House of Commons (26) - Commons Chamber (11) / Westminster Hall (6) / Written Statements (5) / Petitions (2) / Ministerial Corrections (2)
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(13 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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(13 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
You will realise from my dulcet tones, Mr Dobbin, that I am struggling with my voice this morning, but I hope at least to get to the end of my introductory remarks. It is good to see you in the Chair. This morning’s debate takes us to the heart of an important issue in which I know you are interested, as are many hon. Members on both sides of the House. I am pleased that so many from both sides are already present, and am particularly pleased to be joined by my right hon. Friend the Member for Salford and Eccles (Hazel Blears). She speaks on these issues with considerable experience, as a former Minister with responsibility for police and counter-terrorism and a former Secretary of State for Communities and Local Government. She learned a great deal in both those roles and I look forward to hearing her comments later.
This debate takes us to the heart of a complex and crucial issue, namely, the need to take on the extremist ideology that underpins the activities of those who are opposed to our society and seek to destroy it. I want to keep my remarks and the debate simple, because what is at stake right now is the future of an organisation that is playing a vital role within that debate. My straightforward request, which I seek to put as constructively as I can to the Minister, is that transitional funding of £150,000 be made available to the Quilliam organisation, which will fold in the next few days unless interim support is made available. Although I realise that a debate in Parliament is not the time for line-by-line negotiation of every aspect of an organisation’s budget, I hope that, by the debate’s conclusion, the Minister will have given us cause to hope that a resolution will be found to the problem and a way forward established.
Five weeks ago, the Prime Minister made an important speech at the Munich security conference. He argued that we need to differentiate between Islam—the world religion that teaches and practises a belief in peace and a loving God—and Islamist extremism, a political ideology which is opposed to western democracy and is linked to and underpins terrorist violence. He explained that radicalisation is a process that turns non-violent Islamists into people who are prepared to kill human beings, including themselves, in pursuit of their perverted ideology. The Prime Minister pointed out that vulnerable individuals become terrorists not overnight, but as a result of the constant pressure placed on them, whether in internet chat rooms, in prisons or, indeed, on university campuses. He went on to state that we need to work with Muslim-led organisations that are willing to confront that Islamist ideology, provided that, at the same time, they defend human rights, equality and integration. He said:
“So let us give voice to those followers of Islam in our own countries—the vast, often unheard majority—who despise the extremists and their worldview. Let us engage groups that share our aspirations.”
I agree very firmly with what the Prime Minister said.
Quilliam is a secular think-tank that was set up in 2008 by two former Islamist extremists, Ed Husain and Maajid Nawaz. Since then, it has become a unique centre of knowledge of such extremism. It is not an exaggeration to say that its research and networking have had at least as great an influence on the debate about Islamist extremism and terrorism as any other organisation in the UK. It has gained an international reputation for its work. It is interesting that, this very morning, an important conference on counter-terrorism will be addressed by the Minister for Security, Baroness Neville-Jones. Further down the agenda, a senior spokesperson from Quilliam will speak about the same issues and agenda as a senior Government Minister.
Controversy is, predictably enough, never far away from such an organisation. It has made enemies as well as friends. Those associated with Quilliam face considerable threats and abuse as a result of the stance that they take. Quilliam was initially funded by money from private donors in the Gulf. However, that money was withdrawn when Quilliam’s founders publicly criticised Yusuf al-Qaradawi and the use of suicide bombings against Israeli civilians. After that, Quilliam began to receive money from the Home Office and the Foreign Office under the Prevent programme. Quilliam always intended to become financially self-sufficient and was close to achieving private funding on two occasions, only to lose it at the last minute—first, as a result of the credit crunch, and secondly, because of the 2009 uprisings in the middle east.
The money given to Quilliam by the Government has had an immediate and visible impact. Quilliam is one of the few Muslim-led organisations willing to confront extremism directly, to name and shame extremist organisations, and to remain unequivocal in its defence of British values, including free speech, freedom of religion, gay rights and respect for others.
Quilliam has been the most vocal Muslim-led organisation to condemn, without equivocation, suicide bombings and acts of terrorism, and to challenge extremist groups in the United Kingdom. Its bold approach has paved the way for other Muslim groups throughout the United Kingdom to follow suit. By acting as a leader within Britain’s Muslim communities, Quilliam has encouraged other Muslim groups to initiate real debates about issues such as terrorism, religious belief and secularism.
A few days ago, for example, Quilliam issued a statement publicly defending Usama Hasan—a progressive London imam who received death threats for stating his belief in evolution—and criticising the total silence of the Muslim community in the face of the threats against him. The statement encouraged more than a dozen major British Muslim organisations to issue their own statements defending Hasan and his right to free speech.
Quilliam’s staff and supporters make regular media contributions to mainstream UK programmes as well as to specialist Islamic TV and radio outlets. Their statements demonstrate clearly that not all Muslims are extremists. They also challenge Islamist extremists within their own core constituency. In my experience, no other Muslim-led group in the UK does that more effectively.
As the middle east and Pakistan face ever greater turmoil, I believe that Quilliam can make an important contribution, both to our understanding of what is happening and the forces at work, and to the development of a narrative that counters the extremists. Quilliam can also help to challenge Islamist extremism here in the United Kingdom. It has already done much to influence the debate and get the message across to the British public that the vast majority of Muslims are also against extremism. There is particularly important work to do in that regard with young Muslims, who may be disillusioned, concerned about, and fed up with the world around them, and who may be attracted by the perverted ideology of the extremists. We have to make sure that that is countered, and organisations such as Quilliam are in an ideal position to do that.
I have known for some time some of the people involved in Quilliam. My right hon. Friend has mentioned Pakistan, and one of the things that I have found valuable is a report published by Quilliam about a year ago about the radicalisation going on in Pakistan. The organisation was prepared to go to Pakistan and engage with young people in its universities, and to explain to them the realities of British Muslim life. Very few other organisations in this country are prepared to do that, and to do it without a destructive political agenda that feeds prejudices. Quilliam was challenging prejudices, which is in our national interest. It is, therefore, vital that we continue supporting Quilliam.
I am grateful for my hon. Friend’s intervention. He is a great authority on the issues and has an association with Quilliam—as he has said, he knows some of the people involved. He has raised an important issue. In fact, Quilliam has been involved in establishing a Facebook site called Khudi, which has 40,000 subscribers in Pakistan. There are young people listening to the liberal values and arguments being made through that Facebook page. Quilliam is taking the argument into parts of the world where we would find it impossible as individual politicians or, indeed, Governments to advance arguments that would be listened to with any credibility. I pay tribute to Quilliam for doing that work and thank my hon. Friend again for his intervention.
We will soon learn the conclusions that the coroner has reached in the 7/7 inquest. Whatever findings and recommendations she makes, we cannot escape the fact that those responsible for the bombs were a part of our community. We must ensure that there is no room for retreat into denial about extremism. Like my right hon. Friend the Member for Salford and Eccles, I was a Home Office Minister when the 7/7 bombs went off. In the months that followed, she and I travelled the length and breadth of the country in a effort to engage with the Muslim community and encourage it to face up to the minority in its midst that had adopted an extremist ideology and was intent on the destruction of our way of life and the values that underpin it.
I learned a great deal from those many encounters, but the most important lesson I learned was that it would not be me who could persuade young Muslims away from those who would try to radicalise them and turn them into extremists; it must be people within the wider Muslim community itself who do that work. Our job—whether as Ministers, other politicians who are interested in the issue or, indeed, non-governmental organisations—is to empower and encourage people within the Muslim community to do such work for themselves. That was the most important lesson I learned.
Like me, I am sure that the right hon. Gentleman remembers sparring over this issue in relation to the Prevent strategy and the rights and wrongs thereof. However, the Quilliam Foundation is based on not just common sense, but the historical precedent of using those who were opposed to spread the message back to our opponents. That is a very valuable tool; it is not unique but it is an extraordinary tool. I am sure that the right hon. Gentleman would agree that that must not be allowed to perish.
I am grateful for the hon. Gentleman’s intervention. He and I have sparred over many issues, including this one. I have a great measure of agreement with him when we debate such matters. Those who speak with not just knowledge, but experience do so with additional credibility and in a particularly powerful way. We cannot afford to lose the experience that is contained within the Quilliam Foundation. I hope that my remarks and arguments—and those that will be made by others later in the debate—will persuade Ministers not to give a blank cheque to the organisation, but to provide sufficient funding to enable it to survive the immediate future and provide its own sustainable funding in the long term.
I was describing the core of the important work that Quilliam does by supporting, encouraging and empowering those within the Muslim community to take this work forward for themselves. Again, I say that I am not asking for a blank cheque. Indeed, I support the strong argument that Quilliam should get out of Government funding in the longer term because that will add to its sense of independence, credibility and power within the Muslim community. In the long run, that is a sensible way forward, but we need an interim solution that will enable the organisation to survive these next few days and weeks.
Quilliam has not simply sat there and demanded money; it has taken difficult decisions in recent days to make its sustainability more likely. It has reduced staff numbers from 14 to six and has made eight staff redundant. Clearly, those are very painful decisions, but Quilliam regarded them as necessary in the circumstances. The small team that remains at Quilliam is working flat out on funding bids to charitable trusts and other funding organisations. It currently has a number of funding bids in but, as hon. Members know, charitable trusts do not deal with funding bids every day of the week; they have their own cycle and programme for deciding such things. Quilliam needs some time to allow those organisations to consider the bids and to respond, I hope, positively. Another important recent development has been the granting of charitable status to Quilliam in the United States. I hope that that will open up more avenues of potential financial support for it in the longer term.
I would also like to inform the Minister that Quilliam has actively been looking for smaller more affordable offices, which is also an important way of reducing the organisation’s overhead costs. Quilliam is not sitting there expecting a blank cheque from Government; it wants independent funding and it is prepared to reduce its costs. However, at the moment, it faces a real crisis. The request is simple enough. In December, Quilliam was told that there would be no more core funding in 2011-12. Three months is just not long enough for an organisation to move from core funding to project funding. We need a more flexible approach. A grant of £150,000 to cover the year ahead should be made. That is a reasonable investment in the kind of project I have been describing. After that, Government funds should be available only for specific projects that are agreed.
I hope that such an approach will find support from all parties this morning. It is certainly supported by Lord Carlile who, of course, is regarded by many as the expert in this area of public policy. He has made it clear in the media and personally to me that he supports having a transitional grant that would facilitate survival and then a path towards sustainable, independent funding. Quilliam is prepared to confront Islamist extremists. We should be prepared to ensure that it remains in business.
I congratulate the right hon. Member for Wythenshawe and Sale East (Paul Goggins), who has put forward a strong and effective case. He has made a very specific proposal that £150,000 should be provided by the Government. He made it clear that it should not be a blank cheque and specified that the funding would be for 12 months starting next month. What he did not do was to set out precisely what conditions and objectives might be attached, perhaps because he cannot conduct negotiations on Quilliam’s behalf, or he does not want to conduct negotiations here. He indicated clearly that at the end of the 12-month period, Quilliam would have to be self-financing, albeit perhaps having secured grants from Government for specific projects. However, other conditions might have to be attached if the Government were minded to go down that route.
The right hon. Gentleman made it clear that today’s discussion on the future funding of Quilliam is not just about the funding streams of that UK-based think-tank; it is about the Government’s current and developing policy stance on counter-terrorism—what we fund and why and how we should continue to move forward post-Prevent. Is our nation’s security to be based on ideology and on which groups emphasise or downplay certain aspects of Islam, or on reality and on the evidence of policies that have worked and continue to produce results?
As the right hon. Gentleman said, Quilliam’s funding streams are well documented and a loss of substantial funding early in its inception led to its being funded by the Foreign and Commonwealth Office and the Home Office, which illustrates exactly why there is a need for Quilliam to continue. It lost funding by being vocal in opposing extremism in whatever form and from whatever source. As he said, a funder withdrew support early on in Quilliam’s life as a reaction to the organisation’s stance against suicide bombings in Israel. Quilliam’s public stance on that issue was not particularly to do with Islam, but it was part of its consistent, clear and vocal opposition to all forms of terrorism. However, the resultant situation—Quilliam being funded largely by two Departments—clearly raises issues about bipartisanship and credibility.
Quilliam is not the only organisation that publicly and vociferously challenges extremism in all its guises, whether anti-Jewish, anti-Islam or anti-western; nor is it the only organisation in which former extremists have played an active part in educating peoples, Governments and policy makers on how to recognise and counter the type of radicalisation that results in extremist behaviours. The Street project in Brixton was previously funded by Prevent and has also experienced funding cuts. It is a non-sectarian group that works from a mosque and does measurable work in combating the kind of radicalisation that can lead to extremism. Similarly, the Cordoba Foundation has produced projects with a focus on preventing radicalism from becoming extremist action. In about a week’s time, an initiative called “Learning to be a Peacemaker” will be held in this place by an organisation called Initiatives of Change, which is also working in that field.
It is true, however, that Quilliam is distinct and unique in important respects. It is the only organisation that challenges extremist views and activities by effectively straddling both the Muslim perspective and the liberal, secular, mainstream vernacular of modern Britain. It represents the swathes of British Muslims who are Muslim by birth and culture first and foremost, but who understand and adhere to the division between Church and state, which is second nature to mainland Britain. Quilliam sits within the diverse and, at times, conflicting dialogue about Islam that is both acceptable and normal practice among faith-based Muslim groups, but unlike any other organisation of its size and impact, Quilliam also sits comfortably within the traditional western liberal dialogue, which separates to a large extent the personal faith of individuals and the secular, cultural interpretation of those personal faiths.
As the right hon. Member for Wythenshawe and Sale East set out, Quilliam started life as a think-tank, but the very nature of its work—outreach in universities, and research and policy advice—is much more akin to that of an effective and proactive non-governmental organisation. Quilliam’s vocal stance against terrorism that claims to be inspired by Islam has had solid results, which are measurable. Accurately signposting Government to specific individuals with an inclination for extremist action is invaluable in our fight against terrorism. As the right hon. Gentleman said, it remains one of the few groups—occasionally the only group—that consistently challenge and publicly condemn terrorism, from whatever source. As it sits within the Muslim dialogue, it has first-hand access to, and shared understanding of, the dialogues taking place at grassroots level and online that can lead to extremist action. That position is unique and invaluable to the Government’s fight against terrorism.
However, the criticism levelled at Quilliam, and indirectly at the previous Government for funding the group, is worth examination and raises important questions that need to be addressed in relation to any decisions about funding. The first is about its perceived dominance of the mainstream view. Many individuals and organisations are discouraged by an organisation that purports to be the arbiter of what is, or is not, mainstream. That is further complicated by the coming to light of a list produced by Quilliam that seems to many to suggest that some other Muslim organisations, which consider themselves mainstream, are breeding grounds for civil unrest because of ideological perspectives shared to a greater or lesser extent with radical extremist groups.
The hon. Gentleman makes a serious point. However, is it not the case that when taking part in an ideological battle, all groups describe themselves as mainstream? Indeed, even Islamist extremists describe themselves as mainstream, because they are trying to say that everyone who disagrees with them is an apostate. There is nothing unusual, therefore, about Quilliam at one end of the spectrum calling itself mainstream, while other groups at the centre of the spectrum call themselves mainstream, and groups on the radical Islamist end of the spectrum call themselves mainstream. That is not really a valid criticism.
The hon. Gentleman is very experienced in these matters. Maybe on that particular point we will have to disagree on whether my comment is appropriate.
The funding of a think-tank by the Home Office and the Foreign and Commonwealth Office will inevitably contribute to a perceived lack of plurality of voices heard by Government on how best to combat extremism. Lack of funding from other agencies will raise questions about how and whether Quilliam can critically engage with Government, and will cast doubts about its credibility as an independent body with the capacity to critique Government plans and policy on tackling radical extremism. It is true to say, however, that that position conveniently forgets the numerous groups that receive funding from the Government’s Prevent strategy to undertake or continue work to counteract extremist activity. It also overlooks the many Muslim groups that are frequently invited to put their views to Government, most recently a couple of months ago at a conference I hosted here with Murtaza Shibli, when we invited Muslim organisations to share opinions and advice on how best the Government can go forward with the post-Prevent agenda.
No one can doubt the achievements of Quilliam as an NGO. The debate about funding should, therefore, rightly concern itself with levels of funding at a time of financial austerity, and not about whether we should forgo that important insight into extremist narratives. Although I support the continued funding of this much-needed organisation, Quilliam, like other NGOs and agencies working under the vital remit of social cohesion, needs to look hard at how best to make effective decisions within tighter financial constraints. Quilliam also needs to continue to pursue other avenues of funding—as it is doing—to continue, with credibility, a bipartisan relationship with Government and other Muslim groups.
It is a great pleasure to contribute to the debate. I congratulate my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) not only on securing the debate, but on his thoughtful, wide-ranging and incisive contribution. It is also a pleasure to follow the hon. Member for Carshalton and Wallington (Tom Brake), who clearly has experience in these matters. He has raised some important issues, particularly on the plurality of voices, which we need as a society, on what are always contentious and very often sensitive matters. This debate is an opportunity not just to recognise the work that Quilliam has done, but to explore some of the complexity of this area and how Government might go forward.
We are here to highlight the situation in which Quilliam finds itself. I intend to concentrate on that in my remarks, because we need to press the Government for results as much as we need to have a general debate. In my experience, as with a number of groups working on this agenda, Quilliam has very often been brave, courageous, and willing to tread where other people have not perhaps been quite so brave. It always wants not just to highlight the threat that our country faces, but to come up with a practical response about how we can tackle that threat and develop a counter-extremist narrative and agenda to ensure that we build the resilience, particularly of our young people, to withstand extremist messages.
We are at a very important moment in relation to this issue. We had a significant speech from the Prime Minister a couple of weeks ago at the Munich security conference, which marks something of a turning point. He was very firm that the Government cannot tackle these issues alone. Government need help from a wide range of organisations from civil society, the Muslim community and communities across the spectrum. Government can do certain things, but the power to tackle an extremist narrative always comes from the community itself, which has to feel empowered, supported and backed up by Government in order to take on that task. The Prime Minister said:
“governments cannot do this alone. The extremism we face is a distortion of Islam”.
That is absolutely right. Islam is about peace, compassion, tolerance and inclusion; it is not about violence and division. The people who peddle messages of hate actually harm Islam in a way that almost nothing else can. The Prime Minister continued:
“these arguments, in part, must be made by those within Islam…let us give voice to those followers of Islam in our own countries—the vast, often unheard majority—who despise the extremists and their worldview.”
If that is our task, and we need others to help us, then it is very sad that we find ourselves having to press almost for the survival of an organisation such as Quilliam. It is that serious. Unless practical steps are taken by Government to ensure that there is some transitional funding for that organisation, I have no doubt that it will simply fold and not be able to conduct its activities. It has already made significant redundancies of a whole range of staff. From experience, I know how difficult it is to create capacity on these very difficult issues. It takes experience, knowledge and—I come back to that word—courage to stand up and be counted, and very often to make enemies, and face personal threats and intimidation. If we lose that organisation, we will lose that enormously valuable capacity that may well be able to be built up in the future. If something is destroyed, however, it is much harder to build up.
As an experienced former Government Minister, my right hon. Friend will know that Departments sometimes have the capacity, when they are reviewing programmes and trying to look at the whole picture, to let things slip through the net. Is there a danger that Quilliam could slip through the net?
I am grateful to my hon. Friend for that intervention. The debate this morning is an attempt to ensure that Quilliam does not slip through the net, and I know that Ministers in the Department are seized of the issues. We all recognise that these are difficult financial times and that difficult decisions have to be made across the Government, and I want to explore that a little with the Minister, perhaps with some specific questions later. We recognise that these are not easy times. The Home Office, which has taken a significant reduction in its expenditure, clearly needs to economise. My right hon. Friend the Member for Wythenshawe and Sale East has set out a specific proposition for £150,000 of transitional funding to enable Quilliam to pursue the other applications that it has made, which ought to get us to a reasonable position. I recognise that having an organisation solely dependent on public funds is not tenable in the long term.
