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3.17 pm

The Minister of State, Department for Work and Pensions (Esther McVey): It is a pleasure to serve under your chairmanship, Ms Dorries. I think it is the first time, so I am delighted to be here. I congratulate the hon. Member for Makerfield (Yvonne Fovargue) on securing the debate.

Having listened to everything that has been said, there is one thing on which we can agree: this is about homes and people’s lives. This is about people and their local communities and what we can do best to support them. It is frequently forgotten, however, that it is also about the people who are not fortunate enough to be in a house of the size they need, whether because they are on a waiting list or because they live in an overcrowded home. At the same time, we must think about the people who are paying the bill. Taxpayers are funding the homes of people who may have extra bedrooms when they themselves may not.

We have thought about the matter in every which way and from everybody’s viewpoint and have asked ourselves how we best solve the situation. More than 300,000 people are in overcrowded homes and 1.7 million people are on waiting lists, yet there are 1 million spare rooms in people’s accommodation. We have to think about that. In Wigan, there are 3,500 families or more on the waiting list and 1,500 in overcrowded accommodation. I believe that the hon. Member for Makerfield said that 3,300 were affected by the removal of the spare room subsidy. Which group should be given more consideration? We cannot say that; they must all be considered when we decide what we shall do.

There is a conundrum, as we all agree, but how are we to deal with it? We cannot brush it under the carpet—it would have to be a huge carpet—and continue as if there is not an issue. We must deal with it, and we are confronting it. Of course, we know that there has been less house building, and we know the issues associated with that. God ain’t making no more land, and getting planning permission is very difficult. Yet Labour, during its reign, let more than 2 million people into a crowded island. We must cover all the angles and dimensions. We have said that we are putting £4.5 billion into the building of social housing. We are building another 177,000 by 2015. All those things are positive, although there is always more that can be done.

When houses with spare rooms were let, people were making to the tune of £500 million a year. Rent on that was being collected from taxpayers, who were paying that bill. It was unfortunate that those social landlords were getting £500 million a year extra for bedrooms that were not deemed to be occupied under the criteria brought in by Labour in 2008.

Sheila Gilmore: The Minister mentioned the building of affordable homes. A problem with the policy that the Government are currently implementing is the fact that they plan to charge 80% of market rent for them. There will be a substantial increase to the overall housing benefit bill. When the Work and Pensions Committee visited Luton in Bedfordshire, the housing association explained not only that it was obliged to set the rents at 80% of market rent to get a grant to build; it was also obliged as part of that arrangement to turn over some of its existing stock to such higher rents, as it became

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available. Government policies are likely to put up the housing benefit bill faster than the policy we are debating is likely to reduce it.

Esther McVey: I have heard various things—I will say that they are scare stories, because we have heard them before—about what would happen, and they have not happened. In fact—although at the moment this is just anecdotal—in the private sector house prices and rents are coming down, despite much of what the Opposition say; that is actually happening in Wales, which I visited last week.

What are the local authorities and housing associations doing? Some are redesignating homes with respect to their size. Knowsley is doing that. Salford is bringing empty houses into use and converting commercial property units into affordable homes. People are starting to build one-bedroom homes for the first time in a long time. Who would have believed it? Some people and areas are still building three-bedroom homes, despite knowing that they are not needed. One-bedroom homes are needed; they should constitute 60% of new builds. It is incredible that people who do not understand the stock still feel incentivised to build the wrong homes, because they will be paid for the bedrooms, whether they are used or not. That must all change.

We should all recognise the inequality in allowing social sector tenants full housing benefit for a spare bedroom while denying it to private sector tenants. The Opposition’s position seems to be that the policy is pernicious and evil when it affects social tenants, but acceptable when it affects private tenants; Labour introduced that policy in 2008. As has been pointed out many times before, there are two coherent positions: one is the Government’s, which asks anyone on benefits to contribute towards the cost of an extra bedroom; the other is to give anyone on benefits full housing benefit regardless of the size of the house that they need or whether or not they are under-occupying their property. The Opposition’s position is incoherent. It states that social tenants should not have to pay towards an extra bedroom, but private tenants should. We cannot have that.

Yvonne Fovargue: Does the Minister know about the housing position in Wigan, where, because of the shortage of one-bedroom properties, it is possible to rent a two-bedroom private property for less than the median housing allowance? That leads to the ludicrous situation in which someone moves out of a two-bedroom social rented property, because they must pay £14.65 a week to live there, into a two-bedroom private property, where the full rent is paid by housing benefit.

Esther McVey: We have had this discussion before with the Opposition. What the hon. Lady does not understand is that a full cycle is under way in that situation. When someone moves out of a home in one sector, someone else moves in. The 3,500 on the waiting list or the 1,500 who are living in overcrowded homes are moving, in this instance, from the private to the social rented sector. We cannot take only half the equation; we must think about who is moving where, and what the needs are. What might be an overpayment in one area is an underpayment in another, so there is a full circle that continues.

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Sheila Gilmore: The Minister is being very generous in giving way. She has raised issues about spare rooms—it is an emotive phrase. However, some organisations have argued that, if a room is not genuinely spare—for example, if a couple must sleep apart for health reasons, have medical equipment to store, or have a specially adapted house, so that it would be ludicrous to expect them to leave—they should simply be exempted. Those rooms are surely not really spare.

Also, even if the original intention of the policy was to bring parity with the private rented sector—I do not think it was, because it was never mentioned—an amendment was tabled in the other place, and probably also in this House, to the effect that the rule would be applied only if someone refused a reasonable offer of alternative housing. So it would not be retrospective. Is the Minister willing to consider either of those issues?

