Pat McFadden
MP for Wolverhampton South East · Labour · United Kingdom
“In his review Alan Milburn considered that issue and said that, “the UK’s NEET crisis is much more long-term and deep-seated than any decisions taken in the last few years.” As I said earlier, 400,000 more people are in work this year than last year, and the number of young people in employment is up since the election.”
“Since our last DWP questions, both Alan Milburn and the Pensions Commission have published their respective interim reports on young people and on the current state of saving for retirement. I look forward to receiving their final reports later in the year.”
“As Alan Milburn pointed out in his recent report, the UK’s NEET crisis is much more long-term and deep-seated than any decisions taken in the last few years. There are 400,000 more people in work than last year. The number of young people in employment is up by 74,000 since the election.”
“I thank the right hon. Gentleman and send him commiserations for whatever has left him reliant on his crutches today. I am happy to congratulate the businesses he mentioned in his constituency. He raises a serious point: it is important not only to come up with the right policy, but to make it simple for businesses to use.”
“My hon. Friend is right, and I thank Cardiff football club for being a partner. We are supporting nearly 1 million young people and creating up to half a million opportunities for jobs and training.”
“We are making strong progress on expanding youth hubs, with around 130 already in operation across Great Britain. In March, I announced the locations that we want to open in this year, and I have just announced a further 180 locations for the following two years.”
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“I thank my hon. Friend for his intervention. Certainly in the speech that I heard last Thursday, the commissioner was not saying that there were no problems at all. He acknowledged many of the problems and said that he was determined to take a different approach in responding to them from that taken in the past. It is perfectly fair for Members to say, “We’ll see how that works out. Let’s see if he’s serious about what he says.” However, that certainly is what he says, and that is reflected in the work programme. There has been legitimate frustration about over-regulation in the past. If the Commission is serious about weeding out proposals that are not going to go anywhere, that have been lying on the table for years without prospect of agreement or that have been bypassed by events, we should welcome that.”
“We saw that in the recent European Court judgment on the Dano case, which was initiated in Germany and affected a lady who it was judged did not have the right to access social security benefits. We have an interplay between a founding principle of the European Union and social security systems that are national in nature, and it is right that we discuss work in that area with the Commission.”
“It is therefore clear that there is a lot in the work programme that will concern the House. Before I end, I want to turn to the amendment tabled by the hon. Member for Stone (Sir William Cash) and his colleagues on the European Scrutiny Committee. It asks that the Government ask the Commission to develop policies relating to the free movement of citizens. That is something that the Labour party has put forward, and before Christmas my hon. Friend the Member for Leeds West (Rachel Reeves) produced proposals that related to how free movement interacts with access to benefits and public goods. We would like the Commission to work with member states on that, because access to benefits and public goods is not an issue just for the UK but for other member states.”
“I very much agree with my right hon. Friend. The Italian Foreign Minister told me that of the estimated 270,000 illegal migrants who landed in the EU last year, 170,000 landed in Italy. This cannot be a problem for just one member state, because it is broader than that. I shall be interested to hear the Minister’s views on our Government’s input in dealing with both the consequences and causes of this problem. Concerns have been raised about what is not in the programme. The Minister wrote to the Chair of the European Scrutiny Committee about the air quality package and the circular economy package. Concerns about that have been raised by Members of the European Parliament as well. A number of Select Committee Chairs have written to the Chair of the European Scrutiny Committee on the matter.”
“It has already been agreed that Triton will be a European programme and not just an Italian one—the right hon. Gentleman is a little behind the pace if he thinks that is a new departure, because it has already been agreed. The question is about the resources given to the programme and whether it is capable of meeting the task it faces. I remind him of the terrible figure given by my right hon. Friend the Member for Leicester East of the number of people who have drowned in the Mediterranean over the past couple of years.”
