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23 Mar 2007 : Column 1119

When the DVLA entered the cherished numbers market in 1989, perhaps a dozen private businesses traded in used registration marks. Today, there are more than 150 registration mark traders. Many traders deal in marks that are already in use on vehicles, as well as trading in unissued marks, which are available only from the DVLA.

Number dealers currently account for some 35 per cent. of the registrations sold by the DVLA. The sale of marks website is one of the most visited in Government, with some 800 million hits each year. In the next two years, the site will be redeveloped to provide online payment and purchasing facilities. That has been prompted by rapid changes in technology and a greater understanding of customer needs and demands. Customers currently research the website on a 24/7 basis for their desired mark but have to make the purchase during office hours.

When buying the rights to display a registration mark, the purchaser does not acquire legal title to that mark. Purchasers acquire only the right to display the registration mark on an eligible vehicle. The services provided by the DVLA for the acquisition, assignment and transfer of registration marks must be operated in a way that does not compromise the fundamental purpose of vehicle registration marks. Strict requirements are therefore in place for those facilities. My hon. Friend the Member for Plymouth, Sutton emphasised that in her contribution. It is vital that we do not allow fraud to occur.

It is always difficult to identify a desirable mark or an offensive mark, or the different ways that people may use to try to cheat any system that we introduce. Thorough processes and procedures therefore need to be in place to ensure that we have covered all those matters.

Linda Gilroy: Does my hon. Friend feel that sufficient consultation has taken place, including with ACPO? As I said earlier, I did not get a sense from the regulatory impact assessment that that had been done, and I would greatly welcome further information.

Dr. Ladyman: My hon. Friend is right to highlight that point. My understanding is that the police are comfortable with the proposed change. However, I promise that, if the House sends the Bill into Committee, we will double-check that the police are happy. I assure her that we do not intend to allow changes to the system that would permit fraud, and we do not believe that the Bill would have that effect. However, the retention facility that the measure aims to amend had to be withdrawn in 1977 because of abuses of the scheme. It is therefore important that we are alive to the possibility.

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The increasing value of these marks means that the system is open to abuse, as people will try to find ways to cheat others out of valuable marks and the money that comes with them. The DVLA recognises that there will be circumstances where people will try to cheat the system, which is why the changes have been carefully controlled and the procedures carefully planned.

I am absolutely confident—and can give my hon. Friends and the hon. Member for Croydon, South my assurance—that there is no way in which this reform will make it easier to cheat the system. The Bill does not weaken any existing provisions. If it is implemented, all existing standards and legislation will stay in place. As I said, I will check with ACPO to ensure that it remains happy with the scheme.

The Bill’s purpose is to make people’s life just a little bit easier. It will not be necessary to chase the owner of the registration mark each year on retention. The assignment of the right to retention can be made at the point of sale, so people cannot disappear or try to re-sell the mark at any particular time in the future, thereby causing what the hon. Member for Croydon, South identified as a potentially interesting legal situation. We are absolutely confident that these proposals are nothing more than a sensible simplification of the system.

Linda Gilroy: Given that we have seen large reductions in this area of crime, has the Minister consulted his colleagues in the Home Office about the security aspects of the Bill?

Dr. Ladyman: I can assure my hon. Friend that the Home Office is perfectly happy with the proposed changes. I work closely with my colleagues in the Home Office on such matters. Serious issues of security were identified, which always have to be taken into account, particularly if we are to enforce road legislation and deny criminals the use of the road. I believe that this reform will not make that more difficult. Rather, it will simplify the lives of people trading in number plates and those who decide to sell their registration mark in the future. It will make their transactions slightly more profitable and less open to cheating.

I am delighted to say, on behalf of the Government, that we commend the Bill to the House. We congratulate the hon. Gentleman on introducing it. If the House agrees that it should go into Committee, I look forward to working with him. We hope that it will go on the statute book in due course.