Esther McVey: We have put forward a full array of discretionary housing payments and exemptions, which I shall come to. However, I want to point out what Labour intended, when it was in power. Despite today’s claims about how it would have dealt with things, we know what is on the record:

“We hope to implement a flat rate housing benefit system in the social sector, similar to that anticipated in the private rented sector... We aim to extend our reforms to the social rented sector as soon as rent restructuring and increased choice have created an improved market.”—[Official Report, 19 January 2004; Vol. 416, c. 1075W.]

Sheila Gilmore: Will the Minister give way?

Esther McVey: I have given way a lot, and have answers to provide. Despite the bluster and fluster and cries of “We cannot do it,” that policy would have been implemented by the Opposition.

We have provided for the most vulnerable, including disabled children who cannot share because of their disability; foster children; overnight non-resident carers for claimants and their partners; and live-in carers. We have also ensured that tenants can retain a bedroom for an adult child who is in the armed forces and deployed on operations. We have established support, and in addition the courts have confirmed that we have satisfied our equality duties by making additional discretionary housing payment funding available. In total we have provided discretionary housing payment funding of £180 million in this financial year. The Government have given local authorities the money to help people in need. In fact, we have gone further, and within the year we have allocated an extra £20 million for which the 380 local authorities in Great Britain could bid.

What happened with that extra money? Not all the local authorities bid for the extra £20 million that we put in place because they did not feel the need to, and only £13 million was taken, meaning that £7 million was not. Yet again, there were screams of protest from the Opposition about what was needed, but the money had been put in place and yet not all of it was utilised. In my local area, for example, Wirral council still had £180,000 to spend on discretionary housing payments by the end of the month. That was made up of £30,000 left over and an extra £150,000 that had been granted.

We are getting all that information back from people and finding out what they need, so I take great exception

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to the accusation that this policy was developed on the back of a fag packet—I think that is what the hon. Member for Rhondda (Chris Bryant) said.

Chris Bryant: I did not say that.

Esther McVey: It might appear that the Opposition’s benefits policy—

Chris Bryant: I did not say that.

Nadine Dorries (in the Chair): Order. Mr Bryant, please do not interject from a sedentary position. Mr Bryant may not have said “on the back of a fag packet”, so perhaps the Minister will quote the words he did say to make the point. Mr Bryant, if you want to make an intervention, please do so, but do not interject in that way.

Esther McVey: Whether, in colloquial terms, the hon. Gentleman said that it was developed on the back of a fag packet, a cigarette packet or an envelope, it was discourteous, given the hundreds of hours of work that have been put in. I think he used the phrase “on an envelope in the shower”, but that was not the case, because many hours went into developing the policy. That might be how the Opposition make their benefits policy, because so far it seems they do not know what they are doing—what are they agreeing with, or not, and how are they helping the guarantee scheme, or not?

What the Government have done has had a profound effect on what is happening in the country: there are record rates of employment; youth unemployment has fallen for the past six consecutive months; there are record rates of women in work; and, as in the news today, the number of workless households is falling considerably. Far from our policy being made on the back of an envelope or cigarette packet, it is having significant effect. For a moment, I want to think about those people who have now got a job and are fulfilling their potential, supporting their families, getting their foot on the career ladder and working their way up. I meet such people every day, and they say how their lives have been transformed, so it is important that we listen to them as well.

As I said, 86 local authorities applied for extra money, although not all of them spent the extra £20 million, and not all councils felt that they needed it. Many of the Opposition scare stories did not happen at all and, despite the dire warnings, nor did the arrears. The report from the National Housing Federation stated that it is difficult to observe a rise in outstanding arrears. In fact, more than half of all working-age tenants in receipt of housing benefit were already in arrears before the new policy came into effect. While we are talking about people and their lives, moreover, there are lots of examples of people moving and downsizing. Among such people is Suzanne, from south Yorkshire, who had four children who are now grown up and have left home. She did not want to move, but she said that now that she has and has downsized, things are totally different. She has less of a heating bill—less in the way of bills altogether—can manage her cost of living and live within her means. It is key that we look at everyone’s requirements.

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On the loophole that has been mentioned, we have been through this on various occasions. The person in question has to have been in the same house and continuously on housing benefit since 1996 to be part of the loophole. The Opposition were right: we did not know the entirety of the numbers. What we deemed to be roughly right, however, was the figure of £5,000, and we said that we would cover those costs, so we agreed with the local authorities—£2 million to do the extra work necessary. We agreed the amount of money to do the administrative work to support those people. Far from screaming and yelling, we have gone into the issue in our discussions. Indeed, we debated it yesterday, so I think it has been covered.

What is key is that we have to think about the policy into the future, and to support people who are in overcrowded accommodation, whether they are on waiting lists or already in social rented housing. It is about how we best go forward and provide support. We are dealing with the issue, which Labour did not want to do when in office—they were happy to see the housing bill double over 10 years and the waiting lists and overcrowding increase.

Chris Bryant: The Minister has not answered any of my questions, so I will ask them again. She has a moment or two to find the piece of paper bearing the inspiration. My first question is, how many people have already been given back their money because they were illegally charged under the bedroom tax, but who in the meantime have also been given discretionary housing payments? Will they have to pay that back?

Esther McVey: No one will pay anything back. The people who have got discretionary payments will keep them—they will have been paid to the social rented sector—and should they wish to use them going forward, they can.

Chris Bryant: I am grateful to the Minister for allowing my continued interventions. How much, therefore, are the Government writing down in that regard?

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Esther McVey: We have said that we will take that into consideration. We are working on a set of numbers, and we presume the figure to be in the area of £5,000. We will take that cost on board, as we said—both the administrative cost, which we have agreed, and the extra costs that would have been used by the discretionary payments.

Chris Bryant: The Minister is generous in giving way again—

Nadine Dorries (in the Chair): Order. Will this intervention relate to the north-west, Mr Bryant?

Chris Bryant: How much will the total amount of money be throughout the UK and, in particular, how much will it be in the north-west? We need to know the amounts of money the Minister is talking about for writing down purposes.

