant progress on improving mental health care for children and adolescents, but we need to do more, specifically by focusing on this cohort of vulnerable children, especially those who have faced trauma and come from looked-after backgrounds.

[Will Quince]

My hon. Friend mentions vulnerable children. In so many cases, they are 12, 13 or 14 years old. Does he think the answer is to label them criminals or actually to see them for the victims they are? If we do not criminalise them, they will have life chances that do not lead to just a continuation of criminality.

[James Morris]

My hon. Friend makes a good point. There is a balance to be struck. As I said at the beginning of my speech, we need a very tough law enforcement framework in this area. The evidence from the police is that they want that, because it provides a deterrent. However, he is exactly right that the balancing item in the argument, as expressed by my right hon. Friend the Member for South Holland and The Deepings (Mr Hayes), is that we need to understand the underlying drivers. That is why, as the Government recognise in their strategy, we need to focus on prevention and diversion strategies that take young people away from the criminal justice system. One weakness of the criminal justice system, for historical reasons, is that it can lead to a self-reinforcing cycle whereby young people get trapped in the system and cannot escape it.

--- Later in debate ---

[Will Quince (Colchester) (Con)]

It is a pleasure to follow the hon. Member for Ceredigion (Ben Lake). I agree with him wholeheartedly that it is sad that we are debating these issues and that the Government have had to introduce the Bill. It should not be necessary—people should not throw acid in people’s faces, which has a life-changing impact, and they should not use knives on our streets.

However, as the hon. Gentleman rightly says, we are where we are. This is a hugely important Bill because the scourge of knife and acid crime touches not only a number of constituencies within London and our inner cities, but all our constituencies up and down the country. I am sorry to say that its intensity is growing outside the major cities, and it is finding its way into towns such as mine and rural communities. It devastates communities, including mine, where we have had horrific knife attacks. I agree that one victim of an acid or knife attack is one too many. The tragedy is that, in many cases, young people’s lives are taken at an early age when they have so much promise ahead of them, which devastates not only the families but the wider community.

We know that the victims and perpetrators of such offences are often from outside the towns in which those offences are committed. I have referenced one incident in the House previously. There were six knife attacks in Colchester in one evening, and in all six cases, the victims and perpetrators were from outside Colchester—they came from London. This is not just a city issue anymore. County lines are bought and sold like franchises. The perpetrators use children—they know that they are less likely to be stopped and searched on the train or other public transport—to carry drugs, bringing with them fear, intimidation and violence to towns up and down the country. As I said, in the case I mentioned, the victims and perpetrators were all from London. There is an increase in county lines activity and the barbaric activity known as cuckooing. Much of this is, sadly, drug-related.

I welcome the Government’s serious crime strategy and the £40 million that comes with it. I was pleased to speak in the debate just a few weeks ago about that very subject. I have my own views about what we need to do to tackle serious crime, and especially on prevention and diversion. The Government’s strategy includes a number of measures that I wholeheartedly support but, as the Minister knows, because we have had this conversation, the question is how we treat children who have been involved in county lines operations. In many cases we are talking about 12 to 15-year-olds who are groomed by drug gangs in a similar way to how sexual predators groom young people. It can start with the purchase of trainers or a financial gift of some description, or it can start with violence and intimidation of either the young person or a family member. Do we treat those children like criminals, bearing in mind their life chances from that moment on, or do we treat them like the victims they are, and put them back on the right track to a fulfilling life in which they contribute fully to society?

[Theresa Villiers (Chipping Barnet) (Con)]

Does my hon. Friend agree that children’s criminal records should not haunt them for the rest of their lives and that our system should wipe the slate clean at a certain point?

[Will Quince]

I broadly agree with my right hon. Friend. When we criminalise a child at a young age, the problem is that their life chances are impaired to such an extent that a life continuing along the route of criminality is sadly almost inevitable. We should break that cycle when we have the opportunity to intervene—such opportunities are often rare—and ensure that we put them back on the right path. One way to do that is to ensure that a criminal record does not stay with a child forever. For example, someone might commit an offence at a young age after they have been groomed or forced into that action due to violence and intimidation. They could then completely turn their lives around and think, 10 years later, “I want to contribute by becoming a police officer and serving my community.” Currently—I stand to be corrected by the Minister—that would not be possible, because their criminal record continues. I wholeheartedly agree with my right hon. Friend.

