Early in the COVID-19 pandemic, I went to a cakeshop in a nearby suburb, wearing a mask. A man in his 50s was being served. As he turned to leave, he saw my mask and asked why I was wearing it. “COVID … obviously” I replied. He then launched into a tirade, asking me “do you think it’s healthy to re-breath your exhaled breath?” “Why do you think your lungs want to get rid of it?” and suggesting that I read some basic medical science.
So I asked him why he thought it was that operating theatre staff always wore masks, sometimes for marathon surgical operations lasting many hours. He turned and left, saying nothing.
Masks are of course a basic component of COVID-19 control. With aerosol transmission being now understood as the main way the virus is spread, masks are dogs balls obvious critical to reducing transmission. The NSW chief health officer Kerry Chant is always wearing one until she begins speaking in daily press conferences. Premier Gladys Berejiklian can barely finish three sentences without imploring people to wear a mask when in crowded situations like shops or using public transport.
An infectious disease doctor or scientist who is not urging governments to make masks mandatory in public settings is a rare as proverbial rocking horse poo. Victoria, which until today went two full months without a locally acquired case, made masks mandatory as an important part of reaching that achievement.
Gladys has surely now exhausted the thesaurus of asking us nicely. She’s urged, requested, enjoined, called on, entreated, pleaded, beseeched and nearly begged us all to wear masks. But she will not yet order us to.
Her trusty lieutenant Brad Hazzard has told us that the government doesn’t want to make it compulsory on public transport because bus drivers don’t want to have to act like policemen. How lame is this? Bus drivers always “acted like policemen” when they wouldn’t let passengers on a bus in the days when they sold tickets. I’ve often seen bus drivers tell people to stop smoking, to refuse to move off the bus stop until people move down the back of the bus when the aisle was crowded, and to refuse boarding to people when buses are too full. And we also have inspectors, remember.
And then let’s not forget that bus drivers would number among the most exposed workers of all to COVID. Failure to protect their health is indefensible.
With her team having to embarrassingly writhe in public like this, what is the problem here. Why can’t the government just require it?
Across my career I’ve seen a huge number of laws and regulations passed in the service of public safety. Entire fields of occupational and environmental health, building and food standards, food service standards, pharmaceutical regulation, consumer good safety standards, health care worker competency standards and road safety are all neck deep in requirements that you often don’t find in the world’s most impoverished nations, but which are taken-for-granted in advanced nations like ours.
Public heath ethics has green-lighted all of this since the time of John Stuart Mill’s articulation in his nineteenth century writings on liberty of when it’s ethically justifiable to curtail freedoms (basically when someone’s actions may harm others). There are hundreds of ways that the nanny state is good for us.
There are also examples where governments allow and enforce laws that restrict freedoms even when the nasty consequences only affect the person concerned and not others. Car seat belts and crash helmets are two obvious examples.
Mask wearing during highly infectious pandemics is clearly an example of where the consequences of not wearing a mask can elevate the risk of harm to both self and others. Indeed, to the whole community.
Laws greatly increase compliance
There is massive evidence across all fields of public health that laws greatly increase compliance. Take smoking in restaurants as an example. Before Australia’s state governments began dominoing bans on smoking in restaurants, we saw truly bizarre efforts to stop tobacco smoke reaching the lungs of those who didn’t choose to breathe it in. There was an era when you couldn’t smoke withing two metres of a bar. It was OK at 2.01 metres, but not at 2m. This made perfect sense to the smoke which unsurprisingly couldn’t read the signs.
A non-smoking section in a bar or restaurant was like a non-urinating section of public swimming pool.
In the weeks immediately after the 2000 Sydney Olympics, I was funded by NSW Health to compare restaurant smoking rates in Sydney (where the Carr Labor government had legislated a restaurant smoking ban) and Melbourne (where the Bracks Labor government had not).
In Melbourne, across 154 hours of observations in 81 restaurants, we saw 176 people smoking out of 2014 diners. In Sydney, we saw no one smoking among 2646 diners in 78 restaurants over 156 hours.
Political urging will get us only so far with mask wearing. Making them mandatory in all shops, malls, crowded footpaths and on public transport will instantly up rates of use.
