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09:34 - The House divided: - Ayes: 0 / Noes: 32 - The Deputy Speaker declared that the Question was not decided because fewer than 40 Members had participated in the Division (Standing Order No. 41).
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Jeremy Lefroy (Stafford) (Con)
I beg to move, That the House sit in private.
Question put forthwith (Standing Order No. 163).
Health and Social Care (Safety and Quality) Bill
(9 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Jamie Reed (Copeland) (Lab)
I beg to move, That the clause be read a Second time.
Before I begin, I am sure that the eyes of every Member are on events in France and we wish the French authorities the very best of luck in their endeavours in the aftermath of Wednesday’s events.
I congratulate the hon. Member for Stafford (Jeremy Lefroy) on navigating his Bill to this stage. Not many private Members’ Bills make it to this point. This is a good Bill and I am sure we would all like to see it on the statute book. I hope that it can complete its final Commons stages today.
On 13 November 2014, the Secretary of State for Health announced that Dame Fiona Caldicott would be the new national data guardian for health and care, and that her role would become
“the patients’ champion on security of personal medical information.”
She will
“be able to intervene if she is concerned by how an organisation is sharing data. She can refer concerns directly to the Information Commissioner’s Office (ICO) and the Care Quality Commission (CQC)”.
Those principles are supported by all Opposition Members. Sharing data and information can and, indeed, should improve health care, but we must ensure that patient privacy is protected at all times.
If Dame Fiona’s role is to look at how organisations share data, that role will become directly relevant to the provisions in clause 3. In his announcement, the Secretary of State for Health said:
“I intend to put the National Data Guardian on a legal footing at the earliest opportunity”.
The business of the House is not so demanding that he can blame a lack of parliamentary time for not introducing such plans, especially as there have been concerns about data for a very long time. Those concerns have become even more acute since the bungled implementation of the care.data scheme, which is so important to our research base.
In Committee, I told the Minister that if the Government did not make progress on their announcement, the Opposition would help them out. That help has arrived today. The Government have done nothing, so I have tabled new clause 1 to place a duty on the Secretary of State to hold a consultation process on the role of a statutory national data guardian. We do not wish to prejudice the role by prescribing its functions. It is right that the role should be determined by consulting those on whom it will have an impact, not least Dame Fiona herself. Many stakeholders will be keen to contribute to a consultation process; they are crying out for progress.
The Bill places a duty on health care providers to share information wherever relevant. As new systems are put to the test, there will inevitably be more pressure on the national data guardian. The new clause would place a duty on the Secretary of State to start a consultation within 30 days of the passage of the Bill. We are all keen to see progress, and the new clause would ensure that the process got under way almost immediately.
We want the consultation to be meaningful and thorough to ensure that the new role is as effective as possible in maintaining standards by highlighting and, more importantly, fixing poor practice as and when it occurs. The Minister said in Committee that the delay to date was because the Government wanted to consult widely with stakeholders. That is the precisely the purpose of new clause 1, so I can only imagine that the Government will support it. If they oppose it, will he explain why? Will he commit himself to writing to me about the proposed timeline for the consultation and the planned legislative timetable for putting the role on a statutory footing, as we discussed in Committee?
Sharing data can lead to much better outcomes for patients throughout the health and social care sector, but we must ensure that personal data are used safely, and that any promotion of data sharing is done responsibly to improve health outcomes. That principle has already been explored in depth, and the Labour party is clear that it supports that principle, as I am sure do all Members. There is wide support for the role of the national data guardian. Putting it on a statutory footing has cross-party support. I hope that the Government will get on with it today.
Jeremy Lefroy (Stafford) (Con)
I thank the hon. Member for Copeland (Mr Reed) for tabling new clause 1, which allows us to debate the issue. I am most grateful to him for his full and constructive engagement with the Bill. A consultation on making the role of the national data guardian statutory is extremely important, and I fully appreciate the reasons why he has tabled the new clause.
I welcome the appointment last November of Dame Fiona Caldicott as the first national data guardian. Her extensive knowledge and experience in this area will ensure strong and visible leadership. She, together with her panel, will act as a source of clear authoritative advice and guidance across the health and care system. The Secretary of State said at the time of her appointment:
“We need to be as determined to guarantee personal data is protected as we are enthusiastic to reap the benefits of sharing it. Dame Fiona will oversee the safe use of people’s personal health and care information and hold organisations to account if there is any cause for concern, ensuring public confidence.”
Let me make it quite clear that the clauses on the duty to share information are not about care.data, which is another issue for another time. My Bill is about data being shared only with those who are directly responsible for an individual’s care for the purposes of that care. Its remit is very restrictive.
A consultation should, as the new clause provides, include reference to
“oversight of data sharing as set out in”
the Bill. Understandably, concerns have been raised that a duty to share information might somehow dilute the vital principle of patient confidentiality, which is protected by statute and common law. As I have explained before, I do not believe it will do so.
The seventh of the revised Caldicott principles, as set out in “The Information Governance Review”, is that
“The duty to share information can be as important as the duty to protect patient confidentiality. Health and social care professionals should have the confidence to share information in the best interests of their patients within the framework set out by these principles.”
As was set out on Second Reading and in Committee, clause 3 introduces a duty to share information. That must be done when it is in the person’s best interests and it is
“likely to facilitate the provision to the individual of health services or adult social care”.
Having a statutory duty to share information for the benefit of a person’s care, within the clear limits set out in the Bill, would, alongside the existing strong statutory protection for confidentiality, provide health and social care professionals with the confidence to which Dame Fiona’s report refers.
The consultation on the national data guardian will provide the opportunity to set out how oversight would work for the duty introduced by the Bill, should it become law, under the legislation that will make the role of the NDG statutory. If the consultation cannot be established through a clause in the Bill, which I understand may be the case due to the timing of the general election—the Minister will go into that, I believe—it needs to happen at the earliest possible opportunity.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
The new clause relates to clauses 2, 3 and 4. Clause 2 will place a duty on providers and commissioners of publicly funded health and adult social care to use a consistent identifier in a person’s health and care records and correspondence. The consistent identifier must be specified in regulations, and the Government’s intention is that the NHS number will be specified. It is important to note, as my hon. Friend the Member for Stafford (Jeremy Lefroy) outlined, that the duty to use the NHS number would apply only in the direct provision of care and when it was in the individual’s best interests. As he articulately said, this matter is very different from the issues with care.data that we have discussed. There is a duty on professionals to share information in the best interests of patients in respect of the provision of direct care.
Clause 3 will introduce a duty to share information that is held by providers and commissioners when it is in an individual’s best interests and will support their direct care and treatment. As we discussed in Committee, that is an essential part of the delivery of safe, effective and high-quality care.
Clause 4 defines health or adult social care commissioners or providers. Its effect will be that the duties imposed by clauses 2 and 3 will apply only to relevant health or adult social care commissioners or providers. They are defined as public bodies exercising health or adult social care in England and any person, other than an employee, who provides such services or care under arrangements within a public body.
I welcome the constructive support of the shadow Minister, the hon. Member for Copeland (Mr Reed), throughout the passage of the Bill. There has been a great deal of consensus, and rightly so. I am grateful for his support for the role of the national data guardian. As was discussed in Committee, the Government are committed to consulting on the role of the national data guardian and the Secretary of State has given his unequivocal support to the consultation. We believe that having a data guardian is an important additional safeguard in the system.
As the House will be aware, Dame Fiona Caldicott has been appointed as the first national data guardian and has already built up significant credibility in her role of challenging and scrutinising the way in which information is shared across the health and social care system. Strengthening and broadening the role of the national data guardian will further enhance the confidence of patients and the public that there is a strong voice for their rights and protections in this area.
Even without a legislative basis, Dame Fiona’s panel, which was previously known as the independent information governance oversight panel, has built its reputation as an effective and authoritative voice. It has helped to ensure that data and information are shared in a way that allows the health and care system to access what it needs to improve outcomes for patients, while protecting against their inappropriate use. Having made significant progress, there is now clear agreement across the House that it is important to embed the national data guardian in the health and care system as a powerful independent voice, and to put that role on a statutory footing.
Mr Jamie Reed
I am grateful to the Minister for his response and for the constructive way that we have dealt with the Bill, which in many ways demonstrates some of the best traditions of the House. I am a little disappointed, given the fallow—dare I say useless—fifth year of this five-year Parliament, that time has not been found to address these issues. The protection and use of individual data, not just in health services but across the public sector, is one of the biggest and most important emerging issues facing our politics and society, and the Minister is right to say that such matters need to be treated carefully, judiciously, and with diligence and attention to detail.
Given the cross-party support and the Minister’s assurances, I beg to ask leave to withdraw the clause.
Clause, by leave, withdrawn.
New Clause 2
Care and Quality Commission reviews and performance assesments
‘(1) Section 46 of the Health and Social Care Act 2008 (health and adult social care services: reviews and performance assessments) is amended as follows.
(2) For subsection (3) substitute—
“The assessment of the performance of a registered service provider is to be by reference to whatever indicators of quality the Commission devises, but must include indicators of the safety of health and social care services.”’—(Sir William Cash.)
Brought up, and read the First time.
Sir William Cash (Stone) (Con)
I beg to move, That the clause be read a Second time.
Madam Deputy Speaker (Mrs Eleanor Laing)
With this it will be convenient to consider:
New clause 3—Care and Quality Commission annual State of Care Report—
‘(1) Section 83 of the Health and Social Care Act 2008 (health and adult social services: reports for each financial year etc.) is amended as follows.
(2) After subsection (2) insert—
“(2AA) The reports under subsection 1(b), (c), and (d) must, in particular, cover the safety of health and adult social care services in England.”’
Sir William Cash
Before I make my remarks on the proposals, I pay tribute to my hon. Friend the Member for Stafford (Jeremy Lefroy), my neighbour, with whom I have worked for the past five years with great enthusiasm, because he has dedicated himself to all matters in his constituency, but specifically to dealing with the problems that came out of the Mid Staffordshire public inquiry—I campaigned vigorously to get that public inquiry. I also pay tribute to Ken Lownds, whom I regard as a hero of that inquiry in many respects. I pay tribute to his work on zero harm and the Bill. I do not in any way want to leave the Minister out of the tributes because he has done a great job, as has the Secretary of State for Health. I wanted to put that on the record. We are reaching the climax of the Bill and this is the moment to pay tribute to those who so richly deserve it.
The object of new clause 2 is to amend section 46 of the Health and Social Care Act 2008. The section deals with health and adult social care services reviews and performance assessments. It comes under the rubric of reviews and investigations under chapter 3 of the Act on health care standards.
Section 46, “Periodic reviews”, provides that:
“In respect of each Primary Care Trust the Commission”—
the Care Quality Commission—
“must…conduct reviews of the provision of health care provided or commissioned by the Trust…assess the Trust’s performance following each such review, and…publish a report of its assessment.”
It also makes special provision with respect to each English national health service provider. Subsection (3) states:
“In respect of each English local authority the Commission must…conduct reviews of the provision of adult social services provided or commissioned by the authority…assess the authority’s performance following each such review, and…publish a report of its assessment.”
In the light of experience, and to improve the 2008 Act, particularly section 46, the new clause would substitute for subsection (3) the following:
“The assessment of the performance of a registered service provider is to be by reference to whatever indicators of quality the Commission devises, but must include indicators of the safety of health and social care services.”
The purpose of that is to require the CQC to ensure that the indicators used to assess ratings cover the safety of care, which goes back to the question of harm-free provision. Basically, the argument goes like this: the object is to stress that the CQC can be an effective regulator only if it is free of undue influence from Ministers. The measure is a good indicator of whether the Government are prepared to say that they want the CQC to be able to exert influence and carry out its functions irrespective of undue influence from Ministers. In other words, are they prepared to step back and allow the CQC to do its job properly?
The CQC has decided to make safety one of the key indicators for the assessment of provider ratings. As a result, safety is a critical component of the CQC’s new inspection regime. On many occasions, I have discussed with Ken Lownds over dinner and otherwise the origins of much of his thinking on the subject, some of which I had difficulty understanding—apparently some of it comes from aviation safety, but I will leave that to the experts.
Under the leadership of the three chief inspectors, the CQC has put in place specialist inspection teams able to scrutinise the quality and safety of care more rigorously. Inspections no longer simply consider whether providers are meeting the registration requirements, but provide a judgment about the quality of care on a scale running from outstanding to inadequate, offering providers, commissioners and local people fuller information about the quality of care.
The CQC’s tougher, people-centred, expert-led and more rigorous inspections are seeing some outstanding care, and the CQC has already rated many good services. That new approach has also exposed poor care and variations in care, making the level of quality transparent in a way it has never been before.
I have to say that my experience of what happened after Mid Staffordshire—this was before my hon. Friend the Member for Stafford came into the House, and I pay tribute to what he has done to help me since—was itself a matter of the gravest concern. Having witnessed what went on there, I then had to engage in a campaign, and I tried, unsuccessfully, to push the Government of the time into having a public inquiry, but Ministers, including two Secretaries of State, refused point-blank to hold one.
Furthermore, I had to nudge—if I can use that word—those on my own party’s Front Bench quite vigorously. I think that would be the appropriate description. That included our then shadow Secretary of State and the now Prime Minister, who responded magnificently, making an inquiry a manifesto commitment. One of the very first things the Government did when they came into power under the present Prime Minister was to say, “We will have this Mid Staffordshire public inquiry under the Inquiries Act 2005.” As a result of that and of the work of Ken Lownds, my hon. Friend and others of us who have been involved in this issue, including the sponsors of the Bill—I should also refer to them—we now have this new Bill in my hon. Friend’s name, which will make quality transparent in a way it never has been.
We are already confident of the great strides the CQC is making to be an effective regulator of health and social care providers. I hope that the Minister will accept that new clause 2 is exploratory, but I tabled it in the fervent belief that he will respond satisfactorily to my request, because this is a matter of grave concern.
If it is convenient, Madam Deputy Speaker, I will move on to the next new clause, unless my hon. Friend the Member for Stafford would like to respond to my points now. Would that be appropriate?
Madam Deputy Speaker (Mrs Eleanor Laing)
At this point, we are considering new clause 2 and new clause 3, so it would be appropriate for the hon. Gentleman to address new clause 3, if he so wishes.
Sir William Cash
That is very good. I just wondered whether my hon. Friend wanted to respond on new clause 2 before I move on to new clause 3.
New clause 3 proposes to amend section 83 of the 2008 Act, which deals with health and adult social services and with reports for each financial year. The new clause would insert proposed new subsection (2AA), which says:
“The reports under subsection 1(b), (c), and (d) must, in particular, cover the safety of health and adult social care services in England.”
To put that into ordinary language, the purpose is to require the Care Quality Commission to cover safety of care in the annual state of care report. That is hugely important, because it is the narrative to which people will be able to refer in identifying progress on these incredibly important provisions.
Jeremy Lefroy
I would like to speak to new clauses 2 and 3 together. The new clauses tabled by my hon. Friend the Member for Stone (Sir William Cash) seek to embed safety as the central component of the CQC’s inspection regime. My hon. Friend is not only a supporter of the Bill but a major inspiration behind it. His determination in this place to establish what went wrong in the care of his constituents and mine, and to ensure that our NHS was improved as a result, is a major reason for us being here today.
I agree entirely with the principles contained in the new clauses. New clause 2 would place a duty on the CQC to include safety in its annual performance assessment and ratings, while new clause 3 would require the CQC to consider safety in its annual state of care report. I believe that clause 1 of my Bill would already ensure that the CQC has a duty to do all that is contained in new clauses 2 and 3. I will try to explain why.
Clause 1 states that the requirements for registration with the CQC will always cover safety by securing that registered providers of health and social care “cause no avoidable harm”. The CQC will therefore be under a duty both to consider safety in its inspections and ratings and to cover this area in its state of care report. Indeed, it already does so, and here I pay tribute to the previous Government for introducing this annual state of health and social care report through the 2008 Act.
The foreword to this year’s report, to which my hon. Friend the Member for Stone has already referred, is hard hitting about safety and indeed quality. It states:
“The variation in the quality and safety of care in England is too wide and unacceptable. The public is being failed by numerous hospitals, care homes and GP practices that are unable to meet the standards that their peers achieve and exceed.”
I welcome this candour. This is what we expect from the CQC—to hold the NHS and indeed the Government to account, and to ensure that action is taken.
Let me mention an article that appeared in The Times yesterday, showing the huge variability of standards within the NHS and praised some outstanding trusts, specifically mentioning one in Birmingham and a couple of others. What we want to see is those standards being uniform across the NHS. I know that all those working within the NHS and social care want to see that. Nobody goes into work wanting to fail; they want to succeed for their patients to whom they have a duty of care. For our part, it is our responsibility to ensure that they have the environment in which that can happen. That is a small part of what this Bill is designed to bring about.
Sir William Cash
I recall the extraordinary experience of discovering that in order for the original trust in Mid Staffordshire to achieve trust status, an interview was necessary. In that interview, I believe 48 questions were put, 35 or so of which were about finance—not about care and safety. That demonstrated why everything went wrong. Now, however, under these arrangements, the whole situation is completely reversed, which is a thoroughly good idea.
Jeremy Lefroy
I entirely agree. There were moves towards that when the Healthcare Commission, which was responsible at that stage and manifestly failed in the case of Mid Staffordshire, was replaced by the Care Quality Commission—an understanding by the previous Government that progress needed to be made in ensuring the quality and safety of care. That progress has been maintained and accelerated under the present Government.
I was referring to the 2013-14 report. One of my hon. Friend’s new clauses specifically provides that safety should be a part of such reports. Indeed, the report goes into detail over the way in which the CQC has inspected for safety. On page 12, for instance, it gives an example of a wide variation in the ratings on safety and four other measures—effective, caring, responsive and well led—for each department in a particular hospital. The ratings for safety range from inadequate to good, which shows that even within a trust or a hospital, there is a wide range of safety performance. The CQC is therefore already fulfilling what my hon. Friend is seeking in these two new clauses.
Of course, the same might be argued for clause 1 itself: why is it necessary when the CQC is now implementing the Secretary of State’s requirement to ensure that providers “cause no avoidable harm”? The reason is that, without clause 1, a Secretary of State would not have that obligation. While I cannot imagine a Secretary of State who would not consider safety and “no avoidable harm” as top priorities, experience and indeed the CQC’s own report from which I have quoted show that some of the organisations for which the CQC has the responsibility for regulation have not, and might still not, take safety seriously enough.
Sir William Cash
I distinctly remember insisting over and over again during the debates on the whole question of Mid Staffordshire that were taking place until the last general election that it was the Secretary of State who had to take the final responsibility for these matters, and that the duties imposed on him and the functions that he had to perform had ultimately to be his and must not be transferred to some other agency, however worthy it might be and however hard it might work to achieve objectives which, as we now know, were not being complied with satisfactorily, but which are being complied with satisfactorily now, under the Care Quality Commission. The argument that my hon. Friend is advancing comes straight from the history of the experience of Mid Staffordshire, and there is no one better to put the case than him.
Jeremy Lefroy
I thank my hon. Friend for what he has said. I entirely agree that this is an extremely important matter. Clause 1 will ensure that there is no slippage in the future, because the Secretary of State cannot get out of her or his responsibility, and the Care Quality Commission’s annual state of care report will be part of the process of holding the Secretary of State to account. I encourage, indeed challenge, this or any future Government to hold a proper annual debate on the report, because it is a vital report. Indeed, I should welcome a debate on the 2013-14 report, uncomfortable thought it might be for certain people.
I believe that new clauses 2 and 3 are unnecessary, because what they prescribe flows from clause 1. However, I am most grateful to my hon. Friend the Member for Stone for tabling them.
Mr Jamie Reed
I listened closely to the hon. Member for Stone (Sir William Cash). As I said earlier today, and on Second Reading, in Committee and throughout the passage of the Bill that became the Care Act 2014, patient safety is our guiding principle, and we are responsible for ensuring that all that we do is intended to improve it. The purpose of NHS regulation should always be to improve safety and achieve better patient outcomes. I therefore strongly sympathise with the principle of the new clauses. However, I should be grateful if the hon. Member for Stone explained why he does not agree with the hon. Member for Stafford (Jeremy Lefroy) that the duties for which they provide are already covered by the Bill and by other legislation.
A little over 12 months ago, I was a member of the Committee that scrutinised the clause in the Care Act that amended the Health and Social Care Act 2008, which new clause 2 seeks in turn to amend. The new clause adds the following words:
“The assessment of the performance of a registered service provider is to be by reference to whatever indicators of quality the Commission devises, but must include indicators of the safety of health and social care services.”
That is sound in principle, but it seems to me that it would remove from the CQC the flexibility that allows it to exercise its own judgment. Existing legislation gives the CQC a duty to describe and justify its indicators, and to consult on them before carrying out inspections. As the hon. Gentleman said, the Care Act also gives it a power to amend and revise those indicators.
Section 3 of the 2008 Act states:
“The main objective of the Commission in performing its functions is to protect and promote the health, safety and welfare of people who use health and social care services.”
Will the hon. Gentleman explain why he thinks his new clause is needed on top of that, and in combination with the CQC’s duty to consult on the indicators that it uses to assess services? If we support the principle of independent inspection, we need to guard against making unnecessary changes to legislation that could deter the CQC from performing its central role of ensuring the safety of the services that is inspects.
New clause 2 requires the CQC to
“include indicators of the safety of health and social care services.”
We all want the best and most effective legislation to be passed, but I fear that the new clause could be open to significant misinterpretation. The section of the 2008 Act to which the new clause relates concerns CQC reviews of the performance of service providers. The CQC will inspect a number of different services, including services that do not directly involve social care. The new clause, however, could require it to include indicators of safety in social care services regardless of whether the service concerned involves social care. If that is the hon. Gentleman’s intention, will he explain why he believes the provision to be necessary? Furthermore, new clause 2 refers to “social care services”, whereas new clause 3 refers to “adult social care services”. I hope that the hon. Gentleman will be able to explain what appears to be a discrepancy.
As Labour Members have made clear, we believe that patient safety is paramount in our NHS, that effective regulation is key to securing it, and that producing such regulation is our role in the House. I should be grateful if the hon. Gentleman explained why he believes that his new clause is essential to more effective regulation, given that—as the hon. Member for Stafford has pointed out—it seems merely to repeat existing provisions.