I welcome the Bill and will support its Second Reading. It has huge merits but, as a number of right hon. and hon. Members have said, it is not without issue. By its nature, it is reactive legislation that deals with weapons that gangs and criminals have moved on to. Some of those weapons—knives and corrosives—can probably never truly be banned, as we all know that they are available in households across the country. I could probably find several in my kitchen. We need to ensure that we have a multifaceted approach to tackling this issue, and the serious violence strategy has a significant role to play.

First, we need to make sure that our legislation gives the police the powers they need to deal with offenders, which is one thing that the Bill does. Secondly, we need to make sure that, when we intervene, we do so as early as possible. We need to turn children away from gangs and, indeed, when they are the victims of gangs or grooming, we need to give them the protection and support they need.

As I have said previously in the Chamber, we need education in schools to ensure that children know the dangers of carrying a weapon. There are some fantastic charities across the country—many have been set up by parents who have lost a child to knife crime—that go into schools to educate children about the danger of carrying knives. The charities teach children that they are far more likely to be the victim of a knife attack if they carry a knife themselves, and they show them in a graphic way the devastation caused by a knife attack. They show the awful wounds, and they also show what it feels like to be a family member whose child is in hospital or, even worse, has been fatally wounded or murdered.

Thirdly, judges need a full range of sentencing powers so that a person who is repeatedly caught carrying a knife, or who is caught harming an individual, can be given a custodial sentence. I agree with Members who have said that we need to come down very hard on those who are repeatedly caught carrying a knife or weapon, and on those who harm another individual, but there need to be other solutions, such as educational and non-custodial approaches, so that we do not fill our prisons with young people who have lost their future.

At the moment, an individual who is caught carrying a knife may get just a caution. In my view, they should also be sent on a weapons awareness course. A person who is caught speeding, for example—I am not conflating carrying a knife and speeding but, to some extent, it is a useful comparison—has the option of paying a fine or going on a course. It should be mandatory that a person who is given a caution for any kind of weapon-related offence is sent on a course. They should have to see the devastation caused by such weapons, which hopefully would go some way towards breaking their attitude towards carrying a weapon and knife crime. That would not work for everyone, but for some individuals, especially those who are particularly young and have made a mistake—for many first-time offenders it will be just a mistake—it might just break the cycle, and at very small cost. Such courses are, in many cases, run by charities across the country.

Fourthly, we need to identify and address the root causes of this criminality. Why do people carry weapons? How has our society got to this position? It could be social breakdown, regional inequality, family breakdown, absent father figures or a lack of male role models. It could be school exclusion, which has been mentioned, or social isolation—gang culture can provide a sense of belonging. It could be county line activity or prostitution. It could actually be education and the messaging we send out about drugs and drug use.

I find it bizarre that we have middle-class people in this country who drive around in their electric vehicles, drinking their Rainforest Alliance coffee and eating their Fairtrade chocolate, but who have no qualms whatsoever about going out at the weekend and having a few lines of coke, because that does not harm anyone, does it? If only those people saw the devastation that that causes both in the country where the cocaine is sourced from and through the county line activity in this country that takes the drugs from the point of entry to the point at which they are sold. If only they saw, in so many cases, the children whose lives have been devastated as a result. We need to send a clear message that drug taking is not acceptable and that, through the damage it does, it is not a victimless crime.

[Mr John Hayes]

My hon. Friend is making an excellent point that deserves amplification. The gated-lived, middle-class liberals who take drugs have little or no care because they have little or no contact with the kind of people he describes. It is the people on the frontline who suffer, and they deserve to be treated as a priority.