Question put and agreed to.

Bill accordingly read a Second time , and committed to a Public Bill Committee.

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Cystic Fibrosis (Exemption from Prescription Charges) Bill

Order for Second Reading read.

2.8 pm

Mr. John Hayes (South Holland and The Deepings) (Con): I beg to move, That the Bill be now read a Second time.

When Members get drawn in the private Members’ ballot, a dilemma becomes apparent: should we grandstand on a controversial issue that is bound to attract notice—something spicy and irresistible to press and public, a Bill that embodies contentious sentiments that the promoter believes are vital and essential to the whole nation’s future, but nevertheless would have no chance whatever of becoming law—or should we opt for a modest, sensible measure that will not make us famous but might have a real chance of moving hearts and minds in the House, thereby changing public policy?

Despite suffering from the burning temptation that afflicts all who believe that they alone know the solution to the problem of the meaning of life of opting for the first type of Bill, I opted for the second—recalling, as F. D. Roosevelt said, that the “true conservative” is

It is thus with great pride and faith in the reason and fairness of my parliamentary colleagues of all parties that I present this Bill to exempt cystic fibrosis sufferers from prescription charges.

This short, straightforward Bill aims to correct an anomaly—to right a wrong. I will explain why and how, and talk a little about the context, in five points. First, in 1968, the British Medical Association drew up a list of conditions that would thereafter be exempt from prescription charges. They were defined as those

At that time, the vast majority of cystic fibrosis sufferers died in infancy, and the condition was left off the list because then, as now, children were exempt from prescription charges.

Secondly, medical advances have, fortunately, meant that the outlook for sufferers has improved markedly over the past few decades. Average life expectancy is now 31 years, but while times have changed for those affected, the conditions that are exempt from prescription charges remain stuck in a 1968 time warp. Adults with cystic fibrosis are therefore still obliged to pay prescription charges.

My third point is that these are typically people whose education and employment prospects have been profoundly disadvantaged by their ill health. Many are in low income brackets and struggle to make ends meet while coping with a degenerative condition. On top of that, they have to contend with making extra payments for which, according to the British Medical Association’s own criteria, they simply should not be liable.

Fourthly, this anomaly has been recognised for some time by people across the House. It is not a partisan
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issue. Indeed, my attempt to put it right has received support from Members across parties. Before they came to power in 1997, those who are now in government specifically pledged to deal with this injustice, if enabled by office to do so. Hon. Members will no doubt remember that, in 1994, the Labour party—then in opposition—drew up a paper making exactly the case that I am repeating today. Two years ago, my former colleague, Archie Norman, then the Member for Tunbridge Wells, raised the matter, as I have done, through a private Member’s Bill. Sadly, parliamentary time constraints meant that it fell at the first hurdle. I first revived the issue at Prime Minister’s questions last July, when I was assured that the Government were reviewing the matter within existing NHS budget constraints. It is no surprise, therefore, that when I was drawn in the ballot for private Members’ Bills, I decided to use the opportunity to raise the matter again.

My fifth point concerns the surprisingly small cost of including cystic fibrosis on the exempt list. Of the 7,500 people in the United Kingdom with cystic fibrosis, about half are aged 16 or over. Roughly a third of those are in higher education, while another third are too ill to work and are in receipt of benefits. That leaves just around a third of the adult sufferers—about 1,250 people—paying prescription charges. Most pay by annual season ticket, which involves the prepayment of £95.30 for a year. This means that the total cost of including cystic fibrosis patients on the exempt list would be less than £120,000 a year. That could certainly be accomplished within the range of the review that the Government are conducting, which assumes that existing NHS budgets would not be exceeded.

I can tell, however, that questions will be fermenting in the minds of Ministers and perhaps even shadow Ministers: “Why this condition alone? Are not others equally worthy of such an exemption?” The answer is that, unlike some other conditions, cystic fibrosis meets exactly the exemption criteria laid out by the British Medical Association in 1968. It is readily identifiable, and virtually all cases call automatically for prolonged continuous medication.

