Dr Andrew Murrison
MP for South West Wiltshire · Conservative · United Kingdom
“It is good to hear that the Government plan to replenish the dwindling stocks of Patriot missiles in Ukraine, which I suspect it will need this winter. However, Patriot is low volume and high cost. What the Ukrainians need is high volume and low cost.”
“Currently, the Royal Navy has an offshore patrol vessel permanently stationed in the Falkland Islands, but given the threat that is being faced and our need to demonstrate resolve—the sort of thing that, sadly, we did not demonstrate in the early 1980s, which led to miscalculation—will the Minister consider speaking to her MOD colleagues…”
“Since the Foreign Secretary is not going to get the co-operation, fulsome or otherwise, of the Israeli state in differentiating goods and services made in the settlements from those that are assembled, repackaged, produced and grown in Israel itself, how is he going to distinguish the one from the other?”
“The Government insisted on applying the social time preference rate to the disastrous Chagos deal to make an appalling deal look slightly better.”
“Will the First Secretary of State’s exercise in delivering democracy and local accountability and empowering local people include a look at large organisations that cannot be described as governmental or as quangos but that nevertheless exist firmly within the public domain, are established by statute, serve the public and are big employe…”
“I congratulate the Government on the hiring of Alistair Burt—he is a good hire and will do great things for some of these most complex of cases—but does the Minister agree that many of these cases are extremely difficult and exceptionally traumatic, and that it is far better to prevent them happening in the first place?”
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“Healthcare outcomes in this country languish behind those of countries with which we can reasonably be compared, and I do not mean the OECD average. I mean countries such as France, Germany and Holland. On Britain’s disappointing position in the league tables, we must do more to improve on things such as bowel cancer and cervical cancer, on which we are overtaking France and Germany respectively. We need to do that right across the board. I am left with the conclusion that because money, inputs and outcomes are causally related, we have to get the funding right. I hope very much that the Government will consider again the proposal put forward by my hon. Friend the Member for Totnes (Dr Wollaston) and my right hon.”
“When we have to support our families, pay the mortgage and deal with everything that bears down on people in their working lives, it is pretty rotten to see salaries increasing, rightly, in the general economy but not in the public service. It is absolutely understandable that the Government, as a big employer, should seek to contain cost. As an evangelist for reducing our deficit, I will support that, but there comes a point—I welcome the Government’s indication that it is rapidly approaching—when we have to look at pay settlement for those who work so well for us in the public sector. I am absolutely obsessed by outcomes in healthcare; the Secretary of State will know that, because we have discussed it.”
“It is certainly running hot, and my worry about the medical workforce—GPs, hospital doctors and nurses, and everybody who works in our NHS—is that we risk allowing the well of good will not just to get low but to run completely dry. It is absolutely right that we should now look at removing the cap on pay for public sector workers, and that we should think in particular about those working in our health services. These people give far more back to the service than we give to them, in terms of the package, and those of us who go into medicine, healthcare or social care understand that. We do it because we want to give something back. We are altruists, but that only goes so far.”
“Some 10% of women and 30% of men in the criminal justice system have had some involvement with mental health services, or had to access acute mental health services prior to their incarceration. Ninety per cent. of people in the criminal justice system have some form of mental health problem. That is a huge indictment not, I would suggest, of the service, but of all of us. It is absolutely right that in our general attempt to reduce the rate of incarceration in this country, which is far too high, we focus particularly on the people in the prison system who have serious and significant mental health problems. I very much welcome the focus on general practice articulated by my right hon. Friend the Secretary of State for Health and his Ministers. The service, it has to be said, is under pressure.”
“For those people and their families it will be a matter of huge importance, as many of us, particularly those of us on the Government Benches, found out a few weeks ago to our great cost. It seems reasonable that we should indeed have a Dilnot-style cap on our liability for these extraordinary costs that affect a few of us—a number of our families. It is surely right that we should do so, and I have no doubt that that will come out loud and clear in the consultation. I very much welcome the commitment to mental health in the Queen’s Speech. I am particularly interested in mental health so far as it relates to the criminal justice system. It is welcome that we should be revising the Mental Health Act 1983. It has been a good piece of legislation and has served us well, but it is due for revision and updating.”
