Health Bill

Baroness Cash Excerpts

Committee stage
Tuesday 3rd November 2026 Lords Chamber

[Baroness Pidgeon (LD)]

My Lords, this group of amendments is incredibly important. I thank the noble Baroness, Lady Gerada, for tabling most of them and for her powerful words about Jewish staff and patients, and their experiences in the data that she also presented. In different ways, all these amendments are trying to ensure that all parts of the NHS stamp out antisemitism and racism, and provide the right training on it, as recommended by the review from the noble Lord, Lord Mann.

I completely agree with the neutrality point that the noble Lord, Lord Hunt, raised about the uniform that staff wear. I recall that, several years ago, the Metropolitan Police had a huge issue with badges that officers started to wear as part of their support for charities such as Help for Heroes. That was ruled out of order, and they were not allowed to wear them. I think this is a similar thing, and there has been a sort of creep in uniforms over the years in what is acceptable or not. We need to make sure that all staff are seen to be neutral and behave neutrally.

The amendment on assessing the performance of ICBs is important in ensuring that trusts have a duty to prevent this and respond to it; it would ensure that that is integral to these organisations. The noble Lord raised a point about leadership. We on these Benches fully support the Mann review and the implementation of its recommendations, and my noble friend Lord Scriven’s practical suggestion about the NHS constitution is certainly a good idea worthy of consideration by the Minister. I hope the Government will look at how best to implement these amendments—as worded or in a different way—and I look forward to the Minister’s response.

[Baroness Cash (Con)]

My Lords, this looked like a very serious group of amendments on paper but, until we had this debate, quite how grave the current gaps are in the NHS did not really emerge. I thank the noble Baroness, Lady Gerada, for tabling her amendments and the noble Lords who spoke to them. I also pay tribute to the noble Lord, Lord Mann, for his review and to the Government for accepting the recommendations that Members from all Benches in the House appear to accept unreservedly.

I sympathise with and support the intent of every amendment in the group. I particularly support Amendments 79, 258 and 259, given the gaps they highlight and the urgent need to close them. Even in light of what the Government have accepted, it is quite apparent that shocking levels of antisemitism are continuing, and there need to be some urgent interventions to stop that.

I spoke quite recently in this House on Sir David Bell’s review of the levels of antisemitism in schools. It is really quite sad, and a shame for this country, that the review by the noble Lord, Lord Mann, shows the same pattern in the NHS. There is clearly a major problem and it is racism, plain and simple, directed at Jews. Too many institutions are tolerating it in a way they would never tolerate against any other group.

The facts are devastating. Community Security Trust recorded 3,700 antisemitic incidents in 2025—the second-highest total ever recorded. In the 2025 NHS staff survey, as we have heard, 13% of Jewish staff recorded discrimination from their own managers or colleagues. That is intolerable in your workplace. How can anyone possibly feel safe going about their day-to-day interactions? We have heard from a number of noble Lords this evening that Jewish people are the only religious group, the only ethnic group, for whom discrimination from colleagues is more common than discrimination from patients. The hostility is coming from inside the institution, and it is therefore beholden on us, debating this Bill, not to miss the opportunities to address this and close the gaps.

The Commission on Antisemitism found Jewish patients considering whether they should remove their religious symbols before treatment. Imagine feeling so unsafe in a healthcare setting, when you are at your most vulnerable, that you may have to consider concealing that about your identity. Patients who feel they have to hide who they are to be treated have lost trust in the NHS; they have lost faith that their doctors will do no harm—the first and basic premise of healthcare—and they have lost confidence that they will be safe.

The regulator has not done its job, which is why I support these amendments, even though the Government have actions in progress and even though they have accepted the recommendations of the review by the noble Lord, Lord Mann. Around 70% of completed appeals by the GMC against tribunals have succeeded, and we know that if the regulators are succeeding seven times out of 10, there is something fundamentally wrong in the disciplinary decisions.

I will not repeat what has been said by noble Lords in support of their amendments, but we should give serious consideration to the proposal from the noble Lord, Lord Scriven, so that we can address the fundamental issue here: a loss of neutrality and an overt willingness to attack colleagues and patients on the basis of their Jewish identity. My noble friend Lord Blencathra goes even further in his Amendment 279C, and I look forward to hearing the Minister’s response to that. He outlined the very serious reasons why he has asked for that, and those reasons and facts need to be addressed.

