House of Commons

Wednesday 21st January 2015 Commons Chamber

Wednesday 21 January 2015

The House met at half-past Eleven o’clock

Prayers

Wednesday 21st January 2015 Commons Chamber

[Mr Speaker in the Chair]

Oral Answers to Questions

Wednesday 21st January 2015 Commons Chamber

The Secretary of State was asked—

[Karl MᶜCartney (Lincoln) (Con)]

1. What assessment he has made of the effectiveness of steps taken to rebalance the economy in Wales since 2010.

[The Secretary of State for Wales (Stephen Crabb)]

The previous Government were content to allow the British economy to become dangerously imbalanced with far too much reliance on the financial sector in London and the south-east. During this time Wales became poorer and fell to the bottom of the economic league tables, but we are determined to turn that around and achieve a stronger and more geographically balanced economy through a long-term plan, which is already starting to bear real fruit for Wales.

[Karl MᶜCartney]

I thank my right hon. Friend for that answer—and offer him belated birthday wishes.

With regard to the rural economy of Wales, I heard talk when I recently returned to St David’s university college in Llanbedr Pont Steffan of moves to reopen the Carmarthen to Aberystwyth railway line that passes through the Teifi valley. What effect does my right hon. Friend think this would have in reinvigorating the local rural economy, and might it help to rescue my alma mater from the parlous state various vice-chancellors since Lord Morris of Castle Morris have allowed it to descend to?

[Stephen Crabb]

I thank my hon. Friend for his question and his good wishes. I am a believer in investment in infrastructure. I recognise the important role investment infrastructure plays as a driver of economic growth. We have discussed at previous Wales Office questions the reopening of the Aberystwyth-Carmarthen line. He will be interested to know that I will shortly meet the campaign group Traws Link Cymru to discuss the business case for reopening the line and what support we can give, if appropriate.

[Dr Hywel Francis (Aberavon) (Lab)]

I am sure the Secretary of State agrees that one of the best ways of rebalancing the economy is to ensure the interface between universities and the private and public sectors, and I know he recently visited my constituency and the new Swansea university campus at Crymlyn burrows. I am also sure he would wish to join me in congratulating the leader of Neath Port Talbot county borough council, which has developed a wonderful partnership with the university, and Councillor Ali Thomas on the honorary fellowship he will receive next week at Swansea university.

[Stephen Crabb]

I thank the hon. Gentleman for that question, and I absolutely do concur with his sentiments about the role local partners have played in taking forward the bay campus development. I was there on Friday, at the hon. Gentleman’s recommendation, and it is indeed a truly fine example of partnership-working. We know that success in the 21st century will belong to those economies that can harness knowledge and innovation, and having world-class university sites is part of that.

[Mr David Jones (Clwyd West) (Con)]

Has my right hon. Friend noted the recently published report of South Wales chamber of commerce, which notes that confidence in the Welsh economy has been high throughout 2014 and that it looks to remain the same for 2015? Is he as pleased as I am that real business people in Wales are so enthusiastic and keen to talk up the Welsh economy, unlike the hon. Member for Pontypridd (Owen Smith), who devoted his recent article in the Western Mail to talking it down?

[Stephen Crabb]

I thank my right hon. Friend for that question, and he is absolutely right: the sentiment among businesses in north Wales, south Wales and west Wales is very confident and optimistic, and what they tell me every week as I criss-cross Wales talking to them is in stark contrast to the message we hear from the Opposition, who regularly now talk down the Welsh economy and the efforts of Welsh business.

[Mr Peter Hain (Neath) (Lab)]

On the economy, how does the right hon. Gentleman respond to today’s research by the university of Oxford and the London School of Hygiene and Tropical Medicine that only a fifth of claimants who have had their benefits sanctioned and then taken away have found work? Surely this will not rebalance the economy or make it stronger, let alone make it just, and it is diabolically punitive.

[Stephen Crabb]

I have not seen that report so I am not going to get drawn into commenting on the specifics, but I have seen the latest figures for the performance of the Work programme in Wales, which should give us encouragement that we have a set of measures in place that is helping to bring down long-term unemployment.

[Mr Hain]

indicated dissent.

[Stephen Crabb]

The right hon. Gentleman shakes his head, but I encourage him to look at the figures for long-term unemployment in Wales: they are coming down yet again this month, which is positive news. There is much more to be done, but the emerging picture is a very strong and positive one.

[Roger Williams (Brecon and Radnorshire) (LD)]

Tourism is very important to Wales, and to rural Wales in particular. It has been suggested that reducing VAT on visitor attractions and accommodation, as other EU countries have, would stimulate tourism and result in a higher tax-take. Does the Secretary of State agree with that view?

[Stephen Crabb]

I am familiar with the VAT arguments from the tourism sector. Of course these matters are the responsibility of the Chancellor of the Exchequer and he keeps them under review, but I would just point out to my hon. Friend the most recent tourism visitor figures, which showed about an 8% increase last year in international visitors coming to Wales. That has to be a good sign that the tourism sector is on the up in Wales.

[Chris Evans (Islwyn) (Lab/Co-op)]

12. The new year has seen another rise in the tolls on the Severn bridge, and many businesses across Wales tell me that the bridge is now becoming a barrier to business and trade. Will the Secretary of State have urgent talks with the Chancellor of the Exchequer about reducing VAT on the tolls?

[Stephen Crabb]

The hon. Gentleman is right to talk about the burden that the increased tolls place on businesses and on visitors to Wales. We recognise that that is happening. They are, for example, a major burden on the small vans crossing the bridge. I have asked the Under-Secretary of State for Wales, my hon. Friend the Member for Vale of Glamorgan (Alun Cairns), to lead a body of work to look into the options for the Severn bridge, and he is having discussions with the Department for Transport. We also look forward to hearing the views of Members on both sides of the House.

[Glyn Davies (Montgomeryshire) (Con)]

2. What discussions he has had with Ministers of the Welsh Government on waiting times at A and E departments that serve patients from both sides of the England-Wales border.

[The Secretary of State for Wales (Stephen Crabb)]

My ministerial colleagues and I regularly raise concerns with the Welsh Government about the provision of health care along the England-Wales border and we are reviewing the current arrangements to ensure that they meet patients’ needs.

[Glyn Davies]

When my constituents in Montgomeryshire need to attend A and E, they are taken either to hospitals in England, where 87% of patients are seen within four hours, or to hospitals in Wales, where, shockingly, the figure is only 63%. Does my right hon. Friend agree that the Welsh Government and the UK Government should work together constructively to deliver reforms to ensure that only genuine emergencies attend A and E?

[Stephen Crabb]

As ever, my hon. Friend makes a strong and constructive point. At this time of year, the NHS is facing severe pressures across the whole of the UK, and he is right to say that there is a disparity between the outcomes in Wales and those across the border in England. It is right that we should work together to address those disparities, but Welsh Government Ministers in Cardiff should be held to account for the decisions that have led to some of the problems.

[Geraint Davies (Swansea West) (Lab/Co-op)]

Is the Secretary of State aware of the innovative medical centre at the end of Wind street in Swansea, which treats intoxicated people on the spot, freeing up ambulances, police and accident and emergency departments? Will he inform the Secretary of State for Health in England of the success of that venture, and suggest to him that similar facilities here could help to reduce the pressures caused by the removal of walk-in centres?

[Stephen Crabb]

I am not familiar with that facility, although I am familiar with Wind street—from what I have read, not from what I have experienced. However, we will certainly look at that project in some detail and I will raise the matter with Health Ministers.

[Owen Smith (Pontypridd) (Lab)]

Since we last met, the Secretary of State has warned his Cabinet colleagues to mind their language when talking about the NHS in Wales. He said:

“I want them to take care how they speak about health services in Wales…I don’t want to hear anyone talking about a second-class NHS in Wales”.

Is he therefore disappointed that the Prime Minister has overruled him in continuing to bad-mouth the Welsh NHS?

[Stephen Crabb]

I am surprised to hear this from the hon. Gentleman. We on this side of the House are not shutting down the debate on, and scrutiny of, the performance of the NHS. We stand on the side of patients in England and in Wales, and it is quite wrong of him to act as some kind of cheerleader for the Labour party by seeking to shut down the scrutiny and the debate on the Welsh NHS.

[Owen Smith]

I take it from that answer that the Secretary of State is disappointed that the Prime Minister has overruled him. I believe that the Prime Minister has done that because talking about the Welsh NHS is his favourite way of distracting people’s attention from the failings of the NHS in England. Given that there is a crisis in hospitals near the border in Telford, in Shropshire, and in Cheltenham and Gloucester, where Welsh patients are traditionally sent, is it not now time for the Secretary of State to renew his efforts to get the PM to stop talking about Offa’s Dyke as though it were a line between life and death?

[Stephen Crabb]

On the subject of health, there are two apologies that we need to hear from the Opposition today. The first is an apology from the hon. Gentleman on behalf of the Welsh Labour party for the way in which its Ministers in Cardiff have run the Welsh NHS into the ground. The second is from the Leader of the Opposition for his disgraceful and inappropriate suggestion that the NHS should be “weaponised”.

[Stuart Andrew (Pudsey) (Con)]

3. What assessment he has made of trends in the level of infrastructure investment in Wales since 2010.

[The Parliamentary Under-Secretary of State for Wales (Alun Cairns)]

We have been ambitious in our infrastructure investment plans to address the historic underinvestment in Wales by previous Governments. We are enabling businesses in Wales to expand and explore new markets by investing in better train links, less-congested roads and faster broadband speeds.

[Stuart Andrew]

I thank the Minister for that answer. Given the commitment to fund the northern hub in full and the ambition for HS3 to improve connectivity right across the north of England, what is his Department doing to ensure that north Wales can take full advantage of those welcome developments?

[Alun Cairns]

My hon. Friend is right to highlight the significant infrastructure investment being made across the whole of the UK, but of course it is important that north Wales links into the rest of the UK. The fact that Crewe is the HS2 hub is important, and I look forward to hosting a transport summit in the next week or so to discuss how we best link north Wales with the rest of the UK.

[Ian Lucas (Wrexham) (Lab)]

13. What recent discussions he has had with the Secretary of State for Transport on investment in rail in north Wales. Will the Minister confirm that the UK Government have diverted funding previously allocated for the phase 1 and phase 2 modular rail signalling upgrade in north Wales to support investment in rail projects in south Wales?

[Alun Cairns]

I can categorically reject that. The UK Government are making significant investment in north Wales, at the Halton curve, and in south Wales, in the electrification of the main line right through to Swansea and in the valley lines and Vale of Glamorgan line services. I am proud of our record of electrifying railways in Wales. The previous Administration left us as one of the three nations across Europe without any electrified rail; Wales, sadly, was left with Albania and Moldova, and this Government are changing that.

[Chris Ruane (Vale of Clwyd) (Lab)]

Will the Minister congratulate the Welsh Government on providing funding for infrastructure investment in Rhyl? They have provided £28 million for new housing in Rhyl; £22 million for a new community hospital; £10 million for a new harbour; £25 million for a new Rhyl high school; and £12 million for flood defences. Will he also condemn the coalition Government, who have closed down Rhyl county court, Rhyl Army recruitment centre and Rhyl tax office, with the Crown post office possibly being relocated out of Rhyl?

[Alun Cairns]

The hon. Gentleman is somewhat selective in the data he shares. I am proud of the infrastructure investment record of this Government; he failed to mention the north Wales prison and the Halton curve, as well as the investment across the whole of Wales, not only in the north.

[Jonathan Edwards (Carmarthen East and Dinefwr) (PC)]

In recent months, I have been working with the communities of Salem, Cwmdu, Talley and Pumsaint, which have been without landline provision while waiting for damaged lines to be repaired. Communication problems have been exacerbated by a lack of mobile coverage, so will the Minister ensure that mobile not spots in Carmarthenshire benefit from the recently announced investment in mobile infrastructure?

[Alun Cairns]

I am grateful to the hon. Gentleman for raising that important issue. Openreach and British Telecom need to get on top of replacing those lines when they fall because of adverse weather. Let me also congratulate the Secretary of State for Culture, Media and Sport on the innovation he is showing in trying to close those not spots by using both private money and the mobile infrastructure plan, which will make a major difference in these areas.

[Mr Mark Williams (Ceredigion) (LD)]

4. What steps the Government are taking to support the dairy industry in rural Wales.

[The Secretary of State for Wales (Stephen Crabb)]

The Government are very aware of the severe pressures currently facing the UK dairy sector. I have discussed the situation in Wales with my ministerial colleagues, as well as with key stakeholders, including numerous dairy farmers. There are major short-term global factors pushing down prices, and we are calling on banks, supermarkets and major processors to show flexibility and understanding at this time.

[Mr Williams]

I thank the Secretary of State for that answer. We all understand the global challenges facing the industry, but will he urgently speak to his Department for Business, Innovation and Skills colleagues about extending the role of the Groceries Code Adjudicator to the whole supply chain—to all dairy producers—and, crucially, enacting the adjudicator’s power to fine? The next review of the role is not expected until 2016, and many of our farmers will not be functioning as farmers unless we have urgent action now.

[Stephen Crabb]

First, I commend the work my hon. Friend does on the dairy sector in Wales; he is a powerful voice on behalf of dairy farmers in his constituency and throughout Wales. We strongly support the work of the Groceries Code Adjudicator. Its jurisdiction is currently limited, but a review will take place next year. I take my hon. Friend’s point about the short-term pressures, so we look forward to receiving information and updates from him on action we can take.

[Mr Elfyn Llwyd (Dwyfor Meirionnydd) (PC)]

As a Member representing Pembrokeshire, the Secretary of State will be well aware that the dairy industry in Wales still contributes about 10% to the whole of the UK’s production, but that since 1999 its level has fallen by 51%. Will he look at yesterday’s report by the Select Committee on Environment, Food and Rural Affairs, which says exactly what the hon. Member for Ceredigion (Mr Williams) says: give the adjudicator greater teeth to tackle unfair pricing?

[Stephen Crabb]

I thank the right hon. Gentleman for his question, and we are looking exactly at that report. A very severe short-term crisis faces the dairy sector at this time. Nobody pretends that expanding the role of the adjudicator will fix the global problems—big market challenges need to be addressed—but we are doing everything we can to work with the dairy industry and protect the supply base.

[Mr Llwyd]

On the market challenges that the right hon. Gentleman refers to, what steps is he taking to urge his Government to work with the Welsh Government to implement policies we have suggested—for example, the dairy equivalent of Hybu Cig Cymru to market Welsh milk, the use of rural development funding to develop supply chains to counteract volatility, and procurement in the local Welsh sector?

[Stephen Crabb]

The right hon. Gentleman might be surprised to hear that we do follow the policy recommendations of Plaid Cymru and I have looked at the recommendation for that new body. When huge global imbalances are putting such severe pressure on dairy farmers throughout Europe, reaching for a bureaucratic solution and setting up a new quango probably will not make that much difference, but we will look at the proposal in further detail and have that discussion.

[Mr James Gray (North Wiltshire) (Con)]

With dairy prices at 20p a litre, First Milk collapsing last week and the discount supermarkets cutting prices day by day, it is hardly surprising that one dairy farmer goes out of business every 10 days. Does the Secretary of State agree that in addition to the efforts of the EU and national Government, we need to see far more action from the Welsh Government? There is a great deal they could do to support Welsh farmers, as well as farmers in North Wiltshire.

[Stephen Crabb]

I thank my hon. Friend for that question and make two points in response. First, First Milk did not collapse last week. It faces some pressures and there are specific impacts for dairy herds, but that co-operative is still very much functioning. Secondly, on the Welsh Government, we work constructively and co-operatively with them on agriculture issues.

[Nia Griffith (Llanelli) (Lab)]

The Secretary of State rightly recognises the severe crisis in the dairy industry, so with the Environment, Food and Rural Affairs Committee’s dairy price report criticising the grocery adjudicator’s role as too narrow and left toothless by this Government’s failure to set the level of fines that she can impose, will he now act with a sense of urgency, push for an immediate review of the adjudicator’s role and give that assurance to Welsh farmers?

[Stephen Crabb]

I am surprised by the tone that the hon. Lady takes. Under the Government that she supported, no progress whatever was made on implementing a code of practice or an adjudicator. As a Government we have been taking forward these measures. We will look at the specific recommendations of the Select Committee report, but we will take no lessons from the Labour party on the dairy sector.

[Michael Fabricant (Lichfield) (Con)]

My right hon. Friend will know that independent grocers such as Spar in Tywyn in Gwynedd stock Welsh milk, which is clearly marked with y ddraig goch—the red dragon. What steps can he take to ensure that people in Wales drink Welsh milk rather than European milk, which will stimulate the market and support Welsh farmers?

[Stephen Crabb]

My hon. Friend is right. Welsh produce is the best in the world, and when it is labelled as such it gives consumers powerful signals, which they respond to. That is one of the ways in which we have been able to boost exports of Welsh agriculture produce in the past two years, but we will look at what further steps we can take to support labelled home-grown produce.

[Ann Clwyd (Cynon Valley) (Lab)]

5. What assessment he has made of the implications for the Government’s policies of the Auditor General for Wales’s report on “Managing the Impact of Welfare Reform Changes on Social Housing Tenants in Wales”, published in January 2015.

[Mr David Hanson (Delyn) (Lab)]

6. What recent estimate he has made of the number of households in Wales that have received a reduction in benefits since the introduction of the under-occupancy penalty.

[Mark Tami (Alyn and Deeside) (Lab)]

7. What assessment he has made of the implications for the Government’s policies of the Auditor General for Wales’s report on “Managing the Impact of Welfare Reform Changes on Social Housing Tenants in Wales”, published in January 2015.

[The Parliamentary Under-Secretary of State for Wales (Alun Cairns)]

This Government will not shy away from the financial and social responsibility of reforming the way in which housing benefit is allocated. There are no plans to change Government policy following the report from the Auditor General for Wales. We plan to use this report to support local authorities to respond better to local needs.

[Ann Clwyd]

As the Minister will know, there has been a large number of Government reports on the Government’s welfare policies. A Sheffield Hallam university report, for example, shows that the south Wales valleys will experience a £430 million cut in income, endangering 3,000 local jobs as a direct result of Tory welfare reforms. Is not the Minister ashamed?

[Alun Cairns]

The report that the right hon. Lady mentions is an important contribution to the debate, but it focuses on only one element of Government policy. It does not take into account the wider package of welfare reform—something that the previous Administration, sadly, shied away from. This Administration will not do so, because of the important need to tackle Government finances.

[Mr Hanson]

The 1,500 people in Flintshire who are impacted by the bedroom tax face no choice but to cut their incomes, which are already low, because there are no properties available. Will the Minister tell me how many two-bedroom and one-bedroom properties are available in Flintshire today?

[Alun Cairns]

The right hon. Gentleman raises an important point because the number of new social properties built in Wales over the past three years is, proportionately, far fewer than the number built in England over the same period. The Welsh Government have a responsibility to deliver in that area. The Wales Audit Office report also highlights the fact that 47% of tenants had no advice given to them on how better to manage the spare room subsidy and the obligations that it would bring.

[Mark Tami]

Will the Minister explain why it is right to force disabled people out of a home and into a smaller property—should one exist in the first place—rip out all the adaptations that have been made to that property and, presumably, put new ones into a second property? Apart from being cruel, how can such action possibly be cost-effective?

[Alun Cairns]

This Government have made additional money available through the discretionary housing payment to help individuals facing difficult circumstances. Only three out of 22 local authorities in the whole of Wales—Cardiff, Caerphilly and Conwy—applied for additional discretionary housing payments. The hon. Gentleman’s local authority did not do that. Let us be clear: the roots of the removal of the spare room subsidy lie deeply in the Labour Benches, because it was a Labour Administration who took it away from the private-rented sector. We are merely extending that principle to the social-rented sector.

[Hywel Williams (Arfon) (PC)]

My own local authority runs a useful forum for local agencies to plan a response to the bedroom tax, but its work is bedevilled by a lack of certainty over central Government support through the discretionary fund. Will the Minister prevail on his colleagues to give more certainty to future funding, which would help our work?

[Alun Cairns]

The discretionary housing payment is completely flexible and local authorities should use their discretion to see that it is used in the best way. The Wales Audit Office report provides excellent data and highlights some authorities such as Caerphilly and Cardiff that provide excellent practice and support their tenants in meeting the obligations of the spare room subsidy. After all, it is about returning the long-term unemployed back to the workplace, as that offers them the best opportunities and the best prospects.

[Stephen Mosley (City of Chester) (Con)]

8. What assessment he has made of the level of growth in the high-tech sector in Wales since 2010.

[The Secretary of State for Wales (Stephen Crabb)]

Wales has the potential to be a beacon of hi-tech excellence and innovation. Since 2010, thousands of new jobs have been created in the advanced manufacturing, ICT and life sciences sectors. The growth in those sectors is contributing to the rebalancing of our economy, which is so vital to future economic success.

[Stephen Mosley]

Does my right hon. Friend agree that it is remarkable that half the world’s mobile phones contain wafer semi-conductor technology that has been made in Wales?

[Stephen Crabb]

My hon. Friend is exactly right. Remarkable transformations are occurring inside the Welsh economy. Much more work needs to be done, but the picture is a positive one. That view stands in stark contrast with what the Labour party would have us believe, as it consistently—week in, week out—talks down the achievements of Welsh business.

[Paul Flynn (Newport West) (Lab)]

9. What recent discussions he has had on increased shared services jobs in Gwent.

[The Parliamentary Under-Secretary of State for Wales (Alun Cairns)]

The Wales Office continues to hold discussions with the Ministry of Justice on the future of the Shared Services Connected Limited offices in Newport. The Justice Secretary has been clear that he would not support any proposals to offshore jobs from Newport.

[Paul Flynn]

The city of Newport has provided a splendid successful habitat for thousands of civil service jobs. Will the Minister renew his efforts to ensure that shared services, which were pioneered in Newport, are now strengthened and recognised as centres of excellence?

[Alun Cairns]

I am grateful to the hon. Gentleman for raising that issue. It is quite obvious that the pooling of the expertise and experience in Newport provides the shared services facility a great opportunity to try to attract work from both the private and public sectors, and we are determined to do what we can in that area.

[John Mann (Bassetlaw) (Lab)]

10. What assessment he has made of the prevalence of anti-Semitism in Wales.

[The Secretary of State for Wales (Stephen Crabb)]

Incidents of religious and racial hatred are thankfully very low in Wales. But as we approach Holocaust memorial day, it is right that we look again at the efforts we are making to prevent such incidents and to say with a clear and united voice that anti-Semitism and all forms of racial and religious hatred are not compatible with the freedom values that are cherished by the people of Wales. [Interruption.]

[Mr Speaker]

Order. This question is about Holocaust memorial day and the scourge of anti-Semitism. The House should listen to the question and to the answer.

[John Mann]

Thank you, Mr Speaker. The Jewish community across the whole of the United Kingdom is feeling under increasing threat. Will the Secretary of State ensure that the part of the United Kingdom that he is responsible for is as vigilant and as supported as every other part of the United Kingdom, so that his Jewish community can feel that it has our support?

[Stephen Crabb]

I thank the hon. Gentleman for the question. He is exactly right: no member of the Jewish community anywhere in the UK should have to live in fear. He may be interested to know that tomorrow I shall be meeting Rabbi Michael Rose in Cardiff, to talk about those concerns as they affect Wales.

[Jonathan Evans (Cardiff North) (Con)]

Will my right hon. Friend take the opportunity to remark not only upon Rabbi Michael Rose, but also upon the work done by Mr Saleem Kidwai, Secretary General of the Muslim Council of Wales, who has been working so very hard in Cardiff for good community relations for many years?