[Will Quince]

I thank my right hon. Friend for that intervention. It is important to note, though, that although in the past people have thought, “This isn’t a problem for us—this isn’t something that our children would be involved in,” the reality is that it is now quite the opposite. These grooming gangs are looking for people who are not stereotypical. They are looking for children who are particularly vulnerable, and that is not just children from socially deprived backgrounds or from council housing estates—the people one would perhaps automatically associate with being easy prey for some of these grooming gangs—but the young people who are easiest to groom and are less likely to be stopped and searched by a police officer. The enemy is at the gate, and to think that our own children and the children of middle-class families are not as affected as anybody else is a myth. It is a dangerous assumption not to think that every single part of our society and every town in our country is affected, and even rural areas. We should absolutely send out the message loud and clear that this affects everybody’s children, not just somebody else’s.

On root causes, we need to take a much tougher stance on antisocial behaviour. If we do not take a tougher stance on very low-level crime, it will be easier for people to think that other crimes are acceptable. A policing focus on drugs would be particularly helpful. To tackle the issues, we really need to understand the root causes. The strategy goes some way towards achieving that, but there is more work to do.

Let me turn to the specifics of the Bill. There is no reason whatsoever for under-18s to be able to buy these weapons, nor for them to carry them in public, so I very much welcome the Government’s position. There is also no reason to possess certain weapons in private properties. There is no justification for having zombie knives, knuckle dusters and death stars, even in private possession.

[Mr Jim Cunningham (Coventry South) (Lab)]

Successive Governments have failed to tackle the knife culture in this country, so in a way this is not really a political thing. We have had instances in Coventry, going back around 20-odd years, of people giving evidence in court and the individual being given a sentence, but then visiting them as a punishment. That is one part of the whole argument about witness protection schemes.

[Will Quince]

The hon. Gentleman raises a good point. There is no easy answer to this issue; if there was, successive Governments would have addressed it. That was why I was making the point that to really address knife crime and why people carry weapons, we need to understand the root causes and then put in place interventions at numerous points on the journey towards criminality. Even when someone has entered criminality, we should intervene at the earliest possible opportunity to try to break the cycle and turn someone’s life around.

On the online sale of weapons, I very much welcome the banning of the delivery of knives and corrosives brought online, and especially the fact that they will no longer be deliverable to residential addresses. I agree with the position in the Bill: there is no reason why such items cannot be purchased in person. The Bill goes some way to addressing the move towards online purchases, but I have a couple of questions for the Minister. Have we looked into age verification on delivery, which is an option that already exists for a number of products? I appreciate that there are some flaws with that approach, but I think there is something in it to be teased out in Committee. Have we assessed the possibility of individuals getting these weapons delivered to workplaces instead? So many people have even private parcels delivered to their workplaces, so we must ensure that there is no loophole for people to purchase corrosives or knives using that route.

On retailers, have we done any liaison with retailers on theft? If we are to make knives more difficult to come across—I refer back to what I said about these items being in most of our kitchens up and down the country—what work has been done on theft? I can walk into any Sainsbury’s or Tesco store—other supermarkets are, of course, available—and notice that in the kitchen aisle it is only the high-value knives that have any kind of security tag. Some of the very sharp, low-priced knives are just there on the shelves for anybody to pick up. I should also point out that they are not even always above the height that children can reach, which is perhaps another point that needs to be considered. I am not sure whether we need to go as far as having all knives behind a counter so we have to request one, as we do with cigarettes. Perhaps we should look at some kind of security tagging of knives, especially sharp knives. I do not know whether we have looked at having cabinets in shops. I am conscious that that is not the panacea; it will not fix the issue, but it might go some way towards making it harder for individuals to get hold of a knife.

As has been said by many hon. Members, constituents have raised firearms as an issue. Although I represent a wholly urban constituency, I have a number of people who are interested in firearms for sporting purposes. I have some sympathy with the Government’s view on the banning of .50 calibre rifles for civilian ownership. These are very high-powered rifles that can punch through armour. I know that they have been banned in California under Governor Arnold Schwarzenegger. Inevitably, with any such policy, we must make sure that it is evidence based. I understand that there is a case of one of these weapons being stolen, but it was recovered very quickly by the police. We need to make sure that our policy is evidence based. We are talking about a very small number of these weapons. As far as I understand it, we do not have any evidence of these weapons having been used in crimes.