The right hon. Lady has been familiar with the organisation for several years. Is she aware of whether Quilliam was previously given an indication that it should go to other organisations to find funding? If it was but has not been successful in achieving self-sufficiency, the Government would have strong reservations about putting money in again.
This did not become a significant issue until we were facing the current financial circumstances which pertain across Government. I certainly was not aware of a major drive, which was unsuccessful, to press Quilliam to find funds in other sectors. Clearly, the situation now is that economies need to be made. Quilliam has been put into that pot, but I want to explore with the Minister what other organisations are funded and what cuts have been made—I shall come shortly to the Research Information and Communications Unit. We need a better, broader picture of the total resources available, and what decisions have been made about funding priorities. In a few weeks, we are expecting the Prevent review, which will give us more insight into what the balance of organisations ought to be. We absolutely need a balance.
This is not a partisan issue by any measure—it transcends party politics. It relates to the security and safety of our country, and nothing can be more important than that. My right hon. and hon. Friends and I are pursuing the matter to try to get a reasonable settlement.
As my right hon. Friend the Member for Wythenshawe and Sale East said, I was the Minister with responsibility for counter-terrorism at the time of the 7 July 2005 bombings. Even now, I can feel the sense of devastation and shock that there was across the nation when that happened. People were asking who committed the bombings, why they would want to do that to innocent men and women and their families, and what led them to be prepared to take their own life to fulfil what they presumably believed to be their mission and destiny. I do not think that any of us really understood—we still do not—the many and varied factors that lead people down such a path, that lead them even to contemplate taking such steps.
We are better informed than we were then. Several organisations that have been active in this field have helped the Government and policy makers to come to a better analysis of the factors that lead people to extremism, but we do not have all the answers. I entirely accept that, although some of the measures in the Prevent programme were successful, some were less successful, but what we were doing in that area was innovative and, in many ways, experimental.
I have spoken to people in the United States, France, Germany and countries across western Europe who say that this country has been at the forefront of trying to drill down to determine what the factors of extremism are, and how to build resilience among young people so that they can resist such messages. My sense is that those other countries are just beginning to take the first steps. Indeed, that was reaffirmed for my right hon. Friend and me when we went to the United States just last week. Many of the Congressmen and women and Senators acknowledged that they are very much at the beginning of thinking about a counter-radicalisation strategy, whereas this country is well ahead. This country’s position has been aided enormously by the different groups that we have funded to help us. They have had programmes and have been able to develop an evidence base about the best way to counter extremism, and the Quilliam Foundation has been at the heart of that process for the past three years at least.
As everyone knows, Quilliam was formed by Ed Husain and Maajid Nawaz, both of whom had been in the grip of extremists. They had been right at the heart of Hizb ut-Tahrir and knew what it felt like to travel down that path. Therefore, their voices and the voices of others at Quilliam who have been able to set out the emotional process that happens to people on that journey have been enormously powerful and valuable in working out strategies to counter extremism. They were certainly instrumental, when I was the Secretary of State for Communities and Local Government, in my decision to set up the Young Muslims Advisory Group and the Muslim Women’s Advisory Group.
It was the first time in this country that we had people at national level who were able to advise Ministers about what it felt like to be a young person in the community with strong feelings about foreign policy and contentious issues, and with the many pressures that face them at that time of their life. What could the Government do to try to help them to grow up with a sense of this country’s values but also, of course, their important personal identity and heritage? The Muslim Women’s Advisory Group was a fabulous opportunity to find out about women’s lives, and how women could influence the young men in their families to withstand the extremist narrative. We can celebrate the huge amount that we achieved, but, obviously, we have much more to do.
Going around the country after 7/7 with my right hon. Friend the Member for Wythenshawe and Sale East was probably one of the most testing experiences I personally have ever undergone. The sense of anger, bewilderment and shock in communities was palpable, but the message that came across to me time and again was that the overwhelming majority of people in the Muslim community totally rejected the violence that had taken place, and believed that killing innocent people was never justifiable. Unfortunately, the extremism that leads people to contemplate and sometimes adopt violence is with us now—there is no getting away from that—and is likely to be with us for many years to come. Life has changed, and we ought to recognise that the circumstances are very different. That is why it is so important that we have the capacity to tackle that ideology and the way in which people seek to groom others to take the path of violence.
I want to mention a report which I think is relevant to this debate. “Fear and HOPE”, which was published last week by the Searchlight Educational Trust, is about the new politics of identity. Many people who are susceptible to extremist narratives are struggling with their sense of identity: who am I, where do I fit in, where do I belong, what is my value set?
The report, which was based on 5,000 interviews of people across the country who were asked more than 90 questions, provides some fascinating results and evidence. What gives me optimism and hope is that there is widespread rejection of political violence. It is interesting that the vast majority of people who were questioned considered white anti-Muslim extremists to be as bad as Islamist extremists. That tells me that a core part of our communities and population are basically saying, “A plague on both your houses. We want no part of extremism, whether far-right extremism, Islamist extremism or anti-Semitism—we reject all that.”
It gives me great hope for the future that if we can build, sustain and make that heart of our community strong, it will empower and give confidence to young people to say, “I reject the extremist narrative. I reject such ideologies and share the broad values of this country.” That prize is so precious and valuable that the investment of £150,000 to enable Quilliam to move to other sources of funding over the next few months is a small price to pay, considering the scale of the challenge that we face. I absolutely agree with the hon. Member for Carshalton and Wallington that we need a broad range of organisations to help with the agenda at every part of the spectrum. It is without doubt that Quilliam has been prepared to be at one end of that spectrum, to speak out, not to be intimidated, and to state the case for pluralism, inclusion and British values of democracy, tolerance, free speech, and particularly the rights of women. It has been extremely effective in doing that.
Obviously, we must support other organisations, and I will come to that, but it is only three years since Quilliam was established, and to have gained its reputation in the world within that period marks it out as a special organisation that has helped us to build that evidence base. Its report on radicalisation on campuses was extremely good and contained a series of recommendations. We know that there is a problem on some of our university campuses, and the report’s practical recommendations could help us significantly. It produced a report on the use of the internet to promote Jihad. We are now seeing preachers such as al-Maliki on the internet urging people to take matters into their own hands without having a group around them, and to carry out individual acts of terrorism. That report on the use of the internet was a good piece of work. The role of television in influencing young minds is crucial.
Quilliam has produced excellent reports, and done project work—for example, its work in Pakistan, as my right hon. Friend the Member for Wythenshawe and Sale East mentioned, which was funded by the Foreign Office, with road shows prepared in challenging and sometimes intimidating circumstances to make the case fearlessly. It has a tremendous record. It is seeking other sources of funding. It recognises that the current situation cannot continue ad infinitum, but it must be given the chance to do that work.
I have some questions for the Minister, and if he cannot answer them during the debate, I would appreciate it if he got back to me later. The Research Information and Communications Unit was established in the Office of Security and Counter-terrorism in the Home Office three or four years ago. My recollection is that that was a fairly well resourced unit. It received contributions from the Department for Communities and Local Government, the Home Office, and the Foreign and Commonwealth Office, and it brought together a series of people with the skills to develop a counter-narrative, to publish documents, and to do research and much of the work that Quilliam has been doing.
I remember a conversation I had with a senior Minister about the setting-up of RICU. My understanding is that there was an analogy between it and the operation set up at the onset of the cold war to try to counter communist subversion and propaganda. Either such organisations do the work themselves, or they do the research and support other non-governmental organisations that will go on to the front line and fight the ideological battle. I do not think I have seen anything to suggest that RICU is fighting that battle under its own banner on the front line. If it is not doing that itself, why is it not perpetually committed to the support of other organisations such as Quilliam which are prepared to go into the front line?
The hon. Gentleman makes an excellent point, to which I hope the Minister will respond. The comparison between the funding of RICU and the funding that we are asking for in this debate would be illuminating. It is clear that there is a straightforward and simple al-Qaeda narrative, which is that the west is at war with Islam with a feeling of victimhood and grievance. That must be countered, and it is my understanding that that was a core part of RICU’s responsibilities. I would be grateful if the Minister let us know what its resources are, what the product is, what it has been working on and, indeed, whether it can fund other organisations.
The right hon. Lady is making an important speech, and I entirely agree with the broad thrust of what she is saying about Quilliam’s importance. Will she go into a little detail about the discussion she might have had with that organisation about where it sees its diverse sources of funding coming from if it does not come simply from the Home Office, and a time frame for when new sources would come into play if the Home Office were able to continue some of the funding that it is planning to take away?
I am grateful for that question. Until recently, Quilliam was in a position to become self-financing in a short time. It had offers of funding, but we then had the recession, which has unfortunately affected all of us, including charitable donations. We have also had the events in the middle east. I understand that some support was pledged from organisations with middle east connections, but that has not been possible because of recent events. It now has a number of applications with charitable foundations that are active in building capacity, resilience and counter-narratives. It has some applications with individuals who have a long track record of support in this area. It is optimistic about being able to obtain funding. It may not be at the same level as in the past, which is why it has made some redundancies—it wants to cut its cloth according to its resources—but it is optimistic about being able to continue with a core facility and to build from there. That will depend on its reputation and the worth of its product, and rightly so. It should be out there and showing it to people.
I would be grateful if the Minister told us what the RICU budget is, what the overall budget is this year for the Prevent strategy and—I know that there will be a review—what it is likely to be, what other organisations are active in developing the counter-narrative and the counter-extremism part, as opposed to some of the good community work that goes on, and how much funding is provided to external organisations. Much of the Prevent review will be about project funding, and Quilliam absolutely accepts that that is where it needs to be in future. Will the Minster confirm that applications for project funding from the Quilliam Foundation will be considered in exactly the same way as applications from any other body-on the strength of the project that it is putting forward?
We could make decisions on such issues that we may live to regret later. It is so much more difficult to recreate something than to help it to continue to exist. I entirely support my right hon. Friend the Member for Wythenshawe and Sale East in his bid for £150,000 to enable the organisation to have an effective transition. Nothing is more important than keeping our country safe, and I believe that the Quilliam Foundation plays a major role in that objective.
Order. I intend to call the shadow Minister at 10.40, so that gives hon. Members some idea of how much time we have left for the remaining speakers.
It is a privilege to follow that outstanding speech by the right hon. Member for Salford and Eccles (Hazel Blears). Her work and that of the right hon. Member for Wythenshawe and Sale East (Paul Goggins) as Ministers on this topic excited the admiration of many of us when we were on the Opposition Benches. It continues to excite my admiration now that they are in opposition, but still fighting just as hard on this vital topic as they ever did when they were Ministers.
During the 1990s, I occasionally had the privilege of taking part in courses on public speaking, oratory and campaigning techniques with another member of the House of Commons who is now Mr Speaker. He always impressed on everyone who came to our courses that when making a speech one should have, at most, two main points, but preferably only one, with which to belabour one’s listeners over and over again, so that if they remembered nothing else about what one had said, they would remember that one point.
Here is my one point today. It is that countering hostile propaganda is not a commercial enterprise or undertaking. It requires sponsorship and support. It is absolute nonsense to say that people who are brave enough to put themselves in the front of an ideological battle should be selling their product on a commercial basis because that somehow means that their organisation is more vibrant.
If organisations that are fighting an ideological battle do not get support from the Government, they will need to get it from private sources. I know of no organisation during the cold war that fought these sorts of ideological campaigns—there were many such organisations; I was involved in several of them—that managed to make enough money to sustain itself as a going concern commercially. Such organisations had to find sponsorship. As I understand it, Quilliam has been rather particular about the sponsors it has sought. It could have taken money from undemocratic regimes but I believe that it turned down those offers. Although it might have agreed with those regimes on certain issues, it could not agree with the way that they rule their countries and peoples. Let us not fool ourselves into thinking that if Government funding is cut from an organisation, that organisation will somehow transform itself into a profit-making enterprise. It will not; that is not its function. The more time that activists in a counter-propaganda organisation spend raising funds, the less time they have available to do the job of countering radicalisation and extremism.
I hope that the Government will have the good sense to continue funding Quilliam because I am a little concerned about what may be going on under the surface. On the surface, as the right hon. Member for Salford and Eccles said at the beginning of her remarks, we have an excellent speech from the Prime Minister stating that we must be tough on radicalism and that we must not compromise. We must not pretend that people who speak with a double voice, as it were, and say that they are against extremism on the one hand but treat it softly on the other, are the only people with whom we should deal. Although that sort of speech makes all the right sounds, in reality Government officials are kicking away the props that support what is undoubtedly one of the most high-profile and successful organisations in the field of counter-propaganda.
I use those words deliberately because this is a propaganda war involving propaganda by those who seek to radicalise, and counter-propaganda by those who seek to defeat and undermine their campaigns. That sort of work must not be undermined by paid Government officials at a time when the head of the Government says that we ought to do more of it.
Something strange is going on and I think I know what it is. Reference was made earlier to the important conference being held today at the Royal United Services Institute. I had hoped to attend that conference this morning, but I felt that this debate was rather more important. My mind went back to a previous conference held quite a few years ago at the RUSI, and a rather impressive Government speaker on counter-terrorism. I subsequently sought a briefing from that speaker, and the Government gave permission for me to have one. During the course of the conversation, I made the point that one clearly had to encourage moderate Muslims to stand up against minority activists, just as in so many other fields. Particularly during the cold war and student radicalism on campuses in other decades, it had been necessary for moderates to stand up for the silent majority against the noisy activist and—above all—unrepresentative minority. I was intrigued by what the expert official said. He replied, “That’s absolutely true: there is a gap between those who hold moderate values and those who hold extreme values. However, there is another gap between those who hold extreme values and those—a much smaller group—who are willing to turn their extreme values and views into extreme and violent action.”
It seems that the Government—perhaps I should say the establishment, as that remains the same when Governments change—have primarily signed up to focusing on the division between extremist people who do not intend to be violent, and extremist people who intend to be violent. There is some value in that approach, but I do not believe that it should be exclusive. If we depend on people in the Muslim community with extreme views to stand up against others from that community with extreme views who want to be violent, we will not get a happy outcome. We must promote moderate values in the Muslim community. Therefore, we need an organisation that is prepared not only to attack violent extremism, but to counter the pernicious ideology of those who might not be planning violence, but who foster an extreme ideological environment where some people will absorb sufficiently illiberal notions and end up turning to violence.
I am concerned about this issue because there are a couple of ways in which counter-propaganda organisations can work. Some such organisations can, and should, concentrate on changing minds. If we wish to try that, it is important to persuade people who are inclined towards fundamentalism that they are wrong, and to have organisations that are perhaps tolerated more happily than Quilliam within the Muslim ideological community. Those organisations can work on trying to change the minds of those who are already radical.
There is, however, another more important element that must not be neglected. We hope, and I genuinely believe, that the majority of people in the Muslim community—I would like to think the overwhelming majority—hold moderate beliefs and are not extremist at all. The problem is that of the three sectors—the moderate community, the extreme community that is not violent and the extreme splinter community that is violent—the Government machine focuses too much on the second two categories, to the exclusion of the first. The only way we will win an ideological battle or war is by mobilising the silent majority. The silent majority is a hackneyed phrase because we use it a lot. Nevertheless, we use it a lot because it is true; it has to be true, and if it were not we might as well give up on civilisation straight away. We need groups that are not necessarily involved in trying to change minds, but rather in trying to reinforce moderate views that already exist.
It is not unrealistic and I made that explicit at the beginning of my speech. I said that if one does not get funds from the Government, one must get them from another sponsor. Ideally, one should have a range of funders, and the Government ought to be a part of that. My point is that if the Government have any sense, they will not withdraw funding in such a way that an organisation will collapse. If they believe that the organisation’s work is of sufficient value, they should ensure that it has secure funding before they begin to draw down their own funding stream. It is as simple as that.
I will conclude with one further point. It is my second point and I do not mind if hon. Members do not remember it, as long as they remember my first point. There are two types of counter-propaganda. There is counter-propaganda that is designed to persuade people to change their minds, and there is counter-propaganda that is designed to reinforce the moderate views that the silent majority already hold.
I shall give an example. When I was a youngster in the 1960s, a huge argument was going on about whether this country should continue to be defended by a nuclear deterrent. I was sure that it should continue to be defended by a nuclear deterrent, but time after time I would see people on the television and hear people on the radio saying, “No, that isn’t necessary.” I began to think, “Well, I’m only a teenager. What do I know about this?” I began to doubt my own commitment. Then one day, someone from another country was being interviewed on television and he made such a convincing case for the nuclear deterrent, and articulated so much better than I could, as a youngster, the case for what I believed already, that I thought, “Fine. I’m okay. That’s all I need to know. At least one other person in the world, brainier and more articulate than I am, has come to the same conclusion for the same reason.”
I believe that groups such as Quilliam both need to do the type of work that I have described and actually do that type of work. There are moderate Muslims who, because of the way in which radicalism and extremism dominate the narrative, will begin to doubt themselves—even though their own views are moderate. It is the job of a group such as Quilliam to show that when the extremists say, “We are mainstream and you are un-Islamic,” in fact the reverse is the case. To get that message across, people must be knowledgeable and professional, must have a huge amount of detail at their disposal and must have access to the airwaves, the printing presses and the internet.
I am very sorry that the Government, because they believe in persuading people to change their minds, are to kick away the support from an organisation that is dedicated to reinforcing people who do not need to change their minds, but need to be encouraged to speak up and need to be reassured that they are right and the extremists are wrong. This is not a commercial enterprise; it is a political fight. If the Government want to take the line that the organisation must be self-funding and self-supporting, let us ask ourselves this final question. How many Departments would be able to do their work if they had to raise the money to fund it themselves as a result of the product of their work, rather than their income stream coming from taxation? I think we would find that not a single Department—except perhaps the Ministry of fun—would survive such a proposition.
I believe that Quilliam’s work is essential. I believe that it is non-commercial. It has been supported thanks to the work of the right hon. Member for Salford and Eccles and of the right hon. Member for Wythenshawe and Sale East, whom I congratulate on initiating this very important debate. It is no coincidence that more than half the House of Commons members of the Intelligence and Security Committee are here making this case today, even though we are making it in our personal capacities, not as members of that Committee. I shall leave time for the right hon. Member for Wolverhampton South East (Mr McFadden) to speak. I hope that the Government will take our message extremely seriously.
Order. I know that Mr McFadden has been very patient, but I must remind him that the Front-Bench responses to the debate start at 10.40.
Thank you, Mr Dobbin. I congratulate my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) on initiating the debate. We all know that the backdrop to it is the very serious terrorist threat that we face. That is not a myth; it is not something that has been made up. In the London underground bombings, 52 people were killed. Since then there has been the plot to blow up airliners, which resulted in the liquid restrictions on aeroplanes; we have had the shoe bomber, Richard Reid; and we have had the Christmas day attack on the Northwest Airlines flight to Detroit involving Umar Farouk Abdulmutallab. There have also been other incidents—some that we know about and probably some that we do not know about.
To combat terrorism, we of course need security forces to catch and punish those responsible but, as other hon. Members have said, we must also confront and challenge the ideology that feeds such acts. Quilliam is critical in that fight. It cannot all be done by Government and Government agencies. As other hon. Members have said, this is an ideological struggle that must take place within the Islamic community itself.
I have had less direct ministerial involvement in this issue than my colleagues, but of course our political interests are not confined purely to our ministerial experience. However, one issue in which I did have some ministerial involvement was extremism on university campuses. I commend Quilliam for the work and research that it has done on extremism on campuses, which is growing. One of Quilliam’s founders, Ed Husain, outlines very well in his book the expertise with which Islamic extremists use the liberal values of those who run our colleges and universities to propagate what they want to do and put the university or college authorities on the defensive.