Kerry McCarthy (Bristol, East) (Lab): I congratulate the hon. Gentleman on taking the opportunity to raise this issue in the House. I have a young niece with cystic fibrosis, so I am very aware of the hardships, financial and otherwise, accompanying the condition. Is he aware that, according to the Cystic Fibrosis Trust, a child born today with cystic fibrosis can expect to live into their late 40s, as opposed to the average age of 31 that he mentioned? That emphasises his point about the condition requiring treatment over a long time.

Mr. Hayes: That is a good point, and I am grateful to the hon. Lady for mentioning the Cystic Fibrosis Trust, which, along with the British Lung Foundation, has greatly assisted me in bringing these matters to the House’s attention. The point to which she draws attention is a double-edged sword, because as people live longer, the demand on the Exchequer might be deemed to be greater. It is very good news for sufferers, however, and as medical advance is dynamic rather than static by definition, the kind of treatment that we
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can provide might become cheaper and more readily available, and might even lead to a cure. Therefore, when we consider the changing circumstances, we should not automatically assume ever greater costs. Nevertheless, the hon. Lady makes a useful additional remark, which I hope will aid my case.

As I said, there is more than one reason why cystic fibrosis should attract our concern and assistance. It is not only easy to identify but particularly easy to compartmentalise, whereas some of the other conditions vying for a place on the exempt list—and I do not for a moment make light of them—are harder to put into a compartment. Congenital heart disease, for example, is a complex condition covering a range of medical problems, and would be hard to identify so precisely. An undue burden would be placed on those with authority over such matters, as they would be uncertain about the scope of the cost of dealing with such a condition. As the Minister—who has much greater expertise than I have—knows, a number of other conditions are, similarly, much harder to identify clearly and precisely than cystic fibrosis.

The other reason the condition demands such attention is that exempting it from prescription charges is affordable within existing budgets. The estimated sum of less than £200,000 is surely achievable within an NHS annual drugs budget of nearly £7 billion. As I have said, the Government’s review currently assumes no additional expenditure, which, incidentally, is an assumption reflected in the Bill.

Members might wonder why I have taken this matter to my heart. In part, I have done so because a close friend died a couple of years ago from the repercussions of acute fibrosis, and her experience of many years of illness encouraged me to take an interest in the issue, to learn more about it, and to seize the opportunity afforded to those privileged enough to be Members of Parliament to advance the cause.

With your infinite wisdom and long experience, Mr. Deputy Speaker, you know that the House sometimes makes mistakes. More often, however, it comes to the right conclusion in the end, as we were reminded this week when we debated the bicentenary of William Wilberforce’s campaign to abolish the slave trade. Against the odds, Wilberforce fought to make a difference and for social justice. He fought a long campaign on a great issue. My campaign is small, straightforward and humble. To the people affected, however, it would make an enormous difference. Another great Tory, Benjamin Disraeli, said that justice is truth in action. The truth is that Governments sometimes make mistakes too, but they also sometimes take action to make things right. That has much less to do with party than with the nature of fallen men and women’s innate frailty and habitual endeavour to improve.

Today, let us put this matter right by recognising the simple truth of the case and so take action on behalf of a group of long-suffering, vulnerable and deserving people. I hope that the Government will back the Bill, but if for whatever reason the Minister cannot manage to do so today, I hope that that will not be the end of the matter. I hope that in the course of their review the Government will take further advice and receive representations. If the Bill does not sail through Parliament as I expect it to, I shall be happy to make
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my own small contribution to any further consideration in the coming days, weeks and months.

I am grateful to you, Mr. Deputy Speaker, and to the House for its indulgence in allowing me to make my case on behalf of sufferers from cystic fibrosis.