On Amendment 29 and training, I support the recommendation of the noble Lord, Lord Mann, that it is needed, but he was very specific in what he asked for. He called for the mandatory module, used by 1.5 million staff already, to be updated with quality assured content on antisemitism and anti-Muslim hostility. He added that subject experts should be consulted and that the training be monitored and reported on publicly to ensure it has the desired impact, but I have real reservations about the training that would be possible under Amendment 29, because as drafted it does not contain any of the noble Lord’s safeguards. That does not mean we should not consider or expedite the training that is needed.

The record of equality training in the public sector gives a good reason for us to take care. In 2020, the Government phased out unconscious bias training in the Civil Service after a review found no evidence that it changed behaviour, and some NHS anti-racism training has left out antisemitism entirely. Moorfields Eye Hospital’s compulsory anti-racism seminar was reported last year to have made no mention of Jews at all. Training built on theories of privilege has too often placed Jews among the privileged and therefore outside the protection it claims to offer. So, there are lots of types of training that will make the problem a lot worse. I would like to hear from the Minister what types of training and suppliers will be used, and what accountability and monitoring there will be for anything currently being developed.

It is very important to note that the noble Lord, Lord Mann, recommended mandatory training for the chairs and chief executives of NHS trusts within six months of his review, but the Government’s same statement in response to his review said that senior leaders would be invited to complete it by March 2027. I hope that the Minister will explain to noble Lords why a recommendation for mandatory training became an invitation to train, and when that training will be completed by all chairs and CEOs of NHS trusts, as recommended.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I am most grateful to noble Lords across the House for their sensitive consideration of something that is very insensitive: antisemitism and other forms of racism. I know that the words spoken today—the sentiments and the commitments—will resonate across communities in a way that will make a difference, and I personally am most grateful for that. I also am grateful to my noble friend Lord Mann for his review and, indeed, to the former Secretary of State, Wes Streeting, for listening to the voices of those for whom the situation they have to live with day in, day out, is quite intolerable, and for commissioning that review. That set the tone.

As the noble Baroness, Lady Gerada, observed from the outset, we have accepted in full the recommendation of my noble friend’s review, and we are taking action to deliver. As was referred to, we provided our latest update last month. This work is continuing, and I understand that noble Lords are asking for more to be done. Indeed, there is no let-up, but we want to get this right, of course.

I will address Amendments 29, 79, 258, 259 and 279C together. We have all said this, but it always bears saying: there is no place for discrimination, antisemitism or racism in our NHS. As noble Lords have said, patients and staff and those associated with them must be free from all forms of racism and religious hatred—and, indeed, from the fear of that, as well as the actuality. That is at the core of these amendments and this debate.

I say to the noble Lord, Lord Shinkwin, that Ministers have asked all NHS bodies to adopt the IHRA definition of antisemitism. We are receiving a good response and will continue on that.

Health Bill

Baroness Cash Excerpts

Committee stage
Wednesday 28th October 2026 Lords Chamber

[Baroness Pidgeon (LD)]

My Lords, this is a very important group of amendments, and it has been a really excellent debate. One of the most pressing issues facing us is the widening gap in health outcomes between different communities. Healthy life expectancy has fallen in recent years and the gap between the most and least deprived areas of England, as we have heard, now stands at almost 20 years.

The point made earlier by the noble Lord, Lord Crisp, when he talked about the role of the department being one of leadership for health across government, not just running the NHS, is really important as we approach this group of amendments. We have heard clearly that the current legislative framework places relatively weak duties on government to address these wider determinants of health and tackle inequalities.

The House of Commons Health and Social Care Select Committee, in its scrutiny of the Bill, called for a stronger focus on improving the nation’s health and tackling inequalities, emphasising the need for clearer accountability and a more robust approach to prevention across government. Many of the amendments in this group would help to achieve that aim by ensuring that reducing health inequalities becomes a central objective of health policy, and that progress is measured and reported transparently.

My noble friend Lady Walmsley’s amendments, spoken to by my noble friend Lady Tyler, and Amendment 7 from the noble Lord, Lord Patel, would strengthen the duty on the Secretary of State to take steps or action, rather than simply “have regard to”. That is really important. Amendment 14, tabled by the noble Lord, Lord Patel of Bradford, and supported by so many Members of the House today, would require the Secretary of State

“to have specific regard to reducing inequalities”

in coastal communities. The point has been made clearly about the added complexities for such communities, whether those are workforce related or in local service provision. Those are really important.

