4 Dec 2013 : Column 299WH

As the hon. Gentleman outlined, there is a need for sufficient funding. When we look at what this involves, we can quickly appreciate the importance of the subject. He referred to the 75% increase in skin cancer in the past year. As an elected representative with a particular interest in health issues—I am my party’s health spokesperson in this place—I have a close relationship with my counterpart and colleague in Northern Ireland, the Health Minister, Edwin Poots. He furnished me with figures that indicate that the increase in Northern Ireland is equal to the figures given earlier, if not just above in many cases. I find that as worrying as the hon. Gentleman did.

I have read the report and it is helpful to read some of the background information. A team from East Anglia recorded data. Some people will say that there are lies, damned lies and statistics. Perhaps that is not entirely fair, as they can provide helpful information. The team referred to an 11-year study that showed that basal cell carcinoma increased by 81%. They extrapolated their figures across the whole of the United Kingdom to come up with figures. Whether they are entirely accurate, I do not know, but I think that they do give a feel for the subject and an indication of the number of people who may be affected. The report said that

“around 200,000 patients had 247,000 cases of BCC treated surgically.”

That is just one type of skin cancer, which gives an idea of the magnitude of the problem.

I want briefly to give some details of what we are doing in Northern Ireland. Again, I do that from a positive frame of mind, because I believe that, if we are doing something, that can be helpful. The hon. Member for Mole Valley (Sir Paul Beresford) may not have known about the programme that is taking place in the area of the right hon. Member for Chesham and Amersham (Mrs Gillan), but if something good is happening, we should exchange those ideas to help each other. That is something that we initiated in relation to dermatology overall as well as skin cancer. In the past year, the Health and Social Care Board invested some £1 million recurrently and another £3 million non-recurrently in dermatology services, including psoriasis drugs. That is for a population in Northern Ireland, as the Minister will know, of 1.8 million, which puts the amount invested into some perspective.

My second son, like the hon. Member for Gainsborough, was born with what I would refer to as scaly skin, or eczema. I have to say that I did not wash him very often, but my wife would always wash him morning and evening up to about the age of six or seven, as well as creaming him twice a day. What was interesting was that eventually the eczema left him, but, as that left him, something else took its place: asthma. That was an unusual reaction, but as the eczema left, the asthma increased, so there is obviously, as the doctor at the time made us aware, a medical connection between the two conditions. The interaction was close and clear.

The Northern Ireland Department of Health has an additional £240,000 of recurrent funding confirmed for dermatology services in the Northern Health and Social Care Trust. That is only one of four trusts in Northern Ireland. The board is working with the others to finalise their recurrent funding requirements, which are estimated

4 Dec 2013 : Column 300WH

to be about £500,000. I mention that strategy of working together with the trusts because trusts and councils on the mainland could come together to do something similar to spread the cost.

The debate is about the funding of dermatology in the NHS. We are in difficult times, and everybody acknowledges that finance is not always available in the way it was in the past. We have to make better use of the money we have, and we have to try to do that in a way that delivers services and address all the issues. We have tried to do that in Northern Ireland, and I know the House and the Minister are also trying to make better use of the money that is available.

The Health and Social Care Board has also been working with local GPs to redesign the traditional patient pathway for dermatology assessments. Again, early diagnosis is important, and the figures in the background information for the debate indicate that. Some of the survivors of skin cancer I have spoken to would say the same. Some of those cancers are usually completely curable. One cancer, if caught in the early stages, might need surgery, chemotherapy and/or radiotherapy, but there is hope when the dreaded “big C”, as many people call it, comes upon us.

Initiatives have also included the funding of a photo-triage pilot. It will, I hope, help the Minister to hear what we have been doing. The pilot scheme will deliver its results in March next year, and it would be helpful if they were made available so the Minister can see what has happened. As part of the pilot, GP practices can refer patients with suspected malignant melanoma or—forgive my Northern Ireland accent—squamous cell carcinoma to a dedicated photographic clinic, which is used to triage the patient, thus reducing unnecessary out-patient attendances. That pilot can shorten the process and focus resources on the issue in hand. If the pilot is successful, as I hope it will be, the figures it produces will be helpful.

I want quickly to comment on sunbeds. Some Members have spoken about them, and others will speak about them as well, including perhaps the hon. Member for Romsey and Southampton North (Caroline Nokes).

Caroline Nokes (Romsey and Southampton North) (Con) indicated dissent.

Jim Shannon: Maybe not—I thought that might be one of the issues she would touch on.

In my previous job as a Northern Ireland Assembly Member and a member of Ards borough council, in my constituency, I had some influence on this issue. The council was concerned about the effects of sunbeds, and it was aware of the importance of controlling, monitoring and regulating them. It took decisions to do that, and other councils took similar initiatives. Again, that shows we have done things in the way they should have been done.

Again, I congratulate the hon. Member for Gainsborough on bringing this important matter to Westminster Hall for consideration. I very much look forward to the Minister’s response. I hope that my comments about what we do in Northern Ireland have been helpful, and that is particularly true of my comments about the pilot scheme and the way in which triage can work with GPs, hospitals and, more importantly, the patient.

4 Dec 2013 : Column 301WH

Several hon. Members rose

Mr Andrew Turner (in the Chair): Order. We have 22 minutes to go.

3.14 pm

Caroline Nokes (Romsey and Southampton North) (Con): I assure you I will keep my comments brief, Mr Turner. I congratulate my hon. Friend the Member for Gainsborough (Sir Edward Leigh) on securing this important debate on the funding of dermatology in the NHS and on giving Members the ability to raise specific issues that may have been put to them by dermatologists, expert groups and patients.

I am a member of the all-party group on skin, although I am obviously not as exalted a member as my hon. Friend the Member for Mole Valley (Sir Paul Beresford), and I do not share the same expertise, but I have benefited over the years from personal experience of dermatological services. I am also the chair of the all-party group on body image, which has given me the privilege of working with organisations such as Changing Faces, which has brought to my attention some of the work that it does with patients with severe skin conditions. Changing Faces provides what it refers to as skin-camouflage clinics, and the word “camouflage” is interesting in this context. Many people who suffer from serious skin conditions will attempt to camouflage themselves—to hide away—because they are so self-conscious about their conditions.

I was present in this Chamber yesterday afternoon for a debate on the effects of the drug Roaccutane—a very effective, serious drug used to treat severe acne. I have a different Minister to address my comments to today, and I do not intend to rehearse the whole of yesterday’s debate, but there are some pertinent issues that I would like to draw to her attention.

Many sufferers of skin conditions will have depression and anxiety long before they ever get to see a dermatologist, and yesterday we heard in detail how important it is for dermatologists to have the time and the knowledge to be able to go through in detail the possible side effects of any medication that may be prescribed. Even dermatology drugs—drugs for the skin—can have severe side effects, including depression, and I am sure Members will agree that psychological illnesses need careful handling and treatment. Medical professionals need time to address concerns properly, but more than one consultant dermatologist contacted me before the debate to say that the specialism is under pressure and that time is at a premium.

Yesterday, the hon. Member for North Devon (Sir Nick Harvey) raised the issue of Roaccutane and the need for rigorous up-to-date research to ascertain why some groups of patients are more vulnerable to its severe side effects than others. When I say there are severe side effects, I should point out that there have been some incredibly tragic cases, in which young people who have been prescribed the drug have suffered terrible depression, and that has sometimes gone on for many months or even years after treatment has concluded. A number of young people have also committed suicide, and that is thought to be as a result of having taken this drug. Sadly, we lack up-to-date research and scientific evidence that proves a causal link between Roaccutane and suicide.

4 Dec 2013 : Column 302WH

The hon. Gentleman’s contention yesterday—I support him in this—was that only a public authority will be in a position to undertake the level of research required.

I would like to take the opportunity of today’s debate to highlight some points to the Minister. About 13 million people will present at their GP with a skin condition, and family doctors spend a significant proportion of their time treating patients with a skin problem, so dermatology is a significant part of the work of primary care. Dermatologists are concerned that the time they are spending on these conditions is not matched by the investment in research and that dermatology is something of a Cinderella service, as we have heard.

The overall burden of skin disease is large and growing, and to that mix we can add a lack of consultants and the drugs that can have a seriously negative impact on mental well-being, so it is not surprising that there are real concerns. With the specific case of Roaccutane in mind, I suggest that there needs to be better investigation of the causal link between the use of Isotretinoin and depression, self-harm and even suicide. That research is long overdue, and I have no doubt that it will fall to the Department of Health to make sure it is funded. I urge the Minister carefully to consider the case, which I wholeheartedly support, for better science, more evidence and independent study.

I know from work with organisations such as Changing Faces that those suffering serious skin conditions are far more likely than the general population also to suffer depression. Skin conditions can be extremely debilitating, especially for the young; they can cause a lack of confidence and an unwillingness to engage in social activities. At that particularly difficult and hormonal time, they can also have a disproportionate impact on mental well-being.

It is very careless to dismiss skin complaints as nothing more than a few spots or a bit of dryness or redness, especially if the face is affected. To the sufferer, such things can be a huge emotional and psychological burden. My hon. Friend the Member for Gainsborough spoke of the endless images in the media of physical perfection and perfect, flawless skin, and that all adds to the psychological stress.

I wish to focus briefly on training and the importance of making sure there are trained professionals to step into the 180 unfilled consultant posts the British Association of Dermatologists estimates currently exist. In some places, those posts are filled by long-term locums, who might be without the training and credentials required of a permanent appointee.