[Stephen Crabb]

My hon. Friend will also be interested to know that I am meeting the Muslim Council of Wales tomorrow. We had a remarkable and powerful demonstration of unity on the Sunday evening after the Paris attacks, when Rabbi Rose and the Muslim Council of Wales leader stood hand in hand, in unity, supporting freedom values in Wales.

The Prime Minister was asked—

[Siobhain McDonagh (Mitcham and Morden) (Lab)]

Q1. If he will list his official engagements for Wednesday 21 January.

[The Prime Minister (Mr David Cameron)]

This morning I had meetings with ministerial colleagues and others. In addition to my duties in this House, I shall have further such meetings later today.

[Siobhain McDonagh]

Niluk is seven and he has autism. He desperately needs security and routine, but high London rents and insecure tenancies mean that he and his devoted family have moved four times in 18 months. As a result, he has had a breakdown and been admitted to hospital. Does the Prime Minister agree that insecure six-month private tenancies are no place for a family with children, and particularly not for children with autism?

[The Prime Minister]

I agree with the hon. Lady about how important it is that people do have security, particularly when they are looking after disabled children and they need that help. That is why we have been encouraging longer-term tenancies alongside the standard six-month tenancies, and we want to see those developed in the market.

[Robert Jenrick (Newark) (Con)]

First they sold our gold reserves at a record low and then they tried to freeze our energy prices at a record high. Does not this latest display of economic illiteracy confirm that only this Government can prevent us, to be blunt—

[Michael Ellis (Northampton North) (Con)]

James Blunt.

[Robert Jenrick]

James Blunt. Does not that confirm that only this Government can prevent us from returning back to bedlam?

[The Prime Minister]

I think I caught some of that, although I may need to buy the album to get the rest of it, but the point is a good one. The Opposition’s policy of freezing energy prices at the top of the market would be denying the price cuts that are now coming through to customers around this country. But the key to all this is to stick to our long-term economic plan, which again today is seeing unemployment fall and the number of people in work rise to record levels—something which I am sure we are going to welcome right across the House of Commons.

[Edward Miliband (Doncaster North) (Lab)]

Let me start by saying, on the Iraq inquiry, that it was set up six years ago and I agree with the Prime Minister that it should be published as soon as possible.

On the economy, as the election approaches, can the Prime Minister confirm that we now know this will be the first Government since the 1920s to leave office with living standards lower at the end of the Parliament than they were at the beginning?

[The Prime Minister]

First of all, let me agree with the Leader of the Opposition that we want to see this Iraq inquiry published promptly, but let me make this point. If everyone in this House, including Opposition Members, had voted to set up the Iraq inquiry when we proposed, it would have been published years ago. So perhaps he could start by recognising his own regret at voting against the establishment of the inquiry.

[Edward Miliband]

The inquiry was established six years ago, after our combat operations had ended, and frankly, my views on the Iraq war are well known and I want this inquiry to be published.

I notice that the Prime Minister did not answer on the economy. Families are £1,600 a year worse off. He said in his 2010 manifesto that living standards would rise. Can we therefore agree that Tory manifesto promises on living standards are not worth the paper they are written on?

[The Prime Minister]

First of all, let us be clear: the right hon. Gentleman voted again and again and again against establishing the inquiry—but, as ever, absolutely no apology.

Let me deal very directly with living standards and what is happening in the economy of our country. The news out today shows a record number of people in work and a record number of women in work. We are seeing wages growing ahead of inflation, and we are also seeing disposable income now higher than in any year under the previous Labour Government. As for the right hon. Gentleman’s figure of £1,600, it does not include any of the tax reductions that we have put in place again and again under this Government. That is the truth. The fact of the matter is that he told us there would be no growth, and we have had growth; he told us there would be no jobs, and we have had jobs; he told us there would be a cost of living crisis, and we have got inflation at 0.5%. He is wrong about everything.

[Edward Miliband]

The Prime Minister has raised taxes on ordinary families, he has raised VAT, and he has cut tax credits. The reality is that people are worse off on wages and they are worse off on taxes under this Prime Minister.

The Prime Minister thinks everything is hunky-dory. Did he even notice this week the report that came out that said that half of all families where one person is in full-time work cannot make ends meet at the end of the month? You can work hard and play by the rules, but in Cameron’s Britain you still cannot pay the bills—that is the reality.

[The Prime Minister]

I study every report that comes out. The right hon. Gentleman is referring, of course, to the Rowntree report, which says that

“the risk of falling below a socially acceptable living standard decreases as the amount of work in a household increases.”

Under this Government, we have got over 30 million people in work, we have got the lowest rate of young people claiming unemployment benefit since the 1970s, long-term unemployment is down, and women’s unemployment is down. We are getting the country back to work. In terms of living standards, we have raised to £10,000 the amount of money people can earn before they start paying taxes, and people who are in work are seeing their pay go up by 4%. If we had listened to the right hon. Gentleman, none of these things would have happened. If we had listened to Labour, it would be more borrowing, more spending, more debt: all the things that got us into a mess in the first place.

[Edward Miliband]

The Prime Minister is the person who has failed on the deficit. This Prime Minister says—[Interruption.]

[Mr Speaker]

Order.

[Edward Miliband]

This Prime Minister says that we have never had it so good, and he is totally wrong. He does not notice what is going on because life is good for those at the top. Can he confirm that while every day people are worse off, executive earnings have gone up by 21% in the last year alone?

[The Prime Minister]

The right hon. Gentleman criticises me on the deficit—he is the man who could not even remember the deficit. Also, he has now had four questions and not a single word of welcome for the unemployment figures out today. Behind every single one of those statistics is a family with someone who can go out to work, who can earn a wage, and who can help give that family security. We are the party that is putting the country back to work; Labour is the party that would put it all at risk.

[Edward Miliband]

That is total complacency about one month’s figures when the Prime Minister has had five years of failure under this Government. Under this Prime Minister we are a country of food banks and bank bonuses; a country of tax cuts for millionaires while millions are paying more. Is not his biggest broken promise of all that we are all in it together?

[The Prime Minister]

Oh dearie me—you can see the problem that Labour Members have got. They cannot talk about the deficit because it is coming down. They cannot talk about employment because it is going up. They cannot talk about the economy because the International Monetary Fund and the President of the United States all say the British economy is performing well. So what are they left with? I will tell you, Mr Speaker. They have got an energy policy to keep prices high, they have got a minimum wage policy that would cut the minimum wage, and they have got a homes tax that has done the impossible and united the hon. Member for Hackney North and Stoke Newington (Ms Abbott) with Peter Mandelson. To be fair to the right hon. Gentleman, we learned at the weekend what he can achieve in one week in Doncaster, where he could not open the door, he was bullied by small children, and he set the carpet on fire—just imagine what a shambles he would make of running the country.

[Edward Miliband]

This is a Prime Minister—[Interruption.]

[Mr Speaker]

Order. It may well be that this session will take a bit longer, but questions and answers—[Interruption.] That is fine by me, but however long it takes, the questions and the answers will be heard.

[Edward Miliband]

I have to say to the Prime Minister: if he is so confident about leadership, why is he chickening out of the TV election debates?

This is the Prime Minister who will go down in history as the worst on living standards for working people. He tells people they are better off; they know they are worse off. Working families know they cannot afford another five years of this Government.

[The Prime Minister]

Why don’t we leave the last word to the head of the International Monetary Fund? She is often quoted by the shadow Chancellor, who today seems to be having a quiet day: I can see why—because our economy is growing, and people are getting back to work. She said that the UK is

“where clearly growth is improving, the deficit has been reduced, and where…unemployment is going down. Certainly from a global perspective this is exactly the sort of result that we would like to see: more growth, less unemployment, a growth that is more inclusive, that is better shared, and a growth that is…sustainable and…balanced.”

That is the truth. Every day this country is getting stronger and more secure, and every day we see a Labour party weaker, more divided and more unfit for office.

[Sir Peter Tapsell (Louth and Horncastle) (Con)]

Does my right hon. Friend fully recognise the contrast in efficiency of the inquiries into the Crimean war and the Dardanelles campaign compared with the disgraceful incompetence of the Chilcot inquiry into widely held suspicions that Mr Blair conspired with President George W. Bush several months before March 2003, and then systematically sought to falsify the evidence on which action was taken?

[The Prime Minister]

I obviously bow to the knowledge of the Father of the House about the previous inquiries. I would say that the one thing all three inquiries have in common is that I am not responsible for the timing of any of them. The truth is that it is extremely frustrating that the report cannot come out more quickly, but the responsibility lies squarely with the inquiry team. It is an independent inquiry, and it would not be right for the Prime Minister to try to interfere with that inquiry, but I feel sure that when the report does come out, it will be thorough and it will be comprehensive. Let me repeat again: if the Labour party had voted for the inquiry when we first put it forward, the report would be out by now.

[Mark Reckless (Rochester and Strood) (UKIP)]

Q2. The Deputy Prime Minister dared to debate with Nigel Farage. Why won’t the Prime Minister?

[The Prime Minister]

I have made my views very clear: if we are going to have one minor party, we should have all the minor parties. When this happens, one point I will make is what Mr Farage said in 2012 about the NHS—the hon. Gentleman comes to the House week after week to talk about the NHS in Kent—when he said that

“we are going to have to move to an insurance-based system of healthcare”.

That is the UKIP policy—privatise the NHS; I say, “Never.”

[Mr David Ward (Bradford East) (LD)]

Q15. An estimated 13 million people—30% of those who should be eligible to vote—are registered incorrectly or are not registered at all on the individual electoral registration system. In the year of the election, will the Prime Minister ensure that the Government fully support national voter registration day on 5 February, and will he commit himself to taking part in Bite the Ballot’s leaders live event? It might help him in making his decision to know that the Greens have agreed to take part in that debate.

[The Prime Minister]

It is important that people register to vote. That is why local authorities have been given over £7 million to help in that process. Individual voter registration will help to cut out some of the fraud and some of the systems that were used in previous elections.

[Mrs Mary Glindon (North Tyneside) (Lab)]

Q3. This week, Channel 4’s “Dispatches” did an excellent job of exposing the reality of life for millions of people who are in low-paid, part-time and insecure work. Can the Prime Minister not see that his failure to promote decent jobs with decent pay is still a fundamental problem for our economy?

[The Prime Minister]

If the hon. Lady looks at the figures, she will see that eight in 10 of the jobs that have been created in the last year are full-time jobs. The Labour party comes here trying to make a case, but I am afraid that all the evidence has moved away from it. Originally, it was said that no jobs would be created. We now see more people in work than ever in our history. Then we were told that all the jobs would be part time. We now see that the majority of the jobs are full time. Then we were told that the jobs would not pay more than inflation. We now see wages rising ahead of inflation. Of course, that is helped by the cuts in income tax that we have made to help people who are low-paid and take them out of income tax altogether. That is the programme that we are pursuing. There is not an ounce of complacency, because there is a lot more work to do, but we are on the right track.

[Jessica Lee (Erewash) (Con)]

This year marks the 800th anniversary of the signing of Magna Carta. Will the Prime Minister support the Magna Carta roadshow, a project that I am running in schools in Erewash to make all children aware of this important document and, more importantly, of the constitutional history of our great country and the rights and freedoms that we hold so dear?

[The Prime Minister]

I absolutely join the hon. Lady in making that point. This is an important anniversary, and it is important that this country and our Parliament commemorate it properly. We must teach children in schools how our constitution has evolved and what rights we have, because pride in those things is important in understanding what a precious jewel we have in a functioning democracy under the rule of law.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Q4. The target of a maximum two-month wait from an urgent referral for suspected cancer to first treatment for all cancers is being breached. Is there a bigger sign of his Government’s failure than the Prime Minister’s inability to uphold key rights for cancer patients that are enshrined in the NHS constitution?

[The Prime Minister]

It is vital that cancer patients get urgent treatment. Under this Government, half a million more people are getting referred for cancer treatment. That is why cancer survival rates are going up. Let me give the hon. Gentleman the figures for his own hospital area: 96.8% of patients with suspected cancer are being seen by a specialist within two weeks, which is an improvement on 2010; 100% of patients diagnosed with cancer are beginning treatment within 31 days, which is an improvement on 2010; and 94.8% of patients are beginning cancer treatment within 62 days of a GP referral, which again is an improvement on 2010. The reason we have been able to make those improvements is that we put resources into the NHS when the Labour party told us that that was irresponsible. We have also got rid of the bureaucracy in the NHS in England, which is why it is performing better than the NHS in Wales.

[Sir Richard Ottaway (Croydon South) (Con)]

I share the Prime Minister’s disappointment over the delay to the Chilcot report, particularly given that the issue in 2009 was whether it would be published in time for the 2010 election, let alone the 2015 election. Does the Prime Minister agree that the invitation of the Foreign Affairs Committee to Sir John Chilcot to give evidence to us, not to point the finger of blame, but to give him a chance to explain the reasons for the delay, should be accepted to ensure that this situation never happens again?

[The Prime Minister]

Obviously, my view is that when people are asked to appear in front of a Select Committee, and when they are public servants, they should try to meet that obligation. How that is processed is a matter for the House and my right hon. Friend’s Committee. The most important thing right now for Chilcot and his team is to get the report ready and ensure it can be published as soon as possible after the election.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

Q5. Last summer my constituent, Mr Kenneth Bailey, suffered a major stroke while out shopping. The emergency call was classed as a Red 2 priority, yet it took Yorkshire ambulance service an hour and four minutes to get to him. That is just one example of a crisis that is now nationwide. What will the Prime Minister do about that situation?

[The Prime Minister]

What we are doing for the ambulance service is ensuring that there are 1,700 extra paramedics, and we have put £50 million more into the ambulance service over the winter. I hope something that all sides of the House can unite over is that it would be completely wrong for the proposed ambulance strike to go ahead next week. I unreservedly condemn any attempts to go on strike and threaten our services, particularly at this time of heightened national concern, and I hope that members of the Labour party, irrespective of which union they are sponsored by, will do the same thing.

[Charlie Elphicke (Dover) (Con)]

Q6. The Leader of the Opposition will not, but will the Prime Minister welcome the International Monetary Fund saying this week that Britain has the “fastest-growing advanced economy” in the world? Will he welcome today’s announcement that unemployment is falling in Dover, Deal and across Britain, and does he agree with President Obama that we “must be doing something right”?

[The Prime Minister]

I thought it was very kind of the President of the United States to make that point about doing something right, and the IMF is absolutely clear. It said:

“The UK is leading in a very eloquent and convincing way in the European Union. A few countries, only a few, are driving growth:”.

That is what the IMF thinks about the British and American economies. Obviously that is helping in Dover where the claimant count is down by 28% since the election, but we should not be satisfied until everyone who wants a job in our country is able to get a job in our country, and until our employment rate is the best in the G7. That is what I would define as achieving what we want, which is full employment in our country.

[Toby Perkins (Chesterfield) (Lab)]

Q7. The Prime Minister’s crisis in the national health service has its roots in general practice, and the changes the Government made to GP pensions saw a huge number of GPs retire early. In my area in Chesterfield, 40% of places for the future recruitment of GPs are left vacant. How can we expect the country to recruit the number of GPs we need when so few of them have any confidence in the Prime Minister’s running of the national health service?

[The Prime Minister]

The figures show that 1,000 more GPs are working in the NHS today than when I became Prime Minister, and in the hon. Gentleman’s area there are 25 more GPs than in 2010. I agree that we need further changes to ensure that our GP and family doctor service works really well. Four million people already have access to seven-day opening at GP surgeries, and I want that expanded to the whole country. That is a step forward after the step back taken by the last Labour Government, who took GPs out of out-of-hours care altogether.

[Sir Bob Russell (Colchester) (LD)]

Q14. The east of England helped boost the nation’s economic recovery, and we could do even more if the East Anglian rail manifesto was implemented. Will the Prime Minister encourage colleagues to fund that with modern rolling stock for the Greater Anglia main line, and infrastructure improvements through Essex?

[The Prime Minister]

I want to see real improvements in the Greater Anglia service, and the hon. Gentleman is right about the economy in the eastern region of our country, which has 224,000 more people in work compared with 2010. The Chancellor said in the autumn statement that we would provide funding for improved rolling stock, and as well as improvements in Essex we want to help achieve the Norwich in 90 campaign. We also want a service from Ipswich that will get to London in under an hour. That will take investment, but that is part of our long-term economic plan.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

Q8. The delay in the publication of the Chilcot report is widely considered to be a scandal. Does the Prime Minister appreciate that it is important to find out exactly what has gone wrong? We have a major forthcoming inquiry into child sex abuse. The public would not understand if powerful people that might be named in that report are able to delay publication year after year, as seems to have happened with Chilcot.

[The Prime Minister]

I agree with the hon. Lady that it is important that the inquiries are done thoroughly and rapidly. My understanding is that there is no mystery in why it is taking so long. It is a thorough report. The people who are criticised in a report have to be given the opportunity to respond to all those criticisms. That is what is happening at the moment. From what I understand, I do not believe that anyone is trying dodge or put off the report—we all want to see it—but we have to go through the proper processes.

Let me make one other point clear. There is no question of the report being delivered to me and of my deciding not to publish it before the election. The whole report will not reach the Prime Minister’s desk, whoever that is, until after the election.

[Dame Angela Watkinson (Hornchurch and Upminster) (Con)]

Will the Prime Minister join me in congratulating Havering chamber of commerce and industry and the Havering branch of Mind, which are coming together tomorrow evening in an event to promote employment opportunities for people with mental health problems?

[The Prime Minister]

I will certainly do so. It is right that mental health is getting a much higher political profile today than in the past. We have given mental health parity of esteem in the NHS constitution, but my hon. Friend is right that one of the key challenges is helping people with mental health conditions to get in to work. Business can do a lot more by engaging with the charities to help people in that situation.

[Mr David Winnick (Walsall North) (Lab)]

Q9. As we know, next week it will be 70 years since Auschwitz was liberated by the Russians. Is it not important that, when issues such as Palestine are raised—I have raised it and will continue to do so—it should be no excuse for anti-Semitism, a murderous disease that took the lives of millions of innocent people during my lifetime?

[The Prime Minister]

I agree 100% with the hon. Gentleman in everything he says. Anyone who has been to Auschwitz—I went recently—cannot help but be struck by the appalling end that came of the hatred and prejudice fostered across Europe. The sight of all those children’s clothes, toys and bags, and human hair, stays with people for a very long time after they have seen them. Ensuring that the Holocaust Commission that we have established reports soon has all-party support. We will take that work forward and continue to ensure that young people in our schools can make the harrowing but very powerful trip to see Auschwitz for themselves.

[Sir Menzies Campbell (North East Fife) (LD)]

As someone who voted with his colleagues against the Iraq war, I have sought to follow the Chilcot inquiry very closely. May I tell my right hon. Friend that I am aware of no evidence that any witness has sought to alter the progress of the inquiry by delay? I am aware of reports of instances of illness, including in one case a severe illness, among members of the inquiry. After the experience of the Saville and Chilcot inquiries, is not the lesson that the proper template for future inquiries should be Leveson—judge-led, but with a strict timetable?

[The Prime Minister]

My right hon. and learned Friend makes a strong point in the stance he takes. I agree with him. I have not heard anything to say that anyone is trying artificially to delay the report. He is absolutely right about some of the things that have happened to the inquiry panel members, most notably to the most brilliant biographer of Churchill, Martin Gilbert. I am sure the best wishes of everyone in the House go to him. My right hon. and learned Friend makes the fair point that, as inquiries are set up, we should give more thought to trying to ensure they are completed in very good time.

[Stephen Timms (East Ham) (Lab)]

Q10. The Prime Minister said that his policies would eradicate the deficit in this Parliament. Unfortunately, he was mistaken—a very large deficit remains. What is the reason, in his view, why his economic plan has fallen so far short?

[The Prime Minister]

We inherited from Treasury Ministers, including the right hon. Gentleman, the biggest deficit of any country in the western world. As a share of GDP, we have cut that in half. We have done that through a combination of reducing public spending, making sure we have responsible tax policies and strong economic growth. That is what we have delivered. All the way through, the Labour party’s proposals have been for more spending, more borrowing and more debt. They have not even got to base camp of working out why the deficit matters.

[Sir Gerald Howarth (Aldershot) (Con)]

As the Member privileged to represent the home of the British Army in Aldershot, which I can tell the Father of the House was established as a direct result of the inquiry into the Crimean war and the failures thereof, may I ask my right hon. Friend the Prime Minister to reassure me that press reports this morning about discussions on reducing the regular Army from the already low level of 82,000 to 60,000, are wholly unfounded and that, so long as he remains Prime Minister, no such cuts will be contemplated?

[The Prime Minister]

I can absolutely give my hon. Friend that assurance. Those ideas are absolutely not on the table. As long as I am Prime Minister, the regular Army will stay at its current size.

[Pamela Nash (Airdrie and Shotts) (Lab)]

Q11. I very much welcome the reduction in UK unemployment announced this morning. I have to add, however, that that is not the case in my constituency, where unemployment has actually risen very slightly. I am sure the Prime Minister has that in his notes in front of him. For those who are in work, the value of their wages has dropped in the past year by 1.5%, while the wages of the Prime Minister’s constituents continue to rise above inflation. Is the Prime Minister proud that under his watch the poor continue to be poorer and the rich keep getting richer?

[The Prime Minister]

If we look at Scotland as whole, on the year unemployment is down by 20,000 and the rate of unemployment in Scotland is also down. The rate of unemployment in Scotland is lower than the rate of unemployment in, for instance, London, so the idea that this recovery is being felt only in the south of our country is simply nonsense. The hon. Lady mentions wages. Obviously, one of the most powerful things we can do to help people with the cost of living is to take them out of income tax. In Scotland, we have taken 23,000 people out of income tax altogether, and over 2 million people are benefiting from the personal allowance changes that have already helped people to the tune of more than £700 a year.

[Glyn Davies (Montgomeryshire) (Con)]

Q12. The dairy industry underpins the economy of rural Britain, including that of my constituency of Montgomeryshire. The dairy industry is currently in difficulty. Does the Prime Minister accept that the Government must consider all ways to bring stability to this important sector, including whether the powers of the Groceries Code Adjudicator should be extended and strengthened?

[The Prime Minister]

I very much agree with my hon. Friend. It is important that we look at how we can support Britain’s dairy farmers at a time of very low milk prices. This is an important industry for our country and I think there are a number of things we can do; first, make sure that Her Majesty’s Revenue and Customs is prepared to provide the time to pay to support our dairy farmers. There is more we can do in terms of leading exports for British food producers—I know the Secretary of State is very keen on that. Specifically on the Groceries Code Adjudicator, something we have established, it is time to make sure that that organisation has the power, if necessary, to levy fines so that it can get its will obeyed. I also think it is time to look at whether there are ways in which its remit can be extended to make sure it looks at more of this vital industry.

[Gemma Doyle (West Dunbartonshire) (Lab/Co-op)]

Q13. West Dunbartonshire desperately needs a pay rise. A quarter of our children are living in poverty, and this Prime Minister’s policies are failing them and their families. A year ago, the Chancellor suggested that he wanted to see a £7 national minimum wage from this October. Will the Prime Minister tell me why his Government’s evidence to the Low Pay Commission makes no mention of this at all?

[The Prime Minister]

Our evidence to the Low Pay Commission says we need another increase in the minimum wage. It is only under this Government that we have seen a minimum wage increase ahead of inflation, which never happened while Labour was presiding over economic chaos. That is the truth. Let me explain to the hon. Lady. She will have to explain to her constituents why Labour’s minimum wage policy would actually cut the minimum wage in the next Parliament. That is how incompetent and useless those on the Opposition Front Bench are. The best thing we can do is to keep growing the economy, keep creating jobs and keep cutting taxes, because we are on track and the plan is working.