Dr Poulter
I thank my hon. Friend the Member for Stone (Sir William Cash) for tabling these new clauses and I commend him on his tireless work in taking forward the interests of his constituents around the terrible events that occurred at Mid Staffordshire NHS Foundation Trust and the subsequent steps he has been involved with all the way through to improve standards of hospital care provided to the people of Stone and the surrounding areas. He is also right to pay tribute to my hon. Friend the Member for Stafford (Jeremy Lefroy), who has worked tirelessly not just on this Bill, but as an advocate for his constituents and local patients. He is a great credit to the people of Stafford and, party politics aside, being a Member of Parliament is about public service, and he embodies the very best of that in the work he has done in bringing forward this Bill and in his advocacy of the needs of his local patients.
Sir William Cash
I have listened carefully to the arguments that have been put, including those from the Labour Front Bencher. In the circumstances, I am content not to press my new clauses to a vote. There will be an opportunity for reconsideration as the Bill makes further progress and it is just possible that some people will take another look at them—we will have to see. For now, I beg to ask leave to withdraw the clause.
Clause, by leave, withdrawn.
New Clause 4
Doctors’ language skills
The Secretary of State shall by order make regulations enabling the General Medical Council to ensure that all doctors holding a licence to practise medicine in the UK have appropriate language skills to communicate effectively with their colleagues and patients.”—(Sir William Cash.)
Brought up, and read the First time.
Sir William Cash
I beg to move, That the new clause be read a Second time.
It is terribly important to use opportunities of this kind to discuss matters of such importance properly on the Floor of the House. It does not mean that we always have the right answers—sometimes, we do not even have the right questions—but there are some really important issues that need to be given an airing so that people outside can hear the nature of the discussion, rather than having that discussion held by an agency on its own account or, alternatively, by the civil service and then put forward in a Government brief.
Basically, this is a new proposal that deals with doctors’ language skills. There are many people in this country who believe that this is an important issue. It is pretty obvious that ensuring that doctors have appropriate language skills is rather important, especially given what happened in a particular case. I do not remember the names of the individuals concerned, but I seem to recall that the case involved a father who died after being treated by somebody from Germany. It seemed to be pretty likely, if not certain, that the reasons that happened were to do with a lack of proper language skills and proper experience of the medical practices in this country. The doctor was effectively coming here as a locum without appropriate qualifications or sufficient skills to be able to give the kind of treatment that was needed, and the result was a tragedy. Other Members of Parliament may have other such examples.
This is a very important issue. Indeed in April last year, the Medical Act 1983 was amended to strengthen the arrangements to ensure that all doctors have sufficient knowledge of English before being able to work in the UK. My new clause would help to ensure that all doctors were able to communicate effectively with colleagues and patients, which would sufficiently reduce the risk to patient safety caused by a lack of understanding of the English language that could result in the misdiagnosis and mistreatment of conditions. Many people regard that as common sense.
Jacob Rees-Mogg (North East Somerset) (Con)
I thank my hon. Friend for giving way. I am sorry to bring him on to familiar ground, but would this new clause be acceptable under European Union law?
Sir William Cash
My hon. Friend quite properly puts that question to me as I am Chairman of the European Scrutiny Committee of which he is a member. We always come across these questions of interpretation. The short answer is that in relation to the issue of having appropriate language skills, the parameters for the communication of information between the patient and the person giving the treatment would be described as being within the framework of public health and the importance of ensuring that the people concerned—the patient—had not only adequate treatment but the opportunity to ensure that they were not put in danger. I think that in those circumstances it would pass muster and that we could legislate on our own account. If there were ever a challenge, I would propose that we introduce a further provision reading “notwithstanding the European Communities Act 1972” and then legislate. If we did that, under sections 2 and 3 of the 1972 Act the notwithstanding formula would enable us to bypass the European Court of Justice and ensure that we could legislate on our own account in this House to ensure that language skills were needed in English to ensure that patients in this country were properly safeguarded. I hope that I have dealt with my hon. Friend’s point.
Sir William Cash
I see him nodding and I am glad that I managed to pass that test. I am always grateful to my hon. Friend, who ensures that we all keep up to the mark.
On this occasion, I think we would have the capacity to make the change in the first place, but, if not, perhaps we can take a belt-and-braces approach in the House of Lords and use the notwithstanding formula. We shall see.
Jeremy Lefroy
Again, I am most grateful to my hon. Friend the Member for Stone (Sir William Cash) for tabling this new clause, which covers an important subject—the language skills of doctors—although of course the language skills of all involved in clinical care are vital.
Clear and understandable communication is essential to safety and the quality of care of patients. Language skills are a necessary condition for good communication, but not a sufficient condition. They must be accompanied by good communication skills, with which not all of us are automatically blessed, however good our language skills. Communication skills teaching is now an essential part of training in medical and nursing schools and it is to the credit of the previous Government that they ensured that it was embedded in the curriculum of new medical schools and was taken forward in existing schools. I welcome the Government’s support for that important approach.
I understand that regulations have been in place for a short while to ensure that all doctors, whether from within or from outside the European Union, have appropriate language skills before being granted a licence to practise. I want to hear from the Minister what the effect of those important regulations has been and whether he believes that new clause 4 is necessary. I would also like him to consider whether the assessment of language skills should include communication skills within that language.
Jacob Rees-Mogg
I want to speak in support of my hon. Friend the Member for Stone (Sir William Cash). This is an important new clause on a matter that it would be wise to have clearly set forth in primary legislation.
The heart of the matter is, unfortunately, the European Union and the mutual recognition of qualifications within the EU, and there are good reasons for that. The only way to open up service industries generally is if mutual recognition of qualifications takes place, so if we are to have a single market in services that is an important basis for it. However, above and beyond that there must be a fundamental principle of patient safety, which is embodied in this excellent Bill, and a lack of good language skills and of understanding of a language is a danger in both directions. It is a danger for the doctor who is listening to the patient explain his or her symptoms and it is also a danger when the doctor explains to the patient what steps the patient needs to take for better health. If there is confusion, it can have a seriously deleterious effect on the patient’s health.
We must be clear that this is not about restrictive practice or protecting the market for British doctors but about ensuring that there can never be such confusion. As my hon. Friend the Member for Stone says, if this provision runs into trouble with the European Union, we need to state clearly that it is of such fundamental importance that it must override international treaty obligations. It was Disraeli who said in his speech in the Manchester free trade hall in 1872, “Sanitas sanitatum, omnia sanitas”—that the first duty of Minister is the health of his people. That statement has underlined and guided Conservative policy for nearly a century and a half.
Sir William Cash
I recall that Disraeli also said, “The Tory party is a national party or it is nothing.”
Jacob Rees-Mogg
Indeed, although I am less clear on the relevance of that, and I was not intending to swap Disraeli quotations all morning. I just wanted to make that point about a fundamental principle that has guided our party since the 1870s and its relevance in defending health through ensuring that there is a proper standard of English-speaking—or in Wales, Welsh-speaking—physicians.
Sir William Cash
My hon. Friend used the word “ensuring”. That reminds me that insurance is a very important ingredient in the question of health and language skills—and, as my hon. Friend the Member for Stafford (Jeremy Lefroy) said, communication skills as well. If there were to be a failure of language, the consequence of which was to breach the terms on which an insurance contract was devised as between the patient and the national health service, as well as others involved in the contractual relationship, there would be massive financial consequences that could, in certain cases, run into millions of pounds.
Jacob Rees-Mogg
My hon. Friend makes an interesting point. It is possible that that is taken care of by other parts of the Bill. Clause 1 contains the fundamental commitment that unreasonable risks should not be taken, and language could be seen to be part of that. The reason I like the new clause is that it makes it absolutely clear that language is fundamental.
It is very hard to think of a circumstance where a lack of communication could possibly be safe. There may be cases where a patient cannot speak, or absolutely dire emergencies where there is no alternative form of treatment, but in the ordinary course of events language skills must be essential for somebody who looks to work in this country for any length of time.
I hope that the Government will think about this new clause very seriously, and perhaps consider whether a “notwithstanding” aspect is necessary, and that if they do not accept it today, they will look at the matter again in another place.
Philip Davies (Shipley) (Con)
I apologise for not being here when my hon. Friend the Member for Stone (Sir William Cash) opened the batting on this new clause.
I very strongly support the sentiment behind the new clause. It should go without saying that people who are practising medicine should be able to communicate properly in English. It is a sad state of affairs when we have got to a point where we feel the need to introduce legislation in this regard. Whatever the rights and wrongs of the matter, sufficient examples have been reported around the country to indicate that we do have a problem. It may not be widespread—it may only occur in pockets—but it is perfectly clear that in some areas there is a problem that needs to be addressed. If the Government do not intend to accept the new clause, I would like to know what they intend to do about this genuine problem that people have identified.
My hon. Friend the Member for Stafford (Jeremy Lefroy) made a reasonable point about the measures that were put in place, partly by the previous Government, relating to new doctors and people who are currently going through training. The problem with that, however, is that it does not deal with the people who are already practising.
Jeremy Lefroy
My hon. Friend makes an extremely important point. Does he accept—perhaps the Minister will comment on this as well—that the revalidation process that doctors now have to go through should include, if it does not already, as I am sure that it must, language and, indeed, communication skills?
Philip Davies
I take my hon. Friend’s point. I am not entirely sure, though, how robust that process is or whether the same test is applied for people who are currently practising as for those who are starting out on their training. I suspect that there may well be a slight difference in the standard that is expected. I hope that I am wrong and he is right; it will be interesting to hear what the Minister says. I would be interested to know how many people have been struck off because they are unable to communicate effectively—if it is hardly any, or none, that would indicate that the current regime is not working effectively—and how often the measures that my hon. Friend mentions have been invoked.
As ever, my hon. Friend the Member for North East Somerset (Jacob Rees-Mogg) made an interesting point about the European Union. I do not intend to get bogged down in that today, but it would be interesting to know what the Minister’s understanding of this is. If he will not accept the new clause, is my hon. Friend’s point a factor in that, or is it his position, and that of the Government, that nothing in EU law would prevent such a provision from being introduced?
Although I agree with the sentiment behind the new clause, I wonder whether its wording is deficient and could lead to some unintended consequences. My hon. Friend the Member for Stone made great play of the need for people to be able to communicate effectively in English, and he is absolutely right, but unfortunately there is no mention of English in his new clause. That seems to be a rather glaring omission that could lead to unintended consequences at a later date. The new clause merely says that people who practise medicine should
“have appropriate language skills to communicate effectively with their colleagues and patients.”
I think what he is really trying to say is that they should have appropriate English language skills to communicate effectively with their colleagues and patients. As drafted, the new clause would place an onus on people practising medicine to have appropriate language skills in general to communicate effectively with their patients. In the case of a patient who speaks no English whatsoever and speaks Urdu, for example, would the new clause insist, in effect, that their doctor must be able to communicate effectively with them in the only language that they are capable of speaking? That would seem to be a possibility, because the crucial word that has been omitted is “English”.
Jacob Rees-Mogg
I have just checked the territorial extent of the Bill, and parts of it apply to Wales as well, so we should not forget the need perhaps to be able to communicate in Welsh where appropriate.
Philip Davies
My hon. Friend makes a good point. That enhances the complication that could arise as an unintended consequence. I agree wholeheartedly with the sentiment of the new clause and the intention behind it, but I wonder whether its wording may lead to unintended consequences in relation to languages other than English that were not foreseen when it was tabled.
Sir William Cash
As my hon. Friend will appreciate, the new clause says:
“The Secretary of State shall by order make regulations enabling the General Medical Council to ensure that all doctors…have appropriate language skills to communicate effectively”.
I am not prejudging this—I will be interested to hear what the Minister says, if he can take advice on the matter, and of course there is the House of Lords to come—but it may well be that the regulations can identify how my hon. Friend’s points, which I completely understand, can be addressed.
Philip Davies
I am grateful to my hon. Friend. He may be right that the points I make can be overcome in one way or another, whether through his existing wording, which may well work, or perhaps a slightly amended version in another place. I just wanted to flag up this issue because I would not want any unintended consequences to come about as a result of the new clause. The whole point is that the onus should be on everybody to be able to speak English, and I would not want anything to allow for a loophole that prevented that from happening.
I wholeheartedly support the sentiment underlying the new clause. Integration is essential in this country and speaking the language is one of the key forms of integration. I do not see how it is possible to integrate into society if one is not competent in speaking English. I support the idea that people who come to this country should be able to speak English, whether they are patients or doctors—the requirement should apply to both equally. I shall be interested to hear the Minister’s view.
Mr Jamie Reed
Thank you for calling me to speak, Madam Deputy Speaker, and happy new year.
I listened closely to the hon. Member for Stone (Sir William Cash) introducing his new clause 4 and to the other hon. Members who have spoken on it. They are correct to say that good communication between professionals and patients is crucial for ensuring positive health outcomes. I would go so far as to say that it is critical. One of the issues that we need to address in this regard is the needs of patients with sensory impairments, such as deafness and blindness. That is not covered by the new clause and it has no regard for nationality or language skills.
In April 2010 the Health Committee conducted an inquiry called “The use of overseas doctors in providing out-of-hours services” following the tragic death, to which the hon. Gentleman referred, of David Gray in 2008 after receiving medical treatment from Dr Ubani from Germany, who was working his first shift as an out-of-hours doctor in the United Kingdom. The report recommended that the Government make the necessary changes
“to enable the GMC to test the clinical competence of doctors and undertake systematic testing of language skills so that everything possible is done to lessen . . . the risks of employing another unsuitably trained . . . doctor in out-of-hours services.”
Following this case, I understand that the Government have, with the support of Labour, worked to strengthen the powers of the General Medical Council in this regard. We welcome that.
Notwithstanding all this, I am unsure what the hon. Gentleman is trying to achieve. Given the existing practice of the GMC, the new clause, although agreeable in principle, is superfluous. The GMC conducts English language assessments already, and failure to undertake an assessment or failing such an assessment can result in fitness to practise hearings, which can lead to a loss of registration to practise.
These assessments can be triggered in a number of ways. A single complaint from a patient, a health professional or another party can result in an assessment, as can prescribing errors and poor record keeping. Overseas medical regulatory authorities can prompt an English language assessment if they believe that a doctor does not have sufficient knowledge to treat patients in an English-speaking context. Indeed, the GMC website tells international doctors that
“you must satisfy us you have the necessary knowledge of English to get registration with a licence to practise”.
So the GMC needs to be satisfied before a licence to practise is granted. These tests relate to all forms of communication—speaking, reading, writing and listening. It is right that the GMC continues to be vigilant in its oversight of this requirement. Good communication is central to patient safety, and the GMC does a great deal to ensure that those practising in the NHS have the skills required to do so safely.
I want to place on record an acknowledgement of the contribution made to our national health service, which I know nobody doubts, by the many overseas health care workers without whom the NHS would not be able to cope, including in my constituency. On Second Reading of the National Health Service (Amended Duties and Powers) Bill, my hon. Friend the Member for Bolsover (Mr Skinner) commented that he had received a “United Nations heart by-pass” operation, by which he meant that people from all over the world had done a great deal for the health of this country, and we should all be thankful for that.
We have touched briefly on unintended consequences. Some politicians have recently sought outside the House to manipulate and inflame the issue with a view to creating an imaginary bygone Britain in the public consciousness as part of a long-standing flight from reality based on bizarre notions such as “gay rain”, the enforced segregation of breastfeeding mothers from public spaces and the right to use racist language. We must all be careful not to legitimise this abhorrent, detached, cultish behaviour or the perverted mindset which underpins it.
Dr Poulter
I am grateful to my hon. Friend the Member for Stone (Sir William Cash) for tabling the new clause. We all agree that it is vital that doctors can speak and communicate effectively in English. My hon. Friends the Members for North East Somerset (Jacob Rees-Mogg) and for Shipley (Philip Davies) made a number of important points.
I hope I can bring some reassurance to hon. Members that there are already in place, thanks to changes introduced by this Government, a number of strong tests for language competency and the ability to communicate. It is not good enough for a medical professional to be able to speak English; it is important in all aspects of health care that we can communicate effectively with our patients. The ability not just of doctors from overseas when they work in and contribute to the NHS, but of doctors who have been working here for many years to communicate effectively is at the heart of good medicine. There are a number of steps that this Government have taken to strengthen the tests in place.
To echo the comments of the shadow Minister, I have worked alongside many doctors and many health care professionals from all over the world who have come here to contribute to our NHS and to the care of patients. Many of those doctors have been outstanding and continue to look after patients today as we debate the new clause. One of the strengths of our diverse NHS is that because we have a world-class health service, doctors want to come here and contribute as part of their careers, often for a short period, before they return to New Zealand, Australia or the many other countries from which they have come. The diversity of our NHS and the fact that we attract doctors—often the very best doctors—from all over the world is a great strength, but it is vital that all doctors can both speak English and communicate effectively in English. That is not controversial, and it is what good patient care is all about.
Clause 5 and the schedule will introduce a consistent overarching objective for the Professional Standards Authority and professional regulators—the General Dental Council, the General Optical Council, the General Osteopathic Council, the General Chiropractic Council, the Nursing and Midwifery Council, the Health and Care Professions Council and the General Pharmaceutical Council—to ensure that public protection is at the heart of what they do.
The clause introduces the term “well-being” into the objectives of a number of these regulators. This has been a long-standing and established feature of the legislation for the General Pharmaceutical Council, the Health and Care Professions Council and the Nursing and Midwifery Council. The term encompasses those aspects of a health care professional’s role that may have an impact on individuals but may not directly impact on their health or safety: dignity, compassion and respect are all vital aspects of delivering high-quality care. This was highlighted most starkly in the Francis inquiry report of February 2013, which put into focus the terrible and serious failings in the care provided at the former Mid Staffordshire NHS Foundation Trust, which was the basis on which my hon. Friend the Member for Stafford (Jeremy Lefroy) introduced the Bill.
One specific area where real changes in the protection of patients are being made relates to the strengthening of arrangements to ensure that all health care workers have sufficient knowledge of English and the ability to communicate effectively with patients in English before being allowed to work in the UK. The General Medical Council has always been able to check the language skills of doctors from outside the European Union who want to practise medicine in the UK. It does this through the international English language testing system, which covers all four language skills—listening, reading, writing and speaking—and it is widely accepted by employers, the other health care regulators and professional bodies as a means of assessing proficiency in English in a professional environment. The GMC continually assesses the effectiveness of this test to ensure its robustness.
In addition to this test of their language skills, the GMC conducts a professional and linguistic assessments board exam—often called the PLAB exam—for doctors from outside Europe. This tests their reactions to a number of clinical scenarios and their ability to apply their clinical knowledge to the treatment of patients and is the main route by which international medical graduates demonstrate that they have the necessary skills and knowledge to practise medicine in the UK.
However, following the death of a patient, David Gray, and the tragic circumstances surrounding that death in 2008 after he received medical treatment by Dr Ubani, a German national, where language skills were a strong component in the incident, a House of Commons Health Committee report recommended that the Government change the law to allow the GMC to extend language tests to doctors within the European economic area, providing consistency in how doctors from both within and outside the EEA are treated with regard to assessing their language skills, before being allowed to practise medicine in the UK.
The Government made a commitment in the 2010 coalition agreement, which the shadow Minister has mentioned, to stop foreign health care professionals working in the NHS unless they have passed robust language tests. We have fulfilled that commitment in respect of doctors, and we are now putting in place additional measures, through section 60 orders, to introduce language testing for other health care workers.
Sir William Cash
Is the Minister satisfied that the measure complies with European law and that we do not need a notwithstanding arrangement? He may hope that it will not fall foul of the European Court of Justice, but has he taken advice on that? If not, will he do so after we have finished our proceedings?
Dr Poulter
I hope I can reassure my hon. Friend on that. I am absolutely sure that our measures are consistent with European law and I took advice consistently on that, although there was a difference of opinion in how the previous Government and this Government interpreted advice. I work very closely with the General Medical Council, which receives its own independent advice, and I worked with its former chair, Sir Peter Rubin, who has been a tireless campaigner for the measure. Together with the GMC, we introduced measures that are consistent with European law and mean that we are able to test the language competency of EU doctors. I am sure that there is consistency: a similar process is in place in Bavaria in Germany. Although there can be free movement of qualified health care professionals to different member states—their skills can benefit our NHS—it is also important that they can perform a doctor’s functions properly, and it is not possible for them to do that if they cannot speak English and communicate effectively with patients. Our measures are consistent with the advice I have received and, indeed, with the views of the GMC. This is the right thing to do and I am pleased that the coalition Government have put in place language tests.
Last April, I led through this House changes to the Medical Act 1983 to strengthen the arrangements to ensure that all doctors, including those from within the European economic area, must have sufficient knowledge of English before being able to work and look after patients in the UK.
I hope my hon. Friend will agree that patients are much better protected by the new powers the Government have given to the GMC. When the GMC implemented language checks for European doctors in June 2014, it also raised the pass mark for its language tests. The GMC has vigorously used the powers given to it by the Government. Since the Government changed the legislation last April to strengthen the language test arrangements, 128 EEA doctors have been refused a licence to practise medicine in the UK owing to inadequate language skills. That shows that the measure is working to protect patients in the UK from EU doctors who cannot speak English effectively. It is having an effect—it is biting—and making sure that patients are being properly protected. I will write to hon. Members to outline the measure further, and I will perhaps ask the GMC to contribute to that letter. The measure was long overdue and I am proud that we introduced it. It is protecting patients in the UK from doctors who cannot communicate effectively.
As part of a belt-and-braces approach to ensure that all doctors looking after patients can speak a good standard of English and communicate effectively with them, in 2013 responsible officers in England—senior doctors in health care organisations who oversee the employment of other doctors—were given additional statutory responsibility for ensuring that doctors
“have sufficient knowledge of English language necessary for the work to be performed in a safe and competent manner”.
In addition, on medical revalidation, which was raised by my hon. Friend the Member for Shipley, the Government have taken the important step of ensuring that all doctors must show evidence of competency on a maximum of a five-yearly basis in order to maintain their medical licence. That has improved checks on all aspects of a doctor’s work, including how well they work as part of a multidisciplinary team, how well they communicate with their patients and whether they are keeping up to date with medical practice.
Philip Davies
I welcome what the Minister has said and commend him for that initiative. In order for us to be able to see how robust the revalidation process is, can he tell us how many people have been through it and how many have failed as a result?