There’s plainly some visceral ideological biliousness within the NSW Liberal ranks about regulating personal behaviour. Just before I sat down to write this, I went to my local shopping mall. About 80% of women, and 60% of men were voluntarily wearing masks. Good for them and all of us. The others have had 10 months of imploring and are still ignoring it.
It’s unimaginable that a theatre nurse or surgeon would pull the civil liberties card out of their pocket to argue that they shouldn’t have to wear a mask on the job. While COVID-19 threatens nations, it should be equally unimaginable that any government should try to make the same excuses.
Later today Australia’s Senate Select Committee on Tobacco Harm Reduction will release its report to the Senate. The Committee was chaired by Senator Hollie Hughes (Liberal NSW), who has often been openly supportive of vaping. Others on the Committee were Matt Canavan (Liberal National Queensland), who has also embraced vaping; Tony Sheldon (Labor, NSW), Anne Urquhart (Labor, Tasmania), Sarah Henderson (Liberal, Victoria), and Sterling Griff (Centre Alliance, South Australia). Rachel Siewert (Greens, Western Australia) was a participating member who asked many important questions of witnesses in the two days of public hearings.
While the committee had terms of reference and took evidence on a wide range of issues to do with vaping, the main focus was always on the proposal that the Therapeutic Goods Administration would allow doctors to prescribe time-limited access to nicotine juice to be used in vaping, and that those issued with such prescriptions would have them filled at pharmacies. To make this work, the government would have to prohibit the personal importation of nicotine and continue to outlaw its sale through specialist vape shops and any other retailer who wanted to profit from its sale (Ampol aka Caltex put in an enthusiastic submission wanting to do just that).
The TGA itself will be publishing a report by the end of the month on its own deliberations about the proposal for prescription access.
Four memorable moments
There were some memorable moments in the two day hearings. On day 1, the Committee chair Hollie Hughes declared that Colin Mendelsohn, the irrepressible vaping advocate, was her doctor. “The first thing I’d like to say, as a declaration, is that Dr Mendelsohn is actually my doctor. He’s helping with my smoking cessation. Just so it’s clear, I do have a professional relationship with Dr Mendelsohn, whom I saw 60 days ago, which was the last time I had a cigarette.”
No show witness
Hughes also blew a public birthday kiss to the head of the Legalise Vaping Australia campaign, Brian Marlow, who is capital E-D Executive Director of the Australian Taxpayers Alliance, which has long been shy about its funding. LVA’s agenda was at all costs, to stop the ban on personal importation of nicotine and to see off the Greg Hunt/TGA prescription proposal. It looks like they have failed again.
All those giving evidence to the Committee were asked to declare under oath whether they were now or had ever received support from the tobacco, vaping or pharmaceutical industry. One group due to give evidence was the lobby group Legalise Vaping Australia. But at the last minute, they withdrew.
I tweeted wondering if their decision might have had anything to do with avoiding answering under oath questions about support received from vaping or tobacco interests. LVA’s Brian Marlow explained that he had to have an emergency dental procedure.
My 32 page submission (with professors Mike Daube and Matthew Peters) can be downloaded here.
Dr Sarah White from Quit Victoria wondered why Marlow didn’t ask one of the staff he executively directs to sub for him. Marlow replied that it was all too important a matter to delegate to volunteers.
So while all witnesses had to answer questions on competing interests under oath, Legalise Vaping Australia avoided doing so.
“Simon Chapman just lied under oath”
On the morning I gave evidence, I was asked early on by Senator Sheldon “Do you receive, or have your organisation ever received, direct or indirect support from the pharmaceutical industry, including travel, attendance at conferences or event sponsorship, including from manufacturers of nicotine replacement therapies?”
Minutes later a vaping activist from Queensland who was watching the session live, tweeted to Hughes and Canavan “Simon Chapman just lied under oath. 2013 Simon Chapman was on the board of the Cancer Council and took money from Pfizer. Proof “(with a link to a Pfizer document about its charitable donations.
Toward the end of my evidence, Hughes who had not left the room during my evidence and so must have been reading her tweets or getting texts from a staffer who was, asked me if I had been on the Cancer Council board in 2013. As I’d served on the board of the Cancer Council NSW from 1997-April 2006, I thought it was an odd question and replied that no, I was not. I’d also never taken any funding from Pfizer and the “proof” was that Pfizer had given a small donation to a fun run and another to a meeting of people helping to counsel those with cancer.