[Philip Davies (Shipley) (Con)]

There has been a spate of dog thefts across the Bradford district, where a rally has been held to bring people’s attention to the plight of Murphy, a husky stolen recently. It is very distressing for the owners and dogs concerned, who are devoted to each other. Some of these dogs are used in practice for dog fighting, and who knows what fate awaits some of the other stolen dogs? Will the Prime Minister use his good offices to draw attention to this problem and ensure that the authorities investigate these crimes and take them as seriously as any other crime?

[The Prime Minister]

My hon. Friend makes an important point. We are a nation of dog lovers—people are very attached to their pets—and it is appalling when they get stolen, particularly for the sorts of purposes he talked about. Obviously, the changes we have made on compulsory chipping should help, but my heart goes out to anyone who sees a much-loved pet taken from them.

[Several hon. Members]

rose—

[Mr Speaker]

Last but not least, I call Mr Nigel Dodds.

[Mr Nigel Dodds (Belfast North) (DUP)]

As the Prime Minister looks back over his achievements in the past five years and considers what he might—or might not—be doing in the first few months of the next Parliament, and further to the question from the hon. Member for Aldershot (Sir Gerald Howarth), will he commit to maintaining defence spending at 2% of GDP to ensure that our commitments to our NATO allies are met and that our country is secure and strong at home and abroad?

[The Prime Minister]

We are one of the few NATO countries that do achieve 2% of spending on defence, and because of that, we will see, in the coming months and years, a defence equipment programme that is second to none in Europe: two aircraft carriers, new joint strike fighters, hunter-killer submarines and new frigates. We can see a strong defence industry, supported by our commitment that the defence equipment programme specifically should be protected.

Petition

Wednesday 21st January 2015 Commons Chamber

Sarah Champion (Rotherham) (Lab)

- Hansard - - Excerpts

I am presenting this petition on behalf of the businesses and residents of Rotherham who have signed a paper and online petition to try to get the Government to recognise the devastating impact repeat marches in our town centre on Saturdays are having on our economy and sense of community.

The petition states:

“The Petitioners therefore request that the House of Commons urges the Government to consider the rules regarding marches and demonstrations, including looking specifically at the thresholds that are used to ban marches and demonstrations so that they include a provision to consider the economic impact of such marches as well as looking at the restrictions that are in place on the frequency, location, time or date of marches and demonstrations.”

Following is the full text of the petition:

[The Petition of residents of the UK,

Declares that the threshold to ban marches and demonstrations is currently measured in terms of public safety, not economic impact; further that there are currently no restrictions on the frequency, location, time and date of marches; further that the Petitioners believe that marches and demonstrations are having an impact on the lives and trades of residents in Rotherham; further that the Police and local council in Rotherham have tried their best to minimise the disruption to traders in Rotherham of marches and demonstrations to ensure that businesses stay open; further that when marches and demonstrations occur in Rotherham significant parts of the town have to close; further that the Petitioners believe such protests and marches are having a devastating impact on local communities; and further that a local petition in Rotherham on this subject has received nearly 300 signatures.

The Petitioners therefore request that the House of Commons urges the Government to consider the rules regarding marches and demonstrations, including looking specifically at the thresholds that are used to ban marches and demonstrations so that they include a provision to consider the economic impact of such marches as well as looking at the restrictions that are in place on the frequency, location, time or date of marches and demonstrations.

And the Petitioners remain, etc.]

[P001425]

Speaker’s Statement

Wednesday 21st January 2015 Commons Chamber

12:36

[Mr Speaker]

In 2015, the Houses of Parliament, along with the people of the UK, commemorate two important anniversaries: 800 years since the sealing of Magna Carta in June 1215 and 750 years since the calling of the Simon de Montfort Parliament in January 1265. These historic events can be seen as marking the start of a journey towards our modern-day rights and representation. So this week, exactly 750 years since Simon de Montfort summoned that Parliament to meet in the chapter house of Westminster Abbey on 20 January 1265, is an important week for the House of Commons in particular.

It was not the first English Parliament, and the Scottish and Welsh Parliaments have parallel histories, but, because it was the first Parliament in which representatives from towns were summoned, alongside the knights, it is seen as the earliest forerunner of the modern Parliament. I look forward to attending the commemorative events in Westminster Abbey tomorrow, together with Members of both Houses and, importantly, with Members of the UK Youth Parliament. Another important occasion takes place in February, when the four existing copies of the 1215 Magna Carta will be displayed in the House of Lords.

This year sees other anniversaries too, including the 50th anniversary of the death of Sir Winston Churchill, the 200th anniversary of Waterloo and the 600th anniversary of Agincourt. We will also be marking the 20th anniversary of the Disability Discrimination Act, the 40th anniversary of the Sex Discrimination Act, the 50th anniversary of the first Race Relations Act and the 600th anniversary of the role of Serjeant at Arms.

These will all be commemorated in a programme being organised jointly by both Houses of Parliament out of existing budgets. This programme of celebrations, entitled “Parliament in the Making”, is designed to raise awareness of our democratic heritage. Our programme aims to increase public understanding that Parliament is at the heart of our democracy and that its work matters to everyone. It aims to mark our history in innovative ways that are relevant to contemporary society.

I hope that many colleagues will now have seen the first manifestation of that intent in the shape of the banners in Westminster Hall, which give fresh artistic interpretations of key moments in our 800-year journey. I know that colleagues will wish to play a full part in this programme—indeed, there have been hundreds of nominations from Members of Parliament for the schools flag project. Flags designed by schools from all the historic counties of the United Kingdom will fly later this year in Parliament square and at the national Magna Carta celebrations at Runnymede in June. There will be other opportunities to participate, too, with a number of lectures and public arts projects, as well as a major public celebration entitled “LiberTeas” on Sunday 14 June. Details are available on the parliamentary website.

I am grateful—and I feel sure that all colleagues will similarly be grateful—to all the staff of both Houses who have worked hard and imaginatively to make these events possible, and to the Speakers’ advisory group on the 2015 anniversaries, which has advised both the Lord Speaker and me on the programme. In particular, I am sure that the House would want me to thank the group’s Commons Chairman, the hon. Member for Mid Worcestershire (Sir Peter Luff) for the energy and wisdom that he has brought to the task.

It is a happy coincidence that these significant anniversaries fall in an election year. It is less reassuring to note the many challenges to democracy around the globe, recently made manifest in the horrific and devastating events in Paris.

Parliament is not everything about our democracy, but our democracy is not worth anything without this Parliament. That is why it has rightly been at the centre of national attention throughout the centuries and why it must continue to be so. The contest for influence here has ranged from Cromwell to the Chartists, Lords to the Levellers and Speakers to suffragettes. Importantly, it is not only—or even mainly—a matter of decisions imposed from the top down, but of pressure from the bottom up, that has shaped our institution to be what it is today. While the nature and size of the electorate represented here have changed enormously over the generations, the principle of representation has remained remarkably consistent across all that time. It is that principle that, very properly, we commemorate and celebrate this year.

Points of Order

Wednesday 21st January 2015 Commons Chamber

12:43

[Sir Peter Luff (Mid Worcestershire) (Con)]

On a point of order, Mr Speaker. May I thank you for those kind words and express my own appreciation to you and to the Lord Speaker for your enthusiastic endorsement of the whole “Parliament in the Making” programme? May I also endorse what you said about my colleagues on the Speakers’ advisory group and, above all, the energetic team, led by Caterina Loriggio, who are working so hard to deliver the programme?

The banners now hanging in Westminster Hall are a powerful reminder to Parliament that defending the rights of all the people is one of the most important things we do. So finally, Mr Speaker, through you, may I invite colleagues across the House to seize the many opportunities provided and so help us to achieve our objectives of inspiring people about the 800-year history of our rights and representation, educating a new generation about that history and encouraging participation in civil society and our democracy?

[Mr Speaker]

I repeat my thanks to the hon. Gentleman for his work and my appreciation of his courtesy in respect of everybody else’s efforts. Thank you.

[Sir Edward Leigh (Gainsborough) (Con)]

Further to that point of order, Mr Speaker. I have done a bit of research, and have established that the first Speaker was Sir Thomas Hungerford, who took his place in your Chair in 1377. I am afraid that means that you are only 638 years old, Mr Speaker, although it does not feel like that to those of us who sit under your speakership. It also means that in 12 years we shall have another happy anniversary, and we all wish you well for that, too.

[Mr Speaker]

I am extremely grateful to the hon. Gentleman, and I thank him for what he has said.

[Jason McCartney (Colne Valley) (Con)]

On a point of order, Mr Speaker. Given your understanding and co-operation on behalf of the few, and speaking as a former RAF officer, may I highlight another anniversary—the 75th anniversary of the battle of Britain?

[Mr Speaker]

The hon. Gentleman has done so, and he has done so with his usual eloquence—and very succinctly.

If there are no further points of order, we shall move on to a matter of great importance to the House: a Division correction. I have received a report from the Tellers in the Aye Lobby about the Division on Trident renewal that took place at 6.59 pm yesterday. They have informed me that the number of Members who voted Aye was erroneously reported as 35 instead of 37. The Ayes were 37, and the Noes were 364.

Yemen

Wednesday 21st January 2015 Commons Chamber

12:46

[Keith Vaz (Leicester East) (Lab)]

(Urgent Question): To ask the Secretary of State for Foreign and Commonwealth Affairs if he will provide an answer to an urgent question of which he has been given notice.

[The Parliamentary Under-Secretary of State for Foreign and Commonwealth Affairs (Mr Tobias Ellwood)]

I have been asked to reply.

As the House will be aware, violence in Sana’a has escalated. Heavy clashes broke out yesterday between the Houthis and Yemeni security forces, and the situation is evolving rapidly. Although a fragile ceasefire was negotiated, its implementation has been, at best, partial. The presidential office and President Hadi’s home are now under Houthi control.

I am deeply concerned about the situation in Yemen. I urge all parties to step back from conflict in Sana’a, Ma’rib and other parts of the country, and to ensure that the ceasefire holds. Those who use violence, the threat of violence and abductions to dictate Yemen’s future are undermining the security of all its citizens and eroding the political progress that has been made since 2011.

The UK is playing an active role in encouraging all parties to work peacefully together to implement and enforce a ceasefire and return to dialogue within the framework of the Gulf Co-operation Council initiative, the outcomes of the national dialogue conference, and the peace and national partnership agreement reached between President Hadi and the Houthi leadership last September. The PNPA is a framework for peaceful political transition, and I call on all parties to work through the cross-party National Authority—which is effectively a national assembly—to implement the agreement, which should include the establishment of a new constitution.

I spoke to our ambassador in Yemen yesterday. The British embassy in Sana’a remains open and all our staff are safe, but we are obviously keeping the situation under close and active review. Since March 2011, we have advised against all travel to Yemen.

[Keith Vaz]

I thank the Minister for his answer, and thank you, Mr Speaker, for granting the urgent question.

As the Minister has said, Yemen is on the brink of an implosion that threatens to shatter the entire region. The Shi’a Houthi rebel group has encircled, bombed and stormed the presidential palace. When the House debated the death of UK-born hostage Luke Somers in December last year, all the warning signs of an impending crisis were there. No one doubts the Government’s commitment to providing aid for Yemen—last week I met the Department for International Development Minister, the right hon. Member for New Forest West (Mr Swayne), to hear what they were doing—but that aid is not enough. There are troops in the streets, and thousands have already died in sectarian violence during this and last year. The country is of such strategic significance that we cannot afford to allow it to fail.

As the House knows, I was born in Yemen. I left with my mother and sisters in 1965, but I have returned repeatedly in my capacity as chair of the all-party group on Yemen, and I personally cannot say nothing while Sana’a burns.

This is now the time for urgent action. It is an important moment in Yemen’s history. What additional support are we prepared to provide to the Government of Yemen? Yemen is a key ally in the region against extremism and terrorist groups, including those responsible for the attacks in Paris. There is an immediate and extreme danger for British citizens in Yemen, who are estimated to number 2,200. That includes our embassy staff. The US has deployed naval warships to evacuate the US embassy, so what measures are we taking? Will we evacuate our personnel?

Although the UK Government have a good record of providing assistance to Yemen, I fear that our friends and allies do not recognise the importance of the region. What steps is the Minister taking to try to encourage the Friends of Yemen to do much more, specifically Saudi Arabia and Oman? We can all appreciate the work done by the former Foreign Secretary, the right hon. Member for Richmond (Yorks) (Mr Hague), the Prime Minister and others in assisting Yemen during and after the Arab spring. I also applaud the appointment by the Prime Minister of the right hon. Member for Rutland and Melton (Sir Alan Duncan), who I know cares about the country, as his envoy. We need to act. Our focus is on Syria and Iraq, but we cannot allow Yemen to collapse.

Finally, al-Qaeda in the Arabian Peninsula, the group that trained and directed the Charlie Hebdo terrorists, has already exploited the political instability in Yemen. This is where some international terrorists are trained. If Yemen falls, the front line of the conflict will be the streets of London, Birmingham and Leicester. We simply cannot allow this beautiful country to become a haven for terrorism and violence. To fail to act would be a betrayal not just of the Yemeni people but of the bonds of history that bind our two countries together.

[Mr Ellwood]

I pay tribute to the right hon. Gentleman, with his personal connections to the country, for the expertise he brings to the House and for his leadership as chair of the all-party parliamentary group. I appreciate the urgency of the question, but we were not going to make a statement because the situation continues to be fluid. What we say today could well be outdated by tomorrow. The Prime Minister is under house arrest, the President has moved to the south and the leader of the Houthis made a 75-minute statement on television yesterday but did not declare that he was now the leader of Yemen. The situation remains extremely fluid.

The right hon. Gentleman sums up the situation accurately and I agree with him. Strategically, Yemen is an important country for Britain. We have historical connections with it and we have devoted much work to it. I am pleased that he has had the opportunity to speak to my counterpart in DFID about the work we are doing to provide political stability and economic direction as well as improvements to security. He mentions the attack on Charlie Hebdo, and that is a reminder to all countries—not just those in the region but those further off, including Britain—of how terrorism and extremism can leave a region and move much closer to home. We heed his words very carefully.

The right hon. Gentleman mentioned the United States embassy. It is located in a different part of the city from ours and has its own evacuation programme. Each embassy must make its own judgment on what is necessary. The number of Britons operating in Yemen is extremely low and there are good connections between the embassy and those who choose to go against the travel advice I mentioned earlier.

The right hon. Gentleman also mentioned the Friends of Yemen. Let me elaborate on that. That is the organisation run through the United Nations that is co-chaired by Saudi Arabia and Britain. It comprises more than 40 countries and the past couple of years up to $8 billion has been granted to Yemen to help with political, economic and security reform. We must obviously assess the changes that have taken place, but the peace and national partnership agreement is critical. That is a document that has been signed by the President and agreed by the Houthis and given the sentiment expressed in the 75-minute speech I mentioned, we hope that all parties can come around the table and work towards a peaceful solution.

Finally, the right hon. Gentleman is absolutely right that al-Qaeda in the Arabian Peninsula is a spoiler and an example of extremism. The worry about the Ma’rib region, which the Houthis are now pushing into, is that there are pockets of al-Qaeda and there will be a conflict of extremism there unless there is an agreement. That is what we are now working towards.

[Sir Richard Ottaway (Croydon South) (Con)]

I welcome the question of the right hon. Member for Leicester East (Keith Vaz) and agree with the sentiment contained in it, as well as with the Minister’s response. I welcome his tone. The Minister says that our embassy remains open, but can he assure me that if the situation deteriorates measures will be taken to get our staff out and to protect them? Finally, there are media reports about a connection between the Charlie Hebdo attack and the situation in Yemen. Is the Minister in a position to comment further on that?

[Mr Ellwood]

I am grateful to the Chairman of the Select Committee on Foreign Affairs for his question and the manner in which he asks it. He asks at what point we should evacuate the embassy. I will speak to the ambassador later today and evacuation plan is already in place, but it has not yet been activated. I will speak to the ambassador and ensure that the House is updated if the situation changes. He asked about the connections between al-Qaeda and the Charlie Hebdo attacks. It has been reported that there is a link and that the individuals were trained in Yemen. The French authorities are working on that and we are working closely with them to provide support in their endeavours.

[Jeremy Corbyn (Islington North) (Lab)]

I thank the Minister for his response to the urgent question. Will he say something about the involvement of Saudi Arabia, Saudi Arabia’s military operations and any possible incursions into Yemen? Will he assure us that there is no possibility of any British armed forces being sent to the area, either?

[Mr Ellwood]

Saudi Arabia and many of the countries that neighbour Yemen have an interest in the country, particularly Saudi Arabia, which, as I have said, is co-chair of the Friends of Yemen. I will speak to the embassy in the next couple of days to take stock of the changes that are taking place. I will ask about any military engagement that might take place, but as I have said we call for all parties, whether they are in the country or not, to come together and return to the peace and national partnership agreement, to which the Saudi Arabians have also signed up.

[Sir Alan Duncan (Rutland and Melton) (Con)]

I cannot praise too highly the bravery and work of our ambassador, her embassy personnel and DFID staff. I spoke last night to the Yemeni Prime Minister, who was trapped and besieged, and the danger is that Yemen will end up without a legitimate Government and will become ungoverned anarchic space, leading to unchecked terrorist training, civil war, proxy conflict and humanitarian disaster. The right hon. Member for Leicester East (Keith Vaz) is absolutely right to highlight the importance of this country. Will the Minister confirm that the United Kingdom will, as a matter of urgency and as a top diplomatic priority, work with all our Gulf allies, the United States and the United Nations to try to haul Yemen back from the brink of the cliff edge on which it rests?

[Mr Ellwood]

I thank the Prime Minister’s envoy to Oman and Yemen, particularly as he has kept me up to date over the past few days with his contacts and his thoughts and advice. He is absolutely correct that we do not want ungoverned space to develop in Yemen and with all the activities and challenges going on in the middle east, this area does not have the same profile as others. It has now moved up the agenda by virtue of this urgent question and it is important that we give assistance to the country to ensure that all parties come together, not only those in the country but those in the United Nations and the United States, to work towards a peaceful solution.

[Mr John Spellar (Warley) (Lab)]

As we have already seen, the situation in Yemen is a matter of considerable concern for Members on both sides of the House and for many of our citizens of Yemeni heritage in long-established Yemeni communities, including in the borough of Sandwell. As the security system in Sana’a has worsened, there have been reports of Houthi rebels shelling the President’s home in Sana’a and seizing control of the presidential palace.

The UN Security Council has rightly condemned these latest attacks, and clearly the priority must be to resolve this situation peacefully and quickly. In the wake of this sustained violence, may I first ask the Minister what emergency provisions have been put in place to help ensure the safety and security of British citizens still based in Yemen? We know there are many brave and committed NGO workers in Yemen, as well as a dedicated team of UK Government officials. Their work continues to be vital and their commitment to the country is long standing, so can the Minister give the House an assessment of the number of British citizens potentially affected by the recent violence? Will he also set out, as far as he can, what contingency arrangements are in place, should there be an urgent need to evacuate British citizens and personnel from the affected areas?

A statement adopted by all 15 members of the UN Security Council made it clear that President Hadi was “the legitimate authority” of the country. He was reported to be inside his house when it was shelled. The Minister said that the President is now under house arrest. Can the Minister offer any further assurances about the President’s safety and whereabouts?

Clearly, as well as restoring calm to the country, the implications of renewed violence in Yemen are far-reaching given al-Qaeda in the Arabian Peninsula has established it as their base, especially in its efforts to destabilise Saudi Arabia. In light of this, can the Government set out what long-term support is being offered to the Yemeni authorities to help counter the threat of AQAP, and how is this support being affected by the recent attacks? An end to the violence is the urgent priority, and we know that all sides have agreed to ceasefires in the past, but given that today’s attacks followed the breakdown of a ceasefire that had been in place less than 24 hours before, what can international partners do to try and encourage a return to ceasefire talks, and also to secure more lasting agreements?

Yemen faces not only a worsening security situation, but continuing political and economic challenges. Recent progress towards a political transition, including drafting a new constitution and holding a referendum as well as general elections, were welcome, but even this limited progress is now at risk of being undermined by these latest attacks. As the Minister said, the UK is chair of the Friends of Yemen group, so what steps will the UK Government be advocating to focus all parties’ efforts on the need to secure an effective political transition? UN Security Council resolution 2140 was unanimously adopted in February last year and included a sanctions committee responsible for implementing the restrictive measures under that resolution. Can the Minister confirm whether the committee has published any new recommendations or guidance in the light of the recent attacks?

The international community must remain determined to help achieve the transition that is needed within the country, while the UK Government will also have our support in doing what is necessary to ensure the protection of British citizens in the affected areas.

[Mr Ellwood]

First, may I thank the right hon. Gentleman, the Opposition spokesman, for the cross-party support on this? He speaks about the UK diaspora. It is important that it is informed and kept up to date with what is happening in the country. He also spoke about the role of the UN, and I wish to put on record my thanks to the UN special representative to the Secretary-General, Jamal Benomar, who I have met a number of times, including at the UN General Assembly in September, when UN resolution 2140, which the Opposition spokesman referred to, was agreed.

There is, as I have mentioned, a well-rehearsed evacuation plan. The number of Britons based in Yemen is minimal, and the embassy assures me that plan is ready to be activated if required, but that is not currently the case.

My understanding is that the Yemeni Prime Minister is under house arrest. I have no further information on that at present. The right hon. Gentleman is right to underline the spoiling activities of AQAP, and that has already been underlined in the House. AQAP continues to undermine and harass the Government and to undertake targeted assassinations and mass bombings. This makes the situation ever more complex, with the Houthis moving in from the north-west.

The right hon. Gentleman spoke about the constitution and the referendum. They are the building blocks that lead us to a better political space, and they are part of the national partnership for peace agreement, which I mentioned in my opening remarks.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I am grateful to the right hon. Member for Leicester East (Keith Vaz) for bringing this important matter before the House and to the Minister for his thoughtful and informative replies. Does the Minister agree that in supporting the legitimacy of President Hadi, we must be wary of imposing a simplistic anti-terrorist narrative on the reported coup, given that it is likely that the coup’s origins are in more localised tribal, factional or sectarian sources?

[Mr Ellwood]

I should make it clear that, historically, Yemen is a country that has never been broken down along sectarian lines and we hope that is not gong to be the case here. We remain firmly committed to supporting both the integrity of the Yemeni state and President Hadi’s elected Government to implement this peace agreement, along with all parties, including the Houthis.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

First, may I associate myself very much with the comments of my right hon. Friends the Members for Leicester East (Keith Vaz) and for Warley (Mr Spellar) and the right hon. Member for Rutland and Melton (Sir Alan Duncan)? The situation in Yemen is of great concern to many constituents of mine in Cardiff, particularly in Butetown and Cardiff bay, many of whom are of Yemeni heritage. What advice does the Minister have for those who may be worried about friends, family and relatives who are British citizens but who may not have followed the travel advice and may be in Yemen at the moment? Can he suggest what specifically they should do, and can he also give an assurance that the UK Government will give this issue a much higher priority, not only because of the current situation, but because of the poverty and insecurity that there have been in Yemen for far too many years?

[Mr Ellwood]

The hon. Gentleman raises two very important points. First, while this subject may not have had a high profile in the media, that does not mean it has been a low priority for the Foreign Office, the United States and the Friends of Yemen—including in our work with Saudi Arabia. It is of huge concern, but it has not been on the front pages.