My Amendment 20 looks at health inequalities in urban areas and requests a strategy and an annual report. Impact on Urban Health, which is part of Guy’s & St Thomas’ Foundation, recently reported its State of Urban Health research and found that preventable mortality is 2.7 times higher in the most deprived urban neighbourhoods in England than in the least deprived. Urban areas also face some of England’s starkest health inequalities, with people living just streets apart experiencing significant differences in health. You have only to look over the river to the London Borough of Lambeth, where Impact on Urban Health is based: females who live just over a mile apart face an eight-year gap in life expectancy. As we have heard, these inequalities are driven by unfair and avoidable differences in everyday environments. These include exposure to air pollution, differences in housing quality and access to healthy, affordable food. I pulled this area out for specific attention: rather like the coastal communities amendment, it needs specific action.

My noble friend Baroness Tyler spoke strongly to Amendment 18, which would require a cross-government health inequality strategy and subsequent annual reports to Parliament on progress. That would focus minds and energy across government and would address the key point from the Health and Social Care Select Committee, as well as many of our suggestions in amendments and today’s debate.

If we are serious about narrowing the gap in healthy life expectancy and giving everyone the opportunity to live a healthier life, then action on the wider determinants of health and tackling health inequalities must sit at the heart of the Bill, not at its margins. I look forward to hearing the Minister’s response.

[Baroness Cash (Con)]

My Lords, I begin by thanking all noble Lords who tabled amendments in this important group and for the high quality of debate. At this time in the evening, it falls to me to be as brief as possible. As the quality of debate and the points made have been so thorough, I will try not to repeat anything.

We are all very much agreed: from these Benches, we have heard from the noble Lord, Lord Lansley, from the noble Baroness, Lady Manzoor, and from the noble Baroness, Lady Hodgson. We care a great deal about the inequalities in health outcomes in this country, but I am very grateful to the noble Baronesses, Lady Gerada and Lady Royall, for drawing the distinction between healthcare inequalities and health inequalities. It is important, and it is important for the purpose of the Bill and the duties that ought to be placed on the Secretary of State for Health.

It is incredibly challenging and painful to hear the data regarding ongoing inequalities. We know, of course, that healthcare is not the reason why it is in that state. The factors that play a part sit in different departments, which is why these Benches welcome the amendments which ask for a strategy. I hope that the Minister will consider joining up some of the significant work being done by the Government in the Fonagy review and the Milburn review to look at all these issues together.

It would be helpful to hear from the Minister about the specific actions the Secretary of State would be expected to undertake to ensure the duty as it is currently drafted, and how Parliament would be able to assess those decisions. We have heard from the noble Lord, Lord Lansley, about how we might improve on the current legislation, and it is important that we hear how that might be done. The inequalities in general practice are significant and challenging, and I look forward to hearing from the Minister about the Government’s plans to address them, such as through incentives to serve in different areas, targeted work plans and ensuring that enough training, development and recruitment is going on in those areas. I hope that all these issues will be subject to consideration by the Minister.

We cannot expect to reduce health inequalities without addressing these disparities in primary care. We look forward to hearing what might be done and what might be included in this Bill to do that. In the end, we must judge success by whether patients have access to the healthcare needed at the point of delivery. I look forward to the Minister’s response.

Puberty Blockers Trial: Consent

Baroness Cash Excerpts

Thursday 25th June 2026 Lords Chamber

[Baroness Merron (Lab)]

I certainly do agree. As I have said, having put a ban in place, we will take action against those who seek to transgress and benefit from it by seeking to sell drugs that are not permitted. That is a totally unacceptable route for them to follow. They risk the safety and well-being of children.

[Baroness Cash (Con)]

My Lords, yesterday the Minister told the House that the PATHWAYS trial would be covered by insurance. I have been unable to identify any insurance company that will cover such treatment, even in a trial setting, so can she tell us how insurance has been obtained, the information on which it is based and from which provider it has been obtained? I appreciate that this may not be possible in the Chamber due to time, but I would be grateful to see the information provided in detail and the terms of the policy.

