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Mr Nuttall: I can only speculate that it is perhaps as a result of yesterday’s by-election in the parliamentary constituency of Eastleigh, which I am sad to say was won not by the party to which both my hon. Friend and I belong, nor by the party of Her Majesty’s loyal Opposition, but by our coalition partners in government, the Liberal Democrats. It may be that, inexplicably, they found it necessary to celebrate long into the wee, small hours of the night their success in holding what was a Liberal Democrat seat in the first place, and that as a result of that celebration not one of them has managed to make it on to their Benches this morning.
Charlie Elphicke: I thank my hon. Friend for his extremely generous comments. Would he care to comment on the absence of Labour Members? Considering that they made this massive change to the British constitution, putting us under the hegemony of a foreign court and undermining our justice system so wholeheartedly, is it not amazing that they have not turned up to defend it?
Mr Nuttall: It is indeed disappointing that we have not yet had the pleasure of hearing Opposition Members’ thoughts and observations on the Bill. I hope that we will hear from them later in proceedings. Perhaps, just as I am disappointed not to have heard from them, they are disappointed about their by-election performance and are commiserating with each other.
Let me say at the outset that I would have preferred the Bill merely to repeal the Human Rights Act and to make it clear that we would no longer accept the rulings of the European Court of Human Rights. I appreciate what my hon. Friend the Member for Dover said about the nature of international treaties, but it ought to be for this House to give a steer by stating that we think it is time to pull out of the European convention on human rights. I will explain, over the course of my comments, why I think that would be reasonable and feasible, why we could do it without any loss of international influence and why it would be entirely in tune with what the British people expect us to do.
My mind is taken back to the run-up to the last general election, when I detected two common themes that were brought up on the doorsteps, in street surgeries and when I chatted to people on the phone. I am not saying this to be directly critical of the previous Administration; this is just a fact and how I found it. First, people were concerned about what has been described as the “something for nothing” culture. I will not go down that avenue, because it has nothing to do with today’s proceedings. Secondly, they were concerned about the whole arena of human rights and the way they had been enforced in the years following the passage of the Human Rights Act. There was a feeling that we had somehow been dragged down a road that meant that criminals—I will hopefully have an opportunity to explore this in more detail later—are the one group in society who have the time to analyse in depth the detailed provisions of human rights legislation. That group, spurred on by lawyers, seem to have adopted the whole field as a lucrative source of income while incarcerated in one of Her Majesty’s prisons. That, above all, is what has caused my constituents, at least, to feel that somehow the system is letting them down. To put it in a nutshell, that is bringing the whole field of human rights into disrepute.
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Perhaps I would not have introduced the Bill in exactly the same form, but it is nevertheless absolutely a step in the right direction. In common with my constituents, I am far from satisfied that the current position is acceptable, and what the Bill proposes would be far preferable. It would establish a situation that was much more even-handed and fair to the British people than currently, where our constituents feel that it is entirely wrong that time and again what they see as a foreign court is telling our courts and, in essence, this House what they should and should not be doing.
Charlie Elphicke: Is not the key and central point that we need to get the convention and the European Court of Human Rights out of our legal system so that our courts are not hog-tied by the European Court but can follow the hundreds of years of case law that has been developed in the English legal system?
Mr Nuttall: I am grateful to my hon. Friend for that intervention, because he hits the nail on the head. Part of the problem with the whole arena of human rights legislation is that, as the years have passed, particularly as the process has speeded up since 1998, we have ended up in a situation where because of judicial activism there is almost no end to the triviality of the cases that are being brought before the Court. I have some figures on that to which I may refer later. That brings the whole field of human rights into disrepute.
People traditionally thought of human rights in the context of what happened during the last century when unspeakable atrocities were inflicted on men and women by, principally, the Nazis in the second world war, and also behind the iron curtain. My right hon. Friend the Lord Chancellor said in an article in, I think, The Daily Telegraph before Christmas that anyone who is concerned about human rights should be aware of what Alexander Solzhenitsyn wrote in his portrayals of the brutality of the Soviet gulags under Stalin and his successors. Local Communist party members were sent to labour camps without trial for crimes as trivial as being the first to stop applauding at the end of a meeting. Peasant farmers were driven off their land and literally dumped at the end of a railway line in the heart of Siberia and left to fend for themselves or die. People were tortured to death in the basement of Moscow’s Lubyanka prison.
It was having in mind the atrocities that had happened in parts of Europe in the 1930s and ’40s that inspired Winston Churchill and other democratic leaders to come to together in the aftermath of the second world war to forge the European convention on human rights, which was signed in Rome back in 1950. It set out the fundamental rights regarded as the absolute basis for a democratic nation at the time, such as the right to life, the right not to be tortured and the right to a fair trial, which are not the sorts of things that we have seen litigation on in recent times.
It would be remiss of me not to welcome my hon. Friend the Member for Cheltenham (Martin Horwood) to the Chamber, given that we have commented on the absence of Liberal Democrats. We are delighted to see him here—he obviously did not celebrate last night’s result in Eastleigh too much—and look forward to hearing the Liberal Democrats’ views on the Bill later.
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I have set out the background against which the 1950 European convention was crafted. What has gone wrong? We seem to have moved away from those very high moral principles. Although I hesitate to venture down that road, I will dare to do so in the absence of my hon. Friends the Members for Penrith and The Border and for North East Somerset. We have moved a long way from the sorts of rights that were in the minds of the draftsmen of the 1950 convention to where we are today.
Claiming that an individual’s human rights have been infringed has become something of a niche industry in the legal sector. There are now lawyers who appear to do very little else but engage themselves in making claims that one or other persons have had their human rights infringed. It is obviously a lucrative business. They often work at the taxpayers’ expense, thanks to the availability of legal aid. I would be interested to know—perhaps the Minister will be able to tell us this—how many of the claims relating to human rights legislation that go through the courts are funded privately. I venture to submit that there are very few indeed and suspect that the majority are funded through legal aid, a no win, no fee agreement, or charity sponsorship. I suspect that very few individuals pay for their own cases to go to court.
That is a double whammy for the taxpayer, because as well as paying the costs of bringing the case, the British taxpayer picks up the bill if the case is lost but the European Court of Human Rights finds that there has been a breach of an individual’s human rights. In fact, it is probably a triple whammy, because as well as paying the legal aid bill and any damages awarded, we also have to pay the costs of those Government lawyers and civil servants who defend the case. As we have heard from my hon. Friend the Member for Dover, it was revealed recently in a parliamentary answer that Abu Qatada has received about half a million pounds of taxpayers’ money through the legal aid system to pursue his apparently never-ending series of appeals. I do not think that my constituents are alone when they express to me their outrage at the current system.
Charlie Elphicke: My constituents take the view that the half a million pounds that Abu Qatada has been given in legal aid could have been used to great effect to employ more teachers, nurses and doctors and to provide better public services. One reason why people are very critical of Labour for having brought in the Human Rights Act is that it has put an even greater strain on the public finances.
Mr Nuttall:
My hon. Friend is absolutely right. Our constituents are outraged not because of human rights per se, but because of the knock-on effect and where it is leading us as a country. They see the hard-earned money that they have handed over to the Government in taxes being spent on cases, the majority of which are seen as trying it on. They see criminals behind bars bringing cases that are nothing more than fishing expeditions. The criminals have nothing to lose personally if the cases fail and everything to gain if they are successful. From the lawyers’ point of view, if they are being funded through the legal aid system, as is the case with prisoner voting, and they are successful with one case, they can go farming among the prison population
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to find dozens, hundreds or perhaps even thousands of other cases that they can adopt and bring forward for adjudication in order to claim damages.
Charlie Elphicke: Is it any wonder that the overwhelming majority of people tell pollsters that they see the Human Rights Act as a charter for criminals, the undeserving and lawyers? That is a key reason why we should have a new settlement to rebalance the situation and get some real justice back in the UK.
Mr Nuttall: My hon. Friend is absolutely right. That is one of the key reasons why the majority of people in this country would support the Bill.
We have not heard from the Opposition or our friends in the Liberal Democrat party. Perhaps they have been convinced by the strength of the arguments this morning, but they may well oppose the Bill. However, I find that supporters of all political parties support what my hon. Friend’s Bill seeks to do. It is not a party political issue among ordinary voters. They are all equally outraged at some of the cases that have hit the headlines in recent years. I agree with my hon. Friend that people see the Human Rights Act as something that diverts their hard-earned taxpayers’ funds away from the things that they should be spent on, such as providing more doctors and nurses, to paying lawyers to bring forward spurious cases.
Perhaps I could refer the House to one such case. Samuel Betteridge was a young man who raped a 14-year-old girl after luring her to his flat and forcing her to drink alcohol. In 2005 he admitted at Lincoln Crown court two counts of rape and one of attempted rape. His minimum jail term of five years was later reduced on appeal to three and a half years. His parole hearing was fixed for May 2009 but later postponed until January 2010.
Through his lawyers, Mr Betteridge appealed to the European Court of Human Rights on the grounds that the delay in his parole hearing violated article 5 of the European convention on human rights—the right to a speedy hearing. The Strasbourg judges, needless to say, agreed with Mr Betteridge’s submission and found in his favour. They said that
“the delay in reviewing Mr Betteridge’s case was the direct result of the failure of the authorities to anticipate the demand which would be placed on the prison system following the introduction of IPP sentencing”.
Those are indeterminate public protection sentences which, as the hon. Member for Hammersmith (Mr Slaughter) and other hon. Members know, are now being abolished—[Interruption.] Yes, changed; effectively abolished, perhaps.
Mr Andy Slaughter (Hammersmith) (Lab): I will address the hon. Gentleman’s request for the Opposition’s views on the issue under discussion, but IPPs are being abolished, which Opposition Members think is something of a shame. The issues of public protection that the hon. Gentleman mentions, and the balance between the offender and the victim, are being changed not for better but for worse.
Mr Nuttall:
If my memory serves me rightly, together with my hon. Friend the Member for Shipley (Philip Davies) I took a similar view on that matter and—
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I think—went into the Division Lobby to try to avoid it happening. There is a place for such sentences but I do not want to be drawn down that avenue. This debate is not about sentencing policy, but that was the subject of the case I mentioned and it is therefore right at least to touch on how it came about.
