argyrotsipi/train-dataset huggingface dataset:
Report of the Iraq Inquiry — House of Commons, 2016-07-14
Topic: Defense
Michael Fallon (Conservative, Centre-right): Members and Ministers should speak the truth in this particular House, but whether the Prime Minister of the day deliberately misled the House was investigated exhaustively by Sir John Chilcot in the report and I do not want to add any more to what he said I turn now to the issue raised by the right hon. Member for Carshalton and Wallington (Tom Brake) about stabilisation. Since the Iraq war, the Government have increasingly focused first on prevention rather than intervention. We have been helping to build capability with partners and tackling the problems of fragile states at source, which has been possible only because we are now spending 0.7% of our GDP on international development. By helping fragile states to promote good governance, tackle corruption, and build capacity in defence and security forces, we can stop crises turning to the chaos that we have seen. That requires insight and understanding, often into complex situations. We have set up the cross-Government conflict stability and security fund, building on the conflict pool that had been in place for some time and supporting delivery of country or regional NSC strategies All that promotes a much stronger culture of cross-Government working on strategy, policy and delivery in fragile and conflict-affected countries. An example of our success in that so far was the recent deployment to Sierra Leone to combat Ebola, where diplomats, the military and officials from the Department for International Development worked alongside each other. The stabilisation unit that we set up has continued to develop, so we now have experts on hand to deploy in post-conflict situations anywhere in the world, at short notice. I have seen for myself how civilian advisers are now routinely part of military exercises, ensuring that military and civilian staff gain experience of working together before they are deployed, so that development and humanitarian needs get the consideration and attention they need, alongside the military planning We are now trying to make sure our armed forces are properly equipped and resourced. Not only are we meeting the NATO commitment to spend 2% of our GDP on defence, but our defence budget is growing for the first time in six years. That is on the back of the successful efforts we have been making since 2010 to return financial discipline to the Ministry of Defence and balance the defence budget. That is the foundation for the strong focus now on delivering an affordable 10-year equipment programme, allowing us to invest in the right equipment for our armed forces. That programme will total at least £178 billion on new military equipment over the next decade.
Report of the Iraq Inquiry — House of Commons, 2016-07-14
Topic: Defense
Michael Fallon (Conservative, Centre-right): We have taken a lot of measures to involve the reserves more closely with the regulars now. After Iraq, we have been learning more rapidly the lessons from each deployment, particularly those from Afghanistan, to ensure that in future we do not have to wait for the kind of report that Sir John Chilcot has produced, and we are able to learn the lessons as we go and as units return, so that they can be applied to the next units taking up those roles Strategic defence reviews take the balance of investment decisions, including where our main equipment priorities lie. Routinely, decisions on how that money will then be invested rest with the service chiefs, giving them the freedom, and the responsibility, to make decisions on how best to apply their resources, and obliging them to be very clear about where they are carrying risk in respect of potential equipment failures or shortfall. Where changing circumstances or unexpected threats lead to shortfalls, we should be ready and able, quickly and effectively, to make good any shortcomings The Chilcot report recognises that the MOD and the Treasury, between them, worked hard to develop and refine the urgent operational requirements process. As the former Prime Minister told this House, that process did deliver results and new, improved equipment into theatre quickly in the Afghanistan campaign, responding immediately to the needs of our armed forces there. One of Chilcot’s most troubling observations is the lack back then of a clear focus of responsibility for identifying capability gaps during enduring operations. The new post of Deputy Chief of the Defence Staff for Military Capability that has since been established fulfils that role. As well as properly equipping and resourcing our people, the Government have a duty to ensure the welfare of our armed forces and their families, and then to ensure that they suffer no disadvantage when they return to civilian life. By putting the armed forces covenant into law and committing resources to it, we are making sure that all those who put their lives on the line for this country get the help and support they need But however much we have done, and however much things have changed and improved since the Iraq campaign, the question for this House is to judge whether or not we have done enough. My answer is: no, of course we have not yet done enough. It is evident that the Chilcot report contains many harsh lessons still for us to learn. Given its length and forensic detail, it will take us some more time to analyse and to do it full justice. What is clear to me is that we now need to take a long, hard look at our decision-making processes and our culture to satisfy ourselves that misjudgments similar to those made at the time could not recur.