“We may even recall the 2015 manifesto commitment, on which we stood, to implement something that looked a little bit like Dilnot. Most of us at the time thought that was a jolly good idea. Our public services are all about pooled risk. That is what the NHS and our social services are all about—in everything, it seems, except for dementia and other chronic and long-term conditions that require ongoing care. For most of us, they will not actually be that expensive. Mercifully, for most of us dementia care will not be expensive. It is a condition that affects us right at the very end of our life and very few of us will require institutional care. For a few of us, however, it will be expensive.”
“It is good to see you back in your place, Madam Deputy Speaker. We have been treated to a range of excellent maiden speeches from my hon. Friends the Members for Gordon (Colin Clark) and for Hitchin and Harpenden (Bim Afolami), and the hon. Member for Stockton South (Dr Williams). They obviously have the measure of this place already, because not one of them is left in the Chamber, but in his absence, I reassure the hon. Member for Stockton South that we can never have too many doctors in the House. I welcome the commitment in the Queen’s Speech to improving social care, and I welcome the plans for a consultation. All of us who have gone through the general election process—certainly on the Government Benches—will be aware of the importance of this issue.”
“Does my right hon. Friend share my sadness at the lack of contrition displayed on the Opposition Benches, given that Labour’s unquestioned adoption of policy in the early part of the last decade resulted in a massive increase in the number of diesel vehicles, making the air in places such as Westbury in my constituency considerably more toxic?”
“What can be done to encourage the European Union to promote the processing of foodstuffs in developing countries? I am thinking particularly of olive oil and coffee, where the value added tends to be within the European Union.”
“I congratulate my right hon. Friend on his statement, and warmly thank him for listening to colleagues and their constituents. Notwithstanding his comments to my hon. Friend the Member for Bath (Ben Howlett), may I invite him to look afresh at the possibility of hypothecating national insurance contributions, so that contributors to NICs, employers and the public can see a clearer link between their contributions and the services they receive?”
“The Minister is of course absolutely right on the primacy of NICE in this matter, but today the NICE board will be imposing a budget threshold of £20 million a year, which would have the effect of at least delaying or possibly preventing the roll-out of new medicines. Does he share my concerns, particularly in relation to cancer drugs?”
“Given that, I am more than happy to support the Government on this. However, any delay at all will send a signal to those in the life sciences sector; it is important that we make it clear that this will not introduce unwarranted delays in the introduction of new medicines, because frankly that would put them off. A lot of worthy work has been done recently, which has involved spending a lot of money, to support a vital part of our economy, and it would be a great pity if anything in the Bill reduced our life sciences sector’s ability to prosper in the years ahead.”
“Patients in the UK do not enjoy the full range of advanced medicines that are reckoned to be more or less routinely available in countries with which we can reasonably be compared—or if they do, they usually find that they are subject to unwarranted delays before they are treated. That is of course critical in the case of conditions such as cancer, and could well mean the difference between life and death; it will certainly mean a whole load of difference in quality of life. It is vital that we do nothing that would extend that process. In response to my earlier intervention, the Minister gave me sufficient reassurance that the delay that the measure would introduce would be small, and that this would be an opportunity for NHS England to negotiate a lower price for these very expensive medicines. Indeed, that is the intention.”
“It bewilders me that people in this House who argue that the NHS needs more money, which it most certainly does, should support such a proposal when all the money would be going into the pockets of lawyers. NHS England must fund any new drug found to be cost-effective by NICE within 90 days of that approval. This afternoon, the NICE board will approve this new measure, which will establish a budget impact threshold of £20 million. The hon. Member for Ellesmere Port and Neston is right to say that about one in five drugs will probably be within scope of the measure, and that is a cause for concern.”