As we have all agreed, Quilliam is an important organisation. It is important because it is unequivocal in its condemnation of terrorism. It challenges the ideology that feeds it. It condemns suicide bombings; it does not make excuses for them. It takes on arguments perpetrated by the apologists for terrorism. Quilliam is also important in another sense. It challenges the notion, sometimes spread by non-Muslims as well as Muslims, that the terrorist problem is all our fault—the conceited notion, ultimately, that the west is so all-powerful that it is responsible, either through its foreign policy decisions or through other means, for encouraging terrorism. Quilliam challenges that, too, so it provides a service well beyond the argument that currently takes place within the Islamic community.
I am sorry that I came into the debate late; that was because of a traffic problem. Does my right hon. Friend agree that he is repeating almost word for word the message of the Prime Minister both at the Community Security Trust dinner two weeks ago and in Kuwait—the message that he has constantly urged? I understand why the Liberal Democrats want to kill Quilliam, but I just cannot understand why Conservative officials and Ministers in the Home Office want to do it such damage.
I cannot speak for the Conservatives. The Minister will have a chance to do that in a few minutes.
As we have said, what Quilliam does is important because those who lead it are themselves ex-supporters of violent jihad. Therefore it is done with a level of understanding and engagement in ideological and, indeed, theological debate that is well nigh impossible for Ministers. That is important because it is extremely difficult for the state to engage in theological debate, and the argument must be won theologically as well as ideologically.
The Government have proposed to cut core funding for the organisation. That is a mistake. As the hon. Member for New Forest East (Dr Lewis) said, Quilliam has given strength and confidence to others, too. That is a very important aspect of its work. By stepping forward, people from the organisation have given strength to others who probably think these things but may not have seen other people in the debate giving voice to them.
I shall ask the Minister a direct question. I understand that the Home Office budget is under pressure—the pace and scale of cuts is an argument for another day—but is the decision purely budgetary or, as the hon. Member for New Forest East implied, is something else going on? Is there a wider disagreement with what Quilliam has advocated in recent years? I believe that the proposal made by my right hon. Friend the Member for Wythenshawe and Sale East for a grant of £150,000 to give the organisation time and space to seek alternative funding is worthy of support, even in these difficult times.
Let us just ask ourselves this question. What will the debate about terrorism be like if Quilliam folds? The hon. Member for Carshalton and Wallington (Tom Brake) said that there are other organisations. I have not really seen them. I have not seen others stepping forward with the degree of clarity and theological and ideological commitment that Quilliam has had.
There is a complacency about saying that others will simply step forward. I have long experience of seeing this ideology develop, not particularly as an MP, but as a Government staffer. I have seen some of the errors that Governments have made in the past and, frankly, I do not want to return to the situation we had 10 years ago, when we listened to many voices that we thought were representative. There is a danger of complacency in cutting Quilliam’s funding, and if the Minister thinks that other organisations will step forward to fill the void if Quilliam does not get the funding it so urgently needs, I would like him to name them today.
I hope that the Minister has heard the arguments that have been made today. I also hope that he will respond positively to the proposal from my right hon. Friend the Member for Wythenshawe and Sale East and tell us exactly who will speak up and make the arguments that Quilliam has made if that organisation no longer exists.
Thank you, Mr McFadden, for a disciplined speech.
It is a great pleasure to serve under your chairmanship, Mr Dobbin. It is a delight to be involved in a debate that has none of the partisanship we would expect when talking about organisations’ funding.
I congratulate my right hon. Friend the Member for Wythenshawe and Sale East (Paul Goggins) on securing the debate. I also congratulate other right hon. and hon. Members on their contributions, which they made with passion. They have shown their credibility and the experience they have gained in an individual capacity, although as the hon. Member for New Forest East (Dr Lewis) said, they also represent almost half the members of the Intelligence and Security Committee. The Minister would do well to take that experience on board. In that respect, I was impressed to hear that Lord Carlile, who has been the independent adjudicator on counter-terrorism matters, also supports Quilliam. As my right hon. Friend said, the Government have made the wrong decision—I fully understand why, given the cuts to the Home Office budget and the problems Ministers face—but they now have an opportunity to put things right.
I want to put on record my thanks to my right hon. Friends the Members for Wythenshawe and Sale East and for Salford and Eccles (Hazel Blears) for the work they did as Ministers after 7/7. As a West Yorkshire MP, I am well aware of the mood—the shock and horror—in West Yorkshire when we found out that the bombers were from our area. There was great concern in communities, and I am grateful to Members for saying that the majority of Muslim people support the state and do not agree with the atrocities that have taken place.
My hon. Friend takes my mind back to the day I visited Bradford, when he and other colleagues helped to organise an important meeting with the Muslim community. Does he remember that the central focus of our discussion was concerns about the inability of us as outsiders, and indeed of Muslim leaders themselves, to communicate effectively with young people in the community? Is that not something that Quilliam can do very effectively?
Very much so. That was one of the key points. My right hon. Friend the Member for Salford and Eccles was honourable enough to say that although we got lots of things right in Prevent, we also got lots of things wrong. Communication with the community was one of the things that was difficult; at one point, the community felt that it was under attack by the state and that we were describing it as the enemy, for want of a better term. The reality was that we needed to get into the community, and particularly to young people who felt isolated. Quilliam can do that.
What strikes me about the debate is that Quilliam has been acknowledged as an organisation that speaks its mind. In speaking its mind, however, it can also create enemies and problems, including with officials in Departments, although I do not mean that in a critical way—that is just the way things develop and operate.
As has been said, Quilliam has set about these issues and produced important research on a complex and controversial subject. As my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) said, its research and reports on radicalisation on university campuses has been important. It has also done work in British mosques and the prison system. As a former Prisons Minister, I was interested in what Quilliam said about the radicalisation of prisoners.
Quilliam’s reports have been enlightening and important. Just yesterday, it produced a considered and thoughtful report on the situation in Libya, arguing for action by the international community. It has also done important work overseas, and my hon. Friend the Member for Ilford South (Mike Gapes) talked about the work that it did in Pakistan, challenging extremism and promoting a democratic culture. Although Quilliam is not universally popular, it is clear that many of its critics are apologists for radical Islamism.
I have listened to the debate with interest. Accepting Government funding can give rise to the thought that people are betraying themselves as Government stooges. If people rely only on Government funding and have no other funding, are they putting themselves in a difficult position? Such thoughts have undoubtedly alienated some in the Muslim community from Quilliam. It is not surprising that Quilliam is not universally popular, however, because it tackles controversial issues and it is not afraid to tell it like it is.
When we look at Prevent, it is right that we look at all the issues. This is not the time to argue about Government cuts or the timetable for the review of Prevent. However, we should recognise that Quilliam is a powerful organisation, which is supported by many Members of the House with expert knowledge of these issues. People could argue that this is special pleading, but it is special pleading for an organisation that could, as I said in an intervention on my right hon. Friend the Member for Salford and Eccles, slip through the net if nothing happens; indeed, Quilliam is already making redundancies and looking at its finances.
Ministers face difficult decisions in good times and bad times; they have to deal with budgets and other issues, and they rely a lot on support from their officials. However, if decisions are not taken quickly in this case, Quilliam will be lost, and if it is, it will not be rediscovered, as Members have said. We cannot readily call on such expertise.
I hope that the Minister will answer the question posed by my right hon. Friend the Member for Salford and Eccles in the spirit that she asked it. We need to know what is going on. Is this a political decision? Have Ministers reflected on the issue in light of the support for Quilliam? The hon. Member for Carshalton and Wallington (Tom Brake) is right to say that we have to look at every area of spend in these difficult times, but it is important that we do not throw the baby out with the bathwater.
I fear that the Government’s good intentions in reviewing Prevent could put an end to an organisation that has credibility and support in the UK and internationally. In that respect, I am heartened to hear that it has charity status in the US, which shows its willingness to go out and look for other funding. It is important that it retains credibility in terms of where it gets its funding. As has been said, it could get funding from many different organisations, but would that be the right funding for Quilliam, given the context of its work?
I hope that the Minister will reflect on the debate, which has been excellent, well-informed and non-partisan. I understand that difficult choices have to be made, but I hope we can make sure that this organisation does not slip through the net.
In congratulating the right hon. Member for Wythenshawe and Sale East (Paul Goggins), let me say how grateful I am for the constructive way in which he made his suggestions and asked his questions; indeed, I am grateful for the constructive tone in which the whole debate has taken place. I am particularly grateful to have had the benefit of the experience of the right hon. Member for Salford and Eccles (Hazel Blears), who clearly grappled with these absolutely vital, difficult and sensitive issues when she worked in various Departments.
I should say at the outset that there is no doubt that Quilliam has done important work in support of counter-terrorism efforts in this country. Various Members on both sides have quoted the Prime Minister’s Munich speech, in which he set out the course that the Government will follow on counter-terrorism, and Quilliam continues to contribute to that. The Home Office understood the role that Quilliam could play when it helped the organisation get off the ground in 2008. Officials and Ministers provided it with extensive advice and assistance at that time.
The Home Office envisaged that Quilliam would be able to work in and with Muslim communities, and particularly with young people, challenging and exposing terrorist ideology and contributing to the aim of stopping people becoming terrorists or supporting terrorism, to observe the distinction made by my hon. Friend the Member for New Forest East (Dr Lewis). The Home Office judged that, as former radical Islamists themselves, Quilliam’s founders would be able to draw on their own experiences to describe that ideology, explain why it might seem superficially compelling and demonstrate its incoherence. Quilliam subsequently developed a significant research function, and has published some papers on important issues, including radicalisation on the internet, in prisons and in further and higher education.
It is fair to say that, since 2008, Quilliam has developed a brand, a message and a clear public position. It is known not only in this country but overseas, notably in the USA. Throughout that period, both the Home Office and the Foreign Office provided Quilliam with significant financial assistance. Quilliam has received more Home Office Prevent funding than any other single organisation—nearly £1.2 million over the past three financial years. The Foreign Office has provided nearly £1.5 million in project funding over the same period.
Regarding funding for Quilliam and other organisations, Pakistan was mentioned and the important work that needs to be done there. Tackling radicalisation in Pakistan is clearly important but, to put it into context, there are nearly 100 organisations, large and small, supporting Prevent overseas. More than 20 of those are in Pakistan, many of them working anonymously for obvious security reasons. All of those are funded by the Foreign Office.
This financial year, the Home Office has provided Quilliam with six-figure funding. It has been invited to submit bids for project funding in the next financial year.
There are indeed, and I will come to exact figures in a second.
The funding provided to Quilliam has been unique, not only in its scale but in its scope. It has been used not just for projects and programmes but, exceptionally, for significant overheads and running costs. The Government agree that Quilliam deserved some support in the past, and we continue to believe that Quilliam is capable of useful work. However, following a review of all the organisations, projects and programmes supported as part of the Prevent strategy, Home Office Ministers have taken the decision to end funding for Quilliam’s running costs from the end of this financial year. Clearly, that is the heart and purpose of the debate.
I say to the right hon. Member for Wythenshawe and Sale East that there is an offer on the table to Quilliam of tens of thousands of pounds to cover the next few months of basic operations. He and the array of distinguished ex-Ministers on the Opposition Benches will recognise that this not the place to conduct detailed financial negotiations. I want to assure him and everyone who has attended the debate that there is an offer. It would be foolish for me to start negotiating here; I will merely gently observe that the £150,000 transitional money referred to by several right hon. and hon. Members is actually more than the total Home Office money given to Quilliam over the past 12 months, as decided by the previous Government. I would not want anyone to leave the debate with the thought that £150,000 is a small percentage of what Quilliam might have expected to receive. It is actually more than the total budget received from the Home Office in the past year.
Will the Minister give an indication of when Quilliam was first told that it would need to replace the Home Office funding with funding from other sources?
In December. My hon. Friend the Member for New Forest East asked for specific numbers. The trajectory of Home Office direct funding for Quilliam is quite clear. In 2008-09, it was £665,000; in 2009-10, it was £387,000; and in 2010-11, it was £145,000. There was a clear trend in the direction agreed with by everyone who has spoken in the debate: that is, that Quilliam does good work but that a think-tank of that kind should not be reliant for its core running costs on Government funding.
If my hon. Friend will excuse me, I need to make some progress, because others have asked interesting “in principle” questions, which I need to address. He himself gave the impression there was some kind of conspiracy afoot, and I wish to reject that.
Home Office Ministers have taken the decisions they have for three reasons. First, Quilliam has, as we all agree, evolved into a think-tank; it is no longer fulfilling the role for which it was originally funded by the previous Government. Secondly, Quilliam has continually committed to broadening its sources of funding and to becoming more self-reliant, and I think we agree that that needs to happen. Thirdly, Home Office Ministers believe that the Department can no longer make an exception for Quilliam by paying for its ongoing running costs as well as funding specific projects. The Home Office does not support any other think-tank on that basis, a point well made by my hon. Friend the Member for Carshalton and Wallington (Tom Brake).
Let me deal with each of those points in turn. As I have already said, the original purpose for which Quilliam was funded by Government was to work in and with Muslim communities to challenge the ideology of terrorism and extremism. In some cases, that has not been done as successfully as Ministers originally hoped. Since 2008, Quilliam has progressively engaged in a different and rather broader range of activities consistent with its declared intention of being a think-tank. It publishes work on a range of security issues, not confined to the narrower and hugely important issue of countering radicalisation. In doing so, I emphasise again, Quilliam makes important contributions to the overall debate.
I appreciate the pressure of time. I am not sure that I accept the distinction the Minister makes between think-tank work and countering extremism. The publication of the reports is important in countering extremism. To get to the point, can the Minister say who he thinks will step forward and do this if Quilliam folds?
I am trying to come to that point. The principle we want to uphold is that Quilliam should be free to contribute to the wider debate, but not depend on Government funding to do so. The other think-tanks that have also published on radicalisation—including Demos, the Policy Exchange and the Centre for Social Cohesion—all operate on that basis. It is the way that all successful think-tanks need to operate. The right hon. Member for Wolverhampton South East (Mr McFadden) asked a reasonable question about whether think-tank work can contribute to countering radicalisation. That is done by a number of think-tanks. There is an important point of principle about whether think-tanks should continually depend on direct state funding for their core activities to continue their work year after year.
I am grateful to the Minister for giving way: all of us who have been Ministers recognise that the timing of winding-up the debate is a fine art, and there is much ground to cover.
The Minister has recognised the contribution that Quilliam has made. He talked about an offer running into tens of thousands of pounds. We have argued for £150,000. If there is good will, a real interest in making sure that the organisation can survive, will the Minister agree to meet me and other colleagues to pursue that, to see if what may be a narrow gap can be closed?
I am always willing to meet the right hon. Gentleman. I know he met the Home Secretary yesterday, and the situation on the subject has not changed radically in the 12 hours since he met her.
Let me address the issues. The Foreign Office and the Home Office fund a number of small organisations, charities, civil society organisations and faith communities to deliver the Prevent programme, overseas and in this country. There are more than 130 such organisations. To protect them and their credibility we do not disclose their names. I am sure everyone will recognise that they are sometimes working in high-risk environments. Their credibility needs protection because research that appears to be British Government-inspired will inevitably have less credibility.
The right hon. Member for Salford and Eccles asked about RICU. It has clearly received staff and resources from the Foreign Office, from the Department for Communities and Local Government and from the Home Office, recognising the challenge of producing a coherent narrative overseas, nationally and among local communities. I will write to her on the details.
(13 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
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I am grateful to Mr Speaker for granting me the opportunity in Westminster Hall to draw directly to the Minister’s attention a number of important issues regarding the performance of NHS services in my constituency and in the county of Essex. I suspect that the matters that I shall raise and the constituents’ cases that I shall mention are by no means unique to my constituency or the county. However, the Government are developing the most important and, in my opinion, long-overdue changes to the NHS, and I want to ensure that the problems and challenges faced by my constituents are thoroughly and fully considered.
Throughout the endless reforms and reorganisations undertaken by the previous Government, the health needs of patients were never afforded the same priority as the expanding tick-box bureaucracy suffered by my constituents. One consequence of the waste that was created is that the money put into the health service never achieved the true outcomes that my constituents deserved and needed. That has led in part to my constituents suffering poor patient choice and health care services. However, we cannot change everything about the past.
The Minister, the Government and, most importantly, my constituents want an effective NHS for the British people; it should deliver value for the taxpayer, ensuring that the mistakes of the past are not repeated and that all receive the care and front-line services that are their due. It is therefore essential that as the NHS is reformed, the needs of local communities in my constituency of Witham are not overlooked or ignored. That is why this debate is so timely.
By way of background, I shall give the Minister some details about my constituency and some of the health care challenges faced by my local community and me that are specific to the area, and the nature of current NHS services there. I shall then highlight the excessive and overblown bureaucracy that affects the NHS globally, which demonstrates the scale of taxpayers’ money that is increasingly and wrongly being taken from front-line services. I shall also draw attention to some of the most serious and heart-breaking cases that I have come across in the 10 months since I was elected, which show that the NHS too often fails the most vulnerable. I shall conclude my remarks by putting the case for new NHS services being delivered locally under the Government’s planned reforms.
Witham is a new constituency, so I forgive Members for not knowing much about it. It is not far from the London commuter belt, and lies within the heart of Essex. We have tremendous public transport and road links to London. The ports of Felixstowe, Harwich and Tilbury are not far away, and we have some major industrial towns and centres. It is not surprising, therefore, that Witham has experienced significant population growth in recent years. It is an attractive area to live in.
The three local authority areas in my constituency are Braintree, Colchester and Maldon. Under the previous Government, they were required to build more than 27,000 new homes in the 20 years to 2021, and 60,000 new homes between 2011 and 2031. Throughout Essex, the current population of 1.4 million could easily grow by 14% over the next 20 years. Members will be aware from their own areas that population growth inevitably puts more burdens not only on infrastructure but on the local NHS.
The local plans, particularly those that affect my constituency, unfortunately give no serious consideration to ensuring that the quality and quantity of local health services can keep pace with projected population increases and changing demographics. Although top-down targets are being scrapped by the present Government, the attractiveness and desirability of my constituency inevitably means that more people will move to the area, so we can expect to see a significant increase in the local population. That will put demands on local health services that are already struggling to cope.
It is not simply the sheer quantity of people that NHS services will need to support; they will also need to adapt to the changing demographics of the area. Because our local communities attract young families, we need stronger maternity services and paediatric provision. However, the most significant demographic change will be an acceleration of the number and proportion of residents over the age of 65. In that respect, my constituency and the county of Essex are not unique, as health services across the country are responding to an ageing population. By 2021, the NHS in Essex, along with its partners in local government, will need to accommodate the health needs of 45% more people in the county living beyond the age of 65, and 75% more people living beyond the age of 85.
Some of the most significant increases in Essex are expected to be in the Maldon district, part of which falls within the Witham constituency. It is worth noting that about 10% of the Essex population provides assistance, caring for family, friends or neighbours, with higher than average rates in Maldon, where the number of working-age people available to care for older persons will have nearly halved by 2029. These demographic changes present serious challenges to the front line of the NHS in my constituency and in the county.
I am pleased to report that Essex county council is taking a strong lead in implementing the Government’s reforms to deal with the challenge. It has already established a health and well-being board, and the Department of Health recognises it as an early implementer. I would welcome the Minister’s reassurance that the Government, unlike the Labour party, which has made no commitment to NHS funding to support this work, will continue to increase resources when necessary to support the health needs of my constituency and Essex. I shall emphasise throughout the debate the need for the money to be spent on front-line care, not bureaucracy.