[Baroness Merron (Lab)]

Although I am keen to be helpful to the noble Baroness, my comments yesterday related to trials and insurance provisions. I do not know what research has been undertaken since then. I would be pleased to write to her; I cannot promise the detail she seeks, but I will seek to be helpful.

PATHWAYS Study: Puberty Suppression

Baroness Cash Excerpts

Wednesday 24th June 2026 Lords Chamber

I will not pretend that I do not continue to feel discomfort and unease, but I believe that the only way for us all to come to a fair and settled conclusion on this matter—to move forward as a country on this difficult and sensitive issue—is on the basis of clinical evidence in which we trust. Thanks to the strengthened criteria now in place for monitoring children’s well-being and for withdrawing them from the trial, there is now intense scrutiny, and there are robust mechanisms to prevent harm coming to the young people who take part. It is on that basis that I believe we should follow the advice of clinical experts and seek the clinical evidence that will give us the confidence to know that where we settle on this matter in the future is right. I commend this Statement to the House”.

[Baroness Cash (Con)]

My Lords, the proposed PATHWAYS puberty blockers trial for 226 children as young as 11 risks becoming a medical scandal unfolding in real time. Gender-incongruent children include some of the most vulnerable children in society, with disproportionate numbers of that cohort having autism or mental disorders or being children in care. There is an unknown and inestimable correlation with social media that is yet to be uncovered. The challenges for these children and their families, and the difficulties they face, are not to be underestimated, but gender-incongruent and gender non-conforming behaviour is also often characteristic of children who grow up simply to be gay. Surely the Minister does not truly agree with a trial which will place children who would otherwise simply grow up to be healthy gay and lesbian adults on a pathway that may impair their fertility and their sexual development.

The data shows, and the Cass review accepted, that a very large majority of children presenting with gender incongruence will resolve without medical intervention. I assume that the Minister accepts this. That being the case, this trial will be subjecting many physically healthy young children to completely unnecessary medical risks. Let us be clear. The medical risks inherent in taking puberty blockers at such a young age are truly life-altering. They include possible lifelong consequences for brain development, including IQ, bone health, fertility and adult sexual function.

Shockingly, 2,000 children have already been treated with puberty blockers in this country. They were treated at the now closed Tavistock clinic. More scandalously, they went on to adult clinics and we are entirely in the dark about how they are today. The data linkage study to analyse the information about those children has not yet been done. A shocking six out of seven of those adult clinics they went on to have not released the data, despite Parliament legislating for it.

So, what are Ministers doing to require adult gender clinics receiving public money to provide that data? What is the current status of that process? And, when the Government still do not know what happened to the 2,000 children already treated, why and on what grounds are they exposing another cohort of healthy children to medical harm before that question has been answered? It is no good to point to the fact that the noble Baroness, Lady Cass, recommended a trial. Government cannot and should not outsource such decisions and it will be no defence to the litigation coming down the line, as it already is in the US, that the noble Baroness told the Government to do it.

In any case, there are major issues about consent, particularly given the nature of the trial as currently put together. I am deeply troubled by how the informed consent of children can possibly be obtained when they are too young to appreciate what they stand to lose: as young as 11. It is important to set out what they stand to lose. Commencing puberty blockers at an early age may make fertility preservation for these children impossible. Studies show that puberty blockers may affect brain development, including their IQ and memory function, as well as their bone density and organ development. There is currently no long-term data sufficient to quantify those risks. Then, of course, there is a risk that normal adult sexual function—let us call a spade a spade; we are talking about the ability to ever experience sexual pleasure—does not develop when puberty is interrupted at such an early stage.

In these circumstances, it is inexplicable that the Government have rejected the MHRA’s recommendation that children under 14 should not be included in any trial. This trial is for children from the age of 11. How does the Minister justify that children under 14 are to be included in the trial? And how does she argue that any child can give informed consent to such risks? Please can the Minister confirm that these risks and all others will be expressly communicated to the children and families concerned? If this trial goes ahead, it is inevitable that irreversible, unnecessary harm will be done to at least some of these children.

Finally, could the Minister confirm that the Government have carried out an assessment of the future liability coming down the tracks to the NHS, and therefore to the taxpayer? Have the ongoing treatment costs, the treatment-related harms and the future litigation risks been assessed? What is the estimated cost to the NHS and the taxpayer of those, and how will that be funded?