“I shall speak briefly to Lords amendment 3, but first I chastise the hon. Member for Ellesmere Port and Neston (Justin Madders), if I may, for his remarks about money. He is right to say that this is all about money, but I seem to remember that less than two years ago, he stood for election on a manifesto that would have had the effect of opposing the money that is currently going into the national health service, so we should not take any lessons from the Labour party on financing the NHS. The Government are absolutely right to oppose this amendment. It looks a bit like a probing amendment, to be honest, and I am a bit surprised that it has got this far. It would subject this very good Bill to a whole shedload of judicial review. It would be a lawyers’ beanfeast.”
“I very much hope that the support I think the Prime Minister gave to the concept when a number of our colleagues met a short while ago is translated into concrete proposals in the near future, so that—on a cross-party basis—we can have the convention, commission or conversation that we need with the public to establish, in the NHS’s 70th year, a long-term funding arrangement for this national institution that we all hold so dear.”
“That means examining Beveridge versus Bismarck, something in between or something completely different, which requires a commission or a convention—perhaps an Adair Turner-type commission. It needs to have that conversation with the public. On the NHS’s 70th birthday, that is appropriate, because we need to carry the public with us if what we are ultimately suggesting is quite substantial sums of money injected into healthcare to bring our healthcare outcomes to where they should be. As an optimistic sort of person, I rather suspect that the reason why a Green Paper has not been suggested for healthcare—notwithstanding the “Five Year Forward View”, which is only halfway through its evolution—is that the Government are considering such a conversation as a proposition.”
“It is reasonable, after 2020, to look at instruments such as the triple lock to see whether those substantial sums of money should be handed to our national health service. Most elderly people I know would welcome such a thing. We need to look fundamentally at what to do with healthcare funding going forward. It is very good to hear of the injection of money in the Budget, but it will not do in the long term, for reasons that have been explained. A Green Paper will not do either. Although that is welcome for social care, health care is much more complex. A conversation with the public means looking fundamentally at what underpins our health service and trying to work out why outcomes in this country fall significantly short of those in countries such as Germany, which has been mentioned, France and Holland.”
“I congratulate the hon. Member for Hackney South and Shoreditch (Meg Hillier), the Chair of the Public Accounts Committee, on securing this debate. First, I would point out that a strong NHS requires a strong economy, and on that front the Budget brought good news. In the short term, we need to think about how to deal with some of the problems we now face. To that extent, I very much welcome the £2 billion for social care, the £300 million to underpin sustainability and transformation plans and the £100 million for A&E. I also welcome the rumours of more medical school places, which, as my hon. Friend the Member for Totnes (Dr Wollaston), the Chairman of the Health Committee, said, are very important indeed. We need to look at intergenerational fairness. Sadly, most healthcare cost is generated in our declining years.”
“The Royal Navy has run EUNAVFOR Operation Atalanta successfully for many years. Does my right hon. Friend agree that we should continue to usefully co-operate with our European neighbours on such things after we leave the European Union?”
“I congratulate my hon. Friend on the powerful case she is making for her rural constituency. Has she been able to compare and contrast the cost of a community hospital bed with the cost of a bed in the district general hospital to which she referred? I suspect that she has done so and will have found that there is a yawning difference between the two—a very good argument for community hospital beds.”
“My hon. Friend is being generous in taking interventions. I am interested in the study to which she refers. Does she agree that a likely outcome of the configuration of healthcare in the longer term will be increasing specialisation at really quite large district general hospitals? If that is the case, there will be an even greater need for community hospital beds—step-down, step-up care—otherwise people’s only access to in-patient care will be at one of the huge regional or sub-regional centres that I suspect our NHS will be developing in the years to come.”
“The hon. Gentleman clearly has not read the report on the Budget, because its very first sentence, on page 1, starts: “As the UK begins the formal process of exiting the European Union”. He can hardly argue that the Treasury Bench has not taken into account our departure from the EU, can he?”