Everything in the tweet except the spelling of my name was completely wrong and defamatory.
After the session I saw the tweet and demanded it be removed, and an apology be pinned to her twitter feed for a year. She did.
Clive Bates on flavours
Then there was the total owning of the venerable Clive Bates by Senator Anne Urquhardt. Bates, as he likes to remind people with amusing regularity, headed England’s Action on Smoking and Health way back between 1997-2003, 17 years ago. Since Clive thinks that’s a cutting edge credential today, I guess I may as well also declare that in 1963, I was awarded both a Good Camper’s Certificate and was dux of my primary school. Both, you’ll all agree, are important and timely bits of information.
Today Bates is a darling of the vaping cult and welcomed at tobacco industry meetings. Since 2014, he has attended every Global Tobacco and Nicotine Forum, the global tobacco industry’s annual Chatham House rules get together. But he apparently always pays his own way to these and other events, because he made a declaration to the Senate (see #60) on questions about any competing interests and support received.
Earlier in the day, I had made a point that no asthma inhaler drugs (which save lives) use flavours to make the puffer experience more palatable. I also wrote about this here. I wanted the Committee to reflect on why that might be. The answer is that no pharmaceutical regulatory agency in the world would allow drugs to be sold with inhalable flavours because none have been passed as safe to inhale (while many have been passed as safe to ingest in food and drinks). This is apparently not seen as a problem by vaping advocates.
Senator Urquhart put this issue to Bates for comment, asking “There are about 2.7 million asthmatics in Australia. Many of them inhale asthma medication up to five times a day, roughly. None of those are flavoured, because of those safety concerns that Senator Griff raised. If e-cigarettes were regulated as medicines, I assume it would be unlikely that flavours would be approved. Can you just step me through your view? Why is it sensible to not allow asthma puffing drugs to be flavoured but okay to allow vapers to inhale flavours on an average of, I think, 173 times a day?”
After a few squirming attempts to evade the question he finally relented, conceding “But you’re perfectly correct; most of the flavours have not been evaluated as safe for inhalation.” There are now about 15,000 of these.
The Australian Senate Select Committee on Tobacco Harm Reduction’s calls for submissions and its two full public hearing days have concluded with transcripts published, and replies to questions on notice published. This Committee follows the 2018 report from the House of Representatives Standing Committee on Health, Aged Care and Sport on Report on the Inquiry into the Use and Marketing of Electronic Cigarettes and Personal Vaporisers in Australia. That report saw the pro-vaping committee chair Trent Zimmerman and Liberal member Tim Wilson embarrassingly forced to publish a minority report when they were rolled by a majority of the committee. Another minority report from the Liberal member Andrew Laming, a doctor, received a fraction more attention that the time it took to read it.
Australia’s vaping interests think Laming is the bee’s knees and gave him their prestigious award which undoubtedly went straight here.
The Senate Committee is due to publish its report later this month, with some predicting another minority report outcome. This will probably be pleasing to the Health Minister Greg Hunt, whose proposed scheme to ban personal importation of nicotine for vaping and to encourage the Therapeutic Goods Administration to introduce prescribed access to some e-cigarettes with nicotine, was supported by the submissions and evidence of nearly all Australian health and medical agencies which made submissions. This was the position I took in my submission, written with Prof Mike Daube (Curtin University) and Prof Matthew Peters (respiratory medicine, Concord Hospital).
Hey backward Aussies … listen up!
One of the interesting aspects of this enquiry has been the publication of many submissions from overseas. Some of these were apparently solicited by the Committee, but many appear to be unsolicited. It’s understandable that international commercial vaping interests would want to take every opportunity to try and cement some bricks in the wall of a future market, so submissions from tobacco companies like BAT, Philip Morris and Imperial Brands and their acolytes, plus Juul and vaping minnow companies were predictable. But I was surprised to see a good many submissions from individuals in British, US and New Zealand public health.
I’ve asked around my colleagues to see if they are in the habit of – off their own bat – sending submissions to UK, US or New Zealand parliamentary enquiries. None (myself included) can ever recall doing this unless requested to do so, and all agreed that it is an unusual and peculiar form of arrogance that disinhibits people from other countries to try and tell Australia’s politicians where the advice they are getting from their own experts is all wrong.