Esther McVey: The Labour party have never cared so much about money—hence we are in the debt we are in. We do not know how to sort out all of Labour’s problems.

I have said that that is a cost we will be covering and dealing with. We have put discretionary housing payments aside, although of even the most recent £20 million that we have offered, only £13 million was used, leaving £7 million. We have said that of course we will deal with the situation, and that is what we will be doing. At the end of the day, however, we are talking about what is happening in Wigan and the north-west. We have to look at everyone, whether in the social rented sector, in overcrowded homes or on a waiting list, and at how best to deal with the situation. I fully applaud what the Government are doing and the way we are dealing with what we inherited—[Interruption.] I am sorry that the hon. Member for Rhondda is laughing at the situation, because we are picking up many of the problems left behind by him and his party.

3.39 pm

Sitting suspended.

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NHS Patient Data

4 pm

Barbara Keeley (Worsley and Eccles South) (Lab): I am pleased to speak in this debate with you in the Chair, Ms Dorries. Other Members may not know that we made our maiden speeches together, so we have always been inextricably tied in that way.

I am raising issues today because I want the Minister, NHS England and the Health and Social Care Information Centre to appreciate some of the real concerns about past and current uses of NHS patient data. I will talk about concerns about a lack of transparency in decision making, the commercial use of patient data and the lack of consent for that use.

The chair of the HSCIC talked last week about the organisation’s having an “innocent lack of transparency”. That was an inappropriate description of an organisation that is causing serious concern about its handling of NHS patient data. A lack of transparency cannot be tolerated in the part of the NHS that is trusted with safeguarding patient data and I do not accept the description of “innocent” for that lack of transparency.

At a recent meeting of the Select Committee on Health, Members asked questions about decision making on data releases from the NHS Information Centre. The panel members, who included the Minister, were asked how many of the key decision makers from the NHS Information Centre, which released patient data to insurance actuaries, had later become decision makers in the HSCIC. Max Jones, director of information and data services, said:

“The executive directors of the HSCIC with responsibility for this area were not part of the old information centre.”

When asked again whether the individuals who made the decision on transferring data to insurance actuaries became decision makers in HSCIC, he replied that

“the very senior management in the HSCIC is not the same as very senior management that was in the”

information centre.

The Minister has recently given me an answer to a written question that directly contradicts that and I am concerned about that. I asked him about the numbers and levels of staff who had transferred to the HSCIC from the NHS Information Centre. His answer stated that, of the 11 members from the management board of the HSCIC:

“Three of the non-executive directors and two of the executive directors were previously members of the NHS Information Centre management board. One of the executive members is graded as a very senior manager post and the other transferred as a senior doctor.”—[Official Report, 17 March 2014; Vol. 577, c. 457W.]

Given that that directly contradicts Max Jones’s answers to the Select Committee, will the Minister ask Max Jones why he gave those incorrect answers?

Dr Mark Davies, one of the senior executive directors, joined the NHS Information Centre in 2008 and transferred to the HSCIC when that was established. Indeed, an article last August described how Dr Davies sits in the exact same office in Leeds that he occupied when the HSCIC was the NHS Information Centre. He is the director of clinical and public assurance—a post that, surprisingly, is being made redundant this month. Will the Minister tell us why a senior post on public assurance

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is judged to be redundant, given the lack of public confidence in the plan for care.data and the many questions being raised by me and others about commercial uses of patient data?

Grahame M. Morris (Easington) (Lab): I congratulate my hon. Friend on securing this timely debate, which is raising some important issues that we need clarity on. We have just come from a seminar in which the Health Committee had some expert witnesses. Does she agree with the conclusions put forward there about the need for clarity before we go ahead with this data collection? I am thinking particularly about the cyber-security review, safeguards on anonymous or pseudo-anonymous data, separating out purposes for controls, a tighter definition of the care data—

Nadine Dorries (in the Chair): Order. Mr Morris, this is a 30-minute debate, so can you keep your intervention short, please?

Grahame M. Morris: I will. I just want to mention governance arrangements as well.

Barbara Keeley: Very much so. I must tell the Minister that we have not had time to absorb all of what has happened at the HSCIC, but we are disturbed by much of what we have learned. It seems as if there has been a proliferation of organisations and committees and that, as the use of that data and commercial data has burgeoned, the NHS has lost control of what is going on. That is of real concern.

Jim Shannon (Strangford) (DUP): I congratulate the hon. Lady on bringing this matter to debate and on her perseverance at every stage. Does she agree that although the commitment given regarding a patient’s right to their data will be respected, perhaps patients in the NHS see this issue from their own points of view? They do not see the IT implications of what is taking place; because of that, there need to be more assurances for the patient on what happens.

Barbara Keeley: I very much agree. Last night I tweeted that I was to have this debate today and I was astonished with the response I got—an awful lot of people are very concerned about the issue. I will come on to opt-out in a moment, but let me conclude the point I was making about the director of public assurance’s post being made redundant. There will be considerable interest from Parliament on the basis for and the terms of that redundancy. I hope there will be no suggestion of a compromise agreement or gagging clauses. There are serious questions to ask about some of the activities.

While Dr Davies is still in post, there are a number of questions to ask about his role and those of his colleagues in the NHS Information Centre that later became the HSCIC. Dr Davies has been the chair of the four-person data access advisory group. Having two senior HSCIC employees on the advisory group on sensitive data releases, including its chair, brought criticism about a lack of independence. As chair of the group, Dr Davies also had the right to approve data releases unilaterally from the HSCIC, outside the committee. He was therefore in a powerful position. Indeed, it was reported in The Guardian last year that Dr Davies used that power to

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release to the Cabinet Office the confidential medical records of teenagers taking part in the national citizens service.