“I hope that just as we are having a Green Paper on social care, which is welcome, the Government are open to suggestions from the public on how we can fund healthcare through hypothecated taxation or the various other mechanisms open to them.”
“That rolled in publicly funded social care costs, which is also perfectly reasonable, but it bumped up the UK spend on healthcare a few notches in the international league table—it went from 8.7% to 9.9%, and meant we overtook Spain, Portugal and Greece, but we are still well behind France, Germany and the Netherlands. The question for me is how on earth we close that gap. Many right hon. and hon. Members have suggested that we ask a commission to examine the long-term future funding. We need that level of public conversation to enable us to examine how we will lever in the significant funds necessary to close that gap.”
“We find that cancer drugs that are routinely available on the continent are not available here or, if they are available, that they take much longer to appear on the market than they take in comparable countries. We find that cancer staging is delayed in this country, with obvious consequences for people’s chances of survival. It is hardly surprising that the much-cited Commonwealth Fund puts the UK 10th out of 11 in terms of healthcare outcomes for conditions amenable to healthcare. Last year, the Office for National Statistics perfectly reasonably tweaked the figures so that the UK health spend related better to the OECD methodology.”
“The amount of money we spend on healthcare is very much less than the amount spent in the aforementioned countries. Ministers will rely on the OECD average and say that we are doing relatively well in that respect, which is perfectly true. However, the OECD contains countries such as Mexico, Turkey, Hungary and Poland. They are great countries but have healthcare economies that are surely less advanced than ours and that do not therefore present reasonable comparators. We find that poor little five-year-old Ashya King had to go to the Czech Republic for his proton beam therapy for medulloblastoma. That would strike most people in this country as being distinctly odd.”
“The fact of the matter is that the burden of disease is going up because of our ageing population, as are patients’ expectations. We welcome the ageing population and the increase in patient expectations. Innovations and medical advances are also increasing, but all that costs a great deal of money, which the OBR makes clear. It makes it clear that we need to find a great deal of money over the next several years—eye-watering sums—but what is happening now is important as well as the future. Compared with countries such as Germany, France and the Netherlands—countries with which most people in this country would wish to be compared—our healthcare outcomes are significantly worse. In my view, there is a causal link between the amount of money we are prepared to spend on healthcare and the outcomes we will eventually get.”
“Luton and Dunstable hospital is an example of very best practice in that respect, and one that should be mirrored, copied and emulated elsewhere. We are still left with a big problem: the future funding of our national health service. When William Beveridge made his report in the mid-1940s, he tried to address society’s five great evils as best he could and suggested that spending on healthcare would reduce over time the costs of the NHS. How wrong he was. That is an example of how we can get our predictions so badly wrong with devastating consequences. Clem Attlee’s Government rapidly realised that that was wrong, which led to Nye Bevan’s resignation in fairly short order over what became known as teeth and specs.”
“The revenue savings that are necessary over the years to guarantee the five year forward view will not be possible without the injection of significant sums, of which I hope this is the start. I therefore very much welcome the £300 million announced for those capital costs and look forward to even more in the autumn statement. The £100 million announced for accident and emergency is extremely welcome. We have got off relatively lightly this winter—it has been a relatively mild winter—but we cannot expect that to be the case in future. I welcome the Chancellor’s ambition to get the money in place to deal with next winter’s pressures. That is ambitious and I hope that he can achieve that and a system of triage to ensure that people are treated appropriately and by the right practitioner.”
“To sound a cautionary note, I think that it would be wrong in principle if we were to shift from raising money for social care from general taxation, which is the current situation, to a system based on property. The reason for that is very obvious: the most disadvantaged areas are the least capable of sustaining that kind of tax burden. However, £2.4 billion over three years is a great deal of money. I am particularly pleased that the Chancellor suggested in his statement that there will be more in his autumn statement, in particular to fund the capital costs of sustainability and transformation plans. Many of us in areas that will be profoundly affected by STPs are concerned that those capital costs simply are not being met.”