Australia has always been a global pioneer in tobacco control policy and campaigning. As you can read in our submission, we have comparable-to-better smoking prevalence than each of those three nations, achieved without being awash with e-cigarettes. The tobacco and vaping industries have a lot of skin the game of wrecking Australia’s global reputation as a vanguard nation in tobacco control, setting agendas for others. We were first nation to introduce plain packaging, and one of the first to put tobacco stock out-of-sight in shops. We banned tobacco advertising and stopped smoking in pubs and restaurants way before the UK (the USA will probably never fully ban tobacco advertising), introduced graphic health warnings earlier, and have the world’s highest priced tobacco.
So as a banana republic still on the nursery slopes of public health and tobacco control, we naturally appreciate advice from these other nations. Our approach to e-cigarette regulation is consistent with recommendations from the WHO and many other expert agencies and our record in other aspects of public health – such as COVID19 isn’t too bad either (new cases yesterday USA 202,780; UK 16,578; Australia 8)
Four English tobacco control experts Ann McNeill, Jamie Brown, Lion Shahab and Robert West read our evidence and wrote to the Committee. We were invited to reply. Here’s what we wrote.
Response to letters from Professors Brown, Shahab and West and Professor McNeill
Emeritus Professor Simon Chapman AO, Emeritus Professor Mike Daube AO, Professor Matthew Peters AM
We thank the Committee for the opportunity to respond to the letters from Professors Brown, Shahab and West, and McNeill.
Professors Brown, Shahab and West’s brief letter entitled “Impact of e-cigarettes on smoking in England” provides different conclusions from the data on the impact of e-cigarettes on smoking prevalence in England. They claim these as “the correct analyses”. We would however note that:
“With quit attempts at 32.5% of eight million smokers (2.6 million) in 2015, and prevalence of e-cigarette use in quit attempts at 36% in that year, this equates to 54288 additional short to medium term quitters in 2015 compared with no use of e-cigarettes in quit attempts. We would expect up to two thirds of these individuals to relapse at some point in the future, so we would estimate that e-cigarettes may have contributed about 18000 additional long term ex-smokers in 2015. This figure is similar to that estimated indirectly using the estimated effect size of e-cigarettes and the numbers using them. Although these numbers are relatively small, they are broadly similar to previous estimates, and are clinically significant because of the huge health gains from stopping smoking. A 40 year old smoker who quits permanently can expect to gain nine life years compared with a continuing smoker. This number of additional quitters is unlikely to produce a detectable effect on smoking prevalence in the short term, but might be picked up over a period of several years.” (our emphases)
“that 845,152 smokers used e-cigarettes in quit attempts; this equates to 50,700 … additional past-year smokers who report that they are no longer smoking as a consequence of e-cigarette use in a quit attempt in 2017. This is broadly similar to the estimate which we reported for 2015.”
We note that in the Addiction paper, the authors did not discount that figure by two thirds relapsing in the future, as they did in their BMJ paper. Applying that discount to the 845,152 smokers who used e-cigs in a quit attempt (50,700 who were not smoking in 2017 x 0.33) we get 16,731 (3.1%) who by the authors’ 2015 assumptions, would have quit in the long term. Expressed differently, 96.9% of smokers using e-cigs in quit attempts in England in a year are estimated to not quit in the long term. This is a proportion very close to the quit rate (4%) for quit attempters allocated to no quitting support arms in the recent Cochrane trials update.
“This number of additional quitters is unlikely to produce a detectable effect on smoking prevalence in the short term”.
So 16,731 of 7 million English smokers were additional long term quitters in one year because of e-cigarettes: 1 in 418 of all English smokers. We heartily concur with Professors Brown, Shahab and West that “This number of additional quitters is unlikely to produce a detectable effect on smoking prevalence in the short term”. 16,000 -18,000 is not well expressed as “tens of thousands a year”, so we remain curious about why they believe our interpretation of their data is incorrect.
Brown et al’s BMJ paper states that there were 8 million smokers in England in 2015 and their Addiction paper says this had fallen to 7 million in 2017 (a fall of approximately 12.5% or 6.25% per annum). If we assume there were 3 full years encompassed in the 2015-2017 period, there were 3 years of ~17,000 estimated additional long term quitters between 2015-17, then some 51,000 (5.1%) of the extra 1 million who were not smoking in 2017 might be attributable to e-cigarette use. The other 949,000 fewer smokers would be attributable to deaths of smokers, cessation by smokers other than via e-cigarettes and increasing numbers of never smokers thanks to prevention policies and programs.
