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House of Commons

Tuesday 25 January 2011

The House met at half-past Two o'clock


[Mr Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked-

GP Commissioning

1. Mark Lancaster (Milton Keynes North) (Con): What recent progress he has made in introducing GP commissioning consortia. [35632]

3. Stephen Mosley (City of Chester) (Con): What recent progress he has made in introducing GP commissioning consortia. [35634]

6. Nick de Bois (Enfield North) (Con): What recent progress he has made in introducing GP commissioning consortia. [35637]

8. Mr Matthew Offord (Hendon) (Con): What recent progress he has made in introducing GP commissioning consortia. [35639]

11. Christopher Pincher (Tamworth) (Con): What recent progress he has made in introducing GP commissioning consortia. [35642]

The Secretary of State for Health (Mr Andrew Lansley): Last week, I announced the second wave of GP-led pathfinder consortia. There are now 141 groups of GP practices piloting the future GP commissioning arrangements. Those groups are made up of more than 4,000 GP practices, with over half the population starting to benefit from services that better meet their needs and improve outcomes for patients. The Health and Social Care Bill, which had its First Reading last week, sets out the legislative framework that supports our reforms.

Mark Lancaster: Consortia in Milton Keynes have been given £1 per patient as a transition fund. That money is most welcome. It will rise to £2 per head next year. The problem, however, is that the fund is proving hard to access because of the bureaucratic nature of the local primary care trust. Will the Secretary of State look into that and ensure that the money is accessible?

Mr Lansley: I entirely understand my hon. Friend's point. The PCT's role is to support the development of consortia, not inhibit it. The operating framework that was published last month sets out the range of support
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that PCTs should be offering emerging consortia. Milton Keynes PCT has confirmed that it will actively support Premier MK, one of two consortia in the area, with its application to become a pathfinder, and that it is actively working with another consortium in the Milton Keynes area.

Stephen Mosley: Pathfinder consortia will play a crucial role in improving the NHS, so it is imperative that any problems are sorted out as quickly as possible. How does my right hon. Friend propose to help any pathfinder consortium that finds itself in the unfortunate position of failing to deliver the results expected of it?

Mr Lansley: My hon. Friend makes an important point. He will recall that before the election, the Select Committee on Health severely criticised the way in which primary care trusts were going about commissioning. We are looking to consortia because they are clinically led and responsive to patients in designing far better clinical services, and they will have considerable support in doing so. Over the next two years, we will enable them to develop support arrangements, whether through existing primary care trust teams, local authorities, the NHS commissioning board, or a range of voluntary and independent sector organisations.

Nick de Bois: Will the Secretary of State outline the role that charities and voluntary organisations will play under GP commissioning to ensure that the needs and views of patients are at the heart of services?

Mr Lansley: To give my hon. Friend one example, last Friday I spoke to the Motor Neurone Disease Association, which has developed a commissioning support organisation with the Multiple Sclerosis Society and Parkinson's UK. The voluntary sector can therefore be involved directly in helping GP consortia to commission for those critical diseases more effectively. My hon. Friend might have seen what Sir Stephen Bubb, the chief executive of the Association of Chief Executives of Voluntary Organisations, said last week:

Mr Offord: My constituents in Hendon are eager to see the improvements in health services that I believe GP commissioning will bring about. Will my right hon. Friend give examples of where GPs have had the freedoms and responsibilities that we can expect in Hendon?

Mr Lansley: My hon. Friend might like to speak to general practitioners in Redbridge in London who, as a pathfinder consortium, have been pioneering GP-led commissioning for 18 months. They have redesigned care for patients with diabetes and coronary artery disease, and are shifting care in ophthalmology and dermatology to primary care settings. They are demonstrating how this form of locally and clinically-led commissioning is more responsive to patients and more effective.

Christopher Pincher: As we shift from PCTs commissioning services to GP consortia doing so, can my right hon. Friend confirm that the important work done by pharmacies, such as providing anti-smoking clinics and the supervised consumption of drug substitutes, will not be left out in the cold?

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Mr Lansley: My hon. Friend enables me to say that I and my colleagues entirely understand and endorse the stronger role that pharmacies can play, including by assisting with the provision of services such as minor ailments services and medicines use reviews, which will be commissioned through arrangements led by the NHS commissioning board. In addition, the services that he describes, such as stop smoking services, will be commissioned as part of the public health efforts, which will be led by local authorities through their local health improvement plans.

Emma Reynolds (Wolverhampton North East) (Lab): Will the Secretary of State comment on the apparent conflict between, on the one hand, a general practitioner being an advocate for their patient and taking purely clinical decisions and, on the other hand, GPs having to allocate resources in the new system? Will that conflict not lead to a breakdown of trust in the relationship between the GP and their patients?

Mr Lansley: I am afraid the hon. Lady sees a conflict where, to GPs, there is none. It is their responsibility- [Interruption.] No, their first duty is always to their patients, whose best interests they must secure. When she has an opportunity to look at the Health and Social Care Bill, which we published last week, she will see that it makes very clear the duty to improve quality and continuously to improve standards. We all know that we have to achieve that with finite resources, but we will do that much better when we let clinical leaders influence directly how those resources are used rather than letting a management bureaucracy tell them how to do it.

Debbie Abrahams (Oldham East and Saddleworth) (Lab): Can the Secretary of State explain why, at a time when front-line NHS staff in my constituency and elsewhere across the country are in fear of their jobs, it is proposed that the NHS commissioning board will be able to make bonus payments to a GP consortium if, to quote the Bill,

and that a GP consortium may

Is that not the worst kind of excess? We do not want to see it in our banking system, and we certainly do not want to see it in our NHS.

Mr Lansley: I am glad to have the opportunity to welcome the hon. Lady to the Opposition Benches and wish her well in representing Oldham East and Saddleworth. I am sorry that she did not take the opportunity to welcome in particular the Government's commitment to the new women and children's unit at the Royal Oldham hospital.

For years, general practices have been remunerated partly through a quality and outcomes framework. The principle is that if they deliver better outcomes for patients, they should have a corresponding benefit from doing so. In the same way, if the commissioning consortia deliver improving outcomes for patients, that should be recognised in their overall reward.

John Healey (Wentworth and Dearne) (Lab): The Secretary of State talks a lot about GPs using £80 billion of public money to commission services, but if they are to carry on being family doctors, the planning, negotiating,
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managing and monitoring of hundreds of commissioning contracts will be done not by GPs but in their name, either by the people who do it now in primary care trusts or by the big health companies that are already hard-selling the service to new GP consortia. Is he not deliberately disguising the true purpose of his changes, which is to open up all parts of the NHS to big private health care companies?

Mr Lansley: On the contrary, the purposes of the Bill are very clear to see-for example, the duty to improve quality and raise standards throughout the health service. I hope that the shadow Secretary of State will acknowledge that putting clinical leadership at the heart of the system is essential. I entirely understand that leadership is not the same thing as management, as do general practitioners. The Prime Minister and I will meet the first wave of pathfinder consortia tomorrow, and we will support them in taking clinical leadership in designing services for patients and bringing to bear the best management support in doing so.

John Healey: Why will the right hon. Gentleman not be straight with the public? I have with me the White Paper-57 pages and only three references to the market, all of them to the social market. He talks about GP commissioning, but not about the hard-line political ideology that underlines these changes. The Bill puts no limit on the use of NHS beds and staff to treat private patients, it puts no limits on big private health care companies undercutting and undermining local hospitals, and it puts at the heart of the new system an economic regulator charged not with improving services but with guaranteeing and enforcing competition. Is this NHS reorganisation not like an iceberg, with the substantial ideological bulk being kept out of the public's sight?

Mr Lansley: The shadow Secretary of State cannot actually criticise what we put forward in the White Paper or the Bill and is resorting to inventing something else and attacking that. Let me tell him that the one thing we will not do with the private sector is rig the market so that private companies get contracts and guaranteed money whether or not they treat patients. We are not going to give them 11% more money than the NHS would get for doing the same work. We will give NHS organisations a proper chance to deliver services for patients.

Liz Kendall (Leicester West) (Lab): Whatever the Secretary of State claims about his reorganisation, a King's Fund survey showed that more than three quarters of doctors do not believe that it will improve patient care, and even his Department's impact assessment on the Health and Social Care Bill says that the reorganisation risks distracting staff and making them less focused on patient care.

Will the Health Secretary now confirm that the number of patients waiting more than six weeks for their cancer test has already doubled under this Government, and that routine operations are being cancelled? Will he finally listen to the Royal College of Nursing and the British Medical Association, which have told him that his plans are

for the NHS and patient care?

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Mr Lansley: I find it astonishing that the hon. Lady should attack the NHS because some elective operations have been cancelled. We have been through a flu outbreak and very severe weather, and that is what happens as a consequence. She should not try to make a political point out of it.

It is also astonishing that the hon. Lady gets up and says that she does not agree with our policy. On 3 December, she is quoted in GP news as saying that

She supported it. The truth is that before the election the Labour Government instituted practice-based commissioning, introduced foundation trusts, started payment by results and said that patient choice was right. The shadow Secretary of State said just last week that

our plans-

and indeed they are.

Tim Farron (Westmorland and Lonsdale) (LD): Cumbria's current health commissioners-the PCT-chose to scrap the heart unit at Westmorland general hospital, despite medical, clinical and public opposition. Will the Secretary of State confirm that new GP fundholding arrangements allows the possibility of returning services that are clinically supportable, such as a heart unit at Westmorland general?

Mr Lansley: I know, not least from visiting that hospital, how strongly people in my hon. Friend's area feel about their access to services locally. I am pleased to say that he will see in the Bill that one of the duties of the NHS commissioning board is to reduce inequalities in access to health services, and GPs can do precisely that.

Mr Stephen Hepburn (Jarrow) (Lab): The Secretary of State knows fine well that the British public knew nothing at the general election of his plans dramatically to dismantle and privatise the NHS. Will he give them a say now and have a referendum on the issue?

Mr Lansley: Since we have no plan either to dismantle or to privatise the NHS, it is no surprise that people were not told of any such plan. Before the election and in the Conservative manifesto, people were told of our determination to cut bureaucracy and get money to front-line care. They were told of the determination of both parties in the coalition to get decision making close to the front line, to enhance accountability, including democratic accountability, and to give greater responsibility to clinicians to lead the development of services.

Cancer Survival Rates

2. Charlie Elphicke (Dover) (Con): What steps he plans to take to increase cancer survival rates. [35633]

10. Graham Evans (Weaver Vale) (Con): What assessment he has made of the effects on survival rates of his Department's cancer strategy. [35641]

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The Minister of State, Department of Health (Paul Burstow): We published "Improving Outcomes: A Strategy for Cancer" on 12 January, which sets out a range of actions to improve cancer outcomes, including diagnosing cancer earlier, helping people to live healthier lives to reduce preventable cancers, screening more people, introducing new screening programmes, and ensuring that all patients have access to the best possible treatment, care and support. Through those approaches, we aim to save at least an additional 5,000 lives every year by 2014-15.