Perhaps more recently, Dr Davies’s views were becoming out of line on some aspects of the Government’s stance on care data. The Guardian reported in January that Dr Davies said that there was a “small risk” that certain patients could be “re-identified”, because insurers, pharmaceutical companies and other companies had their own medical data that could be matched against the pseudonymised records. He said:

“You may be able to identify people if you had a lot of data. It depends on how people will use the data once they have it. But I think it is a small, theoretical risk”.

The risks in this area have been rightly getting much attention and the Health Committee heard more about them this afternoon. Examples can be taken from the websites of both Harvey Walsh, a company that boasted of having more than a billion linked patient-level records and an ability to track patients over time, and OmegaSolver, the company with the patient analyser tool that it claimed can track patients throughout their hospital care.

In the case of OmegaSolver, its website held example screens showing use of its Patient Analyser tool, which it said could track actual patients within every hospital in England, providing up-to-date information for every disease area.

Grahame M. Morris: My hon. Friend is making an essential point. Whole data sets from the hospital episode statistics have been handed over to third parties, and that is absolutely reckless. We need those data to be deleted to restore public confidence in who has got the data and for what purpose.

Barbara Keeley: Indeed, and I say that they “held” that information because websites such as those that I mentioned were suddenly altered when attention was drawn to the capabilities that those organisations claimed to have when it came to tracking patients. The Minister and hon. Members may have seen reports about how the medical histories of people in public life could be tracked using online tools of that type. Widely reported accidents or medical procedures undergone in NHS hospitals clearly provide enough information to spot one patient event in the records and then read across to every hospital visit for that individual.

I ask the Minister not to echo the mantra he has used before or the one the HSCIC used when asked about OmegaSolver—that only aggregated patient data are used and that that does not represent the experience of an individual. It is clear that commercial companies granted commercial reuse licences have claimed that they can track

“actual patients within every hospital within England”.

As I said in the recent debate on the Care Bill, the hospital episode statistics database was originally an administrative database. When did any of us sign up to having our data used to recalculate the cost of insurance cover or by pharmaceutical companies as customers of OmegaSolver? I do not recall signing up to that and I am sure that other hon. Members did not, either.

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Does the Minister agree that perhaps we should go back to thinking that patients should have the option of having their data used only for clinical care and for commissioning that care? In his response in the Care Bill debate on these issues, the Minister said that

“people can, at any time, object or change their mind, and the Health and Social Care Information Centre must respect their wishes and remove their data from records.”—[Official Report, 11 March 2014; Vol. 577, c. 206.]

At the time he said those words, I thought, “That is not currently the case.” I understand that deletions are not permitted and, once a patient’s record has been extracted, they cannot get it removed from the database. If it is in fact a new development that patients can change their minds and request that their data be removed from the records held by the HSCIC and by commercial companies, that will be welcomed, but I really look forward to the Minister telling us how that happens.

I gave the example of Harvey Walsh. They have described themselves as main suppliers of hospital episode statistics and NHS data to the pharmaceutical industry. Can the Minister tell me how an NHS patient can have their records removed from Harvey Walsh’s AXON database or any of the other databases that are outwith the HSCIC?

In the Care Bill debate, the Minister was also asked a question about whether free text would be uploaded from patient records either now or in the future, and he answered:

“As things stand at the moment, free text is not going to be used. That is the reassurance given by the HSCIC”.—[Official Report, 11 March 2014; Vol. 577, c. 206.]

However, Professor Julia Hippisley-Cox and Professor Ross Anderson have pointed out to Health Committee members that researchers already make use of free text from GP patient records. Indeed, medical students and computer science postgraduates at the university of Sussex and at Brighton and Sussex medical school have begun work on analysing doctors’ notes for data from free text.

The data being used come from the Clinical Practice Research Datalink, and Select Committee members were told that those patient data are being used without specific patient consent or section 251 support—it is section 251 of the National Health Service Act 2006. If the HSCIC has given the Minister an assurance that free text from GP records will not be used, can he tell us whether and when the use of free text from GP patient records in the CPRD will be stopped, particularly given that that appears to be happening without patient consent? Patient consent is important, and I still get the feeling from the HSCIC that individuals are somehow being labelled as selfish if they have concerns about sharing their data.

I want to come back to concerns about the existence of the commercial reuse licences granted by the HSCIC. I have tabled a written parliamentary question on this, but I also put the question to the Minister now. He has confirmed that the HSCIC has granted commercial reuse licences. Will he now provide me with a list of each past and present holder of a commercial reuse licence granted and, for each licence holder past and present, will he list the purpose or purposes for which they applied and were approved to use NHS patient data from the HSCIC and its predecessor, the NHS Information Centre? As patients of the NHS, we deserve to know in which places and with which organisations our data are sitting and what they are being used for.

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Grahame M. Morris: My hon. Friend is being very generous about interventions. Again, she makes an excellent point. We need an effective audit trail. If these data sets are being sold on, we need some effective control. That should be stopped. I hope that the Minister—

Nadine Dorries (in the Chair): Order. Barbara Keeley.

Barbara Keeley: I, too, hope that the Minister will address that.

I want to give an example of data use approved by the Data Access Advisory Group of the Health and Social Care Information Centre, because I think that it is instructive. Minutes from the group’s July meeting show that the advisory group approved the use of hospital episode statistics data for HSpot Ltd and its FindMeHealth application. HSpot Ltd had requested HES data, including consultant codes, with the intention of publishing those data online to enable patients to compare procedures by hospital and clinician. Online information about FindMeHealth says that it is

“a new independent UK comparison site offering choice…to the growing number of people who are choosing to self-pay for private healthcare.

FindMeHealth compares prices across the top self-pay procedures and gives users access to the very latest data from NHS and private sources”.

What we have here is a kind of “Go Compare” website for private health care.

Much was said about uses of patient data in the debate on the Care Bill. The Minister said that information from the HSCIC

“may be disseminated for the purposes of ‘the provision of health care or adult social care’ or ‘the promotion of health’.”—[Official Report, 10 March 2014; Vol. 577, c. 136.]