[Mark Garnier (Wyre Forest) (Con)]

My hon. Friend makes a very good point. As for what the Government have tried to achieve, this Bill is, in every other respect, almost a perfect Bill. However, what they run the risk of doing with a ban on .50 calibre rifles is demonising people in the community who are incredibly law abiding. What we do not want to do is to fall into the trap, which we did with the Dangerous Dogs Act 1991 and the handgun ban, of creating bad law when, actually, this Bill in every other respect is very good law.

[Will Quince]

I agree with my hon. Friend. I could understand it if there was a compelling case that these particular weapons had been used in extensive criminality, or indeed if there was a very strong evidence-based case against them because there was a threat that they would be used in some form of criminality. My hon. Friend the Member for The Cotswolds (Sir Geoffrey Clifton-Brown) put it very well: there are a very small number of individuals who use these weapons. If the Government believe that there is case to do something, then absolutely, yes, let us do so. Let us look at the security of these firearms. Let us perhaps look, in extremis, at allowing them to be kept only at ranges, and secured with equipment that is not usually found domestically. However, there is concern among the sporting firearms fraternity that this might be the thin end of the wedge and that it would lead to further such banning of weapons.

All I am saying to the Minister is: can we take a look at this matter in Committee to make sure that any approach that we take is indeed evidence based? That also goes for the case in relation to manually actuated release system rifles. I agree with the Government’s fundamental position that these are, in theory, dangerous weapons, but I also appreciate the views of those constituents who have contacted me who have a disability. One in particular has contacted me and said that this is the only weapon that he can fire, and the measure would mean that he could not partake in his sport. We need to consider whether we argue for an exemption, whether we tighten up the measures to ensure that these rifles are more secure than most other firearms have to be, or indeed whether they have to be kept at a registered range. I hope that the Minister will take that away and look at it, along with a number of points that have been made by colleagues, in Committee. Let me reiterate the point that any change that we make must absolutely be evidence based.

To conclude, this is a good Bill. Its intentions are indeed very good and sound, but there is work to do in Committee, and there is certainly further work to do on the serious crime strategy. I just hope that we can be pragmatic and look at any and all measures in the future that will go some way towards addressing the scourge that is knife crime—or indeed any crime involving weapons of this nature.

--- Later in debate ---

[Mr John Hayes (South Holland and The Deepings) (Con)]

It is a prevalent liberal misassumption that things can only get better. Their mindset is that progress is inevitable and that whatever we do, society will advance. It is true that, as Disraeli said:

“Change is inevitable…change is constant”,

but things can simultaneously deteriorate as well as improve. In my lifetime, there is no question but that that is exactly what has happened.

In the 60 years of my life—I know you are thinking, Mr Deputy Speaker, “How can that possibly be true? How can that callow youth standing before me possibly have been born in 1958?”, but it is true—civil society has been weakened, respect for authority has dwindled and many of the once routine civilities and courtesies that mitigate the inevitable pitfalls of human existence have been derided, eroded or abandoned. Consequently, life is less gentle than it was when I was a boy. Many have been brutalised and some are brutal. It is very difficult for the liberal establishment to come to terms with that, because the unhappy reality of increasing disorder and criminality contrasts with the myth of progress. It is therefore either disguised or ignored by those who cannot bear to face the facts.

I thought I would offer the Chamber some of those facts this afternoon. They are so extraordinary that when I researched them, I could barely believe them, but they are based on information available from the Library. In the year of my birth, 1958, the total number of violent criminal incidents was 31,522. At the end of 2014—a year for which the figures are available—the total number of violent incidents was 1,245,000. This is an extraordinary change. Even allowing for the change in population, which is significant, and for the changes in the definition of crime, which are not irrelevant, the truth is that there has been an explosion in the amount of serious and violent crime in our country. Most Members in this Chamber will know someone in their circle, family or beyond who has been a victim of some kind of serious or violent crime. Of course, we know that our constituents have been, but many of us will have encountered it in a much more familiar way than that.