“I have already given way to the right hon. Gentleman. In conclusion, I believe that this work programme is a step forward from previous ones. It is closer to British priorities and reflects much of what we want to see, although we do not endorse everything in it and some of it does not apply to us. Like all such programmes, it is only a plan on paper and it will remain to be seen whether the Commission delivers as it has promised. It is certainly urgent that it does deliver to meet real and urgent priorities, and ensure that the European Union works in the interests of its citizens over the next five years. Whatever the plan says on paper, that is ultimately how it will be judged.”
“Before the Chairman of the Home Affairs Committee finishes, will he clarify his view on burden sharing? Does he really think that if these migrants land in Italy, they stay in Italy—or is not the reality that once they get there, they will try to travel to other countries?”
“It is clear that the European Union needs to reform to create more growth, more jobs and more competitiveness, so what is the Minister’s reaction to the warning issued this morning from the executive vice-president of Ford, Mr Jim Farley, who said, on the prospects of “Brexit”, “We really hope that doesn’t happen and we believe that the UK being part of the EU is critical for business”? Why does the Conservative party call for the march of the makers in one breath, yet pursue a policy that poses a direct threat to manufacturing jobs, manufacturing investment and trade? Is it that the Foreign Secretary does not see the contradiction, or is it instead a complete and utter absence of leadership when it comes to the European Union?”
“What progress has the Secretary of State made in his discussions on furthering the single market so that Britain can have greater access to trade and export opportunities for businesses based here? While he has been in those discussions, has he also made any assessment of the effect on the UK economy of being outside the single market, which is where we would be if we withdrew from the EU—an option that he has said he might favour?”
“I apologise that I could not be here for most of this debate, but among the conditions that my hon. Friend is mentioning, I urge him and the Minister not to forget sickle-cell anaemia. Sufferers feel that there is a damaging variability in the quality of treatment available throughout the country and feel that a move away from national commissioning to local-only commissioning might exacerbate that problem.”
“Will the Home Secretary join me in rejecting the new imperialism that we hear after incidents such as this, which seeks to condemn the killings but somehow excuse the actions by blaming ourselves—in this case by saying that the cartoons in Charlie Hebdo were somehow unnecessarily provocative? Does she not agree that we cannot continue to absolve those engaged in terrorism of their responsibility, and that we must agree that responsibility for those actions lies squarely with those who kill innocent people?”
“My point to the Minister is that, now that the position has been made clear, he and his colleagues are in a stronger position to make it clear to the Spanish that it is wrong for them to interfere with the free movement of their own citizens who wish to work in Gibraltar, and the ability of the people of Gibraltar to travel freely back and forth across the border.”
“Many thought that was the implication when the Prime Minister said in his conference speech, “I will sort this issue.” However, his recent speech on EU migration, made just before Christmas, was widely seen as a retreat from that position. It was seen as dealing with issues relating to benefits, and as not compromising the United Kingdom’s attitude to the principle of free movement. If there was any doubt about that position, only yesterday, during his joint press conference with the German Chancellor, the Prime Minister attested to his own belief in, and support for, the principle of free movement. I am sure that that belief and support have been widely welcomed by his colleagues on the Back Benches.”
“As we have heard, these are causing delays of five, six or sometimes seven hours for cars at the crossing and 90 minutes or more for people crossing on foot. These border issues have had a direct impact on Gibraltar’s tourism trade and constitute an unwarranted and wholly disproportionate barrier to free movement between Gibraltar and Spain. Let me pick up on another point made by the hon. Member for Gainsborough. Free movement, as we have heard in our broader debates in this House and this country over recent months, is held up as a cardinal principle of membership of the European Union. For a time, it seemed as though the UK Government wanted to compromise the principle of free movement.”