I would like to take the Minister back to the subject of Roaccutane. It is a highly toxic drug, intended for use in only the most severe cases and requiring very close supervision. It can be prescribed only by a dermatologist, the very specialism in which as I have explained there is a shortage; so patient waiting times increase, and the time the consultant has to spend with each patient reduces, along with the opportunity to discuss changes in their mood or mental well-being. The time for follow-up care is inevitably limited. That all comes together to give patients the impression of long waits and rushed appointments and results in a greater temptation to find a private consultant and pay for a private prescription. Among the families of people who suffered negative effects from Roaccutane, several have emphasised to me how many young people who had self-harmed were in

4 Dec 2013 : Column 303WH

receipt of private prescriptions because the families were too desperate to wait the six months for an NHS consultation.

My experience of consultant dermatologists working in the NHS has been nothing short of fantastic. The professionals with whom I have been in contact are dedicated and determined to get the best outcomes for their patients; and they have cut no corners. However, the growing dermatology case load puts them in an increasingly difficult position—perhaps particularly on the south coast. In places such as my constituency there are longer hours of sunshine and high life expectancy, and the incidence of cases of skin cancer is increasing. That all adds up to a stretched service. A local consultant dermatologist wrote to me outlining what he called a work force crisis, with a national shortage of consultants and considerable variation in the quality of dermatology provision across the country, as services are increasingly provided by those without appropriate training. That cannot go on. The service is demoralised and under pressure, and is struggling to identify where the next generation of skin experts will come from.

I urge the Minister to consider the situation closely. The specialism is crying out for the sort of TLC that the specialists are so good at giving their patients, which gives those patients the confidence to go out and face the world. I commend to the Minister the remarks of my hon. Friend the Member for Gainsborough about training, the threat of fatal mistakes in diagnosis and the need for a national clinical director in dermatology.

3.21 pm

Rosie Cooper (West Lancashire) (Lab): It is a pleasure to serve under your chairmanship for this afternoon’s debate, Mr Turner. I congratulate the hon. Member for Gainsborough (Sir Edward Leigh) on securing this important debate, which will be relevant to the 13 million people who present each year with skin problems, and their families.

I want to focus on psoriasis, on the often under-appreciated burdens that its sufferers bear, which go beyond the effect on their skin, and on the barriers to their getting the best care. On 1 November, I chaired a summit in west Lancashire, where seven of my constituents with psoriasis met the award-winning dermatology team at Ormskirk hospital, as well as some local GPs and the west Lancashire clinical commissioning group. I learned how psoriasis affects people, beyond the plaques on their skin, and the changes that we need to make to secure the high-quality care that my constituents and other psoriasis sufferers deserve.

Psoriasis is a terrible and lifelong condition. I have observed it through a personal connection, because after my mum died my father, who was 62, developed psoriasis. The Psoriasis Association tells me that the average member has been living with psoriasis for 32 years. The personal toll of living with the disease and its cumulative impact, which commits people to lifelong skin care, is enormous. The effects are felt beyond the individual and reach to people’s families, employment prospects and participation in society. The painful plaques are highly visible, which leads to rejection and stigma on top of everything else. Worse, 40% of people with severe psoriasis will develop psoriatic arthritis, which can lead to more pain as well as joint damage.

4 Dec 2013 : Column 304WH

Psoriasis is also associated with mental health problems. It affects the skin and the joints, as well as people’s psychological well-being and life expectancy. Research has shown that the cumulative impact of psoriasis on people’s quality of life can be as significant as that of type 2 diabetes. One person in 10 with psoriasis considers suicide. I met such a person at the summit and it was heartbreaking to hear how the condition had affected her life. That is the most extreme end of the condition, but it shows the devastating impact that psoriasis can have on people’s lives.

Many positive things are happening for people with psoriasis, including the recent publication of the National Institute for Health and Care Excellence quality standard on psoriasis, which gives guidelines on treatment. The national standard constitutes progress, but the Psoriasis Association called it a

“minimum standard, not a gold standard”.

Psoriasis care is not always up to that standard. In some areas, even achieving the minimum standard is, sadly, an aspiration.

To an extent, the degree of understanding and appreciation of the full effects of psoriasis has a direct consequence on the funding of services. Despite the fact that 13 million people present with skin problems each year and that 15% of GPs’ time is spent managing patients with skin conditions, there is still a lack of understanding, even within the medical profession, about dermatology. I have been contacted by a consultant dermatologist who believes that dermatology has been neglected in medical schools and in GP training, so that GPs are often ill-equipped to deal with the variety, complexity and volume of cases. We need more specialist education for people such as GPs who look after patients when they are not in the care of the dermatology team.

3.26 pm

Sitting suspended for a Division in the House.

3.36 pm

On resuming—

Rosie Cooper: Figures provided to me show that 180 dermatology consultant posts in the UK are unfilled, out of a total of 830. In Ormskirk, the dermatology service struggles to attract doctors to fill full-time roles. It has a work load roughly equivalent to that of nearby St Helens, but whereas St Helens has seven consultants, Ormskirk has two. We also need specialist nursing capacity and more space in the department. Nearby services have several light-therapy machines, but Ormskirk has only one, so my constituents have to wait six or eight weeks for treatment—once they have had their referral, and on average there is an eight to 12-week wait just to be seen by a specialist. Ormskirk is an award-winning service, yet the team there do not have the resources they need.

A 2008 audit showed wide variations in treatment. Access to specialist treatments such as biologic drugs, specialist nurse support and psychological services is sporadic throughout the country. Access to psychological support is a major theme of the new quality standard for people with psoriasis, yet 80% of the 170 dermatology departments that responded to the 2013 BAD audit of services reported having no access whatever to psychological support for patients.

4 Dec 2013 : Column 305WH

We know from research that early intervention and appropriate treatment for psoriasis will contribute to a person’s psychological well-being and ability to continue in the working environment. It really is not enough simply to treat the skin. I have seen pioneering dermatology services where patients have access to a resident psychologist as a routine part of their treatment. I want and need that level of support for my constituents. I hope that the Minister will encourage commissioners and dermatology services across the country to look at the evidence base and adopt that model.

That does not mean that we need to find a magical pot of new money; it means using existing tools to incentivise what works best. That could even save money in some cases. Commissioning groups are held to account through the outcomes indicator set; will the Minister encourage the National Institute for Health and Care Excellence to develop indicators covering dermatology? As in other areas, in dermatology we need better co-ordination between primary and secondary care; will the Minister encourage NICE to create a quality and outcomes framework indicator on dermatology, to incentivise that? Eventually, it would be great to see a best practice tariff or a national CQUIN—commissioning for quality and innovation—payment framework for psoriasis. At the moment, dermatology is such a Cinderella service that that seems ambitious, but we must aim for it. We need central clinical leadership to push dermatology up the agenda, to promote quality improvement and to reduce local variation.

Perhaps the Minister will tell us why, when other specialists are getting going with their strategic clinical networks and have plenty of clinical leadership from the centre, dermatology does not even have a national clinical director. From a response to a written question back in May, I learned that NHS England does not have a single person responsible for dermatology. Will she tell us whether that is still the case? We must recognise the burden that psoriasis places on people’s lives and ensure that dermatology services are properly joined up and properly funded. I hope that the Minister will task NHS England with making that happen.

Finally, will the Minister join me in congratulating the Psoriasis Association on a very successful psoriasis awareness week last month? The members have created a booklet, “I wish someone had told me…”, which is full of practical advice, and I recommend it to anyone suffering from the condition. We must all work together to provide a quality service for all patients with skin conditions, particularly psoriasis.

3.41 pm

Mr Jamie Reed (Copeland) (Lab): As always, Mr Turner, it is a pleasure to speak under your chairmanship. I extend my sincere thanks to the hon. Member for Gainsborough (Sir Edward Leigh). I understand that dermatology is extremely close to his heart, and the personal testimony that he shared with the House today was a frank and honest account of what many of our constituents live with daily.

I can scarcely remember a health debate in this place when the hon. Member for Strangford (Jim Shannon) has not been present and made a tremendous contribution. He did so again today, as did my hon. Friend the Member for West Lancashire (Rosie Cooper) and all

4 Dec 2013 : Column 306WH

hon. Members. If only the House could speak with such unanimity of purpose on other issues. The chairman of the all-party group on skin, the hon. Member for Mole Valley (Sir Paul Beresford), also made a telling contribution.

This might be the first time I have debated with the hon. Member for Gainsborough. I was supposed to have debated religious freedom with him at the Oxford Union in 2005 when I was a young Back Bencher, but under pressure from the Whips, I was unable to attend, so we will never know whether that exchange would have been contentious. However, I am delighted to debate the issue before us today.

“Dermatology” is a wide-ranging umbrella word covering more than 2,000 conditions of varying severity, all of which have a detrimental impact on the quality of life of those who are affected. “Cancer” is also a wide-ranging word denoting many different types, including basal cell carcinoma, squamous cell carcinoma, malignant melanoma and others such as Kaposi’s sarcoma and cutaneous T-cell lymphoma. Dermatology also covers skin rashes, skin infections and acne. Acne and skin rashes may not seem to be serious medical issues and do not often cause such serious complications as other skin conditions may do, but they are far from trivial, as we have heard, and may have a huge impact on the psychological well-being of the individuals who suffer from them.

The wide-ranging nature of dermatological practice means that episodes of treatment for conditions are extremely common. Skin cancer is one of the most common cancers in the world, as we have heard, and the NHS estimates that there are around 100,000 new cases of non-melanoma skin cancer in the UK each and every year. Thankfully, through excellent research and brilliant work by professionals and charities alike, skin cancer is becoming more and more treatable, but it is not “job done” and we must continue to strive for even better patient outcomes. I am sure that all hon. Members agree.