Charlie Elphicke: May I raise the case of my constituent, Suzanne Lloyd, who was diagnosed with breast cancer a decade ago? She was told that she had two years to live, but has successfully battled cancer for the last decade. The problem is that she has also been battling health chiefs to give her the drugs that she needs to extend her life. Will the Minister tell the House about measures to increase longevity through greater drug access?

Paul Burstow: Just last year the national clinical director published a report on the extent and causes of international variations in drug usage, which revealed that the UK tends to lag behind other countries in its use of newer cancer drugs. That is one reason why we have introduced the interim cancer drugs fund of £50 million in this current year and will introduce the full fund of £200 million from this April. That will help my hon. Friend's constituent.

Graham Evans: What steps is my hon. Friend taking to ensure that all GP consortia will have access to the expertise they need to commission cancer services effectively?

Paul Burstow: The national cancer director will work with pathfinder GP consortia on commissioning cancer services, and that work will be fed into a cancer commissioning support pack that will be developed to support GP commissioners in discharging their functions effectively. Cancer networks will also be well placed to support GP consortia in that activity.

Mr David Blunkett (Sheffield, Brightside and Hillsborough) (Lab): We all agree that properly evaluated, appropriately prescribed drugs make a big difference to survival, which is why patients welcome what was described as the additional special fund, of which Ministers made mention this afternoon, of £200 million for the coming two years. Why is it, therefore, that the budget for Sheffield has been top-sliced for next year to the tune of £1.5 million to pay towards this £200 million, which was supposed to be additional-to add to and not subtract from-what was available through GP commissioning?

Paul Burstow: The NHS has real-terms increases in its resources, and those resources are going into the programme that we outlined in our outcome strategy. Three quarters of a billion pounds will be going into that programme to deliver improvements in cancer services and the £200 million, being extra, will go into improving cancer services. That is the commitment that the Government have made and that is the investment that we will make.

Emily Thornberry (Islington South and Finsbury) (Lab): Is the Minister listening when Macmillan warns that the proposed changes to the NHS risk us losing expertise in the cancer networks? If that happens, Macmillan says that

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As the Minister in charge of cancer services, should not he be on the side of cancer patients, not backing his boss's reckless reforms?

Paul Burstow: The last comment was pretty cheap, and no Government Member has suggested that the future of the cancer networks is in doubt. Indeed, in the coming financial year, the funding is secure. As we move to the new arrangements, it will be for the NHS commissioning board to decide the appropriate arrangements for commissioning in the future. We are clear that the expertise of those groups could, should and will continue to be used to support commissioning in the future.

Social and Health Care

4. Annette Brooke (Mid Dorset and North Poole) (LD): What steps he is taking to improve co-ordination of social care and health care for the benefit of patients. [35635]

The Minister of State, Department of Health (Paul Burstow): We have set out in the White Paper "Equity and Excellence: Liberating the NHS" and the Health and Social Care Bill how we will deliver the coalition programme for Government commitment to promote greater integrated working. This includes local authorities taking the lead role in the future in joining up local NHS services, social care and health improvement via council-led health and well-being boards.

Annette Brooke: Can my hon. Friend assure me that there will be a joined-up approach when addressing patients' interests and complaints when they straddle social care? Perhaps a single point of contact for a complaint would be a good step forward from what we have now.

Paul Burstow: My hon. Friend is right to draw attention to the need to integrate not only the way in which we deliver and plan services, but the way in which we manage complaints. That is why the Government have included in the Bill our proposals for the establishment of local healthwatch and healthwatch England. Local healthwatch will have the ability to deal with complaints and also have the capacity to refer concerns about services to the Care Quality Commission so that it can take the necessary steps to investigate. In that way, we will deliver a more integrated system for dealing with such complaints.

Mr Barry Sheerman (Huddersfield) (Lab/Co-op): Is the Minister aware that most of us are in favour of much better co-ordination of these services, but we worry about the backdrop of the reforms? In Yorkshire, some doctors are saying, "Come on, guys, this is a bonanza and we will all be California-style millionaires under these reforms." What sort of a backdrop is that for health care reforms and better co-ordination of services?

Paul Burstow: The backdrop that the hon. Gentleman has just painted is a rather thin one. In fact, it does not exist at all. The Government set out in the Bill we published last week that there will be clear responsibilities on GP commissioning consortia, working in partnership
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with their colleagues in local government, to commission services in ways that will improve quality of life for people in his constituency, my constituency and the constituencies of all hon. Members.

Mr Stephen Dorrell (Charnwood) (Con): Does my hon. Friend agree that improved co-ordination between health and social care is fundamental to the delivery of the efficiency challenge faced by the health service and social services? Does he further agree that the £1 billion provided by the health service to reinforce that relationship is an important step taken by the Government to reinforce that interface? Can he assure the House that, as we move into the new world, the existing arrangements for good practice across that interface will be preserved?

Mr Speaker: Order. I know that three questions will attract one answer from the Minister.

Paul Burstow: The answer to all those questions is yes. The right hon. Gentleman is right to draw attention to the additional money going into social care via the NHS. It is intended to kick-start the collaborative working that was often so absent under the previous Administration.

Dame Anne Begg (Aberdeen South) (Lab): The care that someone gets can be defined as either "social care" or "health care", and that can determine the benefits to which an individual is entitled. With that in mind, what conversations has the Minister had with the Minister with responsibility for disabled people about the Government's proposal to withdraw mobility disability living allowance from those staying in residential care?

Paul Burstow: I and the Minister responsible for disability issues in the Department for Work and Pensions meet regularly. In fact, a further meeting on this and other matters is coming up shortly.

Alcohol Misuse (Young People)

5. Fiona Bruce (Congleton) (Con): What recent steps he has taken to reduce levels of alcohol misuse among young people. [35636]

The Parliamentary Under-Secretary of State for Health (Anne Milton): The public health White Paper, "Healthy Lives, Healthy People", sets out how society can harness the efforts of individuals, families, local and national Government, and the private, voluntary and community sectors to take better care of our children's health and development.

Fiona Bruce: I thank the Minister for that reply. Hon. Members will be aware of the recent publicity given to vodka eye-balling, which is a dangerous practice. Members of the ArcAngel volunteer team in my constituency are going into schools seeking to alert young people to this and other dangers of binge drinking and excessive alcohol abuse. What support can the Minister offer to ensure that we can eradicate, in particular, the dangerous practice of vodka eye-balling?

Anne Milton: I thank my hon. Friend for her question, particularly in highlighting this extraordinary practice. I have to say, it was news to me. I congratulate the efforts of that local organisation on highlighting this
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sort of issue with school children. There is no doubt that vodka eye-balling can cause damage to the surface of the eye, ulceration and scarring. Although it has got some publicity, however, a lot of young people are likely to be drunk in the first place when they do it, so the effects are probably overestimated.

Mr Kevin Barron (Rother Valley) (Lab): Did the Minister hear the report on Radio 4 this morning that in the past decade there has been a 50% increase in the number of young people in their 30s being admitted to hospital with alcohol-related liver disease? Does she think that we ought to be looking at how alcohol is promoted and advertised around young people?

Anne Milton: I thank the right hon. Gentleman for his question. I heard the report, and I think that it made particular reference to the worrying trend among young women as well. There is no doubt that our public health White Paper is timely. We need to do something about this. It is important to remember that no one tool will fix this problem; we need to take a wide variety of measures and alter, in particular, young people's relationship with alcohol. However, we will not do that until we get a proper strategy out there.

Simon Hughes (Bermondsey and Old Southwark) (LD): Do Ministers clearly understand that the price of alcohol is a relevant consideration? Will they look at whether we can get relatively cheaper prices for soft and sports drinks? They are a viable alternative for many young people, but the price is often double that for alcohol.

Anne Milton: I thank the right hon. Gentleman for his question. There is no doubt that price is one of the tools to which I referred. However, we need to take a huge number of actions. Reforming the Licensing Act 2003 via the Police Reform and Social Responsibility Bill will bring in a number of measures-for instance, doubling the fines for under-age alcohol sales to £20,000 and giving councils and the police the power to shut permanently shops or bars that persistently sell alcohol to children. That is one other way. Also, the Bill will make local health bosses responsible authorities for licensing decisions. That is an important shift and demonstrates the fact that this is everybody's problem-no one public body can cure this on its own.

NHS Reorganisation

7. Alison McGovern (Wirral South) (Lab): What recent representations he has received on his plans for the internal reorganisation of the NHS; and if he will make a statement. [35638]

17. Bridget Phillipson (Houghton and Sunderland South) (Lab): What recent representations he has received on his plans for the internal reorganisation of the NHS; and if he will make a statement. [35648]

The Minister of State, Department of Health (Mr Simon Burns): The Government received more than 6,000 responses to the NHS White Paper consultations. As a result, we have strengthened both our approach to
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implementation and our proposals in the Health and Social Care Bill, which was introduced in Parliament last week.

Alison McGovern: The Government have embarked on a reorganisation of our health service that involves altering the commissioning process, handing responsibility to those with less experience of contracting, and at the same time unleashing the market, allowing a whole load of new providers in. What risks does the Minister see might be associated with that approach?

Mr Burns: The risk is that if we do not go ahead with these reforms, which are crucial to raising standards and improving outcomes, patient care, survival rates and treatment, we will be doing a grave disservice to the people of this country.

Bridget Phillipson: Last week, north-east regional board members of the British Medical Association made it abundantly clear to me and other north-east colleagues that they have serious concerns about the Government's plans and that they risk patient care. How is it that the Minister is right and they are wrong?

Mr Burns: Because I am afraid that the hon. Lady has not read the whole document, in this case from the BMA, or those from other organisations. What many say, including the BMA, on many of the proposals is that they are supportive of them, but naturally the hon. Lady and others cherry-pick those parts that suit their arguments.

Patrick Mercer (Newark) (Con): The Minister will be only too aware of the worries of my constituents in Newark about the future of the hospital. Will he assure me that the internal reorganisation of the NHS will run in parallel with and improve the delivery of the Newark health care review, rather than the contrary?

Mr Burns: Yes, and let me reassure my hon. Friend-because last summer I had the pleasure of joining him to visit what is an excellent hospital for the people of Newark-that under our reforms, given the commissioning powers of the GP consortia in the area, they will be able to help strengthen and tailor the health care that the hospital delivers, ensuring that it meets the needs of the people of Newark.

Mr Edward Timpson (Crewe and Nantwich) (Con): How does my hon. Friend envisage the commissioning of ambulance services under the new GP commissioning regime?

Mr Burns: Ambulance services will be commissioned through the GP consortia at the local level. What I envisage-this is not prescriptive from the Department of Health, but what I think will develop-is that, just as ambulance services are currently commissioned for geographical areas in England through one PCT, the consortia will appoint lead consortia to commission the services for that area.