Secondly, I agree that many of our constituents will be concerned about what is going on and for loved ones and friends. I advise the hon. Gentleman to encourage his constituents to look at the FCO website, where there will be updates and information on ways to get in touch with the Foreign Office desk. If there are any complications, I would ask him to get in touch with me personally and I will make sure that that communication link is established.

[Sir Peter Luff (Mid Worcestershire) (Con)]

Mr Speaker, there is a considerable irony in the fact that this debate on the crisis in Yemen comes immediately after your welcome statement on the British experience of the rule of law and democracy. What financial assistance are the Government providing to help stabilise Yemen?

[Mr Ellwood]

My hon. Friend makes an important point about the British assistance being provided. We are working not only with the Friends of Yemen, but with the Deauville partnership of nations—a group that came together to support the countries that went through the Arab spring. We also have conflict pool money going into the country, and we are providing security assistance to the Yemeni armed forces. We provided over £173 million from 2011 to 2014, and then we committed a further £78 million for this year—2014-15. That funding comes from the development stabilisation programme.

[Steve McCabe (Birmingham, Selly Oak) (Lab)]

It has been alleged that the Houthi rebels are receiving support and backing from Iran. If that is true, will the Foreign Office consider whether it is in our interests to reopen an embassy and diplomatic relations with that country while it continues to meddle in such a malign way in this part of the world?

[Mr Ellwood]

There is no doubt that Iran has influence in this area, and it can choose to be part of the solution or part of the problem. I very much hope it wants to be part of the solution and to play a helpful and productive role. It is no country’s interests to see Yemen descend into civil war.

On the embassy, we can either shout from afar and complain about behaviour, or we can have a far closer relationship and put these things directly to the country and the Government. That is the objective of reopening the embassy, when the agreement is finally signed.

[Bob Blackman (Harrow East) (Con)]

Further to that question on Iran, will the Minister update the House on what influence Iran can have over the Houthis to make sure they act in a positive way, so that we get a solution in Yemen that recognises democracy and the broad range of people who live within that state, and we ensure this coup comes to an end and people can live in peace?

[Mr Ellwood]

My hon. Friend makes an important point. It is important that all neighbouring countries that have any influence over the various parties involved in Yemen should exert that influence to encourage the warring factions to come back to the table. I hope that Iran will heed that advice, so that we can move towards getting the partnership agreement back in place.

[Mark Reckless (Rochester and Strood) (UKIP)]

The right hon. Member for Leicester East (Keith Vaz) showed considerable personal courage in visiting Yemen, as do our ambassador and her diplomatic staff and the other UK nationals there. Will the Minister visit Yemen if the security situation allows?

[Mr Ellwood]

It is certainly important to show support for our embassy personnel, and the more we can go to these places and engage with people, the better. Given the security situation, however, and the travel advice telling all Britons not to go there, it would be inappropriate for me to turn up there myself.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for his statement, and the right hon. Member for Leicester East (Keith Vaz) for bringing this matter to the attention of the House. This affects us all in the United Kingdom, whether or not we have people from Yemen living in our constituencies. Will the Minister tell us what help the United Kingdom Government have given in the form of practical assistance, including additional intelligence surveillance equipment, extra technical and military aid for the army and, in particular, security scanning devices to prevent suicide bombings? Those three items would give practical help to reduce the level of warfare in Yemen.

[Mr Ellwood]

The hon. Gentleman is right to suggest that the security situation in Yemen matters to people in Britain. From a strategic perspective, what happens in Yemen can have a consequential impact much further afield. We have a security relationship with the country, and if I may, I will write to the hon. Gentleman with more details of the areas in which we are working with the Yemeni armed forces.



Bill presented

Fracking (Measurement and regulation of Impacts) (Air, Water and Greenhouse Gas Emissions) Bill

Presentation and First Reading (Standing Order No. 57)

Geraint Davies, supported by Kelvin Hopkins, Mr David Winnick, Jim Sheridan and Jim Shannon, presented a Bill to require the Secretary of State to measure and regulate the impact of unconventional gas extraction on air and water quality and on greenhouse gas emissions; and for connected purposes.

Bill read the First time; to be read a Second time on Friday 27 February, and to be printed (Bill 158).

Onshore Wind Turbine Subsidies (Abolition) Bill

Wednesday 21st January 2015 Commons Chamber

Motion for leave to bring in a Bill (Standing Order No. 23)

13:11

[Nigel Adams (Selby and Ainsty) (Con)]

I beg to move,

That leave be given to bring in a Bill to provide for the prohibition of the use of public funds to subsidise the development of onshore wind turbines; and for connected purposes.

President Reagan once turned down $50,000 that Congress had authorised for redecorating the White House, but he did accept private donations to spruce up the presidential home on the sound basis that one man’s subsidy is another man’s tax burden. There is no better example of that than the burden of a levy on everyone’s energy bills to cover subsidy payments to renewable energy firms and landowners who happen to have wind farms or individual turbines on their land—the irony being that those who are already asset-rich become even more wealthy at the expense of hard-working taxpayers.

It is fair to suggest that renewable energy should be subsidised to some degree to help stimulate a market, and I agree with that. I am not against all renewable energy subsidies, but we should be supporting technologies that are effective in producing power when we need it and not just when the wind blows. There are technologies that get a relatively poor deal from the subsidy market, and when we look at the efficiency data for onshore wind, we can see why wind is a bad deal for taxpayers. Onshore wind farms are dependent on the wind blowing at the right speed in order to reach maximum output. Because wind speed is variable, so too is the output of Britain’s onshore wind farms. As a result, onshore wind farms are unable to respond to spikes in demand, in contrast to other forms of low carbon generation such as the biomass conversion projects that are being so ably demonstrated at Drax power station in my constituency and that I hope will shortly be introduced at Eggborough power station.

Onshore wind farms generate below 20% of their stated maximum output for 20 weeks a year, and below l0% for nine weeks a year. That means that wind farms are, effectively, failing to reach maximum output capacity for more than half the year. On average, they exceed 90% of their rated output for only 17 hours a year. That is about as much use as a chocolate fireguard. Worse still, Britain’s onshore wind farms are routinely paid large sums of money not to generate electricity—as much as £l million in each week of 2014. Those payments, described officially as constraint payments, ultimately end up on consumers’ bills, meaning that the British public are effectively subsidising the UK’s onshore wind industry not to produce electricity.

Research by the Renewable Energy Foundation shows that Whitelee in Scotland, the site of Britain’s largest onshore wind farm, was paid more than £22 million in constraint payments last year. In other words, it was paid £22 million of taxpayers’ cash not to produce anything. Very nice work indeed if you can get it! Last year, a total of £53 million was paid in constraint payments to wind farms—both onshore and offshore—which is the most since 2010. Wind farms are being paid more than £1 million a week to switch off their turbines.

I am sure that the wind industry will tell us that this method of electricity generation is a way to create jobs. The industry's trade body, RenewableUK, states that the industry

“is set to employ up to a further 70,000 people by 2023”.

The promise of those jobs is totally dependent on the building of large-scale wind farms at sea and the construction of factories in Britain to manufacture the turbines, which are almost all built abroad at the moment. The Scottish energy Minister published figures last year showing that 2,235 jobs were connected directly to onshore wind at 203 wind farms across Scotland, so with an annual subsidy of £344 million, that works out at a cost of £154,000 per job.

The renewables obligation was introduced by the Labour Government to encourage investment in and development of the renewable energy industry. The cost is added to all energy bills, meaning that not only households but industry and employers pay, adding to the cost of all our goods and services. Labour also signed us up to meeting legally binding green energy targets by 2020, with the prospect of financial penalties if we failed to do so. Surely the only possible justification for subsidising these technologies is to drive down costs, but Labour ignored that principle and decided to use subsidies to meet arbitrary and foolishly high targets for green electricity in a very short time scale.

I should like to mention single turbines. These are usually applied for and sited on farmland and they operate under a different regime, the feed-in tariff. Farmers are paid to generate even if they use the power themselves, and they are paid a further amount on top of that for any power fed into the grid. For example, the basic tariff on a 50 kW turbine is 17.78p per kWh, which is £177.80 per MWh, and a further £47.70 for power fed into the grid. If a farmer with such a turbine uses 80% of the power himself, which is not unrealistic, the power fed into the grid and therefore paid for by the consumer will cost a staggering £936.70 per MWh, which is nearly 20 times the wholesale market price. In the case of the owner of a 500 kW farm turbine who uses half the power generated, the price paid by the consumer for the power fed into the grid would be £344.10 per MWh, which is more than six times the wholesale market price. That does not make sense. Those examples show the extent to which the electricity market and, potentially, the farming market are being distorted by this subsidy. A farmer who can get an income of more than £200,000 a year from a turbine has a lesser incentive to improve the competitiveness of his farming activities.

A report produced by Frontier Economics on behalf of the Department of Energy and Climate Change concluded that Britain’s wind energy subsidy was 35% more expensive than the international average. Two countries in particular, Germany and Denmark, have been at the forefront of promoting wind energy. Germany pays £80 per MWh for its electricity from onshore wind, while in Denmark the cost is less than £60 per MWh.

In the last few weeks, we have discovered—thanks to private conversations between the industry and the Labour party—that if, God forbid, Labour was to return to power, it would want to see even more turbines erected across the country. At least neither our comrades the Liberal Democrats nor the Green party—[Hon. Members: “Where are they?] They are not here; they are conspicuous by their absence. At least they have never tried to hide their love of these carbuncles in our countryside. Voters now know that the Labour party, alongside the Lib Dems and the Greens, has no issue with voters paying more for their energy bills and that it cares little about the impact that large turbines have on rural communities.

If wind power really is the cheapest form of renewable energy, as its supporters claim, it should now be able to stand on its own feet without using any more taxpayers’ money and increasing our bills. I am delighted that my right hon. Friend the Prime Minister has said that if the Conservatives achieve an outright majority after the election, subsidies for onshore wind will end. That is welcome news to my constituents in Thorpe Willoughby, Hambleton, Gateforth, Hillam, Riccall, Kirkby Overblow and Spofforth, and right across the beautiful part of North Yorkshire that I represent. I know it is also welcomed by constituents of many of my right hon. and hon. Friends.

I do not blame farmers and landowners for wanting to join in this gold rush. They do not set policy; the Government do, and it is time to call time. We have more than 8,000 onshore wind turbines operational in this country, with 1,300 under construction, 5,200 awaiting construction and almost 6,000 in planning. I agree with Thomas Pursglove, our candidate in Corby and the chairman of Together Against Wind, when he says that enough is enough. My Bill is designed to help communities that feel threatened and powerless in the face of wind farm applications, and to ensure that our constituents are getting good value for the money they pay on their bills. The Bill will also allow other, more efficient technologies to benefit from Government support, and I commend it to the House.

Question put (Standing Order No.23).

[Mr Speaker]

I am sure the hon. Member for Wellingborough (Mr Bone) will be well familiar with the principle that vote should follow voice. It is a fundamental tenet of our parliamentary proceedings, of which the hon. Gentleman, a noted constitutionalist, will be very conscious.

[Mr Peter Bone (Wellingborough) (Con)]

indicated assent.

13:22

Division 134

Ayes: 59

---

Conservative: 55
UK Independence Party: 2
Labour: 1

Noes: 57

---

Labour: 29
Liberal Democrat: 18
Democratic Unionist Party: 4
Social Democratic & Labour Party: 2
Conservative: 2
Scottish National Party: 2
Alliance: 1
Green Party: 1

Ordered,

That Nigel Adams, Chris Heaton-Harris, Sir Paul Beresford, Mr Philip Hollobone, Philip Davies, Jackie Doyle-Price, Mark Garnier, Andrew Bridgen, Mike Weatherley, Mr Ian Liddell-Grainger and Sir Greg Knight present the Bill.

Nigel Adams accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 6 March, and to be printed (Bill 159).

Opposition Day

Wednesday 21st January 2015 Commons Chamber

[14th Allotted Day]

National Health Service

Wednesday 21st January 2015 Commons Chamber

13:33

[Andy Burnham (Leigh) (Lab)]

I beg to move,

That this House notes comments from leading experts that the NHS is under unprecedented levels of pressure and that this is putting patient care at risk; further notes that attendances at hospital A&E departments increased by 60,000 in the last four years of the previous Government and 600,000 in the first four years of the current Government; believes that this is linked to decisions taken by this Government, including cuts to adult social care, the abolition of NHS Direct, the closure of almost one in four walk-in centres and removing the GP access guarantee; and calls on the Government to match the Labour Party’s plans to raise an extra £2.5 billion a year for the NHS, funded by measures including a tax on properties worth over £2 million, to help ease the current pressure and ensure that the NHS is fit for the future.

We have called this debate today to see if we can establish a shared analysis across the House of the causes of the current crisis in accident and emergency departments, and from that, shared solutions. I hope we can all agree that the staff of the national health service and of the ambulance service are working wonders in the most trying circumstances, and that it behoves all of us to put forward our ideas today to relieve the pressure on them, but more importantly, to reduce the risks that too many patients are facing right now.

As I have said to the Secretary of State before, things cannot carry on as they are. As the British Medical Association said last week,

“these ongoing challenges are placing patient care and safety at risk.”

Very poorly people are waiting hours for ambulances to arrive, hours to be seen in A and E, and hours on trolleys in corridors, and too many elderly people are then being held on hospital wards, trapped for days, weeks, even months or, in one case that I will come to later, a full calendar year.

[Hywel Williams (Arfon) (PC)]

Can the right hon. Gentleman establish for the benefit of the House whether the figure quoted in his motion applies to England and Wales or to England only?

[Andy Burnham]

I am not sure which figure the hon. Gentleman is referring to, but the figures in the motion apply to England. I will say more about them in a moment.

The stories of failure keep coming. Today we read that a 38-year-old man in Bristol died of meningitis after an ambulance took four hours to arrive. This is by no means an isolated example. The response time target for the most serious calls has been missed for the past six months in a row. We need to hear today what the Secretary of State is doing about this. Rather than work to improve response times, the only proposal we have heard so far is to allow a pilot relaxing response time standards. There will be two pilots, one in the south-west and one in London. London, as the right hon. Gentleman knows, is the worst-performing ambulance service in the country right now, and we hear today that the chief executive of London ambulance service, Ann Radmore, has resigned. The Secretary of State will need to explain to us today why it makes sense, in the middle of a difficult winter, to run an experiment in the most troubled ambulance service in the country.

[Several hon. Members]

rose—

[Andy Burnham]

I give way to the right hon. Member for Wokingham (Mr Redwood).

[Mr John Redwood (Wokingham) (Con)]

I am grateful to the shadow Secretary of State. Can he explain why Labour only ever now has any interest in England’s health service? We would like to hear about Labour’s conduct of the Welsh health service and its message for Scotland. Does Labour not know that this is an English devolved matter?

[Andy Burnham]

It is my responsibility to hold the Government to account on behalf of patients in England for what is happening in England now. That is my job, and I will make no apologies to the right hon. Gentleman or anybody else for doing it.

The response times in the ambulance service are not good enough, nor is the plan to introduce an experiment in the middle of winter, but the problems are not confined to the ambulance service. We need, too, to relieve the pressure on hospitals. Last week just seven out of 140 hospital A and E departments in England met the Secretary of State’s lowered A and E target. Hospital staff are trying their best, but it is as if the Government have simply given up on it. If that is so, it means that they are giving up on the thousands of people waiting hours to be seen. What is his plan to stop the decline and bring A and E back up to acceptable standards? It is time he told us.

[Several hon. Members]

rose—

[Andy Burnham]

I give way to the Chair of the Health Committee.

[Dr Sarah Wollaston (Totnes) (Con)]

I thank the right hon. Gentleman for giving way. I am concerned. Does he understand the difference between a pilot and an experiment? Does he not think it is right that the Secretary of State should listen to clinically led advice about how we might improve ambulance waiting times, rather than just roll out changes without a pilot, not an experiment?

[Andy Burnham]

I do not think there is a massive difference between a pilot and an experiment. My objection is that that is being introduced in winter—and a difficult winter at that—in the most troubled ambulance service. I am not against a pilot, but it should be conducted at a quieter time of year. I should have thought that bringing it in now would strike the hon. Lady, with her long experience of the NHS, as more than a slightly risky thing to do.

I need to hear today the Secretary of State’s plan. What is his plan to bring standards in ambulance services and A and E back up to where they should be? If he waits much longer to tell us, people will conclude that he simply does not have one. The simple truth is that our hospitals are full and operating way beyond safe bed occupancy levels. It is a system that is visibly creaking at the seams.

[Several hon. Members]

rose—

[Andy Burnham]

I shall give way in a moment.

Another recent case symbolises just how bad things have got. Michael Steel, a dad of two, aged 63, was moved from his ward to a store cupboard while being treated for an inflamed liver. Mr Steel was unable to sleep because he was wheeled in and out of the cupboard while staff went to get drugs from the fridge. One nurse apparently told him it was “absolute chaos”. His son Tom took pictures of the ordeal, including a photo of the ward’s whiteboard where nurses listed his dad’s location as “stock room”. This is the NHS on the Secretary of State’s watch.

[Mr David Anderson (Blaydon) (Lab)]

I agree with the Chair of the Health Committee that the Secretary of State and his Ministers should listen to the professionals on the front line. If they had listened three years ago, we would not have been lumbered with the Health and Social Care Act 2012, because everyone at the professional end of the health service said, “Do not do it.” But they were ignored by the Secretary of State.

[Andy Burnham]

What we can see is that this decline began when the Government made the monumental misjudgment of bringing forward a top-down reorganisation that should never have happened, that nobody voted for, and that took 1.5 million eyes off the ball in the NHS. The Government should have been looking at the front line and maintaining standards there, instead of which they looked backwards, and focused on the reorganisation and the jobs merry-go-round that then carried on. It is really disgraceful that they did that and plunged the NHS into the chaos that it is today.

[Derek Twigg (Halton) (Lab)]

Last Friday evening, I spent time at Whiston A and E talking to doctors and nurses, who do an unbelievable job. I heard about the problem of getting elderly people back into the community when they have undergone treatment. There were also issues around recruiting and retaining nurses and the tariff there, but there does not seem to be any answer coming from the Government.

[Andy Burnham]

My hon. Friend describes the problems well. I know the hospital because I have been there with him. He is right that older people are becoming trapped in hospital. The support is not there for them in their own homes, and nursing home places are not available. I will come back to that theme in a moment.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

On exactly that point, the Health Committee looked at the A and E crisis last week and was told by the president of the College of Emergency Medicine that delayed discharges were due to underinvestment in the community, by which he meant social care, GPs and district nurses. Indeed, one third of delayed discharges were down to social care. One third of frail elderly people, or vulnerable people, cannot go home because of the issues with social care, which has been cut by £3.53 billion under this Government.

[Andy Burnham]

We have record numbers of delayed discharges in the NHS right now. The number may even go past the 1 million mark—I am talking about days lost in the past year. That reorganisation that I mentioned a moment ago cost at least £3 billion, probably more. The budget was flat so where did that money come from? As my hon. Friend rightly says, it came from cuts to the general practice budget, cuts to the community services budget, cuts to the mental health budget and cuts to the social care budget. That is why the community has been stripped bare and people are trapped in hospital. This is a mess of the Government’s making.

[Angela Smith (Penistone and Stocksbridge) (Lab)]

Does my right hon. Friend not agree that the same explanations apply to ambulance response times, by which I mean the closure of the NHS Direct service, the cuts to the social care and the difficulties in seeing a GP?

[Andy Burnham]

That is exactly my argument.

[Several hon. Members]

rose—

[Andy Burnham]

I will make some progress.

I mentioned record numbers of delayed discharges. There are also record numbers of people visiting A and E, record numbers of frail people being admitted through A and E, record numbers of people waiting on trolleys and record numbers of people trapped in acute hospital beds. This is the simple question that has not yet been answered by this Government: why is there this unprecedented pressure in accident and emergency? Until there are proper answers to that simple question—and agreement about the true causes of the A and E crisis—we will not be able to move forward with a proper solution, and that is the point of today’s debate.

When the Secretary of State came here to answer the urgent question two weeks ago, he was asked by my hon. Friend the Member for Halton (Derek Twigg) what he saw as the causes of the increased attendances at A and E. Let me remind the House of what he said:

“We have looked into that matter in huge detail. There are probably three broad factors that are behind the increase in demand. One is the ageing population...The second factor is changing consumer expectation among younger people who want faster health care…The third factor is a refusal by NHS trusts to do what they were pressurised to do in the past, which is to cut corners to hit targets.—[Official Report, 7 January 2015; Vol. 590, c. 280.]

In other words, “Nothing to do with us, Guv.” It is the same old story with this Secretary of State. It is always someone else’s fault: older people’s fault, younger people’s fault, the previous Government’s fault—anyone but him.

[Helen Jones (Warrington North) (Lab)]

My right hon. Friend knows Warrington well. As well as increasing ambulance response time and having fewer GPs than we had in 2010, we are now seeing one of the last specialisms—spinal services—moved from Warrington to Walton with no public consultation whatever. Does he agree that this is exactly the result of the Government’s reorganisation in which no one is accountable for any decisions and the future of hospitals such as Warrington is at risk?

[Andy Burnham]

My hon. Friend is right; I do know Warrington well. Speaking up for my own family who live in Warrington, I will not accept a situation in which their services are taken away without them having the democratic right to challenge those decisions. But that is what has been growing under this Secretary of State. We had the decision on Lewisham—the most outrageous example—in which he tried to close a successful A and E that was serving a very deprived part of London, without any proper process, and he lost in the High Court. Then we had a clause brought before the House that tried to close hospitals anyway. That is what the Government want to do; they want to ride roughshod over local people and close services where they want to, and we will not let it happen.

[Several hon. Members]

rose—

[Andy Burnham]

I will give way to my hon. Friend before making more progress.

[Ms Karen Buck (Westminster North) (Lab)]

If the causes of the A and E crisis are deep and structural, as the Secretary of State has implied, why is it that the number of people in London waiting outside A and E in ambulances rose by 66% in one month—between November and December?

[Andy Burnham]

As usual, my hon. Friend puts her finger on the issue: the crisis is not as the Secretary of State describes. I will come on to that right now, but the first request I will make of him today is to publish the research that proves that the three top reasons he gave in this House two weeks ago are indeed the reasons for the increased demand in A and E, because I do not believe that they are. Perhaps they have made a small contribution, but they are not the real reason for the crisis. Our analysis of what is behind the extra pressure is very different from his. Let me introduce an important and revealing fact into this debate, which picks up on my hon. Friend’s point.

Over the past four years of the previous Government, annual attendances at A and E increased by 60,000. Over the first four years of this Government, they have increased by 600,000. That is a dramatic increase, which is explained not by those long-term structural issues, but by decisions taken by this Government.

[Henry Smith (Crawley) (Con)]

Under the previous Government, Crawley’s accident and emergency was closed. Will the right hon. Gentleman now commit to increasing funding on the NHS, as this Government have done every single year of this Parliament, and promise to do for the next?

[Andy Burnham]

Changes we made were done in a planned way, with measures to increase capacity at neighbouring accident and emergency departments, and they were done for reasons of patient safety. Have a look at west London, where plans to close A and E departments are being railroaded through, leaving intolerable pressure on the remaining A and E departments. It is not acceptable, and the hon. Gentleman should challenge his own Government on what they are doing.