That brings me to NHS bureaucracy in Essex and my constituency, and specifically to our local primary care trusts. The Minister will be aware that the medical needs of my constituents are served by a number of NHS trusts and by the East of England strategic health authority. There is no general hospital in my constituency; local residents usually use the Broomfield hospital run by the Mid Essex Hospital Services NHS Trust, which is based in the neighbouring constituency—that of the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns)—or the foundation trust hospital in Colchester for acute care services. Mental health services are provided by the North Essex Partnership NHS Foundation Trust.
My constituents are served by two of the five primary care trusts in Essex. Those who live in the Braintree district council or Maldon district council parts of my constituency fall within the area covered by the Mid Essex NHS trust, whose budget for 2011-12 has increased to just under £520 million. Those who live in the wards covered by Colchester borough council find themselves being dealt with by NHS North East Essex, whose budget for 2011-12 has risen to just under £547 million.
Later, I will give examples of cases in which constituents have faced unacceptable problems with those health trusts. In the meantime, it is worth looking at the obscene levels of bureaucracy, administration and management that have taken hold of those organisations. The number of managers and senior managers employed by the East of England strategic health authority doubled under the previous Government from 1,300 in 1997 to more than 2,700 in 2009. At Mid Essex Hospital Services NHS Trust, more than £10 million is spent annually on 29 senior managers and 79 managers. In the North East Essex PCT and its three predecessor trusts, the proportion of administrative staff rose from 19% to 33% between 2001 and 2009. The number of managers and senior managers increased from 25 to 84.
Finally, Mid Essex PCT, which serves the majority of my constituents, and its four predecessor trusts, saw administration and staffing levels rise from 17% to 33%, and the number of managers go up from 10 to 102. When we consider that those two PCTs were formed from seven predecessor organisations, it is fair to say that the growth in management and administration over eight years is quite shocking. The PCT now spends almost £13 million on management costs alone. That money, which my constituents and I view as hard-pressed taxpayers’ money, has been taken away from essential local medical care to staff a bureaucracy. Mid Essex PCT is also experiencing slippage in progress on its quality, innovation and prevention plan and, as a result, could now miss its year-end target by £2.7 million. On 16 November, the minutes of its remuneration committee, which have not been disclosed fully, indicate that performance bonuses were to be paid to the chief executive and its executive directors.
What concerns me is not just the vast sums of money increasingly flowing into the pockets of bureaucrats and managers, but the way in which the PCT is behaving and functioning since it embarked on its reorganisation. It seems to have no real idea as to what it is reorganising into. That is a cause for alarm. I hope the Minister is aware that last autumn, North Essex PCT and Mid Essex PCT decided to form a cluster with West Essex PCT under a new chief executive. The first I heard of that change was when I received a press release last September. In a massive blaze of glory, it was announced that the chief executive of the strategic health authority would form closer working arrangements with the PCT.
The hon. Lady has spoken at some length and with real passion about money being poured into the appointment of bureaucrats and managers. In her mind’s eye, a hospital bureaucrat is a man in a bowler hat with a brief case, but is she aware that many people who are dubbed managers in the health service are actually former senior nurses, such as her colleague, the Minister, who bring much of their clinical background and expertise to bear on their role? Nurses in particular get a little pained when politicians talk about managers and discount the fact that many of them are people with a very solid clinical background.
I recognise that NHS managers have a range of health care backgrounds and bring a number of skills to the table. Of concern to my constituents though is the fact that we are dominated by managers who tend to have administrative rather than clinical backgrounds, and they are making key decisions about patient treatment, and even about medical care and access to drugs. None the less, I thank the hon. Lady for her comments and her valid point.
This brings me to the overall efficiency and effectiveness of the reorganisation. I have been told that reorganisation will lead to a significant step forward in delivering greater efficiency for the people of north Essex. None the less, I constantly have to ask the PCT, “What does this mean? What will this look like? What are the costs of the reorganisation?” I was told last autumn that the PCT could not quantify the cost of reorganisation as the process of reconfiguration had only just started. I have been asking for updates, but as yet, have not received any. Each time I ask anything, I am told that my question cannot be answered “at this time”.
There is far too much uncertainty. I welcome reorganisation, efficiency drives and reductions in management and bureaucracy costs, but there are major implications for front-line services. The language of the PCT is constantly about reorganisation producing greater efficiencies, which I would not dispute, but the PCT still has no detailed plans to show what the greater efficiencies will look like and what the formation of the new cluster will mean for local services.
The merging of back-office functions to save money is to be welcomed and I have no issue with that. In this case, however, I have discovered that there is no forward plan in the form of a route map and details of how things will operate. I have been asking questions for six months, but I have not received any substantial details about the new cluster, the staffing arrangements and what it will all mean for patient choice locally. I have sent written questions to the Secretary of State about the reorganisation but, again, I have not had a response.
Will the Minister examine this reorganisation and ensure that more information is made available to the public so that they have some sense of what kind of decision making is taking place locally within the new cluster and the PCT, and what it will mean to them in terms of access to health care and local services? It appears that many of the decisions have been taken behind closed doors, with very little accountability and transparency. It is in the public interest to know what has transpired within the reorganisation, and what the new arrangements will look like as well as the costs and the benefits.
As the PCT should rightly be beginning its winding-down process prior to its abolition, I would like to hear from the Minister about the redundancy arrangements for senior PCT managers. I am sure that that is a matter that is naturally in their minds right now. In view of the colossal levels of waste caused by PCTs, my constituents will be very disappointed to see PCT chief executives and other senior directors receive golden goodbyes to boost pension pots or huge redundancy pay-outs. In the interests of accountability and transparency, all constituents across the country will be looking, during the NHS reforms, for some encouragement from the Government on that issue.
Before I move on to some individual cases, let me just say that I make no apologies for being critical of NHS bureaucracy. In my limited time as an MP, I have seen endless examples of red tape standing in the way of my constituents getting the best health care that should be available to them. I am overwhelmed by the whole culture of tick-box management that has pervaded my local NHS. It is something with which I have been battling, day in, day out, on behalf of my constituents. It is an alarming state of affairs.
Let me now draw to the Minister’s attention a couple of cases. I have been in touch with the Minister and the Department about the issue of Sativex. There have been two cases in my constituency in which the PCTs have refused to treat patients on the NHS with the drug Sativex despite their doctors’ recommending its use to help with multiple sclerosis. In both cases, the PCTs have been able to afford to pay more to their managers and to spend more on red tape and bureaucracy, but have refused to provide vital medical treatment to my constituents.
First, Mr Shipton from Tollesbury was recommended Sativex by four doctors, to help his condition. Those doctors are medical experts who have been treating him and who are aware of his condition and medical needs. However, last September Mid Essex PCT, acting through officials sitting on its area prescribing committee, thought that it knew best and decided that it would not accept a request for Sativex to be prescribed to Mr Shipton on the NHS. That left him in considerable pain and distress. It then took more than a month for the chief executive of the PCT to respond to my request for copies of minutes of the meeting at which that decision was made. The minutes stated that the PCT declined to prescribe Sativex to Mr Shipton
“due to a lack of evidence of significant long-term benefit. Clinical trials are of very short duration and do not compare with current treatment.”
Despite that, however, Sativex is already licensed—in fact, it was licensed last June—for use to improve symptoms in multiple sclerosis patients with moderate to severe symptoms, clearing the way for the PCT to prescribe it. Indeed, the PCT itself had made 31 previous prescriptions of Sativex in 2009-10.
My constituent, Mr Shipton, ended up sourcing Sativex privately, at the cost of £125 plus VAT per bottle, which is a course of treatment that lasts for only two weeks. Contrary to the conclusions of the area prescribing committee, the drug is having a hugely beneficial effect on Mr Shipton. If the bureaucracy of the PCT had not stood in the way, he could have received that treatment at a much earlier date and he would not have had to endure extreme suffering and pain, as well as what I would describe as an unnecessary bureaucratic process.
I have another constituent, Mr Cross from Tiptree, who has also experienced horrendous problems. In fact, his wife, Mrs Cross, is on the phone to my office on a weekly basis, updating us about the terrible position that her husband is in and the suffering that he is experiencing. He has had horrendous problems receiving a prescription of Sativex, although in this instance the obstacle has been dealing with North Essex PCT. Mr Cross is wheelchair-bound and in terrible pain, experiencing constant spasms. In fact, he has recently been in hospital. Given his condition, any treatment would be a welcome relief for him. There is double suffering for his wife, as it were, because she is now effectively his full-time carer. Once again, getting access to this drug has been terrible. He has had his consultant neurologist battling for him and making his case, and I too have battled for him and made his case. But North Essex PCT, despite issuing 16 prescriptions for Sativex in 2009-10, still refused to prescribe this treatment for Mr Cross and gave him a highly dismissive response.
When I took up Mr Cross’s case from September 2010 onwards, I began a process of constant correspondence with the PCT. All I received were evasive non-responses and the odd reference to Mr Cross’s “medical needs”, which were then just dismissed. I found that totally unacceptable. Mr Cross’s condition has since deteriorated and he has been in hospital again. There needs to be a recognition of the endless stress and strain that this process puts on his own domestic set-up, especially his dear wife who is now his constant carer.
There is a compelling case for action in both of those cases, to press the PCTs to provide this drug. Also, both of my constituents have made the point that they have spent their lives working hard, doing the right thing and contributing to society. They felt that in their hour of need the NHS would be there for them, but now they feel that it has not been there for them. That is unacceptable. Although I appreciate that the Minister cannot intervene in individual cases, I ask her at least to examine these cases if she possibly can.
There are two other cases that I want to touch on briefly. The first is that of my constituent Mrs Emily Wetherilt, and again I would welcome the Minister looking into it. It is another example of a local PCT failing to perform adequately to meet the medical needs of my constituents. Mrs Wetherilt is 96 years old and requires 24-hour care. However, despite her case meeting the published criteria for NHS continuing health care funding, Mid Essex PCT has refused to provide any care whatsoever. So there has been no support for her from the PCT. Mrs Wetherilt’s daughter has taken up this matter directly with the PCT’s panel twice and she has been declined on both occasions. The PCT categorically refuses to look into this matter again, because an appeal had not been lodged within the two-week window that was available to Mrs Wetherilt’s daughter.
Many of us recognise that in cases such as this one, when a constituent’s family is caring for them, the family’s priority is looking after their family member and it is not to follow an appeals process within a two-week window. People become very emotional and providing care takes precedence. That care is the priority. Consequently, the tone and the attitude adopted by the PCT are utterly bureaucratic and deeply unhelpful.
Mrs Wetherilt’s daughter has also offered to work with the PCT to find out whether it is possible for the PCT to part-fund her mother’s care, but that suggestion was dismissed by the PCT without even being addressed. That is another example of the inflexible bureaucracy that fails to put patients’ care and needs first. It is more about the process—ticking boxes and filling in forms—and that is wrong.
I have a final shocking case to highlight. It is one that I have raised previously in the House and it is that of my constituent, 14-year-old Bethanie Thorn. Last October, Bethanie was struck down with a terrible illness and left bed-ridden. She literally went from being a healthy teenager one day to being completely bed-bound two days later. The cause of her symptoms was unknown and she became unable to eat as her condition deteriorated. Nevertheless, she faced lengthy delays to get an MRI scan and the other vital checks that were needed to diagnose her condition.
It was only last November, when I raised this matter on the Floor of the House, that the Secretary of State looked into Bethanie’s case and appointments were made for her to have an MRI scan. People in urgent need of an appointment should not have to rely on the Secretary of State, local newspapers or their constituency MP to raise their case and sort appointments out. It shows how serious this case was that, shortly after her scan and check-up, Bethanie was admitted to hospital and she was only able to return home two months later, at the end of January. Her mother has effectively become her full-time carer and her family have had to battle at every single stage for care, appointments and treatment, which is appalling. I must say that, if Bethanie had received the appointment that she needed straight away, she would probably be in a better state of health today. The Minister will appreciate that this has been terribly distressing for Bethanie and her family.
When the NHS was pressed about this case, the only explanation given for the delays was something described as a “broken pathway”. I have no idea what a “broken pathway” is in NHS management talk, but the case has highlighted just how damaging poor performance and failures in NHS services can be to individuals. This girl’s life has changed beyond all recognition now. This case also demonstrates what can go wrong when there are endless layers of bureaucracy in the NHS; it was unclear throughout whether it was Bethanie’s GP, the PCT or the hospital services who were actually responsible for ensuring that Bethanie received the care that she needed. There was to-ing and fro-ing constantly—there really was.
Like all Conservatives, at the last general election I was absolutely proud to stand on a manifesto commitment to cut the waste and bureaucracy in the NHS, so that we could invest in the front-line services and give more powers to doctors and patients. I want to reiterate that in my short tenure—10 months—as a Member of Parliament, all I have seen are examples of how bureaucracy has got in the way. If nothing else, I will continue to battle to get the services for my constituents, in the face of adversity—that is, in the face of bureaucracy.
I welcome the measures that have been announced by the Government about the reforms and plans for the NHS. The purpose of mentioning these cases now is to highlight the fact that in Essex we have seen more of the non-medical side of the NHS in action locally than we have of the medical side, which shows the need for reform of patients’ treatment.
Finally, I want to draw attention to the fact that there is some hope for my constituents. That is the hope that they have placed in Government legislation to reform the NHS. As the Minister will recall from Health questions last week, Witham town is the most urban part of my constituency and Witham town council and others have put forward a very strong case for there to be more health care specialist services in our town. Although Colchester, Braintree and Chelmsford all have significant health facilities, including general hospitals and community hospitals, there is nothing for the people of Witham in our town, and there is nothing for the people from the surrounding villages. That gives the impression locally that there is a two-tier health system.
I mentioned at the start of my remarks that the Witham area includes some pockets of serious deprivation and has a growing population. Unfortunately, the PCT has not taken enough action to close the gap created by the changing demographics and local needs. Maltings Lane is a new housing development in Witham town. It has evolved over a number of years, and many more new homes and other facilities will be built there over the next 10 years, but it was begun with no plans whatsoever for additional health care services. That issue needs to be addressed in the long run, and I hope that the Minister can help my town council, along with our district and county councils, to work with the PCT and the forthcoming GP consortia to develop additional local services that seek to meet local needs. The issue is one of supply and demand, and there is a crying need but no provision.
As a starting point, the town council, to its credit, is working cross-party locally with all our councillors, and has put together a list of services that Witham needs, including an additional surgery, an out-of-hours walk-in clinic, minor injury, oncology and out-patient clinics and a diversity of medical-testing facilities. By adding some of those services to Witham and the surrounding communities, we will naturally see real benefits in the form of health care provision, choice and diversity, and we will enjoy the convenience of more local NHS services.
I am conscious that I have spoken for a considerable time and that many other Members wish to speak, so I shall conclude by saying that although I could raise many more health-related issues, I hope that I have given the Minister a real insight into the challenges that we face in Mid Essex, where we are surrounded by a lot of health activity but have had this bureaucracy that has stifled both the delivery of front-line care to patients, and the choice aspect of health care provision locally. I thank the Minister and colleagues for their patience in listening to my remarks, and I look forward to the Minister’s response.
I congratulate my hon. Friend the Member for Witham (Priti Patel) on securing this debate, and particularly on how she has raised concerns on behalf of her constituents. Witham is very fortunate to have her as its representative.
I served on the Health Committee for a decade; in fact, I was on it for so long that towards the end of that time we were repeating inquiries. We travelled to a number of countries and when we returned home, we always concluded that our health service was the best in the world. We did wonder, however, how on earth we would fund the service if we were starting it from scratch.
Since I first became involved in health matters, the needs and demands of the health service have changed dramatically. I am in a very good position to comment on such matters because when Ann Widdecombe was shadow Secretary of State for Health I was one of her troops, serving on the Committee on the Bill that brought into force primary care groups and primary care trusts. Although the right hon. Member for one of the Southampton constituencies got slightly irritated with my endless questioning and long speeches, if anyone is very sad and wants to read Hansard I recommend the speeches that I made then because everything that I forecast would happen, sadly, has happened. It has taken the present Government to reverse what happened 13 years ago.
I am very familiar with four hospitals: Newham General, the King George in Ilford, Basildon and Southend. I will not share my views of my experiences at those hospitals, because I was there not just as a politician but as a user, along with my family. I shall simply say that the experiences were very different from one another, and they are ongoing.
Let there be no doubt that I agree with everything that my hon. Friend the Member for Witham said. I have to be slightly partisan; I have to tell my hon. Friends who were elected last year that I feel very strongly that during the 13 years of Labour Government the word “deprivation” was not on the register at all for the south of England. There is no doubt that resources shifted from the south to the north. All I say to the Minister, who has a wonderful background, is that I hope we will now be treated fairly. I am confident that that will happen.
I am more concerned now about management generally, particularly that of our hospitals. Why is a school considered good? Because it has leadership from an excellent head. Why are transport facilities good? Again, because there is good leadership. Why is a country successful? It is because of a great Prime Minister. I am challenged on a number of fronts by leadership in our hospitals. I will not go on about matrons, but when people are anxious and have health problems, with which they need to go to A and E for example, they want to know who is in charge. It is not rocket science. Nor is cleanliness and all the rest of it. Leadership is so important, and I do not care if a leader is seen as a bossy boots, like Hattie Jacques. I am fed up with managers who have endless meetings. What are they meeting about? As MPs, we have to take full responsibility for how we represent our constituencies, and if something is not right it is down to a hospital’s chief executive—it is no good their blaming the troops.
My hon. Friend the Member for Witham touched on some matters concerning Essex, for example the demographic pressures and shifts. The council and the NHS have developed, and are continuing to develop, joint commissioning arrangements there. That is very good. In Essex, we are working hard to implement the White Paper, and are progressing well with putting into practice the Government’s flagship reforms. The Secretary of State has been criticised in some areas for rushing the reforms, but in my time in the House I cannot remember a shadow Secretary of State who was in post for as long as my right hon. Friend was, so he had a lot of time to think about the reforms. This is the only job that he wanted, so the idea that he is rushing is wrong.
In Essex, commissioning with the independent voluntary and community sectors is going extremely well, as is the scrutiny of health functions. As the changes—some of which are controversial and challenging—go through, will the Minister reflect on how our hospitals are managed? That is so important. In my previous constituency the fullest age profile was for young people and in my present one we have the most centenarians in the country, so the challenges are very different in different places.
I want to raise a number of quick points. I will not cause the Minister angst, but she will be aware that there is an issue locally with the Essex Cancer Network and the proposal for an increase from seven to 10 linear accelerators. I hope that any increase is in Southend, and that we do not look further afield. The Minister would expect me to say that, and I do not want to put her in a difficult position.
For the past nine months, all health and social care partners and representatives of patients, carers and care homes have been working in a formally governed partnership to deliver an innovative and integrated model of care for the elderly locally. Will my hon. Friend the Minister look at how we are dealing with that? Over the past year, partners have worked together to open a new “step up” intermediate care facility on the Southend hospital site. I wish that many years ago, managers had considered more carefully when deciding to close Rochford hospital. Unlike Basildon hospital, which has plenty of land around it, Southend hospital is landlocked and has nowhere to expand, and we are paying the price.
Demand for care of the elderly is increasing, and I am not entirely convinced that we have a solution at the moment. Children’s services in south-east Essex are doing well. We have been recognised as baby-friendly by UNICEF and have received a certificate of commitment. We are launching a new service for children and young people with disabilities and we are opening a new diabetes rehabilitation suite. Southend hospital has secured a patient safety award. Many good things are happening.
GPs are being asked to deliver health care reforms. When Bernard Ribeiro, who has now been made a peer of the realm, was the lead consultant at Basildon, it was clear where the leadership of consultants was. I am puzzled to know who leads groups now. Endless meetings are held, but we need ownership and someone to take responsibility for what happens when a patient arrives at hospital. Who sees them first? When they go to accident and emergency, are they seen quickly by triage? Who deals with their case afterwards?