Ms Diane Abbott (Hackney North and Stoke Newington) (Lab): Does the Minister agree with the representations of the Select Committee on Health, chaired by the hon. Member for Charnwood (Mr Dorrell), when it said that it was

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in May

in July? The Committee continued:

If he cannot convince his hon. Friend the Member for Charnwood, how is he going to convince the rest of us?

Mr Burns: Let me begin by congratulating my, in fact, right hon. Friend the Member for Charnwood on the report that his Committee produced. The Government will give a full response to it in due course, as is usual. What I would tell the hon. Lady is that what happened in the Bill and the White Paper was what we and our coalition colleagues, the Liberal Democrats, had outlined in our election manifestos, which- [ Interruption. ] Hon. Members may say that, but I suggest that they look at pages 45 to 47 of the Conservative manifesto, which probably very few of them have bothered to do. GP commissioning, along with "any willing provider" et al, are there, and if one looks at the Liberal Democrat one- [ Interruption. ]

Mr Speaker: Order. The Minister's answer must be heard.

Mr Burns: I am extremely grateful, Mr Speaker.

If we look at the Liberal Democrat manifesto, we can see that it also contains proposals for the abolition of strategic health authorities. The hon. Member for Hackney North and Stoke Newington (Ms Abbott) has alluded to the abolition of PCTs, and the reason for their abolition is that, when we have given the commissioning to GP consortia and the public health responsibilities to local authorities, there will be no job for the PCTs to do. Why keep them? There will be £5 billion savings during this Parliament that can be reinvested in front-line services.

Video Link Consultations (Prisons)

9. Philip Davies (Shipley) (Con): What assessment he has made of the effectiveness of video link medical consultations in prisons. [35640]

The Minister of State, Department of Health (Paul Burstow): The Department has made no assessment. PCTs and prison partnerships may consider using telemedicine as an alternative to hospital appointments for offenders, after considering any security issues and the benefits for improved health care. Decisions about treatments for offenders, including video link consultations, are made by local commissioners.

Philip Davies: Red Embedded Design, an SME technology company in my constituency, is working in partnership with Airedale NHS Foundation Trust to enable video link medical consultations to take place in prisons. May I suggest that the Minister look closely at this scheme, which has been rolled out in a number of prisons? He will see the cost benefits and the lack of risk of absconding involved. Will he encourage other PCTs around the country to introduce the system in their prisons?

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Paul Burstow: As part of a wider programme, a demonstrator project looking at telemedicine and telecare, we are looking at a possible roll-out of such approaches. In regard to the specific case of the Airedale NHS Foundation Trust, I would be only too happy to look further at the details and the benefits that have arisen.

Mr Denis MacShane (Rotherham) (Lab): Telemedicine is obviously a help, but nothing beats talking to a real human being about our medical problems. Would the ministerial team consider copying the Conservative-Liberal Government in Sweden, who have banned from all public agencies, including health agencies, automatic answering machines-the kind that tell us to "Press 1", "Press 2" or "Press 3"? Instead, people calling those agencies have to speak to a real live Swede in Sweden. Would not that be a good step forward for our health service?

Paul Burstow: The right hon. Gentleman has found a cunning way of getting in a point that does not directly relate to the question. He makes a very fair point, however. It is important that people should feel confident that, when they pick up the phone and make a call, they can speak to a person. Telemedicine can provide that route as well, through allowing people to get a diagnosis and treatment, as well as access to the appropriate support at the right time.

BCG Vaccine

12. Nic Dakin (Scunthorpe) (Lab): If he will take steps to increase the availability of the BCG vaccine for children. [35643]

The Parliamentary Under-Secretary of State for Health (Anne Milton): I should point out to the hon. Gentleman that there are no problems with the availability of the BCG vaccine. I am also aware that he takes a personal interest in this subject because of his local experience. I am confident that those most at risk of contracting tuberculosis are being offered the BCG vaccination as part of a targeted national programme.

Nic Dakin: Does the Minister not think that it is time to widen that targeted national programme? Tuberculosis is an airborne infection, and it covers a broader area than the areas that are being focused on at the moment. Would not the widening of the programme improve protection?

Anne Milton: Yes, I would just like to point out to the hon. Gentleman that TB has changed from being a disease of the whole population to one that affects high-risk groups. In fact, the Joint Committee on Immunisation and Vaccination looked at this in 2005 and reaffirmed it in 2009. We are confident that this targeted approach is the best way of addressing the problem.

NHS Waiting Times

13. Mr Ben Bradshaw (Exeter) (Lab): What assessment he has made of the likely effects on waiting times of his proposed reorganisation of the NHS. [35644]

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The Minister of State, Department of Health (Mr Simon Burns): The proposed changes will focus the NHS on quality and the results that matter to patients-such as how successful their treatment was-and not just on bureaucratic processes such as waiting time targets. Waiting times are important to patients, along with the quality of their experience and outcomes, which will drive improvements in the future.

Mr Bradshaw: Well, what a revelation! I think that the Minister will find that the public do care about waiting times. Will he confirm that waiting times are already going up, that more people are already waiting more than 18 weeks-the maximum that we achieved when we were in government-and that the performance of accident and emergency departments has deteriorated since he watered down our A and E targets?

Mr Burns: I think that the right hon. Gentleman either did not hear my earlier remarks or had penned his question prior to hearing them. What I said was that waiting times are important to patients-and if he looks at the record tomorrow, he will see that. May I also explain to him that the average median time for the latest month available-November-shows patients completing a referral to treatment pathway in about 8.3 weeks? The right hon. Gentleman's comments on A and E are just factually wrong and somewhat cheap.

Mr John Baron (Basildon and Billericay) (Con): There are concerns that some of the expertise of cancer networks might be lost because of the funding gap between the end of the Government's funding for the networks and the transition to full GP commissioning. Will the Government consider bridging this gap, at least until GP consortia are fully up and running-and therefore better able to make informed decisions about the commissioning of cancer network services?

Mr Burns: I am grateful to my hon. Friend in view of the considerable interest he takes and work he does in this field of health care. Let me reassure him that we have guaranteed the funding for next year, so it can work itself out to a successful conclusion thereafter through the cancer networks in the commissioning plans.

Derek Twigg (Halton) (Lab): Under Labour, hospital waiting times were at a record low and satisfaction with the NHS in its current form was at a record high. Over the last few months, however-no matter how much the Secretary of State does not like it-we have seen more and more operations cancelled or postponed at our hospitals. A number of nurses in my constituency have written to tell me that they are short staffed. One of them pointed out that

Is that not the true picture of what is going on in the NHS at the moment? If the Minister is confident in his Secretary of State's plans for the NHS, will he guarantee that under those plans, hospital waiting times will not rise-or is he going to duck the question like the Prime Minister did last week?

Mr Burns: Under these reforms, by concentrating on raising quality and outcomes, we will give improved quality health care for patients. What I can guarantee is
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that under these reforms, when implemented, people will not only get improved quality treatment but will see times based on clinical decisions rather than being distorted by political processes.

Elective Treatments

14. Fiona Mactaggart (Slough) (Lab): What recent discussions he has had with primary care trusts on their policies on halting elective treatments in cases where such treatment has been demonstrated to be effective. [35645]

The Minister of State, Department of Health (Mr Simon Burns): Strategic health authorities have recently been reminded of the statutory commissioning responsibilities of their primary care trusts in this area, and the need to base commissioning decisions on clinical evidence and discussions with local GP commissioners, secondary care clinicians and providers.

Fiona Mactaggart: What is the Minister's response to the trusts that have been saving money by halting procedures such as hip and knee replacements, hernias and hysterectomies, which have proved to be clinically effective? My constituent, John Deas, has just lost the care of the nurse practitioner who has managed his prostate cancer over some years and has been referred to a GP who will not see him. As the president of the Royal College of Surgeons said that the immediate need to

Does it make any sense governmentally?

Mr Burns: I am sorry to hear about the example that the hon. Lady mentioned; if she would like to write to me with the details, I would be more than happy to look into it. PCTs have a continuing responsibility to provide clinical treatment for their patients. Obviously, once the PCTs cease to exist, that will happen through the GP consortia and the national commissioning board. There is also a legal right in the NHS constitution for patients to be treated when they need to be.

Mr Stewart Jackson (Peterborough) (Con): A number of patient groups across the country are concerned about the future of in vitro fertilisation treatments, particularly when many PCTs downgraded it and put it on a par with things like tattoo removal and cosmetic surgery. Will the Minister confirm that, in future, IVF treatments will fall under the remit of the NHS commissioning board?

Mr Burns: Let me reassure my hon. Friend on IVF. PCT commissioners should have regard to the National Institute for Health and Clinical Excellence guidelines for fertility treatment, including to the recommendation that up to three cycles of IVF treatment are offered to eligible couples. To reinforce this, in November last year, the NHS operations board reminded PCTs, through the SHAs, of that responsibility. Indeed, Mr David Flory of the Department of Health has in the last month or so written to PCTs to remind them of their responsibilities.

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Medical Aids

15. Andrew Selous (South West Bedfordshire) (Con): What recent estimate he has made of the monetary value of medical aids issued to patients by hospitals and not returned in the latest period for which figures are available. [35646]

The Parliamentary Under-Secretary of State for Health (Anne Milton): As my hon. Friend knows, NHS patients are provided with NHS aids free of charge and requested to return them when they are no longer required. Obviously the cost of recovery must be weighed against the cost of the items being lent, but it is the responsibility of the local NHS to monitor the position and arrange for the recovery of medical aids when that is safe and cost-effective.

Andrew Selous: For many years the experience of my constituents, and indeed my own family, has been that hospitals often provide patients with, for example, crutches, without ever asking for them back. I accept that this is a matter for the management of local hospitals, but does my hon. Friend agree that the Department has an interest in ensuring value for taxpayers' money, and that the medical aids involved could be used by other patients who need them?

Anne Milton: I agree. One always hopes that people will act responsibly, and that they or their families will return medical aids. My hon. Friend may know that Bedford hospital has organised a scheme for the collection of aids, and that a number of voluntary organisations are also involved. However, the cost of collection and decontamination or cleansing is sometimes greater than the cost of the equipment itself. Crutches, for instance, cost between £11 and £20. Such is life today.

Topical Questions

T1. [35657] David Rutley (Macclesfield) (Con): If he will make a statement on his departmental responsibilities.

The Secretary of State for Health (Mr Andrew Lansley): My responsibility is to lead the national health service in delivering improved health outcomes in England, to lead a public health service which improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care which supports and protects vulnerable people.

David Rutley: Cheshire East council is working closely with local health care partners in my constituency to tackle the growing challenge of alcohol abuse, which not only causes serious illness and injury but costs our local primary care trust £34 million a year. Does my right hon. Friend agree that that is the right way in which to tackle this growing problem, and will a member of his ministerial team meet me, along with representatives of the council, to help secure the best possible outcomes in Macclesfield?