With England seeing major declines in the use of varenicline, bupropion and NRT use while vaping soared, it is likely that some of those 51 000 would have been smokers who might otherwise have quit using those methods.
This positive figure—however large it actually is when the additional cessation forgone from other evidence-based medications no longer being used is netted out—needs to be contextualised against concerns that e-cigarettes may be holding many smokers in smoking who might otherwise have quit. There is considerable international evidence that this is occurring.
“Cigarette use was persistent, with 89.7% (95% CI 89.1% to 90.3%) of exclusive cigarette users and 86.1% (95% CI 84.4% to 87.9%) of dual users remaining cigarette users (either exclusive or dual) after any one year.”
and
“Among all W1 (Wave 1 or baseline) daily smokers, there were no differences in discontinued smoking between daily smokers who vaped (concurrent users) and exclusive daily smokers”
A just-published paper from the ITC-4CV four country (Australia, USA, UK, Canada) cohort survey found that after 18 months:
“smokers with established concurrent use [smoking and vaping] were not more likely to discontinue smoking compared to those not vaping … it is clear that the rates of transitioning away from smoking remain unacceptably low, and perhaps current vaping tools at best bring the likelihood of quitting up to comparable levels of less dependent smokers. The findings of our international study are consistent with the findings of the US PATH transition studies, and other observational studies, in that most smokers remain in a persistent state of cigarette use across time, particularly the daily smokers.”
A preliminary report of a Swiss study (“E-cigarette Use for Smoking Reduction and Cessation in a Four-year Follow-up Study Among Young Swiss Men: Some may Benefit, but they are Few.”) is available as a not-yet peer reviewed preprint here
This study included over 5,000 young Swiss men. It found that, at the general population level, EC use had no beneficial effects on reducing or ceasing smoking. Non-smokers (never- and ex-) and smokers at baseline were more likely to be smokers 4 years later if they subsequently had initiated use of ECs. The authors conclude that “Some smokers may have benefitted from using ECs, but they were few. At the general population level, ECs are not predominantly used in a way, which might optimise reducing or ceasing smoking. Therefore, the public health effect on the general population of using ECs may be questionable, as may policy measures to facilitate EC use.”
We note in Brown et al’s Addiction paper the fall in the proportion of smokers making quit attempts, from almost 40% in 2013 to about 34% in 2017.
The definitions of quit attempts differ somewhat between the surveys used in different countries and it is acknowledged that quit rates will fall after periods when large numbers of smokers have already successfully quit (for instance immediately following large tax increases).
If the proportion of smokers trying to quit in England was 50% rather than 30%, an additional 1.4m additional smokers would be making quit attempts each year, with an additional 56,000 likely to succeed even assuming no additional cessation support. The challenge for tobacco control in both our countries is to simultaneously increase both the numerator of quit successes and the denominator of quit attempts.
All major companies in the global tobacco industry are now promoting putative harm reduced products, while continuing to aggressively promote cigarettes. It is clearly in the industry’s interests to sell as much of both types of product as possible. If e-cigarettes put quitting in a prolonged holding pattern for many smokers and relapse to smoking is widespread, vaping may be holding many in smoking who might otherwise have quit.
Response to Professor McNeill’s letter is entitled “Additional Comment to the Australian Select Committee on Tobacco Harm Reduction”
We would note the comments below.
Point 1: Here, we would refer the Committee and Professor McNeill to our response above to Professors Brown, Shahab and West.
Point 2: Referring to our submission on page 10, where we write “Relapse to smoking is very prevalent. (A UK 15 month follow‐up of vapers found that overall 39.6% had relapsed to smoking, with those using tank systems faring worst (45.6%).)”, Professor McNeill claims that this is misleading in a number of ways.
“Rather than go into the details, I copy here the conclusions of the study (Brose et al, 2019), but would be happy to provide further information if required: “In a group of ex‐smokers who had stopped smoking for at least 2 months, relapse to smoking during a 15‐month follow‐up period was likely to be more common among those who at baseline vaped infrequently or used less advanced devices”.