We have many wonderful GPs in Southend— Dr Husselbee, Dr Pelta, Dr Lawrence Singer, the Zaidis; the list is endless—and they are all working hard to deliver what the Government want. I believe that my constituency has the only GP pathfinder consortium in south-east Essex, and it has one of only seven partnerships in the east of England announced during the first wave. The group covers a population of nearly 80,000 patients, mainly in the west of Southend.
The practices have been working well together for the past three years and have managed to set up out-of-hospital ear, nose and throat, gynaecology and urology services, which give rapid access to specialist care at less cost to the NHS than at present. The group has implemented a clinical gateway that enhances GP referrals, reduces waste and ensures that patients get to the right specialist first time, which is critical to reducing the amount of money spent and the stress caused to patients waiting for referrals. Practices co-operate closely, with patients attending other surgeries for minor surgical procedures.
As a result of such close working for the past three years, the group is moving forward and seeking to become a sub-committee of the primary care trust, which will not exist within 18 months, and to take greater control of the budgets delegated to it by the PCT. The group has ambitious plans to improve care for the elderly, which I salute, as well as the health of patients with long-term conditions.
When local authority work begins, close working relationships will be vital to align the health and social care budgets to enable—colleagues might be puzzled by this phrase—more integrated working. That will be better for patients and lead to greater efficiencies. Similar joint working is happening between community and mental health programmes. The Health and Social Care Bill clearly puts patients at the centre of the NHS. This is controversial, but when budgets are stretched it is vital that the public are part of the process for deciding how the commissioning budget will be spent. We must take people with us if they are to accept that resources are scarce.
I am delighted to say that our local group has a grant from the Department of Health to define what public involvement should look like. A successful meeting was held recently involving a wide range of stakeholders—that awful word—including patient voluntary organisations, special interest groups and representatives from the local involvement network, Southend and Essex hospitals and the community. It is expected from the initial meeting that an agreement will be reached on how the public can best be involved, both at strategic level and in making decisions about specific projects. One possible outcome involves forming a group of health champions who have received training on commissioned health services.
I will not take up any more of the House’s time, as it is not fair to the colleagues who are waiting to catch your eye, Mr Dobbin, but I say to my hon. Friend the Minister that it would be good for the Department of Health to take seriously any representations made by hon. Members for the great county of Essex.
I, too, congratulate my almost-neighbour and hon. Friend the Member for Witham (Priti Patel). She made an incredibly powerful case about the individual against the state and the powerlessness that people feel against state agencies, which is why we need to return power to the people. I thank her for securing this important debate. I am sorry that my hon. Friend the Member for Southend West (Mr Amess) has been to all the hospitals in Essex apart from Princess Alexandra hospital in Harlow. I strongly recommend it; it is a good place.
As has been mentioned, Essex is a large county, with five primary care trusts and more than 1.4 million people, which is roughly the same population as Northern Ireland’s. Some variation in such a large area is natural, but sadly, my constituency contains serious health inequalities, despite the best efforts of local staff and the Princess Alexandra hospital. Addressing them is not just about health and a stronger work force; to me, it is also about social justice.
I have three points. First, we suffer from significant health inequalities, as I said. Secondly, Harlow has a good hospital; it has its problems, but I strongly support its bid for foundation status. Thirdly, we have a history of funding problems, particularly in west Essex—I am glad to move from north Essex to west Essex—and they must be addressed.
On health inequalities, sadly, more men die from alcohol-related causes in Harlow than in any other district in Essex. The latest statistics show that there are 45 such deaths in Harlow every year, double the rate in nearby Uttlesford and about 50% more than the east of England average of 30 a year. I accept that Harlow is a major town, but families there are struggling with a particular problem, and the rate is higher than in similar towns in Essex such as Colchester and Basildon. Harlow also experiences some of the worst rates of child and adult obesity in Essex. Government statistics show that one in five 11-year-olds in Harlow is obese before leaving primary school. Some 55% of 15-year-olds in Essex drink alcohol, 19% are regular smokers and 13% use drugs, but the problem is particularly acute in Harlow. The rate of adult drug abuse in Essex is 4.8 per 1,000, but in Harlow it is nearly double, at 8.3 per 1,000.
I do not want to paint a negative picture of Harlow. I am proud of my town and constituency. There is some good news. Local faith and charitable groups are aware of the challenges and are responding to them. The organisation Open Road runs an SOS bus and does other anti-drug work, helping people access advice, information, support and more formal treatment if needed. Some other remarkable drug rehab charities do essential work behind the scenes. There are many walking groups, and I have been to a number of events organised by the Harlow athletics club, which is one of the most distinguished groups in the region. Projects such as Kickz work with young people, providing football, boxing and other fitness pursuits.
In that context, Princess Alexandra hospital has had problems, but hopefully it will become a foundation hospital. With a new chairman and chief executive, the hospital is making a strong bid for foundation status, which I support. I have found the chairman of the hospital, Mr Coteman, to be open, honest and straight-talking about the difficulties that we face in Harlow. He is also dedicated. On Christmas day, I visited the hospital wards with Harlow hospital radio and was astonished to see not only that the chairman was going around visiting patients, but that he had brought his whole family with him after travelling from Cambridge for the day. That shows a lot of commitment to the hospital.
It is not just Mr Coteman. I visited the cancer ward at Addison House with Robert Duncombe. The ward is very well run. We have talked a lot about waste and bureaucracy, and of course, we have those problems, but it is a completely different story at Addison House, where five staff share a small office, and when I say small, I mean really small.
The Princess Alexandra hospital is at the cutting edge of research, with its cellular pathology laboratories, for which I hope NHS support will continue. Having visited the laboratories, I know that the genius of their people and their technology is remarkable and bests anything in the private sector. However, the difficult environment means that the Princess Alexandra hospital needs the foundation status for which it has applied in order to take its work to the next level.
I want to touch upon the history of the funding problems in west Essex, which are all the more serious given the health inequalities that I have described. Under the previous Government, West Essex primary care trust struggled with the 20th worst deficit in the UK, and the black hole for 2009-10 was nearly £2 million. I welcome the coalition Government’s commitment to increase health spending in each year of this Parliament, but it is a question not only of getting the right resources, but of spending the money wisely.
When I was a parliamentary candidate, I found out, via a freedom of information request, about a £700,000 cut in funds to the NHS walk-in centre in Harlow. Finances had been mismanaged, so much of the investment was wasted. There have been serious problems with health management, as well as health inequalities, which we must address under the new ways of devolving purchasing power to GPs. I particularly welcome the pledge to remove strategic health authorities, because they seem to be a complete waste of resources and an unnecessary tier of bureaucracy. That money would be much better ploughed into the work of nurses, doctors and health visitors on the front line. I think that the Health Secretary said at the Conservative conference that managers have so far been cut by 2,000 and that front-line staff have been increased by 2,700. I am sure that the Minister will want to clarify that.
On NHS fuel and petrol allowances for workers, I was astonished to discover when I visited my mental health trust that NHS mental health professionals who use their cars all day for their work—this is not just about commuting, but about visiting patients—get tiny fuel allowances, some just 12p a mile. I have tried to investigate the issue, but there seems to be a spaghetti junction of authorities that decide what the rate is. It is unfair, when petrol is at £1.35 a litre, that their fuel allowances are so low. I urge that dedicated NHS professionals who use their cars all day for their work should get a decent fuel allowance.
We must deal with the health inequalities in Harlow. To coin a phrase, we must be tough on health problems, but tough on the causes of health problems, too. Ultimately, the evidence is that we need more early intervention and preventive work, but the cause of many health problems is social deprivation. It is jobs, a stronger economy, higher employment, and opportunity for the many and not the few that will give us a healthier society, which is why I welcome the Government’s economic reform, with lower taxes for lower earners and deficit reduction. It is about not just pure utilitarianism, but social justice.
We must do more. We need more partnerships with grass-roots community groups, such as the local Harlow branch of the Alzheimer’s Society and the Harlow athletics club, which I have mentioned. Hospitals should be the first, not the last resort, which is part of the problem that we face in the NHS today. To do that, resources must be directed towards prevention, and the best people at prevention are the small community and faith groups already in our estates, working with people. When we open up NHS contracts, we must make it easier for small charities and firms to bid for them, as well as the larger, “Tesco” charities. There is fear in some parts of my constituency that our health reforms will be monopolised by vast health conglomerates. I very much hope that we see more co-operatives. I understand that the PCT in Kingston has become a co-operative. If that is the case, I hope that it will be a model that other PCTs and GP commissioning bodies can follow.
I have always said that the big society will only work if we build the little society, too. We must bring real localism to our NHS. We have to give patients meaningful choice. Harlow struggled for years with top-down cuts under the previous Government. For example, the North Essex trust, which, as has been mentioned, supplies mental health services, suffered a £5.3 million cut in 2007.
Finally, why is it that whenever the previous Labour Government cut our services in Harlow, it was presented as a fact of financial management, but whenever the coalition Government are forced to cut spending, it is seen as an ideological outrage? That double standard must be addressed. I am glad that our NHS budget is guaranteed to rise in real terms every year in this Parliament, and hope sincerely that Harlow patients and residents will get their fair share. I look forward to the Minister’s forthcoming visit to Harlow to see for herself the NHS in operation.
Before I call the final speaker, I remind hon. Members that the wind-ups normally start at 10 past 12.
Thank you, Mr Dobbin. Like my hon. Friends, I should like to congratulate my hon. Friend the Member for Witham (Priti Patel) on securing this debate and on giving an articulate exposition of the inherent tension between process and outcomes. I think that one thing that we are all looking forward to from the Government’s health reforms is a greater focus on achieving outcomes and rather less on the processes that she has outlined.
This issue is of great importance to my constituents in Thurrock. Frankly, considering recent years in particular, the performance of our local health services needs to be better. I pay tribute to the staff involved in the care and treatment of patients—they discharge their efforts with the best of intentions and commitment—but, as my hon. Friend the Member for Southend West (Mr Amess) has pointed out, what is often lacking in the health service is leadership. In south-west Essex in particular, poor management at a number of levels has resulted in too many people being failed and in local people’s confidence in the local health provision being too low. We all need to work hard to improve that and give people the health services they deserve.
I shall give some clear examples. My constituents rely on services provided by Basildon hospital, and the primary care trust responsible for delivering them is South West Essex PCT, which is currently implementing a severe programme of cuts, following a significant overspend. I shall deal with the hospital first, but as hon. Members will realise from my remarks, the ongoing issues at Basildon are interlinked with the overspend in the PCT. Dealing with that overspend will have implications for the hospital, too, so there is a great deal of uncertainty among my constituents, and a serious lack of confidence in local health services at present.
Basildon hospital has had a difficult recent history. In November 2009, the then Secretary of State, the right hon. Member for Leigh (Andy Burnham), made a statement in respect of Basildon hospital, following concerns about excessively high mortality rates there, which my hon. Friend the Member for Southend West will remember extremely well. The then Secretary of State said:
“There is still considerable variation in standards throughout the NHS, from one hospital to another, and in some cases the variation is unacceptably wide. That is the case in respect of Basildon and Thurrock University Hospitals NHS Foundation Trust.”—[Official Report, 30 November 2009; Vol. 501, c. 855.]
[Hywel Williams in the Chair]
Since that time and despite various programmes to tackle poor performance at the hospital, my constituents and I are concerned that such variation is unacceptably wide. The hospital management tell me that things are improving, but my postbag tells a very different story. Although many constituents report excellent treatment at the hands of the hospital, simply too many do not. As I say, week in and week out, there are reports in the local press of new things that have gone wrong. The impact on my constituents is that they simply do not have confidence in the hospital and they do not want to be treated there.
It is true to say that there has been some improvement since 2009 but, returning to the then Secretary of State’s statement, that has happened from a very low base. The Care Quality Commission continues to find that there are serious deficiencies in patient care. Most recently, the CQC’s February 2011 report states that of 16 measures taken into account, four needed action and six received suggestions for improvement. Criticisms include a lack of consistent nursing care, a failure to check that equipment is safe, the need for improvements to care for patients with dementia, and issues with poor nutrition and weight loss going unreported.
The hospital’s management are taking rather too much satisfaction from the improvements reported by the CQC. It does no one any good that the reputation of Basildon hospital remains so low. However, there is an opportunity to achieve real change. The current chairman is due to depart and I hope that the Minister will take steps to ensure that the opportunity is taken to provide some decisive leadership to the board, so that the real challenge to improve performance can be dealt with.
On the state of NHS South West Essex, many treatments have recently been cut by the PCT—including in vitro fertilisation—and restrictions have been put on cataract operations. As a Government, we have promised to protect the NHS budget from cuts and we have held to our promise. However, in south-west Essex, people just do not believe us because they are faced with a cost-cutting programme to fix a black hole of some £50 million. How did the PCT get into such a mess? In the past two years, it has taken on 100 extra backroom staff. Those people were not involved in front-line delivery; they were working in the PCT headquarters. The PCT also spent money building a community hospital in Brentwood that is far bigger than required. When I visited that hospital, I went around switching on lights in redundant facilities. That service was commissioned under the private finance initiative, so it will be an enduring cost to the NHS budget. It is a classic example of complete incompetence in managing the commissioning of a service.
A further reason for the overspend brings me back to what has happened with Basildon hospital and the impact that that is having on the wider health provision in south Essex. As confidence in Basildon fell, patients were desperate to be treated elsewhere, which meant that the PCT had to buy services from other hospitals in Essex, London and Kent. The hospital was faced with a loss to its income because of the decline in demand, and it dealt with that by routinely booking additional out-patient appointments in the knowledge that the PCT would pick up the bill. Such a situation added to the financial pressure.
No one has been held to account for the PCT’s overspend. Patients therefore perceive what has happened to be a direct result of the Government’s programme. I cannot emphasis enough that that is not the case. The responsibility for that overspend rests firmly with the PCT’s management. It is disappointing and bad for public confidence that no one has taken responsibility. Unless someone is held accountable, how can we ensure that our constituents regain confidence in the system and trust what we say? When we say that we are ring-fencing the NHS budget, that sounds pretty hollow to my constituents. I pay tribute to Andrew Pike, the newly appointed chief executive of the PCT. He has grasped the nettle and is making the necessary painful decisions to turn the situation around. The price of that is an accelerated programme of redundancies and carefully managed demand for services. That means patients are not getting seen as quickly as they would have done, and my constituents are not getting the same standard of service they would if they lived elsewhere. It also means that the new hospital planned for Grays is likely to be delayed as we fill the black hole, which will lead to much disappointment locally.
I look forward to hearing the Minister’s comments on those issues. Too often, poor performance in the NHS goes unchallenged. While ever-senior NHS managers continue to draw hefty salaries, the least we can expect is that when things go wrong, someone steps up to the plate and takes responsibility. It is galling for members of staff to receive redundancy notices when the people who are responsible for that overspend remain on the NHS payroll. I hope that the Minister will take action to improve accountability among senior management because that will go a long way towards rebuilding confidence.
The hon. Member for Witham (Priti Patel) is to be congratulated on obtaining the debate. Many of my constituents move to Essex as a kind of upward trajectory, so I listened with great interest to what she had to say about a part of the world with which I am not as familiar as I probably should be. The week after the Lib Dems have turned savagely against the Conservative-led coalition’s health care policies—the British Medical Association is debating them today and, as we know, doctors are very worried about what is proposed—hon. Members will expect me to touch on the health reforms generally and how they will affect the people of Essex.
I listened with some sympathy to the complaints of the hon. Member for Witham about bureaucracy. As I have been a Member of Parliament for 20 years, I have tangled with more bureaucrats than I care to remember. However, I always like to stop short of sounding as if I am dismissing people who work for the health service as a whole. My mother was a nurse. She was one of that generation of West Indian women who helped to build the health service after the war. We have to remember that however frustrating it is as Members of Parliament or even as members of the community to deal with bureaucrats in the health service or elsewhere, there are thousands and thousands of people without whom the health service could not work or function. They will tell us that they have survived more reorganisations than they care to remember. They are still there, getting their heads down and trying to provide a service for our constituents.
The hon. Member for Witham made an important point about the proportion of elderly people in our population. We do not have time to deal with that matter fully, but people are living longer and they are suffering from ailments such as Alzheimer’s and other things. Elderly people make up an increasing proportion of the population. A few weeks ago, I went to a nursing conference and a senior nurse said to me that, when she was on the wards, the mean age of elderly patients was about 80. The mean age of elderly patients is now 90 or 100. Elderly people now pose very different problems from those that the elderly posed a few years ago. It is important that we consider the question of how we secure high-quality care—I am reminded of that awful ombudsman report that was published a few weeks ago—how we pay for it and how health care interconnects with the issues of public health and social care. I hope that we will have a chance to return to those matters.
I remind the hon. Lady that, despite her letters to bureaucrats and her undoubted frustrations on behalf of her constituents, when my party left office, satisfaction with the health service was the highest it has ever been. Hon. Members can say that the population was deluded on that, but I do not think that that is correct. We are talking about massive MORI polls. People’s satisfaction was higher than ever. There had also been massive levels of investment, not least in Essex. She will be aware of the new unit at Colchester general hospital, which includes an updated children’s ward. It is fully open and operational, and that £20 million project marks the biggest investment in the hospital’s facilities since it opened in 1985.
Apart from general frustration with bureaucracy, there are specific issues in relation to health care in Essex that are worth mentioning in this short debate. The hon. Lady mentioned Broomfield hospital. She will be aware that, just a few weeks ago, it was highlighted that although the hospital takes more than £1 million a year in car parking charges, its car parks still lose money because it is spending £1.2 million on running costs, including on CCTV, attendants and capital investment—they must be extremely well paid attendants. We also know that the hospital’s move into its £148 million PFI wing was delayed twice before finally opening in late 2010. The opening day was pushed back because staff were trapped in faulty lifts. We also know that the same hospital spent £400,000 on art for its new wing, which was commissioned as part of the development and funded through PFI. PFI is expensive enough—we may debate that at another time. To spend the money on art, when we know how ridiculously expensive PFI can be, seems quite strange.
There have been all sorts of care warnings about hospitals in Essex, such as Queen’s hospital in Romford. We know that the Romford project will be the first of a number of pilot reviews of PFI contracts to see if the costs can be brought down, and anyone who cares about the health service must welcome that. We know that the Braintree community hospital has defended itself after paying out nearly £20 million in damages for clinical negligence. If we are focusing on bureaucracy, we have to focus on how those things happen. We know that the Southend University Hospital NHS Foundation Trust, with which hon. Members will be familiar, has had to respond to concerns about safety, which were raised by the Care Quality Commission. We know that the West Essex primary care trust risks not being able to give an 18-week referral-to-treatment time. We know that NHS South West Essex has a very large overspend—its deficit has been improved, but it still has an overspend—in relation not to bureaucrats, but to acute hospital activity.
We also know, which I find alarming, that the Basildon and Thurrock University Hospitals NHS Foundation Trust is now trying to make savings by allowing waiting lists to extend. That implies a 14-week wait on first appointment, which is why an hon. Member on the Government side said that, when ordinary residents and voters are told that money on the health service is being ring-fenced, it rings rather hollow. Up and down the country, not just in Essex, they can see waiting times lengthening, and new hospitals and new health care facilities that have been promised being delayed. It is for the Government, who have made much of their protection of health care spending, to explain that. The real issue is this. The hon. Member for Witham spoke glowingly about the reforms, but sadly I have news for her. She seems to believe that those reforms will help with the issues that she has raised. As she would know, however, if she had followed the Health Committee, there is a real challenge involved in trying to introduce those reforms, whatever we think of them, while at the same trying to achieve unprecedented savings in health care. The Health Committee doubts whether that can be done.
No one argues with the notion that GPs could have a lot to offer in the commissioning of care, but as the president of the Royal College of General Practitioners has said, there are other ways to do that without subjecting the health service to a top-down reorganisation. I do not want to be unpleasant, but the Government promised, all through their time in opposition, that they would not subject the health service to any top-down reorganisations.