Mr Lansley: Of course we will support the efforts of my hon. Friend and his local council to tackle alcohol abuse. He will have heard what was said earlier by the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), which I entirely endorse.

25 Jan 2011 : Column 160

Local authorities and their communities should have a greater say in what happens in their areas. We will enable them to do so, through the Health and Social Care Bill, the establishment of local health improvement plans, and-as my hon. Friend the Under-Secretary said-the alcohol strategy that we will introduce following the public health White Paper later in the year.

T3. [35659] Ian Lavery (Wansbeck) (Lab): Does the Secretary of State envisage a time when GP consortia may be purchased by foreign companies, and operated and administered thousands of miles away across the globe?

Mr Lansley: No, I do not. I am glad that the hon. Gentleman has asked that question, because I think that there is a world of difference between the question of the exercising of clinical leadership by general practices as members of a consortium in an area and the question of from whom they derive management support. I believe that many will derive it from existing PCT teams, the voluntary sector and local authorities. Sometimes the independent sector will be involved, but it is a question of the consortium choosing where to go rather than being taken over.

T2. [35658] Margot James (Stourbridge) (Con): Some care homes that have received critical reports from the Care Quality Commission are reopening under the same management but with different names. The CQC's practice is to remove earlier poor reports from its website, leaving potential customers in the dark about the poor record of those homes. Will the Minister remind the CQC of its responsibility to highlight poor practice in care homes, and request that it change its practice?

The Minister of State, Department of Health (Paul Burstow): I will certainly ensure that the CQC understands that that is a matter of concern. When it discharges home owners and deregisters them, after receiving an application for a fresh registration, it conducts a thorough appraisal and assessment of their fitness to provide the service. The new owner of a home may well have done a great deal of work in improving the quality of training given to staff, but I agree that it ought to be possible for people to look at the CQC's website and see reports on the quality of the previous provider so that they can assess that as well.

T5. [35661] Paul Blomfield (Sheffield Central) (Lab): A year ago, writing in The Sun, the Prime Minister made a firm and passionate pledge to increase the number of midwives by 3,000. Last week, the chief executive of the NHS told the Public Accounts Committee that the NHS is now short by 4,500 midwives. Will the Secretary of State tell the House when he intends to implement plans to honour the Prime Minister's pledge-or can we take it that it is just another Conservative broken promise on the NHS?

Mr Lansley: Well, I do not wish to embarrass the chief executive of the NHS, but actually, he told me he made an error-he was referring to health visitors, not midwives, when he was talking to the Public Accounts Committee. We are short of health visitors precisely because, through the life of the last Government, the number was continuously going down, and we are
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going to recruit more. Actually, we share the last Labour Government's commitment to increase the number of midwives, not least because of the increase in the number of births, and to do so in pace with that. As a consequence, in conversations that the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton), and I have had with the Royal College of Midwives, we have made it clear that we will do all we possibly can. We already have more midwives in training than at any other time in our history.

T4. [35660] John Stevenson (Carlisle) (Con): As Ministers are aware, GPs in north Cumbria are supportive of GP commissioning and are already working hard for its success. However, given the rural nature of the area, what support will be given to the local hospitals to ensure that they can provide secondary health care within the new regime, when they have to accommodate the additional costs of providing health care in a rural environment?

Mr Lansley: Yes, I entirely endorse what my hon. Friend says about GPs in Cumbria. They are indeed very forward-looking and show that, even under the last Government, practice-based commissioning was demonstrating its benefits, and we are building on that. I mentioned earlier the duty in the Health and Social Care Bill on the NHS commissioning board to reduce inequalities in access to health care. That will be important for rural areas. The pricing arrangements, led by the commissioning board and Monitor, must also take into account varying costs associated with the delivery of care in different localities.

T8. [35664] Mr Tom Harris (Glasgow South) (Lab): If the Government will not even trust GPs with the responsibility of ordering flu vaccine, how on earth can they trust them with commissioning the care and treatment of cancer victims?

Mr Lansley: Of course, it was the last Government who agreed the arrangements with GPs. It was the last Government who, in 2007, undertook a flu review when central procurement of flu vaccine was recommended, but did nothing about it. The public health responsibility is distinct from the commissioning responsibility for health care of patients. We will look at, and we have still to make a decision about, how we procure flu vaccine in future years. We may do it through central procurement or through continuing GP procurement; but either way, we will make sure that we improve on the system we inherited.

T6. [35662] David T. C. Davies (Monmouth) (Con): Can the Minister tell us how much money is spent each year on disposable surgical instruments, and whether any thought has been given to greater use of properly sterilised reusable instruments?

The Minister of State, Department of Health (Mr Simon Burns): The straightforward answer to my hon. Friend's question is, £18 million per annum. The decision to use single-use instruments as opposed to reusable ones is based on many complex clinical factors. For this reason, these decisions are left for the determination of local trusts on the basis of safety, quality and value for money.

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T9. [35665] Grahame M. Morris (Easington) (Lab): May I ask the Secretary of State directly about leaked documents seen by The Northern Echo? They show that a £53 million NHS contract to provide health care services to the prison service in the north-east was awarded to a private company, Care UK, even though the NHS provider was marked higher on quality, delivery and risk. Care UK beat the NHS provider only on price. Is this confirmation of the Minister of State's remarks on Newsnight, that this Bill will create a full market and full competition?

Mr Lansley: The hon. Gentleman is asking about arrangements that we have inherited from his Government; they are from before the election and are nothing to do with the White Paper or the Bill. The contract to which he refers was let by the North East Offender Health Commissioning Unit. This was its procurement decision and it states that a competitive, robust and transparent process was followed. This was not a decision taken or influenced by the Department of Health.

T7. [35663] Karen Lumley (Redditch) (Con): In support of national obesity fortnight, which is currently running, I wish to raise awareness of this serious condition, which causes numerous deaths and other serious health conditions. Redditch has high levels of obesity compared with the average in England. NHS Worcestershire is doing a fantastic job, but what more can the Government do to ensure that the NHS will not be overly burdened with increasing obesity problems?

The Parliamentary Under-Secretary of State for Health (Anne Milton): I thank my hon. Friend for raising this issue, and I know that her local council is running a number of schemes. As she knows, we have published a White Paper on public health, "Healthy Lives, Healthy People". In the spring, we will publish a document on reducing obesity, and we will set out how this will be tackled in the new public health systems and in the NHS. It is important to remember that at this time of year a number of people go on diets and try to lose weight and get fit, and I urge them all to carry on, including Members of this House.

Alun Michael (Cardiff South and Penarth) (Lab/Co-op): Does the Minister accept that during times of illness people often experience associated problems, for example, difficulties with employment and housing, and personal problems, with which they can be helped by the information available through StartHere? Will he ensure that his Department and others treat StartHere as essential to the provision of high-level public service?

Mr Burns: I am very grateful to the right hon. Gentleman for that question because, as he is aware from meetings that we have had, we have been supporting StartHere through NHS Choices. We are now reviewing the benefits of this joint working, and that will help us to understand potential contributions to savings to improve the information flow to those who may be excluded from the use of the internet. He may be interested to learn that I have today written to Ms Hamilton-Fairley, outlining where we are at the moment. I am anxious to resolve this as soon as possible, once the review has been completed.

25 Jan 2011 : Column 163

T10. [35666] Mr Steve Brine (Winchester) (Con): What does the Minister think is the likelihood of the pathfinder consortia examining commissioning arrangements for neurological conditions? This is particularly important, because conditions such as Parkinson's are not familiar to many general practitioners, and commissioning arrangements for these complex conditions are tricky, so they need specialist knowledge. They need to be getting expert support and advice, including from patients and third sector groups.

Paul Burstow: The hon. Gentleman makes some important points about how the new system provides the opportunity to access a range of new resources to develop the way in which commissioning is provided for people with neurological conditions. Not the least of these are the way in which the Neurological Alliance is working to provide a new structure for its way of operating at the local level to offer commissioning support and, from the Department, how the neurological commissioning support group will be able to work with early implementers of the health and well-being boards and pathfinder GP consortia to provide them with the necessary support to develop their capability in this area.

Luciana Berger (Liverpool, Wavertree) (Lab/Co-op): The Minister of State referred earlier to Labour Members cherry-picking quotes, but I do not believe that Laurence Buckman, chair of the British Medical Association's GP committee, was mincing his words when today he described the Government's reorganisation plans as "fatally flawed", warning that they

Why does the Secretary of State believe that he knows better than Dr Buckman?

Mr Lansley: I do not recall the BMA ever agreeing with the previous Government. Let me provide one quote to the hon. Lady:

The shadow Secretary of State said that last week.

Duncan Hames (Chippenham) (LD): The NHS Litigation Authority has presented NHS Wiltshire with a bill for more than £3.5 million in clinical negligence scheme payments this year. Nationally, among closed claims, legal fees made up more than a third of costs last year. How does the Minister propose to switch this expenditure away from lawyers and towards front-line health services?

Mr Lansley: I wish, first, to say two things, but there may be further to add. First, my right hon. and learned Friend the Secretary of State for Justice is working on the implementation of the Jackson review. That, in itself, will help considerably in reducing the extent to which these costs are consumed in legal fees, rather than proper compensation for clinical negligence. As we made clear in response to Lord Young's report, we will also pursue the question of whether we can have a fact-finding phase following up a claim against the national health
25 Jan 2011 : Column 164
service, so as to mitigate what is otherwise considerable additional cost on conditional fee arrangements and getting expert witnesses.

Mr Dennis Skinner (Bolsover) (Lab): Why is it that the Secretary of State does not compliment the Labour Government on providing £110 billion, starting with £33 billion in 1997? Is it not a fact that waiting times have fallen as a result of the nurses, the doctors and that money? Is he frightened to utter the words because in 2001 every single Tory MP marched through the Lobby not to give the money to the national health service?

Mr Lansley: Let me remind the hon. Gentleman that at the general election we just fought we were the party that was committed to increased resources for the national health service. We are the coalition Government who, over this Parliament, will increase resources for the national health service by £10.7 billion, even in the face of the deficit we inherited from Labour. The hon. Gentleman's party's response was to tell us that we should cut the NHS, and we are not going to do it.

David Tredinnick (Bosworth) (Con): Will my right hon. Friend the Secretary of State please explain why it is taking so long for him to come to the House about the regulation of herbal medicine? He has to do that before April to comply with European legislation. What is the hold-up?

Anne Milton: I thank my hon. Friend for his question and I know that he has a keen interest in this subject. I share his frustration that the previous Government spent a long time not doing anything about it. The Medicines and Healthcare products Regulatory Agency has identified the possibility of creating a national regulatory scheme, allowing authorised herbal practitioners to continue to commission unlicensed manufactured herbal medicines after 30 April. We are in discussions with the devolved Administrations, the Health Professions Council and the Complementary and Natural Healthcare Council about the feasibility of a statutory register. As I say, I share my hon. Friend's frustration but we will make proposals shortly.