“It has to be made clear, however, that it is not the fault of the United Kingdom that the Cordoba agreement has become less effective. That is the result of decisions taken by Spain to adopt a harder line against Gibraltar. My first question for the Minister—I would like him to address it in his summing up—is where do things stand with the so-called ad hoc discussions between Britain, Gibraltar and Spain? Has there been any indication from the Spanish Government that they are willing to resume these discussions, and do they accept Gibraltar’s place as a full participant in them? The Select Committee report rightly and strongly criticises the unacceptable and deliberately organised delays at the border crossing, which cause major inconvenience to Gibraltarians, Spanish workers and the huge number of tourists who visit Gibraltar each year.”
“He said that the constitutional status of Gibraltar would not be changed without the consent of the people of Gibraltar, and that the UK Government would not enter into discussions about that issue without the consent of those people. That was the position then, and it remains the position of my party now. This is the cornerstone of British policy on this issue: it is a position shared by the current Government and it is an important issue in common between us. Once that is understood by all concerned, there is room for dialogue and co-operation on a number of issues. That was the kind of policy that was in place under the Cordoba agreement and, with good will, it could be resurrected and put in place again.”
“It is therefore tragic that this issue has been rising in importance and has become a real cause of tension. It makes no sense for the lives of the people of Gibraltar to be deliberately made more difficult as a result of a campaign by Spain to do so. That is wrong in itself and it undermines what is otherwise a strong and long-standing relationship between the UK and Spain. The hon. Member for Gainsborough (Sir Edward Leigh) referred to comments made by my right hon. Friend the Member for East Renfrewshire (Mr Murphy) when he was a Minister. At that time, my right hon. Friend made it clear that this was a matter not of empire, but of popular will.”
“I congratulate the Chairman of the Foreign Affairs Committee, the right hon. Member for Croydon South (Sir Richard Ottaway), and the rest of the Committee on producing the report that has given rise to this debate, and I thank all Members who have contributed, be they members of the Select Committee or the all-party group on Gibraltar or simply interested in the issue. The Select Committee report really concentrates on three areas: issues at the border; issues affecting British-Gibraltan territorial waters; and the international aspects. Let me deal with the overall context of this debate, which as hon. Members have mentioned, should be—and could be even more—a good relationship between Britain and Spain. We are fellow members of the EU, fellow members of NATO and allies in many areas.”
“As democratic countries defending pluralism, there should be no linkage between the battle against the ideology and practices of ISIS and self-determination for the people of Gibraltar.”
“I am sure that the Minister agrees that it is unacceptable to use issues like EU aviation policy or the single European sky policy to put further pressure on Gibraltar. Why should not the airport in Gibraltar and the people travelling there have the same freedom and rights as people elsewhere in the EU? My hon. Friend the Member for Ilford South (Mike Gapes) mentioned the resolution in Congress recognising Gibraltar’s right to self-determination. I am sure that the attempts by the Spanish Government, in the letter from the ambassador to Congress, to link their support for the coalition against ISIS with the issue of Gibraltarian self-determination would be rejected by all of us.”
“I am sure the whole House agrees that the Royal Navy’s Gibraltar Squadron and the Royal Gibraltar Police do a difficult and dangerous job, showing admirable restraint when faced with repeated and sometimes dangerous provocation on the seas. The report also welcomes the use of Gibraltar as a staging post for larger Royal Navy vessels. May I ask the Minister to address the points made by the hon. Member for Beckenham (Bob Stewart), whose military experience is always valuable in these debates? Is it still Ministers’ view that the squadron there has the ships, equipment and manpower to carry out the tasks assigned to it, or is there a need to reassess this in the way that the hon. Gentleman suggested? The international aspects of this issue have also been mentioned in this debate.”
“Let us be clear about the fact that this is not about free passage; it is about state-owned vessels violating sovereignty, and trying to erode the status and integrity of Gibraltar's territorial waters. The Committee drew attention to the Government’s delays in lodging protests against those transgressions, fearing that such delays lessened the impact of our complaints and gave the impression that we were merely going through the motions. In their response to the report, the Government said that practice had changed, and that there was now a weekly submission to the Spanish Government. That is to be welcomed on one level, but the fact that the submission must be weekly prompts another question: what further means of reducing the number of transgressions, and thus the need for weekly submissions, have the Government considered?”