Does the Minister think that the definition that he gave us extends to the HSCIC granting the release of patient data so that commercial companies can run comparison websites on the top self-pay procedures?

We need much greater transparency, and I thank hon. Members present for the questions that they have put on this matter. We need greater transparency from the Health and Social Care Information Centre, but we also need it about the other data sources and the other places where data are held. The chair of the information centre, Kingsley Manning, said in his speech last week that one of its key measures of success might have been that it was

“safely below the radar of public attention”,

but that organisation is no longer below the radar of public attention. Indeed, the organisation has become the story because of the errors that it has made, which mean that hon. Members and the public have discovered just how their confidential medical data are being used by insurers, by commercial companies and even on systems in the United States.

If people look at social media, as I did last night, they will see that there are many comments about just how much distrust people now feel towards the HSCIC. The organisation, as I said at the start, has claimed an “innocent lack of transparency”, but others accuse it of evasiveness and half-truths. As I have detailed, giving misleading answers to the Health Committee on established facts about who works for the organisation does not help.

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All that has to change. Hon. Members, including me in this speech, have talked about ways in which the situation should and must change, and I hope that the Minister understands the vital need for that.

4.16 pm

The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter): It is a pleasure to serve with you chairing the debate, Ms Dorries. In some ways, I wish that we had new issues to discuss; many of the issues that we are discussing today we have thrashed out on a number of occasions in the Care Bill Committee and the Report debate earlier this month, so I am not convinced that there is a lot of new information that I can bring, other than giving further reassurances along the lines of those that have been given. However, it is important to make two points at the outset.

I congratulate the hon. Member for Worsley and Eccles South (Barbara Keeley) on initiating the debate and on her ongoing interest in this topic, but if she has concerns about a witness not giving correct information to the Select Committee, it is of course at her disposal to speak to its Chair, my right hon. Friend the Member for Charnwood (Mr Dorrell), and ask him to take that up with the witness. If she has those concerns, I suggest she does that. Of course, it is very easy to take comments—a few sentences—out of context. It may be that that is the case here; it may be that there are genuine concerns, but if the hon. Lady has those, it is for her to take them up with the Chair of the Committee and ask him to take the matter further.

Barbara Keeley: Will the Minister let me clarify the point?

Dr Poulter: I will give way in one moment. It is also the case, in relation to a number of the other issues and concerns that have been raised during this discussion, that some of the events and some of the evidence given to the Select Committee have of course been superseded by the amendments made to the Care Bill that we debated a couple of weeks ago, so it is difficult to see those points—

Grahame M. Morris: Will the Minister give way?

Dr Poulter: I am giving way to the hon. Gentleman’s hon. Friend in one moment. Let me complete the explanation and then I will be very happy to give way. Events have moved on since some of those evidence sessions, because of course amendments were made to the Care Bill that gave greater clarity and greater reassurance about the protection of patients’ data.

Barbara Keeley: Before the Minister moves off the point about the misleading evidence given to the Health Committee, may I put this to him? The Minister was there with Max Jones and Tim Kelsey—they were there supporting him at the Committee—and I think that this really is down to the Minister. I have, of course, raised the matter with the Chair of the Select Committee, but if a Minister brings civil servants and NHS employees with him to a Committee and those civil servants mislead the Committee—giving incorrect answers not once but twice—I think that it is really down to the Minister to raise the issue as well.

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Dr Poulter: The hon. Lady will recognise that NHS England is an arm’s-length body, so it has less accountability than—or certainly not the same accountability as—a civil servant does to a Minister, and it has a degree of independence. If there are concerns to be raised, as she has just outlined, it is for the Chair of the Committee to write to obtain clarification if he believes that to be appropriate. I am sure he will do so if he feels that that is right. It is not for me, as a Minister, to interfere with the workings of a Select Committee and I do not propose to do so.

Grahame M. Morris: Will the Minister give way?

Dr Poulter: No. I have listened to the same speech from the hon. Gentleman as did my right hon. Friend the Member for Chelmsford (Mr Burns). The hon. Gentleman is always very helpful in tying himself in knots and confusing debates. On this occasion, however, I will make some progress, because I have got 10 minutes left and I would like to put down some further reassurances. I may give way later on, time permitting.

Once again, I congratulate the hon. Member for Worsley and Eccles South on securing the debate, and I would like to say at the outset that we all believe care.data to be a good thing. It is good news for patients, for improving transparency in health care and for improving the quality of research. Those are undoubtedly good things, and we must not lose sight of them in our discussion. The lessons of Mid Staffordshire point out that if we do not properly expose examples of bad care—if we do not have the data, and the transparency in the use of those data, to expose good and bad care in the NHS—bad things can happen to patients. That is a lesson that we must heed.

We must also recognise that if we had had better data sharing in the past, we might have been able to learn better how to recognise patterns in prescribing that were to the detriment of patients, such as the example that has been cited of the use of thalidomide during pregnancy. We might have avoided some very bad things happening to patients if we had had the necessary data. That is what our proposals are about.

This is not a sudden, big-bang change. Opposition Members have put it about that we are dealing with a big change in approach to the use of data in the NHS, but I remind the Chamber that in 1989, hospital episode statistics were first collected for in-patient data, in 2003 for out-patient data and in 2007-08 for A and E data, and primary care data are now being made available.

Of course we understand that the use of data can be concerning, so I want to reassure everyone that the right safeguards are in place, many of them established by the Health and Social Care Act 2012. The new body, the Health and Social Care Information Centre, must have regard to the safeguards put in place by the 2012 Act. The Government take the safeguarding of patient data very seriously.

The commercial reuse of licences was raised in the debate. The Health and Social Care Information Centre has confirmed that some reuse agreements remain in place for specific organisations in relation to approved purposes. The purpose of each application is carefully considered by the HSCIC before it is agreed. That consideration includes the application’s benefit to the health and care system, a safeguard established by the 2012 Act for the use of data.