Dr Poulter
The revalidation process is ongoing and is reviewing everybody on the medical register. It is very easy to revalidate someone who is training to be a specialist as a surgeon or in some other hospital position, because they are assessed annually as part of their specialist training. The revalidation process for the consultant and general practice work force—which kicked off as a five-year programme—is ongoing. Some people have volunteered to come off the medical register, including retired doctors who have not practised for some time. I would be happy to write to my hon. Friend to update him on the revalidation process. It will not be completed for another couple of years, but once we have gone through the first cycle of revalidation the process will be easily repeated. I stress that doctors will be revalidated on a maximum of a five-yearly basis. It is possible for the GMC to seek reassurance with regard to certain specialties by requesting more regular competency tests as part of the annual appraisals.
The revalidation process is an important new power that is being implemented effectively. We need to keep it under review because it is important that all doctors, regardless of the proposed new clause on language testing, are competent, keep up to date with medical practice, able to communicate effectively and empathetically with their patients, and work as part of a multidisciplinary team for the benefit of patients. That applies to general practitioners, hospital specialists and those working in mental and physical health. It is an important step for which the GMC has been asking for many years and in which other health care professions are taking an interest. The Nursing and Midwifery Council is considering revalidating nurses in a similar way in future. It is a welcome measure that will help protect patients and the public. It is making good progress and I will write to my hon. Friend with further details in due course.
Medical revalidation is the process by which the GMC evaluates whether doctors can keep their licence to practise in the UK. In addition, a doctor wanting to work in general practice in the UK must also be on the national medical performers list, which is managed by NHS England. To be included on the list, the doctor must hold a licence to practise from the GMC and, as a consequence of the revalidation programme, he or she must have effective communication skills.
As I outlined earlier, the key step to improving checks on language competency for EEA doctors was the Medical Act 1983 (Amendment) (Knowledge of English) Order 2014, which made changes to the Medical Act 1983. My hon. Friend the Member for Shipley will be pleased to hear that the title of the order refers to English. After all, the General Medical Council regulates doctors on their ability to speak primarily that language, and I hope that that reassures him.
The order gave the General Medical Council the power to refuse a licence to practise to a medical practitioner from within the EU who is unable to demonstrate the necessary knowledge of English. It created a new fitness to practise category of impairment relating to language competence to strengthen the General Medical Council’s ability to take fitness to practise action where concerns are identified.
For example, if I, as a doctor, worked with a doctor about whose language competency I had concerns, or if a doctor was not able to communicate effectively in their day-to-day work, I, fellow health care workers and patients could report the doctor to the GMC, which—in addition to the existing initial point-of-entry language testing powers and the revalidation process—now has new powers to take action specifically in relation to such language concerns. That is another important measure that the Government have introduced to strengthen the GMC’s powers on language testing.
The change enables the GMC to require evidence of English language capability as part of the licensing process in cases where language concerns are identified during registration. Just as doctors from outside the European economic area can be tested on their language competency, the same competency tests now apply to doctors coming to work in the UK from within the European economic area, thanks to the new regulations. We hope that the wrongs identified following the dreadful Daniel Ubani case and the tragic death of David Gray have now been righted through very strong legislation to ensure the competency and ability to communicate in English of all doctors coming to work in the United Kingdom. As I have outlined, additional measures are now in place to enable the GMC to take action if concerns are raised during the ongoing medical practice of any doctor about their ability to speak English and to communicate effectively with their patients.
The process for determining whether a person has the necessary knowledge of English is set out in the General Medical Council (Licence to Practise and Revalidation) Regulations Order of Council 2012. The GMC has published guidance setting out the evidence required to demonstrate that a person has the necessary knowledge of English. With regard to the fitness to practise changes that have been introduced, a new category of impairment relating to English language capability has been created, which allows the General Medical Council to request that a doctor about whom concerns have been raised undertakes an assessment of their knowledge of English during a fitness to practise investigation.
The changes have hugely strengthened the General Medical Council’s ability to take fitness to practise action where concerns about language competence are identified in relation to doctors already practising in the UK. We are in the process of bringing in similar powers for the Nursing and Midwifery Council, the Pharmaceutical Society of Northern Ireland, the General Pharmaceutical Council and the General Dental Council to ensure that the health care professionals they regulate—nurses, midwives, pharmacists, pharmacy technicians, dentists and dental care professionals—will also have appropriate language skills for the roles that they perform. The consultation on our proposed legislative changes for those four regulators closed on 15 December, and we will publish the outcome shortly with a view to immediate legislation.
I want to pick up the good point made by my hon. Friend the Member for North East Somerset about the need for primary legislation. I hope that he is reassured that the existing legislation, and the ability to bring in regulations underpinning that through section 60 orders underpinning the Medical Act 1983 and other Acts, provides the ability to bring in strong regulations to protect patients and the public in respect of language competency. The Government have done exactly that. There will be future opportunities to legislate in the form of a Law Commission Bill, which would make it possible to neaten up the already very robust and strong regulation on language testing that we have introduced. I am sure that we will consider doing so at the first opportunity.
I hope that such measures will reassure my hon. Friend the Member for Stone. Thanks to this Government, strong laws have been passed, and very strict new rules are now in place to ensure that doctors practising medicine in the UK can do so only if they can communicate with patients using a high standard of written and spoken English. With that reassurance, I hope that he will withdraw his new clause.
Sir William Cash
I have listened to the Minister with great care and interest on the question of language skills. Despite his comprehensive description of the measures brought in, I feel that one or two areas might yet be usefully considered in the other place. I would be extremely glad if somebody raised them, just to test those measures further. This is the first time that we have heard such an excellent and comprehensive analysis on the Floor of the House in relation to a Bill of such importance. We are talking about situations in which there should be zero harm, so we do not want any doubts on the question of English language skills. In practice, I am prepared to withdraw the new clause, with the proviso that the matter should be looked at again in the other place at a future date. I beg to ask leave to withdraw the clause.
Clause, by leave, withdrawn.
Third Reading
Jeremy Lefroy
I beg to move, That the Bill be now read the Third time.
I thank all those who have worked with and supported me in bringing the Bill to this stage. I especially thank my hon. Friend the Member for Stone (Sir William Cash), who, as I mentioned on Report, has been an inspiration, as have Julie Bailey, Ken Lownds and many others who campaigned for the Francis inquiry. My hon. Friend the Member for Mid Norfolk (George Freeman), who is now a Minister, was also a driving force—clauses 2 and 3 are substantially based on a Bill that he had previously introduced—and I thank him for his work and support. I also thank all hon. and right hon. Members who served in Committee and who sponsored the Bill.
I thank the Clerks in the Public Bill Office for all their help, advice and skill, as well as the Bill team and others in the Department of Health, who worked extremely hard, for all their skill and advice. Finally, I thank the hon. Member for Copeland (Mr Reed) and his Front-Bench colleagues, and my hon. Friend the Minister and his Front-Bench colleagues for supporting measures that I believe will assist us to get what we all want—higher-quality, safer and more integrated health and social care.
That is the purpose of the Bill: if it does not help in some important ways to achieve that, it will serve no purpose. I believe that it will do so for several reasons. First, it will ensure that every Secretary of State makes patient safety a priority at all times. Would that have prevented the tragic events at Mid Staffordshire or in other hospitals, surgeries or care homes? It would certainly not have done so in every case, but I am convinced that the attention given to safety would have done precisely that—prevented much avoidable harm to patients. In the important words of the Prime Minister in response to the Francis report on 6 February 2013:
“Quality of care means not accepting that bed sores and hospital infections are somehow occupational hazards—that a little bit of these things is somehow okay. It is not okay; they are unacceptable—full stop, end of story. That is what zero harm—the jargon for this—means.—[Official Report, 6 February 2013; Vol. 558, c. 281.]
Secondly, the Bill will put in place another of the necessary building blocks for the integration of health and social care that we all desire. A consistent identifier is not sufficient to bring about integration, but it is most certainly necessary and will help in some way.
Thirdly, the Bill will help the sharing of information, which is vital for a person’s care. Almost everyone with whom I have discussed this matter has told me of times when they or their loved ones have had to repeat information about their care on several occasions, or found that vital information—perhaps regarding medication or allergies—was simply not available to the person caring for them.
Finally, the Bill will bring consistency to the objectives of the regulation of the health and social care professions under the overarching objective of the protection of the public.
During the passage of the Bill, a number of important questions have been raised, both within and without the House. I am grateful to those who have raised them, because it is vital that a Bill such as this receives strict scrutiny.
A fear was expressed that the consistent identifier would become an ID card by the backdoor. The identifier could never become an ID card because it will be used only to facilitate the provision of health services or adult social care, and it must only be used in the individual’s best interests.
It has been asserted that there is no need for the duty to share information because the sharing of information is already required as part of the professional duties of health and care professionals. However, Dame Fiona Caldicott’s review in 2013 concluded that such sharing was not always happening as it should as a result of a “culture of anxiety”. The legislative landscape was found to be a contributory factor and a risk-averse attitude to information sharing was cited as a barrier to sharing by staff who deliver care directly to individuals. The Bill seeks to provide a remedy, while setting clear limits on the information that can be shared and the circumstances under which it can be shared.
Others have concerns about the Bill’s introduction of
“public confidence in the professions”
to the objectives of the regulatory bodies. The Law Commission’s report of April 2014 noted:
“It was argued that maintaining confidence in the profession was being used to punish professionals who pose no threat to the public for something which incurred the profession’s, or the public’s, disapproval. Specific examples included a nurse who was disciplined for publishing a work of fiction about euthanasia and an investigation into a doctor’s behaviour at a Parent-Teacher Association meeting. Some argued that the concept of maintaining confidence in the profession was too subjective and difficult to quantify to form the basis of a statutory duty.”
The report concludes that in constructing the draft Bill on which the provisions of the Bill are based, the Law Commission was
“not seeking to change the current legal position or disrupt the relevant case law. The clause restates the existing legislative position that public protection is the regulators’ ‘main’ objective, and recognises that the public interest also consists of promoting and maintaining public confidence and proper standards of conduct and behaviour.”
I have no doubt that, should the Bill receive its Third Reading today, all the matters that I and others have raised will receive further scrutiny in the other place by experts.
No legislation can guarantee that there will be safe, high-quality care. Such care is founded on the capability, commitment and compassion of those who work day and night in our health and care services; no law can bring it about. What legislation can do, and what this Bill seeks in some small way to achieve, is to ensure that the framework within which those people work is sound—that the systems, resources, training and regulation that they need to provide safe, high-quality care are in place. In doing so, this is a Bill for both patients and professionals; for avoidable harm and poor care hurt both, while safe, high-quality care is a blessing for all.
Sir William Cash
I simply want to say how glad I am that the Bill has reached its Third Reading and to congratulate my hon. Friend the Member for Stafford (Jeremy Lefroy) on piloting it through, with the conspicuous help of the Minister and the Government. As I have said before, Ken Lownds and others have also been involved. Over the many years that I have been involved in the Mid Staffordshire situation, Ken Lownds has been a tower of strength, and we are all very grateful to him.
This is a Bill of national importance on a scale way beyond that of many private Members’ Bills. My hon. Friend deserves congratulations from all parts of the House on bringing it forward. I am glad that the Opposition are giving it a fair wind because it has a truly national purpose. It is in the interests of everybody that we achieve the kind of zero-harm care to which we should aspire.
I am extremely glad that the Bill will now go to another place, where, as my hon. Friend said, there are many experts who will no doubt say quite a lot about it. There may well be further amendments that will come back to this place. I urge their lordships to have regard to the importance of the Bill and the principles that lie behind it, and to seek amendments in the light of the fact that it is about our constituents. We, as an elected House, know—certainly my hon. Friend and I know—of the hard experience and tragedy that have been experienced by our constituents. Our constituents—the people of this country—deserve to have the improved health care that the Bill will help to achieve.
After those few words, I simply reiterate my thanks to my hon. Friend.
Jacob Rees-Mogg
I follow my hon. Friend the Member for Stone (Sir William Cash) in congratulating my hon. Friend the Member for Stafford (Jeremy Lefroy) on piloting the Bill so safely through the House. It is not necessarily easy to get private Members’ Bills through—and nor should it be—given the Scylla of the Back-Bench Tories who are not keen on new Bills coming through and the Charybdis of the Opposition, who sometimes suck Bills down to the bottom of the sea. I therefore congratulate him warmly on having achieved it.
My hon. Friend has done something that rather surprisingly was not done in the first place. The explanatory notes state that clause 1
“has the effect of removing the Secretary of State’s discretion around whether the requirements for registration with CQC should cover safety of care.”
It is amazing that the Secretary of State had that discretion. Why on earth would anyone want the Secretary of State to be able to think, “It doesn’t really matter if the safety of care is implemented or not. I think on this occasion I won’t bother with it.”? How reassuring it is that somebody has had the sense and wisdom to bring forward a Bill to close that extraordinary loophole, drawing on the experiences that are well known, particularly to the Members of Parliament from Staffordshire.
I take great comfort from what my hon. Friend said about the identifiers not being—to carry on with my Greek mythology—a Trojan horse to bring in an identity card system. It really would have set trouble alight if he had been trying to do that, but it seems perfectly reasonable to have a system that sees efficiently who people are within it and has a consistent form of identifying them. Having a notional go at an identity card system does not seem reasonable, so I am glad that he has stated so clearly that the Bill is not intended to do that. I am sure that their lordships will take careful note of that.
It is a tremendously important Bill that is being passed today, and one that I am sure that the other place will want to expedite because there is little time left between now and the end of the Session. The Bill will ensure that the primary duty of not doing harm to patients is established in law. As I said, it is extraordinary that it was not there before. I commend my hon. Friend for his discovery of that lacuna and his closing thereof.
Mr Jamie Reed
I, too, pay tribute to the work of the hon. Member for Stafford (Jeremy Lefroy). The diligence and tenacity with which he has pursued the Bill, and the collegiate nature in which he has done so, are to his eternal credit.
Members across the House, many professional bodies outside this place and others support the principles and aims of the Bill. Harm-free care is something to which everybody in our NHS aspires. Although it is something that, frankly, we should take for granted, it is something that any health care system in any part of the world must work tirelessly to achieve. Credit must go to the NHS staff, both clinical and non-clinical, who work tirelessly, often in very trying circumstances, to deliver high-quality care. I am sure that Members from all parties will echo that sentiment.
I do not wish to repeat what I said on Second Reading, in Committee or on Report, so I will keep my remarks relatively brief. The key principles of harm-free care, data sharing, and consistent objectives for regulatory authorities have been welcomed by the Opposition, and I will touch briefly on the why those things are important.
I have already mentioned harm-free care, and the Bill will give power to the Secretary of State to bring forward regulations to ensure that high-quality, safe care can be delivered. A wide-ranging power is being granted to the Secretary of State, and I welcome the Government’s assurances that any measures introduced will be subject to full parliamentary scrutiny, as is proper with such issues.
We have already debated the benefits and risks of data-sharing, and Third Reading is not the place to do so again. I have been clear about the benefits that can be realised through effective data-sharing, although there are still concerns, many of which I raised on Second Reading. It is important that the national data guardian is put on a legal footing to ensure that any issues that arise can be dealt with effectively and swiftly.
On the regulation of health and social care professions, it is logical to have a consistent overarching objective for regulatory bodies, and right that that objective is patient safety. A number of bodies continue to express concerns about a possible conflict between the practical implications of a number of those objectives, and I ask the Government to keep that under review to ensure that the Bill is effective.
The issue of public confidence runs through the entire Bill, and the hon. Member for Stafford touched on that in some detail. We all want to have confidence that the care we receive is of the highest quality, and to have confidence in the integrity and security of the data and private information that the NHS holds about us. We need to know that our data are used only with our permission and for the betterment of health and social care provision. Finally, we want confidence that doctors, nurses and others are properly supported and regulated to ensure that best practice is always followed. The Bill should help to ensure public confidence in those areas, which is why Labour will support it today.
Dr Poulter
We have had a productive debate, and I thank hon. Members on both sides of the House for their contributions. I put on record my appreciation for the consensual way that the Bill has been approached by all parties, and I thank the hon. Member for Copeland (Mr Reed) for his constructive attitude. Few private Members’ Bills make it beyond Second Reading, and there is determination across the House to improve patient safety. I hope we can get the Bill on to the statute book as soon as possible.
I commend my hon. Friend the Member for Stafford (Jeremy Lefroy) who, with tireless effort, is doing his best to ensure that the terrible experiences at his local hospital never happen again. The Government have thrown their full support behind this important Bill, which will do much to improve the safety of patients and protect the public. I also commend my hon. Friend the Member for Stone (Sir William Cash) on his dedication to raising some of the issues that led to the Francis inquiry and to this Bill, and for his tireless advocacy on behalf of his constituents in Stone and its surrounding areas.
We would not be where we are with this Bill without my hon. Friend the Member for Stafford. All MPs can learn from his example of outstanding public service and putting the interests of his constituents and local patients first. I congratulate him on his dedication and hard work on the Bill. I also thank my officials in the Department of Health, the Clerks of the House, and everybody who has contributed and put a lot of work into the Bill. It is rare for a Bill to get past Second Reading, and a lot of work has been done. I thank everyone who has supported my hon. Friend’s efforts to make these important changes.
I will not dwell on the importance of the Bill because we had that debate on Second Reading, in Committee and on Report. I am sure we all agree that ensuring that the CQC is operationally independent from the Secretary of State and free from political interference is vital. Not Whitehall nor the Secretary of State, but independent, professional inspectors on the ground who understand what good care looks like must carry out hospital inspections, and the Bill will further support the independence of the CQC.
The Bill will also ensure that we improve the use of information for the purposes of direct care. In Committee we discussed the importance of joined-up care, so that a doctor who receives a vulnerable patient with dementia from a care home is better able to care for them because they have access to care records for the immediate purpose of delivering care to that patient. That saves doctors and nurses time and means they can understand their patient better, and the patient will therefore be cared for in a better way. These important measures will help health care professionals to look after their patients more effectively. As Fiona Caldicott said, there is a duty on professionals to share information for the provision of direct care. That is what the Bill is about and it will hugely benefit patients. I reiterate the Government’s commitment to consulting on the role of the national data guardian in the future.
In conclusion, the Bill is about patient care and safety, which should be at the heart of everything our NHS does. This is what everyone engaged in the delivery of health care is primarily concerned about, and that is why many people—including myself—became health care professionals. We care about patients and want to do our best for them. The Bill will do much to improve the safety of patients and protect the public. It is a welcome Bill, and patients in Stafford and across the country will be grateful to the hon. Member for Stafford for introducing it. I thank him for that and urge hon. Members across the House to give the Bill their full support.
Question put and agreed to.
Bill accordingly read the Third time and passed.
Self-build and Custom Housebuilding Bill
Sir William Cash (Stone) (Con)
I beg to move amendment 1, page 3, line 3, at end insert—
‘(3) Guidance issued by the Secretary of State to authorities under subsections (1) and (2) shall only be issued after a statutory consultation period of not less than three months.”
I seem to be doing a bit of overtime today, but I do so in the spirit of debate, discussion and dialogue, and to probe some of the matters inherent in this important Bill.
Clause 3 deals with guidance:
“A relevant authority must have regard to any guidance issued by the Secretary of State when exercising any function conferred or imposed by or under section 1 or the Schedule.
An authority mentioned in section 2(2)—”
that is pretty much any kind of local authority one can imagine—
“must have regard to guidance issued by the Secretary of State when exercising the duty imposed by section 2, including guidance about identifying functions affected by the duty.”
My amendment proposes a further provision for clause 3. It is a simple proposal that would require statutory consultation of not less than three months, and the guidance issued by the Secretary of State would be given only after that consultation period. The type of guidance issued by the Secretary of State under section 3 might be broad, as might the range of situations that may need guidance. Vanguard councils are experimenting with registers, willingly and voluntarily, which will be important. In a nutshell, it would be a good idea to consider having a statutory consultation period of not less than three months to accompany those arrangements.
My proposal is very simple and one that needs to be well considered. All I need say in conclusion is that I regard the amendment as an opportunity to discuss and debate the question. I am happy to listen to the arguments other hon. Members put forward.
Mr Richard Bacon (South Norfolk) (Con)
I am grateful for the opportunity to speak to the amendment tabled by my hon. Friend the Member for Stone (Sir William Cash), which would require statutory consultation before guidance was introduced.
When I originally drafted the Bill, I considered whether there should be consultation before the guidance, and whether it should be statutory. It is worth saying to my hon. Friend that the Bill is quite thin and will work satisfactorily only with guidance—he is right to identify that guidance is an important component. My hon. Friend alluded to the reason for that: the range of authorities that are planning authorities is very wide.
The Bill does two things: it requires planning authorities—the Bill calls them “relevant authorities”—to keep a register; and it requires them to have regard to that register when exercising their statutory functions, whether that is planning, housing, the disposal of land or regeneration. The range of authorities that are planning authorities is wide. For example, an inner-London borough is a planning authority, but so is a national park. In a rural area such as South Norfolk, a rural district council, as we called them in the old days, is a district council and therefore a planning authority. It is not possible to imagine a set of rules or guidance that would be applicable equally to an inner-London borough and a national park. What might be reasonable for us to expect of a planning authority in a mixed rural and urban area with plenty of land to show that it had had regard to its register, might be unreasonable for us to expect of a planning authority in a dense inner-London borough that has much greater land availability problems. For different reasons, it might not be reasonable for us to expect the same thing of a planning authority such as a national park. Any guidance would therefore by its nature be varied, depending on the circumstances.
My hon. Friend mentioned the role of the vanguard councils. He is right that they are crucial. With a small pot of money from the Department for Communities and Local Government, they are experimenting and establishing what works best in terms of establishing and operating a register. The vanguard councils are doing voluntarily and willingly what will in due course become a duty for all councils. The idea is that all councils that are faced with the new duty—the duty to operate a register and to have regard to it—can learn from the vanguard councils about the best way to set up and operate a register, and integrate the running of the register with the council’s planning, housing, land disposal and regeneration functions.
It would be wrong to be over-prescriptive and to place new burdens on councils, especially given that the vanguard councils from which much of the learning will come are at an early stage. I have no doubt that in due course as the Bill is implemented, it will be sensible in most cases for the Department to consult local planning authorities of different types, depending on the nature of the guidance it wishes to issue in different cases. It would particularly be worth consulting vanguard councils, which will have valuable experience to share. That is the point of the vanguards.