The High Court in London originally dismissed the case, but the European Court of Human Rights backed Mr Betteridge and awarded the rapist £640 in damages plus £1,710 in legal fees—I bet that did not go far towards paying those fees. According to my information, Mr Betteridge was apparently not alone in receiving payments for delayed parole hearings and was one of 100 prisoners who has received in total more than £313,000 over the past three years as a result of an alleged breach, found to be an actual breach, of their human rights. Most of our constituents would agree with Robert Oxley of the TaxPayers Alliance who said:
“It’s disgusting that taxpayers are being made to pay for an award to a rapist thanks to European Court meddling.”
Of course, he was referring to the European Court of Human Rights, not the European Court of Justice.
As the House is aware, that was not the only case to hit the headlines. A case with an even more substantial effect, certainly on proceedings in this place, was that of Hirst, which was, in effect, the leading case on prisoner voting rights. In 1979, John Hirst used an axe to kill his landlady in her own home. In the following year he was convicted of manslaughter on the grounds of diminished responsibility and sentenced to life imprisonment with a tariff of 15 years, after which he could be released on licence. In fact, he was not released until May 2004 because of concerns that he might present a danger to the public; for example, he was found guilty of an offence under prison rules when, in 1998, he slammed a van door against a female prisoner officer.
Mr Hirst used his time in prison to teach himself law. He became a student of human rights legislation and a serial litigant against the authorities. There is no time this morning to go into his various cases, but suffice it to say that in one of them the court ordered that the Government pay Hirst £1,000 in damages and a further £7,500 in costs. That was before what we might call his cause célèbre—Hirst v. United Kingdom (No. 2)—which was to prove far more controversial, and related to whether his human rights had been violated because he was not able to vote while he was in prison.
Charlie Elphicke: The case of Hirst is entirely clear-cut. He is a man soaked in blood. He is remorseless and unapologetic, yet he uses taxpayers’ money to seek the right to vote. I am hard pressed to think of a more despicable and evil person in this country.
Mr Nuttall: My hon. Friend echoes the views of many millions of our constituents across the country. Hirst submitted a claim to the European court based on article 3 of the first protocol—the right to free elections—which states:
“The High Contracting Parties undertake to hold free elections at reasonable intervals by secret ballot, under conditions which will ensure the free expression of the opinion of the people in the choice of the legislature.”
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The wording of article 3 does not actually confer individuals with a right to vote. When the Grand Chamber gave its judgment, it stretched a point; the court had already decided in the case of Mathieu-Mohin and Clerfayt v. Belgium that article 3 included an individual’s right to vote and to stand for election.
It is illuminating to consider how Hirst built on the previous Mathieu-Mohin case. It shows how rights are developed incrementally, case by case, salami-slicing common sense and gradually moving away from what most people would think article 3—in this case—actually meant. As was discussed during our debates on prisoner voting, the Court ruled that this issue had not been considered here. I submit that it was considered in section 3 of the Representation of the People Act 1983. It may not have been debated specifically—I was not here at the time—but presumably that was because both sides of the House took it for granted that prisoners would not have the vote. That was accepted by the whole country and the whole House.
Mr Chope: Is not one of the most critical issues the way in which the Court interpreted the amendment through the protocol, which was contrary to the rules of interpretation of the Vienna convention? If we had stuck to those strict rules, we would not have got into the difficulty we are in at the moment.
Mr Nuttall: I bow to my hon. Friend’s greater knowledge of these matters, and I am sure that he is absolutely right. We have allowed ourselves to stray from the original meaning of the article.
I will not detain the House for much longer on the prisoner voting case, but it strikes at the heart of the issue. The Court is, in effect, saying that this House cannot decide for itself what to do and who it can allow to vote in our elections, and that somehow people such as Hirst, a convicted axe killer, should be allowed to vote and decide who has the right to sit in this Chamber. Most of my constituents would say, without hesitation or doubt, that that cannot be right, and it is because of such cases that it is right for us to consider the Bill promoted by my hon. Friend the Member for Dover.
One problem with the European Court of Human Rights is that 47 nations—it is not the same as the European Union, which has 27 members, shortly to be 28—have signed up to the European convention on human rights. With a population of some 800 million, any one of whom can choose to bring a case at any time, it is unsurprising that an avalanche of cases has been brought before the Court. The evidence of the Court’s statistics calls into question how genuine some of those cases are. I looked briefly at the Court’s website, which lists what it calls “rule 39 requests” granted in the past five years for all 47 countries. That gives us an idea of how many countries out of the 47 did not have any cases against them at all. One would have thought that, if the convention were really dealing with serious breaches of human rights, the odd case might be brought before the Court from somewhere in Europe, bearing in mind that all the countries concerned are democracies that operate under the rule of law. One might expect the odd case, here or there, to be brought before the Court.
In fact, only Andorra and Montenegro had zeros beside their name on that list. At the other end of the scale, the United Kingdom soared up to the top with
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5,176 cases. Using that yardstick, one would assume that we had a worse human rights record than any other country, but that makes no logical sense. I believe that those figures are, in fact, attributable to the assiduity of our human rights lawyers in bringing cases to the attention of our courts and then taking them to appeal in Europe, particularly since the passage of the 1998 Act, rather than to any failing on the part of our Government or, to be fair, the last Labour Government. Yet anyone glancing casually at those figures might assume that those Governments had been going around inflicting atrocities on people.
Mention was made earlier of the Brighton declaration, and I believe that the Government have done good work in that regard. It was entirely right that we should use our presidency of the Council to try to bring some common sense to the system and to reform the way in which the Court operates, but I am not sure that that endeavour has met with a great deal of success. I looked at the latest figures available, which represent a snapshot taken on 31 January this year. That makes them quite up to date in terms of Government and international statistics. They showed a total of 126, 850 outstanding applications to the Court, including 3,250 from the United Kingdom. We were not top of that particular chart; other countries had far higher numbers than us. Russia, for example, had 27,450 pending cases. This demonstrates the fact that, with 800 million people entitled to bring their cases before the Court, there is a huge backlog.
One advantage of my hon. Friend’s Bill for the British people is that, by effectively repatriating these powers back to the United Kingdom, it will make things far easier for anyone with a genuine grievance, and who genuinely feels that their human rights have been infringed, because their case will be dealt with entirely within this country.
My hon. Friend the Member for Dover has done a wonderful job. Much more could be said on this issue, and I fear that the time available today does not enable us to do it proper justice in many respects. I would have liked to deal with how we could withdraw from the European Court and the European convention and to explain why I believe that even if my hon. Friend’s Bill, which has much to commend it, were to become law, all we would be doing—unless we withdraw from the convention, as my hon. Friend the Member for Shipley said in an intervention some time ago—is creating another hurdle. As long as we are signed up and as long as people have the ability to go to Strasbourg, we will not solve the problem. Equally, as long as we are members of the European Union and as long as it has the desire to sign up to the European convention of human rights and to build on what it calls fundamental rights under the European Union Agency for Fundamental Rights, which we briefly discussed here a few days ago—and make no bones about it, this is where the leadership of the EU would like to go—we will not, frankly, solve this problem.
Let me finish with two points. First, in yesterday’s by-election, the majority of votes were cast, if not for parties, for candidates who believe as I do that we would be better off out of the European Union. Part of the reasoning is that we would free ourselves from the risk of being tied in to the European convention on human rights by the back door that would result from
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our membership of the EU. Finally, one problem with having this debate today is that it is the final Friday for private Members’ business in this Session. I only wish that this Bill had been able to be considered on the first and not the last Friday, so that it would genuinely have stood a chance of having further consideration in Committee—a Committee on which I would happily have served. I thank my hon. Friend the Member for Dover for bringing the Bill forward and look forward to hearing the remaining contributions to the debate.
1.13 pm
Mr Andy Slaughter (Hammersmith) (Lab): It is a great pleasure to follow the hon. Member for Bury North (Mr Nuttall) and to agree with him on the matter of IPPs—but not, I suspect, much else. We seem to be in the one-hour club, as we are averaging about an hour for each contribution. As someone who regularly exceeds that time in Committee—I get some criticism from the Whips on both sides when I do—it is nice to be among friends in that respect at least on a Friday morning. I am not, however, going to speak for more than an hour today, as I want to leave time for the Minister to respond and perhaps for us to move on to other business.
I do not think that, even if I wanted to, I could match the eloquence of some of the speeches that we have heard, particularly that of the hon. Member for Penrith and The Border (Rory Stewart) and his exchanges with the hon. Member for North East Somerset (Jacob Rees-Mogg). The hon. Member for Penrith and The Border made a compelling case on many issues, not least on minority rights. Human rights legislation is about individual rights, and it is often about minority rights and unpopular minority rights. That issue has not been much addressed in contributions today other than by the hon. Gentleman.
I hope that the hon. Member for Dover (Charlie Elphicke), who has produced a very impressive Bill, will forgive me, or will not misunderstand me, when I say that during his speech I thought that my article 3 rights might be affected—not, of course, because of his argument or his oratory, but because I felt that we had been here before. We have, in fact, been here before, as recently as last December, when the hon. Member for South Norfolk (Mr Bacon) presented a ten-minute rule Bill that proposed the abolition, or repeal, of the Human Rights Act. It was defeated by, I believe, 196 votes to 72. Although the debate was short, the arguments that were advanced were very similar to those that have been advanced today.
I mention that occasion—it was not the only occasion on which the House has discussed these matters—because I suspect that, notwithstanding the considerable effort that has gone into this Bill, it was born of frustration rather than a belief that it would ever reach the statute book. Under the coalition Government, there have been two consultations and a commission report. I think it is accepted on all sides that the resolution of the issue that the commission was set to consider is going nowhere, certainly during the current Parliament. That is clearly frustrating for some Conservative Members, but perhaps it is not surprising, given that in their respective manifestos one of the coalition parties promised to replace the Human Rights Act and the other promised to protect it. That is one of the clearest contradictions between the
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two parties. I am sorry if we are not going to hear from the Liberal Democrats today, perhaps for reasons connected with hangovers.
Martin Horwood (Cheltenham) (LD): I want to correct that statement, and also to reassure the hon. Gentleman of the Liberal Democrats’ support for the Human Rights Act. Let me point out to him that there is not a contradiction, but simply a disagreement between the coalition parties. That happens sometimes in coalitions, and he ought to welcome it.
Mr Slaughter: It may be a distinction without a difference; I do not know. The point is that, as was made pretty clear by the right hon. and learned Member for Rushcliffe (Mr Clarke)—the former Lord Chancellor and now Minister without Portfolio—when he was asked to pronounce on the subject, nothing will happen during the current Parliament. He is a supporter of the Human Rights Act. Indeed, as we have heard today, as we have heard from the Attorney-General and, for all I know, as we shall hear from the Minister for Policing and Criminal Justice, there are some fairly strong supporters of the Act in the Conservative party.