As an author on the Brose paper, Professor McNeill knows that daily vapers had almost exactly the same risk of relapse as those who had never vaped. (34.5% vs 35.9%). The clear messages from that paper are that vaping does not prevent relapse and that even daily vaping is barely different from not vaping in preventing relapse.
Professor McNeill is also an author on a recent analysis of 4 Country ITC study data which concluded not only that “Among all W1 (Baseline) daily smokers, there were no differences in discontinued smoking between daily smokers who vaped (concurrent users) and exclusive daily smokers” but that “Most ex-smokers remained abstinent from smoking, and there was no difference in relapse back to smoking between those who vaped and those who did not.”
“A limitation of this study is the lack of hard evidence for the harms of most products on most of the criteria”
Point 3: Prof McNeill attempts to defend her position on EC safety that is unchanged since 2014 in the face of the substantial new evidence, particularly on respiratory and cardiovascular risk. She asks the Committee to believe that using separate and undefined methodology she as an individual, her academic collaborators and associated organisations have arrived at precisely the same 95% less harmful figure as the group assembled by Nutt in 2013 – a group that noted with a now notoriously sweeping caveat that there was no clear basis for selection of its members and that had very little in the way of data to rely on (“A limitation of this study is the lack of hard evidence for the harms of most products on most of the criteria”).
This 2020 paper from the American Journal of Public Health is highly critical of the continued use of this “95%” figure, or indeed of any ballpark figure stated without the provision of even rudimentary calculations about the long term consequences of using an extremely wide category of ENDS products.
“Trust us. We have considered it.”
Professor McNeill draws the Committee’s attention to a statement authored by herself and Professor Hajek explaining the 95% in more detail which was published as an addendum to the 2015 PHE report.
We agree that the Committee should give this statement its close attention because it actually provides nothing remotely approaching any worked calculations for detailed analysis of any risk comparing cigarettes and e-cigarettes. Like the Nutt report, and Professor McNeill’s reference to reports planned for publication in 2021 and 2022, it basically says “Trust us. We have considered it.”
In their explanatory memorandum, McNeill and Hajek state, firstly:
“Our review aimed to assess whether studies that have recently been widely reported as raising new alarming concerns on the risks of e-cigarettes changed the conclusions of the previous independent review (Britton and Bogdanovica, 2014) and other reassuring reviews.”
“Despite some manufacturers’ claims that electronic cigarettes are harmless there is also evidence that electronic cigarettes contain toxic substances, including small amounts of formaldehyde and acetaldehyde, which are carcinogenic to humans, and that in some cases vapour contains traces of carcinogenic nitrosamines, and some toxic metals such as cadmium, nickel and lead. Although levels of these substances are much lower than those in conventional cigarettes, regular exposure over many years is likely to present some degree of health hazard, though the magnitude of this effect is difficult to estimate.”
Nowhere in this review is any estimate made of relative safety and 95% as an estimate is not anywhere mentioned, let alone calculations provides for any comparison with cigarettes.
Underpinning the unreliability of any academic estimate of relative harm is this statement also made in the Britton and Bogdanovica review:
“The world literature on harm reduction practice is extremely limited. Such data as is available on the content and emission characteristics of products currently on the UK market has been produced almost entirely by independent researchers, not by suppliers. Absorption characteristics are virtually unknown. However, this is data that can and should be required of manufacturers or suppliers, and will be as a result of medicines or TPD regulation, but for up to three years will not be required. While a clearly important area of research, it seems inappropriate to use scarce public research funding to provide this data. This responsibility should be placed, as soon as possible, on suppliers.”
McNeill and Hajek in their 2015 report state:
“We concluded that these new studies do not in fact demonstrate substantial new risks and that the previous estimate by an international expert panel (Nutt et al, 2014) endorsed in an expert review (West et al, 2014) that e-cigarette use is around 95% safer than smoking, remains valid as the current best estimate based on the peer-reviewed literature.”
The West et al report was a submission to a UK All-party Parliamentary group. This report does make that statement that ECs are much less harmful but provides no evidence and defines no process for which a harm determination could be made. Specifically, within the West report, the only estimate of 95% safer is referenced to the Nutt report. It does not endorse that figure – it only states that this is an estimate. Indeed, it states that “the precise harm from long-term use is not known” A careful examination of the documentary trail for evidence supporting the 95% (or any) figure calls into considerable question the argument put by Professor McNeill to the Committee.
Simon Chapman AO 