My hon. Friend’s proposal to turn the consultation process, which I am sure will happen, into a legal obligation with a statutory three-month consultation period would inevitably create more inertia, which is precisely what the Bill aims to cut through. The aim of the Bill is to start to unblock the logjam of housing supply by allowing customers more say over what they want rather than leaving them little choice but to accept what a big developer tells them they want. The underlying philosophical drive behind the Bill is that if we build more houses as if customers matter, we will end up with more houses, which is what the nation so badly needs. The aim is most definitely not to create yet more process and inevitably more delay, which I fear statutory consultation would do.
I understand my hon. Friend’s concerns, but I hope he will agree that statutory consultation is not necessary and consider withdrawing his amendment.
Lyn Brown (West Ham) (Lab)
I thank the hon. Member for Stone (Sir William Cash) for his interest in the Bill and for his speech.
As hon. Members know, the Opposition support the Bill and see no reason to support the amendment in that form. We are convinced by the points made by the hon. Member for South Norfolk (Mr Bacon) and are content with the Bill.
The Minister of State, Department for Communities and Local Government (Brandon Lewis)
I, too, thank my hon. Friend the Member for Stone (Sir William Cash) for taking an interest in the Bill and for working to ensure that the Bill is as strong as it can be. He suggests that there should be a statutory consultation period of three months before any guidance is issued by the Secretary of State. I thank him for raising the important issue of consultation and guidance, and for giving me the chance to explain the Government’s position, which I hope I can.
I know from the experience of our right-to-build vanguards that it is important that any national framework for the register is sufficiently flexible to reflect the considerable differences—my hon. Friend the Member for South Norfolk (Mr Bacon) outlined the differences—in the scope for custom build in different parts of the country. It is important that we seek the views of a wide range of interested parties, particularly when we are establishing the detailed framework, but I am not convinced of the need for a statutory consultation period before the issuing of guidance. I am afraid that the Government cannot support the amendment.
Statutory consultation can have a valuable role, but it is not necessary or desirable for every Government action. When used unvaryingly, it can have a detrimental impact on policy and create significant delays. That is not to underplay my understanding of the point that my hon. Friend the Member for Stone makes—I acknowledge his point.
In many instances, the Secretary of State may issue guidance to local government without being required to consult local government and other partners before doing so. For example, we are not statutorily required to consult on national planning policy guidance. In the case of the Bill, we believe that statutory consultation would only delay the implementation of the custom and self-build register that the Bill seeks to establish. The explicit requirement in the amendment for at least a three-month consultation period seems excessive, especially given that our current consultations on planning policy matters are normally around six to eight weeks, which gives local authorities and others sufficient time to respond.
My hon. Friend’s amendment would also mean that the Government must consult for a considerable period on even minor revisions to the guidance, which would clearly add unnecessary bureaucracy. Arguably, it would increase the burden on local authorities. My hon. Friend wants neither of those things and we strongly want to avoid them.
To deal with what my hon. Friend desires, local authorities have been key influences in the development of the policy, as we have demonstrated through the right-to-build vanguards. My hon. Friend the Member for South Norfolk outlined how important they have been in the development of the policy—I will return to that on Third Reading, which will I hope will happen shortly. We fully intend to maintain this close link with local authorities and other partners in implementing this policy, including in drawing up the guidance.
With those few words of explanation, I hope my hon. Friend feels reassured enough to be able and willing to withdraw his amendment.
Sir William Cash
I have listened with enormous care to what the Minister has said and to the shadow Minister. My intention from the very beginning has been to make sure that the Bill has proper consideration and that it receives all the assistance it needs to get through. I have every confidence that that is exactly what will happen, and I congratulate my hon. Friend the Member for South Norfolk (Mr Bacon) on his proposals. In the circumstances, having listened to the arguments, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Third Reading
Mr Bacon
I beg to move, That the Bill be now read the Third time.
I am grateful to the House for its consideration of my Bill. I should point out that there was a technical amendment in Committee to change the long title, but that was merely to bring it into conformity with the published Bill’s aims on Second Reading, which were narrower in scope than the long title I presented on First Reading. For the record, therefore, I feel I should state that the long title now refers to a Bill
“To place a duty on certain public authorities to keep a register of individuals and associations of individuals who wish to acquire serviced plots of land to bring forward self-build and custom housebuilding projects and to place a duty on certain public authorities to have regard to those registers in carrying out planning and other functions. “
I shall be brief, as the Bill has been discussed thoroughly at previous stages. There was support for it from hon. Members on both sides of the House on Second Reading and in Committee. Other than the technical amendment to the long title, no amendments were made.
I am delighted that there is political consensus in favour of the Bill. The Minister responsible for housing and planning, my hon. Friend the Member for Great Yarmouth (Brandon Lewis), who is my parliamentary neighbour, and the shadow housing Minister, the hon. Member for Wolverhampton North East (Emma Reynolds), have spoken in support of the Bill. I am glad to see the hon. Member for West Ham (Lyn Brown) in her place. The shadow housing Minister would have liked to have been here, but she has other commitments. However, she has been very supportive of the Bill. If we can agree the Bill today, and it gains a fair wind in the other place and reaches the statute book, we will have done a great deal of good for the prospects of self-build and custom house building in this country.
The Bill will require local planning authorities to maintain a register of individuals, or groups of individuals, who wish to acquire a serviced plot of land on which to build a home of their own. Local authorities will then be required to consider the demand for custom build on the register when they, for instance, develop their local plans, regenerate their town centres or old industrial sites, or dispose of surplus public land. I want the register, over time, to become an established mechanism for helping to determine local housing need, similar to the affordable housing register. The register will also form the bedrock of the Government’s proposals for a new right to build, which the Department for Communities and Local Government consulted on last year.
The Bill has been drafted to allow flexibility in the detailed operation of the register to take advantage of the Government’s work in testing the right to build. The Government’s consultation and practical experience with 11 right-to-build vanguard local authorities will inform the final statutory framework for local registers through the detail of the regulations set down by the Secretary of State.
The rationale for the Bill is compelling. We all know that there is considerable latent demand for custom and self-build. We also know that many people want to build their own home, but they are unable to do so, or they find their plans obstructed by the unavailability of suitable land. By helping local authorities to have a better understanding of the local demand for custom and self-build, and then to have regard to that demand in exercising their planning, housing and regeneration functions, the Bill will start to encourage more land to be brought forward for custom build, thus unlocking the huge latent demand for custom and self-build that we know exists.
We will be able to put into action some of the lessons available to us from successful projects, such as the new custom-build communities in the Netherlands, and in other European countries where custom build and self-build are much more common than in the UK.
As the founder of the all-party group on self-build, custom and community housebuilding and place-making, I was particularly pleased last summer to lead a delegation to Berlin to see the successful delivery of a wide range of low-cost collective custom-build projects, which show that it is possible at scale to develop highly desirable options for affordable renting using the custom-build approach. Indeed, it was partly as a result of the Berlin visit that our all-party group assumed its current name. We should have no doubt that involving local people much more closely in developing the housing they want has enormous power to help transform communities.
I offer my particular thanks to the team of officials in the Department for Communities and Local Government, who have done so much to help me with the Bill. I offer my personal thanks to the Clerks in the Public Bill Office, who have been enormously helpful. I also thank all the Members of Parliament who served on the Bill Committee and who have taken an interest in my Bill.
I offer special thanks to Ted Stevens and Michael Holmes of the National Custom and Self-build Association and to the television presenters Kevin McCloud and Charlie Luxton, who have all supported the all-party group’s work during the last year and who have helped to create the environment in which the Bill is seen as the natural next step.
The Bill is not an overnight solution for all the challenges we face in our housing market, but it is an important step towards a world in which we routinely treat the building of houses as if customers mattered. By unlocking the latent demand for custom and self-build, my Bill will help to diversify the market. Most fundamentally, custom and self-build have an important role to play in improving the quality of our newly built environment. We need to build more high-quality homes that are more spacious, that more closely reflect the wishes, hopes and dreams of the people who will live in them, and that are more energy efficient and sustainable. My Bill will help all that to happen, and I commend its Third Reading to the House.
Andrew Bingham (High Peak) (Con)
I was unable to be present for Second Reading, and this speech would probably be more appropriate to a Second Reading. However, the debate took place on a Friday when I was tied up in my constituency.
I want to talk a little about self-build and to promote it based on my own experience. In the early ’90s, I moved house and bought a bungalow that had been built by a self-build group. When I moved in, it quickly became apparent that the quality of the build was way in excess of that of a lot of the other property on offer in and around High Peak at the time.
As we settled in, we noticed certain things. Everything was done to the finest quality. The point about a self-build is that the people who build it build it for themselves. We had bought the property off a member of the original self-build group, and the chap who lived next door was also part of the group. In fact, when I was looking to plant a new hedge at the front of the bungalow, he came out and advised me that the leylandii I was putting in were not quite close enough together and that we did not want anything doing on the cheap on this estate, thank you very much. It is ironic, when I drive past that bungalow, which I moved from some years ago, that the hedge is still standing, and it looks fine and pristine, so I stand by my claims about it.
My neighbour spoke to me about self-build, which I did not understand, and told me that he was involved in another self-build project elsewhere in the High Peak. He suggested that I might like to get involved, as I might want to move to another house and it was a way of moving up the property ladder. I duly went along to the first meeting of the new self-build group, which was put together by a quantitative surveyor who had run the group that had built the bungalow in which I was residing. I remember clearly that we met in a pub, which suited me at the time, in Marple. There was a collection of people I had not met before. As we went around the room, we were asked what we could bring to the group. There was an electrician, a bricklayer, a joiner, a plasterer—all the trades. It was with a little embarrassment, when it came to my turn, that I revealed that my only formal training was as a chef, perhaps creating some anticipation of me brewing up on site. However, I spoke to my late father, Tony Bingham, who was an electrical engineer. Between us, we said that we could contribute to the electrical side.
The QS had identified a piece of land and would do all the planning applications and so on. There were about nine or 10 of us in the group, so there were to be nine or 10 houses. There was a discussion about who would have what plot. In any collection of houses, there is probably one plot that is preferable to the others. We talked about design and it was agreed that lots would be drawn to decide who would have what plot. There was a clear understanding that we would not just work on our own house—if I was having 7 Acacia avenue, my father and I would work on all the houses of Acacia avenue, not just my own. That was the way it would work, which struck me as an excellent idea.
This was in the early 1990s, when property prices were escalating at quite a fast rate. In some ways, there are echoes of today. There were a lot of easy mortgages around in those days—we could have a separate debate on that—but self-build was a way for people to get on to the property ladder by using their own skills. My father and I were going to do the electrical work. I live in a village called Chapel-en-le-Frith, which is in the High Peak. It is very much a community area with people I had gone to school with, so my old school friends were involved in the group. There was a real sense of teamwork and camaraderie, and the QS oversaw the whole project. It is a great way of pulling people together to build properties.
My hon. Friend the Member for South Norfolk (Mr Bacon) made a point about quality, so let us talk about the quality of the properties that will be built. A self-build group or consortium that is building a set of houses of all the same quality is not going to build for themselves houses unless they are of the best quality. Some take part in self-build groups because they can contribute to building a house that is beyond what they could afford to buy on the open market. They may live in the house for many years or they may trade up very quickly. If they are building a house as part of a long-term residential plan, they will not scrimp and do things on the cheap—it will not be all hardboard and plywood. The quality of the build of my house was excellent. At the meeting in the pub in Marple, everybody was clear that they would not scrimp and save, because they were building their own homes. There has been some discussion on the quality of homes that are being built and can be built. One of the many advantages of self-build is that we will get top-quality houses that will last, hopefully, for hundreds of years. That will increase the general quality of our housing stock.
The Minister may well have visited the BRE Trust in Watford, which undertakes research on buildings and the environmental and energy costs of running them. It has done some fantastic work. When I visited a couple of years ago, I was shown a house for which energy costs were—I think, from memory—about £50 for the whole year. Self-build trusts have a lot of discussions about what is on the market to help to reduce energy and heating costs, and £50 a year is phenomenal. I do not think there is anybody in the Chamber or in the country who would not like to heat and warm their house for £50 a year—I think we would all jump at that. Self-build groups can be a vehicle for many of things the BRE Trust has looked at—heat source pumps and so on—to reduce energy costs. A developer who is building many houses may not wish to do that, because of costs and profit. There is nothing wrong with that, but there is an element of “belt and braces” that comes with building one’s home. If there is an energy-saving device that will drastically reduce energy costs—whether a solar panel, heat source pump or technology that is in its infancy—one will consider using it. When it is put into the house, it is there for ever. As well as driving up the overall quality of the houses we are building, self-builds can help the environmental agenda.
Self-build has a great part to play and the Bill, promoted by my hon. Friend the Member for South Norfolk, gives it real teeth and legitimacy. That is why I support it. I still cast my mind back and remember the self-build. It is a fabulous way to get on to, and move up, the housing ladder. This was a way for people to use their skills, whether they were a joiner putting in the doors and window frames or an electrician, with the QS overseeing the purchasing. There will always be issues with a consortium of people. We all know in this place that when there are large groups of people with different opinions we have to satisfy everybody and pull them together. Every self-build group will have such challenges. One member might want a particular design while another member might want another design, but they are bonded together by one thing: to build the best quality house they can. Their skills will not cost them money, just time, so they will build better and, hopefully, more environmentally sound houses for them, their children, their children’s children and our future. More self-build will drive up home ownership, which I am very keen on. Through right to buy, Help to Buy and so on, the Government have done some great things to enable first-time buyers to enter the market. People may be first-time or second-string buyers, but self-build is another way to get people to enter the housing market. With money harder to come by today, it is a great way of enabling more people to get on to the housing ladder and have better quality housing.
This is a commendable Bill. We should support, help and promote self-build. Many people are still not aware of it. I was unaware of it all those years ago until I was approached. We must do more to advocate it. It will not be without its problems—things in life rarely are—but it is a great way of moving forward. I support the Bill.
Lyn Brown
I congratulate the hon. Member for South Norfolk (Mr Bacon) on all the work he has put into the Bill and on getting it this far. I know just how hard that can be, having sat a number of times on private Members’ Bills in the previous Parliament, in particular on the Communities Bill, which took an awful lot of effort and time. I can only imagine the kind of effort he has had to put in to get us to this stage. I also commend him for achieving cross-party consensus. The Opposition are very supportive of the Bill.
If passed into law, the Bill would create an opportunity, for those seeking a plot of land for a new self-build or custom build home, to register their interest with their local authority. The local authority would then have regard to the register in developing its approach to housing and the local plan. We are supportive of this approach, because we think it essential that a range of measures be deployed to tackle the current housing crisis.
We are building half the number of homes we need to keep up with demand, and over the past years we have seen the lowest levels of house building in peacetime since the 1920s. As a result, home ownership continues to decline and is now at its lowest level for 30 years. A record number of young people in their 20s and 30s are living at home with their parents, while 9 million people are living in the private rented sector with little security or stability and facing increasingly unaffordable rents and poor standards.
The Lyons review set out a comprehensive plan for how the next Labour Government will tackle this crisis and get at least 200,000 homes built a year by 2020. A clear conclusion of that review was that we are over- reliant on a small number of builders and we need much more diversity in the housing market. Custom and self-build can be a part of that diversity.
Earlier this year, my hon. Friend the Member for Wolverhampton North East (Emma Reynolds), who apologises to the hon. Member for South Norfolk for not being here today, set out Labour’s plans to boost home building, including measures to support custom and self-build and a register, as proposed in the Bill. Our hope is that as well boosting the level of custom and self-build, we will see an increase in take-up among those on low to middle incomes as a result of having such a register. Custom build should be an option for all those who want their own home—not just for a wealthy few.
In many other countries, the housing market is made up of a much more diverse number of builders, including self and custom builders. This often means the output in house building is much higher, while the homes are also attractive and of good quality—essential if we are to win the support of communities across the country for new homes in their local areas. While the Bill stops short of proposing the fundamental change needed, as set out by Labour, to tackle the housing crisis, it proposes concrete steps that will help boost the self- build and custom house building sector. The Bill is to be welcomed and the hon. Member for South Norfolk is to be congratulated on it. I wish him further luck with it.
Brandon Lewis
I start by endorsing the cross-party harmony and join the hon. Member for West Ham (Lyn Brown) in congratulating my hon. Friend and neighbour the Member for South Norfolk (Mr Bacon) on introducing the Bill. He has carried it through to this stage with his usual passion and individual flair—including mince pies in Committee, which I am still working off on my training bike. It is a testament to my hon. Friend’s passion as well as the necessity for legislation that the Bill has been received so positively across the parties in this House. I am particularly pleased about the cross-party consensus on the Bill’s aims, which will help to give the custom build sector further impetus across the country, and I especially welcome the Opposition’s support.
We had a good debate on Second Reading and in Committee, so I shall not go into too much detail on the Bill’s content. If the House will allow me, I will take a few minutes to explain why the Government support the Bill so strongly and how it will help to take forward our proposals for a new right to build.
The Government are committed to increasing housing supply and helping more people achieve their aspiration of owning a home of their own. When we came into office, the housing market was stalled. In fact, we inherited from the last Labour Government the lowest level of house building since, I think, 1923, which puts things into context. Prospective buyers could not get mortgages, and developers were not building. We have spent the last four and a half years fixing it, and we can see that our efforts are paying off.
I appreciate the comments of the hon. Member for West Ham on the Lyons review and the aspiration for 200,000 homes to be built. I shall come on directly to the number of homes in a few moments, but let me politely point out that this is the third target that Labour has set in the last 12 months. I will be interested to see where the level falls to the next time Labour announces a housing target.
The facts are that we have seen 500,000 new homes built since April 2010 and the number of starts on new homes last year totalled 139,500—up by 15% on the previous year and the highest number since 2007, which should provide some context. The construction industry, furthermore, has been hiring at the fastest rate since 1997. I am sure that my hon. Friends will have seen that the number of first-time buyers is at its highest since 2007, according to a Halifax review published just this week. That is proof that our policies, such as Help to Buy, are working.
We can see light at the end of the tunnel, but there is still more to be done. We want to increase house building rates further and encourage improved standards of design and sustainability. I believe it is through greater diversity in our housing market that this can be achieved. With more competition, more new entrants and more new development, we will increase the speed and, importantly, keep, develop and improve the quality of house building in respect of build, construction and design.
Our volume house builders play a vital role in our housing market, but we know that there is no “one size fits all” model for our market. As the economy and the construction industry recover, we want to see more small and medium-sized builders back in the market. We know how important they are. In addition to their role in increasing the supply of housing, they provide local jobs across the country, as Members will know. They provide a more personalised product and services for local people, and they strengthen the capacity of the house building sector more broadly. They are the reason for the changes in planning terms for small sites, which we announced just before Christmas and they are direct beneficiaries of this Bill.
We are already actively supporting the small and medium build sector. Our support for smaller builders through our £500 million “Get Britain Building” investment fund for smaller builders’ work has already helped to deliver thousands of new homes and to commence work on a further 12,000 sites. We have opened our £525 million builders finance fund to small and medium builders to deliver schemes as small as five homes. Again, that could benefit directly from the Bill and the work behind it.
However, we want to look at more innovative ways of diversifying the market such as the custom build sector, which leads me directly to why we are all here today. I strongly believe that custom and self-build housing can play a central role in securing greater diversity in the housing market and help us to deliver the homes people need. We know we live in a country where there is high demand for custom and self-build. That could be met by the small and medium building industry, as I have outlined.
According to research by the Building Societies Association, one in three people in the UK is open to building their own home, and 1 million people want to build their own home in the next year alone. In fact, according to the website PlotSearch, January is apparently the peak time for subscribers to plot-finding services. It is no surprise that this high level of interest exists; custom build can be cheaper, greener and better designed than conventional market housing.
As I mentioned on Second Reading, a report published by the Lloyds Banking Group in 2013 concluded that self-builders can save between 20% and 25% on the cost of the equivalent home on the open market. According to the National Custom & Self Build Association, a typical three-bedroom home costs just £150,000 to build. It is interesting to think about some of the available options. Just before Christmas, I visited my hon. Friend the Member for South Norfolk in his constituency to visit Beattie Passive, a Norfolk company that showed us how it works. If I recall correctly, it let me have a go at trying to build one of the homes that it can supply. The kit can be supplied for somebody to build their own home at a cost of just £7,500. That makes house building, and custom house building in particular, affordable at a level that people often do not realise is available to them. For many custom and self-builders, the key advantage is the potential for more energy efficiency than can be achieved in typical developments. The Beattie Passive homes are a good example of that. Home owners who can influence the end product tend to have a longer-term interest in their properties, which may result not only in more energy-efficient homes, but, frequently, in better design and increased investment in the community. In fact, custom and self-build residents remain in their homes for about 14 years longer than the average resident.
Despite the advantages of custom building in diversifying the market and producing high-quality, sustainable homes, the market is stymied at present. Custom build currently accounts for only about one in 10 homes in Britain, just over 10,000 a year. That is a far lower proportion than we see in the United States and in other European countries. I think that the state of the market is caused by three main barriers: the limited availability of land, limited access to finance and advice, and the problem of red tape.
Since 2011, the Government have worked with the industry to overcome those barriers and develop the custom building sector. We want to double the output of the sector over a decade, so that well over 20,000 homes a year are built. I have been talking to finance houses—in fact, I did so only this week—about how we can make finance more accessible to those who wish to develop and build their own homes.
We are already encouraging the provision of more land through the planning system. Since 2012 councils have been required, through the national planning policy framework, to assess and plan to deal with the need for housing, including the requirements of those who wish to build their own homes. We have identified 12 Government-owned sites, which have been released for custom and self-build development by the Homes and Communities Agency.
Sir William Cash
The Minister has just mentioned the national planning policy framework. As he knows, today I am due to present a Bill that touches on that issue in a variety of ways, and in a fairly investigative fashion. Does he agree that, whatever instructions may or may not have been given to the Whips in respect of that Bill, it will be possible for us to continue our discussions about the planning and land implications of the NPPF at some future date?
Brandon Lewis
Absolutely. I am always happy to continue any discussion with my hon. Friend, and that certainly applies to discussions about how we can ensure that our planning system is fit not just for today but for tomorrow. My hon. Friend’s intervention gives me another chance to make the point that local authorities who are making plans for housing provision in accordance with the NPPF should concentrate on what housing is appropriate for and required by their areas, and that custom building should form part of that.