[Caroline Lucas (Brighton, Pavilion) (Green)]

Does the right hon. Gentleman agree that with private health firms now on course to win more than £9 billion of NHS contracts, one of the real problems is the fragmentation of the NHS in front of our eyes. Is that a good reason to oppose further privatisation of the NHS, and will he admit that the process that set in train the privatisation of Hinchingbrooke should never have happened?

[Andy Burnham]

I have said that the market was let in too far, and, as Health Secretary in 2009, I changed policy away from what was a version of “any willing” or “any qualified” provider to “NHS preferred provider” and I stand by that. I agree with the hon. Lady that the market is simply not the answer to 21st-century health and care. When the Prime Minister stood at the Dispatch Box about an hour or so ago and said no privatisation on his watch, he was not being straight with the public. Services across the country are being put out to open tender and then transferred to the private sector. That is the Government’s record and the people of this country know it.

[Paul Blomfield (Sheffield Central) (Lab)]

Does my right hon. Friend agree that it says everything about this Government’s attitude to the NHS that general practices that serve the most needy and vulnerable patients, like Devonshire Green and Hanover medical centres in my constituency, are under threat because of the withdrawal of the minimum practice income guarantee introduced by Labour? Does he agree that the Government should immediately stop the phased withdrawal of funding and review their decision to end MPIG?

[Andy Burnham]

I said earlier that there had been cuts to the GP budget, and that is one of the implications of those cuts. The Government have developed a plan to phase out the guarantee that secures practices in some of the more deprived communities. In east London there have been campaigns against practice closures; I know there are similar concerns in Sheffield. That process should be reviewed and if necessary stopped, because no practice should close as a result of any of those changes. That is the commitment I give to my hon. Friend today.

[Several hon. Members]

rose—

[Andy Burnham]

I want to make some more progress; I will give way later.

We need to know the reasons for the increase in A and E attendance. Safely meeting that demand would require an extra eight accident and emergency departments in England, but the Government have been closing, not opening, A and E’s. That is why there is so much pressure in the system.

There has been an even more dramatic increase in the last year. NHS England figures show that there were an extra 446 extra visits to A and E in the 2014 calendar year. That is a dramatic change on the Secretary of State’s watch and the time has come for some honesty from him about the real reasons for it. Until he faces up to those reasons, however uncomfortable they may be for him, he will not be able to develop a proper solution and the situation will get worse. We cannot let that happen.

Let me list what I believe are the decisions of this Government that led to the increase. I will identify four and take each in turn. The first, as Opposition colleagues mentioned, is the decision to scrap NHS Direct and replace it with the flawed NHS 111 service. NHS 111 was originally intended to be a call-handling service, and indeed was conceived by the previous Government. It was intended to simplify access; it was intended to patch people through to the relevant agency, be it the GP out-of-hours service or NHS Direct.

However, when the present Government came into office, they made a major change: they decided that NHS 111 would not signpost NHS Direct but replace it. That was a major mistake. The established and trusted NHS Direct model, a single national contract in the public sector, was replaced with 46 patchwork contracts in the public and private sectors across the country. They replaced the model of nurses on the end of the phone, to provide reassurance for families, with call handlers and computer screens. As a result, where 60% of calls to NHS Direct were handled by nurses, with NHS 111 it is only 20%.

But the present system of call handlers and computer screens is not a case of “computer says no”. The problem is that too often it is a case of “computer says, ‘Go to A and E.’” NHS England figures show that there has been a dramatic increase, in the last year, in the number of people calling NHS 111 who are referred to A and E, or to whom an ambulance was dispatched. In November 2014, there were 67,000 referrals to A and E—a 26% increase on the same month in 2013—and 108,000 ambulances dispatched—a 20% increase on November 2013.

[Alex Cunningham (Stockton North) (Lab)]

All these problems have led to an increase in the number of days that people are taking off as a result of stress—nurses especially. Thousands of days are being lost to the system, adding to the crisis. Should we not be appreciating the staff in our NHS hospitals, and maybe starting by awarding them the 1% pay rise that the pay review body recommended for all of them?

[Andy Burnham]

The Secretary of State’s decision to reject the independent advice of the pay review body about what was fair and affordable, and to single out NHS staff for exclusion from the promise that the Chancellor had made that the public sector, as part of his restraint policy, would get 1%—to say that NHS staff would get less than that—was a kick in the teeth, and was to risk staff morale just at the moment that the NHS needed to be recognising and rewarding those staff, who are working so hard to keep things going. To make inflammatory comments such as those that the Secretary of State has made in the newspapers today is the wrong response. He should be getting back round the negotiating table with those staff. He should be working with them to find solutions. They are keeping the NHS going right now, and they deserve a bit better than they have had off this Secretary of State.

[Alison McGovern (Wirral South) (Lab)]

May I return my right hon. Friend to something very important that he said? He pointed to the distress of our constituents who are being told to go to A and E rather than having reassurance from a nurse on the end of the phone. This is the experience of all our constituents right now, and I would far rather all my constituents had access to a qualified nurse than were just told to go to A and E.

[Andy Burnham]

My hon. Friend calls it just right. One thing the Government could do right now would be to get more nurses on the end of those phones, to provide that experienced voice, that reassurance, that people with young children need before they decide to get in the car and go to A and E. I remember using NHS Direct in such circumstances myself. That reassuring voice has gone, and that is why NHS 111 is placing additional pressure on our A and E. The Secretary of State would not recognise it, with the reasons that he gave, but it is. Staff know it is. The ambulance service know it is. It is time we had a Government who faced up to that reality. My question for the Secretary of State today is: will he now concede that that flawed 111 service has contributed to the 600,000 annual increase in A and E attendances?

The second policy decision that I shall discuss is the closure of NHS walk-in centres. Colleagues who have been in the House for some time will recall that there was a winter crisis in A and E in most, if not all, winters in the 1990s. Then, in the late ’90s, NHS Direct was launched and NHS walk-in centres were opened, with the specific intention of giving people alternatives to attending A and E, which were then under major pressure. The locations of the first wave of walk-in centres were carefully chosen, often where an A and E had recently closed, including at Leigh infirmary in my constituency. In the decade from 2000 to 2010, around 230 walk-in centres were opened across England. Many of those centres became an established and understood alternative to A and E.

However, despite strong evidence to support them, a review by Monitor has found that almost one in four walk-in centres have closed under the coalition Government. Many more are under threat today. Monitor’s review surveyed people who used walk-in centres, and one in five said they would have gone to A and E if that alternative had not been available. Here is my next question for the Secretary of State: will he now concede that, in the areas where those centres have closed, there will have been extra attendances at A and E, and that was it a mistake to close those centres?

Thirdly, I will mention GP services, but let me start by clearing something up. The Prime Minister claimed today at Prime Minister’s questions that there are more GPs now than when he took office. I am afraid, as so often is the case at Prime Minister’s questions, that claim is simply not true. The last census of the GP work force conducted under the previous Government, in September 2009, found that there were 35,917 GPs working in England. The latest census for which figures are available, September 2013, finds 35,561 GPs working in England. When will Ministers start giving out facts from that Dispatch Box, rather than the spin we get week after week?

[Tom Blenkinsop (Middlesbrough South and East Cleveland) (Lab)]

I asked the Prime Minister some weeks ago about the number of nurses in the NHS. In December, the number of NHS nurses in the system had been reduced by over 900 since May 2010, but we were told in November that it was up by about 2,500. The Government were using the figures, and the Prime Minister was answering questions, in terms of hours worked. As we know, nurses are working massive amounts of overtime on single-rate time. Nominal headcount nurses, at this moment in time, are minus over 900 compared with May 2010.

[Andy Burnham]

My hon. Friend makes his point very well. This is what we must challenge as we move forward. Before the general election, people need the facts about what is happening to the NHS. There has been a big drop in the number of nurses working in the community, as my hon. Friend mentioned, and these are the facts that we need to bring home to people.

It is not just the fact that the GP headcount has gone down. One of the present Government’s first acts was to scrap the guarantee of an appointment within 48 hours and incentives to open GP surgeries in the evenings and at weekends. That, combined with cuts to the GP budget, means that it has got harder and harder to get a GP appointment in recent years. The constituents of all the Members present say, “I am ringing the surgery at 8 or 9 every morning and being told that nothing is available for days.” In 2010, the vast majority—80%–of people said they could get an appointment within 48 hours; now, according to the GP survey, one in four people say they must wait a week or more to see a GP.

[Bill Esterson (Sefton Central) (Lab)]

One of the problems in my constituency is that GP surgeries are relying on locums because it is not possible to find GPs to recruit on a full-time basis. Those locums provide a very erratic service; sometimes there is not even a locum available. That is adding to the problem, because as a result, all that is left to people is to go to A and E. I am sure that my right hon. Friend agrees that that is one of the contributory factors, and it proves his point that a chronic shortage of GPs has come about under this Government.

[Andy Burnham]

That is an absolutely vital point. It is not just about GP locums; there are also A and E locums. The Government have, throughout, cut training places, which were another victim of the reorganisation. Ever since then, the number of places commissioned for doctors—and nurses, I might say—has gone down. That leaves us with a bill for agency staff that is literally out of control—it has gone through the roof—and that means that money is now being siphoned out of the NHS at an alarming rate. That is mismanagement; that is what has happened. How must staff working in the NHS feel when they see the bill for agency staff spiralling in this way and know that they will not even get a 1% increase from this Government? They will draw their own conclusions about how this Government value them.

[Richard Fuller (Bedford) (Con)]

The shadow Secretary of State has spent quite a large part of his speech on diagnosis, but at the beginning he asked for solutions, so in that spirit I offer a creative solution. He will be aware that East of England ambulance service has had very poor response times for a number of months—in fact, a couple of years. Would he support a merger of the Red 1 and Red 2 ambulance response services with the fire and rescue service in the east of England, because such a combined force might be in a better position to provide quicker response times? Does he agree with that idea?

[Andy Burnham]

I am prepared to look at it, but I think that the future of the ambulance service should be in integrating better with the rest of the NHS—with GP out-of-hours services and NHS 111. Greater Manchester’s health service is piloting a critical response service to support the ambulance service, and I do not have any objection to that. However, this Government have not got it right when they say that the future of the ambulance service is to merge with the police and fire services as a single 999 service. For me, the ambulance service is a clinical service that should integrate better with the rest of the NHS, and I would prefer to go in that direction.

I said a moment ago that people could not get a GP appointment, and that is also what the GP survey tells us. An extra 290,000 patients say that they have turned to A and E when they cannot get a timely GP appointment. That includes the Secretary of State, who admitted in this House that he had done exactly the same. So will he today accept that the growing problem of people being unable to get GP appointments has played a significant part in contributing to the increase of 600,000 in the number of visits to A and E?

Fourthly, I turn to social care. In my analysis, this is the root cause of the problems we are now seeing. At the start of this Parliament, I warned the Government about their public spending plans and, in particular, warned them against raiding social care to stack up a claim that they were protecting the NHS budget. Government Members should be familiar with the quote because the PM quotes it every week at Prime Minister’s questions. To be more accurate, they will be familiar with half the quote, because that is all he uses, so let me give the House the full version. I said that it would be irresponsible for the Government to increase NHS spending if the way they did it was by raiding the social care budget. I said further that if that goes ahead, they will hollow out social care to such a degree that the NHS will not be able to function, because a collapse in social care support would end up dragging down the rest of the NHS with it.

That is precisely what is unfolding before our eyes right now in the NHS. A report today from Age UK shows how

“hundreds of thousands of older people who need social care are being left high and dry.”

[Mr Marcus Jones (Nuneaton) (Con)]

If we were unfortunate enough for Labour to win the forthcoming general election, by how much would it increase councils’ adult social care budgets?

[Andy Burnham]

I am talking about creating a single budget. There is a big difference between that and what the hon. Gentleman says. I am saying that the time has come to merge the adult social care budget and the NHS budget. More than that, we are going to put an extra £2.5 billion into that integrated system. He should not come here today telling me what I need to do: where is his plan to put more money into the national health service?

[John Healey (Wentworth and Dearne) (Lab)]

My right hon. Friend is giving the House a very good analysis of the social care system. He may have looked at the National Audit Office analysis published in March 2014, which said:

“The intention in the 2010 spending review was to protect spending on adult social care”.

Despite that, because Ministers cut central Government funding for local authorities by 26%, councils have cut nearly £1 in every £10 spent on adult social care in the past four years, leaving Age UK’s director to describe the system as being in calamitous decline. That is clearly a central cause of the current A and E crisis, exactly as my right hon. Friend is arguing.

[Andy Burnham]

My right hon. Friend has absolutely nailed it. Those Ministers on the Front Bench decided—it was a political decision—to cut councils to the bone, and in doing so cut social care to the bone. That was precisely the warning that I gave back in 2010, having just left the Department of Health, where I remember being told that allowing social care to be cut would be a false economy of massive proportions because it would lead to huge inefficiency in the NHS. Hospitals would be unable to function because they could not get people home, and therefore the NHS would back up and the pressure would become impossible. That is what is happening. Those Ministers have done it, and they must be held to account for it.

[Several hon. Members]

rose—

[Andy Burnham]

I will give way one more time.

[Andrew George (St Ives) (LD)]

At the start of his speech, the right hon. Gentleman said he was calling for common ground and consensus in this debate, although he seems to have become somewhat deflected from that path. He knows that I very much agree with his criticisms of the Health and Social Care Act 2012 and other things. He has said, on a constructive basis, that he wants to bring health and social care together. There is potential consensus and common ground in that regard. I would like to hear what more he can say constructively on the areas where, I think, we can find, across all parties, common ground and a way forward.

[Andy Burnham]

To find common ground, one has to tell it straight and put on the table the real reasons why there is pressure in A and E. I bet the hon. Gentleman would not disagree with a single reason I have given: NHS 111, closure of walk-in centres, difficulty in getting GP appointments, the collapse of social care—[Interruption.] Yes, he says he does not disagree with any of those things. If we have a shared analysis, then he and I will have a basis on which to devise solutions. I will come to those solutions later.

[Several hon. Members]

rose—

[Andy Burnham]

I said that I am going to make progress.

Today’s Age UK survey finds that the number of over-65s receiving care has fallen by 380,000 under this Government. Half of the 1 million people who struggle to wash or bathe now get no help at all. Two thirds of the 250,000 people who struggle to feed themselves every day are now left to fend for themselves. There are over 100,000 fewer day care places and over 50,000 fewer people getting meals on wheels. Age UK says:

“Our state-funded social care system is in calamitous, quite rapid decline.”

But worse, it is dragging down the NHS.

[Sarah Newton (Truro and Falmouth) (Con)]

Will the right hon. Gentleman give way on that point?

[Andy Burnham]

In a moment. I said that I had given way for the last time, but I will do so once more for the hon. Lady.

Record numbers of very frail, elderly people are arriving at A and E due to a lack of support in their own homes. Between 2009-10 and 2012-13, there was a 48.1% increase in the number of people aged over 90 being admitted to A and E via blue-light ambulance—in other words, 100,000 very frail, very frightened people in the backs of ambulances going round our towns and cities to be dropped off at a busy A and E. That is what is happening on this Government’s watch.

[Sarah Newton]

Today’s Age UK report contains aggregated England data. Does the right hon. Gentleman not agree that all over our country there are councils integrating social care with the NHS, and, indeed, increasing their social care budgets? Does he not recognise the good work that is going on in the integration pilots in Cornwall, for example?

[Andy Burnham]

I have repeatedly praised Torbay council in the hon. Lady’s part of the world, which was the well regarded pioneer of integrated care. Yes, there are examples of councils around the country trying to do the right thing, but let me make two points: first, the Torbay model has been broken apart by the Health and Social Care Act; and, secondly, councils are trying, but they have been battered by the massive cuts to their budgets about which Age UK is warning today, and which are setting back the cause of integration.

The reality is that elderly people are going into A and E and getting trapped there. As I have already mentioned, there is the sad case of an elderly women in Lincoln who spent an entire calendar year in hospital because a care home place could not be found. That is simply wrong on every level, and it is unsustainable in human and financial terms. The collapse of social care is a root cause of the current A and E crisis because it has led to increased pressure at the entrance door of the hospital, and to the exit door becoming blocked.

For those who still get some support, 15-minute visits are becoming the norm. Richard Hawkes, chairman of the Care and Support Alliance, has said that A and E

“is forced to pick up the pieces when people become isolated, can’t live on their own and slip into crisis.”

My last question to the Secretary of State is: does he agree with Richard Hawkes that cuts to social care have contributed to the extra 600,000 people who now attend A and E every year?

The evidence is clear: on NHS 111, on walk-in centres, on GP services, on social care—this is a mess of the Government’s making. I am sure that the text of the Secretary of State’s speech is full of the usual spin and self-serving excuses, but he must not sit down until he answers directly the four questions I have put to him, not for my benefit, but so that he does not insult the intelligence of the people watching. He is in charge, not me. People are looking to him for answers and solutions, so let me give him some in the time I have left.

As I have said, let us get nurses back on the end of the phones at NHS 111, and let us have a review of the 111 service. I hear that contracts are about to be signed—for instance, to take a contract off an ambulance service—and they will extend this flawed model of care. Will the Secretary of State intervene to stop those contracts being signed until there has been a proper review?

Will the Secretary of State review the plan to relax ambulance response times in the pilot? That is surely the wrong response during this very difficult winter. Is he absolutely convinced that now is the right time to experiment with relaxing established standards? Does it not make sense to delay it until a quieter time of the year, and not to do it in the most troubled ambulance service in the country?

On walk-in centres, would not one of the simplest things the Secretary of State could do to stop the A and E situation getting worse be to commit to halt any further closures? We know that walk-in centres in Jarrow, Nuneaton and Chelmsford are under threat. Would it not help everybody if he just removed that threat today? On GP services, has he considered putting a GP in every A and E?

[Mr Marcus Jones]

Will the right hon. Gentleman give way?

[Andy Burnham]

I have said that I will not give way again.

All those measures could help in the short term, but the truth is that all parties must recognise that there will not be a long-term solution to the A and E crisis until we face up to the crisis in social care, and rethink how we care for the most vulnerable older people. It is not just about money; we need radical changes in the way we use existing budgets for health and care. We need to merge them so that we can change the way in which we care for older people. We need a model of care that starts in the home and supports people there, so that we can drastically reduce the numbers unnecessarily ending up in hospital and becoming trapped there.

Although that model is not just about money, it is partly about money: if such a transformation is to happen, extra investment will be needed to stimulate it. The Secretary of State likes to hold up the better care fund, but I am afraid that councils and the NHS simply do not share his optimism. It robs Peter to pay Paul: the money transferred to councils is nowhere near enough to backfill the cuts to social care, and it leaves a deepening hole in NHS finances. [Interruption.]

The Secretary of State asks where I would get the money from, and I will tell him. The Opposition have committed to provide extra money for an integrated NHS—£2.5 billion a year over and above what he has committed—with social care as part of a single service for the whole person. By contrast, under the public spending plans the Government have set out for the next Parliament, it is clear not only that the A and E crisis will deepen every year, but that it will soon become a full-blown NHS crisis.

The NHS used to be the Prime Minister’s priority; now it does not feature in his top six election themes. We know that there will be no money for it beyond what the Government have promised, because the priority is tax cuts for higher rate taxpayers, although they have not yet identified where the money for that will come from. If the outlook for the NHS is grim, it is utterly dire for local government and social care. Taking public spending back to 1930s levels will absolutely decimate what is left of our social care system, and if the system goes into freefall today’s problems in the NHS will become entrenched. Will the Secretary of State go back to the Chancellor, argue for a better deal for the NHS and social care, and match Labour’s pledge to prevent a permanent care crisis in the next Parliament?

The NHS is now at the crossroads, and the coming election presents an enormous choice between Labour’s plan to lift the NHS out of its current crisis by investing £2.5 billion in the NHS of the future, and the coalition approach under which—with the Government unable to face up to the mess of their own making in A and E or to produce a plan to turn it around, and unwilling to find the extra money it needs—the NHS is dragged down by a toxic mix of cuts and privatisation. The stakes could not be higher. This crisis cannot go on: patients have suffered enough. They need an election, a change of direction and a Labour Government to secure the NHS.

14:10

[The Secretary of State for Health (Mr Jeremy Hunt)]

What utter, disgraceful nonsense! I will rebut every single thing that the right hon. Member for Leigh (Andy Burnham) has said.

This has been a tough winter for the NHS, and I first want to pay tribute to the hard work of staff on the front line who have been working exceptionally long hours in very challenging circumstances. What they want right now is practical help, a vision for the future and a sensible plan to get there—all of which this Government are delivering. They do not want to be turned into a political football. The public have noted that while Labour Front Benchers sometimes sound restrained in parliamentary debates, they are the opposite in the TV studios, where they do everything possible to whip up panic and a sense of crisis. That is not the behaviour of a responsible Opposition.

As NHS England and the King’s Fund have said, the NHS is coping well under real pressure and, in the words of Dr Cliff Mann, president of the College of Emergency Medicine, trying to weaponise it for political purposes is “toxic”. Indeed, Professor Chris Ham, of the King’s Fund, said this week:

“This is a long-term issue not to do with this particular government—the previous government faced many of the same challenges...patients who are really poorly will still get a very good and very quick service.”

[Angie Bray (Ealing Central and Acton) (Con)]

In contrast to what we have heard from the Opposition, will my right hon. Friend join me in welcoming the seven-day-a-week GP surgeries opening up across Ealing and Acton and the plans for the new walk-in health centre for Acton? Will he join me in condemning the Labour-led council’s decision last night to cut the public health budget?

[Mr Hunt]

That is the reality: there are new and improved services for the NHS up and down the country, but what we get from the Labour party in my hon. Friend’s constituency is scaremongering leaflets saying that hospitals are being closed when they are not. Labour should apologise for scaring very vulnerable people. It claims to stand up for them, but by scaring them it is doing the exact opposite.

[Mr Marcus Jones]

Unfortunately, the right hon. Member for Leigh (Andy Burnham) did not do me the courtesy of giving me a right of reply when he mentioned the walk-in centre in my constituency. Does the Secretary of State not think that it was completely irresponsible for the right hon. Gentleman to make such comments, given that the issue was raised by a whistleblower and that the information does not come from the clinical commissioning group that is considering walk-in centres in my constituency?

[Mr Hunt]

Exactly. My hon. Friend makes the point very well, and I will tell him something else about the hospital in his constituency. The George Eliot hospital was a failing hospital with very high mortality rates, and its deeply entrenched problems were swept under the carpet by the previous Labour Government, but this Government have turned it around and it is now a successful hospital. It is doing incredibly well because we faced up to the problems that Labour ignored.

[Angela Smith]

Sickness-related absence is going up around the country. In Barnsley, it has gone up by two percentage points in the past two weeks. A one percentage point increase equates to £1 million a year. Not only will that hit budgets, but it is a real sign that the NHS is under severe pressure.

[Mr Hunt]

The NHS is under pressure, so the hon. Lady will welcome the fact that Barnsley Hospital NHS Foundation Trust in her constituency has 34 more doctors and 74 more nurses, and that we are currently doing about 2,000 more operations every year for her constituents. Yes, there is pressure, but this Government are investing on the back of a strong economy so that we can put more money into the NHS and give her constituents a better service.

[Barbara Keeley]

rose—

[Frank Dobson (Holborn and St Pancras) (Lab)]

rose—

[Mr Hunt]

I am going to make progress, but I will give way later.

I want to look at the pressures that the NHS is facing, because the right hon. Member for Leigh asked about the direct causes. There are more than 1 million more over-65s than there were four years ago. Many older people become particularly vulnerable when it is cold, which is why winters are always difficult for the NHS. The truth is that over successive decades, we have made older people more dependent on emergency care by under-investing in primary and community care, reducing the responsibility of GPs for out-of-hours care, removing the personal responsibility for patients from GPs, and failing to integrate health and social care.