Polling in December 2025 showed that almost 70% of the public was against giving puberty blockers to children and 63% wanted this trial to be stopped. As the Government consider a fresh start in other ways, I beg the Minister to think again and stop this trial.

[Baroness Barker (LD)]

My Lords, this Statement takes place in the context of a relentless campaign against trans people that started among right-wing politicians in the United States of America but has been seized on here: the bandwagon has been jumped upon by politicians in this country. That is the context.

We on these Benches have a policy towards trans people that is based on our belief that trans people not only exist but have a right to exist, and they have a right to exist with the same dignity as the rest of us—and part of that is having access to appropriate healthcare. I ask the Government, as, I hope, they seek to defend this test against the kind of political campaigning that we have just heard, to bear in mind that the use of puberty inhibitors is not the harmful intervention that has just been characterised. It is a safe medical intervention that has been used for different conditions since the 1980s, and there is already a lot of data on it. However, as the noble Baroness, Lady Cass, identified in her review, an absence or at least an insufficiency of data about the use of inhibitors in relation to people who have gender dysphoria. That is why this trial, consisting of 226 people, in a highly regulated period of group activity, has been allowed to go ahead in order to generate the data that she says we need.

It is true that last week the independent MHRA approved an update to the basis on which the trial is going to happen, in order to make sure that the safeguards were increased. It is not unusual for that to happen in a medical trial. It is not unusual for trials to stop and take note of what has happened initially and then for revisions to be made to the basis on which they are run.

We on these Benches believe very strongly that medical treatment should be based on science and evidence, not on belief and ideology. This trial has been under sustained attack from political organisations such as Sex Matters which do not believe that trans people should exist or should exist with the dignities that they currently do. This trial is currently the only legal route for anybody to access puberty blockers, so in the interests not just of accurate scientific evidence but of children who need this treatment, will the Minister ensure that the people who have undertaken this research are protected from the relentless political attacks against trans people?

Terminally Ill Adults (End of Life) Bill

Baroness Cash Excerpts

Committee stage
Friday 16th January 2026 Lords Chamber

[Baroness Coffey (Con)]

My Lords, I have Amendment 68A. I am conscious that I asked the noble and learned Lord, Lord Falconer of Thoroton, whether lasting power of attorney can be used. I am pleased to say that, in the debate, he said no. However, I am concerned that we may start to see quite a lot of case law emerge with this Bill if it becomes an Act. It is therefore really important that we start to put the level of protections into the Bill, as has just also been suggested by the noble Baroness, Lady Berger.

The reason I am particularly keen on the lasting power of attorney issue to be put into the Bill is in recognition that this could become something that people—I recognise that these are people who are getting towards the end of their life and may have less than six months to live—would expect, if they had already transferred their decisions to a person acting with an LPA, in order to start making these decisions. However, I think the sentiment of the Committee, and certainly that expressed by the noble and learned Lord as the sponsor of the Bill, is that that should not be the case. That is why I particularly want to see this in the Bill.

I appreciate that I do not have a Bill team of civil servants to say whether this is precisely how it should be addressed, but I hope that it is been sufficiently comprehensive, also considering Sections 9 and 11 of the other Act, to make sure that, if somebody is to make this decision, it has to be wholly and exclusively their own. It cannot be done within fluctuating conditions where people interchange on who is making the decision; it must be just the one person whose life it is who considers whether to take their own life.

[Baroness Cash (Con)]

My Lords, I support this group of amendments for a specific reason. I tried to ask the Minister this question during their closing speech last week, but there was not time. The Equality and Human Rights Commission gave evidence at the Select Committee—I declare an interest that at the time I was a commissioner, but am no longer—in writing and orally, expressing grave concern about the adequacy of the equality impact assessment. The points coming up in support of this group raise real questions around this.

I ask the noble and learned Lord, Lord Falconer, to say when we will see addressed the gaps identified in that evidence given by Alasdair Henderson, a commissioner at the EHRC, and in a follow-up letter written to the noble and learned Lord, Lord Hope, identifying specifically where the EHRC was concerned. When will we see a follow-up to that? It seems to me that many of the points in this and subsequent groups are about the vulnerabilities of individuals because of certain protected characteristics and the lack of protection for them. The EHRC has expressed no position on this Bill but is very concerned about it. I think the same applies to many Members of this House. We need answers to these questions to inform this debate fully.