Skin diseases represent more than one third of diseases in children. One in five children in the UK have eczema. The British Association of Dermatologists, in its recent evidence to the Select Committee on Health, stated that children with serious skin conditions have their quality of life impaired to the same extent as those with chronic illnesses such as epilepsy, renal disease and diabetes.

Acne is a very common skin disease and affects many people. It is often trivialised as a passing phase for teenagers, but that is not the case and it can continue throughout their 20s, 30s and even 40s. The scarring left by acne is permanent and may have lasting effects on the psychological well-being of those who are affected. The British Association of Dermatologists says that it may have a major impact not just on someone’s relationships, but on their employment prospects throughout their life.

In this very Chamber yesterday afternoon, hon. Members debated the side effects of a drug, Roaccutane, used to treat acne. It is very effective in clearing up acne and is often prescribed to those who suffer the condition. It can be prescribed only by a specialist dermatologist because of its associated side effects, which, it is said, can range from relatively minor issues such as dry lips and chapped skin to serious mental health problems linked to depression and suicidal thoughts, as well as physical conditions such as diabetes and kidney problems.

4 Dec 2013 : Column 307WH

When a significant number of people rely on such treatment to improve their quality of life, Government of all colours must give a commitment properly to fund research and development for new treatments. Many thousands of people rely on drugs such as Roaccutane and face the many risks associated with them. We must commit to developing new and safer drugs. Will the Minister give that commitment today? Will the Government help to facilitate the development of new medicines and new treatments for these conditions?

In 2009, the previous Labour Government legislated to introduce a ban on under-18s using sunbeds. That ban was an important step in protecting people of all ages from what can be harmful tanning practices. Will the Minister, who is responsible for public health, tell us what steps she is taking to increase awareness of the risks of using sunbeds? I certainly hope that she will retain the previous Government’s focus on the issue.

Other skin complaints have an impact on many millions of people in the UK and continued work is essential for progress to be made. I again thank the hon. Member for Gainsborough for securing this debate because at a time when funding and commissioning in the NHS have been thrown into turmoil—some clinical commissioning groups will have their funding slashed in the next couple of days—it is crucial that treatments and research are properly funded.

The funding of dermatology services in the NHS has been made ever more complex by the Health and Social Care Act 2013 with some treatments now being commissioned by NHS England on a national scale and others being left to local clinical commissioning groups, resulting in a fragmentation of services and a poorer experience for patients. The British Association of Dermatologists said:

“Provision of the type of care affected people need is under resourced, fragmented and of variable quality in terms of manpower and facilities. This is exacerbated by poor teaching and training of dermatology in medical schools and general practice, and underfunding of relevant research.”

These very serious concerns have been raised by a well-respected charity with unparalleled expertise in this area. Will the Minister tell us whether they have been raised by anyone else with her Department, and what action the Government are taking to tackle them?

The resources available for dermatological purposes are majorly overstretched. It is estimated that skin conditions result in 13 million consultations each year in general practice—I think we heard that figure earlier. If we had the pro rata equivalent of dermatology consultants in Germany, France, the USA and elsewhere, we would need almost 10 times as many as we have currently. Will the Minister also tell us whether there are recruitment plans in place to ensure that this highly specialised discipline is adequately catered for throughout the national health service? Not only is access to dermatological expertise in the UK subject to a postcode lottery in terms of quality, but the resources and the necessary work force are simply not there to care for the patients who rely on those services.

We have heard many testimonies today, and not just those of hon. Members here. When hon. Members speak of their own circumstances and difficulties, we achieve a better quality of debate and tend to edge towards

4 Dec 2013 : Column 308WH

better policy outcomes. In the light of the testimonies we have heard today and of what our constituents, patient groups, charities and professionals tell us, it is clear that the evidence points to a specialism under severe strain. It is underfunded, understaffed, under-resourced and, as a result, under immense pressure. The profession’s staffing levels are clearly a major problem.

Sir Paul Beresford: The biggest problem is education. It takes a very long time to give someone expertise, particularly in this area with around 2,000 diseases or variations of them. Will the hon. Gentleman think carefully and recognise that any unfilled consultant place goes right back to a lack of education under his Government?

Mr Reed: I am grateful for that intervention. I make the point repeatedly every time hospital doctor statistics are mentioned by Ministers. I absolutely recognise the hon. Gentleman’s point and welcome his making it: he is absolutely right to say that education is surely at the core of the problem.

Staffing levels in the profession are clearly a major problem. Will the Minister give an assurance today that those who need the services of a specialist dermatologist will have access to them? If not imminently, when? Should the Government bring forward effective proposals, I give the Minister the assurance that they will have the Opposition’s support. Where the Minister cannot answer my concerns, I would appreciate a written reply.

3.50 pm

The Parliamentary Under-Secretary of State for Health (Jane Ellison): It is a pleasure to speak under your chairmanship, Mr Turner. I pay tribute to the hon. Members who have spoken today and particularly to my hon. Friend the Member for Gainsborough (Sir Edward Leigh) for securing the debate. As has been illustrated throughout, this is an under-discussed area and it seems to be neglected in other ways, too. The debate has been valuable, and I have certainly learnt a lot during its course and in my preparation for it. Inevitably, there will be some points on which I cannot give a full answer today, but I shall endeavour to follow up with hon. Members if I cannot. I also pay tribute to the all-party parliamentary group on skin. I have looked at the recommendations in its recent report, and I pay tribute to the members of the group who have spoken today.

We have heard from several Members how many people are affected by skin disease and I shall not go over those numbers, which are very large indeed. There is a huge range of skin diseases; some are manageable and others are life-threatening, as we have heard. All have an impact on people’s lives and, in particular, can affect their personal appearance, as Members have highlighted in moving terms. In that way, skin problems perhaps represent more of a day-to-day challenge than many other conditions. They impact on all aspects of life, such as employment and personal relationships. It is, therefore, important to ensure that people with skin disease receive both the treatment and support that they need. As today’s debate has highlighted, considerable challenges remain, many of which we have not necessarily bottomed out during the debate, but we have begun to highlight some.

4 Dec 2013 : Column 309WH

Let me first plug the national framework. Skin disease is a long-term condition, and through the NHS mandate we have made it clear to NHS England that we want to see the NHS among the best in Europe at supporting people with long-term conditions. We want them to live healthily and independently, with better control over the care that they receive. Those improvements are monitored through the NHS outcomes framework, for which ambitious expectations have been set out. In turn, the NHS will monitor the performance of clinical commissioning groups through the clinical commissioning group outcomes indicator set, on the quality of the services and health outcomes achieved through that commissioning.

As my hon. Friend the Member for Gainsborough highlighted, commissioning for most dermatology services is a matter for CCGs. They are better placed to use their clinical insight, local knowledge and local relationships to do excellent commissioning at a local level than Ministers in Whitehall, but I take on board the challenge about the more specialist areas. We are not leaving CCGs to commission without support. NHS England is working closely with them to ensure high-quality commissioning, and it has established commissioning support units and quality surveillance groups across the country. However, as my hon. Friend the Member for Mole Valley (Sir Paul Beresford) said, it is certainly something that I can raise on appropriate visits when the opportunity arises. As the Public Health Minister, given that so much of my portfolio is localised, I am very keen to draw attention to good practice where we see it.

There is an example in the area of my hon. Friend the Member for Gainsborough, where his local CCG has introduced a teledermatology pathway, which allows patients to be reviewed at their own practice. We also heard of an excellent example from Buckinghamshire, which I was speaking about with my right hon. Friend the Member for Chesham and Amersham (Mrs Gillan) during the break for the Division. The pathway in the area of my hon. Friend the Member for Gainsborough is being implemented across 10 practices from September. If it is successful, it will be rolled out across all the practices in the Lincolnshire West CCG. I am always interested to hear about good practice. A number of kind invitations for visits have been made during the debate and I look forward to following those up with Members so we can highlight people who are being innovative in a way that will help other commissioners.

As has been mentioned, with some highly specialist dermatology services for conditions that cannot be treated locally, it is appropriate for NHS England to commission them directly. NHS England has set out detailed service specifications for the services that it directly commissions. I realise that a number of Members have made points about the national clinical director, and that issue has been raised in other contexts, too. It is a matter for NHS England whether it appoints a national clinical director. I understand, from asking it the question, that there are no current plans to introduce an NCD for dermatology, but it is continuing to discuss with the British Association of Dermatologists the best ways to improve outcomes for patients.

As has been said, aspects of treatment of people with skin conditions can be considered under any of the five domains. That change in the new NHS focuses on

4 Dec 2013 : Column 310WH

people as individuals rather than on their conditions, which is why the patient pathway and not the organisations that treat them is given the closest attention. Many of the national clinical directors have cross-cutting roles—I have come across that in other areas of my portfolio—rather than roles that are related to individual medical conditions, so it is not the case that dermatology is being singled out. Clinical directors often cut across.

There is interest in the research—points have made about it—that is going on to get better results in dermatology and to come up with new treatment, so I shall touch on that. I reassure the Chamber that investment by the National Institute for Health Research in skin research increased from £4.7 million in 2010-11 to £8.7 million in 2012-13. That includes the NIHR investing £2.6 million over five years in the biomedical research centre at Guy’s and St Thomas’s and the King’s College London centre, which is leading the way in research on cutaneous medicine. The NIHR is dedicated to translating these scientific discoveries into improvements in treatment, which we hope will benefit patients at the earliest opportunity.

The NIHR has also awarded nearly £2 million to Salford Royal NHS Foundation Trust to undertake a programme of research on psoriasis. The studies will look at crucial issues, including individual patient experience, difficulties faced by service providers and identifying levels of risk in populations. I hope that the hon. Member for West Lancashire (Rosie Cooper) will take particular comfort from that, and I am sure that she will be interested in the outcome of that programme. The NIHR is also investing nearly £1 million in a trial of silk therapeutic clothing for the long-term management of eczema in children.