I believe—this may account for the rather sparse attendance of members of all parties today, apart from the four who have spoken so eloquently—that the issue will not be resolved by any method other than the continuation of the current Act, perhaps with additions or amendments. Nothing is perfect, particularly in this field. I do not think this will be resolved unless we have a majority Conservative Government, and, judging by the declaration of the returning officer in Eastleigh at 2.45 this morning, I think that that is an increasingly remote possibility in the foreseeable future.
I am not going to recite our reasons for enacting the human rights legislation. As my hon. Friend the Member for Dunfermline and West Fife (Thomas Docherty) said two months ago in response to the hon. Member for South Norfolk, we were and remain very proud of it, but, as several Members have pointed out today, it came about as a result of an historical process, and one which had support from all parties.
I think it fair to say that it was under Labour Governments that the principal advances were made, albeit with the support and encouragement of senior members of the Conservative party—none more senior than Winston Churchill, who, as early as 1943, proposed the foundation of the Council of Europe, and none more so than David Maxwell Fyfe, who was in large part the drafter of the convention. Although it came into effect in 1950, it was not until the late 1960s that British citizens had the right to go to the European Court, and not until the enactment of the Human Rights Act that human rights issues could be adjudicated in the British courts. All of that seems to me to be sensible progress, undertaken in a considered way that even, perhaps, the hon. Member for North East Somerset would approve of, as it took us some 40 or 50 years to decide how to address human rights. This has not been rushed into; it has been considered over a long period.
The whole purpose of the convention’s incorporation into English law is to give direct access to British judges and British courts, rather than matters having to be
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dealt with in Strasbourg. In fact, only about 10 judgments a year now come from Strasbourg. We intended that British citizens should be able to bring human rights cases to British courts in front of British judges, and I think we achieved that in the Human Rights Act. The Act enshrined in domestic law most of the rights contained in the convention, and it also included two additional clauses to underline the importance of freedom of conscience and religion and a free press.
The Act was deliberately crafted to ensure British courts were not merely an echo chamber of the European Court of Human Rights. It took the rights of the convention but allowed our judges to interpret them as they saw fit, meaning that while UK courts have to take account of Strasbourg case law on cases relating to a convention right, they do not have to incorporate it and can depart from it where appropriate. That was made explicit by the then Lord Chancellor, Lord Irvine, when he said domestic courts must be allowed “flexibility and discretion” in developing human rights law, which is precisely what the Human Rights Act gives.
It is for those reasons that we find it perplexing that Government Members find incorporation of the convention and having a British Human Rights Act to be less acceptable than the previous situation. As has been said, there are absolute rights, limited rights and qualified rights. Crucially, the Human Rights Act maintains parliamentary sovereignty and the supremacy of Parliament as the only law-making authority. If a British court finds that our legislation does not comply with the Human Rights Act, it cannot use the Act to force Parliament to change the law. Instead it will issue what is known as a declaration of incompatibility, and it will then be up to Parliament and Parliament alone to decide the best way to respond. It may choose not to respond at all. There are sufficient safeguards in respect of the margin of appreciation and other measures to permit the Act to function in the organic way intended.
It is true that there are problems with the exercise of jurisdiction by the European Court of Human Rights, and that it is an unwieldy body with a huge backlog of cases. Those matters can be addressed, however, but none of them is sufficient of itself for us to choose to opt out, which no other country apart from Belarus would contemplate. It would be damaging to both UK jurisdiction and our reputation abroad.
We hear many stories—often apocryphal, exaggerated or only partly told—about the deleterious effects of the Human Rights Act. In reality, however, it has empowered many individual citizens and vulnerable people in respect of domestic violence, disability, mental health, age discrimination, sexual orientation, religious discrimination, maintaining a private life and maintaining the right to protest. There have been landmark cases in all those areas. I will not go through them case by case, as they are a matter of public record. It remains the fact that this is a valuable addition to English law. It is not an alien creature. It is an important check on Executive and state power in the interests of the individual, and, frankly, it is worrying that this Government wish to attack the Human Rights Act, especially when considered alongside other steps they are taking to restrict legal aid and access to justice.
On Monday, the House will debate the Justice and Security Bill, which is another attempt to hide away, in an excessive way, public scrutiny and the right to fair
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and equal access to justice in this country. We should be looking for ways to expand and extend the rights of individual citizens, and that is exactly what the Human Rights Act did. As I said, Labour Members are extremely proud of that legislation. We do not say that it cannot be improved, but we do say it is wrong-headed and misconceived to think that by repealing the Act and trying to invent something in a unique way, separate from that which has been established, primarily through the agency of British lawyers and British politicians, over a period of 60 years, we are going to get a better deal. That is a fantasy on the part of some Government Members. They are not going to get their way in this Parliament and I hope that they will not get their way in any future Parliament. I hope that the Minister will confirm that it is the Government’s intention not to legislate in this Parliament in the way that has been indicated, be it through a private Member’s Bill or in any other way.
1.25 pm
The Minister for Policing and Criminal Justice (Damian Green): I start by congratulating my hon. Friend the Member for Dover (Charlie Elphicke), not only on the powerful case he made in his introductory speech and on choosing such a central and serious issue for his private Member’s Bill, but on the depth of the Bill itself. My hon. Friend the Member for Bury North (Mr Nuttall) made the point that this Bill is different from some of those debated here on a Friday morning, in that a huge amount of thought has clearly gone into the detail. My hon. Friend the Member for Dover is to be congratulated on that and on framing his speech in the way that he did. It was instructive that his speech and this Bill provoked the speech made by my hon. Friend the Member for Penrith and The Border (Rory Stewart) and the modern version of a Socratic dialogue between him and my hon. Friend the Member for North East Somerset (Jacob Rees-Mogg). A Friday morning when this House is forced to confront the difference between deontological and utilitarian responses to the moral consequences of our actions cannot be described as a Friday morning wasted. I think we all felt better educated and informed at the end of that dialogue, and that was even before my hon. Friend the Member for North East Somerset added to the philosophical wisdom we had from my hon. Friend the Member for Penrith and The Border with his own inimitable lecture on the history and the necessity of our being cognisant of the importance of history in all this House’s deliberations.
The Bill would make significant changes to the existing UK human rights framework to attempt to address a number of concerns that have been expressed throughout this debate. Those changes include: repealing the Human Rights Act; having the UK still bound by the European convention on human rights but with the convention no longer forming part of the UK legal system; and the creation of a new set of UK rights, which add to and alter the existing rights in the European convention. That would, for example, remove the possibility of using the right to family life as a means to avoid deportation.
It is probably sensible for me at the outset to set out the Government’s policy, as was requested by the hon. Member for Hammersmith (Mr Slaughter), who speaks for the Opposition. I should congratulate him as well,
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because that was the shortest speech I have ever heard him make.
[Interruption.]
He says from a sedentary position that he was under orders. It is another unusual experience in this House to find someone under orders to speak for less time than they would like rather than for more, which is the normal Whips’ instruction, in my experience. Let me make it clear for him and for the House that the Government remain committed to the European convention on human rights and to ensuring that those rights continue to be enshrined in UK law.
However, we are also closely involved in the process of reform of the Strasbourg Court and we must ensure that it can focus more quickly on the cases that need its attention. I hope that there is agreement across the House on the need to reform the Court, and that the Brighton declaration, which I shall come to later in my speech, is testament to our hard-won efforts in realising the Government’s pledge to reform that Court. We must recognise that much more needs to be done, however. The achievement of the previous Lord Chancellor, the Minister without Portfolio, my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke), in bringing about that important reform and persuading many countries to go along with it is extreme, but there is still more to do.
I agree with my hon. Friend the Member for Dover that one of the biggest problems is the misrepresentation of the Human Rights Act and public bodies misapplying the concept of human rights or using them as an excuse for bad decisions. That has been at the root of many of the problems in this country with judgments of the Court, some of which have been brought up in the course of the debate and with which I shall deal later.
The other main changes that the Bill would make include ensuring that legislation passed by Parliament can only be changed by Parliament and setting out in statute a list of individual responsibilities that would not impose direct legal obligations on individuals but would be taken into account when courts were considering the application of the new UK human rights. The issues raised by the Bill inevitably attract a wide range of views, although the House should note that most of the views expressed in the debate were supportive of my hon. Friend, and the debate has been helpful in airing them.
The coalition’s programme for government was clear about the importance we as a Government attach to the question of civil liberties. Human rights are an essential element of any wider consideration of civil liberties in a modem democratic society. My ambition in the course of the debate, which will clearly go on for a number of years and, conceivably, into future Parliaments, is to reclaim human rights from the position of being almost a “boo” phrase. There is something absurd about a situation in which people can regard human rights and support for them from Parliament or the courts as leading to bad consequences. Something has gone seriously wrong when we reach that stage and we need to reclaim human rights so that they are, as they ought to be, the motherhood and apple pie of politics. There is no reason for anyone to object to human rights being applied to as many societies as possible throughout the world. Nevertheless, we are where we are and the legislative framework for human rights in the United Kingdom is a subject on which there are strongly held and often conflicting opinions.
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The programme for government recognised those opinions and contained a commitment to
“establish a Commission to investigate the creation of a British Bill of Rights that incorporates and builds on all our obligations under the European Convention on Human Rights, ensures that these rights continue to be enshrined in British law, and protects and extends British liberties.”
“promote a better understanding of the true scope of these obligations and liberties.”
In accordance with that commitment, the independent Commission on a Bill of Rights was established in March 2011. The commissioners were experts who reflected the full range of views in the UK human rights debate, and included public supporters of all the main political parties.
The commission carried out two written consultation exercises and undertook a programme of seminars and visits to all parts of the United Kingdom in order to discharge its terms of reference. It reported to the Deputy Prime Minister and to the Secretary of State for Justice on 18 December.
I hope the House will agree that the commission’s final report was a thoughtful and detailed consideration of the key human rights issues and the human rights landscape in the United Kingdom today. The Government are grateful to the commission for the diligent way in which it discharged its terms of reference. Unsurprisingly, the commission’s report covers many of the issues and concerns that appear in the Bill. For reasons that I will set out later, the Government do not believe that now is the right time to decide on the changes proposed in the Bill, but if the House is minded to take the Bill into Committee, I will later set out a number of points that may assist the House in its further consideration. In doing so, I will make use of the very helpful work done by the commission, which is set out in detail in the final report.