Developers have already been selected for six of the 12 Government sites. They include the award-winning Trevenson Park site in Cornwall, which Igloo Regeneration is currently developing. The Park Prewett site in Basingstoke is the largest of the custom building sites in the programme, and will generate 1,250 new and affordable homes. We can see the potential for more custom building in sites such as Ebbsfleet and Bicester. Yesterday I visited Brighton and met representatives of KSD Housing, which has a fantastic “modular build” proposal that could work well in the custom building sector as well. It could provide a very good model for the delivery of, in particular, affordable housing in the future.
I mentioned my visit to the constituency of my hon. Friend the Member for South Norfolk to see the housing built by Beattie Passive. That company has also built homes in my own constituency—council homes. It is great to see, under this Government, the first council homes to be built in Great Yarmouth for a very long time. Beattie Passive is able to work with the custom and self-building industry not just to deliver homes, but to teach people how to build their own homes. It enables them to develop new skills as well as new houses. That is important because, although we all enjoy watching great programmes such as “Grand Designs”, many people do not realise that custom building and self-building can be affordable. It is not necessary to have a lot of money in order to build a home; indeed, it is possible to buy a home-building kit for £7,500. The Bill does a great deal to make people more aware of the options that are available.
We are working to improve access to finance for all who are involved in custom and self-build. Following on from previous funds, earlier this year we launched a £150 million five-year serviced plot investment fund to finance up to 10,000 plots. We are also exploring with lenders how we can increase the number of custom and self-build mortgages. More lenders are already offering self-build loans, and gross lending on self-build is predicted to increase this year to £1.9 billion annually. It is clear from our discussions with lenders that the more that this sector develops, the easier it will be for them to assess it and ensure that mortgage funds are available. They are very interested in the sector.
Mr Bacon
Will the Minister take this opportunity to commend Mr Stephen Noakes, who is the chair of the Council of Mortgage Lenders and the head of mortgages at Lloyds Bank? He has not only supported the work of the all-party parliamentary group on self-build, custom-build and independent house building, but has demonstrated a sustained commitment to developing mortgage products for the self-build sector.
Brandon Lewis
I am happy to commend Mr Noakes. My hon. Friend has made a good point. Lloyds, Nationwide—whose representatives I met this week—and, indeed, other finance houses are very interested in this market, and want to see it grow. It is obviously a challenge for them to make assessments and provide funding on the basis of those assessments, but they are also keen to ensure that the market is as de-risked as possible, so that their finance can be as affordable as possible for consumers who wish to build their own homes.
Advanced technology and advanced manufacturing may provide one solution. If the National House Building Council and other organisations recognise that if a property carries a lower risk, it will be a better lending proposition for mortgage companies. Another solution is the provision of land specifically for local planning purposes—the Government sites that I mentioned earlier are an example of that—so that mortgage companies can focus on a particular area rather than adopting a scattergun approach. All those measures would help the market to develop. The more the market develops, the more secure it becomes, and the better the prospects become for lending and the affordability of lending.
We are actively reducing the amount of red tape. Self-builders are already exempt from the community infrastructure levy, and last year we announced additional changes to section 106 affordable housing contributions. Those changes have the potential to save custom and self-builders many thousands of pounds.
We are continuing to work closely with the National Custom and Self Build Association. I join others in congratulating the association, and thanking its members for the excellent work that they have done in promoting the sector. We are also working with others in industry to increase the amount of information that is available to consumers. The online self-build portal should be the first port of call for anyone who is interested in custom and self-build. I am sure that it will provide more information and advice this year, and that that will be enormously helpful to all who are interested in custom and self-build but lack the experience or confidence to embark on a project. We can see that those polices are having an impact. According to the National Custom and Self Build Association, more than 5,000 new plots are in the pipeline. However, if we are to achieve our aim of doubling the size of the sector over the next decade, we shall need to go further.
We believe that the main barrier that is stopping more people building their own homes is the lack of suitable plots of land. That is why, in the autumn, we engaged in consultation on a new right to build that would give prospective custom builders the right to a plot of land from their local council for the first time. The consultation set out our vision for that right. Eligible prospective custom builders will be entitled to register with their local planning authority for a suitable, serviced plot of land on which to build or commission their own homes. The demand on the right to build register for custom build will be taken into account in the preparation of local plans, so that there are appropriate planning policies for the provision of enough plots of land for custom build. Registered custom builders will be offered suitable plots of land—with planning permission—for sale through the local planning authority, at market value.
Many prospective custom builders, local authorities and members of the custom building industry, as well as other professional bodies, have contributed to our consultation, and we are now considering all the responses. We are working with 11 local authorities to test the way in which the right to build will work in different contexts throughout the country. I want to clarify that our intention is to legislate for the full right to build in the next Parliament. This is a new area of policy that requires careful consideration and we want to make sure that we get it right. The Bill is an important part of this process.
The role of local authorities in bringing forward land is particularly novel and needs further consideration, and we want to make sure that the right forms an integral part of the planning system. It must support the local plan making process and existing planning designations. This will continue to prevent inappropriate development and protect precious landscapes such as the green belt. That is why we are proceeding carefully and will ensure that the views from the consultation and the vanguards inform the full legislation for the right to build. However, this Bill will legislate for the first element of the right, namely that local authorities will be required to establish registers of custom builders in their area.
I will explain our proposals for the register. First, the register will be a useful indicator of the scale and nature of demand for custom build in each local area. It builds on national planning policy by putting the requirement on a statutory footing—something I know Opposition Members fully support. It will also collect valuable information on the precise nature of this demand. By asking what size of plot, what location and what price range, local authorities and the custom build industry will be more able to respond to demand for custom build.
The register will also become a useful tool in the making of local plans. Many local authorities have been proactive in planning for custom and self-build, as national planning policy requires. However, as Minister for housing and planning, I know of aspiring custom builders who have contacted me as their local authority is not planning to meet their needs. By creating the register and creating this statutory duty, we will improve the local plan-making process so it meets the needs of custom builders. We must ensure that there is enough transparency to allow the information on the nature of demand for custom build to be used by the custom build industry, while, obviously, the data of individuals are well protected. The register will be useful in this way only if it demonstrates actual local demand for custom build plots. Local authorities should be confident that those on the register genuinely intend to build or commission their own home and consequently have the financial means to do so—which touches directly on the point my hon. Friend the Member for South Norfolk made a few moments ago.
This is why we are proposing that eligibility criteria be set out in the regulations that flow from this Bill. That will ensure that local authorities have the right to reject an applicant, should they fail to meet these eligibility criteria, and be confident that applicants will not waste their valuable time and energy. Local authorities should also have the power to remove individuals from the register in certain prescribed circumstances, to ensure that it remains an accurate and reliable source of information.
Of course, we are keen to allow a necessary degree of flexibility. There are areas of the country, such as areas of low demand, where the local connection test is counter-productive. We want the register to help develop affordable custom build housing and propose that individuals can register through registered providers.
The Bill will require that local planning authorities publicise their register. Custom builders must be aware of the register if it is to provide information on the nature of demand. The Secretary of State has the power to issue guidance to ensure that registers are adequately publicised. How precisely the register is publicised will be at the discretion of the local authority, once this guidance is taken into account.
We are currently testing how the custom build register and the entire right to build will work in practice with 11 vanguard local authorities across the country. There was a high level of interest from local authorities to pioneer the right to build. I believe we are now working with some very innovative local authorities who are a great example across the country. I particularly appreciate the diversity of authorities that submitted expressions of interest.
These vanguards are committed to establishing registers and making suitable plots available to those on the registers. They vary in location from Teignbridge to Oldham. They vary in size of project from thousands of units to single figures. They vary in context from cities, such as Sheffield, to national parks, such as Exmoor and Dartmoor. They also vary in experience. Every single vanguard brings something new to the table.
I also want in particular to mention South Norfolk, the local authority where my hon. Friend’s—he is the owner of the Bill—constituency lies. It shares his passion and is getting other authorities and institutions involved in custom build. I am sure that we will see much more custom and self-build demand met in that area in future. Its work alongside neighbouring local authorities, including with the Broads Authority, is an excellent example of co-operation in more complicated administrative areas.
All these vanguard projects will help design the right to build that we will legislate for in the next Parliament. However, they will additionally inform the regulations for this Bill, and I am pleased to say that all the vanguards intend to have custom and self-build registers, like those that this Bill would require, online this month. The vanguards will also give us a greater understanding of the resource requirements of the register. This experience will inform the regulations of this Bill to ensure that the costs of the register are proportionate and not burdensome on local taxpayers. In case anyone is concerned that we have somehow “forgotten about London”, we are working with the Greater London authority to test the feasibility of a pan-London register.
Our experience with the vanguards and the responses to the consultation will help us to ensure that the right to build supports the development of affordable housing as well, and I have outlined today the £7,500 example from by Beattie Passive. We want the right to build to support the development of affordable housing.
I am pleased to say that there are examples that demonstrate that this is possible across this country. Many registered providers have produced affordable housing and shared-ownership schemes through custom build, such as Coastline Housing in Cornwall. Some of our vanguards are working with registered providers to bring forward custom build development in this way. Custom build affordable housing offers a unique approach to shared ownership as the level of finish that the homeowner takes responsibility for can give them a greater equity share and help get them more firmly on the property ladder. I saw a direct example of this with a housing association I visited in the constituency of my hon. Friend the Member for Norwich North (Chloe Smith) just before Christmas.
New affordable housing solutions are one result of the diversity that custom build and this Bill will bring to the market. If we look to Berlin, we can see how much further this could go. The building groups of Berlin, formed of ordinary citizens, have come together with support from the local government, and have now produced thousands of homes, many in the last five years. If we look to Holland, we see another model of custom build development for urban extensions. I have touched on yet another model that could significantly improve build-out rates, which custom build opens up. Advanced housing manufacture harnesses technology to increase the speed of construction without sacrificing design. It is used worldwide to support housing delivery, but is a relatively small industry in this country. Custom build is the perfect part of the sector to see it develop and to benefit from it. Nevertheless, housing groups, such as the Accord Group in Birmingham and others I have mentioned, are taking the lead in developing the advanced housing manufacture industry, and they can produce a wide range of high-quality and environmentally friendly timber frames, and specialist insulation and innovative techniques that can be put up in just one day, as I have seen for myself.
I have explained how custom build could change the housing market with our support. This Bill will put in place the legislation for the first part of the right to build, allowing individuals wishing to build their home to register with their local authority for a suitable plot of land. As such, it builds on national planning policy and guidance which already requires local planning authorities to identify and plan for local demand for custom build in their local plans. I hope, following the outcome of the consultation and the experience of the vanguards, that we will be able to bring forward legislation in the next Parliament to implement the full right, giving registered custom builders the opportunity to be offered a suitable plot of land for sale through their local council.
With that in mind, and clearly with the support of the entire House today, I congratulate my hon. Friend the Member for South Norfolk again. I am more than happy to support and endorse this Bill.
Question put and agreed to.
Bill accordingly read the Third time and passed.
European Parliament Elections Bill
(9 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Christopher Chope (Christchurch) (Con)
I beg to move, That the Bill be now read a Second time.
This is the first of three Bills that I hope we shall have the chance to discuss today. In a sense, this is my contribution to manifesto development for the Conservative party in the run-up to the next general election, and I am delighted that my hon. Friend the Member for Cardiff North (Jonathan Evans) is here in the House today, as he has a great deal of knowledge of this matter: he is a former MEP and, indeed, leader of the Conservatives in the European Parliament. He understands what our policy used to be. The Conservative policy used to be in favour of open lists for European Parliament elections, rather than the closed lists we have at the moment. I hope the Minister will say that he agrees wholeheartedly that open lists are more democratic than closed lists, and that open lists are likely to encourage more people to participate in European elections, because they will have a real choice, rather than having choice limited by the closed list system. This would be a good thing for democracy. As you know well, Madam Deputy Speaker, if you have a good point, there is no need to labour it, so with that, I have the pleasure of moving the Second Reading motion.
Jonathan Evans (Cardiff North) (Con)
It is a great pleasure to rise to support my hon. Friend the Member for Christchurch (Mr Chope) on the introduction of this Bill. He rightly informs the House that the Conservative party has historically been in favour of open list elections to the European Parliament. Of course, we used to have individual first-past-the-post elections until 1999, but in the run-up to the introduction of proportional representation in the European Parliament elections in 1999 the House had to give its attention to what form of elections should be undertaken. One requirement we had to take into account was that for proportional representation itself.
Although this House has generally set its face against change in favour of proportional representation, let me clearly declare my hand: I have always been a strong supporter of proportional representation. Being a Member of Parliament who serves the Conservative cause in Wales, I know that there would have been significantly more such Conservative MPs in this House over the years had we had a proportional system rather than the first-past-the-post system. The Conservative party has generally had the support of about 25% of the Welsh electorate—on occasion, it has increased to about 33%—yet in two general elections we ended up with no Welsh Members, notwithstanding the fact that one fifth of the electorate voted for our party. That has its impact on the way in which people look at the provenance of a political party.
The Conservatives have suffered from that in Wales and, in fairness, the Labour party has suffered in vast swathes of England from exactly the same phenomenon. I therefore make no apology for the fact that when proportional representation was introduced, I was very much in favour of it. When I was subsequently selected as the lead candidate for Wales in the European elections in 1999, I was in the happy situation of saying that I had no embarrassment about topping the list in an election on a proportional basis, given all the support I had publicly given to that change.
What I found to be absolutely unacceptable, however, was that the choice by my party members to put me at the head of the list meant that every vote cast in the Conservative cause was a vote for me to be a Member of the European Parliament. I say that notwithstanding the fact that, perhaps slightly differently from my hon. Friends the Members for Christchurch and for Gainsborough (Sir Edward Leigh), I have always been an enthusiastic supporter of British membership of the European Parliament. I do not claim for a moment, however, that all the party members in Wales shared my view. They selected me to head their list, but they have a range of views and undoubtedly some among the electorate would have found it more acceptable to cast a vote for a Conservative who shared their more cynical views about our European engagement. That was not permitted because of legislation passed immediately before the elections in 1999—in 1998, I believe.
At that time, the Conservative party argued strongly against that legislation, taking the battle up to the other place to hold it off, in order to ensure that we had an open list system. Clearly an open list system is thoroughly more democratic, so one has to wonder why we have a closed list system. I must tell hon. Members that the reason goes back to an advertisement published in The Guardian at the time of the debate on the scrapping of clause IV—its removal was led by the former Prime Minister, Tony Blair. The advertisement was a direct challenge to his authority and it was signed by 10 Labour MEPs. After the introduction of the closed list system, all 10 were purged from the European Parliament by the Labour party in subsequent selections, so we can begin to understand why we ended up with legislation that is anti-democratic: it was an opportunity to control what happened in Strasbourg and to control the choices voters would be permitted to make. Our party rightly opposed that, but, bearing in mind the immediacy of the election in 1999, there had to come a time when a system had to be agreed and eventually the Conservative party’s opposition was withdrawn so that we could have a system we could work with. It is a matter of great disappointment that in the intervening period no effort has been made to change the system.
My hon. Friend the Member for Christchurch is not trying to reinvent the wheel here, because eight other countries in Europe operate an open list system—I do not know how welcome that news will be to him. Denmark, Italy, Luxembourg, the Netherlands, Austria, Belgium, Finland and Sweden all have variants of open list systems. Those countries all allow their voters to make a selection from among individual candidates who may well all be from the same party, if they wish to support that party in the election.
Only five countries have a closed system. During my time in the European Parliament I found the French system to be the most pernicious, and it is therefore disappointing that in certain aspects we follow that example. At least we can say that we have a regional closed list system. France has a national closed list system, which means that the votes for the respective parties are counted across the republic and the seats allocated thereafter, but not to the people who stood in those elections—they are allocated to the parties. Hon. Members who have visited France during European elections may recall seeing photographs of the main party leaders, because their names appear at the head of the European list, even though there is no prospect whatsoever of their accepting a seat in the European Parliament. What happens thereafter is that that person’s name is expunged and the seat allocation is decided by the parties in the weeks following the election. For this House, we are used to seeing the television coverage of debates that take place during the election campaign and on polling night a declaration is made as to who has been elected as the Member of Parliament. In France’s European elections we do not know probably for two or three weeks after the election who will be serving in the European Parliament, because that decision has not been made by that stage by the leadership of the individual parties.
We can see that the closed list system concentrates power at the top of the political party. That is why it was introduced by Tony Blair, and it is why the Conservatives rightly opposed it back in 1998. My hon. Friend the Member for Christchurch began his remarks by saying that he wanted to make a constructive contribution to the formulation of the Conservative party’s next general election manifesto, which is why I very much hope the Minister will accept that all the arguments are in favour of the Bill and that it will make progress—if not perhaps in this Parliament, in the next one.
Sir Edward Leigh (Gainsborough) (Con)
I congratulate my hon. Friend the Member for Christchurch (Mr Chope) on presenting this Bill. I concur and agree with my hon. Friend—indeed, he is a good friend—the Member for Cardiff North (Jonathan Evans) who has adduced some very powerful arguments for a change in thinking. Much as I admire the Minister’s independence of spirit, I accept that he is hardly like to change Government policy on a wet Friday in January, but I very much hope that he will listen to the very intelligent arguments that have been made.
In my view, and in that of most people, an open list system is a much more democratic way of electing Members of the European Parliament. It is undoubtedly entirely pernicious that a small group of people—sadly, modern political parties are quite small in their numbers—can decide on who heads a list and that person is then automatically elected. All they have to do for the next five years is attend every party meeting and ensure that they are well in with their regional party. They remain No. 1, and whatever the people want, they get elected. We have heard the history of the debate in the Labour party in the 1990s, so I will not repeat it, but it shows that this is not a party political matter. It is an issue that the Labour party could look at as well as the Conservative party.
If we believe in the European Parliament and want to create interest, we should want to have characters elected—people who stand up for something. It is surely right that if they are popular in their region, they can rise up the list and people can vote for them individually. The political parties should not fiddle around, decreeing that a certain sort of person should rise to the top; it is up to the people to decide, as the will of the people is seldom wrong.
Before I sit down—it is the will of the House that this debate is fairly short—let me say that there is a wider issue. A big debate will continue about whether we have elections to the House of Lords. Personally, for all sorts of reasons, I do not agree with elections to the House of Lords. If they do happen, they will undoubtedly be under proportional representation. It would be a complete disaster if people were elected to the House of Lords under a closed list system. It really would be ridiculous to put a load of party hacks in the second Chamber, which is not about people forming a Government but about rationally trying to reform legislation, because we had kept this closed list system. The arguments are very strong. We will not get a result today—
Philip Davies (Shipley) (Con)
Before my hon. Friend sits down, may I say that we have a system that is neither open nor closed; it is neither fish nor fowl. Yorkshire and the Humber region elected Edward McMillan-Scott as a Conservative on a closed list system. Basically, people were invited to vote for a party and they voted Conservative. He defected to the Liberal Democrats and carried on as the MEP as a Liberal Democrat, even though nobody had voted for him as an individual; they had only voted Conservative. The current system is complete nonsense; it is neither one thing nor another.
Sir Edward Leigh
It is also scandalous that someone can defect from the party to which they had been elected and then just carry on in the European Parliament. My hon. Friend has put his finger on it: this is neither fish nor fowl. It is actually completely illogical. Debate and reform are needed, and I commend my hon. Friend the Member for Christchurch for moving this Bill.
Mr Steve Reed (Croydon North) (Lab)
I congratulate the hon. Member for Christchurch (Mr Chope) on securing this bill. I will, if I may, speak just briefly.
We welcome this debate about the voting system at European elections. The hon. Gentleman is not known to be a constitutional and electoral reformer, or indeed an advocate of the European Union. Indeed, as the hon. Member for Cardiff North (Jonathan Evans) said, he holds a rather more cynical view of that institution. For that reason it is perhaps surprising to find the hon. Gentleman advocating a system of election so popular on the continent. From Belgium and Denmark, to Greece and Cyprus, open list electoral systems are a prominent part of European democracies.
The hon. Gentleman’s contribution today is welcome. Labour supports the principle of proportionality. There are merits to an open list system, whereby voters can choose individual candidates from a list provided by each party. Closed party lists can be impersonal, and can arguably weaken the link between the representative and the regional area. They offer less in the way of voter choice. Power is in the hands of parties to select candidates who are more likely to win. Arguably, that can lead to similar types of politicians entering politics. Candidates are selected by party leaders, who may sometimes be tempted to pick what we may consider to be the safer choice, which can further diminish the ability of Parliaments, both domestic and abroad, to challenge the Executive.
Closed lists, of course, can stifle independent voices, which is why I think the policy is attractive to the hon. Gentleman. That said, however, I respect the arguments that suggest that closed lists are more amenable to measures that can increase representation of women, ethnic minorities and other groups that are under-represented in our Parliaments. There are strong arguments on both sides of this discussion. We welcome the debate on this issue and look forward to continuing it as the hon. Gentleman takes his Bill forward.
The Parliamentary Under-Secretary of State for Education (Mr Sam Gyimah)
I am grateful to my hon. Friend the Member for Christchurch (Mr Chope) for bringing the issue of the voting system for European parliamentary elections before the House. He spoke with characteristic force and clarity, although with brevity on this occasion. He made his point clearly that this is a Bill that he wants to be considered in the next Conservative manifesto. I am sure that the powers that be will have noted that.
Clearly, the voting system that we use to elect our representatives is a matter of great importance and will have a significant impact on our democracy and the relationship between the public and those elected to serve them. I will try to set out the Government’s position. The Government take such matters seriously and welcome debate and discussion on proposals for changes that seek to enhance the democratic process. I therefore thank all Members for the debate so far. It is something on which there is a degree of consensus.
The voting system in use for European parliamentary elections has been debated at some length in both Houses of Parliament. Clearly, there is a range of views on the merits of the closed list voting system. It is fair to say that the closed list system is simple for electors, and it ensures that across a region seats are allocated in proportion to the votes cast.
However, I am conscious that there has been dissatisfaction with the closed list system both inside and outside Parliament and the debate today has highlighted that concern. Criticism has centred on the system being “closed”. The parties solely determine the order in which candidates are awarded the seats that they achieve. It is argued that that puts too much power in the hands of the parties and results in MEPs who are remote from the electorate. All those arguments are very strong indeed. We recognise that introducing an open list system might help to address the issue of MEPs being seen as distant from electors, because it will bring candidates closer to electors. However, the open list system is not currently used in any statutory elections in the UK.
Introducing an open list voting system at European parliamentary elections in Britain would require both primary and secondary legislation. Realistically, in terms of timing, it is not feasible at this late stage in the current Parliament to make the necessary legislative changes. In addition, there will be a number of practical and logistical implications that would need to be considered in changing the voting system for European elections.