My hon. Friend the Member for Gainsborough will know that NICE has also published guidance on a range of dermatological conditions, including atopic eczema in children and psoriasis, and it has issued quality standards on those topics. NHS England is statutorily required to have regard to NICE quality standards, and we expect health and care professionals to take NICE guidance on the treatment of relevant conditions fully into account when deciding how to treat a patient.

NICE has also recommended a number of drugs for the treatment of dermatological conditions such as eczema and psoriasis. Patients have a right in the NHS constitution to access drugs and treatments recommended by NICE technology appraisal guidance that their clinicians want to prescribe.

As I acknowledged earlier, and as has been very much illustrated during the debate, skin disease can have adverse psychological effects on patients. The NICE quality standard on psoriasis recognises that and sets out that people with psoriasis should be offered an assessment of how their physical, psychological and social well-being is affected when they are diagnosed and when they undergo treatment. It is the responsibility of all commissioners, providers and clinicians to ensure that patients receive the psychological and emotional support that they need. Hon. Members may be aware of the IAPT—improving access to psychological therapies —programme, which is an NHS programme rolling out services across England offering interventions for people with depression and anxiety disorders. I understand that as part of that programme, NHS England is looking

4 Dec 2013 : Column 311WH

at how best to support people with psychological problems arising from their physical problems. That issue was raised a number of times during the debate.

I listened carefully to the comments of my hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), who highlighted that the issue of Roaccutane was discussed only yesterday in the Chamber. It is associated with rare, serious side effects and can only be prescribed by or under the supervision of a consultant dermatologist. The BAD has published guidelines for its members about when to prescribe it and how best to monitor patients for adverse effects during treatment. I will certainly make a point of catching up with my hon. Friend the Minister of State, who responded to that debate. I will ensure that we touch base with regard to the important subject that my hon. Friend the Member for Romsey and Southampton North has raised today.

The issue of GPs’ and other health workers’ education and training has come up a lot. My hon. Friend the Member for Mole Valley made it the focus of his speech. It is important that health professionals have the right training. Training and education of health professionals is a matter for Health Education England and the royal colleges. NHS England is statutorily required to have regard to the NICE guidelines, and we expect health professionals to have regard to them, too. I am aware that the BAD has produced toolkits and guidance. They are valuable resources for health professionals and should be promoted widely. NHS England has responsibility to support CCGs, as I said, with commissioning guidance and tools and it can flag up the relevant dermatology guidance and standards.

I understand that NHS England’s domain director for long-term conditions regularly meets the president of the BAD, who is also an adviser to the all-party group on skin. I am sure that the issues about the education of GPs are raised at those meetings.

The current framework for accreditation and re-accreditation of GPs with a special interest remains under review, following the transition to the new arrangements for the NHS in England. NHS England is working with the Royal College of General Practitioners and with dermatologists to produce an improved and consistent accreditation system. It is expected that there will be a report early next year, and I am sure that there will be interest from hon. Members in that.

I am concerned about the point that has been made about the shortcuts being taken on some of the training courses. I thought that what was highlighted today was quite alarming. I have heard that before. It is certainly something that I will put on the agenda for my forthcoming meeting with the Royal College of General Practitioners. I will report back to my hon. Friend the Member for Gainsborough, who raised the matter and said that there was considerable interest in it in the House.

Since 2002, there has been a 40% increase in consultant dermatologists, but I accept that that is from a modest base. It is clear that, although there was an increase of 28% between 2002 and 2012 in the total number of staff, we still have more to do, but things are improving. Health Education England needs to ensure that we have the right dermatological work force. I will ensure that it is aware of the issues that have been raised today and highlight the concerns of hon. Members.

4 Dec 2013 : Column 312WH

Many of the problems highlighted in the debate have not really been funding issues, which I suppose makes a change in an NHS debate. They have actually come out of a lack of engagement that hon. Members have highlighted. I think that some hon. Members have even alluded to there being a sense of complacency sometimes with regard to skin conditions and they asked whether such conditions are taken sufficiently seriously. I am not sure that in this debate we have quite got to the bottom of why clinicians perhaps do not choose to specialise in or pursue this line of work, but today’s debate is useful in highlighting that.

Sir Edward Leigh: Will the Minister take away to her fellow Ministers the point that the psychology of all this is very important and, in particular, read the report from the group chaired by my hon. Friend the Member for Mole Valley (Sir Paul Beresford)? A lot of people, when they poke fun at others because of their appearance —their skin colour or something else—do not realise that they are causing them psychological damage. That is the particularly the case with children. It is an important point that we want to be taken away from the debate.

Jane Ellison: I am very happy to give a commitment to take that point away and I will certainly bear it in mind in other discussions that I have.

I am glad that some hon. Members have taken the opportunity offered by the debate to highlight the growing issue of malignant melanoma. It is absolutely right to say that we need to make more people aware of the dangers of skin cancer. I was struck by the point made by my hon. Friend the Member for Romsey and Southampton North about the regional variation and the fact that in her area it is a particular problem.

The Department has funded Cancer Research UK to continue to test approaches to encourage, in particular, men over the age of 50 to visit their GP if they have signs of skin cancer. I have to say that, if anyone can come up with a magic way of making men over 50 approach their GP about anything, that would be very welcome and they would be rewarded by all parts of the NHS.

Sir Paul Beresford: There is a largish American community in Surrey, just outside my constituency. They are very aware of skin protection, to such a degree that there is a slight recurrence of rickets.

Jane Ellison: That is perhaps a debate for another time, but I note the concern. There is a happy medium to be struck.

Hon. Members might be interested to know that in autumn 2013 Cancer Research ran a campaign in south Devon, utilising text message communications, phone consultations with specialist nurses and volunteer community outreach to try to address some of the barriers to getting harder-to-reach groups to seek advice about skin concerns. Between 2003 and 2011, Cancer Research also collected data via the Office for National Statistics monthly omnibus survey to measure awareness, attitudes and reported behaviour of adults in relation to sun protection. The Department is funding a repeat of that survey in 2013, so that Cancer Research can track changes over time. I think that the results will be very interesting.

4 Dec 2013 : Column 313WH

Public Health England, in partnership with the Department, NHS England and other stakeholders, proposes to run a local “Be Clear on Cancer” pilot campaign in early 2014 to encourage the early detection of malignant melanoma. The South West Strategic Clinical Network will host that pilot. It will build on evidence from the work in this area that I have just described.

This is a sizeable challenge. We can only, as individual Members of Parliament, take every opportunity that we can to encourage people to seek help from their GP and not to put that off, because for some cancers, the only thing that explains different outcomes for men and women is the fact that men refer themselves later and therefore do not benefit from early diagnosis.

With regard to the point made by the shadow Minister, the hon. Member for Copeland (Mr Reed), on sunbeds, I can respond to him separately on some of the specific things that he asked. I will make the point that the figures that I have seen for the problems associated with sunbeds are highly regionalised and that is one reason why public health is now devolved to local government. Some local government areas are giving the issue real attention and making it a priority. It is perhaps better suited for that sort of local and regional priority than it is for a national campaign, but I take the point that he makes.

A range of support is in place to help GPs to identify malignant melanoma. There is NICE guidance, “Improving Outcomes for People with Skin Tumours including Melanoma”, and there are the “Referral guidelines for suspected cancer”. We cannot highlight them too often.

I would like to take this opportunity to recognise the hugely important role that patient support organisations play. As has been said, they sometimes operate on a shoestring. They make an enormous contribution in helping patients to understand and cope with their conditions. Sometimes, knowing someone who can stand alongside us and say, “I know how you feel and this is how we have learned to cope with it,” is very important as a supplement to clinical guidance.

I again congratulate my hon. Friend the Member for Gainsborough on securing the debate and raising the profile of what is an important issue. As I said at the outset of my speech, I have learned a lot in researching my response to the debate, and I will now have these important issues firmly in my mind in my meetings and visits, where I can raise them. I pay tribute to the work that my hon. Friend is doing and to the all-party group. I assure the House that I will make NHS England and all the relevant bodies that I have mentioned today aware of the issues raised in the debate and the depth of feeling expressed about them.

4 Dec 2013 : Column 314WH

Press Charter

4.8 pm

Richard Drax (South Dorset) (Con): It is a privilege to be under your chairmanship, Mr Turner, for this debate on press freedom as I see it. A colleague of mine would like to speak for a short time, so when I conclude, he will ask to speak. I know that others wish to intervene, and I would be very happy to take interventions.

Having been a journalist for some 17 years, this subject is dear to my heart. The principles of free speech and a free press are cornerstones of our democracy. At its best, our press is indeed Churchill’s

“vigilant guardian of the rights of the ordinary citizen”,

rooting out wrongdoing and holding the powerful to account. At its worst, it is vicious and petty, wounding those it should protect, but for all its faults, I am proud and fortunate to live in a country with a free and often irreverent press. It is a beacon of hope across the globe, which is why I was genuinely surprised when, back in March, 530 hon. Members dared to cross a threshold not crossed for 300 years.

In response to the Leveson inquiry, the Government established a new system of punitive exemplary damages in an amendment to the Crime and Courts Bill. Only 15 Members voted against, myself included, and some of the glorious 15, as TheSpectator magazine called us, are here today.

Since then, the press charter has received Royal Assent. The legislation amounts to the toughest regulation of the press in the free world, and it has been greeted with widespread condemnation. In the US, where freedom of the press is enshrined in law under the first amendment, such legislation would be illegal. The New York Times states that the regulations will

“chill free speech and threaten the survival of small publishers and Internet sites.”