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Grahame M. Morris: Will the Minister give way?

Dr Poulter: I will give way in a moment; I am just going to finish this point. Following concerns expressed by the Health Committee in its meeting of 25 February, Sir Nick Partridge, a non-executive director on the HSCIC board, has agreed to conduct an audit of all the data releases made by the predecessor organisation, the NHS Information Centre, and report on that to the HSCIC board by the end of May.

Furthermore, a report detailing all data released by the HSCIC, including the legal basis on which those data were released and the purpose to which they are being put, will be published by the HSCIC on 2 April. That report will be updated quarterly. I reiterate that the HSCIC will release information for health and care uses only.

Grahame M. Morris: The Minister is arguing that the scheme is an extension of what happened before, but there is clearly a quantum difference. There is general agreement that it is a wonderful thing to have data sets for research and public health purposes. The difficulty that the public have, about which we need to restore confidence, is when that information is being used for marketisation—for marketing purposes—by commercial reusers. I am not reassured by the Minister’s comments, but he has an opportunity to correct the problem in the House of Lords.

Nadine Dorries (in the Chair): Order. Mr Morris, that is a very long intervention.

Dr Poulter: It is difficult to reply fully to such debates when we have very lengthy interventions, of which the hon. Gentleman is very fond. I would like to spell out to him what the quantum difference is. The Government have, through the 2012 Act, put in place safeguards for data protection that the previous Government never had. In particular, under the 2012 Act, data can be used only for the benefit of the health and social care system. We have put in place the safeguard that people can opt out from having their data collected and used. Those safeguards were not in place when the previous Government—

Barbara Keeley: Will the Minister give way?

Dr Poulter: No, it is important to make these points. The hon. Lady is very party political on the matter, and it is important that she recognises failings that existed in the past. I have mentioned the collection of in-patient data from 1989, out-patient data from 2003 and A and E data from 2007-08. I am not aware of any safeguards put in place by the previous Government to allow patients actively to opt out of the collection of those data. If she is aware of any, I would like her to clarify the record.

Barbara Keeley: The Minister is talking about opt-out, but I asked him a specific question about commercial reuse licences. I understand that there are at least six of those—six massive copies of all hospital episode statistics data—out there. How does an NHS patient get their data deleted from those copies, which sit with companies such as Harvey Walsh and OmegaSolver? How does that happen?

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Dr Poulter: The point is that people have the opportunity to opt out of the programme if they wish to. The HSCIC can also put in place contractual safeguards if there are sensitivities around data. Our amendments to the Care Bill created a “one strike and you’re out” situation for any companies that use data, whereby if there is any misuse of data, they will be struck off.

The safeguards established by the Government—those in the 2012 Act and the announcement by my right hon. Friend the Secretary of State that people could opt out of the collection and use of their data—are welcome. Such safeguards never existed under the previous Government, and we have made good progress in protecting patient confidentiality, although that is not to say that we do not need to reassure the public further.

We must make sure that we have rigorous processes in place. In the brief time available, it is worth outlining some of the strong measures in the 2012 Act, which established the HSCIC and set out the framework in which it will operate to ensure that data are being used appropriately. Under section 260 of the 2012 Act, the HSCIC must not publish the information it obtains in a form that would enable an individual other than a provider of care to be identified. That is a strong protection for individual confidentiality in the publication of data.

Under section 261, the HSCIC cannot disseminate or share data that could be used to identify an individual other than a provider of care except where there is another legal basis for doing so, which, as we have said, would be only in extreme circumstances such as a civil emergency. Under section 263, the HSCIC must publish a code of practice clarifying how it and others should handle confidential data. Under section 264, the HSCIC must be open and transparent about the data it obtains by publishing a register with descriptions of the information. The HSCIC is working now to ensure that it is transparent about all the data it has released to others.

Moreover, the Government have already introduced the commitment that if someone has concerns about their data being used in such a way, they can ask their GP practice to note their objection and opt out of the system, after which no identifiable data about them will flow from their GP practice to the HSCIC. Directions to the HSCIC under section 254 of the 2012 Act, which are separate from the amendments considered by the House as part of the Care Bill, will ensure that that commitment to patients has legal force.

There are strong safeguards in place, and Opposition Members would do well to recognise that the 2012 Act has put us in a much better place. Safeguards are in place that never existed when the previous Government extended the use of data sharing in the NHS. We all recognise the benefits of care.data, and we must recognise that, with the additional safeguards in place, we will have a system that will help to improve health and care research and the quality of care available to patients.

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Tamils (Sri Lanka)

4.30 pm

Mr Lee Scott (Ilford North) (Con): It is a pleasure to serve under your chairmanship, Ms Dorries. I secured this debate to call for justice for the Tamil community in Sri Lanka—indeed, for everyone living there—after a long struggle over many years. I thank my right hon. Friends the Minister, the Foreign Secretary and the Prime Minister for getting us to the stage we are at now. I also want to express gratitude to the United States, Macedonia, Montenegro and Mauritius for jointly tabling the resolution that is currently before the United Nations in Geneva.

After all this time, when it is quite obvious that the Sri Lankan Government are not going to deal with matters themselves, we need a comprehensive international investigation. I am pleased that such an investigation is included in the UN’s draft resolution, and although I know that that is still being worked on, I would like to put a number of points to the Minister. I would like to see put forward as tough a resolution as is humanly possible. I have seen that the current draft resolution says that crimes up to 2009 would be investigated, but many crimes have been committed since then that must be looked into as well. The demilitarisation zone should be expanded to include the east of the country, where crimes have been perpetuated, as well as the north.

It is also important for there to be a free political stage—people should not be persecuted for trying to speak up and stand as opposition parties in Sri Lanka, as they are currently.