Political parties, candidates, electoral administrators and electors would all need to receive guidance and instruction in the workings of the new voting system. This would be a novel and potentially complex system for electors, but the problems are surmountable. There will obviously be the issue of redesigning the ballot paper, which would be significantly different under an open list system.
Jonathan Evans
Looking around the Chamber, I think that I am the only person here to have stood in a European election and I have done so on two occasions. Although there is a box on the ballot form by which one can vote for a party, where the names are listed it has been the practice on a number of occasions for people to choose to put the cross alongside the name of the candidate rather than in the box for the party. Generally, if it appears in the area where the party has its candidates’ names, it is counted as in favour of that party. That is another indication that my hon. Friend’s point is surmountable.
Mr Gyimah
My hon. Friend, as he says, has great experience of standing for election. He makes the point quite clearly about how the ballot paper would need to be redesigned. As I said, I believe the problems are surmountable, but it is worth putting on the record that moving from the current system to an open list system would mean that there would be some practical difficulties to surmount. Moving to an open list system would also raise cost issues, and given the Government’s central role in funding European elections, we would wish to consider it very carefully.
All that having been said, the Government can understand why my hon. Friend the Member for Christchurch has tabled the Bill. The timing is an issue and practical implications need to be considered, but the subject should seriously be borne in mind in the next set of election manifestoes. With that in mind, I recommend the Bill to the House.
Mr Chope
With the leave of the House, may I respond to the very encouraging words from my hon. Friend the Minister? It looks as though this is the revelation of a new part of the Conservative party manifesto. I certainly hope so. It is also good that we have so much support from the hon. Member for Croydon North (Mr Reed), because if such a measure is going to make progress it is best that it does so on a cross-party basis. There is cross-party support for the idea of increasing voter engagement in elections, whether one is a Eurosceptic or a Europhile, as it is in the interests of democracy and of the European Union that there should be maximum participation in the elections to the European Parliament. I should have tabled the Bill much earlier in this Parliament, but I will take it away and hope that I see it reflected in the Conservative party manifesto.
I beg to ask leave to withdraw the motion.
Motion and Bill, by leave, withdrawn.
Madam Deputy Speaker (Dame Dawn Primarolo)
Order. It has been brought to my attention that due to a misunderstanding the motion in the name of the hon. Member for Cheltenham (Martin Horwood) on the calendar of business for Friday 27 March for Second Reading of the Pavement Parking Bill did not appear on today’s Order Paper. I will therefore ask the hon. Gentleman to move his motion at the appropriate time, as I am reinstating it in the Order Paper after motion 5.
UK Borders Control Bill
(9 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Christopher Chope (Christchurch) (Con)
I beg to move, That the Bill be now read a Second time.
Let me share a chilling thought with the House. The United States had both the suspects of Wednesday’s Paris atrocity on its travel ban list, but the two French citizens who are the suspects were freely able to come to and go from the United Kingdom should they have so wished. That is one of the consequences of our lack of control over our borders, in stark contrast with the control that the United States has over its borders.
The principal attribute of a sovereign country is its ability and rights to control which aliens, that is non-citizens, can visit or stay and which cannot. That is the issue that the Prime Minister has correctly highlighted in his various speeches on immigration during the course of this Parliament. On 14 April 2011, he said that
“for too long, immigration has been too high. Between 1997 and 2009, 2.2 million more people came to live in this country than left to live abroad. That’s the largest influx of people Britain as ever had…and it has placed real pressures on communities up and down the country. Not just pressures on schools, housing and healthcare—though those have been serious…but social pressures too.”
He went on to talk about those social pressures and issues relating to integration. The Prime Minister referred to 2.2 million extra people coming to this country between 1997 and 2009, and it is against that background that the Conservative party manifesto for the last general election said that
“immigration today is too high and needs to be reduced. We do not need to attract people to do jobs that could be carried out by British citizens, given the right training and support. So we will take steps to take net migration back to the levels of the 1990s—tens of thousands a year, not hundreds of thousands.”
That led to the pledge.
What are the latest figures? They show that between June 2010 and June 2015—that is, over the course of this Parliament—we will have a net increase of migration into our country of a further 1.1 million. Roughly speaking, that is some 200,000 people a year for the first three years, 250,000 people last year and a similar number this year. That means that over the course of the five years of this Parliament, the rate of increase will be even greater than the rate of increase that was so rightly criticised by the Prime Minister in his speech in 2011 and that led to his concerns being reflected in the Conservative party manifesto. I welcome the Prime Minister’s recent reaffirmation in his speech on 29 November that he is determined to try to get net immigration down below 100,000 a year—in other words, to the tens of thousands.
It is worth considering a brief history of what has happened. The treaty of Rome in 1957 set out free movement for economically active people—in other words, for people who were working or self-employed. Everybody thought it was perfectly reasonable that someone who had a job could go and undertake it in another country within what was then the European Community comprising a much small number of nations. In the early 1990s, that right was extended to the non-economically active. Worst of all, article 8 of the treaty on the European Union conferred rights as European citizens on all those holding individual nationality of an individual member state. Against that background, this Government and this Parliament are severely constrained in what they are able to do about this matter unless we change the law along the lines set out in this Bill.
Clause 3 states:
“Section 7 of the Immigration Act 1988 is hereby repealed.”
That section, which is entitled “Persons exercising community rights and nationals of member States”, says:
“A person shall not under the principal Act require leave to enter or remain in the United Kingdom in any case in which he is entitled to do so by virtue of an enforceable Community right or of any provision made under section 2(2) of the European Communities Act 1972.”
It then goes on to explain how that will be implemented. Interestingly, although most of section 7 was passed into law on 20 July 1988, section 7(1) was not passed into law until 20 July 1994—six years later. I suspect that that is because the Government of the time realised in the late ’80s and early ’90s, when we had Prime Minister Thatcher in charge, that the implications of implementing it in full would potentially be very significant. Let us remember that at that stage net immigration into the United Kingdom, including immigration from the European Union, was running at about 37,000 a year. Now, over 120,000 people a year are coming in just from other countries within the European Union. In my submission, we need to ensure that the people who are currently given a privileged position under section 7 have that removed from them so that each case can be treated on its merits, as I think the public would wish.
The problem is that because of European law and the judgments that are passed by the European Court of Justice, even groups that we thought were exempt from the provisions of section 7 are now being included. In the case of Chen, for example, the United Kingdom initially made provision to allow the primary carers of European economic area residents—self-sufficient children —to seek leave to enter or remain under paragraph 257C to 257E of the immigration rules. In that case, it was ruled that those people were entitled to come in anyway. Whatever has been passed by the European Community has been extended in its impact, making it more difficult for us to be able to take control of our own borders.
Clause 1 reasserts the sovereignty of the United Kingdom in determining which non-UK citizens may enter our country and the circumstances in which non-UK citizens may be required to leave the United Kingdom.
Clause 2, which is entitled “Regulation of entry by non-UK citizens”, says:
“Notwithstanding the provisions of the European Communities Acts, or of any other Act or Order, Regulation or Directive, the United Kingdom retains the exclusive right to regulate entry by non-UK citizens to the United Kingdom and to determine the circumstances in which non-UK citizens may be required to leave the United Kingdom.”
I have referred already to clause 3. Clause 4 deals with registration certificates. Obviously, we must have some system of ensuring that people who are in this country who are not United Kingdom citizens are able easily to demonstrate their right to be in this country. That is why clause 4 states:
“From the date of the coming into force of this Act and notwithstanding the provisions of the European Communities Act 1972, any non-UK citizen resident in the United Kingdom without the authority to remain in the United Kingdom provided by a current visa, visa waiver, residence permit or other official document must apply for a registration certificate to confirm their right of residence in the United Kingdom.”
The clause goes on to set out how that would work. Certificates would be issued and administered by the Secretary of State, and the content of the forms and the grounds on which applications could be granted or refused would be prescribed by the Secretary of State.
The model that I used for those provisions is what is currently contained in the UK visas and immigration legislation, under which one can apply for a registration certificate. There is no requirement for a European economic area or Swiss national exercising treaty rights to fill in an application for such a registration certificate, but they are encouraged so to do because they can then demonstrate that they are entitled to be in the United Kingdom. Clause 4 would operate on that basis, except that under my Bill it would be mandatory for somebody to apply for a registration certificate and hold such a certificate.
As an aside, one can see what a farcical situation we have reached. The Government have said that they are concerned that a large number of people with criminal convictions from other European Union countries are coming into the United Kingdom, so I was encouraged when I saw that the application form for a registration certificate says under section 10:
“Please provide details as requested below of any criminal convictions you may have both in the UK and overseas.”
There is provision to set out all that detail. It is in the national interest that we should know whether people applying to come into this country have criminal convictions. There has been a series of well-publicised cases where people with previous criminal convictions have committed further crimes in the United Kingdom, which has caused outrage.That was fine, until I noticed that the form went on to say:
“However, please note that should you fail to provide this information this will not result in the rejection of your application.”
That is written in because the European Union will not allow us to require such information. This is just another example of the farcical situation that we are in at present, where we do not have control over the people entering and leaving our country.
Under clause 4, the registration certificate system would require people to fill in the form accurately and give information about their previous criminal convictions, in exactly the same way as anybody who wishes to go to the United States of America has to obtain a visa. If it is all right for the United States, why is it not all right for the United Kingdom, which is an attractive place to visit? People are not deterred from visiting the United States by such a requirement, and they would be no more inhibited from coming to our country if we had such requirements. The Bill would ensure that as far as possible people would be able to stay in the United Kingdom if they wanted to, provided they had registration certificates.
There is no point in issuing a command without having a sanction, so clause 5 states that anyone who is present in the United Kingdom after 31 December 2015 without legal authority or without having applied on or before that date for a registration certificate shall be guilty of an offence, as would anybody who entered or attempted to enter the United Kingdom without legal authority after that date. Clause 6 sets out the penalties. Under the current regime, there are no effective penalties against those who come into our country and we do not know how many such people there are.
In March 2014 I asked the Home Office for its
“most recent estimate…of the number of illegal immigrants employed in the UK; and what change there has been in this number since May 2010.”
The Minister for Security and Immigration, my hon. Friend the Member for Old Bexley and Sidcup (James Brokenshire) answered:
“HM Government have not made any estimate of the number of illegal migrants currently employed in the UK. Given the clandestine nature of illegal migrants, any estimation is, by definition, extremely difficult and prone to considerable uncertainty.”—[Official Report, 3 April 2014; Vol. 578, c. 740W.]
He then went on to explain all the wonderful things the Government are doing.
On 7 April I asked the Minister
“how many illegal workers whose employment has been the subject of penalties pursuant to section 15 of the Immigration, Asylum and Nationality Act 2006 (a) have been deported and (b) are still in the UK.”
He replied:
“We are better placed than ever to identify and charge those working illegally…It would not be possible to provide the information requested without linking immigration case outcomes to our data on civil penalties issued on employers. This would incur disproportionate costs.”—[Official Report, 7 April 2014; Vol. 579, c. 116W.]
That was another completely useless response from a Government who are apparently trying to regain control over our borders, which has my full support, to ensure that the only people living here are those we really want to live here. As part of that process, of course, we need to know who those people are.
Where does one go for information about how many people are here illegally? One source of information is the Government’s December 2013 publication, “Sustaining services, ensuring fairness: Government response to the consultation on migrant access and financial contribution to NHS provision in England”. It estimates that, at any one time in England, there are about 2.5 million overseas visitors and migrants, of whom about 450,000 are from the European economic area, 1.4 million are from outside the EEA, 65,000 are ex-pats and 580,000 are irregulars,
“including failed asylum seekers liable to removal, people who have overstayed their visas and illegal immigrants”.
The Government document estimates that there are 580,000 people here who should not be here, and it goes on to explain the significant burden they are placing on the national health service in various ways and how they are not contributing as they should be.
That is the scale of the problem. There may be well over 500,000 people in this country who have no right to be here whatsoever. The Bill would, in a sense, flush them out, because if they did not have British citizenship, a residence permit or the right to stay here, they would be guilty of an offence.
I have raised before in this House the issue of what the Government are doing to enforce the provisions that make it illegal to be here without authority. I have been told that there is no need to introduce new legislative requirements, such as those in clauses 5 and 6, because section 24 of the Immigration Act 1971 is clear that people who are in breach of the provisions can be prosecuted. Section 24(1) on “Illegal entry and similar offences” states:
“A person who is not a British citizen shall be guilty of an offence punishable…with a fine of not more than level 5 on the standard scale or with imprisonment for not more than six months, or with both, in any of the following cases:—(a) if…he knowingly enters the United Kingdom in breach of a deportation order or without leave; (b) if, having only a limited leave to enter or remain in the United Kingdom, he knowingly either—(i) remains beyond the time limited by the leave; or (ii) fails to observe a condition of the leave; (c) if, having lawfully entered the United Kingdom without leave…remains without leave beyond the time allowed”,
and so on.
In the context of the very large numbers of people thought to be in the country illegally, one might think that we would exercise effective sanctions against them. I was therefore extremely disappointed, although I must tell the Minister that I was not that surprised, to find that in 2013 the number of defendants convicted for offences under section 24(1) in all cases of people overstaying their time limit for leave—there may be hundreds of thousands of them—was two in the magistrates court and four in the Crown court. There was only one conviction in the magistrates court and one in the Crown court under section 24(1)(b)(ii) for failing to observe leave conditions.
At the moment, even the existing law is not applied. People in this country illegally and in breach of their obligations are not prosecuted or proceeded against, which is nothing short of scandalous. That is another reason why the Bill would provide a fresh starting point. Everybody not here legally would have the opportunity to leave, to seek to regularise their position by applying for a certificate or to face the consequences of failing so to do.
If we won back control over our own system, we could require people coming into the country to provide fingerprints or DNA samples. At the moment, that matter is governed by the Eurodac regulations. I have done a lot of work on migrants crossing the Mediterranean, landing in Italy and finding their way into other parts of Europe. In Italy, they are often not processed at all: their fingerprints are not taken, so nobody knows that they have ever been in Italy, which means that they can ultimately present themselves in another country in the European Union and seek asylum. Some asylum seekers or migrants try to fight the system and refuse to give their fingerprints—the Italian authorities say they do not take their fingerprints because they refuse to give them—so I suggested that if such people do not want to give their fingerprints, we should take a sample of their DNA, but I was told that that would be illegal under the Eurodac regulations. This is crazy: what harm can there be in people seeking asylum supplying their DNA, particularly if they do not want to give their fingerprints?
Sir William Cash (Stone) (Con)
My hon. Friend will perhaps recall that a short time ago, I presented the United Kingdom Parliament (Sovereignty and Jurisdiction over Borders) Bill, which contains a provision that would deal with any difficulties that we have in respect of immigration policy by bypassing the European Court of Justice and using the hallowed formula, “notwithstanding the European Communities Act 1972”. All the regulations and provisions that would otherwise prevent us from getting proper control over our borders would be wiped away by taking that very simple step. What astonishes me is that that formula would return governance to this country. I hope that he will bear that in mind.
Mr Chope
I am delighted that the Bill will have the even more enthusiastic support of my hon. Friend. I agree with him that there is no point in pretending that we can sort this problem out without distancing ourselves from all the European Union regulations. That is why I have drafted the Bill in a way that reasserts the sovereignty of this Parliament over the borders of our United Kingdom.
I am conscious of the time, Madam Deputy Speaker. I could carry on for a bit longer, not least to point out some of the practical shortcomings of the worthy proposals that the Prime Minister made in his speech on 29 November, but I will not do that and will instead sit down, having proposed the Second Reading of the Bill.
Sir Edward Leigh (Gainsborough) (Con)
My hon. Friend the Member for Christchurch (Mr Chope) has given a comprehensive description of his Bill. I do not need to follow him down that route and will speak very briefly indeed.
My hon. Friend was right to have this short debate to draw the attention of the House to what has become one of the most important issues facing our country. Managed migration works. We welcome people, in a managed way, who want to come here to live, work and make a contribution. That is good for the economy. There is no dispute about that, and neither was there any dispute in the early years of our membership of the European Union over whether the free movement of workers between economies that performed in fundamentally the same way worked.
Unfortunately, the whole system is breaking down. It is breaking down not just in our country, but across Europe. The reason it is breaking down is that we now have economies that perform on a very different level and that have very different levels of benefits—in countries such as Romania and Bulgaria. I make no criticism of Romanians or Bulgarians—they are wonderful people, they work hard and they are welcome to come here in a managed way. I have always warmly welcomed people of Polish and Lithuanian extraction. Nobody disputes that they should be welcome. However, because there are economies with very low wage and benefit rates, the cardinal principle of the European Union, which perhaps worked in the 1960s, 1970s and 1980s, simply does not work now.
This debate is exercising the whole nation, not just a small group of Conservative Back Benchers who are obsessed with European and want to criticise the European Union. Many people around Europe who take an intelligent interest in whether the European Union is functioning properly are concerned about this issue. There is concern about it throughout the Conservative party, from the bottom to the top, because we are simply reflecting public opinion. The public are concerned and, therefore, there is concern even at the level of the Prime Minister.
Mr Chope
Does my hon. Friend accept that another issue that concerns the public is the distortion of policy? If 120,000 people a year are coming in from the European Union and we cannot do anything about it, all the pressure is on trying to reduce the number of people who come in from outside the European Union, many of whom might be able to make a bigger contribution to our economy and society.
Sir Edward Leigh
Yes, and we have had that debate. Apparently there is also a debate inside the Government. Those such as the Home Secretary argue that we must effectively expel all people who have completed their course—as I think happens in the United States—so that the moment they complete their university or college education they must go back to India or wherever. We read in the press that, apparently, other members of the Government—such as the Chancellor of the Exchequer who is responsible for the good management of the economy—say that we must allow those people in. All the pressure now on the Home Secretary is to try and reduce immigration from elsewhere in the world, but those people may be essential to our economy. The whole system is not working well at the moment.
As I was saying, it is not only a small group of Conservative Back Benchers who are concerned with this matter, but the wider public and indeed the Prime Minister. We understand that when he was drafting his recent speech on immigration, right up to the last minute he was determined—indeed, he went to a parliamentary meeting and talked to colleagues—to take action in terms of having some control over our borders, such as an emergency brake or whatever. This Bill is a contribution to that debate, and we must have a serious debate, away from emotion, charges of racism and all that sort of nonsense, which obviously do not apply in this case. People simply want managed migration. The system is not working at the moment, and there must be a sensible debate.
It is simply not acceptable for the Chancellor of Germany to say that such a debate is a no-go area. If we are fortunate enough to see the return of a Conservative Government, there will be a referendum. At the moment we understand that the German Chancellor has said that the issue is a no-go area, and that if it is brought up in negotiations she will veto it and it will not happen. I do not think that is a good way to proceed. If we believe in the European Union but proceed in that way, all we are doing is fuelling the fire of Euroscepticism, and forcing more and more broad-minded people, who otherwise would support our membership of the EU, to say that we have to leave. If someone supports membership of the EU, they must believe that it needs to evolve. If we believe that because a principle worked well when the European Union had very few members it is some sort of religion that is set in stone and cannot be changed, all we do is fuel the fires of Euroscepticism, and indeed something much more sinister.
We see throughout Europe what I believe is the wrong view that states that everything is bad about our countries—I do not believe that for a moment; I think they are some of the most wonderful countries in the world—and that that is the fault of a particular minority. Today it might be Romanians, Bulgarians or Poles, but in the last century it was other minority groups such as Jewish people, and in the preceding centuries it might have been those of a different religious domination. If we do not have managed migration, and if the centrist parties—the Conservatives, Labour and the Liberals—do not have a sensible debate, all we do is fuel support for extremist parties that will run with this issue. There is no doubt about that. This serious matter needs to be addressed. It will not be resolved by my hon. Friend’s Bill, but we must have a managed, rational debate on managed migration. The Bill is the first step in the right direction, which is why I commend it.
Philip Davies (Shipley) (Con)
I rise briefly to support the Bill. Whenever I carry out surveys among my constituents, immigration is always one of the top two issues that they are concerned about, and no wonder given the figures cited by my hon. Friend the Member for Christchurch (Mr Chope) on the level of net immigration into this country, which is running at around a quarter of a million people a year. To me and many of my constituents that is simply unacceptable, but it is also unsustainable, which in many ways is the biggest issue. Immigration is putting a huge strain on our public services, whether the NHS or school places. We simply do not have the wherewithal to build the number of houses that would be needed to house such a level of immigration. It is perfectly obvious that it is unsustainable in the long run and that the numbers need to be brought down dramatically.
As my hon. Friend said, the Prime Minister made his pledge at the previous election, and I do not doubt the sincerity with which he did so. I am sure that he was certain in his own mind that that was what he would deliver were the Conservatives to win that general election. As a caveat, I should say that we did not win the general election, so the Conservatives had to form a Government with our gallant Lib Dem colleagues. Whatever anybody thinks about them, they are not renowned for being tough on immigration. It was inevitable that any coalition with them would result in a weakened immigration policy. I accept that backdrop, but I am sure the Prime Minister, even with a hand tied behind his back, would accept that he would have hoped to do better than he has on immigration.
My hon. Friend was right to make the point that the levels of immigration are similar to those under the Labour Government, but there is a difference. It is fair to point out that, in this context, Peter Mandelson made it clear that the Labour Government sent search parties out to find people from around the world to come to the UK. Having that level of immigration was a deliberate policy of the Labour Government, whereas it is not a deliberate policy of the current Government. Those levels of immigration have happened despite their intentions and best efforts. In many respects, they have faced a perfect storm.
Martin Horwood (Cheltenham) (LD)
Fascinating as it is to hear the hon. Gentleman’s views on what Peter Mandelson thought about immigration, thousands of people in this country today hope to hear a debate on Second Reading about the dangerous, costly and unpopular practice of pavement parking, my private Member’s Bill that is a little further down the Order Paper. As the hon. Gentleman promised to be brief, I wonder whether he will be able to bring his remarks to a close at some stage. That would be very helpful.
Madam Deputy Speaker (Dame Dawn Primarolo)
Order. The hon. Member for Shipley (Philip Davies) was making a speech on the current Bill. It is not for the hon. Member for Cheltenham (Martin Horwood) to stand up and give an advert for his Bill. The hon. Member for Shipley is in order and has been speaking for a very short period of time thus far. We should allow him to make his points without interruption. That might help the speed of business.