Many other countries have joined the chorus of disapproval. A senior delegation of “concerned” publishers and editors from the World Association of Newspapers and News Publishers will visit Britain next month. They are coming here, to this island that has stood and fought for freedom for so long, to demand an end to

“continued attacks on press freedoms”.

We are in poor company. Other countries that the team have visited include such bastions of free speech as Ethiopia, Libya, Yemen, Tunisia, Mexico, Honduras, Ecuador, Colombia, Guatemala, Ukraine and Azerbaijan. One really could not make it up.

Free speech organisations around the world are asking us to rethink. They fear that the changes set a dangerous precedent for non-democratic regimes, and our Foreign Secretary agrees. Why, then, are we going down this road? True democracies erect a barrier between Government and the press for good reasons, and there is no excuse for dismantling it. It is claimed that the royal charter protects press freedom because it can be changed only by a two-thirds majority in Parliament, but that is illusory. Such a majority rule was enacted in the Enterprise and Regulatory Reform Act 2013, but a simple amendment would allow a future Government to sweep it away at any time with a single-vote majority. Even the two-thirds safeguard is misleading, especially when we consider how an emotive topic such as Syria nearly persuaded

4 Dec 2013 : Column 315WH

the House to take the country to war. Large majorities are not as rare as the charter would have us believe, especially if the cause is deemed to be right, whether it be going to war or cracking down on the press.

Wind the clock back a bit. When Lord Justice Leveson published his report in November 2012, he called for “voluntary, independent self-regulation.” The deal stitched up at 2 am over a pizza by a group of politicians and the celebrity lobby group Hacked Off was far from voluntary, independent or self-regulating. The newspapers and magazines that it covers include the 1,000-plus regional and local papers that were exonerated by the Leveson inquiry, none of which was told that the meeting was taking place. There was no parliamentary scrutiny or consultation with the industry or the public on the terms of the state-sponsored royal charter, even though there are compelling constitutional questions about the imposition of a royal charter on an industry that does not want one. My hon. Friend the Member for North East Somerset (Jacob Rees-Mogg) has put those well.

Jacob Rees-Mogg (North East Somerset) (Con): I am grateful to my hon. Friend for his flattering comments. Can he recall any occasion since the late Stuart period, when the Stuart kings were trying to establish an absolute monarchy, on which a royal charter has been used for the purpose of extending the power of the state? I hope that the Minister will be able to answer that point as well.

Richard Drax: My hon. Friend is extremely good on that subject, and I would not begin to question his knowledge. I am sure that what he says is the case, and we would both be grateful if the Minister answered that point in his wind-up.

The legislation also raises questions under human rights laws. The eminent human rights lawyer, Lord Lester, says that the new system may breach article 10 of the European convention on human rights. In a letter to The Times, he wrote:

“There is no need for further state intervention, as proposed by Hacked Off celebrity campaigners. We need a system of independent self-regulation that encourages professional standards and provides effective redress, avoiding unnecessary litigation.”

Instead, what we have is state licensing of the press. That was unthinkable only six years ago, when the Select Committee on Culture, Media and Sport concluded:

“statutory regulation of the press is a hallmark of authoritarianism and risks undermining democracy.”

I could not have put it better myself.

Unfortunately, much has changed in the past five years. The American satirist H. L. Mencken famously said that in a democracy,

“journalist is to politician as dog is to lamppost.”

Now, with the aid of organisations such as Hacked Off, which is totally unrepresentative, the lamp post has turned on the dog. The motivation of some of my colleagues is dubious, to say the least. The sharpening of axes has been heard for some time. Cash for questions, cash for honours, cash for lobbying, mortgage flipping, duck houses, moats—the list goes on. As for Hacked Off, it simply wants to curb what it calls the “excessive” power of newspapers. I appreciate, as I am sure everyone does in this room and in the country, that there have been examples of appalling behaviour, and victims are

4 Dec 2013 : Column 316WH

understandably angry, but let us not forget what spawned the Leveson inquiry: phone hacking, which is already a criminal offence. As Lord Lester has said, the country’s

“plentiful criminal and civil laws”

already regulate the press.

Far from nothing having happened as a result of Leveson—a complaint that I hear all too often—the repercussions have been profound. The biggest newspaper in the country closed down, and 61 journalists were arrested. Prosecutions are ongoing in a number of courts across the land. Those in favour of the royal charter say that it will not impinge on a free press, but I disagree, as does Fraser Nelson, the editor of The Spectator. He wrote that as soon as Lord Leveson’s recommendations were published, the number of calls he received from Members increased markedly, all suggesting that comments with which they were unhappy should be removed or clarified. That is precisely the chilling effect that I and many others feared and have warned against.

Today, we have reached an impasse. The press is unwilling to sign up to the royal charter. Instead, the newspapers have gathered all the recommendations of the Leveson inquiry into their own set of regulations for the Independent Press Standards Organisation, which I have here.

Philip Davies (Shipley) (Con): Does my hon. Friend agree that not a penny of taxpayers’ money should be spent on setting up a recognition panel, which the Secretary of State accepts might be entirely redundant? It would be useful if the Minister set out whether any public money has already been spent on setting that up. Does my hon. Friend agree that it would be much better instead to allow the establishment of the Independent Press Standards Organisation, which will be up and running in early 2014 and would enable statutory control of the press to be avoided?

Richard Drax: I could not have put it better. My hon. Friend, with his free and independent mind, speaks wisely. We ask the Minister to comment on that point.

Most newspaper editors and publishers are willing to sign up to the IPSO regulations. They are tough, and they are independent of both politicians and the press. For example, no editor would be allowed on the arbitration panel, and potentially crippling financial penalties of up to £1 million could be placed on titles that step out of line. Far from being toothless, the regulations would bring swift and fair redress to those who have been badly treated.

Lord Leveson called for a system that all sides could agree to—I ask hon. Members to note the use of the word “all”—and evidently the royal charter fails in that regard. It seems as though the Government have seen that for themselves. The Secretary of State for Culture, Media and Sport was reported to have said last month that the press charter could be redundant if newspapers produced an effective system of self-regulation. They have done so, and I have it right here.

Perhaps one day we can create a British Bill of Rights that incorporates freedom of speech and freedom of the press, which would give us the same protection as the American first amendment. Despite the fact that all three parties are agreed on the royal charter, I hope that self-regulation will prevail. It is in all our interests.

4 Dec 2013 : Column 317WH

Mr Christopher Chope (Christchurch) (Con): My hon. Friend refers to self-regulation; is he aware of any other system of press self-regulation anywhere in the world that is as stringent as the proposals?

Richard Drax: My hon. Friend and almost neighbour makes a good point. I shall answer it with what might be a humorous point. After the 15 of us had voted against the Government on that day, I was called within minutes, not by the BBC or any organisation in this country, but by the news desk of the Russian equivalent of the BBC, to ask what I was doing. I find a certain irony in that.

Mr Andrew Smith (Oxford East) (Lab): I apologise for missing the very beginning of the hon. Gentleman’s contribution due to the retiming of the debate. I congratulate him on securing it. Does he understand the scepticism there will be among many members of the public due to the previous failures of self-regulation? The proof of the pudding will be in the eating, and we will know how effective this self-regulation is only when it is exercised. That is how the public might develop confidence in it.

Richard Drax: The evidence—the cake—is in the IPSO documents, and the public can tuck in whenever they want. As I understand it, when the press signs up to the IPSO regulations, those regulations will be contractual, so the press will have to follow its own rules. What more evidence does the public need than the document that I am holding? If all the papers, and others who sign up, agree to the regulations, which they say they will, we will have gone a long way towards reassuring the public that something has at last been done.

With those comments, I shall close. I hope the Minister is able to comment on the Secretary of State’s remark that if the press gets on with setting up its own regulatory body, the Government will withdraw the royal charter and allow the press to regulate itself, and, most importantly, safeguard freedom of speech and the freedom of the press in this great country of ours—the United Kingdom.

4.22 pm

Mr Richard Bacon (South Norfolk) (Con): I shall be brief. I congratulate my hon. Friend the Member for South Dorset (Richard Drax) on his speech. I, too, was impressed by what the Secretary of State said. I hope that we will hear the sound of back-pedalling from the Minister when he speaks. There should be no doubt that what the Government propose is state licensing; my hon. Friend made that clear. If the Minister is unwise enough to say anything to the contrary, no one should take too much notice. The legal underpinning by statute—it might be divided between various bits of architecture, but the effect is the same—would mean that those who do not sign up, and they alone and they uniquely, will be exposed to exemplary damages. I had a call from the Russians as well, by the way. I found it as disturbing as my hon. Friend did that they should want to interview me about press freedom.

Karl Popper wrote “The Open Society and its Enemies”, and Sir Edward Boyle, the former Conservative Minister of Education, wrote an essay on that book, in which he said that Popper had first made him realise that of all human rights, the most important was the right to criticise one’s rulers. The problem with what the Government had proposed—I hope that I can say “had”—is that the

4 Dec 2013 : Column 318WH

Government would set the parameters for what was and was not acceptable criticism, and opinions will differ on what is and is not acceptable criticism at any one time.

I have a document from the Nuclear Decommissioning Authority, commissioned by KPMG, which contains criticisms of Nuclear Management Partners Ltd, its contractor, for very poor leadership and for intervening to a very limited extent. It cost hundreds of thousands of pounds of public money. I know that Government do not want it in the public domain, because the copy that was first sent to me was redacted. I have now got hold of an unredacted copy. The conversation about what should and should not be in the public domain is obviously a permanent one. The idea that the Government should be the arbiter of that is wrong.