“As we have heard during the debate, the inconveniences and delays can be turned on and off. Obviously, if lengthy notice is given of a visit, it will be easy to step down the pressure and ensure that the inspectors do not see things as they sometimes are. It matters how such visits are conducted, and when they are conducted. Paragraph 84 of the report suggests that the Government should consider using article 259 of the Lisbon treaty to take Spain to the European Court. May I ask the Minister for his response to that suggestion, which was also mentioned today by the right hon. Member for Croydon South? The report gives detailed information about the sharply increased number of transgressions of British- Gibraltan territorial waters, which sometimes occur as often as 50 or 60 times a month.”
“I thank the hon. Gentleman for his intervention. A serious aspect of this issue is that when we question such principles, we may sometimes do so without thinking about how they are used by our own citizens who, in possession of a British passport, can move freely—and live and work freely—throughout the European Union, as many do. Given the principle of free movement, the Government are absolutely within their rights to complain to the European Commission about what is happening on the Gibraltar-Spain border. They have done so before; may I ask the Minister whether they will do so again, stressing the issue of the recent delays and the impact that they are having on the economy and citizens of Gibraltar? Will the Government also call for Commission visits to be made with little or no notice?”
“My hon. Friend makes a strong point. We have seen a great deal of solidarity with the people of France in the last 24 hours against the appalling acts of yesterday. When these things happen, and when democracies are faced with the ideology of those who would kill and attack pluralism and free speech, we do not seek a chain of other issues to connect to them. We do it because we defend our own values, which are under attack from the ideology that led to the bombings in Madrid, which has led to action in this country and drove those responsible for the terrible events in Paris yesterday. On these international issues, will the Minister say what efforts the UK Government are making to make it clear to the international community that Gibraltar’s status must not be used in this way?”
“It is in the interests of the United Kingdom, of Gibraltar and of Spain to try to get back to the kind of co-operation that we had a few years ago. With good will, that can happen. I shall end where I began, by saying that we two countries are allies with much in common. We in the UK do not seek to raise tensions with Spain, and that is why restraint has been shown, but it cannot be right for such undue pressure to continue to be placed on Gibraltar. We must get back to the situation that we had a few years ago, because that is in everyone’s interests. The cornerstone of our policy is the wishes of the people of Gibraltar, and that cornerstone remains firmly in place.”
“The right hon. Gentleman makes a strong point. Through the Cordoba agreement, we had good co-operation on a number of day-to-day issues to make the relationship between Gibraltar and Spain work. It is not down to any change in the UK’s position that that co-operation has been eroded. We need to take the action necessary to get back to that situation. A few years ago, we had constructive dialogue, and my message today is that we cannot continue with the current situation. The report says that the people of Gibraltar feel “under siege” by the repeated border delays and transgressions of territorial waters. This has not happened by accident, or because of a change in policy by us. It has happened because of a change in policy by Spain. It is hurting Gibraltar, but it is also hurting the people of Spain.”
“We have also had Mr Salmond saying he admires “certain aspects” of Mr Putin’s policies. The state-owned “Russia Today” channel has written of the hopes it has invested in Mr Farage and his desire to see Britain leave the EU. Let me quote: “In such a scenario, there are possibilities for Russian-British rapprochement on many levels”. It also said: “A UK exit from the EU could mean a dilution of the famed Trans-Atlantic alliance between Washington and London.” Perhaps it is incumbent on all of us, particularly those who desire such a scenario, to take account of who will be cheering if they get what they wish for.”