Let me deal first with the points made by my hon. Friend the Member for Dover in his introductory speech. He explained that one of the 10 pillars of his Bill is that freedom of thought, conscience and religion should be protected to a greater extent than they currently are. He further explained that this greater protection is necessary because of the attitude to religion and belief. I am sure many will agree with him on that. He may be aware that the Strasbourg Court recently gave judgment in four cases concerning article 9—the article that deals with freedom of thought, conscience and religion—and that in each of those four cases the applicant was Christian.
The outcome of those cases confirmed that, for example, our law allows people to wear crosses at work, and that British employers are generally very good at being reasonable in accommodating people’s religious beliefs. We welcome any reasonable steps that employers can take to accommodate the wishes of their Christian employees or of those who hold a different religion or belief. Under the Equality Act 2010, employees of all religions and belief are protected against discrimination. Employers can lawfully stop their employees wearing jewellery, including a religious symbol, at work only if they can show that their policy does not disadvantage people belonging to a particular religion or belief or, if it does, that it is a proportionate means of achieving a
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legitimate aim. There are obvious examples of health and safety reasons why a particular item might be thought to be dangerous.
Those decisions were widely welcomed. My hon. Friend the Member for North East Somerset said that he could not remember any acclamation for a judgment of the Court, and he is of course right. Nevertheless, it is fair to say that the response to that particular raft of judgments, which touched on one of the most sensitive areas involved in modern human rights legislation, were perhaps slightly grudgingly welcomed by those, particularly in the media, who would not normally think of themselves as friends of the Strasbourg Court.
My hon. Friend the Member for Dover raised a huge number of other important issues, including that of self-defence. It would be interesting—and perhaps for later discussions—to understand how the Bill’s additional provision in relation to self-defence is intended to relate to law in England and Wales or Scotland outside the Human Rights Act, in particular the provisions currently before the House in the Crime and Courts Bill.
Charlie Elphicke: I was pleased to serve on the Committee scrutinising the Crime and Courts Bill. The moves made in this area are welcome. My contention is that that should be far more fundamental to our way of life, rather than in a particular provision, which is why I tried to detail the articles in the Bill.
Damian Green: I am grateful and the House will be grateful to my hon. Friend for that important clarification. He also spoke, rightly, about section 2 of the Human Rights Act and the obligation for the courts to take into account Strasbourg jurisprudence. He entered the discussion that has been taking place for some time about what exactly that should entail. The Commission on a Bill of Rights noted that Lord Phillips, then President of the Supreme Court, said in evidence to Parliament:
‘If the wording “take account” gives a message at all, it is that we are not bound by decisions of the Strasbourg court as binding precedent.’
I think that many will welcome that clarification.
My hon. Friend the Member for Dover also mentioned the International Criminal Court and terrorist trials. Not only are there offences of universal jurisdiction—this was debated by my hon. Friends the Members for Penrith and The Border and for North East Somerset—but there are clearly offences, such as war crimes and genocide, that have universal jurisdiction and are of such seriousness that they can be tried anywhere. There have been trials in the UK for such offences, and indeed Parliament chose to extend the possibility for that in the Coroners and Justice Act 2009.
My hon. Friend the Member for Dover also raised a point of debate—one of continuing importance—on the balance between rights and responsibilities, arguing that the possession of rights must inevitably entail some responsibilities. The commission had points to make on that as well. It concluded that rights should not be made conditional on the exercise of responsibilities. It concluded that a Bill of Rights may allow the courts, when awarding damages, to take into account the conduct of the applicant, but my hon. Friend’s Bill would go further in incorporating the notion of responsibilities in
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determining whether a right has been breached. It concluded that any provision on responsibilities should only be declaratory.
I would like to deal with some of the points my hon. Friend the Member for Bury North made in his thoughtful speech. He said that the Brighton declaration had not been successful, but I must part company from him on that, because I think that the declaration is a substantial package of welcome reforms. Their implementation is being negotiated in Strasbourg. No changes have yet been made to the text of the convention, but once the reforms are realised we expect their net effect to be that more cases will be resolved at a national level and fewer will go to Strasbourg. The European Court will be able to focus on the more important cases, which is what it was originally set up to do, and, equally importantly, to do so more quickly.
I am conscious that in previous debates on the subject, particularly those relating to individual cases, and often those involving extradition, including from this country to the United States, Members on both sides of the House have expressed understandable frustration about the delays in the legal process. That is because British citizens have been kept in British jails for many years not because of delays in the British legal process—of course, there are also delays in that process—but specifically because of delays in the European Court. The measures that will follow the Brighton declaration, which I think will lead in the long run to cases appearing before the Court more rapidly and, therefore, more rapid decision making, will have a direct effect on individual human rights, because they will mean people spending less time in jail.
Mr Nuttall: I must have inadvertently misled my right hon. Friend and wish to clarify my views on the Brighton declaration. I think, for the reasons he has just set out, that it is a step in the right direction. All I had intended to do was show that the most recent statistics bear out the need for what was agreed as part of the declaration to be brought into force as a matter of urgency.
Damian Green: I am grateful for my hon. Friend’s clarification. I completely agree with him that the sooner implementation can happen, the better it will be not only for us but for individuals.
My hon. Friend also made the point about rule 39 applications about the stay of deportation, and the UK’s supposedly very high numbers in this regard. Under rule 39 of the Strasbourg Court, the Court may, on application, advise a stay of deportation, for example. This is about indications, not violations per se, and the Court has become stricter about granting such requests. As a result, fewer than one in 20 requests made for interim measures against the UK are now granted. In real numbers, that is only about 30 or 40 requests a year.
Various hon. Members have talked about prisoner voting. I think that everyone would recognise that the strength of feeling in this country is clear, and we have been clear in our view that it should be a matter for national Parliaments to decide. The Government are under a legal obligation to bring forward legislation. We have therefore published a draft Bill that presents a range of options, including banning prisoners sentenced to four years or more from voting, banning prisoners
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sentenced to more than six months from voting, and reaffirming the current ban on prisoners voting. We have asked a Committee of both Houses to examine the Bill. In the end—the point made most eloquently, as ever, by my hon. Friend the Member for North East Somerset—Parliament is sovereign and it will decide on whether to change the law, and the draft Bill is the first step in Parliament’s considering the issue.
Charlie Elphicke: I note that the draft orders for the Committee are on the Order Paper. Can the Minister tell the House how many proposed members of the Committee have legal training?
Damian Green: Off the top of my head, I do not know which of its members have legal training. As a matter of principle, however, I suspect that a Committee considering such legal matters would benefit from having a mix of legal experts and people who are not legal experts but are capable of asking simple but important questions. The interplay between legal expertise and the lack of legal expertise can often result in good and practical legislation. As a final thought on this, I should point out what my right hon. and learned Friend the Attorney-General has said, which is very clear:
“Parliament is sovereign in this area; nobody can impose a solution on Parliament”.
There was an exchange between my hon. Friend the Member for Bury North and the hon. Member for Hammersmith about indeterminate sentences for public protection. The Legal Aid, Sentencing and Punishment of Offenders Act 2012 introduced a new legal framework for dangerous offenders which has now been commenced and which replaces the IPP with a new extended determinate sentence. However, prisoners currently serving IPPs will not be released unless the Parole Board authorises it on the usual basis of risk assessment. It is important to set that out.
Having dealt with some of the points made by hon. Members, let me deal with the Bill itself. It is unusually serious and detailed for a private Member’s Bill, and it deserves a detailed and serious response. The Bill draws on the structures of and mechanisms in the Human Rights Act 1998 but makes important variations, deletions and additions.
Clause 2 deals with the interpretation of the new UK rights set out in schedule 1. Under the Bill’s new framework, clause 2 would replace section 2 of the Human Rights Act 1998, which deals with the interpretation of convention rights. Section 2 requires courts and tribunals, as I have said, to take into account rulings from Strasbourg when determining a question that has arisen in connection with a convention right. Clause 2(1)(a) to (c) lists a wider range of sources that the UK courts may take into account when determining a question that has arisen in connection with a UK right.
Further consideration needs to be given to whether the courts need to be conferred a discretion in legislation in order to take into account the sources listed in clause 2. Courts already cite judgments from other jurisdictions, such as Canada, when determining human rights issues. Paragraph (b) is unnecessary, because by repealing section 2(1) of the Human Rights Act, domestic courts would no longer be obliged to take into account Strasbourg jurisprudence.
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Similarly, the Government are not certain that it is necessary to state in legislation that the ordinary rules of precedent continue to apply. Considering the obligations under section 2(1) of the Act, Lord Bingham held that courts should continue to follow binding precedent.
Section 6 of the Act makes it unlawful for public authorities in the UK to act in a manner that would breach a person’s convention rights and goes on to define what is a public authority for the purposes of the Act. Section 6 and the definition of public authority attracted a lot of comment and attention when the Commission on a Bill of Rights sought views on the existing legal framework. In the conclusions of its final report, the commission said of this important matter:
“The one area where we conclude that a case for change should certainly be considered is in respect of the definition of a ‘public authority’. In line with a majority of those respondents who expressed a view on this issue, we conclude that the growing prevalence of the outsourcing of once traditional publicly provided functions to private and third sector providers means that the current definition should be looked at again if a UK Bill of Rights were to be taken forward.”
Clause 7 of the Bill covers similar ground to section 6 of the Act, but it does not address the issue of definition directly. Instead, the clause’s focus, as described in the Bill’s explanatory report, is on ensuring that public authorities should not be penalised for applying legislation approved by Parliament.
Charlie Elphicke: I thank my right hon. Friend for giving way; he is being very generous in taking interventions. Does he recognise and accept that the majority of people in this country have lost confidence in the European Court of Human Rights and its judgment and that it should reassess its entire approach and look at striking a better balance in interpreting the convention rights?
Damian Green: My hon. Friend is right that many people in this country now have little confidence in the judgments of the Court. A separate issue has been raised by my hon. Friend the Member for North East Somerset about the legitimacy of the Court whether we agree with individual judgments or not. As I have said, the Brighton reforms introduced by the previous Lord Chancellor are designed to remove one source of irritation with the Court, namely its current backlog, delays and concentration on the types of cases that I do not think its founders intended it to concentrate on. The Court was set up to deal with big, international human rights issues and to drive forward human rights in countries with no history of Parliament, courts or the free press—all things that we in this country should not, but perhaps do, take for granted. I agree with my hon. Friend the Member for Dover that there is widespread feeling that the Court has gone off-track. That is precisely why the Government set up the commission and why the commission’s report is so interesting.