The right hon. Gentleman spoke as if that was nothing to do with Labour. However, he knows what damage was caused by the GP contract changes in 2004, he knows that his Government failed to integrate health and social care for 13 years, and he knows that where Labour runs the NHS today—in Wales—the performance is even worse. Instead of debating constructively, he chose to start this year by putting up a scaremongering poster that implied that the NHS would cease to exist if this Government were re-elected. That is not good enough. The whole country can see that, for him, it is not about the ward, but the weapon; it is not about the patients, but the politics. For this Government, it is about the patients.

[Mr Redwood]

Does my right hon. Friend understand Labour’s attack on privatisation? Under Labour, the NHS always had private-sector contractors as GPs— and nothing has changed; and it always bought all its pharmaceuticals from competitive, profit-making pharmaceutical companies—and nothing has changed. What is the shadow Secretary of State’s grievance?

[Mr Hunt]

Privatisation is one of the most pernicious fears that Labour is seeking to stoke up—not least because, as Secretary of State, the right hon. Member for Leigh allowed the decision to go through that Hinchingbrooke hospital should be run by the private sector. He has been running away from that decision faster than anything that anyone has seen before, because he is still trying to curry favour with the unions.

The companies on the shortlist for Hinchingbrooke hospital were Circle, Serco and Ramsay Health Care. He could have stopped that as Secretary of State, but he did not. He knows—[Interruption.] Those were the three bidders—the private sector-led bids. He could have stopped that process when he was Secretary of State, but he chose not to. That makes my point very well.

[Barbara Keeley]

The Secretary of State and the right hon. Member for Wokingham (Mr Redwood) asked what had changed. Under Labour, we did not have tendering for £1.2 billion of cancer and palliative care services, as we are seeing now in Staffordshire and Stoke, where the majority of those tendering are private companies. We did not have that.

[Mr Hunt]

What the last Government did, that was right, was to say that—[Interruption.] I am just saying what the last Government did right. The hon. Member for Worsley and Eccles South (Barbara Keeley) might want to hear this, because I do not usually compliment the last Government.

To bring waiting times down to 18 weeks, the last Government said that they would support the NHS by allowing the private sector to do some operations. We have continued that policy, not changed it. The result, the hon. Lady will be pleased to know, is that 6,000 more operations are happening every year in her constituency under this Government than in 2010.

For this Government, it is about the patients. That is why we increased the NHS budget; why we hired 9,000 more doctors and 6,000 more hospital nurses; why we are doing nearly 1 million more operations a year than four years ago, with fewer long waits than ever; why we have increased cancer referrals by half, saving an estimated 1,000 lives every single month; and why we have learned the lessons of Mid Staffs by putting in place safe staffing, having independent inspections and turning around six failing hospitals.

Patients say—[Interruption.] The right hon. Member for Leigh should listen to what patients say, because he did not do that when he was Secretary of State. Patients say that their care is safer and more compassionate than ever, with the independent Commonwealth Fund saying that under this Government, the NHS has become the best health care system in the world.

[Frank Dobson]

rose—

[Mr Hunt]

I give way to the former Secretary of State.

[Frank Dobson]

Will the Secretary of State confirm that the only reason why he has been able to recruit British doctors is that the previous Government increased recruitment into medical schools by 35%?

[Mr Hunt]

I welcome the fact that the previous Government increased training places, but as the right hon. Gentleman will know, having been Secretary of State, those doctors have to be paid for. The NHS budget has not been cut, as the shadow Secretary of State wanted, so we can afford to pay for those doctors. There are 219 more doctors serving the constituents of the right hon. Gentleman because of the decision that this Government took to protect the NHS budget.

Even more important than what we have done for patients in this Parliament is the fact that, under this Government, the NHS has developed its own plan for the next five years, the “Five Year Forward View”. Because we have a strong economy, we can back that forward view with a record £2 billion extra for the NHS front line next year alone.

Part of our commitment to the NHS—this is a real difference between the Government and the Opposition—is that we face up to difficult decisions, including on pay. No one wants to be more generous to staff who work long hours than I do, but the official advice that I received as Secretary of State was clear: the cost of accepting the pay review body’s recommendation would be £450 million, which would mean that hospitals might lay off between 6,000 and 14,000 nurses.

It is easy for Labour to support a pay strike, but it is deeply cynical if it cannot pay for its promises, as it knows it cannot. Labour claims to stand up for staff, but will it today stand up for patients by condemning the strike right in the middle of winter, which was supported by only 4% of NHS workers, or do the votes and financial support of the unions matter more? The test of a party that aspires to govern is not the easy decisions that it makes, but the tough ones. We have seen nothing brave or principled from Labour today.

[Andy Burnham]

I have a direct question and I would appreciate a direct answer. If the agency bill in the NHS was the same as the one I left behind, would not the Secretary of State be able to afford the modest, below-inflation increase that the Chancellor promised to all NHS staff?

[Mr Hunt]

Let me tell the right hon. Gentleman why the agency bill has gone up. It has gone up because hospitals are trying to recruit doctors and nurses to tackle the problems of Mid Staffs that he left behind. As they improve their staffing, they will gradually get more full-time nurses, but in the short term, they do not want to put patients’ lives at risk.

I want to return to the situation this winter. To relieve the immediate pressures, we have given the NHS a record £700 million, which has allowed it to recruit an extra 796 doctors, 4,700 nurses and 3,094 other staff, making a total of 8,590 additional staff, and to increase bed capacity by 6,400. We have more staff, more beds, more GP appointments and more GPs in A and E than ever before for winter.

What is the impact of the extra support that we have given the front line? The target is to see and treat people in A and E within four hours. Compared with the last full year for which Labour was in office, 3,000 more people are being seen, treated and discharged within four hours every single day. The mean time that people wait for a first assessment has fallen from 77 minutes to 30 minutes, and nine out of 10 people, even under the pressure of the additional visits, continue to be helped within four hours. That performance is better than anywhere else in the United Kingdom—and, indeed, better than in Canada, Australia, New Zealand, Sweden and any other country in the world that measures A and E performance.

While the NHS is straining every sinew to meet high standards, the public will not accept the cynical politics that demands that we call it a crisis in England, while refusing to call it a crisis in Wales, where Labour is in charge and the problems are far worse. According to the House of Commons Library, in Wales, double the number of people are kept waiting in A and E, and nearly double the number of people wait too long for an urgent ambulance. For Labour, poor care matters only when there is a political point to be scored. For a party that aspires to run the NHS, that is simply not good enough. How Nye Bevan would turn in his grave if he knew that the party that founded the NHS was turning its back on patients with such contempt in his own back yard!

[Mark Field (Cities of London and Westminster) (Con)]

Although I appreciate that there will inevitably be a battle between the two parties to a certain extent in this debate, the Secretary of State is at his strongest—this is what I hear from all the health care professionals in my constituency—when he talks about his patient-centred vision for the health service of the 21st century and when he looks away from the here and now and towards the future that we all know is desperately needed by all our constituents: a patient-centred NHS. I hope that he will say a little more about that.

[Mr Hunt]

I will, and that is what this is about—putting patients first. That is why we need important reforms such as ensuring that every vulnerable older patient has a named accountable doctor—I will mention that later in my remarks—and why we must remove barriers between the health and social care systems.

[Sir Hugh Bayley (York Central) (Lab)]

It has been well known in the NHS for decades that an ageing population means that more needs to be spent in real terms each year on the NHS than in the year before. In 2010, when the Government came to power, 8.2% of our gross national income was spent on the NHS, but that has now fallen to 7.9%. How can that possibly be an increase in the Conservative party’s commitment to the NHS?

[Mr Hunt]

Because the only way we could return the economy to growth was by tackling the deficit left by the Labour party—the worst deficit in the developed world. Labour left us with that problem; we have sorted it out and are turning the country round. If the hon. Gentleman wants to increase spending on the NHS, as I do, the only way to do that is through a strong economy, which is what the Government are delivering.

[Several hon. Members]

rose—

[Mr Hunt]

Let me make some progress. In A and E, as everywhere in our hospitals, it is important that whatever the pressures, people are given safe, compassionate care. Our NHS is one of the safest systems in the world, but we still have around 1,000 avoidable deaths every month. We still put the wrong prosthesis on someone once a fortnight, operate on the wrong part of someone’s body once a week and leave a foreign object in someone’s body twice a week. Just five years ago, we had the tragedy at Mid Staffs, which, we should never forget—[Interruption.] I am quite shocked that people are laughing when we are talking about harm that happens in the NHS every month and about what happened at Mid Staffs. We must not forget that Mid Staffs was hitting its A and E targets for much of the period that that same department was tolerating the most horrific care. Whatever the pressure to hit targets, the Government want every vulnerable person to be treated safely and with the highest standards of dignity and respect.

Two years ago, we introduced the toughest inspection regime anywhere in the world. The result was over 6,000 more nurses on our hospital wards, cases of MRSA and clostridium difficile halved over this Parliament and more than 200 NHS organisations have signed up to halve avoidable harm and avoidable death over the next three years. Care is getting safer. While we lead the NHS through that painful process, what is the reaction from Opposition Front Benchers? They criticise us for running down the NHS and still maintain—as the right hon. Member for Leigh did in December—that it was a mistake to hold a public inquiry into Mid Staffs. He talked about listening to patients, but this is what Julie Bailey, a Mid Staffs campaigner whose mother was a patient at Mid Staffs said about his comments in December:

“The message he is sending out is that it is better to cover things up than to criticise the NHS, however bad things are. The inquiry uncovered huge failings in the NHS and he thinks it shouldn’t have taken place at all. It is very worrying because if he becomes Health Secretary again at the election it is clear we would go straight back to the bad old days of covering up.”

[Bob Stewart (Beckenham) (Con)]

One problem last month in my local hospital, the Princess Royal university hospital, was the lack of space, and ambulances were backed up. It is not just a staffing problem; it is a spatial problem. Does the Secretary of State agree that if we had more space in A and E departments, we could get people off the streets?

[Mr Hunt]

Space is a problem in some A and Es, which is why we have expanded A and E capacity. Other places have different problems, but the long-term solution is to have improved capacity outside hospitals in community care. That is the real challenge and what the “Five Year Forward View” is about.

[Andy Burnham]

Given what the Secretary of State has just said, may I gently remind him that I was the Secretary of State who appointed Robert Francis QC to inquire into what happened at Mid Staffs, against the advice of the Department of Health, and that report was published before the last election. If he is being fair, he should bear that in mind at all times.

The Secretary of State reeled off a list of things that are wonderful in the NHS today—everything has got better; everything is fine; and it is the best in the world. At the beginning of the debate, I reeled off cases of people waiting hours or even dying while waiting for ambulances, or being treated in cupboards. I hope that he will not conclude his remarks without addressing the very real suffering and poor care that is happening across England right now.

[Mr Hunt]

If the right hon. Gentleman did such a wonderful job and wants to talk about Mid Staffs, why are patient campaigners so outraged by his comments and feel that he did everything he could to brush those problems under the carpet?

[Alan Johnson (Kingston upon Hull West and Hessle) (Lab)]

Will the Secretary of State give way?

[Mr Hunt]

I will give way to the former Secretary of State in a moment, but I want to finish—[Interruption.] Exactly. I have read the Francis report and I have acted on it. [Interruption.] I have just listed what we have done: £700 million, 4,700 more nurses and 800 more doctors.

[Andy Burnham]

It’s not working.

[Mr Hunt]

But the right hon. Gentleman’s constituency has more doctors and more nurses who are seeing more people every year within four hours and doing 4,000 more operations every year. That is working for his constituents, but there is pressure out there and we need to support people through a difficult winter.

The right hon. Gentleman mentions stories that are, of course, very tragic, but never once has he brought up stories about the problems happening in Wales. Too often, we get the impression that, for Labour Members, poor care under a Labour Government—whether in Wales today or Mid Staffs previously—does not matter as much as poor care under this Government when they can make a political point. A party that really cared about the NHS would be as outraged about problems when they are in power as they are when in opposition. For this Government, poor care is poor care, and we will deal with it wherever and whenever it happens.

[Alan Johnson]

Does the Secretary of State remember the words of the Prime Minister when he stood at the Dispatch Box and presented the report from Stafford? He said that what happened at Stafford was not the fault of any previous Secretary of State, including my right hon. Friend the Member for Leigh (Andy Burnham). The Prime Minister was a statesman on that occasion; it is a shame that the statesmanship has slipped since.

[Mr Hunt]

I have a great deal of respect for the former Secretary of State, but if he had followed the debates on Mid Staffs in this Chamber he would know that my disagreement with the shadow Health Secretary is over the reaction to Stafford and whether we will learn from those mistakes. When I have made speeches talking about the problems of poor care in the NHS today, he goes straight out to the TV studios and says that that is running down the NHS. That is not acceptable when we are taking difficult decisions to turn round failing hospitals and face up to problems in exactly the way suggested by the Francis inquiry.

[Several hon. Members]

rose—

[Mr Hunt]

I will make some progress because I want to answer some of the questions asked by the right hon. Member for Leigh. One reason for the pressure I have outlined is that people increasingly expect to get medical care 24/7, just as they are able to bank, shop and book their holidays 24/7. The NHS cannot be King Canute and try to stop that—I am not blaming patients, but that is how patient expectations are changing, and we need to give them better alternatives to turning up in A and E.

Over the past two years, we have expanded weekend and evening GP appointments for more than 5 million people. We have also rolled out the 111 service, which now handles—these are the facts—three times more calls every year than its predecessor, NHS Direct. The right hon. Gentleman criticised 111, so let us look at the facts. Of those who call 111, 30% say they would have gone to A and E but decided not to as a result—that is 2 million journeys to A and E and around 600,000 ambulance call-outs avoided because of 111. Unlike NHS Direct, one third of all 111 centres can now access a summary of people’s GP records, and that will apply to nearly all 111 centres this year. Not only can people talk to a doctor or nurse, as they did with NHS Direct, but if they give consent they can do something that they could never do under NHS Direct and talk to someone who knows about them and their medical history.

Another big challenge facing A and Es is the increasing complexity of the illnesses that people are presenting with, including many older people with conditions such as dementia, diabetes or asthma. Such people often end up being admitted to hospital rather than treated and sent home, and that is not just challenging for the system; it is often wrong for the individual. A busy A and E can be the worst possible place for a frail, older person with dementia, which is why in our vision for the NHS every vulnerable person has a doctor who is continually responsible for their care, whether or not they are in hospital, and who ensures that they have proper care wrapped around them, thereby reducing the likelihood of emergency hospital admissions. Too often, that does not happen. Too often, the buck stops with no one. That is why, this year, we reversed the 2004 decision and brought back named GPs with personal responsibility for everyone aged 75 and over. That is helping 4.5 million people. With 800,000 of the most vulnerable people, we are going even further, giving them guaranteed rights to prompt and proactive care from their GP.

On social care, for too long, some of the most vulnerable people in our country have suffered from disjointed care with NHS and social care systems that, rather than talk to each other, constantly try to pass the buck. For the first time from this April, we have required all local authorities and NHS organisations to work together to plan care in a joined up and seamless way, as part of the better care programme.

[Diana Johnson (Kingston upon Hull North) (Lab)]

Will the Secretary of State give way?

[Mr Hunt]

I am going to make progress.

When that happens, we should see, for the first time ever, not an increase but a reduction in emergency hospital admissions. For patients, that will mean something important: a doctor or nurse will be in charge of every person in the social care system; medical records will be shared, so that people get safer and more joined-up care; and joint teams will work together across the NHS and social care systems, rather than the silos and boundaries that have plagued the system till now.

The Government have never pretended that the challenges facing the NHS are straightforward, but with more doctors, more nurses, more operations and safer care than ever before, we have shown our commitment to that most precious institution. We have put our money where our mouth is, with protection for the NHS budget during cuts, financial help this winter and support for the NHS’s plan for the future. More important than the money are the values behind it: our passion for the highest standards of compassionate care for every person who needs the NHS. Good care, not clever politics, is the future for our NHS.

[Several hon. Members]

rose—

[Madam Deputy Speaker (Dame Dawn Primarolo)]

Order. I should inform Members that 28 Back Benchers are seeking to take part in the debate this afternoon. I hope that it will not be necessary to have time limits, but I ask each Member to consider speaking for only eight minutes approximately, or 10 minutes maximum. If any Member speaks for too long, it will subsequently be necessary to have a time limit, which could be quite severe on the last few speakers. That would be unfortunate, so if that could be borne in mind and if Members watched the clock, that would help enormously.

14:42

[Alan Johnson (Kingston upon Hull West and Hessle) (Lab)]

Thank you, Madam Deputy Speaker. I will do my best to comply with your instructions.

As the Secretary of State was talking, my mind went back to the “responsible opposition” of the right hon. Member for South Cambridgeshire (Mr Lansley). I remember the efforts that went on for more than 40 years around Manchester to tackle the appalling level of infant mortality by reconfiguring maternity services. As the local newspapers said, that was stopped at every stage by politicians defending bricks and mortar. In the end, when that change went through, it was the Opposition who tried to reopen the issue. Before my noble Friend Lord Ara Darzi became a Minister, he did a very important review on London, where there were more single-handed GP practices than anywhere else in the country post-Shipman, and people attending A and E was a bigger problem than anywhere else. Lord Darzi put forward sensible proposals, which were agreed by clinicians and the NHS in London, but the right hon. Member for South Cambridgeshire opposed them. He issued an unfortunate press release about polyclinics—unfortunately, he spelt it “polly”, but it was not a clinic for parrots. I said to him, “Don’t adopt a policy that you can’t spell.” There are numerous examples of the previous Opposition doing that.

I bet I am not the only one in this House—I bet there are Members in all parts of the House—who rues the day when the right hon. Member for South Cambridgeshire got his hands on the NHS. His ideas for what to do, which culminated in the top-down reorganisation, were not new—I remember them from my first day as Health Secretary. He is not a bad man who hates the NHS, by the way. In many ways, he has great affection for the NHS, but he got things totally wrong. He slung across his draft Bill on what the NHS would look like after his top-down reorganisation. I read it that evening and it was horrendous.

The Government have done two things to erode confidence in politics in this country. The first is the Liberal Democrats’ conversion from opposing tuition fees to the extent that they wished to abolish them to supporting tuition fees to the extent that they agreed to treble them. The second is the Conservatives’ conversion from a pledge that there would be no top-down reorganisation of the NHS to the implementation of a top-down reorganisation so huge that, in the words of the previous NHS chief executive,

“you can see it from space”.

That is a vivid but not inaccurate description of a reorganisation that closed 170 organisations, created 240 new ones, made 10,000 staff redundant and re-employed 2,200 of them.

[Dr Julian Huppert (Cambridge) (LD)]

I will not highlight the right hon. Gentleman’s role in tripling tuition fees. The shadow Secretary of State said that, when he came into office—this is part of his defence— he got rid of the pro-privatisation agenda that he inherited. Who does the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) believe the shadow Secretary of State was criticising in that comment?

[Alan Johnson]

I do not understand the hon. Gentleman’s point about my role in trebling tuition fees. I certainly was the higher education Minister who introduced tuition fees, against fierce opposition. I supported them and made the arguments—all the arguments we now hear from Liberal Democrats—against the opposition of the Conservative party.

In terms of privatisation, we did introduce independent treatment centres. At every stage, we asked the local NHS, “Have you got the capacity to get these waiting lists down? Have you got the capacity to carry out the elective surgery without denuding emergency services?” which happened all the time. Hon. Members will be surprised how many found that capacity when we said, “Okay, we’ll introduce an independent treatment centre.” Suddenly, consultants stopped going to the golf course and taking Saturdays off. They got the waiting times down. In places that did not have capacity, we introduced independent treatment centres. The role of the NHS is to treat patients, and I am very proud of the record that we and my successor, my right hon. Friend the Member for Leigh (Andy Burnham), stood on in 2010.

[Mr Kenneth Clarke (Rushcliffe) (Con)]

Does the right hon. Gentleman agree that, since the late 1980s, every Secretary of State from both political parties, with the exception of the right hon. Member for Holborn and St Pancras (Frank Dobson), accepted that one could raise the quality of patient care by introducing competition and choice of provider in the system? The right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) quite sensibly pursued that policy, as did Alan Milburn, with particular vigour, and the shadow Secretary of State when he was in office. Will the right hon. Gentleman try to encourage his successor not to go back on that, because the health service is now much better at coping with the problems of changing demand than it was 20 or 30 years ago?

[Alan Johnson]

The right hon. and learned Gentleman knows, because we have debated this before—I will come on to some of the history—that the big difference between what he and other Governments did during the 1980s and what we did is the single tariff. They competed on price. We had a single tariff that meant that, wherever that operation took place, it was paid for at the same rate.

With that top-down reorganisation that we could see from space, all the Conservative party’s efforts to convince the public that they could be trusted with the stewardship of the NHS were thrown into disarray at a stroke. The fact that the NHS tops the list of public concerns as we approach a general election can be traced to that self-inflicted wound.

The Conservative party leader’s efforts to detoxify the Tory brand vis-à-vis the NHS could be described as an attempt to return to the consensus that existed prior to the 1980s. The great historian of the NHS, Rudolf Klein, says that following its contentious birth there followed 35 years when the NHS was “cocooned in consensus”. That changed in 1982, when the Thatcher Government’s internal think-tank, the Central Policy Review Staff, produced a paper with the option of replacing the NHS, a tax-financed health service, with a system of private insurance. This option—the right hon. and learned Member for Rushcliffe (Mr Clarke) will probably remember this—was, incidentally, presented to Ministers not by the Secretary of State for Health but by the Chancellor of the Exchequer. It was defeated thanks to the efforts of Norman—now Lord—Fowler, but it expressed for the first time the idea that a tax-funded NHS was wrong and broke that 35-year consensus.

From that moment, through weird and wonderful ideas, right up to 2005 when Conservatives Members stood on the platform of the ridiculous patient passport, their policy has been about taking money out of the NHS and changing the very principles of the service. I could not describe it better—I think there would be agreement on this—than the great American clinician and health care expert, Donald Berwick, who I believe the Secretary of State has used during his time in office as an adviser. He describes the NHS as

“one of the truly astounding endeavours of modern times”

and, in a wonderful phrase, as

“a towering bridge - between the rhetoric of justice and the fact of justice.”

This ideological battle is not over. Indeed, it has just been joined by the ultra-Thatcherite leader of UKIP. The hon. Member for St Ives (Andrew George) is no longer in his place, but he was perhaps right in thinking that we should get back to a consensus on the NHS.

We could raise relevant arguments about many aspects of the NHS. Indeed, my colleagues in Hull and I are talking to the Secretary of State about some issues central to Hull. However, in this speech I do not want to talk about clinical health or the successes of the NHS. I want to talk about one of its failures. At the tenth anniversary of the NHS in 1958, there was a debate in this Chamber. Nye Bevan, the great architect of the NHS who was mentioned earlier, stood up and said what a great success it had been, but that the failure had been mental health. He spoke, using the language of the time, of the disgraceful conditions in our mental hospitals. Of course, there has been a huge improvement since 1958, but it remains a fact that mental health is a poor relation of the NHS, and children and adolescent mental health is a poor relation of that poor relation.