“However, it is also the case that the EU as well as NATO can use its collective leverage and its adherence to democratic values to resist land grabs and aggression. If this dimension is not always clear in our domestic debates here in the United Kingdom, it is certainly clear to many former Warsaw Pact countries, which regard EU membership, at least in part, as important in protecting them. Now we know that there are politicians in this country who admire Mr Putin and what he has done. The UKIP leader has said that Putin is the politician he most admires. He has attacked some for their stance on Ukraine, but not Mr Putin. In fact, he has accused the west of “playing war games” in Ukraine. He is not the only nationalist leader who has expressed admiration for Mr Putin.”
“In his response, I hope the Minister will clarify what further options on sanctions are under consideration at EU level, and what talks have taken place with the United States about differences between the sanctions regimes agreed at EU level and those operated by the United States. The unified European response has been important, and it serves as a reminder, if one were needed, that there is a security dimension to EU membership and that by standing together we can be stronger in the face of what Russia is doing in the Ukraine. Of course NATO serves as the main alliance for our defence, and recent statements from a number of leaders reiterating their support for article 5 are welcome.”
“What is happening in Ukraine poses major challenges for us relating to security, stability and values. We cannot simply hope that it goes away. The first challenge relates to foreign policy itself. No one wants further to inflame a conflict with Russia, yet its actions in Ukraine cannot go unanswered. That is why it is right that both the European Union and the United States have imposed sanctions. Unity on those sanctions is essential, and we had a debate about them at the beginning of their imposition. It is important that states set aside short-term economic interests in order to communicate to Russia that it cannot do what it would wish, which is to divide and rule and pick off one state after another. Unity is key, and we must resolve to maintain the sanctions and to increase them, if necessary.”
“Member for Maldon reminded us in the most stark way that here on the continent of Europe, a state’s territorial integrity has been systematically undermined by the fomenting, arming and backing of Russian separatists. Crimea has been annexed and parts of eastern Ukraine are effectively beyond the reach of the Ukrainian state. This destabilisation has continued, despite the Minsk agreement reached a short time ago. All of that is taking place against a deepening economic crisis for Ukraine, with a newly elected Government struggling to grip these twin security and economic crises. Beyond Ukraine, as has been referenced several times in the debate, there have been a number of incidents, such as transgressions of airspace, that remind us of how things were in the past. Of course, this situation dominated the recent G20 summit.”
“We have also heard the alternative view, put most forcefully by the hon. Member for Gainsborough (Sir Edward Leigh), that we should see this from the Russian point of view. Others perhaps fell somewhere between those two views. I always hesitate to differ from the hon. Member for Beckenham (Bob Stewart), but I do not agree with this metaphor about poking the bear with a stick. The problem with the metaphor is that countries are not bears, but knowledgeable institutions; they know the rules and they know about borders and histories, but the bear does not. I do not think the analogy sticks, therefore, and so I do not think we can absolve Russia of its responsibilities by using that analogy. There are few more urgent issues facing us than what has been unfolding in Ukraine over the past year. The hon.”
“I echo the congratulations to the hon. Member for Maldon (Mr Whittingdale) on securing this debate. He talked about the EU association agreement, Euromaidan, the shooting down of flight MH17, the sanctions and the response. I am pleased that he also raised the potential influence of the John Smith fellowship programme on the current generation of Ukrainian politicians. I say that as a former trustee of the John Smith Trust. It is an organisation I have had an association with since its foundation. During this debate, broadly speaking we have heard two views. We have heard the view represented by the hon. Members for Maldon and for The Cotswolds (Geoffrey Clifton-Brown) that this has been an outrageous breach of territorial integrity that requires a strong response and which we cannot allow to stand.”
“We cannot regard those countries’ actions as poking the bear with a stick. They have a right to sign such agreements if they wish.”