Philip Davies
I am grateful for that, Madam Deputy Speaker. I am not entirely sure what has happened to the patience of the hon. Member for Cheltenham (Martin Horwood), but as you said, I have only just got started. He has ensured that the chances of getting on to his Bill have become more limited, but I shall make progress. I can see why he is anxious—he does not want us to talk about Liberal Democrat immigration policy and wanted to divert attention away from it.
The Government have faced a perfect storm. In some respects, this country will always have much higher immigration. Many more people from the EU want to come to this country rather than go to other EU countries. That is partly, or perhaps mainly, because of language. If a person is looking for a job, they will go to a country where they can speak the language. It is great benefit to all that English has become a universal language, but immigration is a downside, because people from the EU who speak English who are looking for a job are more likely to come here than go to other EU countries.
The benefits system is another factor. I applaud the Government for the efforts they have made to restrict access to benefits for people from the EU. It is much tougher for people coming to this country to claim benefits. The Government intend to make it tougher still, which I very much support. Many EU countries have a system of benefits under which people have to pay in before they can take something out. Under our system, people can to a large extent take things out even if they have not paid anything in. That is also a pressure on immigration into this country.
There is also—the Government could never have predicted this—the collapse in the economy around the EU and the fact that economic growth in this country has been so much better than in the rest of the EU. I think I am right in saying—the Minister will correct me if I am wrong—that this country created more new jobs in the last year than the rest of the EU put together. Of course, that will be a magnet for people looking for a job, and they will want to come to this country. I fully accept that there is no way the Prime Minister could have predicted that five years ago, when he made the promise that he did. He has faced a perfect storm.
That is why my hon. Friend’s Bill is so important. We may be a victim of our success in some ways, and other things may be beyond our control, but the fact is that, although people want to control immigration into this country, they also want something else: some honesty in the debate on immigration. Whatever anybody says, and no matter what rhetoric people use, the honest fact—the public know this, so I have no idea why politicians are so reluctant to admit it—is that while we are a member of the EU under the current regime, we cannot control immigration. We cannot say that a certain number of people will come into this country—we simply cannot. The Prime Minister made his promise in good faith, but it was one he was not entitled to make, because we do not have the ability to control the numbers of people coming into this country. My hon. Friend’s Bill would allow us to do that.
In my view, we need to leave the EU; that is the only way we can control immigration into this country—not just the numbers, but the nature. My hon. Friend made the good point that the free movement of people may sound like a great principle to some, but it also means free movement of criminals. If we look at the nationality of the prison population, we see that there has been a massive increase in recent times in the number of Bulgarians and Romanians. If we had had proper controls, we could probably have stopped those people coming into the country in the first place because of the criminal records they have back home.
We need to control immigration—I think that is something the Minister agrees with, and the Government also seem to agree with it—but we have to be honest with people. We have to acknowledge and accept that the only way we can control immigration is by stopping the free movement of people in the EU. As long as we have that, we cannot control immigration, and we will just be spitting in the wind with the measures we take. I therefore hope that, to properly control immigration, the Government will accept my hon. Friend’s Bill.
Mr Steve Reed (Croydon North) (Lab)
I congratulate the hon. Member for Christchurch (Mr Chope) on securing the debate. However, his Bill is a reminder of the gap between what the Prime Minister’s Eurosceptic Back Benchers demand and what he says.
Only this week, at his joint press conference with Chancellor Merkel of Germany, the Prime Minister confirmed his support for the principle of free movement within the EU. To be fair to Conservative Back Benchers, it must be hard to keep up with the Government’s position. First, it was that the Prime Minister was going to “sort this out”, as he said in his conference speech. Then, there was the great retreat from that position in his pre-Christmas immigration speech. Now, when standing alongside Chancellor Merkel, he talks of his new-found love for freedom of movement.
The gap between the Prime Minister and his Eurosceptic Back Benchers illustrates his plight. No renegotiation in Europe could ever satisfy some of them, other than one leading to Britain’s exit from the EU. Europe does need to change, but the tragedy for Britain is that, since being elected, the Prime Minister has spent more time negotiating with his rebellious Back Benchers than with other EU leaders. His attempts at megaphone diplomacy, such as his ill-fated opposition to the appointment of the new Commission President have left him isolated and, dare I say, humiliated.
Dragging Britain closer to the EU exit door would be damaging enough if that was the Prime Minister’s thought-out strategy. Worse than that, however, he is marginalising Britain in Europe without even thinking it through. A British exit from Europe by default is an even bigger failure of leadership than exit by design.
I have some sympathy with the hon. Gentleman and other speakers on the Government Benches over their disappointment with the Government’s record on immigration. I do not think it is fair to blame that entirely on the Liberal Democrats either, who are a minority in the coalition. The Government have abandoned the Prime Minister’s “no ifs, no buts” immigration target. The chief inspector of borders finds that the Government make no attempt to check potential immigrants’ criminal records. In October last year, the Public Administration Committee found that 50,000 failed asylum seekers have been lost. We do not know where they are. What is needed is not exit from the European Union, but renegotiation, delays before new arrivals can claim benefits, more and properly trained border staff, proper entry and exit checks, and a requirement for applicants to provide criminal records.
What is remarkable about the debate over Europe in the Conservative party is that it thinks speculation about the UK leaving is Europe is costless. It is not. It places a huge question mark over British jobs, rights at work, investment and our place in the world. It is a growing national tragedy that the Prime Minister is too weak to stand up to the Eurosceptics in his party, or to engage our European Union colleagues properly.
Sir Edward Leigh
The hon. Gentleman is making a very serious point. We are all agreed that we want to stop criminals entering the country. Is he saying that the Labour believes there should be some sort of device by which we can require EU nationals entering this country to prove that they are not guilty of a criminal offence, or some way in which we can prevent criminals from other EU countries coming to this country? Is he saying that?
Mr Reed
The Labour party is very keen to negotiate from a position of solidarity with our European Union colleagues. That is what the Labour party would do if elected in a few weeks’ time.
In the meantime, I remain very disappointed that the Prime Minister has failed to engage our European colleagues and the leaders of our fellow EU states in proper negotiations. By failing to do so, he will never secure the improvements that I think Members on all sides of the House would like to see on this issue and in our relationship with the EU.
The Parliamentary Under-Secretary of State for the Home Department (Karen Bradley)
I congratulate my hon. Friend the Member for Christchurch (Mr Chope) on the Bill and on the debate he has started today.
The Bill raises important issues on the control of immigration to the UK. That is a key priority for the Government, and we have taken significant steps to strengthen the border and immigration system, including in respect of who is allowed to enter the UK and who is allowed to remain. I therefore strongly commend the intention behind my hon. Friend’s Bill, but I do not believe that the measures it contains are necessary. There are also aspects of the Bill that would be unlawful.
The measures contained in the Bill do not reflect the extent to which the new powers and other reforms to control immigration, which the Government have put in place already, provide an effective basis for controlling our borders. For example, the Immigration Act 2014 put in place a series of fundamental reforms that will ensure our immigration system is fairer to British citizens and legitimate migrants, and tougher on those with no right to be here. The 2014 Act limits the factors which draw illegal migrants to the UK and introduces tough domestic reforms to ensure that our controls on access to benefits and services, including the NHS and social housing, are among the tightest in Europe.
A number of my right hon. and hon. Friends have mentioned net migration numbers. Our reforms have cut net migration from outside the EU by nearly a quarter since 2010, close to levels not seen since the late 1990s. Under the previous Labour Government, more than 1 million EU nationals came to the UK from 2004 to 2010. As my hon. Friend the Member for Gainsborough (Sir Edward Leigh) said, managed migration works. Like him, I am positive about both this country today and the future. We have a diverse population, which makes the UK a great place to be. It is also worth saying that there are pockets of the country where there has been significant amounts of migration, but there are areas that have not seen great changes in population. According to the Office for National Statistics, my own constituency saw an increase in population of 200 between 2004 and 2013, and some of them will, of course, be UK nationals returning.
My hon. Friend the Member for Shipley (Philip Davies) raised the issue of our economy. We have a booming economy in this country compared with the rest of Europe. The job is not finished, but our long-term economic plan means that the prospects for this country and this economy are better than they are anywhere else. He is right about the number of jobs created here in the UK. I understand that over the last four and a half years, we have created more jobs here in the UK than have been created in the whole of the rest of the European Union combined. That is why there is a pull factor for people. I can well understand that. I can understand why somebody sees an opportunity to get a job in Britain and thinks that it offers a better chance. We can all sympathise with that and understand it, but we have to be clear that migration policy must be fair to UK nationals living here today.
The Government have fundamentally changed the system we inherited, under which an EU national could arrive in the UK and claim benefits shortly after their arrival and for a significant period, with few checks on whether they had a real chance of finding work here. Now, EU national jobseekers cannot claim benefits until they have been resident here for three months, and then only for three months before we test whether or not they have a genuine prospect of finding work in the UK. Now, they have no access to housing benefit, and we have introduced new powers to remove EU nationals who are not fulfilling the requirements for residence and to prevent their re-entry for 12 months. We have new powers, too, to deport EU national criminals more quickly.
The Immigration Act 2014 will strongly reinforce our work to secure our borders, enforce our immigration laws and continue to attract the brightest and best to the UK. Implementation is well advanced: many of the measures have gone live and are already having a positive impact on the ground. For example, we have revoked more than 4,500 driving licences held by illegal migrants, and since July 2014 we have deported more than 150 criminals, using new powers provided by the Act. New measures in it, including the immigration health surcharge and measures to tackle sham marriages and civil partnerships, will be introduced on a phased basis between now and April 2015. The Immigration Act also makes it easier to remove those with no right to be here and ensures that the courts must have regard to Parliament’s view of what the public interest requires in immigration cases, engaging the qualified right to respect private and family life under article 8 of the European convention on human rights.
Mr Chope
I sympathise with the Minister, given the responsibilities she has. I have just been looking at the immigration statistics issued on 27 November, covering the period July to September 2014. It says there that there were 9% fewer enforced removals from the United Kingdom compared with the previous 12 months. If the Government are getting so tough on deporting these people—quite rightly—why were there fewer removals in that period?
Karen Bradley
I thank my hon. Friend for his question and I shall come on to his comments. We must be clear, however, that the Immigration Act gives us new powers. We have powers to remove people without regard to the number of appeals that they could previously have used. We should look at the powers that we have today and the criminals we can deport today.
Foreign criminals and immigration offenders are no longer able to hide behind weak human rights claims to prevent their removal from the UK—something that they could do before. We do not need the Bill’s provisions to enable us to deport foreign criminals or remove immigration offenders. The Court of Appeal has now confirmed that the consideration of a family or private life claim must be conducted in the light of Parliament’s view of the public interest, as set out in the Immigration Act.
The measures taken by the Government have significantly strengthened the legal framework for our border and immigration system provided by the Immigration Act 1971 and other legislation, which regulates non-UK citizens’ entry to, and stay in, the UK. The legal framework and operational measures we have put in place provide and implement the powers needed to examine non-UK citizens before or on arrival in the UK to determine whether they should be admitted or granted or refused leave to enter, in accordance with the immigration rules and regulations laid before Parliament.
Mr Steve Reed
According to a recent survey of border staff, 98% of them have warned that they do not have enough resources to protect the border effectively. Why is that?
Karen Bradley
As the hon. Gentleman will know, it is this Government who dealt with the failing UK Border Agency and introduced Border Force and UK Visas and Immigration. My meetings with Border Force officials and guards on the front line are always positive. It is clear to me that those dedicated professionals are doing all that they can to protect our borders, because they understand just how important it is for them to do so. I shall deal shortly with the issue of criminal movement within the European Union and across our borders.
The Immigration (European Economic Area) Regulations 2006 provide for the admission of EEA nationals and their family members and the removal of those who are not entitled to reside, in accordance with European Union law.
While I agree with the thrust of my hon. Friend’s thinking, I believe that parts of the Bill would be unlawful. Its aim is to ensure that the United Kingdom has absolute control over the right to prevent non-UK citizens from entering the UK, and to determine the circumstances in which they may be required to leave. It asserts the absolute sovereignty of the UK in controlling its own borders, notwithstanding our existing international treaty obligations and the domestic legislation that gives effect to them.
The Bill would repeal section 7 of the Immigration Act 1988, which provides the basis on which those exercising European Union rights are not required to obtain leave to enter or remain in the UK under the Immigration Act 1971 and subsequent legislation. Essentially, it seeks to curtail the free movement of EU citizens to the UK under existing treaty rights. The provisions curtailing rights of entry are not compatible with EU free movement rights, and we cannot pass national legislation that does not comply with EU law.
Sir Edward Leigh
Does the Minister accept, therefore, that the Government’s settled position is to acknowledge that there can be no change in the treaties, and that EU nationals must have unrestricted access to this country?
Karen Bradley
I shall come to the restrictions that the Government place on EU nationals, particularly those with criminal histories.
The Bill would not achieve its intended objectives owing to the principle of direct effect, which means that EU nationals can derive rights directly from the free movement directive and the treaty on the functioning of the European Union, whether or not those provisions have been given effect in UK law.
Let me now deal with the question from my hon. Friend the Member for Gainsborough (Sir Edward Leigh). Free movement is not without conditions, and I am keen to ensure that any free movement includes the free movement of criminal information. I want to ensure that a police officer in Leek, in my constituency, has as much information about an individual residing in Leek as a police officer in any other town in any other country in the European Union has about someone with a criminal past. The 35 measures that the UK chose to opt back into in December last year are vital to ensuring that criminal information moves freely between EU countries. If we are to keep UK citizens safe, we shall need to know about the criminal past of people who are trying to enter the UK.
EU nationals arriving at the UK border can be stopped and questioned by Border Force officers to establish their right of admission to the UK when that is appropriate. Border Force officers can refuse admission to EU nationals when such action is necessary and proportionate—for example, owing to their criminal convictions or conditions arising from a previous removal or deportation, or when officers have reasonable grounds to suspect that admitting them would give rise to an abuse of free movement rights. In the first three quarters of 2014, 1,205 EU nationals were initially refused admission at the UK border. Opting into the 35 measures means that we shall have more and more information about criminals, and we will—and do—exercise the right to refuse their admission to the UK.
Effective renegotiation is the way to bring about a real change in the basis for EU migration. My right hon. Friend the Prime Minister set out his agenda for that in November. It includes the introduction of a four-year residency requirement before an EU national can have access to in-work benefits or social housing in the UK, the removal of child benefit for non-resident children of EU nationals, and further powers to deport EU criminals and tackle abuse.
I do not believe that the measures proposed by my hon. Friend are necessary for the proper control of our borders. For all the reasons that I have given, the Government cannot support his Bill.
Mr Chope
Well, what a disappointment it is that the Government are not going to accept this Bill. I thought it was going to go through, but instead I am going to have to explain my disappointment to my constituents and to a wider audience. The debate has been useful, however, because it shows the extent of the constraints that this Parliament has chosen to impose on itself. [Interruption.] The Minister is agreeing with that. We have chosen to fetter our ability to control our borders, and this Bill would enable us to take the fetters off.
Karen Bradley
I just want to clarify what I was agreeing with. I thought my hon. Friend was going to talk about the great steps this Government have taken to ensure that we have managed migration. I apologise if I misunderstood what he was about to say.
Mr Chope
Nothing I have said, or that I intend to say, is designed to detract from the achievements of the Government. All I am saying is that despite the Government’s best efforts—as my hon. Friend the Member for Shipley (Philip Davies) said, this Government have been working a lot harder and more effectively on this than the previous Government did—faced with the evidence I have educed today, I do not see how under the current legal regime we are going to be able to reduce net migration into this country to the tens of thousands, rather than the hundreds of thousands as is the case at present.
The Prime Minister reasserted in his speech of 29 November his desire to get net migration down below 100,000. I agree with that. All I am saying is that I do not see how it is going to be done. We have got to have an open and honest debate about this, and it may well be that my hon. Friend the Member for Shipley is right that the only solution—unless we can get our EU colleagues to change the treaties, which seems to be a rather uphill struggle—is to put this issue to the British people in a referendum. They have not had the chance to have their say on this before because when we last had a referendum we had no concept of European citizenship and free movement of people, as imposed on us now. We could say to the people, “Do you wish to retake control of your own borders and re-establish ourselves as a sovereign nation with control over our own destiny, or do you wish to remain in perpetuity subservient to a supranational power, the European Union?” That is a clear proposition and I think it is implicit in what I have been saying that when presented with that choice I would choose freedom, sovereignty and democracy—and the rule of law.
I am therefore sorry that this Bill is not going to make any more progress. I could test the will of the House on it, but if I was to do that, I would jeopardise the chance of having even a very short canter round the next Bill on the Order Paper, so I beg to ask leave to withdraw the motion.
Motion and Bill, by leave, withdrawn.
Defence Expenditure (NATO Target) Bill
(9 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Christopher Chope (Christchurch) (Con)
I beg to move, That the Bill be now read a Second time.
This is my third contribution today to the manifesto development of the Conservative party for the next general election, and this Bill was inspired by the Bill of the right hon. Member for Berwickshire, Roxburgh and Selkirk (Michael Moore) to introduce a target of 0.7% of GDP for international development expenditure. It occurred to me that if the Government are in favour of that Bill, surely they must be in favour of a similar Bill on defence expenditure, in line with the communiqué from the NATO conference in Cardiff and what has been enunciated on numerous occasions by Defence Ministers from both the main parties. If NATO’s policy is that each country in NATO should spend a minimum of 2% of GDP on defence and we support that, why are we not prepared to incorporate it in statute?
The argument traditionally deployed against such a move is that the Exchequer should not fetter its own discretion, and therefore it would be unreasonable to have various areas of earmarked expenditure. As the Government have abandoned that principle in favour of having earmarked expenditure incorporated within statutory limits, as in the case of overseas aid, why not do the same in respect of defence expenditure? This is a straightforward proposition and, as far as possible, the drafting of this Bill is designed to mirror that in the similar Bill on overseas aid.
Philip Davies (Shipley) (Con)
Given that it was supposedly so important that we introduced a 0.7% target because it was supposedly an international commitment made in 1970, does my hon. Friend agree that this international commitment on defence made in the 1990s should surely take precedence over the one made in 1970?
Mr Chope
My hon. Friend makes a compelling point, and I am sure it will find favour with the Government. If the Minister is going to say that he cannot do this because the Liberal Democrat minority do not support the NATO target, let him say it. In any event, I hope that the Conservative party will have no inhibitions about making clear in its next manifesto its commitment to spending in each year of the next Parliament—when it is the governing party—a minimum of 2% of GDP on defence.
Philip Davies (Shipley) (Con)
I do not support the Bill, because I do not believe any spending should be hypothecated in the way my hon. Friend the Member for Christchurch (Mr Chope) is seeking to do. I understand his motives for introducing the Bill, and I certainly think that all those people who trooped into the Lobby to vote for our 0.7% target on overseas aid because it was an international commitment, albeit one made in 1970, should—if they are so bothered about international commitments—all be trooping into the Lobby to support this Bill, too. I do not see why one is so important and the other one is not, and I shall be interested to find out why people should think that is so.
I do not believe that spending should by hypothecated, but the point I wish to make is this: if we look at the Office for Budget Responsibility forecasts for the next few years, we see that the spending of every Department as a proportion of GDP will decrease, apart from the spending on overseas aid. That applies to health, education and everything else. There is a 2% target for defence, but the OBR says that by the end of the next Parliament—unless my hon. Friend’s Bill is accepted—defence spending will be down to 1.5% of GDP. I do not believe in hypothecated spending, but that amount of money is far too low and the Government need to address the situation. If it takes my hon. Friend’s Bill to do it, fair enough, but I would rather we did not have any hypothecated spending at all.
Sir Edward Leigh (Gainsborough) (Con)
I oppose this Bill. I know where my hon. Friend the Member for Christchurch (Mr Chope) is coming from, but hypothecating the expenditure of a Department in legislation is economically illiterate. It makes no sense at all, and we cannot right one evil by creating two evils. Although I am strongly in favour of the 2% commitment on defence expenditure, the Treasury must approach the defence budget in the same way as it approaches all other budgets: we decide what we would like to do, we decide what we can afford to do and we live within our means. Whatever our views on international development, I am strongly in favour of spending on humanitarian aid and of many other aspects of our budget. However, while we are going to cut expenditure on Lincolnshire police by £3 million, and we cannot afford to have more than one patrol car operating in my 600 square mile constituency at night, it seems that, because of the growing economy, we can afford to increase international aid development by £1 billion. I cannot believe that that is the right way to run the economy.
I understand why my hon. Friend has introduced this Bill. He is drawing attention to an appalling hole into which we are digging ourselves. We must get out of it and proclaim the principle that we believe in defence spending, international aid and all the other good things that we want to do, but, as a Government, we must live within our means and spend what we can afford to spend.
Kerry McCarthy (Bristol East) (Lab)
The UK already exceeds the 2% target for defence expenditure. At the moment, we are one of the very few countries that meets its target. Obviously, it was on the agenda at the NATO summit in Cardiff, at which the allies agreed to aim to move towards the existing NATO guidelines of spending 2% of GDP within a decade. They also agreed that those countries that were already spending the minimum of 2% would aim to continue to do so. That is the international framework. The matter is now back on the political agenda after the global economic crisis slightly knocked it off course, with many countries being forced to make defence cuts.
Labour believes that the right time and place to take decisions on the future role, shape and capabilities of the UK’s armed forces will be in the next strategic defence and security review, which will take place in the next Parliament. We were concerned that the last SDSR was very much a Treasury-led exercise. It left the country with an aircraft carrier without any aircraft or maritime patrol capabilities. It is imperative that the next SDSR is strategically led and fiscally responsible. It cannot be just a Treasury-led exercise. Its fundamental starting point should be what we want our armed forces to do.
I wish to allow the Minister at least a couple of minutes to speak, so I will conclude on that point.
The Minister for the Armed Forces (Mr Mark Francois)
I am grateful to the hon. Member for Bristol East (Kerry McCarthy) for allowing me to chip in briefly.
I commend my hon. Friend the Member for Christchurch (Mr Chope) on introducing this Bill and on giving us the opportunity to discuss this important subject, albeit rather briefly. He has never been slow in making contributions to the Conservative party’s manifesto development process whether as a Minister or as a Back Bencher, and he has been most industrious in making a contribution today.