We have the expression “a free press” for a reason. The people who are prepared to toy with these new ideas bring to mind the expression of George Orwell, who spoke of

“playing with fire by people who don’t even know that fire is hot.”

4.24 pm

The Parliamentary Under-Secretary of State for Culture, Media and Sport (Mr Edward Vaizey): It is a great pleasure to serve under your chairmanship, Mr Turner. I thank my hon. Friend the Member for South Dorset (Richard Drax) for securing this important debate. I have read his fine contributions to our various debates on press self-regulation, so I knew before the debate about his extensive experience as a journalist. He reminded us that he was a journalist for 17 years, so his remarks and his passion should be taken with the utmost seriousness.

I am not entirely certain—it is not in my brief—how many of my hon. Friends present today were winners of The Spectator parliamentarian of the year award, but I offer those who are present and who have won that award my heartfelt congratulations. Although I was at the beginning of the lunch, I was called away to a meeting, so was not present at see them receive their award. This is the first opportunity I have had to congratulate them. In passing, I also welcome the Under-Secretary of State for Communities and Local Government, my hon. Friend the Member for Grantham and Stamford (Nick Boles). Given that he is going to witness a fellow Minister being beaten up over the next 15 minutes, perhaps this is a respite from the ordeals he has faced at the hands of colleagues over the past 12 months or so.

Jacob Rees-Mogg: Will the Minister give way?

Mr Vaizey: I will finish my last joke before I get on to serious points. The Spectatorhas led a robust campaign against the royal charter. I am not one of those MPs who rang The Spectator; I have not rung to complain about its coverage of my activities. I recently took part in one of its discussions on the future of technology companies. I cannot quote exactly from memory, but the blog afterwards said something like, “The Minister said the Government was doing a lot in this area, but none of his examples were convincing.” I give way to my hon. Friend.

Jacob Rees-Mogg: Is the Minister aware that the Under-Secretary of State for Communities and Local Government, my hon. Friend the Member for Grantham

4 Dec 2013 : Column 319WH

and Stamford (Nick Boles), is very wise when it comes to the question of the freedom of the press?

Mr Vaizey: We have certainly noted the Under-Secretary of State’s comments. Unfortunately, I opened the door to that point by referring to his presence.

I shall take the opportunity provided by the debate to discuss the issues raised about the royal charter. It is more than a year since Lord Justice Leveson—Sir Brian Leveson—published his report, which ran to an astonishing 1,987 pages in length and, I think, 5 lb in weight. The report covered a vast territory. It examined the existing self-regulatory structure of the press, as one of its core themes. It set recommendations—to which the Government responded—for, I would say, a reformed system of independent press self-regulation. Let me take this opportunity to remind the House what those recommendations were.

The key elements of the recommendations in the report can be summarised as follows. The first was maintenance of a vigorous free press. The second was having the maintenance of press self-regulation at the heart of the new system that delivers the key principles set out in the report. The third was to have incentives that encouraged the press to use that self-regulation system and created benefits for those who signed up to and followed it. In addition, an independent recognition body should be able to recognise that a press self-regulator was adhering to the principles.

Richard Drax: I am going to ask a horribly cruel question. Has the Minister read the IPSO document? I entirely endorse every word of the speech that he is making— it almost sounds like my speech—so I hope that he will conclude at the end that my colleagues and I are right.

Mr Vaizey: I have not read every word, but I have examined the principles and been briefed on the matter. To pick up on what my hon. Friend says, we can recognise a huge amount of common ground between us.

The independent recognition body should be able to recognise when a press self-regulator is upholding the principles. By adhering to them, the press can take advantage of incentives. It is important to remember that the recognition body is there, first, to recognise the self-regulator, and then to carry out periodic checks every few years to ensure that the self-regulator adheres to the Leveson principles. It will not be, and was never intended to be, involved in the self-regulation of the press.

Mr Bacon: Will the Minister confirm that the Government are willing legally to disadvantage those who will not sign up to their proposals?

Mr Vaizey: I would put it another way: the Government would incentivise those who join an independent self-regulator that adheres to the Leveson principles.

All three main parties have agreed that the royal charter is the best way to deliver the recognition body that Leveson recommended. I referred earlier to the fact that I have read all the speeches of my hon. Friend the

4 Dec 2013 : Column 320WH

Member for South Dorset. I was able to point out that he had been a journalist for 17 years, because he mentioned it again in this debate, but let me prove that I have read his speeches: I know that the fact that all three main parties have adhered to the idea of a royal charter will not persuade him, as he said in one of his speeches that when the three parties were agreed, it set alarm bells ringing for him.

Richard Drax: The Minister, in typical fashion, took the words out of my mouth. I could not have said it better myself.

Mr Vaizey: We are making considerable progress. My hon. Friend has so far said that the speech I am giving could be his, and now he says I am as eloquent as he is.

There has been much concern expressed in the House and in some quarters of the press about the charter damaging press freedom. I recognise that those arguments have been put, but I have to state that the Government do not believe that to be the case. The Government are clear that free speech and freedom of the press are vital; they underpin our democracy. The Government would not seek to implement anything that endangered those fundamental principles. Indeed, the Prime Minister was clear from the outset that he had serious misgivings about taking any action that could infringe free speech and a free press.

Richard Drax: I am most grateful to the Minister for giving way so often. The Prime Minister also assured us that there would be no statutory underpinning of the royal charter by law, but there now is. What has changed?

Mr Vaizey: My hon. Friend has taken the words out of my mouth. I was going to say that that is why statutory legislation was avoided and why a royal charter was chosen to establish the recognition function instead. It is important to get the point across that politicians will not be able to meddle with the charter on a whim. There are clear safeguards built into the charter to ensure that it cannot be amended unless a very high, strict bar has been surpassed. Any proposed change must be ratified by a resolution of both the House of Commons and the House of Lords, as well as with the unanimous agreement of the board of the recognition panel.

Richard Drax: As I said in my speech, what happens if we have a change of Government? We cannot hold future Governments to legislation if they change it. It does not matter whether the fraction is two thirds or whatever it is now; the legislation will be wiped out by one vote, if indeed it was a close call, would it not?

Mr Vaizey: The Government went to great lengths to ensure that the royal charter could not be meddled with at will. The statute states clearly that change would need the unanimous agreement of the recognition panel, and that both the House of Commons and the House of Lords must approve a change. Two thirds of Members must agree to the change, as well as the members of the body itself.

4 Dec 2013 : Column 321WH

Mr Bacon: The Minister stated a minute ago that it was not a statute, but a royal charter. Now he says “the statute states”. Does he accept that there is a statutory element?

Mr Vaizey: As I said earlier, the Prime Minister made it very clear that statutory regulation of the press was not a road he would ever go down. The recognition body is not a regulator of the press; that is a really important point to get across. The recognition body comes into being through a royal charter, not through legislation.

Richard Drax: Will the Minister give way?

Mr Vaizey: I really must make some progress, if my hon. Friend will allow me, because we are coming to the end of the generous time that I have been allocated for responding to the many points that have been put to me—

Dr Julian Lewis (New Forest East) (Con) rose—

Mr Vaizey: But of course I recognise an old friend.

Dr Lewis: On a point of order, Mr Turner, can you clarify, for the benefit of those of us who might like to intervene on the Minister later, how long the debate has to run?

Mr Andrew Turner (in the Chair): Until 16:40.

Mr Bacon: Plenty of time.

Mr Vaizey: I do have plenty of time—that is right—and 1640 obviously refers to the time that the debate closes, rather than to the Stuart period of history referred to earlier by my hon. Friend the Member for North East Somerset (Jacob Rees-Mogg).

It is important to stress that the press royal charter cannot simply be changed by Ministers without recourse to Parliament. That is a very important point. All other charters can be changed or dismantled by the Government of the day without any recourse to Parliament at all. In the case of this charter, safeguards have purposefully been put in place to stop any such meddling.

Philip Davies: Will the Minister address the question that I posed in my intervention on my hon. Friend the Member for South Dorset (Richard Drax)? Has public money been used in setting up a recognition panel? If not, will he make a commitment that it will not be, given that even the Secretary of State has admitted that the panel could turn out to be completely redundant?

4 Dec 2013 : Column 322WH

Mr Vaizey: It is on the record that a degree of public funding will be required to ensure that the recognition panel is established and able to take applications for recognition, but that is time-limited. I cannot confirm exactly whether any public money has been spent so far, so I will write to my hon. Friend. As far as I am aware, none has been spent so far, but I cannot, on the basis of the note I have been passed, absolutely confirm that.

Dr Julian Lewis: The Minister is being extraordinarily generous in giving way. I would like to suggest a way forward by drawing, I hope, a not-too-tortured parallel. We had a vote, which was referred to in the opening speech of my hon. Friend the Member for South Dorset (Richard Drax), on Syria. If that vote had gone the other way, I doubt whether the chemical weapons would have gone, or whether we would have had the deal with Iran. The Government are now claiming credit for those things having happened, even though they were defeated in a vote. Can the Minister see where I am going with this?

Mr Vaizey: No.

Dr Lewis: Well, it will become clear. I doubt whether we would have had on offer anything like as tough a regime as that constituted by IPSO without what the Government have done up till now. Would it not be an idea to give it a trial and see whether it works? The Government could then legitimately claim credit for having brought it forth, when otherwise it would not have come forth.

Mr Vaizey: My hon. Friend tempts me, perhaps uncharacteristically, to claim credit where it might not be due, but I recognise the force of the point that he makes. It is important to stress that the independent self-regulation body that is being set up by the press is welcome. It is also important to stress that it is entirely a matter for the press whether they choose to seek recognition for that body. As I have said, the benefits that come through being recognised by the recognition panel are entirely voluntary. I do not think it is any secret, and I am sure that my Secretary of State has put it on the record, that we are delighted with the progress that the press has made in this area.