Time is against me, because I want to give the Minister plenty of time to respond. That is what we were promised—no more top-down reorganisations. As for waste of money, one problem with letting all those PCT bureaucrats go is that they have to be paid redundancy. The hon. Lady said that she hopes that they will not be paid big redundancy packages. I am afraid that they will be, and many will be re-employed. GPs will be less accountable to patients and the danger that many people, including GPs, see is that the big American health maintenance organisations will be able to get inside and act as commissioners for GPs, who, after all, joined the health service to heal and not to be managers.
I feel sorry for Government Back Benchers. They believe that the issues that they find so challenging about bureaucracy, cuts and patient accountability will be solved by the reorganisation. I can say with complete confidence that, if anything, the reorganisation, which is too fast and at the wrong time, will make those problems worse. It gives me no pleasure to say that, but anyone who has analysed the so-called reforms can see that they are a car crash in slow motion.
It is a pleasure to serve under your chairmanship, Mr Williams. I do not believe that I have had the pleasure before. I congratulate my hon. Friend the Member for Witham (Priti Patel) on securing the debate. The fact that she has attracted so many of her fellow Essex MPs is a testament to the importance of the issue. The health services in any MP’s constituency are always of major concern and it is fantastic to have an opportunity to raise some of those issues in the Chamber.
I must add to the comments made about the staff in the NHS. The staff in Witham, and across Essex, should be congratulated on their work. I trained as a nurse, like the mother of the hon. Member for Hackney North and Stoke Newington (Ms Abbott), and worked in the NHS for 25 years. I understand, therefore, some of the complexities of their job, and their dedication and expertise in driving benefits for my hon. Friend’s constituents on a daily basis is valued greatly. As a Government, we want to ensure that we support all staff and give them the framework to provide the highest standards of care for everybody they treat.
Before I go further, the hon. Member for Hackney North and Stoke Newington need not feel sorry for Government Back Benchers at all. She does them a disservice by suggesting that they do not see the reforms for what they are. They are an opportunity, for the first time, to bring patients and their clinicians closer together in shaping the services that they need. She is right to say that the previous Government put untold investment into the NHS. Spending on health doubled, if not more, in the time that they were in government. It is important to realise, however, that just chucking money at services does not mean that they will get better—we need to have value for money. Taxpayers expect and deserve that, and for every pound of taxpayers’ money that goes in, £1-worth of services needs to come out at the other end, and that is central to the debate.
We have set out proposals to free the NHS from bureaucracy and central control. My hon. Friend the Member for Witham eloquently set out her concerns, as did a number of other hon. Members, about those levels of bureaucracy and about her constituents receiving the health care that they need, with the choices that they want and with the highest standards that they deserve. Like all members of the public, we want to end the overbearing top-down oppression and give front-line professionals the freedom to innovate and make decisions based on their clinical judgment and the needs of their patients, rather than centrally dictated, process-driven targets that have dogged the NHS in the past 13 years.
Responsibility for budgets and commissioning care will transfer from bureaucrats to consortia of clinicians, so that we can drive up the very highest standards of health care and achieve the highest outcomes that are specific to local communities. My hon. Friend the Member for Harlow (Robert Halfon) raised the issue of inequalities in health. It is critical to have outcomes that are consistent for everybody, not just a few, and a much simplified system—without two layers of management, the strategic health authorities and PCTs—which is, actually, reorganised in a way that is less top-down and more bottom-up. Why are we doing that now? Now is the time to do that, because now is the time that we are determined to drive down the overall administrative costs to the NHS, and achieve a better dialogue and partnerships with health and care professionals in all sectors.
Pathfinder consortia are now in place across all five Essex PCTs, involving a total of 146 practices and serving a population of almost 1 million people. The Essex commissioning consortia pathfinder in the area of my hon. Friend the Member for Witham consists of seven practices and serves a population of 70,000—debates are often an opportunity to demonstrate that we know all about the figures. I understand that the Witham practices are in negotiations about forming a mid-Essex consortium.
My hon. Friend the Member for Southend West (Mr Amess) raised a point on funding. As part of our desire to improve the standard of NHS care up and down the country, we are consistently increasing the amount of money that we provide. Total revenue investment in the NHS in 2011-12 will grow to more than £102 billion a year. The allocations announced on 15 December will provide PCTs with £89 billion to spend on the local front-line services that matter most—that is an overall increase of £2.6 billion, or 3%. Of that, Essex will receive £519.6 million, which is a cash increase of 3.2% above the national average. From 2013-14, the NHS commissioning board will allocate the majority of NHS resources to consortia, and funding will be arranged so that every area gets its fair allocation, based on the burden of disease and disability, which, again, is a point that my hon. Friend raised. Details of that will be announced shortly.
My hon. Friend the Member for Witham discussed population growth and demographics, and the pressures that they will bring to bear. I am pleased that the county council is taking a proactive approach—that is the thing to do—to get ahead of the game and make improvements to public health. With an ageing population, it is critical that people stay healthier for longer.
On redundancy and staff, there is, in fact, a great deal of natural wastage in the NHS already, and there are schemes such as the mutually agreed resignation scheme, which is intended to help the process. To some extent, redundancy is dictated by legislation and locally agreed terms and conditions of service. Some good staff will move on to assist the consortia.
The clusters that my hon. Friend spoke about are an important part of the transition, gradually moving upwards through the PCT organisation. The new consortia come in at the bottom. I suggest that she arrange monthly meetings with the PCT because, clearly, there are many issues that she wants to raise, in particular individual cases. She discussed the problems of Mr Shipton and Mr Cross not receiving Sativex. Of course, that will change when we have consortia, and clinicians make commissioning decisions. That will change things, and it will increase the opportunities for patients and their families to affect decisions.
My hon. Friend spoke about the case of Mrs Wetherilt, which sounds absolutely dreadful—no one should have to battle away like that—and she has raised the case of Bethanie on several occasions with the PCT. I do not know the details of it, and, as she recognises, I cannot intervene, but it is important that systems work for people who have complex needs or diagnoses. It is critical that we get that right.
On that point, I know that my hon. Friend the Member for Braintree (Mr Newmark) would have liked to mention the new community hospital in Braintree. It is a good example of a community hospital that serves the local community, which is what people want. I know that he campaigned long before the present Parliament on getting the right services for pregnant women who need maternity care.
My hon. Friend the Member for Southend West has a long and distinguished career on the Health Committee. I could say that I learned everything I know at his knee. Having sat on the relevant Bill Committee, his frustration over the formation of the PCTs must at times be unbearable. Being a prophet of the unwelcome consequences of legislation is not necessarily any comfort, albeit it is to his credit. His comments about leadership are so important, and it is not just clinical leadership but leadership across the board. Something that does not often get a mention is political leadership. Politicians and people in government have to be clear, when they are talking about health services, that nothing but the highest standards and quality of care will do. We have to keep saying that and be unrepentant about doing so. What the Government can do is set the right framework and outcomes. We get what we ask for, and if we ask people to wait more than four hours in accident and emergency, that is what we will get. Whether or not that is measured does not necessarily determine whether anyone gets better. Therefore, the Government have to be clear about exactly what they want, and not chase headlines.
Linear accelerators: does not everyone want one? Everyone would like a linear accelerator. However, my hon. Friend the Member for Southend West is right in saying that we have to take the public with us when we make such decisions. “Consultation process” is a hackneyed phrase now. I do not think that anyone has much confidence in consultation processes. What we have to do, and what I feel we will be able to do through the health and well-being boards and the involvement of local authorities, is get a real and democratic voice for local people. I share my hon. Friend’s dislike of the term “stakeholder”. We are taxpayers; it is our money.
My hon. Friend the Member for Harlow discussed inequalities, and was right to say that they are a matter of social justice. For instance, it is outrageous that in Westminster there is a 17-year difference in mortality: people born in some parts of Westminster may live 17 years less than those born elsewhere in the borough—that is truly shocking.
My hon. Friend raised the issues of alcohol-related deaths and obesity, and discussed the fantastic work done by many local organisations. Again, health and well-being boards will be an opportunity to put public health right at the heart of local authorities, which have a long and proud history of improvements in public health and bringing together all the organisations that do so much.
My hon. Friend was also right to say that there is tremendous social capital in our communities. In my travels around the country—I try to get out a lot, for fear someone might say that I do not get out enough—I have been fascinated to find in some of the most deprived areas the greatest social capital, innovation and response from local communities to do something about their problems. They want a way out of poor health outcomes and the crime in their area, and their resourcefulness is outstanding.
My hon. Friend the Member for Thurrock (Jackie Doyle-Price) discussed variations between Thurrock and Basildon. She was right to say that they are completely unacceptable. We cannot interfere from the centre with appointments, but she was right to reiterate the need for first-class leadership, and it was good to hear her positive comments about the new chief executive. The organisations around the country that do well have good leadership, and it is not about driving a coach and horses through something, which is what I fear the previous Government tried to do. They tried to dictate from the centre and tell people what to do. Actually, what good leaders need is inspiration and enthusiasm. They need to gather people up along the way and have a clear vision of what everyone is working towards. Such skills are hard to define, but we recognise them when we see them. I hope that Essex will get the leadership that it clearly deserves, and for which all Members of Parliament in that area have been fighting.
I agree 100% with my hon. Friend on getting accountability right. As a constituency MP who has a PCT with one of the worst financial records in the country, I know that, sadly, it is the public who suffer as a result of poor management. We are determined to get accountability right. Again, that comes to setting the right outcomes.
I believe that GP consortia, health and well-being boards and public health in local authorities will result in the kind of joined-up planning that all Essex Members want, and that we will see the improvements in health care services and public health that we want. I have outlined some of the ways in which we intend to transform the delivery of services and ensure that, in the transition from the old system to the next one, we get a patient voice that is loud and clear, and that patients get the services and the care that they need and deserve.
(13 years, 9 months ago)
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Thank you for calling me, Mr Williams, and for presiding over this debate. The Richard Lee primary school in my constituency is a 1950s Hills-system-built school. It is built of reinforced concrete and high-alumina cement, and it has simply come to the end of its design life. Its rebuilding was repeatedly delayed because of needs arising from rising rolls in Coventry and demand for new-build schools, but it was due to be rebuilt in 2009. As a result of the collapse of another school in Coventry, that rebuild was further delayed.
The devolved capital budget for the Richard Lee primary school last year was £49,150, £40,000 of which was spent on essential repairs and maintenance, leaving practically nothing for any development within the school, any enhancements or any improvements. This year, that devolved capital money has been reduced to £9,439. The main problem with the Richard Lee school, according to the head teacher, is that it badly needs a new roof. It simply cannot be patched any more. There are patches on patches, it is coming apart, and water is ingressing the school in many places. Even if a new roof were possible with the school’s construction, it would cost in the order of £500,000.
The school needs a new boiler, and has had to close twice in recent months because the boiler has failed, but the cost would be £40,000. The windows, which form entire walls in many of the classrooms, are being pulled apart by the strains on an ageing building. As a result, they are draughty, cannot be secured, and are sometimes sealed with curtains and pieces of cloth to make the classroom environment something like bearable. A quote for replacement windows is of the order of £110,000.
Six toilet blocks are in need of refurbishment at a cost of £7,000 a block. There are awful smells and regular flooding from blockages. Despite £15,000 being spent to sort out the drains, that did not solve the problem in its entirety, and on one occasion sewage flowed freely across the school car park. There is rising damp in classrooms. They are being recarpeted and retiled regularly, but children cannot sit on the floor for story times or anything else without sitting in wet.
There is a lot of asbestos throughout the school, and although it is safe in its undisturbed state, the cost of any repairs is considerably higher than it would otherwise be. Because capital funding is being spent on repairs and maintenance, second-hand furniture is regularly bought from other schools that manage to obtain new equipment through their budgets.
The Minister and the Government claim to be interested in the big society and believe that organisations other than the Government should make a contribution to the maintenance of services that people need. The school is pretty good at tapping into local organisations and scrounging money. Local firms, such as E.ON, Jaguar Land Rover, the Prince’s Trust and local church groups, have all helped by painting and decorating parts of the inside and outside of the school. When I visited it recently, there was evidence in two separate classrooms of teachers painting the walls having bought paint to decorate their own homes.
A burst water heater resulted in reception children being taught in the corridor for more than six weeks while attempts were made to dry out the classrooms and lay new flooring. The children returned to their classrooms in February, after the half-term break, but sadly the new flooring is already beginning to lift because of damp and will have to be removed again during the Easter break. I hope that this time it will be refloored satisfactorily.
The education welfare officer, who monitors attendance weekly, is worried about the number of absences through illness. With 4.5% of pupils absent, she believes that those genuine absences are due in part to the cold, damp conditions that the children must endure in many of the classrooms. The school does not comply with disability discrimination legislation. It has seven flights of stairs inside and four outside. They cannot, without huge expense, be adapted with ramps or lifts because of the nature of the building.
The council is so worried about the state of the school that, in May last year, it commissioned a technical report to see what needed to be done, whether the school was safe, and what the options were for keeping the school open and viable. A technical report by Martech Technical Services Ltd said that for the time being the school is safe, despite evidence of carbonisation of the cement, and therefore the beginning of corrosion of the steel reinforcement of the concrete structure, and that it could have its life extended for 10 years, but that the costs would be considerable. A simple 10-year extension of the school’s life would require concrete repair costing about £20,000, corrosion inhibitor costing about £40,000, anti-carbonisation coatings costing about £30,000, a new roof, which the head put at £500,000 and Martech put at £450,000, and preliminaries costing about £90,000. It gave no figures for contingencies such as removal and replacement of ceilings, asbestos removal, access and internal redecoration. I put those figures to the Minister in the light of the school’s capital programme of £9,439 a year.
As I was going through what I would read out from the report, I was worried that the Minister would think that I am exaggerating the difficulties, so would he be prepared to visit the school? I have been in politics for a long time, and I am rarely surprised by what I see. Nevertheless, a visit to this school is shocking. It is a good school and its recent Ofsted report—received only yesterday—stated that there have been considerable improvements, that the school is well led with an engaged and supportive governing body and that the teaching staff have made significant efforts to improve the output of the school. Ofsted is not obliged or encouraged to talk about school buildings, as that is not part of its job. In this case, however, the Ofsted report did comment on the state of the building and the impact that that was having on the school.
What on earth is the school to do with £9,400? The council is desperate to include a rebuild of the school in its capital programme, but the uncertainty about that programme, and the diminished resources that it has for the whole school estate in Coventry means that it is worried about committing to technical appraisals and the architectural work that would be needed. It does not know whether the rebuild money is likely to be forthcoming in the near future, and such technical work would take a big slice of the Coventry capital programme. I would like the council to go ahead with the necessary preliminary planning work so that the school can be rebuilt at the earliest opportunity. I do not believe that extending the life of the school is in any way viable, but the council needs reassurance about its future capital programme before it makes a considerable outlay at the expense of other school needs in the city.
I do not know whether the Minister can provide any comfort with regard to plans for the future. The Secretary of State talked about the varying needs of primary schools, perhaps as part of moves to excuse his decisions on the Building Schools for the Future programme. He said that there were other needs, and that it was not only about secondary schools. Having reached this situation, however, there is no alternative for Richard Lee primary school other than a total rebuild, even though, as the Minister knows, that will be expensive and in the order of £8 million.
If the Minister believes that I am in some way exaggerating the difficulties faced by the school, I ask him to come and have a look. I am sure that he will be as shocked as I was by the state of the school buildings. If he cannot find time to visit, perhaps he would be prepared to meet a delegation so that some of the dedicated governors and teaching staff can meet him, and he can see in detail some of the things that I have seen. Most of all, may we have clarity about future funding programmes so that the council can make a commitment to what is needed? Even if we have a programme now, it will be 2013-14 at the earliest before a new school can be provided.
Having got through this winter, I frankly do not know how the school will get through next winter, and I am certain that it will not be able to do so with a capital programme of £9,000. The degree of patching and mending evident at the end of this winter is far more than the school’s resources can cope with. Good people are providing a good education to children in my constituency, but they are being undermined by the appalling state of the buildings in which they are asked to work.
I congratulate the right hon. Member for Coventry North East (Mr Ainsworth) on securing this debate and on raising an issue of concern in his constituency. I do not know whether this is the first time he has secured a debate in this Chamber, free from the constraints of being a Minister; I know how frustrating it can be as a Minister that one does not get the opportunity to air important constituency matters. However, the right hon. Gentleman has certainly aired one such matter today very graphically, and I appreciate the concern that must be felt by him, by parents and by teachers regarding the state of the school that he described.
The Minister responsible for schools, my hon. Friend the Member for Bognor Regis and Littlehampton (Mr Gibb), is unfortunately detained with Committee work today, but I will pass on the request for him to visit that school if he is in Coventry, or to meet a delegation. I know that he has campaigned on behalf of schools in the past, and that he is a strong advocate for improving provision for all pupils, teachers and parents.
As the right hon. Member for Coventry North East knows, improving provision is a priority that the Government share. Even in times of austerity, we are determined to make this country’s education system among the best in the world by ensuring that schools prepare every pupil for success. I congratulate Richard Lee primary school on the comments it received in the recent Ofsted report. The dedication of the teaching staff and those signs of improvement are doubly to be congratulated because of the challenging physical circumstances involved.
Our ambition is based on the simple but profoundly important principles of giving teachers and heads greater freedom, giving parents greater choice, providing higher standards for pupils, and reducing the amount of red tape in the system. We have taken steps to achieve those aims. The academies programme has been expanded, and we are now looking at the national curriculum with the intention of restoring it to its intended purpose—a minimum core entitlement beyond which teachers can tailor their tuition to meet the particular needs of pupils. By February 2011, the Department for Education had received 323 proposals to set up free schools, and that initiative is progressing. Through such changes, each local area will have a good mix of provision, and parents will have real choices for their children.
As the right hon. Gentleman persuasively argues, school buildings, teaching staff and pupils need to be a continuing part of the investment, and the coalition Government are committed to ensuring that that remains the case. However, we are faced with exceptionally tough circumstances. The appalling economic and financial inheritance left by the previous Government, of whom the right hon. Gentleman was a member, is one of those obstacles. The amount that the Government currently spend on debt interest payments could be used to rebuild or refurbish about 20 primary schools such as Robert Lee every day. We urgently need to reduce the deficit, and the previous Government knew that. They had already set a target of a 50% reduction in Government infrastructure expenditure by 2014-15, but they failed to admit that an impact on school building would be inevitable after such a reduction. Although I recognise the parlous state the school is in, it is not something that happened over the past nine or 10 months. The situation has been in decline for some time, and there were opportunities to address it in the past.
The underlying financial position was not the only element that the previous Government chose to ignore. Since four-year-olds are too heavy for storks to transport, there is generally four years’ notice of a child’s need for a primary school place. A small part of the pressure on places arises from migration and immigration, but the birth rate has been rising since 2002, levelling off for a couple of years from 2007.
Two years ago, Members of the then Opposition highlighted the increasing need for primary school places in a debate in this Chamber. On 3 March 2009, my hon. Friend the Member for Kingston and Surbiton (Mr Davey), now the Minister responsible for employment relations, consumer and postal affairs, led a debate on the need for primary school places in London. My hon. Friend the Member for Bognor Regis, now the schools Minister, and my hon. Friend the Member for Brent Central (Sarah Teather), now the Minister responsible for children, also took part. All speakers underlined the need for action to ensure that there are enough school places for the children who need them, and although the debate focused on London, the issue has spread beyond the capital.
Making sure that there are enough places in schools is fundamental; it is the most basic need of the school system. Nevertheless, the Government of the day chose not to treat the matter with the seriousness it required. Instead of tackling the need to which my hon. Friends drew attention, the Government proceeded with their unaffordable and inefficient Building Schools for the Future programme, announcing the entry of new authorities to that programme on 15 July 2009, and last year on 8 March and 5 April, just before the general election.
