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Mr. Andy Reed (Loughborough) (Lab/Co-op): My right hon. Friend the Secretary of State has announced that the Care Quality Commission will be reporting in due course. He will not be surprised to hear that in a meeting with Charnwood carers group, I found that the quality of care in the community and in care homes is high on people's agenda. In fact, many were in tears at their own experiences, despite the tick-box reality of the commission's work. Will Ministers ensure that there is genuine personal care in such places? That is what people really want, for the dignity of their elderly relatives.
Phil Hope: My hon. Friend is right to highlight issues of concern about the quality of care, whether it is care of people in their own home or in residential care homes. The Care Quality Commission plays an essential role in monitoring and inspecting care homes to ensure that standards are sufficient. We need to go further and ensure that all care, whether in a care home or in a person's own home, is personal and tailored to meet individual needs. The Prime Minister's announcement of free personal care for everybody who is looked after in their own home and has the highest level of critical need is a major step forward and-
T7.  Paul Rowen (Rochdale) (LD): Following the recent death from swine flu of Louise Jones from Leigh, what steps is the Secretary of State taking to increase the number of extracorporeal membrane oxygenation-ECMO-beds, especially in the north? The UK has only five, whereas there are 23 in Australia.
Andy Burnham: Of course, the case of the 24-year-old woman, who did not live directly in my constituency but in Tyldesley, which is nearby and, as the hon. Gentleman knows, not so far from his constituency, was incredibly sad. I am led to understand that, in that case, the clinicians did not think it possible for the patient to travel. However, a decision was taken recently to expand ECMO provision in Leicester. The clinical advisory group advised that it was right to concentrate provision in that area, given the huge amount of training and intensive support that the unit needs. The decision has been taken, we recognise that such technology has a very important role to play and I hope that the hon. Gentleman welcomes that decision.
Rob Marris (Wolverhampton, South-West) (Lab): Some of the big pharmacy wholesalers, such as Phoenix Healthcare and Alliance Healthcare, are also retailers and so refuse to supply wholesale to small, new and independent pharmacy retailers. Will the Minister look into that apparent restraint of trade, please?
Mr. Mike O'Brien:
The answer is yes, I am doing that. There are concerns about the way in which wholesalers are now using, in effect, funnels to restrict the ability of some of the pharmacy retailers to get access to drugs,
thereby driving up the price. I am concerned about this, and we need to watch it very carefully.
T10.  Mr. Colin Breed (South-East Cornwall) (LD): During the summer recess another NHS dentist in my constituency left the NHS and went private. The provision of NHS dentistry is getting worse year by year in Cornwall generally. When are the Government going to do something about it?
Ann Keen: NHS dentistry provision has improved in the past few months in most areas of the country. PCTs are given the priority to secure access to such provision for all who seek it. All 10 SHAs have now set themselves the aim of achieving that by March 2011 at the very latest.
Mrs. Ann Cryer (Keighley) (Lab): Can my right hon. Friend ensure that PCTs in areas where first-cousin marriages are the norm will provide genetic screening and counselling and ensure that the communities are aware of that provision?
Mr. Mike O'Brien: My hon. Friend raises a very important point. Before giving a firm assurance on that, we need to take some advice on the clinical implications from those whom we would call upon to carry out such tests.
Mr. John Baron (Billericay) (Con): Many cancer patients complain of feeling isolated during their treatments, citing lack of appropriate information and support. The Department's "Cancer Reform Strategy" promised the introduction of cancer patient experience surveys to help to monitor better-quality care that is given to cancer patients. Could the Minister explain why this measure still has not been introduced, two years after it was first promised, and what is he going to do about it?
Andy Burnham: I agree that it is very important to help people to live with cancer. In this financial year, we are providing some £1.6 million to Macmillan for precisely that purpose-to help people to get on with their lives and deal with the effects of living with cancer. On the specific issue that the hon. Gentleman raised, I will write to him.
Charlotte Atkins (Staffordshire, Moorlands) (Lab): Yesterday was world arthritis day. What is being done to ensure earlier diagnosis of rheumatoid arthritis, which is a very painful and disabling condition if it is not detected early, often leading to people being unable to work?
Ann Keen: That is a very important point in relation to rheumatoid arthritis. As has been stated, this week is world arthritis week. We are having a discussion with Dame Carol Black on how we can enable the health work force, particularly GPs and others, to be aware of the early detection of this painful crippling, which obviously has many implications for the patient's quality of life.