Dr William McCrea (South Antrim) (DUP): Specialists in the field state that the figures that point to a more than 50% rise in young drinkers ending up in hospital are a gross underestimate of the serious problem. What further steps can the Department and the Government take to address this important problem?

Mr Lansley: As the hon. Gentleman will recall from earlier exchanges, it is absolutely right that we must have a series of measures to tackle alcohol abuse. Price is part of it, as is the enforcement of legislation. Community alcohol partnerships have been very promising. We must have better alcohol education, and I spoke at the first annual conference of Drinkaware yesterday, encouraging it in the work that it does. We must understand that we have to change people's behaviour and that the damage that can be done is intense. As a consequence of chronic alcohol abuse, large numbers of people are coming in and out of intensive care units, presenting an enormous burden to the health service as well as doing great damage to themselves.

25 Jan 2011 : Column 165

Gordon Birtwistle (Burnley) (LD): The College of Emergency Medicine recently stated that if a hospital A and E unit is to be downgraded to an urgent care centre, the nearest A and E unit should be no more than 12 miles away. Will the Secretary of State revisit the cases of A and E units that were recently downgraded by the previous Government to urgent care centres when the nearest A and E unit is more than 12 miles away?

Mr Lansley: Yes. My hon. Friend makes a very important point. I promise I will discuss with John Heyworth of the College of Emergency Medicine precisely the point that my hon. Friend has raised. The College of Emergency Medicine says that it does not recognise what an urgent care centre is. From its point of view, hospitals should either have an emergency department or an A and E or they should not. If they do not, it is very important to be clear that they do not. I feel that we need to be much clearer about the nature of the service provided in A and E departments and the distinction between that and the service provided in minor injury or minor illness centres.

David Wright (Telford) (Lab): Do not the reorganisation plans for the NHS, coupled with cuts to local authority budgets, mean that public health projects in this country will effectively be binned?

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Mr Lansley: No, they will not. We are making very clear our determination to ring-fence public health budgets so that prevention does not suffer, as it did under the hon. Gentleman's Government. In 2005-06, the first things to disappear as a consequence of financial pressures were the public health budgets and public health staffing. We will not allow that to happen.

Zac Goldsmith (Richmond Park) (Con): I welcome the Government's commitment to ending mixed-sex wards, but does the Secretary of State agree that it is both unnecessary and extreme to extend that policy to children's wards and to enforce it with the threat of fines?

Mr Lansley: I entirely understand my hon. Friend's point, and the rules we have set out for the NHS are very clear. We are also clear that we will ensure, through the NHS, that people have access to the privacy and dignity they have a right to expect, contrary to what the hon. Member for Leicester West (Liz Kendall) has said. She said that as long as they get the treatment through the NHS, it does not matter whether they are in mixed-sex accommodation, but that is not our policy. It does matter, and we will enforce it.

25 Jan 2011 : Column 167

Points of Order

3.35 pm

Mr Ivan Lewis (Bury South) (Lab): On a point of order, Mr Speaker. I seek your guidance. The Secretary of State for Culture, Olympics, Media and Sport has today made an announcement of grave importance for the future of media in this country. Despite a clear recommendation from Ofcom and the Secretary of State's admission that he has been unable to reach agreement with News Corp on adequate remedies, he has failed to do the right thing and refer the bid to the Competition Commission. This follows the shambles of the Business Secretary's prejudicial conduct and doubts about the impartiality of the Secretary of State and the Prime Minister. Surely the Secretary of State should come to the House and justify his actions.

Mr Speaker: I am grateful to the shadow Secretary of State for giving me notice of his intention to raise a point of order. As he knows, there is a written ministerial statement today on this subject. I have not received any notice of an oral statement at this stage. What he has said will have been heard on the Treasury Bench and I trust that when the Minister has anything more to say, he will do so to the House at the first opportunity.

Grahame M. Morris (Easington) (Lab): On a point of order, Mr Speaker, I wonder whether you would give the House your guidance. A few months ago, in topical Health questions, I asked the Secretary of State about a £53 million NHS contract that was awarded to a private health care company called Care UK. I have already written to the Cabinet Secretary about the apparent conflict of interest in relation to companies such as this and donations to the Conservative party, but I seek your advice on whether it would be more appropriate, in the interests of openness and for the benefit of people watching, if Ministers declared their interest when right hon. and hon. Members raised these issues in the Chamber.

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Mr Speaker: There are very clear rules on these matters, which it is the responsibility of every Member of the House, including Ministers, to observe. I must say to the hon. Gentleman, in all gentleness but helpfully, I hope, that that is not a matter for the Chair. Some might think that he is continuing or starting a debate, which is not a matter for a point of order.

Ian Paisley (North Antrim) (DUP): On a point of order, Mr Speaker. Can you confirm that you have received a letter from the hon. Member for Belfast West (Mr Adams) indicating his resignation from the House? Can you indicate that he will not be allowed to breach any of the constitutional requirements that he, like any other Member, must receive office under the Crown before he can leave the House? If that is the case, can you indicate when you will reply to him instructing him of his obligations as a Member of the House?

Mr Speaker: Let me say to the hon. Gentleman, to whom I am grateful for his point of order, that correspondence with the Speaker is private and is not the subject of exchanges on the Floor of the House. What Members might or might not say about their correspondence is a matter for them, but I intend to keep my own counsel. There are procedures to be observed, and observed they must be.

Kevin Brennan (Cardiff West) (Lab): On a point of order, Mr Speaker. We have learned today that the economy shrank in the last quarter of 2010 and that, even taking the inclement weather into account, growth would have flatlined; that is on top of yesterday's remarks by Sir Richard Lambert of the CBI. Have you received any notification from the Chancellor of the Exchequer of his intention to come to the House to explain what steps he is going to take to deal with this emerging crisis?

Mr Speaker: No, and I think I can recognise an attempt to initiate a debate at this distance.

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Firearms (Amendment) Bill

Motion for leave to introduce a Bill (Standing Order No. 23)

3.39 pm

Thomas Docherty (Dunfermline and West Fife) (Lab): I beg to move,

The Bill is purposely rather limited in its scope and objectives. It is not about banning recreational shooting or the proper use of shotguns for legitimate rural estate management. Rather, I am seeking to close a loophole in our current firearms legislation-legislation that the Home Affairs Committee, under the chairmanship of my right hon. Friend the Member for Leicester East (Keith Vaz), has identified as both complicated and confusing.

At present there is no minimum age for possessing a shotgun licence. This is at odds with the legislation covering other firearms, where there is a minimum age of 14. According to figures that I obtained from the Under-Secretary of State for the Home Department, the hon. Member for Old Bexley and Sidcup (James Brokenshire), almost 5,000 children in England and Wales possessed a licence to fire a shotgun. Of those 5,000 or so licences, 26 were issued to 10-year-olds, 72 to 11-year- olds, 134 to 12-year-olds and 231 to 13-year-olds. It is unfortunate that neither the Scottish Executive nor the Northern Ireland Executive keeps figures centrally for their devolved areas. However, I am sure we can assume that the figures are proportional to those elsewhere.

Currently, as the House knows, licences are issued by the chief constable of the police authority for the area in which an applicant resides, although for practical purposes the decision is often delegated to a more junior officer. For the purpose of this debate, it may be easier to refer to the chief constable. The applicant needs only to state their reason for wanting a shotgun licence, and needs to provide no evidence. If a chief constable wants to refuse a licence, the onus is on the chief constable to demonstrate their reasons against granting it. As the report from the Association of Chief Police Officers on the Cumbria shootings spelled out, an application for a licence can be refused only if the police can demonstrate that they believe that the person is a danger to the public, or that the applicant has "no good reason" to have a shotgun, or that the applicant is subject to certain statutory prohibitions.

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So at present chief constables have very little, if any, scope to refuse an application from a 10 or 11-year-old. This is, I believe, a most unsatisfactory situation for our chief constables to find themselves in. As I said at the beginning, the Bill is limited. It does not necessarily preclude the young person from firing a shotgun, because the current legislation merely provides that a young person be supervised by an adult, whether or not that young person possesses a licence. However, the Bill will send a clear and straightforward message that our society is not comfortable with the principle of young children handling lethal weapons.

I am grateful to the House of Commons Library for providing information on the situation in other countries. For example, in Finland applicants have to be 18, but a 15-year-old can get a permit for hunting or shooting with consent from guardians. In Ireland, New Zealand and Lithuania 16 is the minimum age for possessing a shotgun licence. These are just a few examples to illustrate my case.

Even the United States, a country known for its liberal or even libertarian views on the control and use of firearms, has recognised there must be some limits and controls. More than half the states-32 now-have set a minimum age for the use of shotguns and other firearms. The majority of these states have set the minimum age at 18. Surely if the United States accepts the need for a minimum age, it is not unreasonable for the House to consider the case for restrictions.

I am grateful for the cross-party support that I have received for my Bill, and the fact that the Scottish Executive, although they obviously have no legislative competence on the matter, support the principle of a minimum age of 14.

In conclusion, the Bill seeks merely to tighten the existing legislation, to bring shotguns in line with other comparable legislation at home and overseas, and to ensure that access to dangerous-nay, lethal-weapons is restricted for the very youngest members of our society.

Question put and agreed to .

Ordered ,

That Thomas Docherty, Mr Michael McCann, Mr Jamie Reed, Pete Wishart and Steve Rotheram present the Bill.

Thomas Docherty accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 20 January 2012 and to be printed (Bill 135).

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European Union Bill

[3rd Allocated Day]

[Relevant document: The Fifteenth Report from the European Scrutiny Committee, The EU Bill: Restrictions on Treaties and Decisions relating to the EU, HC 682.]

Further considered in Committee

[Dawn Primarolo in the Chair]

Clause 6

Decisions requiring approval by Act and by referendum

3.45 pm

The Minister for Europe (Mr David Lidington): I beg to move amendment 57, page 4, line 36, at end insert-

'(2A) A Minister of the Crown may not give a notification, under Article 4 of Protocol (No. 21) on the position of the United Kingdom and Ireland in respect of the area of freedom, security and justice annexed to TEU and TFEU, which relates to participation by the United Kingdom in a European Public Prosecutor's Office or an extension of the powers of that Office unless-

(a) the notification has been approved by Act of Parliament, and

(b) the referendum condition is met.'.

The Second Deputy Chairman of Ways and Means (Dawn Primarolo): With this it will be convenient to discuss the following:

Amendment 54, page 4, line 36, at end insert-

'(2A) A Minister of the Crown may not confirm the approval by the United Kingdom of a decision under the provision of Article 25 of TFEU that permits the adoption of provisions to strengthen or add to the rights listed in Article 20(2) of that Treaty (Rights of citizens of the European Union) unless-

(a) the decision is approved by Act of Parliament, and

(b) the referendum condition is met.'.