However, I must be fair to the previous Government. They were not the only ones who failed to respond to rising birth rates and the impending pressure on school places. Local authorities have statutory responsibility for ensuring that there is a school place for every child who needs one, and several authorities have been slow to respond to the emerging evidence of pressure on school places.
As well as being responsible for ensuring that there are enough school places, local authorities are responsible for ensuring that schools such as Richard Lee primary school are kept in good condition. Clearly, that is a particularly big challenge in this case. Schools shoulder some of that responsibility through the delegation of school management to the schools themselves. The central Government capital grant is intended to help, but the maintenance of premises is one of the purposes of revenue budgets. The revenue budget for the 484 pupils of Richard Lee school in 2010-11 was more than £1.5 million, which averages about £80,000 for every 25 pupils—an average class size. Freedoms for schools entail responsibilities and, for every school, those responsibilities include a share of the maintenance responsibility.
However, none of that improves the situation of the pupils of Richard Lee school, some of whom have been having lessons in conditions that no one would regard as satisfactory, as the right hon. Member for Coventry North East rightly highlighted. I was relieved to learn that all the classes are now at least taking place in classrooms. I understand that, as he said, for a spell after the boiler burst, some classes were taking place in corridors, which is completely unsatisfactory.
We are taking a number of urgent and decisive steps to tackle school building needs. First, we have put a stop to the bloated and misdirected Building Schools for the Future programme, because we recognise, as the right hon. Gentleman’s party did not, that the top priorities for investment in school buildings have to be ensuring enough school places and tackling poor building condition—precisely the needs that Richard Lee primary school embodies. Through the work of the capital review that Sebastian James is leading for us, we are developing ways of managing capital that will be more efficient and give better value for the funds spent. We expect the review to report in the next few weeks.
In the announcement of 13 December, £13.4 million was allocated to Coventry city council and its schools for capital investment in Coventry schools in 2011-12. We expect similar levels of funding to be allocated from 2012-13 to 2014-15. The allocation forms part of a national allocation for Department for Education capital of £15.8 billion during the four years from April this year to March 2015. To put that in perspective, the figure for 2014-15 is 60% below the historic high of 2010-11, but the average annual capital budget during the four-year period will be much higher than the average annual capital budget in the 1997-98 to 2004-05 period.
Within the allocations, basic need and maintenance are the areas to which we are giving priority. For 2011-12, the grant to Coventry for new pupil places is £6.5 million and the maintenance allocations come to £5.8 million. It is now up to Coventry city council to decide its priorities for the available funding, having regard to the building needs of the schools in the city and in line with its statutory duties and local priorities.
I seek clarification. I want to make the Minister aware that there are four Hills system schools in the city, two of which are in my constituency. The school that we are discussing is but one of them. He appears to have just talked about a capital allocation for Coventry that in total is about £13 million. He knows that a rebuild of Richard Lee in itself would take about £8 million of that city-wide £13 million pot, leaving practically nothing for distribution to the rest of the city. Is that figure to remain the same, and is my understanding correct that he said we would have clarity on the capital budget within the next few weeks?
The right hon. Gentleman knows that if we had more money from Building Schools for the Future—if money had been spent much more efficiently on the schools that were built at that time—more money would have been left over in the budget to spend on primary schools that are in a parlous state. I did say that the Sebastian James review will report in the next few weeks—imminently—about how we will approach capital spend in the future. I hope that the right hon. Gentleman will be able to take some clarity from that.
The situation is not easy. As I have said, we are in very tight budgetary circumstances, but I entirely recognise the particularly harsh circumstances in which Richard Lee primary school finds itself physically at the moment. I gather that Richard Lee was included in Coventry city council’s original primary strategy for change submitted in 2008 as part of the city council’s primary capital programme. Work on the school was to be a new build project, with an estimated budget cost of £8 million, as the right hon. Gentleman said.
However, the school was not subsequently prioritised in the council’s primary capital programme. That was a matter for the council. Instead, another school was deemed a higher priority due to its condition and the need to address additional pupil numbers. One might wonder about the state that school must have been in compared with the school to which the right hon. Gentleman is referring.
The primary capital programme will not continue beyond the current comprehensive spending review term. Therefore, there will be no opportunity of funding for the school through that route. However, I understand that Richard Lee school is now the council’s top priority for capital investment when funding can be identified.
We know that there are schools, such as Richard Lee, in need of refurbishment that missed out in previous Government capital programmes, and people feel that they have therefore been treated unfairly. We are determined to continue to invest in the school estate overall. It is for local authorities to determine their priorities locally. As I have said, the average annual capital budget during the period will be higher than the average annual capital budget in the 1997-98 to 2004-05 period. However, I recognise that in the short term it will be difficult for schools to adjust to reduced capital funding.
We will introduce a new approach to capital allocation, which will prioritise ensuring enough places and addressing poor conditions as quickly as we can. That model will be outlined in the capital review, which, as I said, will report in the next few weeks. Within the funding available to us, our intention is that the new model will prioritise areas that are experiencing high pressure to increase the number of school places and those with buildings in most need of repair, as would appear to be the case for Richard Lee school.
We are determined to ensure that money is spent on school infrastructure and the buildings themselves, not on bureaucracy and processes, which have claimed too much of the funding in the past. Even when funding is tight, it is essential that buildings and equipment are properly maintained to ensure that health and safety standards are met and to prevent a backlog of decay that is expensive to address. Clearly, the patching of patches that the right hon. Gentleman mentioned is not the most effective way of spending resources.
By stopping Building Schools for the Future projects that were not contractually committed, we have been able to allocate £1.337 billion for capital maintenance for schools, with more than £1 billion being allocated for local areas to prioritise maintenance needs. In addition, £195 million will be allocated directly to schools for their own use. We have also allocated £800 million for basic needs in 2011-12, which is twice the previous annual level of support. We expect similar levels of funding to be allocated from 2012-13 until 2014-15. The capital allocation for this year for Coventry city council and its schools was announced on 13 December, as I said. It is now up to the council to decide how it prioritises its local spending.
I entirely appreciate the right hon. Gentleman’s very genuine and clear frustration with the state of that primary school in his constituency. I repeat my congratulations and thanks to the staff and governors for the job that they are doing in very adverse circumstances. We are determined that in future what reduced moneys there are for capital spend will be targeted at those most in need, in terms both of the condition of the fabric of buildings and ensuring that sufficient places are available, given rising school rolls. I hope that the right hon. Gentleman will be able to see from the results of the James review, coming out soon, how we intend to achieve that, so that there may be some renewed hope for his school—now at the top of Coventry’s priorities—to get a better settlement in the future to deal with the problems that it clearly has. I will pass on his request for a visit or for a meeting with a delegation to the Minister of State, Department for Education, my hon. Friend the Member for Bognor Regis and Littlehampton, who is responsible for schools. Once again, I congratulate the right hon. Gentleman on having raised the subject today.
(13 years, 9 months ago)
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It a pleasure to serve under your chairmanship, Mr Williams. I welcome the Minister to the debate and I am glad to see him almost in his seat.
I spent 11 years as a district councillor in a local planning authority. As many colleagues will know, being a local councillor is a frustrating affair, but never more so than when it comes to the provision of housing for local people. Many obstacles are set in the way of local councillors, and there is often great hostility. With huge numbers of people on the housing waiting list, I wished we had been able to get to grips with the issue better.
Regional spatial strategies provided for local plans and core strategies to include more houses. That was a valuable stick, which ensured that many authorities made plans for homes, when they might not otherwise have done so. However, the inclusion of houses in local plans and local development framework core strategies was almost always achieved in the teeth of fierce resistance from local people. A great many houses were planned but never built, and that is a key issue, which we need to confront. Plenty of areas did not have regional spatial strategies; indeed, in my time, the south-west still had not put even the bare bones of a spatial strategy in place.
Most important, however, the strategies removed the need for local councillors to think about the merits or demerits of increasing local housing. They could simply hide behind the Government’s skirts and say, “It is all that nasty Government’s fault that new houses have come to your area.” They never needed to confront local people or hostile sections of communities about why increasing local housing provision was a good thing. Quite simply, that infantilised councils. Furthermore, the arrangements gave a huge advantage to those who opposed the plans. One thing follows the other; if a positive argument is not made for increasing local housing, it is hardly surprising that the most extreme views on the other side win the day.
I therefore greatly welcomed the Conservative party’s publication two or three years ago of its Green Paper “Open Source Planning”. It talked about a huge change of emphasis in our approach to planning. We were going to consult much more deeply with local communities, about not just the houses themselves but the reasons why they might be required. We were going to acknowledge that people lost amenity when large amounts of housing were built. We were going to provide a carrot, which we now know as the new homes bonus, to compensate local people in some way for the fact that they would have problems when the new houses came along. That was good common sense.
I already knew at that stage that deep consultation was absolutely necessary. In the Winchester district, we had the courage to act ourselves. We went out into the community and consulted widely. We sat down with large groups of local people, ran workshops and tried carefully to explain why we wished to build more homes. As a result, we found that we could persuade people. If we took the arguments out there and set them out rationally, people would listen; they would accept more housing if they could see why it benefited their communities. We received 3,000 separate responses to the consultation, including nearly 50,000 separate comments. That just goes to show that we really can engage communities if we wish to. That change—consultation, getting together with communities and deciding with them what they need for their areas—forms the principle plank of the proposed changes.
Neighbourhood planning empowers local communities to shape their own responses to their population’s needs, as set out by their local councillors, and councillors have to make that case persuasively. That is all well and fine, but where does the new homes bonus fit in? As I said, the issue is loss of amenity, which is slightly difficult to quantify. Most of the benefits that people think about when we talk about new homes are in the realm of public goods. For example, new homes might provide the critical mass for the local shop, ensure the continuation of the local school or reduce out-commuting in search of local employment. All those things are persuasive, and it is difficult to relate them to the fact that people will be stuck in more traffic when they go to work or might find it more difficult to see the local doctor. However, many individual households will see little, if any, direct benefit from the fact that new houses are going up.
Why not soften that blow, therefore, with a contribution towards whatever the community wishes to spend its money on? That is the right way to move things forward. Indeed, why not go further? There has been lots of criticism, certainly from members of the Select Committee on Communities and Local Government, that such an approach somehow involves bribery and that it is a bad idea for money to change hands in the planning system. I understand that argument, and I see where people are coming from, but if people suffer a direct loss of amenity and see their lives somewhat devalued, is there anything wrong with making a payment to them or reducing the amount of council tax they pay for several years? I think not. If people see that the authorities understand that they are genuinely losing something, even if only for a brief period, as a result of new homes coming along, we can responsibly make payments in kind to them.
For that very reason, it is incredibly important that all proposals for the new homes bonus include the assumption that spending should be very local to where the development happens. That leads me to my first question to the Minister. What about the 80:20 split in two-tier areas? Why does a county council need to have a share if compensating local people is the primary objective?
I congratulate my hon. Friend on introducing such an important debate. The 80:20 split is of great concern to Rugby borough council, which argues that it has taken forward the proposals for the new housing from which Rugby will benefit. It is concerned that a proportion of the new homes bonus will be allocated to the county council, which will benefit from development under the section 106 agreement and the community infrastructure levy. I hope that the Minister will give us a little more detail about where this 80:20 split comes from. I note from the responses to the consultation that it is a starting point for negotiation, but those who represent the authority in my area would be interested to understand a little more about where the split comes from and where it is likely to end up.
I thank my hon. Friend for that timely intervention. I absolutely agree with what he says. In a moment or two, I want to develop this argument a little further, because there is some confusion about where infrastructure comes from.
It is a pleasure to serve under you, Mr Williams. My area is in a two-tier district. Does the hon. Gentleman accept that the funding for the new homes bonus comes from reductions in the formula grant, which affect the county council? According to the hon. Gentleman’s argument, the reduction in Lancashire county council’s formula grant will be redistributed only to the district authorities, which, in my area, is Hyndburn borough council. Does he not accept that that argument is flawed and that the Minister should not adjust the formula grants for shire authorities if they will not receive any of the bonus at the end of the year?
I thank the hon. Gentleman for his intervention. He makes some cogent points, which the Minister will want to respond to in a moment.
There is a danger here. We are clearly channelling payments down to a community for its loss of amenity, but it is dangerous for us to confuse that with the provision of infrastructure. Let me develop that argument a little more. Page 11 of “New Homes Bonus: final scheme design” states:
“Local authorities will have flexibility on how to spend the unringfenced grant…In many cases this will involve advanced planning with other local service providers to ensure that there is timely delivery of infrastructure for the new development. For example, local authorities can pool funding to deliver infrastructure.”
I hope that that will not be read as an invitation to spend the new homes bonus on infrastructure that would be provided by the community infrastructure levy or other agencies in any event. There is a dangerous blurring of the margins here, and I seek some reassurance from the Minister that the new homes bonus will be focused on local communities.
There is a further confusion. The community infrastructure levy is coming through. Section 106 will be narrowed to deal only with site-specific issues. On top of that, there is open spaces funding—I think it will still exist, although I am not 100% certain—and the new homes bonus. There will, therefore, be three potential ways of providing infrastructure, and I would like some reassurance from the Minister on the potential confusion about them. I have had evidence on the issue from local parishes in my area, and particularly from West Meon parish council, which I met recently. Its members were very confused about where open spaces funding would sit in the new matrix.
Just yesterday I received a letter from Hampshire county council, which is particularly worried about the timing of the community infrastructure levy. It says:
“We believe the arbitrary date of April 2014 will cause serious problems both for ourselves and the district councils and risks triggering a growing infrastructure deficit.”
It goes on to request that only local planning authorities with robust policies in place for CIL should be subject to the changes by April 2014. That causes me to worry that there is going to be yet more impetus for the new homes bonus to be spent on infrastructure that should otherwise be provided by different mechanisms.
I congratulate my hon. Friend on securing the debate. I agree with what he has said and also the comments from my hon. Friend the Member for Rugby (Mark Pawsey) and the hon. Member for Hyndburn (Graham Jones) about the 80:20 split. Will my hon. Friend the Member for Meon Valley (George Hollingbery) comment on another issue? In my constituency there is a significant problem of empty properties. We have 896 empty properties in the town of Nelson alone. Will my hon. Friend join me in welcoming the Government’s decision to include long-term empty properties being brought back into use as part of the new homes bonus, thus boosting the financial viability of regeneration schemes in areas such as Pendle?
That is entirely to be welcomed. I would add that a section in the recently published final scheme for the new homes bonus reminds us that the spending review also announced that the Government were investing £100 million through the Homes and Communities Agency to enable housing associations to support local authorities to bring more than 3,000 homes back into use. As a package, I think that is to be welcomed. It is right that the new homes bonus should also be made attractive by bringing empty homes back into use.
My second question to the Minister is about transfers across local planning authority borders. I emphasise again that the new homes bonus is to compensate for a loss of amenity. However, what about the loss of amenity to those sitting on the other side of a local planning authority boundary? All of us who represent rural constituencies—and even those who perhaps represent slightly more urban areas—will recognise a situation in which one planning authority plans a large number of homes in an area of its administration which will not have any effect on its citizens.
There is such a development in my constituency at Whiteley, where 15 years ago a large new development of 4,000 homes was built. It was immediately adjacent to Fareham town, which has no contacts at all with Winchester district. All contacts went south. Under current rules on the new homes bonus, all of that new homes bonus would flow to Winchester and not to Fareham where it rightly should be. Likewise, we are now confronted by a proposal from Fareham borough council, which wishes to build 6,000 homes on the border of Winchester constituency, with most of the loss of amenity affecting those in Wickham and Knowle in the Winchester district authority.
I believe we should be able to form neighbourhood forums across LPA boundaries, and some of the payment of the new homes bonus should go directly to those forums across boundaries. We should at least encourage the chief executives and leaders of local councils that reduce the amenity of those across the border to share and share alike.
I thank my hon. Friend for giving way and for securing this important debate. House building is probably the biggest issue in my constituency at the moment. The Labour-led Kirklees council is pushing a local development framework plan using the old regional spatial strategy house-building target of 26,000. There is a lot of suspicion about that, particularly about the new homes bonus.
My hon. Friend spoke about the loss of amenity. My constituents are really worried about the loss of amenity of green belt, green fields and the countryside. Could we ask the Minister about the possibility of a massively disproportionate new homes bonus for houses built on brownfield sites and regeneration of empty homes, which my hon. Friend the Member for Pendle (Andrew Stephenson) mentioned, as opposed to a bonus for homes built on greenfield sites? That would be a really positive step.
I thank my hon. Friend for his intervention and add his question to the Minister’s already long list.
It is a pleasure to serve under your chairmanship, Mr Williams, and I congratulate my hon. Friend the Member for Meon Valley (George Hollingbery), his hon. Friends and the hon. Member for Hyndburn (Graham Jones) on their contributions to the debate.
My hon. Friend the Member for Meon Valley fairly set out the problem that the new homes bonus is intended to address. For decades house building has failed to keep up with people’s needs, and a combination of the recession and the regional spatial strategies targets that generated a bow-wave of opposition in many areas, led to a steep decline in the number of new homes provided. The year 2009 saw the lowest level of house building in England and Wales in peacetime since 1923, and the cost of a new home doubled in real terms between 1997 and 2007.
There is no doubt that housing is central to economic success as well as to personal well-being. We need to make building homes a motor for growth again. The new homes bonus will do exactly that. It has localism at its heart; it will re-energise communities; it will give them an incentive to say yes rather than no, which was the consequence of the top-down, target-driven scheme that it partly replaces.
I welcome the Minister’s comments that this is a positive policy to encourage growth, and his assertion that it will create growth. However, what is the incentive to build houses in light of the following two factors? The hon. Member for Pendle (Andrew Stephenson) touched on them. The first is population decline, and the second is the existence of too many houses already.
I suggest that the hon. Gentleman look at the empty homes element of the new homes bonus as particularly appropriate for the communities of east Lancashire. My hon. Friend the Member for Pendle (Andrew Stephenson) made exactly that point. It is an important way of providing a market signal to those who own empty homes, to encourage them to invest in them and bring them back into use.
I accept the Minister’s point that long-term voids are not on the council tax base, but short-term voids are. There will be a mix when a row of terraced houses is demolished: there will be short-term empties, occupied houses and long-term voids. Some houses will be deducted, so short-term voids are included in the net figures for the new homes bonus. Will the Minister comment on that?
In describing his policies the Minister talks about regeneration, but also about two-into-one and three-into-one schemes. The hon. Member for Pendle has some of those schemes in his constituency which, I know, are very successful and are selling well. There will be net reductions in the new homes bonus available for constituencies such as Pendle. Surely, the two-into-one and three-into-one schemes and short-term voids should not be part of the new homes bonus. We need to add to the council tax base process an element that includes those that are on the council tax base, and not just talk about long-term voids that are not. Will the Minister accept those points?
I notice that Pendle is credited with 107 new homes, so it will be getting the new homes bonus. It is only fair to my hon. Friend the Member for Meon Valley, who initiated the debate, to turn to his points.
It should be clear that the Department for Communities and Local Government has set aside almost £1 billion for the scheme over the spending review period, including £200 million in 2011-12. That funding for 2011-12, contrary to the assertion of the hon. Member for Hyndburn, is additional money outside of the grant formula.
The balance between market and affordable homes is also crucial and, therefore, there is an additional £350 payable for each affordable home for the following six years, on top of the new homes bonus for homes in general. That means that local authorities could receive up to £9,000 for each affordable home over the next six years.
I thank the Minister for giving way. I served with him on the Localism Bill Committee, and we had long debates about the benefits of incentives versus coercion. Does he agree that it is important that the Government should constantly review the level of the bonus, for both normal and affordable housing, to ensure that the incentive is sufficient to generate the necessary level of house building?