As my hon. Friend the Member for Cheltenham (Martin Horwood) made clear, there are no contradictions in the views of the two coalition parties on this matter. We simply disagree about how best to preserve and enhance human rights in this country. That disagreement will form part of the debate.
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Clause 7 would introduce a new test, at least in terms of our existing human rights legislation, of whether an act of public authority could
“reasonably be regarded, in all the facts and circumstances of the case, as compatible”
with the new UK rights. The explanatory document on the Bill makes the point that that provision contrasts with the strict test under the Human Rights Act of whether an act is compatible with convention rights. The document goes on to explain that
“there are different precise interpretations of human rights, and if the public authorities are within the bounds of what a reasonable person could regard as satisfying the requirements of the UK rights, they should be allowed to get on with their job without being second-guessed by the courts”.
Deviating from the current supervisory approach of the courts would require significant further consideration before we legislated on this subject.
In a similar vein, article 20 of my hon. Friend’s Bill of Rights would ensure that nothing in certain articles of the rights
“shall be regarded as preventing restrictions on the political activity of aliens.”
Under that American usage, “aliens” means people who are not citizens, as was understood when the convention was drafted in 1950. However, that is not the current UK formulation and I suspect that we may wish to use different language if we proceed with the Bill.
One of the major issues raised by the Bill, and one that has been at the heart of our debate this morning, is our relationship with the convention. I understand that it is my hon. Friend’s intention that his proposals would sit alongside the UK’s obligations under the convention. Indeed, the Bill makes specific provisions in relation to the convention. However, it would be the effect of his Bill that the convention rights would no longer be directly effective in our domestic law. Our domestic courts would instead make their decisions under the new, adapted code of UK rights.
With that in mind, it would be helpful for the House better to understand the intention behind clause 9(4). If my hon. Friend’s intention is to sever the link with the convention, why does the Bill provide for our courts to continue to have regard to the scale of damages awarded by the Strasbourg Court?
Charlie Elphicke: I am happy to provide clarification on that. There is a history in our courts of granting damages that are entirely run-away. The one area in which most of us can agree with the European Court of Human Rights is in its more level-headed and sanguine awards of damages, because it is taxpayers who have to foot the bill. That is the one area where the jurisprudence of the European Court holds some water.
Damian Green: I am grateful to my hon. Friend for that clarification. He is right that the European Court might prove a better friend of the UK taxpayer than our courts in that regard.
That is not the only area in which it is possible to regard what comes out of the Strasbourg Court as more sensible than what emerges from our courts system. In my previous job as Minister for Immigration, I was struck that the Strasbourg Court had a more sensible
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test of what rights should apply when deciding whether someone should be removed from this country than was sometimes applied in our domestic courts. It may be unusual for a Minister to wish for European jurisprudence to take precedence over UK jurisprudence, but there were some cases in which I did so. My hon. Friend makes a good point about damages, but that is not a unique area in which the Court can be regarded as quite sensible.
It would be reasonable for the House to debate a number of other detailed technical issues, but I hope that over the past few minutes I have illustrated that, as one would expect, there would have to be significant scrutiny of large parts of this Bill were it to proceed further.
I wish to say a bit more about what will happen now because, as I have said, a twin-track approach is needed and we must know what will happen during the rest of this Parliament. As several hon. Members have said, the United Kingdom played a pivotal role in shaping the original human rights framework in which the rights were, literally, fundamental. Indeed, then hon. Members from across the House, including David Maxwell Fyfe and Hartley Shawcross, were architects of what was at the time a document that everyone in Britain was very proud of.
The convention was designed to address terrible abuses of human rights in a fractured continent. We have all read in history books about the state of post-war Europe, and it is important to put this debate into an historical context. Today we talk about European rows and problems, great though they are, but just 70 years ago—it is not ancient history—the continent was completely fractured. We now have a Europe in which we can argue about how human rights are best enforced, rather than a Europe in which we have to enforce basic human rights. The situation is immeasurably better now than it was, and that change has taken place during our lifetimes. We have come a long way from the time when the convention was absolutely necessary, but not everything has changed and our concern then—as now—was to give those who most needed protection from the excesses of state power a clear understanding of the rights and remedies available to them. That means that the human rights framework must be accessible and proportionate in its application.
The convention should be used to defend the most vulnerable, but because of the way some articles in the convention have been interpreted by the Court, people do not feel that that basic fairness is being applied any more. Indeed, the desire to ensure that the mechanisms in place to protect the most vulnerable exist for that reason and no other was at the heart of the programme of reform that turned into the Brighton declaration, just as it is at the heart of our calls now for further reform of the Court of Human Rights.
The Court is important for the protection of human rights from Iceland to Turkey, but as I have said it faces a huge backlog of nearly 130,000 applications. Some of those may include examples of the type of fundamental abuses that Maxwell Fyfe and others sought to remedy back in 1950 and in a very different world. However, if the Court is to retain its legitimacy—this point has rightly been raised in the debate—it must focus on its core functions. The UK helped draft the convention and there is no controversy about its values, which
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everyone still supports, even those most sceptical about the value of the Court. Many more people are extremely sceptical about the Court’s performance yet they nevertheless sign up to the basic values in the convention.
It cannot be repeated too often that the convention has contributed to important changes for the good in many countries across Europe; for example, the decriminalisation in many countries of homosexuality, or the recognition in former Soviet countries of religious freedom. Given our discussions today, and the frequent public discussions, about the necessity of protecting people’s capacity to express their religious views, it is worth remembering that in other countries the convention has been extremely helpful in allowing people to express their basic freedoms.
There are other examples. Legal systems and police behaviour have been improved by the convention in countries where the tradition of democracy and the rule of law is less than it is in ours. I hope we can all agree that the problem is not the convention itself, but how it is sometimes interpreted.
Our concerns about the Court bring us back to its fundamental role; it is supposed to focus on the most egregious violations of human rights throughout Europe. We might think that the UK would rarely, if ever, be found in breach, and I am happy to say that is the general situation. Last year, the Strasbourg Court ruled against the UK in only 10 instances. The underlying question we need to consider is whether those cases, and the apparent breaches, were of a magnitude that the founders of the convention would recognise. We have to ask ourselves what we expect of the Court today and how we can help to restore its legitimacy. Those are the questions we are dealing with now.
We would like the Court to have the following priorities, particularly after the Brighton declaration. First, it should not involve itself in cases that national courts have already decided properly. In this country, one would expect that to be so more often than not. Secondly, the Court should focus its resources on the most deserving cases; on the surface, a backlog of nearly 130,000 suggests that is not happening. Thirdly, the Court should not delve into our own legislation without very good reason. The margin of appreciation must be observed. Fourthly, judges adjudicating serious cases must be of the highest quality. Each of those priorities would involve a big programme of reform for the Court, but individually and collectively they are extremely important to ensure continuing support for the legitimacy of the Court. We may yet need deeper and more fundamental reform to preserve the role of the convention.
At the outset, I mentioned a Commission on the Bill of Rights, and I referred to its findings in relation to the provisions in my hon. Friend’s Bill. I remind the House of some of the commission’s key conclusions.
Martin Horwood: I am eager to hear the commission’s conclusions, but given the fact that the Government are opposing the Bill and supporting the next Bill we are to debate, which would reinforce the Government’s commitment to devoting 0.7% of our national wealth to international development, I hope the Minister will be able to share the commission’s findings with the House in writing rather than extending debate on the Bill unnecessarily.
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Damian Green: I can only say that were I extending debate on the Bill unnecessarily, Mr Deputy Speaker would call me to account. I am dealing with the central issues that the Bill has raised, and I hope I am doing so in appropriate detail, as the measure is so serious and important. However, I take the hon. Gentleman’s point and I shall delay no further.
On the central question of whether there should be a UK Bill of Rights, a majority of the commission concluded that there is a strong argument in favour. That was on the basis that any such Bill would incorporate and build on all the United Kingdom’s existing obligations under the European convention on human rights, and that it would provide no less protection than is contained currently both in the Human Rights Act and in the devolution settlements. This was in line with the Commission’s terms of reference.
The majority saw the current lack of public ownership of the Human Rights Act and the European convention on human rights as the most compelling reason in favour of a new Bill of Rights. Indeed, my hon. Friend the Member for Dover made similar points in his speech. Some of those in the majority who favoured a Bill of Rights felt that any new Bill could usefully define the scope of some rights more clearly and adjust their balance. That is another point on which there is some concurrence between the Commission’s findings and the rationale behind the present Bill.
The two Commissioners in the minority concluded that the Commission’s two consultations and its deliberations had failed to identify any real shortcomings in either the existing Human Rights Act or how it is applied by the domestic courts. Although unable to reach agreement on all its conclusions, the Commission’s report identified issues that would need careful consideration before a Bill of Rights was introduced. Given the ongoing human rights debate, it is no surprise that the Bill also touches on some of these issues, for example, on what scope there is for more clearly incorporating the concept of responsibilities as well as rights in any new legislative framework. The Commission also proposed consideration of whether any new Bill of Rights in the future should include additional rights beyond those contained in the Human Rights Act, and my hon. Friend’s Bill addresses similar issues.
The Commission was also united in urging the Government to continue to pursue reform of the European Court of Human Rights. The Government agree to the importance of maintaining the report’s momentum. My right hon. Friend the Lord Chancellor and Secretary of State for Justice recently appeared before the Joint Committee on Human Rights and made it clear that in his view there was a strong case for further reform along the lines that I have expressed today. He is working not just with colleagues in Government here, but in Strasbourg to secure an agreed approach to the longer-term future of the Court.
Mark Hendrick (Preston) (Lab/Co-op):
On a point of order, Mr Deputy Speaker. The Minister has now been speaking for 45 minutes. Each Conservative Member who spoke in the debate did so for about an hour. Clearly, this is a tactic to stop us getting to the International Development (Official Development Assistance Target) Bill, which the Government supposedly support. Does using
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such tactics to stop the Bill being heard today not make a mockery of the Prime Minister’s attempts to try to detoxify the Conservative party?