[Baroness Lawlor (Con)]

My Lords, I will speak to my Amendments 40 and 59. The changes I propose may seem puzzling or pedantic, but, when dealing with legislation about life and death, every word matters. My amendments aim to bring the same care for language to subsections (2) and (3) as is used in subsection (1), which sets out that only if the conditions in paragraphs (a), (b) and (c) are met then assistance to end a person’s life, in accordance with Clauses 8 to 30, may be provided. If any of these conditions is not met then the action is subject to the existing criminal provisions of the Suicide Act 1961.

As they now stand, subsections (2) and (3) do not set out conditions in this way. Rather, they describe other parts of the Bill. Clause 1(2) is framed as an observation about Clauses 8 to 30, and Clause 1(3) apparently sets out a geographical marker for the certain steps provided for elsewhere in the Bill that “must be taken”. Subsection (2) therefore seems entirely redundant, since it purports merely to note what is said elsewhere. Subsection (3) is puzzling. Is the “must” a mistake or should it be “may only”?

Perhaps more important than such redundancy, inelegance and imprecision in drafting is that, in their present form, subsections (2) and (3) do not deprive those who act in contravention of the paragraphs they contain of the protection of the law from assisting suicide. They fail to make it explicit that this remains prohibited and punishable unless it meets subsections (2)(a), (2)(b), (3)(a) and (3)(b). My amendments would remove this perhaps unintentional looseness—the sponsor may wish to comment on the intentionality or otherwise—by making it explicit that assistance to end a person’s life may not be provided unless subsections (2)(a), (2)(b), (3)(a) and (3)(b) are all met.

--- Later in debate ---

[Lord Falconer of Thoroton (Lab)]

I apologise. I do not know whether the noble Lord feels that he is withdrawing a compliment or withdrawing an insult, but I get what he is doing.

To the noble Baroness, Lady Cash, before she gets to her feet, I say that she is right. In relation to the ECHR points that were raised by, I think, Mr Stevenson, who was the commissioner—I have the name wrong.

[Baroness Cash (Con)]

It was Alasdair Henderson, who gave evidence to the Select Committee and raised a lot of the concerns that have been reiterated by the noble Baroness, Lady Berger, and others today. Indeed, the point that the noble and learned Lord makes about being poor and having a choice is something that is really of concern to the EHRC, which raised that in evidence orally and in writing and, subsequently, in the letter to the noble and learned Lord, Lord Hope. Indirect discrimination, because of circumstances, is one of the problems with this Bill that troubles us most greatly. That has not been addressed, which is why the EHRC, without taking a position on the principle, has asked for that clarification. I would like to know whether it needs to write formally to request that, or is its evidence before the Select Committee and its subsequent letter adequate? Can the noble and learned Lord please clarify?

[Lord Falconer of Thoroton (Lab)]

The commissioner for the EHRC raised a number of points in relation to the risk of discrimination under the convention. The Government have done an equality impact assessment and, broadly, they adopt the approach that it is unlikely that the courts will interfere in a deliberate choice made by the Government, or the legislature in this case, as to what the limits would be of an assisted dying Bill. I agree strongly with that. It is the approach that the English courts have reflected in relation to assisted dying, and it is the approach that the European Court of Human Rights has taken as well. I therefore do not think that the views expressed by the commissioner to the Select Committee are right, but I am more than happy if the noble Baroness, Lady Cash, would like to raise specific ones—or all of them—she can do so with me, and I can raise them with the Government as well.

--- Later in debate ---

[Baroness Cash (Con)]

I am grateful for the chance to clarify my point. It is not about litigating any of those complex issues. The EHRC is the regulator for this type of law in this country. The EHRC evidence, given before the Select Committee and written subsequently in answer to the committee’s questions, is that the equality impact assessment is inadequate, and it requests that those inadequacies be clarified. I do not have the text to hand, but it specifies in its letter to the noble and learned Lord, Lord Hope, the protected characteristic categories that it is particularly concerned about. That inadequacy, which was just now highlighted by noble Baroness, Lady Berger, is what is leaving us with our hands tied behind our backs and unable to give an answer in this debate.