I will shortly be speaking about some of the other incentives that are in place, but I agree with my hon. Friend that if we had more money we could have bigger incentives. Nevertheless, it might be wise to wait for the scheme to bed in before starting that revision.
The scheme will pay grant equal to the national average for the council tax band concerned on each additional property, and it will be paid for the following six years as an un-ring-fenced grant. I stress that it is not ring-fenced; the Government make no prescription and give no advice to local authorities on how they might spend the money. It is entirely a matter for the recipient authorities. That brings me to who are the recipient authorities.
My hon. Friend the Member for Meon Valley asked me to say something about the split between the county and district tiers in two-tier areas. First, I should say that in single-tier areas, 100% goes to the principal local authority; in county areas, 80% goes to the district planning authority, and 20% to the county council. When I say “it goes”, that is the default position, but it is open to each of those authorities to consider whether they want that to be the case in all circumstances. For instance—this is an example; it is not intended to be a Government directive—if the tipping point for the creation of a new primary school were involved, there might well be some other consideration than 80:20. I remind the House that when it comes to local authority spending, it is generally the case that 80% is spent by the county and 20% by the district, so we are inverting that ratio.
Every development is different and will need different services to support it, and different local concerns will drive the choice on how to spend the new homes bonus. Local authorities and local communities are best placed to negotiate those choices in meeting the needs of local neighbourhoods. My hon. Friend spoke of local communities having the loudest voice. I certainly agree with him on that, hence the 80%, but there are also parish and town councils; and in many unparished areas there will be residents’ and community groups. I would expect sensible local authorities, in working through the new local planning arrangements with neighbourhood plans, to see the bonus as a vital part of negotiating effectively with those communities on how the new homes bonus should apply in those areas.
My hon. Friend also asked how the boundaries question would be dealt with, and gave the example of Whiteley. That may be seen as pulling in the opposite direction to his point about county and district investment, because both of the areas that he spoke of are in Hampshire. The county council will benefit by just over £1 million from the new homes bonus—that will be its 20% for the coming year—and it is a provider of services across both of the areas mentioned. In such situations, the fact that there is a top-tier section of the new homes bonus may be to everyone’s advantage. In addition, the Localism Bill introduces a duty for local authorities to co-operate, which is relevant in establishing plans, taking decisions about how things such as the new homes bonus should be spent, and how some common objectives can be met.
My hon. Friend the Member for Colne Valley (Jason McCartney) asked about the possibility of adapting the new homes bonus to give preference to approvals on certain types of land. That is not part of the scheme; nor, as things stand, do I foresee it happening in future. However, the introduction of the neighbourhood planning system will give local communities and local neighbourhoods a much firmer grasp of such decisions as they build up their neighbourhood plans under the district plan, which is subject to the national planning policy framework. I hope that my hon. Friends are satisfied to hear that.
If I may, Mr Williams, I shall use the rest of my time speaking about the different streams of money that support the Government’s intention to see vigorous, sustainable development across the country. My hon. Friend the Member for Meon Valley asked about open spaces funding. The Department has set aside £11.2 million for community green spaces funding for the coming year. That goes principally to supporting groundwork for the green flag award accreditation scheme, and the federation of city farms and community gardens partnership work programme. Those programmes continue on a comparatively modest scale, but the amount that local authorities choose to allocate for parks and other green spaces is rightly a matter for them.
Do I take the Minister to mean that open spaces funding will not be levied on developments from now on?
I am sorry to say that I did not catch what my hon. Friend said.
I apologise. Am I to take his comments to mean that local authorities will no longer be levying an open spaces fund—a charge for open spaces?
I shall take note of that question and write to my hon. Friend, so that I do not give a misleading response.
The Government have given communities the opportunity to participate much more strongly in the process of protecting spaces through the community assets list, the community right to reclaim land and the community right to bid and challenge. Local communities that are concerned about these matters therefore have a number of opportunities to become directly involved.
As well as the new homes bonus there is, as my hon. Friend said, the community infrastructure levy and section 106 agreements. Both are specifically directed to infrastructure investment and planning outcomes. They are different from the new homes bonus; they are not ring-fenced and there is no obligation for the money to be spent on infrastructure or related matters.
Local authorities will have the opportunity to introduce a community infrastructure levy. I note the concerns that my hon. Friend passes on from Hampshire, but it is important that we get these incentives in place quickly. If my hon. Friend lets me have that correspondence, the Department will give some thought to those matters.
Section 106 will be scaled back so that it is specifically directed to deal with the impact of particular developments. Statutory tests were introduced in 2010 to ensure that obligations are directly related to proposed developments. Regulations prevent section 106 agreements and the community infrastructure levy being collected for the same piece of infrastructure. After 2014, tariff-style planning and obligations will not be permitted. The characteristic level at which the community infrastructure levy is likely to fall would be between £5,000 and £10,000 per home. Taken with the new homes bonus, it is a really powerful incentive for communities to agree to new developments.
(13 years, 9 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Thank you, Mr Williams, for relieving me of my Chairman duties so punctually. It was a great relief to have a rest and a coffee before I opened this debate. I am pleased to see the Minister in her place, because this is a subject that she will understand from her time in the national health service. I requested this debate on the future of the National Blood Service to highlight the intentions of the Government to sell off “elements” of the service to the private sector. I understand that there have been some preparatory discussions with a number of contractors. That was revealed in a report in the Health Service Journal. Three possible contractors are Capita, DHL and TNT.
In the paperwork relating to this debate, Members may notice that I have an “R” after my name. I spent 34 years in the national health service. Although I specialised as a medical scientist in microbiology in the NHS, I spent some of my former years in the National Blood Service, particularly in emergency transfusion services, so I have some experience of the subject.
The NHS staff who deliver that service are highly skilled and highly trained and it is essential that they are. I notice that a number of my colleagues are here, and I am quite happy for them to get involved in this debate. I will only spend about 10 minutes talking on the subject.
The annual review of the National Blood Service—and it is its own review—highlights the efforts that have gone into offering a world-class service to the NHS. It is probably the best blood service in the whole of the globe. Thanks to its unique clinical knowledge and experience and the support that it receives from its many dedicated donors and families, many people who need blood and organs can be saved. In its annual review, the organisation has spent some time evaluating its system and performance. In other words, it has looked at itself in great depth and that has allowed it to achieve substantial savings and to lower the cost of a unit of blood. According to its annual review, a unit of blood has dropped from £140 to £130 and it should reduce further to £125 this year, which will mean a saving of £30 million a year to the NHS. That money can be reinvested in NHS front-line patient care.
The National Blood Service administers not just units of blood, but organ donation, tissue donation and work on stem cells. There have also been improvements in the delivery of organ donation procedures, including training additional specialist nurses and increasing the numbers of people who are prepared to contribute organs. User hospital trusts pay for the blood products and services. It is important that both hon. Members and the public understand that blood and tissue donors give their services for free.
I congratulate the hon. Gentleman on securing this important debate. May I ask him a question on the subject of reform? The National Blood Service is crying out for new donors. Should the fact that there is still an arbitrary ban on certain groups of society giving blood, such as gay men, be up for review or does he think that such a ban is okay?
Everything should be up for review at the present time. I am quite sure that the National Blood Service is considering that matter as part of its review.
Donors give their services absolutely free to the national health service. The Department of Health funds the production of all the organisation’s services within its factories, processing centres and laboratories. The system has a record of sound financial control, of which the NHS should be proud. I was in the service when cleaning services were compulsorily tendered out to the private sector. If my memory is correct, that resulted in a reduction in the quality of service. We saw wards cleaned less frequently and an increase in hospital infections such as clostridium difficile, E. coli 0157 and methicillin-resistant Staphylococcus aureus. We have all seen the publicity that such infections have received. Privatisation would introduce an element of cost cutting in order to increase profit. Shortcuts, reduced training and a reduction in quality are all strong possibilities.
The public who donate their services for free will be discouraged from taking part if the profit motive is introduced. The demand for blood from those who have serious health conditions will not diminish, but the supply of donors is in danger of being reduced.
I congratulate my hon. Friend on securing this debate. As I understand it, the National Blood Service is allowed to use the blue flashing light to transport blood to the most serious cases. Is it not the case that if the service were privatised, the private sector companies would transport the blood but would not be able to use the blue-light service because it is restricted at the moment?
If that were the case, it would make it much more dangerous for those patients who were waiting to receive that blood or organ. I would not like to see that happening.
The National Blood Service has created a strategy for each of its departments as it strives to improve its service and, looking at the review in great detail, in my view, it is succeeding. It is aware of the current economic situation and the constraints that it is working within over the next few years. It is planning more developments in future years. The question that has to be asked is why sell off something that is working so well. I understand that scientific staff have been angry about these moves. They have blasted the Government plan and demand changes to the Health and Social Care Bill, which will let private companies cash in on lucrative Government contracts.
Does my hon. Friend share my concern about the staff who currently work in the National Blood Service? Many of them opt to work in such services because they believe in the public good and in the common good. Does he share my concern about the impact that privatisation will have on them?
Yes. That is exactly right. Those staff, who are well trained specialists in their area, are very concerned about the damage that this proposal would do to the blood transfusion system and they are very angry about what is possibly going to happen. Of course, they also fear that donors will walk away. There are 1.4 million volunteer donors at the moment. They donate about 200,000 units every year, which is a huge amount of blood, and all of it is donated voluntarily. Privatisation of the blood service has been tried in New Zealand and it drove down the number of blood donors. It deterred them from making that contribution freely, because donors do not like to see their organs or blood as part of a private sector business.
Why should the private sector profit from blood that is given freely? There is no private sector organisation that has the expertise to provide the range of services—blood supplies, tissue, organs and specialist products, plus the specialist research expertise—that are provided by the NHS blood transfusion service.
I congratulate the hon. Gentleman on securing this important debate. He raised an important issue when he said that there are a number of reasons why people give blood. Personally, I gave blood at the Galpharm stadium in Huddersfield a couple of years ago because I was inspired by Adrian Sudbury, the journalist from The Huddersfield Daily Examiner. Before he died, he also inspired people to sign up to the bone marrow register maintained by the Anthony Nolan Trust. So there is a lot of good work going on and the hon. Gentleman has identified that. I hope that the Minister, in her deliberations, will think about the other roles that the National Blood Service plays. The hon. Gentleman quite rightly identified that the service is not only about giving blood but about giving tissue and other material. I thank him for making that point.
I thank the hon. Gentleman very much. That was a very positive contribution, based on his own specific experience. There is a petition about this issue, there are now some 35,000 signatures on it, and it is building up all the time.
I also congratulate my hon. Friend on securing a very important debate about an issue that is of great concern among the public. I wanted to ask him about the lessons from overseas countries where blood transfusion services have been privatised and where it is standard to pay for donated materials. What lessons can we learn from those countries about the safety of supply?
I referred earlier to another privatisation that took place in the health service, when cleaning was put out to tender. Of course, the quality of the service was reduced. That is exactly what I fear will happen with the blood service, because if someone is in the business of making money and making profit they take short cuts. It is as simple as that.
The petition that I was talking about is building up. In addition, 300 people got in touch to say how much they valued the blood service. For many of those people, their loved ones personally benefited from the altruism of a fellow human being.
The blood service began before the national health service, around the time of world war two, when the demand for the service originated. So the blood service is older than the NHS.
I am very concerned. The Government are saying that only elements of the NHS blood transfusion service are under discussion at the present time but that is a dangerous route to go down. I hope that the Minister will take this issue back to the Government and the Secretary of State, and ask for a review of this particular service that the public so dearly love. The other thing that I will say is that if someone is looking for a big society in action, the blood service is it.
Having not served under your chairmanship before, Mr Williams, I now find myself doing so twice in a day. It is a pleasure.
I congratulate the hon. Member for Heywood and Middleton (Jim Dobbin) on securing the debate and I pay tribute to his experience of this sector. I also echo the tributes that he paid to the staff who are part of such a fantastic organisation and who are one of the reasons why it has such a high reputation.
The debate is an important opportunity to discuss an issue that is not only important to the NHS and the public but which has been the subject of very unhelpful rumour and speculation. I become very disappointed when I see scare stories in the press that are not necessarily based on any foundation and that will only result in scaring people off donating blood, tissue or organs. Those stories are not helpful. I urge the hon. Gentleman and the other hon. Members sitting beside him that if they want to clarify the situation they should please feel free to contact me. That is much better than running scare stories, or a story getting out of hand, so that the issue becomes a disservice to the public we are all trying to serve.
Contrary to what some people have been saying publicly and indeed privately, there are no plans to privatise the blood service, which is part of NHS Blood and Transplant, or NHSBT. I can say categorically that we are not selling off the service. If I do nothing else in this debate, I want to knock that rumour on its head.
The Government have said previously that we will retain a single national system for blood with NHSBT at its helm and we stand by that statement. Under its current management team, NHSBT has done a great job and it continues to do so. It has maintained—indeed, greatly improved—the stability and security of the blood supply. It has also improved productivity in blood processing and testing by more than 50% in three years, which is a true achievement.
I have a letter from Andrew Pearce, who is the head of donor advocacy in the NHS. The second paragraph says:
“The review is at an early stage and is likely to take a few months. Although we cannot rule out that the review might eventually suggest that some of our supporting activities should be market-tested, this is by no means certain.”
There is some doubt in that letter, which is from someone within the blood system itself, about whether market-testing is going on with a view to something else happening. People do not test something for the market if they are not intending to put it out to tender.
I thank the hon. Gentleman for his intervention. What matters is that people get good value for money from the taxes that they pay. What also matters is that we do things effectively and efficiently, so we constantly market-test within NHS provision. We should do so. What matters to us is having a quality service. However, we are not selling off the blood service and we are not privatising it. As for performance, I am sure that the hon. Gentleman will agree that the performance of our blood service puts us in the top quartile compared with other European blood services. That is a fantastic achievement.
I reiterate the hon. Gentleman’s comments about what the improvements in the blood service mean. There has been a reduction in the price of a unit of blood, down by £15 from £140 in 2008-09 to £125 today. As he rightly pointed out, that reduction saves hospitals £30 million each year, which can be channelled straight back into patient care. Again, I pay tribute to the staff who have achieved that reduction.
It would be a huge oversight on my part if I did not also pay tribute to those who donate their blood for the benefit of others. I am pleased to learn that my hon. Friend the Member for Colne Valley (Jason McCartney) has donated blood himself. Every year, 1.4 million people donate blood, which means that 2 million units a year are donated in total. That equates to 7,000 new units of blood every day, or about five a minute. Statistics are wonderful when one is engaged in a debate such as this one; they show the scale of the donations that are made. Those donations have saved countless lives and continue to do so. Indeed, the altruistic donor system is one of the rocks that the NHS is built on and we will not do anything to jeopardise public confidence in it.
It would also be remiss of me not to mention organ donation. The one thing that we do not do often enough is to thank people who donate their organs and those of their loved ones, saving many lives in the process. We have made great improvements in organ donation, which is up by 28% since 2008, but we must continue to make improvements. I do not want anything, anyone or any public statement to jeopardise any of that. On the contrary, we want to carry out a review to help NHS Blood and Transplant to improve its operational efficiency even further and provide an even better service.
The blood service must be seen in the context of its role in the NHS. The hon. Member for Easington (Grahame M. Morris) mentioned courier services for getting blood around the place. We have been using courier services for many years—the previous Government did so as well—to deliver organs and tissue, and there is no question of putting the delivery of blood at risk.
Just for the record, it was my hon. Friend the Member for Bradford South (Mr Sutcliffe) who raised that issue, but it is one that I am concerned about.
Will the Minister address the new role of the economic regulator, Monitor, and the responsibilities that it will have regarding competition? Will its remit extend to the blood service?
I apologise for confusing the hon. Gentleman with the Member who was sitting next to him. At least it gave me the opportunity to clarify the point. To ensure that I give the hon. Gentleman a precise answer, I will have to come back to him on Monitor because I do not have the information with me. I will happily do that after the debate.
The blood service is self-funding, in that it recovers the cost of collecting, testing and processing blood through the price paid by the NHS for each unit. The price of a unit is therefore directly related to the efficiency with which NHSBT conducts its operations; the one feeds into the other. If the cost of a unit of blood goes up, there is pressure on budgets, so the whole NHS has an interest in NHSBT being as efficient as possible and keeping the cost low. The £30 million that we have been able to put back in demonstrates that costs are being kept low, and more can be spent on patient care.
The review of NHSBT was announced in the report produced by the arm’s length bodies review in July 2010. The review is ongoing, and I cannot say what the outcome will be, but I would like to explain what the review is about, and in doing so, clarify what it is not about and hopefully reassure the hon. Member for Heywood and Middleton and all those who might share his concerns.
The review will identify opportunities both to help NHSBT further improve the efficiency of its operations, and to save money. Aspects of NHSBT’s activities covered by the review include IT, estates, testing, processing and logistics. NHSBT has recognised that those areas have room for improvement, in both developing services and increasing efficiency; such functions can often be carried out more efficiently. NHSBT already outsources some of its activities to private sector companies, for example facilities management, legal services and the call centre, so by exploring whether greater savings are possible, the review does nothing new. It simply takes a currently successful model, which has demonstrated that it can improve, and considers whether it would work if it were to be expanded.
As I said, we are looking to ensure maximum efficiency for NHSBT, and I am sure that the hon. Member for Heywood and Middleton agrees with that aim. We will do whatever works, and whatever can ensure a safe supply of blood to the NHS.
Will the review of the British national blood service be subject to European competition law?
I am pretty sure that it will, but I will check.
There have been suggestions that outsourcing some other functions might lead to donors declining to donate. We are absolutely clear that in exploring other opportunities, we will not put at risk any aspect of public health. I do not want donors or any Member here today to believe that this is privatisation of our highly respected National Blood Service.
I thank the Minister for clarifying that there will be no sell-off—no privatisation—of the National Blood Service. Some Opposition Members are concerned that if there was some privatisation there would be a drop in donations, which is something that no one in the House would wish. Hopefully, Members on both sides of the House can now pass on that information, so that there is confidence in the National Blood Service and we see an increase in donations. We welcome the efficiency measures as well.
I thank my hon. Friend for reiterating that point. Blood is donated freely to the NHS to improve and save patients’ lives. Like any donation, it is a gift, and we want to maximise the opportunities for that gift. We do not want to do anything to discourage donors. I state categorically that the donor-facing aspects of blood donation are excluded from the review, which will ensure that the relationship between NHSBT and its donors is not compromised.
My hon. Friend the Member for Pendle (Andrew Stephenson) mentioned that people, in particular men who have had sex with men, are excluded from blood donation, and that issue is currently under consideration. I understand that there has been a lot of concern that the rules are outdated, and we will make an announcement on the issue at some point in the near future.
I feel that I have been repetitive, but I need to be to make the point, so I reiterate the Government’s support for, and belief in, a single national system for donated blood and organs, with NHSBT at its helm. That does not mean there is a blinkered belief that the system has already reached the peak of its potential; it would be remiss of the Government to think so. NHSBT, like all areas of public and private life, must continue to innovate and to challenge itself if it is to provide the best possible service. The current review is designed to explore how it can do that, to keep the price of blood—the cost to the NHS—as low as possible and to provide the high-quality blood service that donors and recipients deserve.
I agree that we should continually look at research and at improving the system for the people of this country. I have no problem with that, except that I would like the service to remain within the NHS.
In everything he does, the hon. Gentleman operates from a deep-seated belief in organisations such as the NHS, and he wants the best, not just for his constituents but for the people of this country. I therefore urge him, as I urge all Opposition Members, not to play politics with this issue, although I am sure that that is not his intention. If Opposition Members have any concerns, I urge them to discuss them with me; my door is open. It would be a tragedy if anyone did anything that reduced the number of donors coming forward. We are determined to ensure that that does not happen, but scare stories in the press can have that unintended consequence. We should not believe everything that we read in the newspapers.
Question put and agreed to.