Government amendment 58.

Amendment 81, page 4, line 42, at end insert-

'(aa) a decision under Article 43 of TFEU which would result in the removal of the existing powers of the United Kingdom in relation to nautical limits;'.

Amendment 36, page 5, line 5, at end insert-

'(ba) a decision under the provision of Article 81(3) of TFEU (family law) that permits the application of the ordinary legislative procedure in place of a special legislative procedure;'.

Amendment 37, page 5, line 5, at end insert-

'(bb) a decision under the provision of Article 82(2)(d) of TFEU (minimum rules on criminal procedure) that permits the identification of further specific aspects of criminal procedure to which directives adopted under the ordinary legislative procedure may relate;'.

Amendment 38, page 5, line 5, at end insert-

'(bc) a decision under the provision of Article 83(1) of TFEU that permits the identification of further areas of crime to which directives adopted under the ordinary legislative procedure may relate;'.

Amendment 100, page 5, line 27, after '(enhanced co-operation)', insert 'except in the field of EU patents'.

Amendment 13, page 5, line 33, at end insert-

'(ja) a decision which results in the participation of the United Kingdom in any enhanced co-operation procedure.'.

25 Jan 2011 : Column 172

Amendment 8, page 5, line 35, at end insert-

'(l) a decision to extend the use of the European Financial Stability Mechanism to member states other than the Republic of Ireland.'.

Amendment 79, page 5, line 35, at end insert-

'(4A) In subsection (1) "decision" includes a further implementation of the decision under Article 122 of TFEU to extend the use of the European Financial Stability Mechanism to any member state other than the Republic of Ireland.'.

Amendment 40, page 14, line 9 [Schedule 1], at end insert- 'Article 81(3) (family law).'.

Amendment 55, in clause 7, page 5, leave out lines 44 to 46.

Mr Lidington: We turn now to decisions on which a referendum would always be required. Decisions taken in accordance with the Treaty provisions listed in clause 6 would always require approval by Act of Parliament and a referendum. One group of decisions covered by clause 6 are the one-way, irreversible decisions that would transfer competence from the United Kingdom to the European Union, including a decision that the UK would participate in a European public prosecutor's office, which can be set up to combat crimes affecting the EU's financial interests. Should the UK ever take part in the European public prosecutor following such a referendum, the decision that this country should take part in any expansion of the powers of that prosecutor is also listed in clause 6 and would therefore also be subject to primary legislation and a referendum.

Emma Reynolds (Wolverhampton North East) (Lab): With regard to Government amendment 57, will the Minister make it clear to the Committee why the Government have singled out the European public prosecutor's office in their opt-in to justice and home affairs and why they are not including other measures in that area on which they have a decision to opt in? The amendment is slightly untidy, so will he clarify that it will amend clause 6(2), as the European public prosecutor's office is mentioned in clause 6(4)(c)?

Mr Lidington: The wider issue of justice and home affairs opt-ins is the subject of a number of amendments and new clauses that have been selected for debate tomorrow. If the hon. Lady will forgive me, I think that that will be the appropriate time to deal with it. We have decided to single out the European public prosecutor because that was a clear and explicit commitment in the coalition agreement and the coalition programme. The agreement stated:

In accordance with that policy, we are putting a referendum lock on a decision by any future British Government to join the European public prosecutor and a further lock on the UK taking part in any expansion of that prosecutor's powers.

I am grateful to my hon. Friends the Members for Daventry (Chris Heaton-Harris), for Wycombe (Steve Baker), for Cleethorpes (Martin Vickers), for Bury North (Mr Nuttall) and for Crawley (Henry Smith) for noticing a potential gap in the drafting of the Bill. As drafted, clause 6(4)(c) and (d) might not automatically trigger a referendum in the event that the UK chose to participate in the European public prosecutor after it had already
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been established. That is because the measure under the United Kingdom's protocol on the area of freedom, security and justice, which would be used to allow us to take part in the European public prosecutor's office or in an expansion of the office's powers in those circumstances, does not have to cite the legal base of article 86 of the treaty on the functioning of the European Union.

Government amendments 57 and 58 respond to the concerns identified and expressed by my hon. Friends in their amendment in order to close that potential loophole. We did not intend to leave any doubt about the matter and, being keen to make that correction, I therefore urge the Committee to approve those Government amendments. These would ensure that a referendum would be required in all cases before the United Kingdom could join the European public prosecutor's office or an extension of its powers, whether the decision was taken before or after the prosecutor had been set up, or before or after the powers had been extended.

Mr John Redwood (Wokingham) (Con): I am very grateful for that concession, which improves the Bill. Now that the Minister is in this spirit of concession, does he not understand that most people think that criminal justice is central to their sovereignty in Parliament, and that the same provision should apply to all opt-ins under the criminal justice provisions? Why will he not concede that?

Mr Lidington: My right hon. Friend makes his point firmly, as I expect him to, but as I said earlier we will have the opportunity to debate justice and home affairs opt-ins in more detail during debates on the clauses that are set down for tomorrow. I look forward to hearing the concerns that he and other Members express on that occasion.

A number of amendments in the name of my hon. Friend the Member for Daventry seek to add a limited number of further JHA articles to either clause 6 or schedule 1, and I say to him and my right hon. Friend the Member for Wokingham (Mr Redwood) that I am well aware of and understand the Committee's concerns about justice and home affairs matters. I share their view that they are matters of political, often of legal and sometimes of constitutional, significance, so I look forward with interest to the arguments that my hon. Friend might put forward later today.

On those amendments, which will be the subject of debate later today, I signal now that I am confident that I can make a compelling case why those particular articles should not be listed in clause 6 but be left, where they are appropriately dealt with, in clause 9. I shall explain briefly today and, I expect, at greater length tomorrow how that fits into wider JHA issues, as I set out in my written ministerial statement last week.

Mr David Nuttall (Bury North) (Con): I thank the Minister for the courteous and generous way he is piloting the Bill through the House and through its long period in Committee. He will be well aware that I warmly welcome the general principle of the Bill and, indeed, supported it on Second Reading. He will also be aware, however, that I have to be honest and say that it is not the Bill I would have preferred to discuss today. I make no secret of the fact that I think we should be discussing a Bill to give the people of the United Kingdom a referendum on our continued membership of the European Union, but we are where we are.

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I supported the Bill on Second Reading on the basis that I would use every opportunity to try to strengthen and improve it as it progressed through its remaining stages, and I am heartened by the announcements that the Minister has already made this afternoon. He has demonstrated that he feels the Bill is capable of improvement by virtue of his bringing forward the Government's own amendments to it.

My amendment 54 and consequential amendment 55, as with so many amendments tabled for discussion in Committee, seek to strengthen the Bill by improving the scrutiny that would have to take place should any future transfer of competence occur.

Under clause 7(2)(a), a Minister may not confirm the approval by the United Kingdom of


Amendment 54 would require such a decision to be approved not only by an Act of Parliament, but by the people of the United Kingdom in a referendum. It proposes a new subsection (2A) to clause 6, rather than including the decision in the list of decisions in clause 6(4), because the procedure for the ratification of decisions under article 25 of the treaty on the functioning of the European Union is essentially the same as that for decisions under article 42 of the treaty on the European Union, which relates to a common European Union defence policy.

Under the European Union treaties, all citizens of member states are also citizens of the European Union. As the Committee will be aware, the list in article 20(2) of the treaty on the functioning of the European Union is separate from and additional to the list of rights in the European Union's charter of fundamental rights, which was given the status of treaty law by the Lisbon treaty. I will list briefly the European Union citizenship rights set out in article 20(2). The first is the freedom of movement and residence within the European Union. The second is

and in local government elections in the member state of residence

The third is the right to

when the EU citizen's member state is not represented in a non-EU country. The fourth is

A decision to strengthen or add to the rights set out in article 20(2) could be of great importance, and could be wide-ranging. Article 25 of the same treaty appears to place no limit on the sort of rights that may be added. For example, there appears to be nothing to prevent the adoption of provisions that give European Union citizens the right to vote in national elections in member states other than the state of which they are a
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citizen. Such a new basic right would constitute such a major transfer of power that such moves should be approved by all the people of the United Kingdom in a referendum. By definition, new or extended rights for European Union citizens transfer power from the United Kingdom-the power over whether it accords such rights to the citizens of other European Union member states. The UK would be required to respect those rights for all EU citizens as a matter of treaty obligation, and they would ultimately be enforced by the European Court of Justice, whose rulings are binding and are backed by its power to levy unlimited fines on member states. The new or augmented rights would be enshrined in the EU treaties and could be reversed only by a new, full-blown amending treaty. That would be, for all practical purposes, an irreversible transfer of power of constitutional magnitude, as it would deal with our citizens' rights.

4 pm

I believe that amendment 54 is completely within the spirit of the Bill, which is about requiring the consent of the British people to transfers of powers to the EU. It would not infringe the EU treaties or prevent article 25 of the TFEU from being used. It would simply require the British people to approve the transfer of power involved. My consequential amendment 55 would simply remove the current provision from clause 7, as it would no longer be required if it were moved to clause 6 under amendment 54.

Chris Bryant (Rhondda) (Lab): The hon. Gentleman referred earlier to consular protection, which, as he knows, has been enjoyed by all citizens of each EU member state for some considerable time. If we have no representation in a particular country, British citizens can go to a French, German or Spanish embassy and receive the same consular protection that they would expect from the UK. Does he really think that that should require a referendum?

Mr Nuttall: As I understand it, that is already provided for in article 20(2), so there is no need to introduce it again. Amendment 54 would apply only to future extensions of that article.

Chris Bryant: But following the creation of the European External Action Service, there is provision for some extension of that right. That is for obvious reasons, namely that many of the smaller countries in the EU have no diplomatic service or representation in quite a lot of countries. Just as we use the services of the Australians in some cases, for instances in Laos, and the French diplomatic services in other cases, surely it would be wrong to put the need to have a referendum in the way of an extension of that provision for British citizens or any other EU citizens.

Mr Nuttall: I hear the hon. Gentleman's point, but the difficulty is that article 20(2) covers much more than just that matter. As I said, it covers the likelihood of citizens of other EU states being allowed to vote in our national elections. There is real concern about that, and there would be a drive and desire for citizens of the UK to have their say if the EU ever sought to allow it.

Chris Bryant: When I was Minister for Europe, I probably had more correspondence with British people living in Spain than with those living in any other
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country in Europe. The best part of 1 million British people now live in Spain, and many of them feel that they need greater protection by the EU-for instance, if their houses are being pulled down because of the changes to housing and coastal laws. They would like to be able to vote in Spanish general elections, so that they can have a voice in Spanish society. Does the hon. Gentleman think it is wrong that they should be allowed that?

Mr Nuttall: I believe it should be up to the Spanish to decide who should vote in Spanish elections, not the EU, just as I do not want the EU telling our country whether citizens of another EU country should have the right to vote in our national elections.