Report of the Iraq Inquiry — House of Commons, 2016-07-14
Topic: Defense
Michael Fallon (Conservative, Centre-right): The Chilcot report itself holds to account those who were involved and took the key decisions, and it makes its judgments on them. It is for them, not for me, to respond to those judgments and to account for the actions and the way in which they took their decisions at that time On the decision-making culture, the detail of the committees and the machinery of government which we discussed a few moments ago is not the stuff of headlines and speeches, but Chilcot shows us that some of these internal procedures of government are important. He sets out in pretty stark terms what happens when those structures—and the opportunities that they provide for the proper flow of information and challenge—are missing or are bypassed. In defence, we have transformed in recent years our approach to risk. We have a clear focus of responsibility in each key area. We have designated risk duty holders and it is their responsibility to come to me if they believe that the levels of risk in their areas are becoming excessive. I expect military chiefs and commanders now to show the same degree of rigour and transparency with respect to operational planning Our organisation and culture must not prevent our people from challenging and questioning institutional assumptions, even if those assumptions are made by their superiors. That was a point eloquently made yesterday by my right hon. and learned Friend the Member for Beaconsfield (Mr Grieve), and it was made again by the hon. Member for South Antrim (Danny Kinahan) today That view is fully shared by the current Chiefs of Staff—each of whom served in different roles during the Iraq campaign, including the outgoing and the incoming Chief of the Defence Staff—and it is shared by the permanent secretary. We are committed to leading defence through a period of rigorous reflection, analysis and improvement, and I am determined to make that improvement happen. I need, and the House would want me, to be absolutely sure that when our servicemen and women are deployed in future—and, inevitably, that is when, not if—nobody will be able to point to Sir John’s report and justifiably accuse us of repeating the same mistakes. I want to give the House an assurance that Sir John’s report will not be the last word In conclusion, our strategic defence and security review reminds us that we are living in an ever more dangerous world. Despite the report and the Iraq campaign, we must still be ready to act, as we have shown in our participation in the international coalition campaign against Daesh in Iraq and Syria today. We must remain as committed as ever to protecting our people and standing up to any kind of terrorism or aggression that seeks to destroy our very way of life. Sir John and his team, I repeat, have done us all a great service. Their work will enable us to learn the vital lessons from those operations in Iraq and ensure that we are not condemned to make the same mistakes in future Question put and agreed to. Resolved, That this House has considered the Report of the Iraq Inquiry.
Detention under Mental Health Act — House of Commons, 2016-07-14
Topic: Health
Alexander Paul Beresford (Conservative, Centre-right): It would be interesting to compare and contrast those statistics with the suicide statistics. By law, anyone arrested under section 136 must be seen within 72 hours by a psychiatrist or a medical practitioner with psychiatric training, which represents an enormous safeguard.
Detention under Mental Health Act — House of Commons, 2016-07-14
Topic: Health
Henry Bellingham (Conservative, Centre-right): I support my hon. Friend the Member for Mole Valley (Sir Paul Beresford) in everything that he is trying to do. Does the Minister agree that the time limit in the safeguards in section 136, which require an examination by a registered medical practitioner or an interview by an approved medical health professional within 72 hours, could be reduced to perhaps 12 hours? That would mean that the person in question would get more immediate help.
Detention under Mental Health Act — House of Commons, 2016-07-14
Topic: Health
Michael Penning (Conservative, Centre-right): To conclude, it is absolutely right that this issue has been brought to the House, although I am aware of it. I was aware of it before I took on my portfolio and, to be fair, even before I came into the House, because my mother was a mental health nurse for more than 40 years. We are in a much better position today than we have been in the past, and we have a better understanding of mental health and learning difficulties—[Interruption.] The phone in my pocket is buzzing; it may well be someone trying to get hold of me urgently It is important that we work together. I give my hon. Friend a commitment that if we cannot get this right using the measures that we are working on, an amendment to section 136 might be exactly what we need Question put and agreed to.