2.20 pm

Meg Hillier (Hackney, South and Shoreditch) (Lab/Co-op): I will be brief, as time is short.

I congratulate the hon. Member for South Holland and The Deepings (Mr. Hayes) not just on raising this important issue but on an eloquent and passionate speech that said all that needs to be said on behalf of people suffering from cystic fibrosis. The debate has also highlighted the way in which we spend health service funds.

As the hon. Gentleman said, the original exemptions list was drawn up in 1968. When it was last reviewed in 1998, cystic fibrosis was not added to it. It is not entirely clear to me why that is; the hon. Gentleman might wish to intervene to explain. It might be partly because of progress in medical research, as he suggested. As he said, when the list was first drawn up most sufferers did not survive beyond the age of 16, but now they are living longer. My neighbour’s daughter died of cystic fibrosis at the age of about 30.

Mr. Hayes: I am grateful to the hon. Lady, of whom I am an immense admirer. That will blight her career if nothing else does!

I have discussed the review informally with Ministers. The truth is that throughout consideration of the list, different conditions have been vying for a place on it. Because of the dynamic nature of those conditions and their treatment, it has always been very difficult for Ministers of any political party to make a judgment about what should and should not be on the list. I do not deny that the issue is complex, and I do not suggest that this is a black-and-white case, but I think that cystic fibrosis stands out as a condition that is definable and whose treatment is affordable.

Meg Hillier: I thank the hon. Gentleman for his intervention, but I think that the lack of consensus is a problem. I support much of what he said, and I would naturally support the idea of free prescriptions for cystic fibrosis sufferers; however, I also represent people with many other conditions. I fear that if we pass a private Member’s Bill dealing with one condition, we will see a rash of private Members’ Bills dealing with many other conditions, and there will be no coherence in the system. However difficult it may be, I believe that we should have the capacity, in Government and in Parliament, to achieve a broad consensus that produces a better result across the board rather than just for one group.

I support much of what the hon. Gentleman has said and I wish the Bill well, but I wonder whether it is the best vehicle for achieving what he wants. I echo his comments to the Minister about the review that the Government are undertaking. I agree that it should take a proper, robust look at this issue, but I do not think that that should involve endless delay. We have waited long enough for the issue to be dealt with one way or another. I also think that the review should look
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closely at the parameters of any exemption, so that exemptions are about the condition—cystic fibrosis, or any other condition—and not about medical or drug needs that might arise for other reasons. Otherwise, the system could be open to abuse.

May I ask the Minister what consideration the Government have given recently to exempting cystic fibrosis, whether any consideration has been given to any other long-terms conditions, and what representations she has had from other groups? If she is not willing to exempt cystic fibrosis, what action might the Department of Health take to deal with the anomalies in general? Perhaps she could also comment on the cost element that the hon. Gentleman raised.

Time is short, so I will end my speech here. I congratulate the hon. Gentleman again on raising this important subject.

2.24 pm

The Minister of State, Department of Health (Ms Rosie Winterton): I congratulate the hon. Member for South Holland and The Deepings (Mr. Hayes) on his success in the private Members’ ballot and on drawing the issue under discussion to the attention of the House. I also thank my hon. Friends the Members for Bristol, East (Kerry McCarthy) and for Hackney, South and Shoreditch (Meg Hillier) for their contributions.

The hon. Gentleman made some important points, and all the contributions have reflected the difficulties involved in this issue. The hon. Gentleman is right that cystic fibrosis is the most common inheritable disorder in the country; it affects about 7,500 children and adults. However, it is also true that there have been considerable improvements in the care of, and services for, people with cystic fibrosis. It is marvellous that 75 per cent. of sufferers now survive into adulthood. Two decades ago, only 12 per cent. of affected children survived into adolescence. That increased survival rate is the result of improvements in treatment, better care and the work of certain organisations—I join all Members in paying tribute to the Cystic Fibrosis Trust, which has done much to draw attention to its cause.

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