Mr Deputy Speaker (Mr Nigel Evans): That is not a point of order, but the hon. Gentleman has made his point in a forceful manner. Had I believed there to be a filibuster taking place, I would have intervened and prevented it from doing so. I have not heard a filibuster.
Damian Green: I am grateful, Mr Deputy Speaker. I understand the hon. Gentleman’s disappointment. I am happy that he has at least had the chance to express his support for the Government’s commitment to meeting their aid targets, which we have done more successfully than any other previous Government.
To return to the subject of the Bill before the House, most fundamentally, all Commissioners agreed that any debate on a UK Bill of Rights had to be fully alive to the sensitive issue of devolution and that, in itself, cautions against change at this time. Human rights are intricately woven into the existing devolution settlement, and as that settlement is to be reconsidered in the relatively near future, that argues strongly against any precipitate changes to the existing human rights framework in the United Kingdom. The Commission’s final report notes:
“As a matter purely of practicality all of us believe that, while we would not want to see an inhibition on further discussion in the light of our report”—
it is lucky that it said that, because there will not be one—
“it would be essential to await the outcome of the referendum (in Scotland) before moving towards final decisions on the creation of a UK Bill of Rights for the obvious reason that it will only be after the referendum that the future composition of the UK will be known.”
I hope that the House would agree that it is difficult to fault the logic of that conclusion, which provides a persuasive reason as to why now is not the time to embark on wholesale changes to the human rights framework.
In the context of the devolution settlement, and of the Commission’s comments, it is interesting to note from the report that the Commission’s findings revealed wide differences of opinion in different parts of the United Kingdom. Respondents in Scotland, Wales and Northern Ireland often argued that there was little or no call for a UK Bill of Rights among their populations.
My hon. Friend’s Bill is serious and detailed, and a huge amount of work has clearly been done on it by some very talented drafters and lawyers, but I hope that he will appreciate that it could be slightly premature to jump this particular fence at the moment. The whole House should express its gratitude to him, however, for bringing the Bill before us. This debate has given me a chance to thank him and the Commission on a Bill of Rights for their work, and to explain where matters stand following the publication of the report. I am happy to assure him that the report, the Bill and the points expressed in today’s debate by him and the other hon. Members who have spoken will continue to inform further Government opinion on this important topic.
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2.16 pm
Mr Christopher Chope (Christchurch) (Con): I welcome this opportunity to make a short contribution to the debate, not least because I have the privilege of being chairman of the Committee on Legal Affairs and Human Rights of the Council of Europe. We deal on a regular basis with the subject that has been debated today. I have also recently been appointed as the rapporteur with responsibility for drawing up an opinion from the parliamentary assembly on proposed protocol 15 to the convention on human rights.
I should like to begin by commenting on the Minister’s typically generous and reasonable speech. He talked about the universality of human rights, and about how we must concentrate on defending the most vulnerable people in our society. In relation to the Commission on a Bill of Rights, he argued that the time was not now right for this measure. However, I do not see any great distinction between the views being expressed in Scotland and those in the rest of the United Kingdom on this issue.
Bearing in mind what the Government are doing on prisoner voting eligibility, there is a strong case to be made—especially in the light of the Bill, into which my hon. Friend the Member for Dover (Charlie Elphicke) has put so much work—for saying that the Government should introduce a draft Bill, perhaps along the lines of the proposals for prisoner voting, in which the different alternatives put forward in the commission’s report could be set out. It could then be submitted, in the form of proper legislation, to scrutiny by a Joint Committee of both Houses. We would then be able to make some progress.
One of the messages from yesterday’s by-election result is that there is an enormous amount of public cynicism about the lack of progress on issues such as these. The public are concerned about abuses of human rights legislation and the perverse judgments being implemented, and they want the House to take action in those areas and others.
Martin Horwood: Will the hon. Gentleman give way?
Mr Chope: I will indeed. I wonder why the hon. Gentleman is wearing a lapel badge. Anybody would think he had something to celebrate, but I do not think he has, really.
Martin Horwood: As the hon. Gentleman has mentioned the by-election—and my “I like Mike” lapel badge—will he allow me the privilege of being the first Member to congratulate Mike Thornton on his imminent admission to the House as the new Member of Parliament for Eastleigh? Perhaps the hon. Gentleman would like to reflect on whether the historic victory of the Liberal Democrats in Eastleigh—we are the first party in government in at least 30 years to defend successfully a marginal seat in a by-election—can be attributed to the fact that we have not displayed the same kind of ideological disunity over issues such as human rights and international development that he is demonstrating right now from the Conservative Benches.
Mr Chope:
To reinforce the point I was making, the complacency that flows through every word that the hon. Gentleman has uttered will be seen as anathema to
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the majority of people who voted in the by-election in favour of Eurosceptic parties who want a completely fresh look at our relationship with the European Union.
Mr Chope: I give way to my right hon. Friend the Minister.
Mr Deputy Speaker (Mr Nigel Evans): Order. We are in danger of veering off piste in a big way. There is going to be a big post-mortem about what happened in yesterday’s by-election, but let us not start it in the Chamber right now. Does the Minister wish to intervene?
Damian Green indicated dissent.
Mr Deputy Speaker: I call Mr Chope.
Mr Chope: I am obviously happy to congratulate anybody who has been elected to this House, and I hope in due course to have an opportunity to meet the new Member representing Eastleigh. That does not mean, however, that we should ignore the importance of the issue before us today, and I suspect that a majority of the people who went out to vote yesterday would have been in favour of the Bill on the grounds that something has to be done about abuses of human rights legislation and the Court’s perverse judgments.
The Brighton declaration is being carried forward by means of draft protocol 15 to the European convention on human rights. From my perspective, one of the most important parts of that draft protocol will be its amendment to the convention’s preamble, emphasising the importance of having a system that introduces proportionality as well as subsidiarity into the Court’s decisions. But if I look at the opinion of the European Court of Human Rights on draft protocol 15, I detect a lack of enthusiasm for the part of the protocol that will mean changing the wording of the preamble. I hope I am not being unduly sceptical in wondering how keen the Court is on the principle of emphasising the subsidiarity and the doctrine of the margin of appreciation, as reflected in the outcome of the Brighton conference.
In that context, some people believe—I have heard judges of the Court themselves expressing this opinion—that it does not make a ha’porth of difference what is in the preamble, as it is only the actual text of the treaty that makes a difference. That reminds me of the importance of how these treaties are interpreted. One problem at the moment is that the treaties are being interpreted by the Court in a way that is out of tune with the specific wording in the Vienna convention, which says that there should be a strict interpretation of treaties rather than allowing them to be interpreted in an expansive way over time.
The way to change the wording of a treaty, as is now being proposed, is to introduce a protocol to that treaty. The way to introduce a requirement that there should be prisoner voting would be to amend article 3 of protocol 1 rather than to try to do it by the back door by using judicial legislation—effectively what the Court has been doing. This is where the great frustration arises
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among the public when they see human rights that they all believe in—the right to life, the right not to be tortured and so forth—losing direction under the Court. The universality of human rights is important, as reflected in the debate between two Old Etonian Members earlier. We should be talking about the universal declaration of human rights, rather than trying to use the European convention and the EU legislation that incorporates it as a means of trying to impose on individual sovereign Governments and Parliaments a set of rules that do not accord with the culture of those individual countries.
Let me end by reiterating my thanks and congratulations to my hon. Friend the Member for Dover. Unlike many Members who present private Members’ Bills, he put a great deal of personal effort into the drafting of his Bill. Presenting legislation, especially private Members’ legislation, is an iterative process, and I hope that in the next Session of Parliament, either my hon. Friend or a colleague who is successful in the ballot will present the Bill again—perhaps taking into account some of the points made by the Minister—so that by the time of the next general election, Conservative Members are clear about where we want to go and what legislative change we want to make. We shall then be able to respond to public concern, rather than saying that it is far too early to do anything and giving every reason under the sun for not being able to make up our minds. My hon. Friend has done a great service to the House and the country in concentrating minds on this important issue.
2.26 pm
Charlie Elphicke: I thank those who have spoken today: my hon. Friends the Members for Penrith and The Border (Rory Stewart), for North East Somerset (Jacob Rees-Mogg), for Bury North (Mr Nuttall) and for Christchurch (Mr Chope), the Minister and the shadow Minister, the hon. Member for Hammersmith (Mr Slaughter). This has been a very useful, interesting and wide-ranging debate. I thank the Minister for his detailed remarks about the Bill, which I hope will help me to improve it if I present it again in the next Session.
May I make a short plea? When the members of the Committee that will consider the draft Bill on prisoner voting are being selected, can we ensure that at least
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some of them have legal training and that there is a wider reflection of the views of the House as a whole, so that all views are represented as well as possible? This is an important issue which has been very controversial for the House, and there are deep and passionate feelings about it. I thank the Minister for setting out his own views.
I particularly thank my hon. Friend the Member for Penrith and The Border for his interesting argument about the issues of morality and universality. The issue of morality was explored by Lord Justice Laws, a Court of Appeal judge, in a speech in November 2012 entitled “Do human rights make bad citizens?” Let me gently point out in response to my hon. Friend, who, sadly, is no longer in the Chamber, that Lord Justice Laws said this:
“the entrenchment of rights in the culture of the State carries with it a great danger. It is that rights, a necessary legal construct, come also to be seen as a necessary moral construct. Applied to the morality of individuals, this is a bad mistake.”
As for universality, Lord Hoffmann, a well-known leading Law Lord for many years, said in a 2009 speech entitled “The Universality of Human Rights” which he delivered shortly before his retirement:
“at the level of abstraction, human rights may be universal…At the level of application, however, the messy detail of concrete problems, the human rights which these abstractions have generated are national. Their application requires trade-offs and compromises, exercises of judgment which can be made only in the context of a given society and its legal system… If one accepts, as I have so far argued, that human rights are universal in abstraction but national in application, it is not easy to see how in principle an international court was going to perform this function of deciding individual cases, still less why the Strasbourg court was thought a suitable body to do so.”
Let me finally say in response to the hon. Member for Hammersmith that it is a great shame that Labour did not take the opportunity to reconsider its approach to human rights, and a great shame that he is more enthusiastic about the spending of taxpayers’ money on human rights claims than about funding for the White City estate and its important public services.
Having said that, Mr Deputy Speaker, I beg to ask leave to withdraw the motion.
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International Development (Official Development Assistance Target) Bill
Question (13 July) again proposed, That the Bill be now read a Second time.