Contingencies Fund — House of Commons, 2016-06-07
Topic: Health
Gregory William Hands (Conservative, Centre-right): I thank the hon. Lady for that question. I will ensure that she gets a reply, which she deserves, because this is a deeply distressing issue and the Government take it very seriously indeed. I do not believe it is appropriate to use the Contingencies Fund in this particular case. She will know that the consultation on the reform of financial support to those affected closed on 15 April, and we will be replying in due course. Meanwhile, the Department of Health has identified additional money—£100 million from its budget—for these purposes. This is in addition to the £22.5 million that it spends on this annually, as well as the further £25 million announced in March 2015. These steps will more than double the support.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): I am grateful for the opportunity to respond to this urgent question. As the House knows, HIV can be a devastating illness, and we know that pre-exposure prophylaxis—PrEP—can make a difference to those at risk of contracting HIV and to those who are already HIV positive. However, it is crucial that we have a full understanding of all the issues surrounding PrEP As with any new intervention, PrEP must be properly assessed in relation to clinical effectiveness and cost-effectiveness. That is why we have today asked NICE to conduct an evidence review of Truvada for PrEP of HIV in high-risk groups. This evidence review signifies the next step forward and will inform any subsequent decisions about commissioning. It will look at the evidence for effectiveness, safety, patient factors and resource implications. The NICE evidence summary will run alongside a pilot scheme in which we are investing up to £2 million. Public Health England is currently identifying the most effective places for the pilot to take place It is also important to remember that Truvada, the drug used for PrEP, is not yet licensed for this use in the UK. That is why, as well as the pilot scheme, the Government want to see the evidence review, which will help to inform future commissioning decisions about PrEP PrEP is only one of a range of activities designed to tackle HIV, which is of course a Government priority. It is also important to stress that the challenge remains of tackling high rates of some sexually transmitted infections, particularly in high-risk MSM—men who have sex with men—communities. Our £2.4 million national HIV prevention and sexual health promotion programme gives those at highest risk the best advice to make safer choices about sex The UK has world-class treatment services and is already ahead in reaching two of the three UNAIDS goals of ensuring that we have 90% diagnosed infection, 90% of those diagnosed on treatment and 90% viral suppression by 2020. In 2014, 17% of those living with HIV had undiagnosed infection, but 91% of those diagnosed were on treatment, of whom 95% were virally suppressed. We are determined to continue to make real progress to meet these goals, and we are considering carefully the role that PrEP can play in helping us to get there.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): Some of the shadow Minister’s questions are simply ahead of the moment, as it were. As I said clearly in my statement, NHS England has made clear how it feels about being the commissioner, based on a legal argument that it has published. No decision has been made about who the commissioner is. Clearly, we need to reach a decision, and we discussed that earlier today in the Health Committee. However, there are a number of stages we have to go through—as I say, the drug is not even licensed for use as PrEP in the UK We have set out a series of stages we will go through, which will help to inform a final decision. On the questions the hon. Gentleman posed, we are not in a position to make a judgment. There is more we need to know about clinical effectiveness and cost-effectiveness and about the pilot—
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): No, that is not the case. There has been an important study—the PROUD study—but that looked at clinical effectiveness. There is a wider piece of work to be done—of which the pilot programme that we have announced is part—to enable us to understand where PrEP fits in in terms of clinical and cost-effectiveness, and how it fits into the HIV prevention landscape more broadly, alongside other HIV interventions that are commissioned. There is work yet to do, but we are not standing still. We have announced this important pilot and committed money to it, and we have asked NICE for an evidence review. All this will go into our consideration.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Michael Whitney Freer (Conservative, Centre-right): I agree with the shadow Minister apart from on one thing, which is his asking my hon. Friend the Minister to show leadership. Having campaigned on many male sexual health issues as chair of the all-party parliamentary group on HIV and AIDS, I can say that this Minister has been unfailingly supportive in addressing many of the issues facing not just men’s sexual health, but particularly gay men’s sexual health. I therefore take issue with that call for leadership Having said that, I have lost too many friends to AIDS over the years not to challenge NHS England’s decision not to fund PrEP. HIV infection rates in this country are on the increase and existing strategies are not working. It is not acceptable to suggest that we simply continue to do the same. I have a meeting with the Minister on 13 June. Will she agree to widen that to other stakeholders?