[Will Quince]

Notwithstanding my right hon. Friend’s point, does he accept that it has become a lot easier—in fact, has never been easier—to report a crime?

[Mr Hayes]

It is true that in criminal statistics there is the well-established principle of the dark figure—the number of crimes never discovered because they are never reported—and that this also needs to be taken into account in any comparative analysis, which is why I qualified mine heavily before I offered it.

None the less, in the year of my birth there were 1,194 recorded robberies; the number now, extraordinarily enough, is 74,130. We have had roughly a seventyfold increase in the number of robberies during the 60 years of my life. This is indeed an extraordinary change. As parliamentarians, our recognition and acceptance of this is an important part of reconnecting ourselves with the lives and assumptions of the people who suffer these kinds of crimes. The more we detach ourselves from this reality and bury our heads in the sand, the more people believe we either do not know or, worse, do not care. I know that people across the Chamber do care, but denial is not good enough.

That is why I welcome the Bill. It is an important acceptance that action is needed, that further measures are required. It is not, of course, the whole solution—the Government would not claim it was, as right hon. and hon. Members have said—but it is a step in the right direction, although it will need to be refined in Committee. I will not go into why and how, because that has been amply rehearsed already, but it is important to consider some of the issues the Bill deals with: the availability of weapons; how easy or difficult it is for the police to deal with prosecutions; and the culture associated with this increase in violence, particularly among the young and in urban areas.

Our preoccupation with the here and now does not help. We have a culture dominated by the immediate at the expense of measured contemplation. We no longer think about what was or might be; we think of now, and we do not want people to feel that now is worse than it once was. Yet, having that long-term view and more contemplative approach to public policy is an important way to deal with some of the things I have described.

The idea that things are not getting better is unpalatable, which is why the Bill is pertinent and welcome. Crime has many causes, and some have been rehearsed in the debate. They include communal disintegration, family breakdown and the absence of opportunity, but fundamentally criminal behaviour is about the absence of values—values that the law-abiding take as read: care for others, personal responsibility, respect for the rule of law. In the absence of those values, the gulf is filled by altogether less desirable things—greed, anger, sloth, lust, gluttony, envy, pride. They are not, after all, new sins; they have been common to the human condition since man was made—and the results can be deadly.

Crime is not an illness to be treated, and the perpetrators of crime are not patients. Crime is the product of choices that people make. Those choices might have been affected by their circumstances, but it is pretty insulting to working-class people of the kind I was brought up among to tell them they are more likely to be criminals because they live on a council estate, work in a factory or never had a formal education of the kind I and many here enjoyed. Let us be clear: we have to identify malevolent behaviour and deal with it appropriately in the interests of public respect for the fairness of the justice system. Every time we do not, we undermine the regard for the rule of law among less well-off people—those hard-working decent people who do the right thing and do not choose the course of crime but go about their lives in a peaceable, decent and honourable way.

Let us now think about what more needs to be done. Certainly we need to tackle some of the “drivers” of crime, as they have been described by other Members. I have mentioned a few, in the context of health and the life of civil society, but I think that the internet is, or can be, a malevolent influence in this regard. We need to get tough with the social media platforms that glamorise violence, and, in particular, glamorise the use of the weapons of violence.

As I suggested earlier to the Home Secretary, we also need to adopt a cross-departmental approach to deal with support for the family and support for communities. The hon. Member for Sheffield, Heeley (Louise Haigh)—who I thought spoke extremely well, as I told her privately—mentioned early intervention. Early intervention does matter, and there is no better early intervention than a strong and stable family. My early intervention was my mum and dad, who taught me the difference between what was right and what was wrong. You can fudge these things, and you can have a high-flown debate in fancy terms about sociology, but in the end it comes back to that: people having a very fundamental sense of what is acceptable and what is unacceptable, and what is good and what is bad behaviour. Families really matter in that respect.

We know that there is an association—if I may get sociological for a moment—between certain kinds of young people and crime. They tend to be young people whose families have broken down, and who have not had the role model of a strong father. We need to take a lateral approach in considering some of those causal factors.

Finally—