I recognise the force of the argument that my hon. Friend the Member for South Dorset has made, but as I say, the charter itself will not play any direct role in regulating the press. It is there simply to recognise and periodically review any independent self-regulator, and when I say “review”, it will not even review the workings of that panel, but will look to see that it still adheres to the principles that are set up—

Mr Andrew Turner (in the Chair): Order.

4 Dec 2013 : Column 323WH

Leasehold Reform

4.40 pm

Jim Fitzpatrick (Poplar and Limehouse) (Lab): Mr Turner, it is a pleasure to see you presiding over this debate this afternoon. I am also very pleased to see the Minister here in Westminster Hall and the hon. Member for Worthing West (Sir Peter Bottomley), who has led on this issue in this House for a number of years now. I know that he wants to make a contribution to the debate before the Minister responds, so I am very happy to see that he is here.

This is a growing issue. I have had a number of cases in my constituency of Poplar and Limehouse in the past 16 years involving people in very expensive properties; professional and qualified individuals, residents who paid large sums of money for the homes that they inhabit. They are being ripped off and exploited by unscrupulous property management companies and individuals who have spawned these management companies.

That is my own local perspective. However, this is a national issue. As I understand it, about 5 million people are in leasehold tenure in the United Kingdom and only one other country has that degree of tenure. A note on the statutory instrument that we debated last week in Committee—the Redress Schemes for Lettings Agency Work and Property Management Work (Approval and Designation of Schemes) (England) Order 2013—said that 40% of all new properties are under leasehold tenure. East London, where we have massive regeneration and lots of new properties and conversions, is I think one of the areas with the biggest number of properties under leasehold tenure. This is not a situation that will go away. It has been growing for years and will continue to grow.

When we were in government, I know that we tried to address the issue to a certain extent. We had a number of stabs at it, but sadly we did not cover it. I am very hopeful that the Minister will be able to say that the coalition is still very interested in the subject and want to address it.

It is not just leasehold tenure that is an issue. I have to declare that I live on an estate that was previously managed by Peverel, which was previously owned by the Tchenguiz brothers, who were quite notorious. An Office of Fair Trading report is due out this Friday; I will mention that later. I am a freeholder, but because I am on an estate that is run by a property management company I have a covenant and therefore I am included and have a role to play. I want to put that on record, so that I am not accused of any conflict of interest.

Despite the reforms in the statutory instrument, there are still specific problems, including unfair charges for repairs, insurance and electricity supply, and complex procedures for residents to seek redress; those procedures are supposed to be informal. When residents get to land valuation tribunals—I know that the structure of those tribunals is itself being reformed—property management companies turn up with heavyweight legal teams, including barristers, and put people under massive pressure. One other difficulty is that, even where residents win their legal cases, the legal costs incurred by the property management companies, which were supposed to be capped at £5,000 but are not, suddenly appear on the bills of the residents for the following year as part of their service charges. That is grossly unfair and adds insult to injury.

4 Dec 2013 : Column 324WH

Mr Andrew Smith (Oxford East) (Lab): I congratulate my hon. Friend on raising this very important issue. Does he agree that these problems are a particular nightmare for elderly residents who simply cannot cope with the pressure that they are put under and the extent of the rise in costs?

Jim Fitzpatrick: My right hon. Friend anticipates a point that I will make later, namely that these problems are not restricted by class, age or geography. They relate to properties ranging from pensioner and retirement flats that have a value of only £50,000 through to million-pound properties in my part of east London. However, when we are talking about pensioners in their retirement homes and other such communities, the trauma and the stress caused by these issues is even greater. Although there are some restrictions in the legislation about the fees that these property management companies can charge, and measures dealing with the ability of local authorities to prosecute these companies when they see that there is a transgression, local authorities appear to be unwilling or unable to respond legally.

I know of a number of cases. In my constituency, I have two high-profile cases running at the moment: one on the Canary Riverside development and one on the West India Quay development. Both involve companies owned by the Yianis Group and are operated by Octagon Assets. They are in major disputes with residents, who have real problems in getting their situations resolved. The right to manage estate ballots procedure is very complex, especially where there are absentee owners who are sub-letting, and it is also very expensive. At the Kingsmere development in Brighton, it cost residents £30,000 to take action and they failed to secure the right to manage their own properties. An individual in Battersea, Mr Dennis Jackson, entered a dispute with his property management company about £7,000. He incurred legal costs of £76,000 and nearly lost his £800,000 flat, which he now has to sell to pay for his legal fees. That example shows the level of professional individuals we are talking about. They have to relocate to deal with the problems they have had to face.

We have had predators such as the Tchenguiz brothers and Peverel, the largest property management company in England, with many complaints from pensioners and others about onerous and unnecessary maintenance work and about exacting fees; my right hon. Friend the Member for Oxford East (Mr Smith) mentioned the pressures on pensioners. There is no requirement on these property management companies to demonstrate value for money, or to ensure quality of service.

I would be grateful if the Minister, when he responds to the debate, brought us up to speed on the OFT investigation into Peverel and on the leasehold inquiry, which I believe has been announced. I know that he will not be able to say too much without compromising embargoes and so on, but I know that there have been announcements, so it would be good to put on the record today exactly what is happening.

I congratulate the Leasehold Knowledge Partnership both in respect of the full OFT investigation into residential leasehold and the securing of the OFT report into the Peverel-Cirrus price-fixing racket, which involved warden call and electronic door systems in retirement leases. Again, that relates to the point that my right hon.

4 Dec 2013 : Column 325WH

Friend made about pensioners. I believe that the report is due out this Friday, but I would be grateful if the Minister confirmed that.

I thank the LKP and Carlex for their briefings and the information that they have given me, particularly the information about repayments to residents: £1 million to residents at St George Wharf; £500,000 to residents at Charter Quay; and £400,000 to residents at Chelsea Bridge Wharf. Those are huge sums, and they demonstrate that something has gone badly wrong in this sector.

We have had the statutory instrument and the redress scheme. I asked the Minister’s colleague—the Under-Secretary of State for Communities and Local Government, the hon. Member for Keighley (Kris Hopkins), who presided over the statutory instrument—about the redress scheme. He was able to say that the scheme, which has now been extended, means that, if someone is not in the scheme they will not be able to operate. Perhaps the Minister could say a little more about how the scheme will make it simpler for residents and tenants to be treated fairly. Also, can he give any information about the OFT inquiry, its duration and the liaison between his Department and colleagues in the Department for Business, Innovation and Skills about that?

The fundamental question is whether the Government accept that this issue must be addressed, with solutions in due course—

4.48 pm

Sitting suspended for a Division in the House.

4.59 pm

On resuming

Jim Fitzpatrick: Do the Government accept that this growing issue will not go away and that action is needed? Certainly, the OFT announcement suggests that the authorities recognise that, although whether that is because the Government have told them, I am not entirely sure. It would be good to hear the Minister’s view on that.

Returning to my right hon. Friend’s intervention, leasehold crosses class and age boundaries, and includes everything from expensive lofts and expensive apartments to retirement bungalows and flats, and it is not geographically limited, either. The issue affects the whole country.

On the Delegated Legislation Committee, the Minister’s colleague, the Housing Minister said that he is prepared and happy to meet me, the hon. Member for Worthing West and other colleagues with an interest. I would be grateful if the Minister confirmed that meeting. Obviously, the OFT inquiry means that things will be happening in parallel, but it would be good to put that directly to the Housing Minister and the Department at some time in the future.

5 pm

Sir Peter Bottomley (Worthing West) (Con): I thank the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) for using the Delegated Legislation Committee to draw the Government’s attention to the matter, and I congratulate him on securing this debate.

4 Dec 2013 : Column 326WH

I welcome the Minister, and I hope that he will pass on to his departmental colleagues and to Ministers in the Ministry of Justice the fact that something needs to happen to make things fair, to give people freedom and to avoid what I have called criminal behaviour in leasehold deals, price-fixing cartels, the cheating of freeholders and excessive exit fees and fiddles. Opportunist lawyers are playing the system, and at times the Property Chamber—or the Leasehold Valuation Tribunal, as it was—has not been led with the determination that secures justice for people sorting out ordinary disputes between a leaseholder, a managing agent or a freeholder.

I would like to invite the barrister Justin Bates, for example, to say out loud the ways in which opportunist managing agents and freeholders can frustrate an application to the Leasehold Valuation Tribunal or the first stage of the Property Chamber, where, as the hon. Gentleman said, the fee is fixed at £500, yet a lawyer can explain to the respondent, the managing agent or the freeholder, “You can make applications to delay the hearing, you can apply to go to the county court or you can bounce between the two. And, by the way, if you take the advice of some lawyers and apply for the right to manage, it can take up to 18 months for the courts to dispose of the fact that you do not have to have the letters RTM in the name of the proposed management company that would replace the managing agency appointed by the freeholder.” As my hon. Friend the Minister will know, the freeholder appoints and gives instructions to the managing agent, and the freeholder has every interest in the managing agent doing what the freeholder wants and not what is right by law or necessarily in the interest of the leaseholder.

I first became involved in the matter indirectly because of my Worthing home, which is leasehold. The other five owners and I took up an offer from the freeholder to buy the freehold. It took us two exchanges of letters to agree a price. The managing agent appointed by the freeholder was very good, and we continue to use that managing agent now. That is an example of how the system is supposed to work. If we had had a dispute over the price, we could have gone to the Leasehold Valuation Tribunal and solved it, but we did not need to do that.