“That has not been positive in the past and I would not like to see it visited on areas such as mine in the future. I would be concerned if the measures announced today, which appear to advantage disproportionately free schools seeking to select their intake, introduced grammar schools by the back door. I am particularly concerned for health and social care. I very much welcome the positive announcements that have been made today. By my reckoning, they mean £2.4 billion over three years for health and social care, which will be very helpful, over and above the announcements that have been made previously—in particular, the increase in the social care precept to 3%.”
“We have long ignored technical education in this country, to our great disadvantage, and I suspect that our poor productivity compared with our European competitors is in large part due to the fact that we have not skilled our workforce in the way we should since 1945. I therefore very much welcome this development. I also welcome the funding for children who wish to access selective education. I think that the hon. Lady missed the point that it is money for children on free school meals, so it is not generally available. It is a measure that seeks to improve the chances of the poorest. I would have thought that the Labour party welcomed that. However, I oppose further grammar schools. They would not be good for areas like mine. I fear this development because its flipside is an increase in the number of secondary modern schools.”
“I hope very much that we will have some reassurance from Treasury Ministers that plumbers, electricians, plasterers and people of that sort will not be disadvantaged, particularly as we consider further measures to equilibrate them with employed people, such as those who have been described on parental benefits and the like, which of course ignore the fact that employed people have advantages that the self-employed very often do not. I do not have a university in my constituency, but I do have a further education college. I know that the principal of Wiltshire College will warmly welcome today’s announcement on T-levels.”
“The Conservative party always has been and, I hope, always will be the party that supports white van man and—may I say on this particular day?—white van woman. It is vital that in abolishing class 2 NICs and instituting class 4 NICs, we do not disadvantage those individuals covered by them. My back of a cigarette packet calculations support the concerns expressed by the hon. Lady. Her figures were more or less the same as mine.”
“It is a great pleasure to follow the hon. Member for Nottingham East (Chris Leslie). It is also a pleasure to support the statement and the OBR’s “Economic and fiscal outlook”, which supports it and gives generally very good news and confounds many of the doomsayers who have been prognosticating so luridly over the past several months. I say from the outset that, although I agree with the statement and some of the things that were announced, I have some small concerns about national insurance. On that matter, I find myself in agreement with the concerns expressed by the hon. Members for Nottingham East and for Leeds West (Rachel Reeves). It is very important to ensure that we do not disadvantage self-employed people.”
“It is a great pleasure to contribute briefly to this debate. I congratulate my hon. Friend and neighbour on bringing this matter to the House’s attention. Does he agree that these are not good people and that these groups probably contain within them individuals who are intent also on acquisitive crime? Not only are they violent people, but they are probably also eyeing up the property of our rural constituents, which, as he will know, is very much under threat at the moment from bespoke criminality focused on thieving to order. The suspicion is that this population and the hare coursing population are very often one and the same thing.”
“I agree with the argument that the right hon. Gentleman is developing, but what he is suggesting would be politically unpalatable. Given that the majority of healthcare costs that we generate in our lifetimes come at the extremes of life, does he agree that one way of selling this to the population, and especially those pensioners who are principally in the frame, would be to say that the £2.2 billion per annum that the 2.5% element of the triple lock will probably generate by the end of this decade might be hypothecated into the national health service? In that way, we might gain some level of acceptance from pensioners.”
“Does the Secretary of State agree that it is vital that we move towards a fully paperless national health service, but that it will be very difficult to do so as long as national health service trusts cannot talk to each other electronically? Radiological images, for example, are often not available when consultants see patients, who therefore have to have the test again, which is contrary to all the precepts of good practice in the Ionising Radiations Regulations 1999.”
“I am listening with great interest to my hon. Friend’s speech. Is he familiar with the practice undertaken by some local authorities of diverting floodwater from roads on to farmers’ fields without permission, thus washing away topsoil of the sort that I think he is about to touch on, and also potentially introducing pollutants into sensitive sites?”