Paul Farrelly (Newcastle-under-Lyme) (Lab): On a point of order, Mr. Speaker. I want to raise a chain of events that may be of some concern to the House. Today The Guardian reported that it had been prevented from reporting a written question tabled by a Member of Parliament. This morning I telephoned The Guardian to ask whether that MP was myself. The question was printed on the Order Paper yesterday and relates to the activities of Trafigura, an international oil trader at the centre of a controversy concerning toxic waste dumping on the Ivory Coast. The question also relates to the role of its solicitors, Carter-Ruck. I understand that yesterday Carter-Ruck, quite astonishingly, warned The Guardian of legal action if the newspaper reported my question. In view of the seriousness of this, Mr. Speaker, will you accept representations from me over this matter and consider whether Carter-Ruck's behaviour constitutes potential contempt of Parliament?
Let me first say to the hon. Member for Newcastle-under-Lyme (Paul Farrelly) that I think that he has just made representations. I am grateful to him for his point of order and for courteously giving me advance notice of it. A written question has indeed been tabled, as he said, by the hon. Gentleman himself. It is not sub judice under the House's rules. It has already been published on the notices of questions, and it is also available on the Order Paper and, indeed, on the parliamentary website. There is no question of our own proceedings being in any way inhibited. If the hon. Gentleman wants to pursue this as a matter of privilege, there is of course, as he will doubtless know, an established procedure for raising it with me in writing. Furthermore, I now understand that an injunction is no longer being sought. I hope that that reply is helpful both to the hon. Gentleman and to the House.
Mr. Heath: I also wish to speak about the matter raised by the hon. Member for Newcastle-under-Lyme (Paul Farrelly), because it seems to me that a fundamental principle of this House is now being threatened by the legal proceedings for an injunction and the consequent proceedings for contempt of court in respect of injuncted material. As you know, we have enjoyed in this House since 1688 the privilege of being able to speak freely. We have also developed the right of British citizens to know what we say in this House and have it reported freely. Is there an opportunity for a wider debate on what I think is a very substantial matter, either through a consideration of privilege or on the Floor of the Chamber?
Mr. Speaker: There are usually further opportunities, as the hon. Gentleman, as an experienced parliamentarian, can testify. I hope that he will not mind if I point out that one suitable opportunity to raise the matter might be at business questions, in relation to which he himself enjoys a privileged position.
David Davis (Haltemprice and Howden) (Con): You, Mr. Speaker, are the defender of our rights and privileges in this place. This is a new class of injunction, a so-called super injunction, in which the press are not even allowed to report the injunction itself and the existence of the case. That is how Parliament's reporting has been stopped by it. Could you undertake to the House to do two things? First, will you take legal advice to see whether the courts can be instructed not to grant injunctions that close down reporting of this place? Secondly, will you seek a meeting with the Secretary of State for Justice, who I know is sympathetic to this-it is not a party matter-to see whether the Government can act to achieve that same aim?
Mr. Speaker: I am not sure that I can accommodate the right hon. Gentleman in relation to his first question. I am not sure that it would be right to interfere with a legal process in the way that I think his question would invite me to do. I would like to reflect further upon the second point that he has very reasonably put to me.
Dr. Evan Harris (Oxford, West and Abingdon) (LD): On the same point of order, Mr. Speaker. While you are reflecting on that point, may I ask you also to reflect on whether the increasing habit of solicitors of seeking injunctions in advance of publication, not only in this case but in others, might regularly prevent newspapers from reporting such questions? Given that the efforts of John Wilkes MP in the 18th century to provide for the reporting of parliamentary proceedings were such an important breakthrough, and indeed led to the disuse of sedition laws against this House, would it be possible for you to reflect on that and see whether something urgently needs to be done to control the habit of law firms of seeking to prevent the reporting of this House?
Mr. Speaker: It has always been my pleasure to reflect on any observations put to me by the hon. Gentleman, but I fear that he is seeking to inveigle me into a wider debate than I should enter this afternoon. I think it is fair simply to reiterate the point that the proceedings of the House have been, and will be, in no way inhibited. For today, I would like to leave it at that.
Dr. Julian Lewis (New Forest, East) (Con): On a point of order on an entirely separate subject, Mr. Speaker. In a spirit of optimism, when the House rose in July, I put down an extremely short question for named day answer to the Secretary of State for Defence, simply asking
"what discussions he has held with his US counterpart on vulnerability to electromagnetic pulse attacks; and if he will make a statement."
I am tempted to say that that is hardly rocket science, but maybe it is. Nevertheless, I tabled that question at the end of July, and yesterday I had my named day answer: "I will answer shortly." Surely to put down a named day question in July and get a holding answer in October is utterly unacceptable, even with the Ministry of Defence?