I would like to cite three awful statistics published by the Office for National Statistics. First, 10% of children between the ages of five and 16—or to put it another way, three in every class—experience mental health problems. The second disgraceful statistic is that that figure rises to 60% when applied to children in care. The final disgraceful statistic is that 95% of imprisoned young offenders have a mental health disorder. Many of those young offenders should not be in prison at all. I have raised the case on the Floor of the House of my constituent, Vince Morgan, a young man with a severe psychotic illness who committed suicide in a prison cell having been failed by every single organisation and authority that was meant to help him. Section 136 of the Mental Health Act 1983 is still being used to incarcerate children, mainly as a result of the failure to provide sufficient in-patient tier 4 child and adolescent mental health services facilities.

Forgive me for being parochial, but this is a crucial issue in our area. In Hull and East Riding, we were served well by an in-patient unit called West End for 20 years. When NHS England assumed responsibility for tier 4 services as a result of the changes from the reorganisation—all other tiers being the responsibility of the local clinical commissioning groups—it changed the specifications for tier 4 units, saying that they had to be open seven days a week, 24 hours a day. There was no consultation with anyone. This was done in March 2013. As West End was open only from Monday to Friday, with children spending the weekends at home—a regular feature of CAMHS treatment—the unit was closed. The option of extending the provision, so that it was a seven-day service, was never offered. Parents of children who had benefited from this important part of the NHS had no input whatever in a decision made by a huge quango that had no local accountability and no local presence. So much for the glib slogan, “No decision about me without me”.

I raised this issue in the Chamber on 23 October. The Minister of State, Department of Health, the right hon. Member for North Norfolk (Norman Lamb), who is in his place, gave me a sympathetic response. I am convinced that he cares deeply about the problems of mental health, but he appears to be entirely powerless to do anything about them. Since then, there has been a review of tier 4 services by NHS England, which, as the Health Committee has said:

“does not provide a conclusive answer on the reasons for the current problems, nor on whether there are sufficient beds”.

In addition, that Health Committee report, published in November, pointed out that NHS England had

“presided over a system which has resulted in children being sent hundreds of miles to access care.”

There has been no resolution on this issue in Hull and East Riding, or in other parts of the country, such as Devon and Cornwall. We have a foundation trust provider that recognises the problem and has identified a site for a new seven-day in-patient service, but the commissioner at NHS England has yet to commission. The CCGs are powerless. The acute trust often has to open its adult wards to children.

Let me tell the House what this means to the victims of such failure—to the children who were once so well served by the West End unit. Maisie Shaw is a 13-year-old who has had serious mental health problems since her father died two years ago. Her mother, Sally, is a teacher. Clearly, children need to be close to their family when they are undergoing treatment. Family involvement is a crucial aspect of their recovery. In December, Maisie took an overdose after breaking into a locked medication box at her home in Hessle. As it was a Saturday, there were no CAMHS staff on duty and, of course, no in-patient facility. She was taken to Hull royal infirmary on Saturday and cared for in a locked ward at the maternity hospital, with a 24-hour guard until Monday morning. She was sent to Stafford, which is almost 200 miles away, and then to Sheffield, which involves a round-trip of 120 miles by her family to visit her. As part of her treatment, she will be home at weekends, but when her mother asked what help would be available for this very disturbed child if there was an emergency, she was told to ring 999.

The subject of my debate in October 2013 was Beth Hopper, who is now 15. Beth’s mother, Kathy, is a staff nurse for the NHS. Beth is an extremely intelligent girl who has, according to her school, huge academic potential. She suffered a severe mental breakdown at the age of 11 and spent nine months at the West End unit, which opened at weekends specifically to tend to her needs. Kathy believes that the unit saved her daughter’s life. Since West End closed, Beth has been sent away 19 times. She has been to Cheadle, 103 miles away. She has been to Liverpool. She has been to Warrington. She has been Nottingham. She has been Widnes. Of course, while there is no argument that to travel further for more expert care is a factor in physical health, it is rarely the case with mental health, particularly when the patient is a child. Indeed, Maisie and Beth’s clinicians in Hull often have to travel to care for her in these distant locations, thus adding to the cost of that care. It is no exaggeration to say that the condition of Beth and Maisie is actually being made worse by this treatment. It is truly scandalous.

So that Beth’s voice is heard in this debate, I will read out a letter that she sent to her mother the other week. She wrote this:

“I really just don’t know what to do or what I want, or what is best for me anymore.”

Forgive her grammar.

“I aren’t happy here. I am happy at home, but I am scared that things might go like they were before. I just want normality. I want to have the chance to be a kid for once, before it is too late. I feel as though nobody is listening to me. I am so isolated here I am scared to join the groups and don’t want to make new friends anyway. I want my old friends, who I miss.”

We need to hear these children’s voices.

[Sir Gerald Kaufman (Manchester, Gorton) (Lab)]

I am listening with sympathy and concern to the case histories that my right hon. Friend is describing. He might be surprised to learn that a constituent of mine with mental health problems was sent to Hull, without any consultation with his family.

[Alan Johnson]

It could not have been a CAMHS service, because we have no tier 4 service available in Hull.

I have cited two long-standing cases from my average-sized constituency, but I have recently heard about another case—that of Jordan Hatfield, a 15-year-old who, last May, took 45 paracetamol tablets in an attempt to end her own life. She spent six days on a medical ward and has been in Cheadle for the past week. Her mother does not drive and has small children, so it is impossible for her to visit. My colleagues in east and north Hull, and across the East Riding, will have other examples, because, as the Select Committee and NHS England, in its obscure way, pointed out, there is a lack of services in this huge swathe of eastern England.

On the wider question of mental health, we will not achieve parity of esteem by cutting funding. NHS trusts providing mental health care have lost £250 million of funding since 2012—the first fall in a decade. In addition, as my right hon. Friend the shadow Secretary of State pointed out, two thirds of local authorities have reduced their CAMHS budgets since 2010, while more than three quarters of adults who access mental health services had a diagnosable disorder before they were 18, yet only 6% of the decreasing mental health budget is spent on under-18s.

The report of the taskforce on mental health in society, commissioned by my right hon. Friend the Leader of the Opposition, and published on Monday, has much to recommend it, particularly the right to mental health treatment in the NHS constitution; expansion of the enormously successfully IAPT—improving access to psychological treatment—programme; and the introduction of waiting-time standards for access to CAMHS. These are good ideas, and they need to be put into practice, regardless of which parties are in government. However, somebody needs to get a grip of this issue now. We cannot go on letting our children down in this horrendous way.

15:02

[Richard Harrington (Watford) (Con)]

I will do my best, Madam Deputy Speaker, to stick to the eight-minute guideline—without casting any aspersion on the previous speaker, the illustrious former Secretary of State. I shall be watching the clock.

So much has been said about the situation nationally, and I found the speech by the shadow Secretary of State, which I listened to carefully, very political, controversial and adversarial. I shall do my best not to speak in that manner. Instead, I would like Members to listen to my personal experiences in the Watford area, from speaking to people and visiting, several times, the A and E department, the general hospital, the clinical commissioning group, and so on. As a Back-Bench Member, that is about the best I can do. It is very confusing watching these tennis matches—as soon as the Secretary of State says something, the shadow Secretary of State is on television saying completely the opposite. It is confusing for people who work in the NHS and the rest of our constituents.

As the Secretary of State said, there is unquestionably pressure on the NHS. Everybody knows that. We all know the statistics about people getting older and needing more medical care. I frequently have to ask my mother, when she phones the GP every other day, “Is it necessary?”, and I am sure she thinks it is always necessary, because when people get older, they need care, and the Government have to respond to that. However, these insinuations and open statements by the Opposition that NHS spending has been cut are untrue, and they frighten people. It is a fact—it cannot be disputed—that spending has increased in cash terms every year since the coalition came to power and by £13 billion overall, and will increase by £2 billion alone next year.

I have spoken to consultants and nurses at Watford A and E—I have been there nearly every week since the beginning of the year—and I have seen ambulances backing up, and all the things that people on both sides of the House have mentioned. When I ask the A and E consultants why, they say, “These are not people with trivial illnesses, but people with serious concerns.” It is not a question of people with sore thumbs phoning the national number and being sent to A and E—I am certain of that, having spoken to many people in reception. We are not talking about people who should be going to see a nurse or a walk-in centre; these are serious matters, and there are a lot more of them. The extra GP hours will help, but I will come to that later.

The Watford area is making progress, however. Northwick Park hospital has just opened a big A and E, which I am sure will take off some of the pressure; the Herts Valley CCG has had a 5.5% increase; and there are more than 1,000 extra doctors in the region since 2010—I have seen them; they are not just a statistic. I have spoken to them and the management. They are real people. Similarly at Watford general, we have 142 more full-time nurses. I opened a new ward last week at Watford general, and there is a £1.6 million ambulatory care unit. There are lots and lots of new things, yet Labour did a party political broadcast from Watford hospital that really annoyed the staff, the management and my constituents, because it frightened people and gave the impression that the service was disintegrating and disappearing.

On the important subject of GPs, there is no question but that it was a mistake by previous Governments to restrict GP working hours. I commend the Watford Care Alliance for being among the first to get money under the Prime Minister’s fund to finance seven-day opening for GP services till 8 o’clock, which has made a significant difference. In Watford alone, there will be 16,000 extra appointments this year, which is a lot.

I am delighted that the Health Secretary came to visit Dr Mark Semler, whom I hope he will agree was inspirational in the way he spoke about the programme. He is a local GP who has taken this challenge on. Of course, there are big challenges with IT and explaining it to other staff in the area, but he is an inspirational man, and I think we had a constructive conversation with all the doctors about the implications of this policy. They have taken on the extra hours, and they know it is providing a service. In time, it will help significantly in providing a service to my constituents and taking some of the pressure off A and E.

I am pleased that Watford was one of the first in the country to do that, and I think it has been a success. I know the Government’s ambition is to roll it out to the rest of the country, which would be a major step forward. The actual infrastructure—the offices, the surgeries, the premises—are there, and to anyone from a background outside the public service, it would seem strange to have all those assets and not to use them for the benefit of the customers, who, in this case, are the patients. I commend the Government for that and I thank the Secretary of State that Watford was one of the first places in the country to do this.

Finally, I want to comment on the air ambulance service, which, as he often does, my hon. Friend the Member for Bedford (Richard Fuller) mentioned earlier. I have seen it and think the service is very impressive, and I hope the Government will consider giving it some of the LIBOR funding—it would be an excellent use of that money.

[Oliver Colvile (Plymouth, Sutton and Devonport) (Con)]

I thank my hon. Friend for his constructive speech. It is incredibly helpful, because a lot of people get very concerned when we play “Punch and Judy” occasionally. Does he recognise the role of pharmacies, which are a key part of our NHS that we need to make greater use of?

[Richard Harrington]

My hon. Friend makes a good point. Some pharmacists feels under threat from internet pharmacists—not illegal ones abroad, but proper ones—but the personal contact with pharmacists and the advice they offer can provide them with an enhanced role in the internet era. So I agree with him totally.

And that, Madam Deputy Speaker, concludes my comments.

15:09

[Frank Dobson (Holborn and St Pancras) (Lab)]

Whatever people like or dislike about the language, I do not think anyone could deny that the NHS at the moment is struggling to care for patients in the way that the hard-working staff in the NHS would like to be able to care for them and to deal with them as promptly as they would like. Everyone recognises that the NHS is managing to cope only because of its amazingly dedicated staff doing amounts of work and quality of work far above the call of duty. I have to say that a nurse from one of the two great hospitals in my constituency, to which the Secretary of State referred, said to me, “If he says how wonderful we are and then defends us not getting a pay increase, I will throw up.” I do not think she intended doing it in front of patients, but the hypocrisy of the approach she describes seems to me to be indefensible.

This situation is not entirely novel. A and E has been facing difficulties and has been overstretched in many parts of the country, even during the summer. That is largely because too many people are having to go to A and E or are being taken to A and E because they cannot be looked after properly at home. That is one of the main reasons. If people are kept in, there are not enough beds. I noticed that the Secretary of State quoted the King’s Fund. Having been interested in health care in London for 40-odd years, all I can say is that the main contribution of the King’s Fund has always been to demand reductions in the number of hospital beds; then, where there are not enough of them, it comes up with a million reasons why there are not enough—none of them being that there are too few beds; it is always some other factor rather than the shortage of beds itself that it manages to blame.

The reason why people, particularly the elderly and the physically and mentally disabled, have to go into hospital is that they cannot be safely looked after at home. Once they are in hospital and occupying a bed, they cannot safely be discharged home. So, they are brought in because there is no adequate care at home, and they cannot go back out of a hospital bed because there is no adequate care at home. The Government simply cannot get away from the fact that there have been massive reductions in care at home, particularly for the elderly. Logic suggests that if there are more elderly people who are chronically ill, there should be an expansion of the service to meet the increased need. In fact, however, services have been contracting.

The excellent work done by my hon. Friend the Member for Leicester West (Liz Kendall) a fortnight ago—just a small aspect of it—demonstrated that there had been almost 200,000 fewer people getting meals on wheels. I do not know whether the Government ever deigned to consider the impact of that, but if old people who previously relied on meals on wheels were not getting them, they were probably no longer being properly fed, and if they were not being properly fed, they were more likely to need nursing care. If no additional care was available, they were more likely to go to A and E and, once they had gone into a hospital bed, they were less likely to be safely discharged simply because they were no longer getting meals on wheels.

The meals on wheels service does not have the function only of providing food. On every day that a person gets meals on wheels, somebody is checking how they are doing, and it gives those who are lonely some human contact. The disappearance of all those meals on wheels will undoubtedly have led to more elderly people having to go to A and E, and fewer elderly people being able to be treated safely at home.

[Diana Johnson]

I am listening carefully to what my right hon. Friend is saying. He has the perspective of a London MP. In Hull over the Christmas period, we had the longest wait for A and E in the country—and this at the same time as we have seen a quarter of the local authority budget being cut, which impacts on social care. It seems to me that the two are very closely related. Does my right hon. Friend agree?

[Frank Dobson]

I entirely agree with that. The fact is that the services that can be provided at home need a higher priority than they have had in the past—under any Government. They need more staff with more time, because many of the people attempting to provide a service are given a quarter of an hour to dash in, help somebody wash or cook and then dash out again to rush along to somewhere else. If one person takes up more than a quarter of an hour, they will be late for the next person they are supposed to be looking after. What is more, all these people get lousy pay. In fact, the level of pay that such people get is a disgrace.

We also need a massive improvement in the co-ordination of services between hospitals, GPs, health visitors, nurses and the people providing those practical cleaning services and so forth. This will cost more. Anyone who pretends that we will not have to pay some more to get a service that works to replace one that does not is either just misleading themselves or—in the worst version—misleading other people.

Previous Governments have not expanded the services in line with the need, but the recent response of this Government has been to contract the service available, which is indefensible. Proposals under the new regime—if that is the right term, Madam Deputy Speaker—have brought about fragmentation, competition and binding legal contracts between various providers of these services. If anybody thinks that will improve co-ordination, they are again either deceiving themselves or attempting to deceive the rest of us.

In this country and in this House, we have to wake up to the fact that if we want a first-class service, we are going to have to pay a first-class fare. That was something I wrote in a long and entirely personal memorandum to the Prime Minister, not long before I foolishly resigned as Health Secretary. I pointed out that a massive increase in investment was needed. I am quite proud of some of the things I did when I was Health Secretary. That might have been the most important thing I did, because about two years later, the Government put an extra £40 billion into the health service. To be fair to the Prime Minister, I received a note from him saying, “Your long personal note triggered what we did.” I felt pretty glad about that.

When we talk about these issues, we need to bear in mind that our NHS is easily the most cost-effective system in the developed world. The total we spend on health care is 9.4% of gross domestic product: the Germans spend 11.3%, the French 11.6% and the United States, which has an insurance system like the one the leader of UKIP wants to introduce here, spends 16.9% of their GDP on health, and life expectation there is lower than ours.

The other really startling point, when we get people such as the King’s Fund and others demanding reductions in the number of hospital beds, is that for every 1,000 people we have three hospital beds, while the French have more than six and the Germans eight and a half. So far as I know, there is no daft consensus in either of those countries to get down to the British level.

15:19

[Paul Burstow (Sutton and Cheam) (LD)]

It was a pleasure to listen to the right hon. Member for Holborn and St Pancras (Frank Dobson). I was particularly struck by the point he made about the important case for investing in our health and care system. I dare say that the note that he mentioned will in due course be published under the 30-year rule, and that we shall then have a chance to read the full text. It must be said, however, that it took nearly four years for the argument he was advancing to be understood and acted on, and that those were lost years during the a 13-year Labour Administration.

[Frank Dobson]

I should point out that, partly as a result of earlier negotiations, we had secured an increase of £20 billion.

[Paul Burstow]

I may return to that point later, but first I want to talk about my own experiences of my local national health service, and in particular about a visit that I paid to my local trust, Epsom and St Helier University Hospitals NHS Trust, at the beginning of the month. During the visit I had a chance to meet staff, including A and E staff. I pay tribute to the hard work that is done in the trust, and especially to the work that is done in the A and E department. Last week Epsom and St Helier was placed sixth among all the London trusts in terms of the time for which people were having to wait in A and E, when measured against the standard, and, according to figures that were published yesterday, 99% of people are seen within the standard four hours. That is an example of great performance. The trust is facing great pressure, but it is doing a fantastic job none the less, and that side of the story ought to be told. We ought not to focus only on hospitals that may not have learnt some of the lessons that have been learnt by my local trust.

The A and E staff members whom I met made it clear that there was no single cause of the pressures in their department. In fact, the precise mix of factors varies from one hospital to another, and from one area to another. St Helier, however, has made excellent use of the winter funding it has received. It has added capacity to A and E, and has introduced examples of good practice. For instance, there are daily reviews of patients to ensure they are being given the right treatment in the right place; patients who are ready to be discharged are identified on the previous day so that arrangements can be made in good time; and there is a system of “ward buddies”, enabling corporate staff to provide additional administration support at times of extreme pressure—such as the present time—in order to assist safe discharge. A further welcome boost is the news that an extra £325,000 has been provided to assist people’s safe discharge to their own homes or to step-down care.

A piece of work examining the position in the Sandwell and west Birmingham area revealed huge variations between attendance rates by practice. Its authors found that some people considered A and E attendance to be the norm, and that a fifth of attenders made a conscious decision to go to A and E on the previous day. They also found that many A and E attenders believed that it was not even worth trying to access primary care in the first place. There are issues relating to communication, understanding of the system, and how we explain it. That cannot be dealt with in a universal, national way; it must be tailored to patients’ preferences and their expectations of the system at local level. That piece of work has already helped those in Sandwell to think about how to target messages more effectively in order to ensure that people have access to the support they need at the time they need it.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

Does my right hon. Friend agree that there should be a proper investigation into winter planning in each area? As he says, factors vary greatly. In my area, for instance, the factors affecting Addenbrookes hospital are very different from those affecting the Lister hospital in Stevenage. I think that planning needs to improve. This year, the same thing happened throughout the country. The A and E departments asked for £700 million, the Government gave it to them, and yet there have been all these problems.

[Paul Burstow]

I think it important for the system to learn lessons from the areas where winter planning has worked well, and for us to ensure that those lessons are transferred and replicated around the country. The NHS is not always as good as it could be at ensuring that lessons are not just stuck in one place.

[James Morris (Halesowen and Rowley Regis) (Con)]

Will the right hon. Gentleman give way?

[Paul Burstow]

I must make some progress if others are to have a chance to speak.

The NHS has grappled with a productivity challenge during the current Parliament, but it should be noted that it was first set up and signed off by the last Administration. The target was £20 billion, and it was to be delivered within a shorter period than the coalition Government set in their 2010 spending review. The Labour productivity programme was set in 2009, and it was clear then that the NHS was on notice that it faced a very tough settlement regardless of which party was in government after the 2010 general election. Reducing management overheads has been a key part of our efforts to balance the books during this Parliament. Focusing on the management overhead costs of the commissioning side of the NHS in the legislation that went through the House at the beginning of the Parliament was sensible, and increasing clinical involvement in commissioning was another important move.

[Frank Dobson]

Will the right hon. Gentleman give way?

[Paul Burstow]

I will not, because I want others to have a chance to make their speeches. I hope that the right hon. Gentleman will forgive me.

In fact, that legislation did not change the configuration and organisation of hospitals, although that is how it is routinely portrayed by Opposition Members. As a result of the change to commissioning, £1 billion a year is now being saved, and there are 13,000 more front-line staff in the NHS. Having laid the blame for the pressures on A and E on a reorganisation of the NHS, which is the central proposition advanced by him today, the shadow Secretary of State then tells us that the solution is another comprehensive reorganisation. Is he now suggesting that that is not the case?

[Andy Burnham]

Will the right hon. Gentleman give way?

[Paul Burstow]

I will, unlike the right hon. Gentleman on many occasions earlier.

[Andy Burnham]

The right hon. Gentleman clearly was not listening to my speech. The central proposition is that what I described as the “root cause” of the A and E crisis was the imposition of devastating cuts in social care, which are leaving people unsupported in their own homes. Will the right hon. Gentleman now say—because he was there—that it was wrong of him and his colleagues to allow social care to be cut in that way, given that the cuts are now presenting the NHS with an enormous productivity and efficiency problem?

[Paul Burstow]

The right hon. Gentleman is right to raise that question. I wanted to ask him a question that relates directly to his point, and, indeed, answers it. I hope that he will agree with me—and, indeed, with the Minister of State, Department of Health, my right hon. Friend the Member for North Norfolk (Norman Lamb)—that we need a fundamental review of NHS and care spending, in the round, and that finances in that area need to be addressed before the spending review that any Government will carry out later in the year. We need to ensure that we are clear about the level of investment that will go into our health and social care system. So far, I have heard no clear indication from the right hon. Gentleman of his relative spending priorities when it comes to health and social care, and they need to be made clear if we are to establish a consensus.

[Andy Burnham]

Will the right hon. Gentleman give way?

[Paul Burstow]

I will give way once more, but then I must make rapid progress.

[Andy Burnham]

My answer to the right hon. Gentleman’s question is that I want a single service: a single service for the whole person. I want a national health and care service. We should no longer have two budgets; we should have a single budget, and we should then use the money as best we can to support people, starting in their own homes—and we are going to invest an extra £2.5 billion.

The right hon. Gentleman did not answer the question that I asked him. I asked him whether he and his Government colleagues, in those early days, made a mistake in allowing social care to be cut to the bone? Every week I am accused of saying that it is irresponsible to give real-terms increases. The right hon. Gentleman allowed social care to be raided. Should we not receive an apology for that today?

[Paul Burstow]

Let me deal quickly with that and then come on to what we need to do next.

As a result of the 2010 spending review, we invested £7.2 billion extra in social care over the life of this Parliament. I regret the fact that not every local authority has fully spent that resource on social care, and although the right hon. Member for Leigh (Andy Burnham)wants to make this an issue of blame I want to try to try to analyse the problem. It has already been said that some local authorities have struggled purposefully to reorganise their services to make the best use of the resources available and have delivered better outcomes, not least by investing in services such as re-ablement, which significantly reduced the call on ongoing care services.

It was right for the Government to put the resources in and make the commitments we did and it was right in the autumn statement this year to commit the £2 billion for the NHS as a down payment to deliver Simon Stevens’ NHS Forward View. Although that is good news, I want to flag up a couple of concerns. First, there needs to be clarity about the funding commitment in every subsequent year during the course of the next Parliament. We have had some indications from the Labour party and some from the Liberal Democrats, but we have not yet had clarity from the Conservatives about how they would address the £8 billion gap.