In the limited time available, I wish to point out that, as one of the 12 founding members of the North Atlantic Treaty Organisation, the UK adheres to the principles of its membership. According to NATO’s own figures, we have the second largest defence budget in the alliance, behind the United States, and the largest defence budget in the European Union. Moreover, the defence budget and the defence programme are in balance across the next 10 years. We have the assurance of a stable and well-managed budget, and confidence that defence is both affordable and deliverable, having taken some, at times, extremely difficult decisions to put right the mess that we inherited in the Ministry of Defence from the previous Labour Government.
The NATO summit in Wales proved a pivotal moment for defence spending and investment. It represented the first ever collective public pledge on defence investment made by NATO allied leaders and was a clear acknowledgement of the challenges we face from the rapidly evolving and diverse potential threats on NATO’s borders and the need to reverse the trend of declining defence budgets to tackle key capability shortfalls. Clearly, living up to the commitments made at the Wales summit on defence investment will be challenging for all allies and progress will take time. For many, even halting the decline will be a significant challenge. Importantly, however, along with reaffirming the continuing and unwavering commitment of allies to NATO as a transatlantic alliance, there is now a willingness and commitment among allies to try to turn around the decline in defence spending, particularly on the part of our European allies.
The Wales summit was a critical moment for the NATO alliance, coming as it did in the immediate aftermath of Russia’s adventurism in Ukraine, growing instability from the middle east to north Africa and the conclusion of the international security assistance force mission.
I conclude by pointing out that we still spend 2% of our GDP on defence. We will continue to do that to the end of this Parliament and going into the—
Business without Debate
Hon. Members
Object.
Bill to be read a Second time on Friday 27 March.
Railways Bill
Motion made, That the Bill be now read a Second time.
Hon. Members
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Bill to be read a Second time on Friday 27 February.
Dogs (Registration) Bill
Motion made, That the Bill be now read a Second time.
Hon. Members
Object.
Bill to be read a Second time on Friday 6 March.
Convicted Prisoners Voting Bill
Resumption of adjourned debate on Question (5 December), That the Bill be now read a Second time.
Hon. Members
Object.
Debate to be resumed on Friday 16 January.
Benefit Entitlement (Restriction) Bill
Motion made, That the Bill be now read a Second time.
Hon. Members
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Bill to be read a Second time on Friday 16 January.
Road Traffic Regulation (Temporary Closure for Filming) Bill
Resumption of adjourned debate on Question (7 November), That the Bill be now read a Second time.
Hon. Members
Object.
Debate to be resumed on Friday 16 January.
Illegal Immigrants (Criminal Sanctions) Bill
Resumption of adjourned debate on Question (24 October), That the Bill be now read a Second time.
Hon. Members
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Debate to be resumed on Friday 16 January.
House of Lords (Maximum Membership) Bill
Motion made, That the Bill be now read a Second time.
Hon. Members
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Bill to be read a Second time on Friday 16 January.
EU Membership (Audit of Costs and Benefits) Bill
Motion made, That the Bill be now read a Second time.
Hon. Members
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Bill to be read a Second time on Friday 16 January.
Wild Animals in Circuses Bill
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Hon. Members
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Local Planning and Housing Bill
Motion made, That the Bill be now read a Second time.
Hon. Members
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Mutuals’ Deferred Shares Bill [Lords]
Bill read a Second time; to stand committed to a Public Bill Committee (Standing Order No. 63).
Health Services (Lewes)
(9 years, 11 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Norman Baker (Lewes) (LD)
I welcome the opportunity to discuss the local health issues affecting my constituency. Of course, the debate comes at an opportune time given the attention that has been given to the NHS locally.
I welcome the funding the coalition has given to the NHS, which is of course more than the Labour party gave or would have given had it been elected to office. I also welcome the £1 billion reduction in management costs that we have secured as a coalition and the investment in extra doctors and nurses. There are elements of the Health and Social Care Act 2012 that I strongly welcome, too, including the decision to make public health once again a local authority responsibility, to integrate better health and social care and to give more say to our local GPs in decision making. They will be in a far better place to make sensible decisions than the alphabet soup of various bodies that they replaced. I also welcome steps that the coalition has taken to end the preferential treatment for the private sector in terms of financial arrangements that the previous Government introduced.
As everybody in this House will recognise, we have a serious challenge with the ongoing costs of the NHS, including the fact that NHS inflation is always greater than normal inflation and, most recently, with the pressure on accident and emergency places, and consequently funding. The chief executive of the NHS, Simon Stevens, has called for a real-terms funding boost of £8 billion per year by 2020-21, on top of efficiency savings and further reforms to the NHS. I believe—I support my Lib Dem colleagues in this—that we should maintain the additional £2 billion that was secured in the autumn statement. In addition, as we said at our conference, we should invest a further £1 billion in real terms in 2016-17. That would be maintained in future budgets, paid for by capping pensions tax relief for the very wealthiest, aligning dividend tax with income tax for those earning over £150,000, and scrapping the shares-for-rights scheme. Of course, once we had finished the job of tackling the deficit, we would increase health spending in line with the growth in the economy.
So there are steps we can take, but we need to look at this in a more fundamental way as well. I suggest that we should prioritise, more than we have so far, the provision of primary health care in our local communities. That not only helps the people within those communities but takes the pressure off accident and emergency departments. I am particularly concerned about the pressure exerted on Brighton general hospital and Eastbourne district general hospital, which serve my constituency. My hon. Friend the Member for Eastbourne (Stephen Lloyd) has written to the chief executive of Eastbourne DGH seeking urgent assurances that it is able to cope with the demands currently placed on it. Both hospitals are failing to meet the Department of Health’s target of 95% of patients being dealt with within four hours, which is a matter of concern. One of the ways to deal with this is to have better local services and investment in primary care.
I am going to raise a number of issues with the Minister; I am not sure whether he will be able to respond to them all today. If there are outstanding matters on which time does not allow for a response or on which he is insufficiently briefed, I ask him or his officials to write to me subsequently with answers.
I am particularly concerned about the situation in Seaford, the largest town in my constituency, with a population of some 25,000, where we have had broken promise after broken promise from NHS bodies over very many years. They have always promised to improve services, to provide more local services, to introduce diagnostic testing and the like, and one after another of those promises have been broken by successive primary care trusts, strategic health authorities and the rest. I welcome the fact that we now have local GPs involved who live in Seaford and therefore have some chance, through the clinical commissioning groups that the coalition introduced, of bringing some services to the town that are not currently there.
Specifically, it is shocking that a town the size of Seaford with its population spread—there are many elderly people—has no minor injuries facility. Lewes, where I live in the constituency, does have such a facility at Lewes Victoria hospital, but Seaford, which is much larger, does not. I have been in discussions about this with the CCG and with the local ambulance trust. In my view, the local ambulance trust ought to provide paramedics to help with the provision of minor injuries facilities in Seaford, if only by stationing ambulances that are not required on urgent calls, thereby diverting people away from accident and emergency services and enabling them to stay in their own town rather than having to travel a very long way to Eastbourne or Brighton to secure treatment. My first request to the Minister is that he should have discussions with the ambulance trust to make progress on ensuring that a facility of some sort, even a mobile one, can be put in place for my constituents in Seaford so that they are able to have their minor injuries dealt with, sensibly, in the town rather than clogging up the accident and emergency unit at Eastbourne, which, as I say, is not meeting its target of delivering treatment to 95% of people within four hours.
We have a new facility in Seaford—the Horder centre, which I argued for and which is now delivering some services. It has taken over from Seaford Day hospital, which was a mental health facility. However, its range of services is inadequate, and I would like more NHS business to be put through it, given that there is capacity in the building. My second request to the Minister is to engage with the Horder centre to find out whether we can extend the range of services in that building to ensure, again, that pressure is taken off A and E departments.
Another issue relates to the Newhaven Downs facility, which is just to the west of Newhaven and not very far from Seaford. This is a relatively new facility and is of quite a good standard, but it is chronically underused. I want to know why, when we are short of money, we have a good facility that is not being used to anything like its maximum potential. It could be used to deal with people from Newhaven and Seaford in my constituency and from Peacehaven in the constituency of the hon. Member for Brighton, Kemptown (Simon Kirby). What is the forward plan for improving and increasing the use of the Newhaven Downs facility?
I am conscious that one of the problems is that if we are to invest locally in primary care, we have to keep the A and E facilities and the acute hospital money there while the improvements are made. There is therefore a need for a one-year investment programme to ensure that both angles are covered until the primary care facilities take over. I imagine that this is a problem not only in my constituency, but elsewhere, so is there a plan to implement the Government’s aim, which I very much welcome, for far more people to be treated locally in their own communities? That is the right policy, but it needs pump-priming to ensure that it can occur. The question is how that happens when A and E departments and acute hospital trusts are still being funded as they have been.
The problems of the need to travel to acute hospitals have been exacerbated by the transfer of services from the Eastbourne district general hospital to the Conquest hospital in Hastings. The East Sussex Hospitals NHS Trust runs those two facilities, which are some way away. The sad fact is that we are now seeing a two-tier acute hospital service in East Sussex, with Brighton and Hastings having pretty much the full range of services, and Eastbourne being downgraded. That is a matter which my hon. Friend the Member for Eastbourne is very worried about, as is the local population.
My constituents in Seaford and Polegate are sometimes asked to make extraordinarily long journeys to Hastings, which is a very long way away. The hospital in Hastings is nowhere near the train station and is very difficult to get to. We have already seen maternity services transferred there—by sleight of hand, I might say— with a so-called temporary transfer which then became permanent, bypassing the normal consultation arrangements, not to mention bypassing public opinion. I have to say to the Minister—I do not say this lightly and I have not said it before in 18 years—that I do not have confidence in the management of that NHS trust to deliver the right thing for the people of my constituency or even to play straight with them. That is a matter of great regret to me.
If, at least for the short term, my constituents are required to travel a very long way for very basic services, which I hope will change, the NHS trust in Eastbourne and Hastings which has been responsible for that situation needs to take some responsibility for the transport implications. Will the Minister set out what he believes are the responsibilities of the NHS trusts that generate extra transport requirements, but then wash their hands of the consequences and say it is a matter for the county council as the transport authority, the commercial bus company, the rail company or somebody else—anybody apart from them—to pick up the pieces?
The hospital in Brighton, the Royal Sussex County hospital, which also runs the Princess Royal hospital in Haywards Heath has accepted that there is a need to do something about that. It has organised a bus running between Brighton and Haywards Heath, which is a good service used by patients and by those who work in the health service as well. No such arrangement has been put in place between Eastbourne and Hastings and I want to know why not. It is not sufficient to say that people can get the bus, because my constituents sometimes have to pay extraordinary amounts of money to get taxis from where they live to Hastings, and no money is paid back. Some of these are poor people who cannot afford to pay for taxis. That is an outrageous situation for them to be in. I ask for the Minister’s help in dealing with that important transport issue. I hope he will accept the principle that if an NHS trust causes a transport problem, it has a responsibility to deal with it, rather than washing its hands and pushing it on to somebody else.
I draw the Minister’s attention to another problem on which I would welcome some help. It relates to a retirement development called St George’s Retreat at the far north-western corner of my constituency. Hundreds of retired people are living there in a pleasant community, but it is right on the border. Those people naturally look across the border to West Sussex for their health services, but West Sussex does not want to know about them because they are technically in East Sussex, and East Sussex says that they are so near the West Sussex border that they should be accessing West Sussex services.
How can that particular conundrum be solved? People are in limbo without proper services. One approach—this is a bit like the solution for minor injuries—would be for a district nurse and other health visitors to pick up some of the casework at that large facility once a week, rather than expect people to travel very long distances because of where they happen to live.
I am also concerned that pressure on A and E in Eastbourne is being caused by the lack of facilities in Polegate, which is a long-running issue. Polegate is in my constituency to the north of Eastbourne. It has two doctors’ surgeries in Manor Park and Downlands, and they are chronically short of space. The doctors are ready, willing and able to deliver more services locally, which, quite rightly, is what the Government wants, but they are unable to do so because they simply have no space. When I visited those surgeries I was horrified by the lack of space.
There have been plans for a very long time—we have been let down by successive primary care trusts—to improve the facilities and have a new medical centre in Polegate by combining the two surgeries. That is a sensible suggestion and the Minister’s colleague, the Minister of State, Department of Health, my right hon. Friend the Member for North Norfolk (Norman Lamb), came to look at the situation. The reality is that my constituents and, indeed, the doctors are being held back and asked to deal with an inadequate situation in inadequate conditions because of the lack of a medical centre. What pressure can the Minister bring to bear on the clinical commissioning group to ensure that the problem is dealt with?
The Lewes Victoria hospital, which is in my constituency, is in the county town of East Sussex and has a minor injuries facility. It is much loved, very well respected and hugely supported by the friends of the hospital, who have done so much over the years to make sure that it is a lovely place to be. I had a minor op there myself recently and I was extraordinarily impressed by the level of care and compassion shown by all the staff, to whom I am very grateful. I want to put that on the record.
Unfortunately, the hospital is also technically run by the East Sussex Hospitals NHS Trust, which has no particular interest in the place. It is outside its catchment area. It was left standing when the music stopped and it should not be in the trust’s purview. I want the arrangements to be changed and for the Victoria hospital to be transferred to somewhere that has more interest in it than the trust. Will the Minister consider that? My view is that there should be a community trust across Sussex. Failing that, the hospital should be handled by Brighton, which is more local to it.
The hospital is losing facilities, such as the pacemaker clinic, which is shocking. At a time when we want to get more, not fewer, facilities in towns, they are disappearing. That simply clogs up A and E and other hospitals, where parking is particularly difficult.
My last point, which was raised with me by the chief executive of the South East Coast ambulance service, relates to a curiosity to do with ambulance waiting times. I would be grateful if the Minister looked at it and came back to me. Ambulances are being left waiting outside the A and E section of the hospital in Brighton. Why is that happening? The hospital does not want to accept the cases because they worsen its figures for the time people wait in A and E. Therefore, in order to, in effect, fiddle the figures, ambulances are wasting their time and patients are kept there until the hospital is confident it can see them within the four-hour limit. That is not sensible, and nor is it what the Government and Health Ministers want. Will the Minister look at that? In my view, the clock should start ticking as soon as the ambulance arrives on the forecourt or on the premises of the acute hospital. If he could give me an assurance that that will be the case in the future, I would be grateful.
The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
My right hon. Friend the Member for Lewes (Norman Baker) has raised a number of issues and I will do my best to address them in the limited time available. I will, of course, write to him about any issues I am unable to get on to today.
I congratulate my right hon. Friend on securing the debate. A number of the points he has made are of great importance to both him and his constituents. Before I continue, I want to highlight the extra work carried out every day by all those who work in the NHS in his constituency, including staff alongside whom I have worked during my time in the NHS. During a busy time in winter, we should be proud of our front-line staff and the hard work they continue to do, even with the increased demand caused by winter pressure on our health service.
My right hon. Friend was right to say that there is now less bureaucracy in our health service and more money for the front line. Thanks to our having stripped out some of the bureaucracy, we will have £6.5 billion more for front-line care over this Parliament than we would otherwise have had. That has been independently audited, and I am sure that all patients in Lewes and elsewhere are very pleased with that.
Primary care trusts have been replaced with clinical commissioning groups. My right hon. Friend talked about some of the historical frustrations with PCTs in his constituency. I hope that the changes made on the introduction of CCGs—their clinical leadership is provided by clinicians who have actually looked after patients and understand their needs—will already have led to improvements in care in his constituency. The fact that some of the reviews now taking place are led by clinicians who run the process of allocating local health care funding will ensure that the right decisions are made about local health care priorities and about meeting the needs of patients.
Health and wellbeing boards now ensure that health and social care services are better joined up, which is important for looking after vulnerable patients, the disabled and the frail elderly. Health and wellbeing boards provide an opportunity to integrate services further, which is particularly important in a very diverse county, such as East Sussex, with rural as well as urban areas. East Sussex health and wellbeing board is grasping the opportunity to join up the local provision of primary community care, the acute sector and social services care.
An important part of meeting some of the challenges faced by the local NHS—my right hon. Friend mentioned the issue of the throughput of patients at Brighton—is to join up adult social care with NHS services better to ensure that acute beds can be freed as quickly as possible for those who are the most sick, with others being transferred into the most appropriate care setting. I know that the local health and wellbeing board takes an active interest in that issue.
My right hon. Friend raised issues about health services in Seaford and Polegate. As he rightly outlined, high-quality premises are an important part of ensuring high-quality primary care services. I understand that NHS England’s Surrey and Sussex area team is working with the Old School surgery in Seaford to explore options for the improvement of its facilities. The capital funding to create new consultation rooms for the Downlands surgery in Polegate has been agreed, and the work is intended to be completed by April 2015. That will bring improvements to patients who attend that surgery. I understand that there have been some quality issues with the premises of another practice in Polegate, the Manor Park medical centre. From memory, it is on a crossroads in the town centre. That issue is in the forefront of the mind of the Surrey and Sussex area team, which reassured me yesterday that it is looking at how to improve the situation.
Such issues are not just for the local clinical commission group; there might be a role for the local authority—perhaps with contributions from developers, where available—to support the local NHS by building new facilities. In areas of housing growth, such as around Eastbourne, the local authority could work collaboratively to collect developers’ contributions to put in place local infrastructure for schools and the local NHS. I am sure that that will be considered as a result of this debate. There is also an opportunity for the local NHS to work more collaboratively with the local authority to address some of the premises issues and to improve the quality, size and capacity of places in which local patients are treated.
As I have said, local clinicians and local authorities have been empowered through the creation of clinical commissioning groups and health and wellbeing boards to bring together health and social care. That is particularly important in the context of the issues relating to Seaford that were raised by my right hon. Friend. I am aware of the changes made at Seaford day hospital, and he outlined some long-standing frustrations with earlier decisions made by the PCT. I understand, however, that Horder Healthcare has taken over the hospital to run services, and that physiotherapy services are being provided there, which is at least a step in the right direction.
As part of the East Sussex Better Together programme, plans are being developed to bring as many services as possible, such as out-patient and diagnostic services, closer to people’s homes and communities. It is particularly important to minimise the travel that frail and elderly patients have to undertake when they need access to local health care services. Seaford is one of the key local communities that is under consideration as part of the Better Together programme. More generally, the Better Together programme is about the three local CCGs in East Sussex and the county council working together to ensure that there is a more integrated approach to delivering more community-based care across the county. That is a welcome step forward.
I am sure that the important addition of clinical input now that clinicians are leading CCGs will ensure that there is more joined-up working. The Better Together programme will look at where it is possible to join up primary and community health services, as well as at where out-patient clinics can appropriately be provided in a primary care setting. As far as is possible, we should have a one-stop shop for patients, particularly older patients. There could be blood testing for warfarin control, diagnostic services, GP services and other high-quality local community health care services in one location. Where that can be offered, it is of huge benefit to patients. In my conversations with the CCG yesterday, I was very pleased to hear that the Better Together programme is looking at exactly how to achieve that in the Seaford area. I have asked it to discuss further with my right hon. Friend how it intends to take that forward over the next few months.
It is important to talk briefly about the issues that my right hon. Friend raised about the future of Lewes Victoria hospital, which I know well, having performed some day operations there in the past with my then consultant. I understand that in October 2014, High Weald Lewes Havens CCG initiated a formal procurement process to enhance and improve the community services contract. As part of the general review of services, community services will clearly play a key part in delivering services closer to home. Lewes Victoria hospital has a track record of delivering high-quality community-based care.
A new contract for the hospital is expected to be awarded in spring 2015. That will be followed by a period of transition planning, with a view to having the new community services contract in place by the autumn. The CCG has confirmed that it plans to continue providing community health services from Lewes Victoria hospital and it is keen to ensure that the skills and expertise of the existing community services staff and the three community hospitals in the area are at the heart of plans to improve patient care and experience. I am very reassured by my conversations with the CCG that the future of Lewes Victoria hospital as a centre for delivering community-based care, day case operations and other high-quality care for people in Lewes and the surrounding areas is very secure. I am sure that that will be welcomed by the people of Lewes and the surrounding areas.
In the time that is left, I turn to the services at Eastbourne district general hospital. The hospital continues to offer a wide range of services, including emergency, out-patient, medical, surgical, diagnostic and day surgery services. I am aware that some of the services provided by East Sussex Healthcare NHS Trust have been relocated since 2013 and that improvements in patient safety have been achieved through that. I will come back to that a little later.
Although consultant-led maternity services, overnight paediatrics, orthopaedics and emergency general surgery have been sited at the Conquest in Hastings, other services, such as acute stroke care and ear, nose and throat services, have been centralised at Eastbourne, so it would not be fair to say that Eastbourne district general hospital has been the loser in the redistribution of services. It has gained from the addition of acute stroke care and ear, nose and throat services. I will turn to maternity services in a moment.
Health care commissioners are assured that there have been significant improvements in patient outcomes since stroke services have been centralised at Eastbourne. Better care is being delivered to patients as a result, which is something that both my right hon. Friend and I welcome. The trust is performing above the national average against a number of standards for stroke care.
Maternity care has been a challenge for the trust, and an emotive and controversial issue locally. One historical issue concerned safe staffing levels for maternity units, because I believe that the Conquest and district general hospitals both managed fewer than 2,000 births a year. There was a particular challenge with a lack of consultant senior cover out of hours—that is important to protect patient safety—and a challenge in encouraging and recruiting junior doctors to staff the middle-grade rotas at those trusts. Although I understand that the changes are emotive and controversial, they were about ensuring that the highest quality of care could be delivered for women, and a midwifery-led unit at the DGH now promotes choice. There are ongoing enhancements to the midwifery-led unit in Crowborough, and acute obstetric services are being centralised at the Conquest.
Perhaps it will reassure my right hon. Friend to know that following the changes, the number of serious incidents at the trust decreased from 17 between June 2012 and May 2013, to six for the same period in 2013-14. Clinical evidence points to a safer and better service for women, although I understand that these are emotive issues. East Sussex county council’s health, overview and scrutiny committee continues to provide rigorous scrutiny of those services, and has agreed that the decision to single-site consultant level maternity and in-patient paediatric services was in the best interests of the health service and the residents of East Sussex.
I am running out of time so I will wrote to my right hon. Friend about the issues he raised about St George’s park and ambulance response times, but I congratulate him again on securing this debate on an issue that I know is of great importance to him and his constituents. I encourage him to liaise directly with the local NHS and to continue championing these important issues.
Question put and agreed to.