I am grateful to the hon. Gentleman for his point of order. As he will know, the content of answers is of course not a matter for me, and answers must be handled by the relevant Minister, but he makes his point with his customary force and alacrity. Who could disagree that the delay that he has experienced is
frankly unacceptable? I hope that Members on the Treasury Bench will have heard the point. I did exhort Ministers to respond in a timely way to questions, and I do believe that I emphasised in exchanges just before the recess that simply to respond with a holding answer several weeks later, along the lines of "I will respond shortly," does not meet the spirit of what I have said and is frankly resented by Members in all parts of the House.
Mark Lazarowicz (Edinburgh, North and Leith) (Lab/Co-op): On a different and somewhat more restricted point of order, Mr. Speaker. You rightly take to task Ministers who let material go into the public domain in advance of a report to Parliament. Would you consider the position of statutory bodies that have an obligation to report to Parliament? I ask that question because the Committee on Climate Change, published an excellent report yesterday in Parliament. The full report including full documentation was released at one minute past midnight yesterday and was presented to the House later that day. Should other bodies that report to Parliament also ensure that they do not release material of any substance until Parliament has had a chance to receive the report in question?
That leave be given to bring in a Bill to make provision for the recall of Members of the House of Commons in specified circumstances; to provide for the holding of primary elections in such circumstances; and for connected purposes.
It is not easy in the current climate to recall the emotions that we felt as new MPs or that mingled sense of pride and awesome responsibility when we heard the returning officer read out our names. Most hon. Members felt in their bones that entering the House was one of the greatest and most exalted moments in their lives, yet today we find ourselves scorned.
The standing of the House has never been lower. In a reversal of 300 years of democratic development, the very fact of being elected to public office is sometimes, it seems, regarded as a disqualification. We all know that this issue is not just about allowances. It is true that a thorough overhaul of the system is essential-I think everyone accepts that now-but what we have come across in our constituencies is more than a sense of anger about specific and identified expense claims. Rather, it is a more generalised rage against politicians as a class: a sense that MPs have become remote and self-serving, and that we have become spokesmen for our parties in our constituencies instead of the other way around.
We have all heard, on doorstep after doorstep, "You're all the same. It doesn't make any difference how I vote, nothing ever changes." My Bill aims to address those concerns. I want to restore dignity to this House and independence to its Members. I want to shift power from the Executive to the legislature, from parties to Back Benchers, and from Government to people.
Our constituents have a point when they complain that it does not matter how they vote. At four of the last five general elections, fewer than one in 10 parliamentary constituencies changed hands. The fifth of those was, of course, the Labour landslide of 1997, but even then, more than 70 per cent. of seats were held by the parties that already controlled them. In other words, most of us represent pocket boroughs. As long as we retain the right to stand under the colours of our parties, we have tenure. Our incentives are thus twisted. Instead of answering outwards to their voters, MPs in safe seats are encouraged by the system to answer upwards to their Whips.
My Bill would abolish the concept of a safe seat, eliminate pocket boroughs and open candidate selection to the wider public through open primaries. It would allow local people to have a direct say over who gets to be their MP in the first place, and give local people and local parties the right to petition their returning officer to organise open primary ballots. It is right that that should remain a matter of choice-this is not about legislating for political parties in a free society.
Two months ago in Totnes, we saw how enthusiastic voters are about having a say in party nominations. More than 26 per cent. of registered voters-more than 16,000 people-took part. That gives the winner of that
primary a head start in the general election and, for that reason, I hope that it will be adopted by other parties. Indeed, Members on both sides of the House have since indicated that they, too, favour the democratisation of the selection process.
One serious objection levelled against open primaries since then is the cost. The Totnes primary cost the Conservative Party somewhere in the region of £40,000, mainly in postage, yet my Bill is specifically designed to deal with that problem, and at zero additional cost to the taxpayer. Under my Bill, local people-supported by one or more parties-could petition their returning officer to organise a primary contest at the same time as a pre-existing local or European ballot. The primary election would be piggy-backed on to an election already due to take place. The returning officer would have to include an extra ballot paper with the names of those on the shortlist. Each party that chose to take part would have to pay the marginal additional cost for having its ballot paper included, but it would be a cost of hundreds not thousands of pounds.
At the same time, my Bill would provide for a recall mechanism-that is, a way to trigger a by-election where a Member of this House was guilty of serious wrongdoing. Plainly such a measure would need safeguards. We would need to ensure that it could not be triggered frivolously or on partisan grounds. We would need to guarantee that charges could not be levelled against MPs simply because they had voted with their conscience. A recall vote should be entered into-as the Book of Common Prayer says of matrimony-"reverently, discreetly, advisedly, soberly". Triggering a primary would require the backing of a significant number of local people, and it would also require confirmation of serious wrongdoing by the Committee on Standards and Privileges.
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