2.29 pm
Mark Hendrick (Preston) (Lab/Co-op) rose—
The debate stood adjourned (Standing Order No. 11(2)).
Ordered, That the debate be resumed on Friday 26 April.
Business without Debate
Bank of England (Appointment of Governor) Bill
Resumption of adjourned debate on Question (6 July), That the Bill be now read a Second time.
Debate to be resumed on Friday 3 May.
Equality (Marriage) (Amendment) Bill
Motion made, That the Bill be now read a Second time.
Bill to be read a Second time on Friday 8 March.
Free School Meals (Children over the age of 16) Bill
Motion made, That the Bill be now read a Second time.
Bill to be read a Second time on Friday 3 May.
Cosmetic Surgery (Minimum Standards) Bill
Motion made, That the Bill be now read a Second time.
Bill to be read a Second time on Friday 3 May.
Town and Country Planning (Control of Advertisements) (England) Regulations 2007 (Amendment) Bill
Motion made, That the Bill be now read a Second time.
Bill to be read a Second time on Friday 22 March.
1 Mar 2013 : Column 642
Merton and Sutton PCT (Prescribing Policy)
Motion made, and Question proposed, That this House do now adjourn.—(Joseph Johnson.)
2.33 pm
Siobhain McDonagh (Mitcham and Morden) (Lab): Like many Members, I have a lot of concerns about what is going on in the NHS at present. My local NHS has to save £370 million a year and two out of five of our general hospitals are about to lose both their accident and emergency and maternity units. I am sure I will want to raise my concerns about that in the future. The long-promised reopening of Mitcham’s local Wilson hospital as a local care centre has still not happened, even though it is in the Merton ward with the lowest life expectancy, while the redevelopment of the Nelson as a local care hospital in neighbouring Wimbledon, one of the wealthiest places in south-west London, is under way. Also, after one of the biggest top-down reorganisations in NHS history, GPs are being forced to become managers rather than clinicians, so I think it is fair to say I have a lot of concerns.
In the case I am raising today, however, the problem is much more fundamental. It is about the price of a man’s life. Is £5,000 too much to pay to keep someone going? It is also about a controversial drug and the terrible way the NHS deals with patients who slip between the gaps. In a small way, it is about how NHS managers avoid their responsibilities and ignore elected representatives such as me. But most of all it is about my constituent, Mr Liakuat Aziz, and whether he should be allowed to have the treatment he desperately needs.
Mr Aziz is 61 and lives in lower Morden. In December, he came to my advice surgery. He is a nice man who has worked hard, and he has a family. He has been through a lot, and just at the point he thought he was making progress, he has hit a brick wall. His story touched me straight away. Mr Aziz explained that he had had numerous long-term health conditions, although when I saw him he seemed well. In 1995 he had a coronary artery bypass graft. After the operation, he had numerous setbacks and developed severe lung injuries. He had a tracheostomy and was found to have significant restrictive lung disease. He also suffers with ischaemic heart disease and underlying emphysema. He underwent right heart catheterisation, and he had significant pulmonary hypertension.
Fortunately, Mr Aziz was placed under the care of some amazing doctors. In particular, he is being treated by Dr Stephen Brecker, Dr Phil Marino and by one of the leading practitioners in this field, Professor Brendan Madden, at the St George’s and Royal Brompton hospitals’ joint pulmonary hypertension clinic. Despite all that treatment, Mr Aziz was still in a very precarious condition, with severe pulmonary hypertension group 2 and group 3 disease. In addition, he had long-term lung fibrosis from cardiac surgery, ischaemic cardiomyopathy and a biventricular implantable cardiac defibrillator in place—that is not very easy to say, let to alone live with. By January 2011, his condition had worsened. He suffered from breathlessness and he could not get around. His doctors decided to try a new treatment—sildenafil.
To you and I, Mr Deputy Speaker, the word “sildenafil” might not mean very much, but we have probably heard of its other name—Viagra. Most people think of Viagra
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as a fun drug or as a relatively trivial treatment for erectile dysfunction. I do not want to go into the rights and wrongs or the merits of Viagra today. It is well known as a sex aid, but what a lot of people do not know is that Viagra is also a very effective treatment for pulmonary hypertension. It is not the only treatment, and for many patients it will not be suitable or cost-effective, but given Mr Aziz’s numerous lung and heart conditions his doctors thought that sildenafil was a solution. Indeed, numerous medical studies have shown that it has a role to play.
Professor Madden himself conducted one such study in 2006, with Allenby, Loke and Sheth. After looking at the evidence from a group of patients, they concluded:
“Sildenafil offers potential to treat patients with pulmonary hypertension by selectively inhibiting phosphodiesterase type five pathways in the lung.”
Between them, they concluded that it should be recommended for selected patients with pulmonary arterial hypertension. Every one of their patients saw reduced pulmonary vascular resistance, and all could walk further and faster as a result. The same conclusions were made by the much larger Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology, and the European Respiratory Society, endorsed by the International Society for Heart and Lung Transplantation. Their 2009 report is the basis for commissioning policy, and is responsible for the current guidelines into the treatment of pulmonary hypertension. Their conclusion was that
“Sildenafil is an orally active, potent, and selective inhibitor of phosphodiesterase type-5.”
They found that various studies
“confirmed favourable results on exercise capacity, symptoms, and haemodynamics.”
So the medical community agrees that in certain circumstances it is a legitimate treatment.
Professor Madden duly began Mr Aziz on sildenafil and, thankfully, Mr Aziz responded.
St George’s hospital’s department of cardiothoracic surgery has written to me to say that Mr Aziz
“had an extremely good symptomatic response to Sildenafil”.
By March 2012, his mean pulmonary artery pressure had dropped to just 28 from 40 the year before. His pulmonary vascular resistance was down to 2.9 Wood units from 4.5. He could walk without being out of breath and all was well, until suddenly Mr Aziz was contacted by his local GPs at the Cannon Hill Lane surgery to say that they could no longer prescribe him with sildenafil as Sutton and Merton primary care trust had instructed them to stop prescribing it.
It transpires that throughout 2012, the PCT had been advising the GPs not to prescribe the drug but Professor Madden and other doctors had repeatedly stepped in. I have been shown letters and applications on Mr Aziz’s behalf throughout 2012, one from March, one from July and one from October. I believe there are more, but in the end, despite it being pointed out that discontinuing the prescription would be
“a threat to Mr Aziz’s life”,
and despite his having been on it for nearly two years, the NHS decided it would not fund it. Viagra, even for a sick man, was not the sort of thing it wanted to be seen prescribing.
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That is where I came into the picture two and a half months ago. As MPs, we see lots of people. I take up thousands of cases a year and I write tens of thousands of e-mails and letters on behalf of my constituents, but only very rarely do I get involved in such a story, which is really about life and death. I knew I had to work urgently. I wrote to all the doctors, the PCT and the NHS. Professor Madden wrote straight back, and what he said only added to the urgency:
“Mr Aziz has benefited significantly from Sildenafil therapy, and it is my opinion together with that of my colleagues Dr Phil Marino and Dr John Wort, Consultant in the Pulmonary Hypertension Unit at the Royal Brompton Hospital and Dr Stephen Brecker, Consultant Cardiologist at St George’s Hospital that Mr Aziz should continue on Sildenafil therapy.”
I was shown notes that showed that before he was put on 50 mg doses of sildenafil, Mr Aziz
“experienced a marked and constant deterioration in both symptoms and functional capacity...despite aggressive optimisation of his cardiorespiratory co-morbidities.”
Before taking sildenafil, Mr Aziz had exercise tolerance of under 50 yards. According to the notes, he had
“genuinely disproportionate and at least moderate pulmonary hypertension out of keeping with his existing co-morbidities”.
He was, in short, in a very bad way.
Even after Mr Aziz was put on 50 mg doses, the doctors sought out other solutions as they wanted to be sure the treatment was not too extravagant. They twice reduced the dose to just 20 mg, but both times, according to the notes,
“he rapidly experienced an increase in symptoms and functional decline that only resolved on restoring the dose to 50 milligrams.”
It was obvious to the doctors that Mr Aziz had
“shown a clear response to Sildenafil based on symptoms, functional capacity and right heart catheter data.”
The doctors clearly concluded that, in line with the medical studies I mentioned earlier, Mr Aziz was an exceptional case and was best treated by what we would call Viagra. His course of sildenafil, which costs less than £5,000 a year, was making a difference to him and it was not insignificant.
Chillingly, Professor Madden wrote to me to say:
“We are all of the opinion that his condition could deteriorate precipitously if the medication were to be stopped, and indeed this could bring about his premature death.”
When I received that letter, it brought home to me what I was dealing with. Professor Madden, one of the most eminent practitioners in his field, had told my constituent he could die and, naively, I thought that meant that the case would be dealt with urgently, so I waited for my local NHS to get in touch.
I waited. I wrote e-mails and letters reminding the NHS that the issue was quite urgent, and I carried on waiting. My caseworker phoned virtually every day and, on 23 January, we started counting the calls. We called Ann Radmore, the chief executive of NHS South West London. She would not take our call, but her office asked us to speak instead to the chief officer of Merton’s new clinical commissioning group, Eleanor Brown. We left a message, but did not get a call back. We called Tony Foote in Ms Radmore’s office and he promised we would get a call by 30 January. We did not, so we rang and rang every day, and they said we could speak only to Mr Foote, but he was never in and he never rang back.
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At one point, things looked up. On 8 February Ms Radmore’s PA actually spoke to my caseworker and promised to get back to me. But then nothing, and the waiting continued. No one answered the phone. No one got back to me. Here was a man who could die without this drug, but the bosses at Sutton and Merton primary care trust would not even deign to talk to his MP. Eventually, I had no choice. Two months after first contacting them, I raised the case at Prime Minister’s questions. I complained that I had been
“defeated in my attempts to get a response from NHS South West London”
and asked if he would help me get a response. Otherwise, I said,
“my constituent might die”.
“try to get a better answer”.—[Official Report, 13 February 2013; Vol. 558, c. 853.]
I am not necessarily a fan of the current Prime Minister, but I have this to say about him: he has astonishing powers. Within five minutes of my asking him, while he was still standing at the Dispatch Box in this Chamber, my office had a call from the local NHS. Yippee, I thought. Finally someone was taking this seriously. All the stops would be pulled out. Progress would be made. Somebody would talk to me. We would clear things up. Mr Aziz would be all right. No, the caller simply said, “Ah yes, about your case. We’ll try to find out what’s going on.”