Mr Virendra Sharma (Ealing, Southall) (Lab): I am grateful for the hon. Gentleman’s generosity in giving way so early in the debate. I am sure that he will agree with my hon. Friend the Member for Harrow West (Mr Thomas), who said in a debate a few weeks ago that the Home Office and the UK Border Agency should stop deporting Tamils to Sri Lanka while the resolution is being discussed by the UN.

Mr Scott: It is important that anyone who fears for their life and their future should not be deported to Sri Lanka at this time.

It is vital that the resolution goes through. Neither I nor anyone else should do anything today to try to hinder that, but we must also think about where we go from here. Let us hope that the resolution goes through later this week, but where do we go then? The Sri Lankan Government have never given any signal that they intend to carry out their duties as a Government representing all peoples in their country, so nothing should be taken off the table when considering what we must do to ensure that the resolution is adhered to and justice is done. Without question, before there can be even a chance of reconciliation, there must be justice.

I call for peace for all in Sri Lanka. The accusation has been levelled at me that I am speaking on behalf of only one people. I am talking on behalf of everyone—I do not want anyone in Sri Lanka to suffer, whatever their religion or background might be. It is not for me to say who is guilty or not; the whole point of a comprehensive international investigation is to find that out. Someone was responsible for the death of women and children, for the rape of women and for the persecution that has gone on, and they must be held to account.

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I commend the action taken so far, particularly the Prime Minister’s words in Brussels last week. He explained exactly why the UK has called for and is backing the UN resolution. Constituents who have come to see me have a right to know what has happened to their families. There have been so many disappearances— they have a right to know what has happened to their brothers, sisters, aunts, uncles, nieces and nephews in Sri Lanka. The only way forward is through a comprehensive international investigation.

Time is very limited today, so I will restrict my words as I know that colleagues wish to speak. I want to say something that I have said on a number of occasions: if we do not get the justice that people so rightly deserve, we should hang our heads in shame, no matter what our political party. We must work together, just as my right hon. Friends in the Government are doing.

Bob Blackman (Harrow East) (Con): Does my hon. Friend agree that one of the aims of this week’s resolution is to build the biggest and broadest coalition of world support for whatever measure is passed, rather than a narrow base? We must demonstrate the world’s opinion of the situation in Sri Lanka. By necessity, that means being forced to compromise on some of the wording in order to achieve a worldwide position, but hopefully we will bring all powers into the decision-making process and so increase the pressure on Sri Lanka for a proper resolution of the situation there.

Mr Scott: I thank my hon. Friend for his comments. I believe that we must get through the toughest resolution we can. I was at the United Nations in Geneva and of course I heard the comments from some of the countries that do not support the resolution. I will not name them all, but I will point out the slight irony of the Russian ambassador saying that he does not believe that a country should involve itself in another country’s affairs, although that is another matter. None the less, I recognise the fact that many countries do not support the resolution, and it is vital that we have as wide a base of support from the world community as possible. I hope and pray that sufficient numbers will support the resolution and that it will go through. There will of course have to be compromises, but I want it to be as tough as possible, on the grounds that I laid out at the start of my speech.

John Mann (Bassetlaw) (Lab): Does the hon. Gentleman share my hope that, should the resolution be passed this week, the UN will take immediate action, as it has done over recent months, to initiate its own investigations as a matter of priority?

Mr Scott: I thank the hon. Gentleman for his intervention and totally agree with him. The UN should play a vital role.

I would like to conclude by saying that once the resolution goes through—I hope and pray that it will—it is important that the UK helps in any way it can. I know that that will happen. We must help to gather evidence, some of which now goes back a long time, and make the investigation work. We must also take nothing

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off the table and do what is necessary to ensure that the Sri Lankan Government comply with the resolution once it is passed.

4.38 pm

Siobhain McDonagh (Mitcham and Morden) (Lab): Good afternoon, Ms Dorries. I congratulate the hon. Member for Ilford North (Mr Scott) on securing this debate at such an apposite time. Although I believe, like him, that the UN resolution on Sri Lanka is a move in the right direction, my constituents are concerned that it excludes some issues—including, notably, the period since the conflict ended. The atrocities committed during the conflict were appalling. President Rajapaksa headed a regime that most observers believe committed war crimes and crimes against humanity. During the conflict, it dropped cluster bombs on the area it had designated a no-fire zone. Even now, nearly 150,000 Tamils remain unaccounted for.

But the transgressions have continued. With no commitment to an independent international investigation that would lead to reconciliation, the political situation in Sri Lanka is worsening. The UN human rights commissioner, Navi Pillay, has said that

“although the fighting is over, the suffering is not”,

and that Sri Lanka is

“heading in an increasingly authoritarian direction.”

Amnesty describes a Government

“cracking down on critics through threats, harassment, imprisonment and violent attacks.”

Archbishop Desmond Tutu has said that

“anyone remotely connected with the losing side…is being hunted down, tortured and raped, five years after the guns fell silent.”

More than half the abductions mentioned in the report took place in the last year alone. Tamil places of worship are routinely targeted. A policy of displacement through militarisation led the UN special rapporteur in December to describe the living conditions of tens of thousands of Tamils as “very precarious”. Human rights campaigners have been targeted, including Balendran Jeyakumari, who was arrested and assaulted earlier this month and whose defenders were also detained when they tried to investigate. Earlier this month, the leading Sri Lankan Catholic Bishop Rayappu Joseph was accused of treason. Sri Lanka is now the most dangerous place in the world to be a journalist, and there have been thousands of disappearances. According to Freedom from Torture, Sri Lanka is now the country from which it gets the most referrals. Human Rights Watch has also released a shocking report on the rape and sexual abuse of Tamil detainees.