I might be reading too much into this, but I wonder whether the reason the current article refers only to European parliamentary elections and local elections is that people in the world of the EU would like national elections done away with. In their world, there would be only regions within the great European Union. Is that why no mention of national elections was made in that article?

Emma Reynolds: Is the hon. Gentleman really suggesting that hard-headed, pragmatic pro-Europeans say that we should do away with general elections in member states?

Mr Nuttall: I have no idea what each individual thinks-that is up to them. All I am saying is that those who promote the EU project, which states the need for ever-closer union- [ Interruption. ] Those who promote the EU project would very much like there to be simply EU elections and local, regional elections, effectively bypassing Members of Parliament. The thrust of the legislation means that that is where we are headed, and it is one of many reasons why I tabled amendments 54 and 55, and I commend them to the Committee.

Mr Denis MacShane (Rotherham) (Lab): My treat, which I can never find the resources or time to put into effect, is to send the comments that hon. Members on both sides of the House make to our fellow European politicians. I should like President Sarkozy, Chancellor Merkel, Prime Minister Tusk or the representatives of any one of the nine Nordic and Baltic states that were hosted by the Prime Minister at Downing street last week, to read that someone stood up in the Chamber of the House of Commons and said that we are about to abolish national elections. They would realise what a wonderful world the House of Commons can become. To paraphrase Karl Marx on history in the famous opening lines of "The Eighteenth Brumaire of Louis Bonaparte", the House of Commons, when it debates the EU, starts as muddle and descends quickly into farce. We are already firmly into those two categories today.

Clause 6 refers-

Kelvin Hopkins (Luton North) (Lab): Will my right hon. Friend give way?

Mr MacShane: Might I just finish my point on clause 6? My hon. Friend and I have had many exchanges here and in the Tea Room over a number of years, and my affection for him grows with each passing moment.

Government amendment 57 calls for a referendum with reference to an extension of the powers of the European public prosecutor's office, but clause 6(4)(c) already lists the requirement for a referendum when
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there is any change in the treaty involving the participation of the UK with the EPPO. That is just the technical muddle.

I remember sitting on the Government Benches, where the hon. Member for Broadmoor is now sitting.

Mr Keith Simpson (Broadland) (Con): Broadland!

Mr MacShane: There are times when the European Union debate makes me think that I am in Broadmoor-in respect of speeches made on both sides of the House, some of which reach the highest clouds of fantasy and invention.

When I was on the Government Benches, getting the wording right was interesting. Foreign Office officials are brilliant draftspersons, but they are not necessarily quite as focused on the detail or on internal contradictions in legislation, because they do not always produce Bills. Clause 6 and amendment 57, which I assume will go through tonight with a Government majority despite the best efforts of Conservative Back Benchers, actually contradict themselves.

Kelvin Hopkins: The important thing about elections is not just that they are a method for electing people to a Chamber such as this, but that those people have power to exercise on behalf of the people who vote for them. Should we not be careful to ensure that this House, this Parliament and our Government retain power? Otherwise, democracy becomes meaningless and we would just be a decorative part of the constitution instead of an effective part, as Bagehot would say.

Mr MacShane: My hon. Friend is one of the most decorative parts of this House, and I hope that, after the reduction of representation in the wretched Parliamentary Voting and Constituencies Bill becomes law-it will weaken the House of Commons unless the other place defends our constitutional rights-when there will be 50 fewer of us, he is to be found among the survivors.

This is the eternal argument. The most sovereign person in the world was Robinson Crusoe on his island. No one could tell him what to do, and he did not tell anyone else what to do. Our nation's history is entirely about finding partners and allies and making treaties. I invite hon. Members to go to the National Gallery and look at the depiction of the signing of the treaty of London signed in 1604, which has four British dips and four Spanish dips and you cannot tell the difference between them. That treaty brought to an end 50 years of conflict between Spain and Britain because-

Mr Redwood: We won.

Mr MacShane: That is a good crack, but I think that the right hon. Gentleman will find that Spanish power messed up the continent for another 100 years until we won again. If the House of Commons only exists to express the sentiment of the football fan that "We won, and they have to lose", Britain will never advance.

Chris Bryant: If the right hon. Member for Wokingham (Mr Redwood) is correct that we won in 1604, why did we spend the next 20 years trying to marry off the heir to the British throne to a Spanish infanta?

Mr MacShane: I am glad that we are now marrying off one of our royals to someone who has the attributes of a very normal, pretty Englishwoman. We wish William and "Caterina" every success.

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To return to the Bill and the clause, I campaigned for many years in this House, on an all-party basis, for laws and measures to combat human trafficking. That cannot be done on the basis of a single decision of this House alone. In the last Parliament, it took a great deal of work by hon. Members on both sides of the House to persuade the then Prime Minister to first sign and then ratify the Council of Europe's convention on trafficking. The Home Office's view was that it did not want to be told by anyone-and this was the Council of Europe, not the European Union-what to do or to accept any obligations. Ministers and officials came up with argument after argument about why the Council of Europe convention should not be signed. I am glad to say that parliamentary pressure from both sides wore them down and the then Prime Minister, Tony Blair, signed and ratified it. It was an important step forward. As ever, it was not the final solution to that dark and wretched side of globalisation, but it was a step forward.

4.15 pm

Similarly, the European public prosecutor's office might at some stage in the future be of importance to our country, to the Government, whatever their colour, and to the House. At the beginning of the previous decade, we heard exactly the same arguments against the European arrest warrant. People said that it was an intolerable interference in British sovereignty, with Brussels marching in to arrest anyone it wanted. By the time of 7/7, however, when one of the wanted suspects had fled to Rome, where the civil liberties lawyers, the judges, the left and the supporters of Islamism were wrapping their arms around him to protect him, the EAW had-thank goodness-become part of our law, having been adopted by the European Union, and so that gentleman was back on a plane to London before he could say "strong cappuccino".

Mr William Cash (Stone) (Con): Does the right hon. Gentleman recall the case of the person in Leek, Staffordshire whom it was proposed, under an arrest warrant, should be taken over to Italy, and who was convicted in his absence to 15 years, but who, thanks to the intervention of my hon. Friend the Member for Staffordshire Moorlands (Karen Bradley) and the Prime Minister, has been completely exonerated? He was not even within 1,000 miles of where the murder took place.

Mr MacShane: The hon. Gentleman is perfectly right, but we could all list examples in Britain of improper arrests. It does not vitiate the need for international co-operation against criminality-I mentioned trafficking, but there are other examples-if that is what we want. International co-operation on the basis of, "Well, you'll co-operate with us, but we won't co-operate you", will never happen. I am glad that there was not a referendum lock on the EAW, because otherwise that gentleman from 7/7 would still be waiting in Rome until we had had our referendum.

Jacob Rees-Mogg (North East Somerset) (Con): The right hon. Gentleman seems to think that the example given by my hon. Friend the Member for Stone (Mr Cash) was invalid, but that his own similar individual example is valid. Why is it valid when it supports his argument, and invalid when it does not?

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Mr MacShane: On the contrary, there are anomalies with the EAW. I have cases myself involving the Polish authorities, in particular, sending out generalised arrest warrants for people who have done little more than nick a bike. None the less, a law is a law is a law. If we want criminals whom we want dealt with in Britain to be sent back here, we have to accept that what is sauce for our criminal goose has to be sauce for other criminal gander.

Mr James Clappison (Hertsmere) (Con) I invite the right hon. Gentleman to contemplate the evidence given to the Home Affairs Committee by an eminent lawyer in the field of extradition about the extent of the problem he has just described: arrest warrants coming from Poland and other eastern European places for trivial offences, resulting in many of those on the receiving end of one being locked up in British prisons and police stations, wasting a considerable amount of time and occupying valuable space.

Mike Gapes (Ilford South) (Lab/Co-op) rose-

Mr MacShane: I give way to my hon. Friend.

Mike Gapes: Is my right hon. Friend aware that recently a Romanian national was arrested in east London and taken back to Romania on an extradition warrant issued by the Romanian authorities? This individual had been involved in the most terrible form of trafficking of human beings and criminal activity in Romania.

Mr MacShane: May we bring an end to these individual cases from right hon. and hon. Members?

I am glad that the "costa del crime" has been shut down thanks to enhanced European co-operation. I put it to hon. Members on both sides that in a few years' time it might be to our country's advantage to have an effective prosecutor's office working to ensure that the people whom we bring to justice can face inquiry and remedy. I accept that the Bill will pass, but I am nervous about saying to our European colleagues, "Forget that idea, because we will have to have a referendum on it first." I do not want to use hyperbole, but were I a trafficker or someone who did not want to be brought to justice on a trans-frontier basis, I would be quite happy to see a referendum take place before effective action could be taken against me.

Ben Gummer (Ipswich) (Con): As it happens, the European arrest warrant has recently been of great use to one of my constituents who had suffered a grave injustice in Spain, which is an argument in favour of the European arrest warrant. We have also heard some arguments against it, but these are all arguments that can be put to the British people. We can have a mature debate in front of them. Why does the right hon. Gentleman oppose that?

Mr MacShane: That takes us into a slightly broader aspect of the debate, where there are differences between us. I started my political life campaigning in pubs and elsewhere against the demand, which was very prevalent after my student days, that there should be a referendum on capital punishment. Again and again, the cry is for a referendum, and we heard it in health questions today, when it was asked whether we could have a referendum on NHS reforms. I do not think that any hon. Member on the Government Benches would give a fleeting thought to that proposition, but if a referendum on a public prosecutor's office is good, why is a referendum on
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something that will impact far more directly on the British people-namely the Government's proposals to change significantly the way that our health service is delivered-not good?

Chris Bryant: Will my right hon. Friend give way?

Ben Gummer: Will the right hon. Gentleman give way?

Mr MacShane: Well, I am tempted to-

Mr Cash: Sit down?

Mr MacShane: To be told to sit down by the hon. Gentleman, who, to his great credit, has never long warmed a Bench if he could stand up, is undoubtedly a real pleasure to be had from my small contribution to this debate.

Mr Redwood: The big difference is that the Government's health reforms are reversible if they do not work or if a future Government do not like them, whereas the surrender of power to Europe is irreversible.

Mr MacShane: Again, this shows a failure to understand that if we do not like a treaty, there is an alternative. I have been told over the 16 years in which I have sat in the House that almost any change would undermine Britain. Indeed, the right hon. Gentleman famously said that the Amsterdam treaty would mean the abolition of the United Kingdom. Can anybody in the Committee tell me a single thing that was in the Amsterdam treaty?

Chris Bryant: The protocol on broadcasting. [ Laughter. ]

Mr MacShane: There we are: when we need an anorak, there is always one from Rhondda. I am grateful to my hon. Friend.