“My hon. Friend is right to draw attention to the recent £7 million loan to the French National Front party, and to return us to the question of who would cheer if the European Union were to fall apart at the hands of nationalist movements and parties. For the rest of us, such comments and actions are a reminder that we should not be cavalier in dismissing the importance of the security side of a strong and united European Union which believes in democracy and freedom, and stands opposed to Russian aggression. That is well understood by Angela Merkel, who, a few days ago, told Welt am Sonntag : “Moldova, Georgia and Ukraine are three countries in our eastern neighbourhood that have taken sovereign decisions to sign an association agreement with the EU”. She added: “Russia is creating problems for all three of these countries”.”
“I think that the unified European Union response on sanctions has been helpful in that context, but, as I have said, NATO is our principal source of collective defence. Let me also say to my hon. Friend that if he secures the policy for which he has worked for many years, he should bear in mind who will be cheering most in the context that we are currently discussing.”
“That path would lead to the lifting of sanctions, it would improve conditions for the Russian people, and it would gain Russia greater respect in the world. So we should be firm, we should be resolute in helping, and we should offer our assistance to Ukraine in terms of the sanctions and the governance help I have set out, but we should also be clear that this alternative future remains open to Russia and that it is far preferable to the current direction of relations between us.”
“Would the Minister consider offering similar help to Ukraine at this difficult time—if it has not already been offered—so that it can improve its governance, enhance transparency, and increase confidence in the democratic process? The situation both within Ukraine and between Ukraine and Russia poses great dangers for stability and for peace. A huge amount of commitment and vigilance has gone into developing a network of states that do not transgress one another’s borders and do not foment nationalist and separatist movements within states. We defend this settlement and realise its value. Of course there is potentially a different future for relations between Russia and other European states. Russia could cease aggression. It could let Ukraine choose its own path. It could respect the territorial integrity of other states.”
“There has been a 7% contraction in Ukraine’s GDP this year, and inflation is running at around 22%. The IMF now believes that, on top of the $17 billion aid package that was announced in April this year, a further $15 billion is needed. The Ukrainian economy is in deep trouble, and in urgent need of stabilisation. In governance terms, too, the country needs both reform and help, and Britain could play a valuable role in that regard. In the early 2000s, this country offered help to new democracies of eastern Europe in the form of advice on and assistance in the running of Ministries, robust budgeting, and the transparency of actions. That help was valuable and important to those countries at the time.”
“I need to make some progress, and allow the Minister to wind up. The issue between Ukraine and Russia is not the only relevant factor. We should also consider the economic health and the strength of democracy in Ukraine itself. Of course those issues are related, because as long as Russia backs the separatists in the east, it will be all the more difficult for Ukraine to recover and stabilise economically. Indeed, as well as the geopolitical aim that was referred to by the hon. Member for Beckenham, it may be a Russian aim never to allow Kiev to have full economic control of the east. Ukraine has a new President and a new Parliament, and they have the urgent task of not only defending the country’s territorial integrity, but stabilising the economy and delivering honest government.”
“They want an excellent system that offers high quality integrated care that minimises hospital admissions, manages pain treatment and enhances quality of life wherever they live in the country. The experience of patients, as told to me and to others, is that we are still a long way from having a system in place that delivers that standard of care wherever people live. I pay tribute to the work of the Wolverhampton sickle cell care and social activity centre based in Bilston in my constituency and to the other patient-led groups around the country, to the Sickle Cell Society, which is the national organisation that speaks up for sufferers, and to the work of the all-party group on sickle cell and thalassaemia, which is chaired by my hon. Friend the Member for Hackney North and Stoke Newington (Ms Abbott).”
“There is no known cure and for those who have it, the symptoms can vary from relatively mild, infrequent pain to much more serious episodes of crisis, frequent hospital admissions, strokes, often in very young people, organ damage and reduced life span. At the heart of the debate about treatment for the condition lies one simple question: why, with all the progress that has been made—there has been progress—is there still such variability in the treatment for sufferers, leading to enormous and debilitating pain, unnecessary and expensive hospital admissions and damaging consequences for the families of those who suffer from sickle cell anaemia? Some hospitals and some specialist care units do a fantastic job, but patients with sickle cell anaemia do not want islands of excellence.”