The Sri Lanka regime has shown that it cannot be trusted to act fairly towards the Tamil community. During the conflict, it fired cluster bombs, white phosphorus and rockets at Tamils. Now it represses Tamils in other ways. My constituents want Britain to do all we can to ensure that the UN resolution is a first step towards justice and reconciliation. If we had done more sooner, we might be in a better place now, but we are where we are. The Minister must ensure that Britain monitors the human rights situation vigorously and supports the work of the commissioner. I look forward to his response.

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4.41 pm

The Minister of State, Foreign and Commonwealth Office (Mr Hugo Swire): I thank my hon. Friend the Member for Ilford North (Mr Scott) for securing this timely debate on the situation of the Tamil people in Sri Lanka, and I pay tribute to him for his tireless work as chairman of the all-party parliamentary group on Tamils in raising the profile of human rights issues in Sri Lanka and seeking progress on accountability for the events that took place during the war, both of which are vital if Sri Lanka is to put its past behind it, thrive in future and achieve lasting peace. I also thank him for acknowledging this Government’s work to secure a strong resolution on Sri Lanka at the United Nations Human Rights Council in Geneva this week. As he knows, I was in Geneva a few weeks ago and made a speech there in support of the motion with which we are closely involved.

As my hon. Friend knows, human rights in Sri Lanka is an issue that has rightly occupied a great deal of my time since I took over the Sri Lanka portfolio from my predecessor, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt); it took up a lot of his time too. The decision to attend the Commonwealth Heads of Government meeting in Sri Lanka last November, although criticised by the Labour Opposition at the time, was absolutely the right thing to do, as it brought the concerns of many Sri Lankan people into sharp focus both here in the United Kingdom and around the world.

My right hon. Friend the Prime Minister saw the situation for himself when he visited the north, as the first Head of Government to do so since 1948. People came out in force to make their voices heard, tell their stories and demand the truth following Sri Lanka’s appalling war. Separately, my right hon. Friend the Foreign Secretary and I met civil society and religious leaders and heard about continuing impunity for human rights violations including, as the hon. Member for Mitcham and Morden (Siobhain McDonagh) said, disappearances, sexual violence and attacks on religious minorities.

While there, we were also reminded that Sri Lanka is a beautiful country, with the opportunity to build a strong, peaceful and prosperous future. But to do so, the Government of Sri Lanka need to show magnanimity and build the foundations for successful reconciliation. That means going beyond the important steps of reconstructing areas badly affected by the war, reintegrating child soldiers, resettling internally displaced people and de-mining. Incidentally, I am pleased that the United Kingdom contributed an additional £2.1 million last year to support de-mining work in Sri Lanka. Sri Lanka also needs to establish the truth for those who seek it, restore livelihoods to those who have lost them, deliver a sustainable political settlement, ensure an end to impunity, and ensure the independence of the judiciary and space for freedom of speech.

Much of that was reflected in the remarks made by my right hon. Friend the Prime Minister at the Commonwealth Heads of Government meeting, where he raised the United Kingdom’s concerns directly with President Rajapaksa, which he would have been unable to do if he had not gone there in the first place. The Prime Minister made it clear that if Sri Lanka had not properly begun a credible, independent domestic

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investigation by March, he would use the UK’s seat on the Human Rights Council to call for an international investigation.

Siobhain McDonagh: I was always taught that self-praise is no praise. There are many people who must be praised for struggling since 2009 to bring to light the evidence of the terrible atrocities that happened in Sri Lanka. One of them is the film producer Callum Macrae, whose film “No Fire Zone” is up for a documentary award in the One World film festival. Will the Minister congratulate Callum Macrae and extend his thanks to the other people who fought nobly when nobody was prepared to listen?

Mr Swire: I pay tribute to all those who have lifted the veil over what has gone on in Sri Lanka, including Channel 4, whose programmes have been dismissed by some elements in the Government in Sri Lanka. A lot of people have been campaigning for the investigation, which I hope will achieve support in the next 48 hours.

The time has come to address these things. The 24 February report of the UN high commissioner for human rights, Navi Pillay, bore out the concerns expressed to us in November. Its assessment was that human rights concerns continue, including compulsory land acquisition, shrinking space for civil society and media, rising religious intolerance and the undermining of independent institutions such as the judiciary. The report also assesses that the Government of Sri Lanka have

“failed to ensure independent and credible investigations into past violations of international human rights and humanitarian law”

on both sides during the war, which Ms Pillay attributes to a lack of political will.

The British Government strongly support that assessment. It is of deep concern that yet again the Government of Sri Lanka have failed to implement the recommendations of a Human Rights Council resolution. Additionally, Ms Pillay’s remarks during her visit to Sri Lanka last year that the country is

“showing signs of heading in an increasingly authoritarian direction”

are also of great concern to us.

Sri Lanka’s failure to investigate human rights violations is the reason why, when I represented the UK at the high-level segment of the UN Human Rights Council in Geneva on 3 March, I called for the international community to act and strongly encouraged the Human Rights Council to unite in supporting the call for an international investigation contained in the draft resolution on Sri Lanka. We are determined to win the council vote, which will take place later this week. The UK has taken a forward-leaning position and provided leadership, and will help break new ground if the council is successful in establishing an international mechanism. That is why my right hon. Friends the Prime Minister and the Foreign Secretary, my ministerial colleagues at the Foreign and Commonwealth Office and I have personally engaged with the majority of Human Rights Council countries. On 21 March, my right hon. Friend the Prime Minister led a call for European Council conclusions that put the EU’s full support behind the resolution.

We have been encouraged by the responses, but will continue to press hard for support right up until the vote takes place. We are taking nothing for granted. We

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have been working extremely closely with non-governmental organisations and other interested groups and listening to their views and aspirations. I take this opportunity to pay tribute again to all the individuals in this House and outside it who have campaigned for this moment. The time has come for a genuinely credible investigation

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with an international dimension to assess once and for all what went on. It will only help all the people of Sri Lanka move forward.

Question put and agreed to.

4.49 pm

Sitting adjourned.