A day or two later I got a letter from Eleanor Brown. It is not a very helpful letter, but it is a classic of its kind. It starts with a belter of an apology:
“I must apologise firstly for the undue delay in providing this response.”
“I understand that your letter was not, for reasons at present unclear to me, received in this office at the time of posting.”
Not a good start, but she goes on:
“However, once received by email . . . there were, unfortunately further delays.”
She does not specify what these were, but continues:
“Although there were certain extenuating reasons for these”—
again, she does not say what these were, but it is nice to know there were some reasons—
“this was clearly unacceptable, particularly in circumstances such as Mr Aziz’s.”
“Please pass my sincere apologies to Mr Aziz for any distress and inconvenience this may have caused.”
Nothing about all the phone calls, nothing about my having to go to the Prime Minister himself, but we will let that pass because at least I had been given a clear and thorough explanation of the case, hadn’t I? Well, not quite. There follow two pages of droning procedural equivocation, but no answer to the basic question: was the treatment right in this exceptional case, and is £5,000 too much for a man’s life?
Instead, I am treated to long passages of tedious linguistic somersaults desperate to pummel me into accepting that, despite all the evidence, this is not an exceptional case. For instance,
“The fact that a treatment is likely to be efficacious for a patient is not, in itself, a basis for an exception”
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“If a patient’s clinical condition matches the ‘accepted indications’ for a treatment that is not funded, their circumstances are not, by definition, exceptional.”
There is even the most remarkable leap of logic, when Ms Brown says:
“NHS Sutton and Merton was not withdrawing funding as funding had not been approved initially.”
It seems to have been overlooked that this was a letter that would be read by a human being. The letter concludes:
“I hope I have been able to reassure you, and Mr Aziz, that in reaching the decision regarding funding all correct procedures, as used throughout the whole of the NHS South West London area, were followed and done so in a timely manner. Yours sincerely”.
Crikey. Now that I think about it, if there is one thing that has impressed me about my local NHS in this case, it probably has not been its procedures.
A number of issues remain. Professor Madden, who remains one of the most learned doctors in this field, continues to believe that Mr Aziz’s only hope is sildenafil. Professor Madden has once again re-applied for funding. He continues to argue that Mr Aziz’s case really is exceptional, owing to his heart disease, his lung disease, his diabetes, his emphysema, and so on—all his very particular conditions. Mr Aziz did receive the treatment, and it did work. Professor Madden continues to believe that without treatment Mr Aziz would deteriorate, and that the cost of his inevitable hospitalisation would far exceed the cost of the drug. According to Professor Madden, only 4,500 people in the country suffer from pulmonary arterial hypertension, and Mr Aziz’s co-morbidities are extremely rare.
I have no doubt that the NHS receives many requests for Viagra, but this one is truly exceptional. Perhaps the Minister will enlighten me—is it only my local NHS that says £5,000 is too much for one man’s life? Would Mr Aziz have a better chance if he lived somewhere else? Based on my experiences over the past two and a half months, I know whose opinion I trust. Is it that of one of the country’s leading experts in chest conditions or that of the people who lose letters, do not reply to phone calls or e-mails, specialise in extenuating circumstances and do not communicate in human?
Mr Aziz is a good man with an extraordinary medical history: group 2 pulmonary hypertension and group 3 disease, on top of massive cardiac and lung disease. He is a testament to our NHS. However, he needs a drug that most people, if they are honest, think is a bit of a joke: Viagra. He needs it not for recreational purposes, but to stay alive. My local NHS would rather let him suffer than allow him the only drug that works on him. It would cost thousands of pounds a day to look after him in hospital, but they will not provide £5,000 to keep him out. They have behaved appallingly to him and treated me and my office with a basic lack of respect.
We all know that the NHS is facing pressures it has not had to face before, but in this case Viagra is not a sex tablet; it is a life-saver. The medical consensus is clear that in exceptional cases, such as Mr Aziz’s, it should be prescribed. I hope that the Minister will be able to concentrate her reply on this specific point: even though it is for Viagra, is £5,000 really too much to pay for a man’s life? Thank you, Mr Deputy Speaker, for the opportunity to make the case.
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2.51 pm
The Parliamentary Under-Secretary of State for Health (Anna Soubry): I congratulate the hon. Member for Mitcham and Morden (Siobhain McDonagh) on securing the debate and on rightly bringing this matter to the House’s attention. I hope that I can offer her, if not the answer to her question, a number of points and perhaps arrange some sort of meeting between her, the local PCT and all those involved in Mr Aziz’s care to establish why he is not receiving the treatment that he and Professor Madden believe he should have. The PCT should be held to account for why it has not provided that treatment. That really is where the problem, if it is a problem, and certainly where the responsibility lies.
The hon. Lady will know that PCTs have been around for some time. One of the reasons why the Government were so keen to introduce the Health and Social Care Act 2012 was to abolish PCTs and have exactly these sorts of commissioning decisions, which have frustrated so many Members on both sides of the Chamber, made by those best placed to make them: clinicians, effectively through GP-led clinical commissioning groups. As a result of the Act, those people will make such decisions in future.
The hon. Lady started her speech with a political point, so I will make a political point as well. We wanted to get rid of PCTs because too often they are overly bureaucratic and they are certainly not accountable. It was our desire to change that by taking the decisions away from bureaucrats and putting them back in the hands of clinicians. That was one of the fundamental underlying reasons why we were so keen to get the Act through this place and on to the statute book. Far from damaging the NHS, and far from denying patients medications and, perhaps most importantly, explanations, the Act will ensure that these types of problems no longer exist.
It is not for me, as Minister for Public Health, or through any other role that falls within my brief in the Department of Health, to make a case for or against the PCT’s decision. Its members will certainly receive a copy of the Hansard report of this debate so that they can read the hon. Lady’s remarks and mine. I understand that there is a chance that they may be watching this debate. If so, no doubt many of them will be hanging their heads in shame. If they are not, then frankly they should be, if the hon. Lady is accurate in her description. I think that she must be, because I too have a copy of the letter from the Sutton and Merton borough teams that she quoted. It seems that they have a profound problem somewhere in their system, because they clearly did not answer her letters or e-mails or respond to her telephone calls. She is the Member of Parliament. This is about her constituents and her local PCT, and if there is anybody they should respond to, it is the Member of Parliament. MPs are the people who come to this place to represent the people in their wards and absolutely to do what she has done, which is to advance the case of Mr Aziz.
For all I know, there may be a very good reason, not just financial but clinical, as to why this particular gentleman should not receive this particular drug—I know not. I know it sounds awful to say it, and I hate saying it, but it is not my job to know. It is not the job of a Minister to say that somebody should or should not receive a treatment. However, it is my job to make it
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absolutely clear that whoever someone is in the NHS, they should treat that person with care and compassion. That means that they should sit down with somebody like Mr Aziz and explain to him, or perhaps to his elected representative or his general practitioner, the good, solid reasons as to why or why not a particular decision has been made. It is absolutely vital for them to have the courtesy, never mind the care that we would hope for, to do that.
I admit that it might have been late in the day, but I specifically asked my officials to contact NHS South West London to obtain some sort of statement that I could present, because I do not want to do anybody any injustice—Mr Aziz or, indeed, the PCT. Unfortunately, the statement that I have is handwritten and I am having difficulty reading it, so I will not read it out. In fact, it does not tell me anything that I have not already been told.
It is important to explain that the National Institute for Health and Clinical Excellence provides the NHS with evidence-based guidance on the clinical effectiveness and cost-effectiveness of drugs and other technologies. NICE, as an independent body, makes the decisions on whether a particular drug has a clinical or cost-effectiveness basis on which it should be prescribed. Where treatments have been positively appraised by NICE, PCTs are legally obliged to provide funding for them. However, NICE has not issued any guidance to the NHS on the use of sildenafil nitrate for the treatment of pulmonary arterial hypertension. That is the problem. It is because NICE has not given that advice to the NHS that the treatment is at the discretion of the PCT and we are in difficult times. There were difficult times under the previous Administration. There always are, because we do not have a bottomless pot of money, and treatments—often brilliant treatments—increasingly cost huge amounts of money.
Siobhain McDonagh: On that precise point, Mr Aziz, who is here listening to this debate, said to me on the way in, “Siobhain, I have paid my taxes for 35 years. I do not want a drug that makes me look better—I want a drug that is going to save my life.”
Anna Soubry: I was coming to that in due course.
Apart from making these comments at the Dispatch Box, I cannot advance Mr Aziz’s case, because I do not know his case. I know what the hon. Lady has said, and I know that he has been through, to use these awful words, due process. His application has been considered. Having looked at what the PCT says in its letter, I can see that his case has been through all the sorts of processes that one would expect. I hope and pray that in the course of all that and through the various appeals that he has made, everything has been properly considered by the PCT.
It strikes me, however, that the most obvious thing that should have been done has not been done. Nobody seems to have sat Mr Aziz down—this is not the hon. Lady’s job, because she knows no more than I do—and explained things to him. If there is a good reason, he should be told. If it is about the money, we need to know exactly what the problem is. I suggest that those who may be listening, whether they be in this building or watching on television, should sit down with this man and discuss the way forward for his treatment.
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They should provide him with an explanation, because he is not just a human being—and it does not matter whether he is a good or a bad man—but one who is extremely ill with a life-threatening disease. Somebody needs to sit down and do a proper job on this, just like the hon. Lady has done in bringing the case to the House.
I despair—we should not have to be here, but we are. The emergence of the clinical commissioning groups will lead, I hope, to a far better system. They will make decisions based on their own knowledge and understanding as clinicians. They will also, in many ways, be far more accountable than primary care trusts have been. Every CCG will have a representative on the upper-tier local authority’s health and wellbeing board. The theory that generated the highly controversial legislation that went through this place is that it would be much better for decisions to be made at a more local and accountable level by those best placed to make them, namely health professionals.
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I fear that I have not been able to answer the question asked by the hon. Lady and Mr Aziz, whom I wish well, as we all do. I hope that, as a result of this debate, which the hon. Lady quite rightly called for, people will sit down and not only perhaps have a rethink, but certainly give a human being an explanation, if for no other reason than because, at the end of the day, he pays their wages. On those somewhat positive remarks, I hope that this matter might be concluded to everybody’s advantage.
Mr Deputy Speaker (Mr Nigel Evans): As we conclude proceedings, may I wish you all a happy St David’s day.