“I am following closely my hon. Friend’s remarks, which are, as ever, wise. Does she share my concern that if we are to transfer money from capital to revenue, the sustainability and transformation plans, most of which imply a certain level of capital investment in order to save revenue in the long term, will not be possible?”
“My hon. Friend is making a very good speech. Does she share my concern about the 3% precept, as shifting the cost of health and social care away from general taxation on to a property-based tax has obvious problems—not least, that it will disadvantage communities that are less well off?”
“There is much in the hon. Gentleman’s speech with which I agree. Does he agree that the fundamental issue is that countries such as Germany, France and Holland, to which people here would reasonably compare this country, spend a great deal more money through either the Bismarckian system that he describes or others—this country’s system is based on Beveridge—and that somehow or another we are going to have to close that gap, as it is highly likely that the difference in mortality, morbidity and outcomes generally in this country compared with those aforementioned countries is causally related to the amount of money that we put into healthcare?”
“I am sorry to intervene on my hon. Friend so early in his speech. Does he agree with me that the OECD average is probably a specious comparator? It covers countries—such as Mexico and Turkey, and former eastern bloc countries—whose health economies, laudable though they may be, are not ones with which most people in this country would wish ours to be compared.”
“It is reported that around £20 million has been paid to 16 former Guantanamo Bay detainees. This morning, Lord Blunkett suggested that that sum should be formally reviewed because the public will be dismayed. They will be particularly concerned if any of that money has gone to fund terrorism. Will the Minister undertake to review the £20 million, or thereabouts, that is reported to have been paid to these individuals?”
“I am following the right hon. Gentleman’s remarks closely, as ever. Does he agree that the end result of all this is that Sinn Féin is winning the war, by which I mean that it is managing to shift public opinion so that, somehow, the troubles become an issue to do with the actions of the British state and not to do with the murderous barbarism of terrorism during that period? Would he also say that it is having some measure of success in that endeavour?”
“Does my right hon. Friend agree that that support should extend to the provision of the costs of engaging a solicitor to advise those who have been sent letters by the Ministry of Defence inviting them to unburden themselves about the events of 30 or 40 years ago in order to assist the police with their inquiries? I am sure that he would not want those individuals inadvertently to incriminate themselves or those they were operating with all those years ago. If he is correctly suggesting that we should be properly supporting our veterans who served in Op Banner, then that must surely extend to finding the cost of engaging solicitors to advise those individuals properly and appropriately.”
“I am grateful, because this is very important. My right hon. Friend says, in effect, “if allegations have been made”. These letters, as I understand it, contain no allegations but will be disturbing nevertheless to the predominantly elderly gentlemen who receive them, who will need proper advice on whether to unburden themselves in the way that is suggested or whether to ignore the letters. I think that that advice can come only from a solicitor. My question is whether the MOD will provide the costs of the provision of that legal advice.”
“There was, of course, a Board of Trade inquiry, conducted over five days in London. The penalty handed down to the Darro’s master seems unduly lenient, given that he was going much too fast in thick fog and failed to observe the rules for the prevention of collision at sea. Worse still, he stood off as men drowned, giving rise to a much circulated story that he was disinterested in rescuing men of colour. It has to be said that that allegation is unsubstantiated. The wreck was rediscovered in 1945 by a Navy hydrographer, and was explored by the Isle of Wight diver, Martin Woodward, in 1968.”
“Post-apartheid, the Mendi has become a staple in the South African national story: monumentalised, used to name warships, and used to name this day—South Africa’s armed forces day. It is the inspiration for South Africa’s principal civil award for courage, the Order of Mendi. Still deeply and uncomfortably controversial in South Africa, we will probably never know the full details of what exactly happened on that cold foggy night, but the fortitude and dignity of the labour corps volunteers is beyond doubt. War is never glorious, but those who serve in it often are, as this episode so clearly demonstrates. John Gribble and Graham Scott, in their excellent account of the sinking published this month by Historic England, describe what happened after the collision.”