I respect the Member for Europe, for whom there is a great deal of affection among those of us in the House who are first-class Euro-bores. The Member for Europe-[Hon. Members: "Member for Europe?"] I apologise: the Minister for Europe is a sincere and serious chap. I have recently been much involved in the issue of Kosovo. One of our great problems there is that whereas the United Kingdom recognises Kosovo, along with 21 other member states, led by Britain-there is, I hope, not a cigarette paper of difference between those on our Front Bench and those on the Government's on the importance of helping Kosovo find its way to a future-five EU member states do not recognise Kosovo. As a result, we are utterly stymied in so much that we could and should do to help Kosovo find its way towards some stability, and because Kosovo has no stability or sense of security, that is contagious in other countries in the Balkans. There are times when this Government would, if anything, like to exercise a little more authority in Europe, in order to achieve key foreign policy goals.

Jesse Norman (Hereford and South Herefordshire) (Con): Will the right hon. Gentleman give way?

Mr MacShane: I shall give way for the last time, and that is it.

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Jesse Norman: I thank the right hon. Gentleman very much, and I am greatly enjoying his comic turn. On a point of information, is he engaged in a one-man filibuster, or is this a genuine contribution to the argument?

Mr MacShane: If the hon. Gentleman and every other hon. Member had remained seated, rather than jumping up and insisting on making interventions, I would have sat down about 10 minutes ago. [Hon. Members: "No!"] I am hearing cries for me to go on and on-I do not think that anything similar is happening in the other place-but I will sit down in due course.

I have no intention of filibustering; I have come here to make the point that remains at the heart of the Bill. That is that no Minister of the Crown-whether of this Administration, a Lib Dem Administration or, in four and a half years' time, when my right hon. Friends are on the Government Front Bench, a Labour Administration-is going to sign a either a brand new treaty or a significant amendment that so unacceptably transfers authority and power away from this House and the Government of the nation that that Minister would have to come back here and say, "We have looked at this and we are very uncertain about it. We think it is significant and we are going to give the British people a referendum on it." "Significant" is the key adjective in this regard.

That shows the intellectual dishonesty at the heart of all these debates. The Bill is being introduced simply because the Conservative part of the Government could not honour its commitment to have a referendum on the Lisbon treaty, could not repatriate any powers and could not alter the existing treaties. Because the Conservatives are locked into their coalition agreement with the Lib Dems, the only reflection of five years of consistent, campaigning Euroscepticism they can offer to the British people is this Bill. I accept that it reflects the prevailing mood among the largest single party, the Conservative party. The Prime Minister and the Foreign Secretary have campaigned consistently on Eurosceptic themes.

Ben Gummer rose -

Mr MacShane: I will not give way. The hon. Gentleman will make his points in due course.

In opposition, it was possible for the Conservatives to campaign as Eurosceptics, but they cannot but govern as Euro-realists. This we have seen in whole range of-

Mr Cash rose -

Mr MacShane: I am sure that the hon. Gentleman will have a chance to make his point very shortly.

As Euro-realists, this Government have been-by my standards-responsible and helpful, shovelling out money to Ireland and working with Chancellor Merkel on serious treaty amendments that will increase economic surveillance of all the 27 member states, on foreign policy and on other issues. I really have no huge complaints to make about the Government at all. I say again, however, that it is inconceivable that any Minister of any Government in the future is going to come back from Brussels and say, "I've signed such a bad treaty. I'm not really sure about it. It is so significant in its alteration of the powers between the UK and the rest of the EU that I want it put to a referendum."

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Mr Cash: The right hon. Gentleman is making a big show about all this. First, there was a referendum in 1975 under a Labour Government. Secondly, there was also a promise in the Labour manifesto about a referendum on the constitutional treaty. Thirdly, if the right hon. Gentleman had been here yesterday, he would have heard those on his own Front Bench proposing a mechanism to ensure that, in certain circumstances, there would be a referendum on all matters within the treaties. So, for practical purposes, he needs to ask himself whether the Labour party is now contradicting the position that he is adopting.

Mr MacShane: I will leave that point for my right hon. and hon. Friends on the Front Bench. I am not sure whether their new clause has been selected for debate today, but it proposes to set up a broad oversight committee, which might indeed be a rival to the Committee of the hon. Member for Stone (Mr Cash). I do not think that the proposal will make much progress, however.

The worry for me is that, at least among the majority party on the Government Benches, we have a Eurosceptic majority. We have to accept that. There are also many Eurosceptics on these Benches- [ Interruption. ]

The Second Deputy Chairman of Ways and Means (Dawn Primarolo): Order. Mr MacShane, could you please turn your phone off? This is the second time that it has rung in the course of your contribution. While I am on my feet, may I ask you to refer to the amendments, and not to be tempted by interventions to reflect on anything that is not within them?

Mr MacShane: I apologise, Ms Primarolo. I thought that the phone was in silent mode, but it was not. I have learned something. At least my tie is sober and silent! I accept that interventions have dragged me here and there, but we are a friendly kind of House when it comes to European debates-to begin with, at least. I have been trying to sit down for about 10 minutes, but hon. Members just will not let me.

4.30 pm

The Second Deputy Chairman: Perhaps I can help the right hon. Gentleman to sit down. Has he concluded his remarks? If not, he may continue, but he should not reflect on what I have said.

Mr MacShane: I was concluding my remarks until various Members got up to intervene.

My conclusion is simply this. There may come a time-not now, I accept-when a majority in this House and a duly elected Government feel that they want to take the lead to alter a European Union treaty-to propose a new one or make amendments to an existing one. They will then find that they are being held back by the tone, if not the strict legal content, of this Bill. This is coming dangerously close to what an Under-Secretary at the Foreign Office, Mr Henry Hopkinson, said about Cyprus in 1956-that it would "never" be free.

I genuinely worry about the signal we are sending to our EU partners at a time when we all, quite irrespective of our party political positions, need more co-operation and more enforcement in Europe, whether it be on Tunisia, on growth policies or on finding solutions to the problem in Ireland, where, as the Prime Minister rightly pointed out, we export three and a half times more British goods than we do to China. I worry greatly
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that this Bill, and particularly the new clause on the need for effective prosecution of criminality in Europe, will send out precisely the opposite signals. Our nation might well suffer, not tonight or in the next few weeks or months, but in the future, as a result of this deeply isolationist proposal.

Chris Heaton-Harris (Daventry) (Con): The last time I spoke after the right hon. Member for Rotherham (Mr MacShane), I was slightly unkind to him. Even though he has given me lots of material to do the same again, I will not. I was a Member of the European Parliament when he was the Minister for Europe and we would have had many disagreements, but I would like to think that we could at least agree to disagree in a friendly manner. The right hon. Gentleman was definitely treading on thin ice when he spoke about Robinson Crusoe being cut adrift, but it is all welcome for the purposes of debate.

I wish to make a point about the European public prosecutor, which I am against, and it is one of the reasons why I tabled the amendments. When I was an MEP, there was a great Scottish National party MEP, Sir Neil MacCormick. In the first debate that ever took place on this subject, he reminded me that having a European public prosecutor would mean changing the way we do criminal law in this country-moving away from habeas corpus towards a more Napoleonic code. Perhaps that is worth reflecting on in this place and giving the British people a chance to have a say on it. I very much welcome Government amendments 57 and 58, and I am pretty sure that the great Sir Neil MacCormick would have done so.

I tried to explain to my constituents at the last general election that I had a bit of experience of European matters and that, given the opportunity, I would try to use that experience in this place. I also explained how the Conservative party would try to stop any future power grab by the European Union, as set out in its manifesto. When this is coupled with my membership of the European Scrutiny Committee, I hope that my constituents in Daventry will forgive me for continually talking in the Committee stages of this Bill. It is a very important Bill which contains a great deal of merit.

My amendments 36 to 38 simply require approval by an Act of Parliament and a referendum before a United Kingdom Minister can give final agreement in the Council to a proposed justice and home affairs ratchet decision when the UK has already opted into the proposal for that decision. Such proposals are subject to unanimity in the Council.

Amendment 40 requires a decision under the amending treaty, a decision under article 48(6) of the Treaty on European Union or a 48(7) ratchet decision that abolishes the veto of EU proposals on family law to be approved in a referendum. Family law matters can fall under EU competence, and the veto could be abolished by an article 81(3) ratchet clause. I know that that is highly unlikely, and I know that the EU's ability to become involved in family law has existed for a long time-since long before the Lisbon treaty-but I think that Members on both sides of the Committee can agree among themselves and with our European partners on matters such as the mutual recognition and enforcement between member states of judgments and decisions in extra-judicial cases.

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However, genuine concern is felt by many people, and I am definitely one of them. In December 2005, the European Commission tried to make a case for applying the pre-Lisbon ratchet clause to qualified majority voting in EU proposals concerning maintenance obligations, which are obviously a family law matter. It was knocked back in the Council at that point, but anyone who listens to or reads debates in the European Parliament-as I now do-and anyone who reads statements from European Commissioners will understand that a bit of pressure is beginning to be applied. I should appreciate an assurance from the Minister that he is aware of that pressure and will continue to keep an eye on any challenges that may be forthcoming. I do not intend to press the amendment to a vote.

Mr Clappison: Amendment 40 is very important, and my hon. Friend is making a very good speech which is clarifying matters. I understand from what he is saying that family law matters are currently subject to unanimity rather than qualified majority voting, and that he is concerned about what is being proposed. He will know that the Commission has a long history of moving from unanimity to qualified majority voting, and seeks to do it on many occasions. Can he confirm that, as this is within the framework of the treaty on the functioning of the European Union, the European Court of Justice will have jurisdiction over the family law matters to which he is referring?

Chris Heaton-Harris: I believe that that is the case, although the Minister for Europe may correct me, as he is much better qualified to answer my hon. Friend's question.

My main amendments are concerned with problems that I have identified in the justice and home affairs ratchet clauses or opt-ins. We saw an example here not long ago. Just after the general election, the United Kingdom had to decide whether to opt into the European investigation order. Many Members considered the way in which the legislation was scrutinised and enacted to be unsatisfactory. Along with others, I tabled an urgent question with the aim of establishing whether we were going to opt in.

I think that there is a better way of scrutinising important justice and home affairs matters. I appreciate that in that instance the general election and various recesses caused a problem, but nevertheless I am sure that this place can do a great deal better when it comes to scrutiny, and I believe that the Government can do a great deal better when it comes to enactment. I therefore very much welcome last week's written ministerial statement. Someone like me could pick a few holes in it-on dates and who has the first say, for example-but it is a massive step forward and I thank the Minister for it. I also welcome, as I said, the Government amendments in this area.

The Government have already opted in to the negotiations on the European investigation order, which allowed European police forces to insist that the British police put citizens in the UK under surveillance and grant access to their DNA. I suggest that that is quite a big deal to the United Kingdom. The way in which the EIO was put before the House-eventually, in an oral statement in July-was most unsatisfactory. The intention behind my amendments is to ensure parliamentary scrutiny of such matters.

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