“It is a pleasure to debate this matter under your chairmanship, Mr Owen. Sickle cell anaemia affects an estimated 12,000 to 15,000 people in the UK and around 400 people in the west midlands, where my constituency lies. The associated condition, thalassaemia, affects around 1,000 people, although hundreds of thousands more in our country carry the trait for these conditions. They mainly, but not exclusively, affect the Afro-Caribbean community. Sickle cell anaemia is the most common genetically inherited condition in the UK. Roughly one baby every day is born with the condition in our country.”
“It is time we ensured that the best care is available to all sufferers, delivered by a system that understands the condition, fully respects the patient and allows sufferers to live as full a life as possible. I hope the Minister can respond to the issues I have raised today in a way that makes that more likely. On the issues for which he does not have immediate answers, I hope he will go back to the Department and press his officials to make sure the changes we know are needed happen.”
“In some ways, it is less about knowing what the best care looks like and more about ensuring that it is delivered to the highest standard throughout the country, regardless of where patients live. The condition also requires some smart, joined-up thinking between different agencies. Repeated hospital admissions because of a lack of a bed to sleep on is not a smart way to deal with a condition such as sickle cell. Sufferers have to put up with a life of pain, but good treatment, the right information and the right lifestyle can make an enormous difference. That treatment, information and help vary so much is not acceptable. Dignity and respect are essential for all NHS patients: sickle cell patients feeling they do not always get that should be a concern for us all.”
“Given that concern already exists about the large variation in the quality of treatment, knowledge of the condition and the priority given to it, sickle cell organisations fear that a move to only local CCG commissioning will exacerbate the problems. Can the Minister ensure that the way treatment is organised in future is in line with the central aim of the peer review exercise—to deal with the variability of treatment issue—rather than its being organised in such a way as to make it more difficult? I repeat that our aim should be a system that makes the best the norm, rather than balkanising care and creating a lottery, depending on where sufferers live. Sickle cell anaemia is an issue that deserves more attention than it has received and a greater priority in the delivery of high-quality health care.”
“I appreciate the cost pressures on the NHS, but will the Minister agree to commission a departmental analysis on whether free prescriptions for sickle cell sufferers would cost money or lead to net savings because they would reduce avoidable hospital admissions? What of how sickle cell care is to be delivered in the future? NHS England is currently the body responsible for commissioning care for rare diseases. That is sensible, because sufferers might be concentrated in different parts of the country and sometimes there may be few sufferers. However, a review is taking place into how that will be done in the future, the results of which are due next year. There are three possible models: continuing with national commissioning, co-commissioning with clinical commissioning groups locally, or leaving it all to CCGs.”
“Those issues are absolutely central to the experience of sickle cell patients. Can the Minister tell us this morning what is happening to those peer review recommendations? Will he undertake to go through them not in a general way, but point by point, and to give a progress report to the House if not today, then soon and in writing? Such a report would be welcomed by sufferers and would ensure that there was follow-up on these important recommendations. Then there is, for patients, the basic cost of living with the condition. To live with sickle cell is to live with pain, and that often means frequent prescriptions. For some patients, the cost can be prohibitive. This is not just a matter of money, but of behaviour. If people do not use their pain relief efficiently because they cannot afford more, it can affect their condition.”
“If there are sufferers of a genetically inherited condition who do not feel they are being treated as such, that is not acceptable and something we should take very seriously indeed. Another issue identified by the peer review process is poor quality of data. That leaves us unsure about the number of sufferers and unsure, beyond emergency admissions, about the resources devoted to treating the condition. How can we ensure that there is the right treatment if we do not know how many sufferers there are or where they are? What is the Minister doing to improve those clearly identifiable data problems? The peer review made a number of good and important recommendations about access to specialist care, staffing levels, training, psychological support and managing the important transition between paediatric and adult care.”