Also in my constituency is a block of flats where a number of people—poor, old and some of whom were dying—found themselves applying to get back money that had been wrongly taken from them. It took well over a year to get the case to the Leasehold Valuation Tribunal. Partly because of my intervention, the freeholder recognised that what it had done was wrong and it offered £70,000 to the leaseholders, which was accepted. The sum was less than the leaseholders would have got in court, but at least it solved the problem.

The hon. Member for Poplar and Limehouse rightly mentioned Martin Boyd and Sebastian O’Kelly and their work with the campaign against retirement leasehold exploitation. LKP has saved millions of pounds for hundreds of people. The Government’s Leasehold Advisory Service does its best, but it does not have enough money or resources, and sadly it has to take advertisements from people who should not be advertising at all, let alone through a Government advisory service. I name Mr Benjamin Mier, who, when shown a report by the Judicial Conduct Investigations Office, resigned his position. If he had not, the report would have been made public. Because he resigned after reading the report, we do not

4 Dec 2013 : Column 327WH

know what is in it—actually, we do know what is in the report because we know what he had been doing, but we do not have that information formally. People only have to read the comments of the chairman of the Leasehold Valuation Tribunal to know what Mr Mier did.

Besides answering the debate today, for which I am grateful, will the Minister please ensure that the whole Government come together, follow the OFT investigation into what is going wrong commercially and consider what the Serious Fraud Office had, and the OFT has, on Peverel, which has been named? I would also like the Minister to consider Mr Israel Moskovitz, who, again, has played the system to avoid his leaseholders in Plymouth getting into dispute resolution, the Leasehold Valuation Tribunal, or the right to manage or the right to purchase.

The Association of Residential Managing Agents, with our former colleague Keith Hill as its arbitrator, has some of the right ways forward. It ought to be illegal for any managing agent or freeholder to take a commission from an insurance company without having an open book and without showing that what they are doing is in the best interest of leaseholders.

I am pleased that the right hon. Member for Kingston and Surbiton (Mr Davey), who is also the Secretary of State for Energy and Climate Change, and I had meetings with the OFT that have led to the decision this week to investigate. There is more to come. Bluntly, it is wrong that were I a convicted fraudster who came out of jail yesterday, I could set up as a managing agent today without having to meet necessary and obvious standards. Such standards are not just for those who live in big flats on the Thames—those with lawyers and expensive flats—but for small people who cannot get anything other than a leasehold property of their own in which to live, hopefully without undue cost.

We must make the system such that managing agents have a duty to paying leaseholders to get the best possible service at the right price and leaseholders do not have to pay for things that are not needed. The OFT will address the door-call systems whereby many hundreds of blocks of flats—there are probably six in my constituency, and I know there are such flats in the constituencies of both the Chancellor of the Exchequer and the Prime Minister, and there are probably some in most constituencies—are forced to have unnecessary renewals at prices fixed by almost a cartel. They are not actually cartels, because the two other so-called bidders do not do the work. If I were 99% of the market, I do not think I should get relief from the OFT rules by confessing my sins after the Serious Fraud Office had passed my case to the OFT.

I will not go on, because there will be other opportunities for the House to consider these matters. The hon. Member for Poplar and Limehouse has rightly spoken for millions of people, and it is time that Parliament and the judiciary took action to stop such scandals, costs, frustration and worry for ordinary individuals who are just trying to live quietly at home.

5.7 pm

The Parliamentary Under-Secretary of State for Communities and Local Government (Nick Boles): It is a pleasure to serve under your chairmanship, Mr Turner. I feel much safer with you watching over us.

4 Dec 2013 : Column 328WH

I congratulate the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) on securing this debate and on speaking with both passion and persistence on an issue that I know is of great importance to his constituents. I also thank my hon. Friend the Member for Worthing West (Sir Peter Bottomley) for his contribution and his persistence in pursuing the matter, which some might view as arcane but is a very real source of worry and distress in many people’s lives.

I am responding to this debate in place of the Housing Minister, the Under-Secretary of State for Communities and Local Government, my hon. Friend the Member for Keighley (Kris Hopkins), as he is required to respond to an Opposition day debate on business rates. I may not be able to address all the issues, and if I try to do so, I might not address them as intelligently as he would have done, but I know that he is happy to write to hon. Members to follow up on any issues. Of course, he is also happy to hold the meeting mentioned by the hon. Member for Poplar and Limehouse, to which he has already committed.

Residential leasehold is indeed an important and growing housing sector. Many leaseholders, like my hon. Friend the Member for Worthing West, are happy with their home, but we recognise that some leaseholders are not. The Housing Minister’s postbag makes that very clear.

The hon. Member for Poplar and Limehouse has raised a wide range of issues, and I will attempt to address as many as I can in the time available. I am glad to have been asked how the redress schemes will assist leaseholders and others. Since 2010, the Government have become increasingly aware of the issues in the residential leasehold sector, particularly to do with the quality of service. The Enterprise and Regulatory Reform Act 2013 gives the Secretary of State for Communities and Local Government the power to require all residential letting agents and property management agents in England to be members of a Government-approved redress scheme. We are making good progress on implementing those powers, and we expect to start approving such schemes early in the new year.

Sir Peter Bottomley: I have a brief technical point that I do not expect the Minister to answer today. In law, a leaseholder is a tenant, but leaseholders are not always counted as tenants, so will he try to check whether the schemes will cover leaseholders, as well as people normally referred to as tenants? Perhaps the Housing Minister can come back to us on that.

Nick Boles: My understanding is that it will, but we will certainly write to my hon. Friend to reassure him. I skipped over a sentence that seems to imply that it will be the case, but we will confirm that to all right hon. and hon. Members present.

I want briefly to address the right-to-manage legislation. I must admit that this is the first time I have ever heard about it, so I may not make as much sense as hon. Members deserve. The leasehold right-to-manage legislation is designed to be available to as many private sector leaseholders living in blocks of flats as possible. The right was designed for use on a block-by-block basis. Applying the legislation to estates is complex and might result in the right becoming less, rather than more, accessible. Right-to-manage ballots can be complex and

4 Dec 2013 : Column 329WH

potentially expensive, and the legislation sets out in detail the procedures that all involved must obviously follow and comply with. The provisions aim to protect the interests of all parties, including those of the leaseholders. I am sure that my hon. Friend the Housing Minister will be happy to discuss that further if appropriate.

The hon. Member for Poplar and Limehouse mentioned high charges to leaseholders for repairs, insurance and utilities. The law provides leaseholders with a range of important rights to do with service charges, including the right to be consulted, the ability to challenge the reasonableness of charges at independent tribunal and the right to obtain information.

The right hon. Member for Oxford East (Mr Smith) mentioned older and vulnerable leaseholders, who may find it onerous or stressful to attend a tribunal or to exercise their rights. Free initial legal advice is available from the Leasehold Advisory Service—LEASE—which is funded by my Department.

Sir Peter Bottomley: I want to add a tribute to Anthony Essien, the chief executive of LEASE. He and the Master of the Rolls, as the head of the Court of Appeal, would agree that judgments by the Leasehold Valuation Tribunal and on appeal need to be trawled through, so that instances of when poor, ordinary people have been frustrated at great cost and worry can be collected. As the hon. Member for Poplar and Limehouse (Jim Fitzpatrick) said, the costs pile up and then come back as service charges. More work is needed.

Nick Boles: I hope that I will be able to address, at least in part, the question of the ability of property management companies to recover their legal costs from leaseholders, even in cases where the leaseholder is the successful party, by adding them on as service charges for the following year. Whether the landlord can recover his legal costs, and if so, in what way will depend on the terms of the individual lease. Even when a lease does allow the recovery of legal costs as a service charge, the courts and tribunals still have the power to prevent that from happening by issuing what is known as a section 20C—of the Landlord and Tenant Act 1985—order, if they judge it appropriate. Of course, to get such an order does require someone to go through the court or tribunal. Each case will be determined on its merits, and independent legal advice should be obtained, but where leaseholders believe that they have grounds to do so, they should consider applying to the court or tribunal for such an order.

4 Dec 2013 : Column 330WH

I want to address questions about the Office of Fair Trading. There have been several reviews, and I want to ensure that I get the information correct. I am advised that the OFT is carrying out an investigation into property management groups that use associated companies to supply security systems and other services, and I believe that it expects to report on that shortly. The OFT is also undertaking a separate market study of property management, but that is only in the initial stages, so I am unable to say exactly how long it will last or when it will report. I do know, however, that the OFT is seeking views on the scope of the study, which should be provided by January. I am absolutely certain that the Housing Minister will be able to provide more detail when he meets hon. Members.

At the end of his speech, the hon. Member for Poplar and Limehouse asked what is perhaps the most important question, which is whether the Government are saying, “Nothing to see here, move along,” or whether they are recognising the problems and abuses and the fact that, while some steps have been taken, including those in the Enterprise and Regulatory Reform Act 2013, other subjects may need examining. I reassure the hon. Gentleman and others that we do understand that there is abuse and that there are vulnerable people who are not best placed to defend themselves. We are open to conversations about ways to improve matters without massively over-complicating systems or adding hugely to the burden on either the taxpayer or leaseholders.

Sir Peter Bottomley: Does the Minister agree that, in addition, the professional standards bodies for surveyors, bankers, barristers and others should review whether the actions of some of their members should lead to reviews of whether professional standards are being met? If someone does something illegal, that is clearly wrong, but someone doing something that is against the public interest should not happen in a profession.

Nick Boles: It is certainly the case in other professions that people can be struck off, even if not found guilty of a criminal offence, for breaking the code of that profession. I am sure that every profession will want the public to have full confidence in its professional standards and in its maintenance and enforcement of them.

Question put and agreed to.

5.16 pm

Sitting adjourned.