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): I thank my hon. Friend for his kind words. I take this issue extremely seriously. He is right to say that we face a challenge in relation to HIV rates, and particularly, as I said, STI rates in the high-risk MSM community. I stress again that while it will no doubt have an important part to play, PrEP is not a silver bullet for sexual infections, particularly in some of those high-risk groups. It is important to understand that. We have to continue to look at a whole range of measures. When I recently met the chief executive of the Terrence Higgins Trust, we touched on this As my hon. Friend says, we have a meeting coming up. I apologise for not responding to the shadow Minister’s question about meeting stakeholder groups. Of course I will meet all the key stakeholder groups. I have already had some formal and some informal discussions on this, but of course I am very open to having further such discussions. Stakeholders were involved in the process that NHS England has been involved in. NHS England has made its position clear, and there is a matter due to go before the courts on which I will not comment further. Yes, I will engage on this. Yes, of course I accept that we need to do more, and of course we all share the concerns about rising HIV infection rates, particularly among the MSM community. I too lost friends to the AIDS epidemic that my hon. Friend mentions. I take this issue extremely seriously, but we have to follow a sensible process, and that is what the Government are doing.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): It is probably worth clarifying that we asked NICE to undertake an evidence review, not a technology assessment. What drugs are licensed for are matters for drug companies to address. The Government do not initiate the process on whether a drug is licensed— the drug company must initiate it. It also worth noting that when a drug is licensed for a new purpose, as would be the case for Truvada in PrEP, the company could apply for the patent to be extended to cover this new use. Again, that is something that the drug company would do On the hon. Lady’s first point, I agree that we need to consider the impact on women in the circumstances she described. That is one of the arguments for carefully planning this pilot programme and taking those sorts of factors into account.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Andrew William Murrison (Conservative, Centre-right): The process that the Minister has outlined is correct, but does she recognise that the French Government have already approved Truvada for pre-exposure prophylaxis, and does she understand the urgency in this? The results of the UK PROUD study, funded by the MRC, are quite unequivocal, so we really need to get this going. Will she also reflect on the fact that the study showed no difference in the incidence of other sexually transmitted diseases, because Truvada does not protect against them, so the message has to go out that a condom is absolutely essential?
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): My hon. Friend is quite correct on his latter point about the impact of PrEP. Whether it was commissioned or not, and whoever it was commissioned by, we would still have the significant challenge that he describes around STIs. Drug-resistant gonorrhoea, for example, is a problem that we are increasingly aware of There are international comparisons that we can look at, as my hon. Friend mentions. I have looked at the matter in some detail, and the picture across the world is that many countries are in broadly the same position as the UK. They are trying to understand, leaving aside the question of clinical effectiveness, more about how PrEP can be used as part of an HIV prevention programme in broader cost-effectiveness terms, and how it compares in cost-effectiveness terms with other available interventions. My hon. Friend is right that there is work to do, and we are not resting easy on this. We are moving forward, and we are working on and planning these pilots now.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): The NHS England position is based on a legal argument, and as the matter is likely to go before the courts, it is not really appropriate for me to comment further. There was a little discussion this morning on this subject in the Health Committee, for which some Members were present. I have laid out a process by which we will work out how and where this is commissioned. Clearly, we need to identify the commissioner I do not accept the right hon. Gentleman’s challenge about fragmentation, simply because if we look around the world at a series of very different health systems, we see that they are all going through broadly the same process of understanding where PrEP sits. There are a number of options, but first we need to go through this work. On his latter point about stigma, he is right to identify that it is a significant concern, but I do not accept that that is what this represents. He knows my personal commitment to tackling stigma, and we could not have made it clearer that addressing rising HIV rates, addressing STIs in the MSM community and looking at the challenges surrounding things such as chemsex are all very much front of mind, and we have given considerable time and thought to them. We must challenge stigma wherever it rears its head.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Philip Thomas Hollobone (Conservative, Centre-right): Given the challenges of HIV, I think that my constituents would be excited by the prospects that PrEP offers. They would, however, be a little disturbed by the fact that every country in the world seems to be going through the same process, and duplicating, replicating and holding up what could be a very exciting development to combat the spread of HIV across Africa. Many countries are suffering from this far worse than we are, and they would be horrified by the thought that the process could get bogged down in a court when this treatment, if it were available, could do very real good.
NHS Commissioning (Pre-Exposure Prophylaxis) — House of Commons, 2016-06-07
Topic: Health
Jane Ellison (Conservative, Centre-right): My hon. Friend is right to recognise that PrEP has potential. It is, in fact, being used in some places internationally. The point I was making was that there is no simple, one-size-fits-all solution. Different countries have different challenges. For example, the level of HIV prevalence and the services available to manage that prevalence, and to manage testing, are very different in different countries. That forms different landscapes into which PrEP might fit. To give an example from Africa, PrEP was licensed last year, and it will be available for sex workers in selected sites. HIV prevalence among female sex workers is estimated to be just under 60% in South Africa. There are different contexts in which PrEP is being taken forward, and that is just one of them.