Secondly, despite the commitment of £7.2 billion for social care during this Parliament, not all that money has got through to social care. I acknowledge the efforts that councils have made already, but we cannot ignore the fact that social care has been a poor relation of the NHS not just during this Government’s lifetime but under successive Administrations of parties of both persuasions over a very long time. I have asked the Secretary of State to ensure that social care benefits from some of this £2 billion and urge him again today to do just that. It is unacceptable that some councils are paying fees for care that condemns staff to rates of pay below the national minimum wage and it is no wonder that as a result we have among the highest staff turnover rates of any part of our economy and that it is so difficult to recruit.

To conclude—although I could go on a little longer—I want to address the comments made by the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson). In a debate that had been about much heat but not a great deal of light, he cast important light on one of the key challenges for whoever is in government after the election, which is how we ensure that we reform our mental health care system to deliver the parity of esteem the Government have set out as an ambition and have started down the road of delivering. We still have a long way to journey, however.

We still have a separation in our health care system between the service that delivers for physical health and the service that delivers for mental health, yet those two things are inextricably linked. We know that half of lifelong mental health problems start in adolescence and need to be addressed at that point. The goal of parity of esteem, which is shared across the House, is right. We need parity of esteem in outcomes, rights and resources and I welcome the investments made by the Government, the commitment to continue the improving access to the psychological therapies programme that was started by the previous Government and has continued under this one, the launch under this Government of a children and young people’s IAPT programme and the emergency care concordat. I thank the Minister of State, who is on the Front Bench today, for launching the children and adolescent mental health services review, which must provide a route map for reforming CAMHS for whoever sits in the Secretary of State’s office after the general election. If it does not, it will have failed in its task. We need a plan and we need that plan to be implemented through the spending review after the general election.

The debate has highlighted yet again that we are yet to reach consensus in this Chamber on how to improve our NHS. There are people of passion and commitment on both sides of the House who have in their heart and at their core a desire to maintain a national health service that is free at the point of use and available on the basis of need. We need to extend that to ensure that our social care system is no longer left behind in the way it has been by successive Governments.

[Several hon. Members]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Speeches of up to eight minutes would be helpful if we are to try to get everybody in—do not worry, you did very well, Paul.

15:32

[Mr David Lammy (Tottenham) (Lab)]

Two years ago, a friend of mine collapsed on a football playing field and an ambulance was called. The ambulance should have reached this major emergency within eight minutes, but it took 17 minutes and my friend died of a heart attack on that field. The seriousness of this debate for many families beyond this Chamber—I am thinking of the wife and three children that he left behind—cannot be conveyed. It is right to begin by saying that the £700 million that has been found and the £150 million for the challenge fund are absolutely desirable and necessary at this time. I remember, as a former Minister in the Department dealing with the winter crisis, that those funds are very important.

I want to take the House back to a dark time for the NHS, when it was routine to wait in A and E for six, eight or 12 hours, and to what it took to change that system. It was a great privilege for me to begin my ministerial career in the Department of Health. The then Member for Darlington was busy, controversially, dealing with foundation hospitals. The then Member for Barrow and Furness was busy at that time, controversially dealing with nurses’ pay and increases we wanted, and with the GP contract. I found myself leading on emergency care, and I was the Minister who took through the changes for that A and E target.

We brought in Professor Sir George Alberti. For a number of reasons, it was hugely important that we had a clinician leading the charge across the NHS. We needed to persuade the GPs about access if this was to work. We brought in the target—48 hours, since abolished —and a lot of practice at the front door of A and E. The phrase we used all the time at that point was “See and treat and triage”, but it worked only if we looked at the system as a whole system. Important targets in the rest of the hospital—in cancer, in cardiac care—were necessary. Frankly, it is a crying shame that seven of the 15 major targets were missed under this Government.

We also needed to deal with social care, of course. If £3.53 billion is taken out of social care, there must be consequences. We should remember that much of this debate has been in the past tense. There are further cuts to come, with day centres to be closed. We see phrases pop up in local authorities such as “New pathways for the elderly”. New pathways to what? New pathways to isolation; new pathways to falling over at home alone; new pathways to going without food; and new pathways to ending up at the door of A and E.

We also introduced NHS Direct to ensure that nurses could deal with calls promptly and move on. I never conceived that we would get rid of the nurses in NHS Direct, and that we would move solely to a system of algorithm. Is it surprising that NHS Direct staff are directing people to the door of A and E? Our system worked because before people went to A and E they could go to a walk-in centre. We can call them urgent care centres if we want, but they are essential—they are part of the triage, a part of the see and treat method that we need. Again, however, one in four of them has been lost, resulting in the crisis we see before us.

Here in London it is worse, because we are losing A and Es—gone at Chase Farm, gone at Hammersmith, gone at Central Middlesex, going perhaps at Epsom and St Helier, gone at Charing Cross—and with a population rising to 10 million. This is a serious debate because it is about to get worse. No wonder the chief executive of the London ambulance service resigned yesterday. She is leaving a sinking ship under this Government’s watch, and this House and the people will remember that, because it is specious of the Secretary of State to come to this Chamber and say the debate is solely about more nurses and more doctors. It is not. It is about the system—the NHS.

Who is accountable under this new structure? Is it NHS England? Is it the CCGs? Is it the CQC? Is it another jargon organisation? No one is responsible—certainly the Secretary of State is not, because he gave up those responsibilities in 2012. That is the mess this Government have got into without even putting it in the manifesto. It is a disgrace.

15:40

[David T. C. Davies (Monmouth) (Con)]

I would like to tell the House what I think is an absolute disgrace. Not once during the speech made by the Secretary of State for Health, not once in any of the speeches made by Opposition Members and not once in Welsh questions earlier today did any Opposition Member raise the issue of what is happening in the national health service in Wales. Labour has been responsible for the health service in that part of the United Kingdom for the past 16 years, and Labour Members are running scared of making any mention of it or drawing any comparisons involving it. According to a House of Commons Library document—and they don’t come much more neutral than that—the NHS in Wales, run by Labour, is doing far worse than the NHS in England on almost every measure.

[Andrew Gwynne (Denton and Reddish) (Lab)]

I do not know whether the hon. Gentleman was present for Welsh questions earlier; I certainly was. Perhaps he was asleep, because the shadow Secretary of State for Wales, my hon. Friend the Member for Pontypridd (Owen Smith), used three of his questions to the Secretary of State to ask specifically about the NHS in Wales.

[David T. C. Davies]

I checked the Order Paper this morning, and no one had tabled a question about the NHS in Wales.

The shadow Secretary of State for Health, the right hon. Member for Leigh (Andy Burnham), said earlier that he was not responsible for Wales, but the reality is that there are 20,000 patients in England who are registered with Welsh GPs and who have their health care provided in Wales. The right hon. Gentleman is, to some extent, responsible for the poor level of service that those people are currently receiving.

[Clive Efford (Eltham) (Lab)]

Will the hon. Gentleman give way?

[David T. C. Davies]

I am happy to give way, but I have to say that Opposition Members have used up rather more of their allocation than Members on this side.

[Clive Efford]

The hon. Gentleman seems to be talking about records. This Government came in with no mandate whatever and planned to close nine of the 31 accident and emergency departments across London. What state does he think the A and E service in London would be in if his Government had been successful in every case? They were prevented from achieving their aim by public campaigns, including the one in Lewisham, in my part of London.

[David T. C. Davies]

I am absolutely certain that the A and E situation in England would be far better under this Government than it is in Wales, where, according to the House of Commons Library report, 13% of patients in major departments wait more than four hours in A and E. That is approximately double the percentage recorded by major departments in England. The question of ambulances has been raised several times today. Wales has the worst ambulance response rate in the United Kingdom, with around 55% arriving within eight minutes, compared with more than 70% in England.

The shadow Secretary of State talked about privatisation, but it was the Labour Government who, quite rightly, started using the private sector to improve the national health service. I have here a quote from the Labour Secretary of State in 2002; I will not mention his name. He said of the private sector that

“we intend to use it when it can bring expertise or resources to help improve services.”—[Official Report, 26 February 2002; Vol. 380, c. 547.]

We have carried on doing the same thing. A few years later, a different Health Secretary said:

“The NHS has always made use of the private sector and will continue to do so”.—[Official Report, 25 October 2005; Vol. 438, c. 163.]

She also promised that, the following year, patients would be able to choose from any health care provider—NHS or independent sector—that met NHS standards.

It was Labour’s policy in government to use the private sector. There is nothing wrong with that, but it is totally ridiculous for Labour Members now to pretend that the Conservatives are trying to privatise the NHS. That is a big lie: we will never, ever privatise the NHS, but we are quite happy to use the private sector when it can provide a better service, just as the Labour Government did. The last word on this came in 2005, when Professor Allyson Pollock wrote a damning book about the privatisation of the national health service. She was criticising the Labour Government.

[Sir Oliver Heald]

Does my hon. Friend agree that Labour took things a bit too far? The shadow Secretary of State tendered out the Hinchingbrooke hospital, which ended up in the private sector. That has not been a success, and I think it is better if a trust runs the hospital—

[Andy Burnham]

I did not do that.

[Sir Oliver Heald]

Oh yes he did!

[David T. C. Davies]

I agree with my hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald). The reality is that Labour Secretaries of State said over and over again that they were quite happy to use the private sector, and they did. They were probably right to do so in many instances, and we have continued to do so. There has been no departure from that policy.

[Andy Burnham]

On a point of order, Mr Deputy Speaker. I have always to correct the record when these statements are made. I apologise for delaying the House, but I am going to carry on doing it. I did not put it out to tender; it was a process I inherited, and in the middle of that process I changed the policy from “any willing provider” to “NHS preferred provider”. Contrary to what the Secretary of State said at the Dispatch Box, NHS Peterborough and Stamford was still in the race.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

You have certainly corrected that. It is a point of correction, rather than a point of order. It is all on the record now and everyone can continue. Let us see whether we can turn the heat down a bit.

[Sir Oliver Heald]

Further to that point of order, Mr Deputy Speaker. I just do not accept the point of order that the shadow Secretary of State has made. May I just—

[Mr Deputy Speaker]

Order. No—I said straight away that it was not a point of order, but a point of correction. The point is that it is all on the record for people to read tomorrow, to continue a debate on who is right and who is wrong. Both parties, quite rightly, have stated what their belief is. Mr David T.C. Davies has not much time to go and I am very worried that he will not get to the end of his speech. He has only eight minutes in total.

[David T. C. Davies]

Thank you, Mr Deputy Speaker. I am grateful, because I want to talk about quite a few other things. We did not hear very much about waiting time comparisons, but of course the waiting times in England and Wales are very different. In Wales, people wait at least 26 weeks, with 14,745 having been waiting for more than nine months for treatment; in England, people wait about 18 weeks. One hundred and fifty people have died in Wales waiting for cardiac surgery.

[The Minister of State, Department of Health (Norman Lamb)]

My hon. Friend mentioned Professor Allyson Pollock. Is he aware that she particularly highlighted the extraordinary amount of money spent under the previous Government on the private finance initiative, mortgaging the future of the NHS to the tune of more than £80 billion? In the course of the next Parliament, that will cost more than £11 billion.

[David T. C. Davies]

I commend the professor’s book, and I hope Labour Members read it, as well as looking at the NHS comparators between England and Wales, which they obviously have not done so far. I would like Labour Members to tell us whether—if they ever are in government; I hope they will not be—they will guarantee to continue with the cancer drugs fund, which has allowed thousands of people in England to live longer and more productive lives than they otherwise would have.

The situation is not the same in Wales, where these cancer drugs are routinely denied to people. I am talking about people such as my constituent Ann Wilkinson, who is also trying to care for a very ill husband but who has been denied Avastin. She has had to find other means to get it, and other seriously ill people in Wales have had to move to England or find people’s spare rooms to sleep in.

We heard something about cuts, but the reality is that we have guaranteed the NHS budget in England while it has been cut by about 8% in Wales. Thousands of people are members of Action for our Health, a group comprising people campaigning in Wales to be treated in England. Some people say that the NHS is the envy of the world, and perhaps it is, but the NHS in England is very much the envy of Wales. To see that we need only ask the thousands of people—ordinary patients—in a campaign group who want to be treated by the NHS that is run by this coalition Government and not by the NHS that is run by Labour.

I wish to finish by saying to my right hon. Friend the Minister that I congratulate him on the better ambulance response times he is delivering in England than Labour is delivering in Wales; on the better accident and emergency turnaround times he is delivering in England than Labour is delivering in Wales; on the shorter waiting lists in England than people face in Wales; and on the cancer drugs fund, allowing people to live longer in England than they otherwise would in Wales. Most of all, I congratulate him on protecting that NHS budget—on standing up for the NHS instead of cutting the budget, as the Labour party has done in Wales. I very much hope that he is able to continue with that good work in years to come.

15:48

[Mr Stephen Hepburn (Jarrow) (Lab)]

If anybody wants to see the direction in which this Government are going with the NHS and what impact their policies are having on it, they should come up to my constituency.

Let us think back to the Prime Minister’s weasel words before the last general election—that the NHS was “safe” in his hands and that he wanted the initials NHS to be synonymous with and to define his name. Then let us look at what is happening today. It is a wonder he can lie in bed straight at night, as we see the NHS in crisis—the only thing it is doing is crying out SOS. He promised that there would be no reorganisation, but what do we get? We get the biggest reorganisation since the NHS was formed, and one set up for one thing and one thing only: to privatise the NHS. Some £3 billion has been spent on that reorganisation and the bill is going up—£3 billion that should have been spent on the sick instead of on P45s going out to thousands of nurses when cuts are implemented. It is disgraceful.

Ministers have only to come to Jarrow to see what is happening. In my local hospital three elderly patients wards have closed, a minor injuries unit has closed and now, to make matters worse, a popular walk-in centre, which sees over 27,000 patients a year, is to close. The closure is opposed by everybody in the area—the council, the trade unions, the patients and the staff.

[Mr Jim Cunningham (Coventry South) (Lab)]

Has my hon. Friend noticed that the Government are running true to form, like the previous Conservative Government, when we had bed blocking and people sleeping on trolleys because they could not get a bed in hospital? Has he noticed particularly that local authority budgets could have provided for the elderly and prevented bed blocking?

[Mr Hepburn]

That is exactly the point that the shadow Secretary of State made in his opening speech.

As we heard earlier, local managers are not listening. They are stooges of the Government and they are carrying out the cuts without listening to local people. It is disgraceful. They are not incompetent, and nor are the Government—they know exactly what they are doing. There is a deliberate effort to sabotage the NHS by piling those 27,000 patients a year on to the local doctors.

[Andy Burnham]

I am listening carefully to what my hon. Friend says. His walk-in centre, like mine, was one of the first to open and is greatly valued by the community. I make this offer to him today: if he and his community can keep the campaign going and keep that centre open, and if I am the Secretary of State in May, it will stay open for good.

[Mr Hepburn]

I am sure people in the area are extremely grateful for that statement of support and commitment and that pledge from the shadow Secretary of State. I only hope he will become Secretary of State.

The Government and the management of the NHS are not incompetent. They are acting deliberately. The 27,000 patients in Jarrow who now go to the walk-in centre will have to go to the doctors’ surgeries, where it is difficult enough already to get an appointment. That will only exacerbate the problem. When they go down to A and E, which is doing a terrific job, the situation will only get worse. The Government know exactly what they are doing. They are trying to sicken people of the NHS so that they can turn round and say, “The NHS is not working. We will bring in the private sector to help out and to take it over.” That is the policy of this Government.

[Steve Baker (Wycombe) (Con)]

Under the previous Government, my predecessor was not able to prevent the closure of A and E. If Labour is in government, I shall remember his speech today and the promise that was given to him, and I shall watch closely what happens.

[Mr Hepburn]

I can assure the hon. Gentleman that after that pledge I will certainly be watching the shadow Secretary of State when he gets in, to make sure our walk-in centre is still going.

Who gains from the present situation? Only two lots of people—the Tories, many of whom are up to their necks in involvement with private health care providers, and the profiteers, the health care providers, who are going to come in and cherry-pick the best services so that they can make profits. I welcome the shadow Secretary of State’s statement and commitment today. It will boost the morale of the people of the north-east who are so desperate to keep the service.

[Rehman Chishti (Gillingham and Rainham) (Con)]

The hon. Gentleman just asked the shadow Secretary of State whether his walk-in centre would be kept open and the answer was yes. However, we should not look at future promises. We should look at the past and what was done under the previous Administration. In 2006, Medway hospital in my constituency had the seventh worst mortality rate, yet nothing was done. We must judge Labour by what it did, not by future promises.

[Mr Hepburn]

We must remember that it was the Labour party that created the NHS, that saved the NHS in 1997 and that tripled spending on the NHS in our last period in government. It is the Labour party, when we get in, that will return the NHS to the people—unlike the Tories, who would return the NHS to the profiteers who fund them and their organisation. The only way to get rid of the crisis in the NHS is to get rid of the Tories.

15:54

[Stephen McPartland (Stevenage) (Con)]

I am proud of the NHS and I am proud of its staff. The Lister hospital in my constituency is very large and employs thousands and thousands of staff who, I am proud to say, save lives on a daily basis. The hospital is one of the NHS’s big success stories, as it is currently undergoing a £150 million redevelopment.

I spend a lot of time at the hospital, because I am always opening things and looking at new plans and buildings, which include a new endoscopy unit and theatre, a new A and E unit and a new theatre and ward block, none of which have as yet been fully opened. I have opened a variety of other units, including new scanning units. Some £150 million has been invested in the NHS in Stevenage, which is the biggest ever investment in the NHS in Hertfordshire’s history. As the county predates the Norman Conquest, Members will understand that that is a pretty big investment.

[Sir Oliver Heald]

I congratulate my hon. Friend on the investment and the fantastic facilities of his hospital. In my neighbouring constituency, we say that if someone wants to find the Lister hospital, they should look for the cranes, which are there for the construction of all the new buildings. Does he agree that it has taken a Conservative-led Government to make those improvements?

[Stephen McPartland]

My hon. and learned Friend is correct, and he supported me all the way as I fought with the Treasury, the Department of Health and every single system to ensure that we got the deals signed, sealed and delivered and the buildings constructed on time. I am proud of the investment and the staff who work in the hospital, but I am concerned about the way that Members talk down the NHS. Thousands of NHS workers in my constituency feel very depressed about the situation. They put in a huge amount of hours and a great deal of effort, and what happens at the end of the day? People say that their A and E is in crisis. That is completely unacceptable. Last week, the A and E department in my constituency saw 93.7% of people within the four-hour target. This week, it is on target, with nearly 95% of people, which is down to those doctors and nurses working their backsides off on a daily basis to ensure that they save lives.

[Rehman Chishti]

I pay tribute to the work my hon. Friend does in his constituency. I often see it on Facebook and read about it on the internet. He is a tireless campaigner for the health service in his constituency. He mentioned the A and E in his constituency. A linked issue is that of resources. In my constituency, £13.4 million has just been invested in resources for the A and E department—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I do not want such long interventions. If the hon. Gentleman wishes to speak, we can always put him on the list. If he wants, he can save something for later.

[Stephen McPartland]

My hon. Friend makes a fantastic point, and he is a fantastic campaigner, too. I am sure that that money would not have arrived without a huge effort on his part.

The Leader of the Opposition was in my constituency last week, and we were grateful to him for his visit. He came and celebrated the £150 million investment that I had secured for my hospital. He can come as much as he likes, because I got more donations, supporters and volunteers from his visit. Perhaps he could come on a weekly basis. Incidentally, let me talk about the Lister treatment centre, which the right hon. Gentleman visited. It was privatised under the previous Government. I ran an 18-month campaign to have this private facility returned to the NHS, and I succeeded. I am probably the only Tory MP in history who has managed to renationalise a part of the NHS that had been privatised under a Labour Government. I worked very hard on that campaign, but it was lonely work. The local Labour council did not back me; the local Labour candidate did not back me; the Labour shadow Secretary of State did not back me; the Leader of the Opposition did not back me; but the GMB union did and for that I am very grateful.

Three people died in that facility and 8,500 patients’ records were lost. It was a complete and utter shambles. Clinicenta Carillion, the organisation that was responsible for running that facility, destroyed the lives of thousands of people in Hertfordshire; that must never be repeated. That is what we talk about when we talk about the NHS. Who did I stand up for? I stood up for the patients, for the staff and for their families. Where did I get my information from? From members of staff who were working in that facility daily, under huge pressure, suffering and working as hard as they could to provide the best service they could. They could not do it, because their hands were tied behind their back—the contract was so bad. The local hospital was not even allowed sight of the contract until it was signed, sealed and delivered by the previous Government. They did not even know what they were being signed up to, which is a disgrace. I am proud of my hospital and the staff who work in it, but we must always remember that, at the end of the day, these are human beings, who are working incredibly hard to deliver real improvements in services.

Fortunately, that facility is being handed back to my local hospital. The Secretary of State for Health worked with me. He allowed me to come and see him, and we had a variety of meetings. I argued with the Care Quality Commission. I was very lonely throughout that campaign, but at the end of the day the Secretary of State worked with me and he nationalised that private facility, which the previous Government—disgracefully—privatised. I am proud of the Secretary of State, and I am only sorry that he is not in his place, because I wanted him to come and open one of our wonderful new facilities in February. The Prime Minister can come in March.

The facility that I was discussing got so bad that GPs lost confidence and wrote to each other saying, “Do not refer patients to this facility or you will put them at risk.” The CQC started proceedings to revoke the licence. That facility was falling apart—a facility that was privatised by the previous Government. It was nationalised by the Conservatives.

So I am proud of the NHS and proud of the staff who work in it. I am proud of the £150 million development in my constituency, which is making my hospital one of the most modern facilities in the UK. I am disgusted that the Leader of the Opposition wants to weaponise our local NHS and never once backed my campaign to bring that shameful private contract back to the NHS. The Labour party should apologise to my local community for playing Russian roulette with our local health service and politics with my constituents and patient safety.

16:02

[Alison McGovern (Wirral South) (Lab)]

It is a pleasure to follow the hon. Member for Stevenage (Stephen McPartland). I listened carefully to his speech. He has very good taste in one respect—the football team that he supports. Although he praised the NHS staff—of course, the NHS staff I represent and speak to work incredibly hard; I pay tribute to them—in almost everything else he said, he could not recognise the glaring fact of the reorganisation being the root cause of some of the problems that we are seeing, and he was wrong in his assessment of the shadow Secretary of State’s contribution. The NHS is an extraordinarily important issue to us all. Opposition Members show great passion, as the hon. Gentleman did, and we would all pay tribute to the hard work of NHS staff. There is no difference between us on that point.

I commend the speech by my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson), who is not in his place at this moment. I was particularly moved by his recounting of the experience of his constituents—teenage girls suffering from mental health conditions. It is what the House of Commons should be there for, to allow us to hear his constituents’ voices in that way. I would hope that, in our debates on mental health, we can do much more to bring those problems in our system to the fore.

I want to talk about what I see as three possible solutions to the current difficulties and crises in the NHS.

[Ian Austin (Dudley North) (Lab)]

Vote Labour, vote Labour, vote Labour.

[Alison McGovern]

My hon. Friend makes an excellent point, but I want to outline some of the specifics that might be entailed by that position. I want to talk about three elements of changing the NHS that I take to be very important. One of them is pretty parochial, but the other two are terribly important for our whole country.

The first concerns a walk-in centre in my constituency. Not everybody in the House will be an expert on the geography of Merseyside and, specifically, the Wirral, though I know that everybody will appreciate how important it is that they learn about it. In my part of the world, our local hospital is quite far from those of us in south Wirral. There was a hospital in south Wirral called Clatterbridge hospital, which I was born in. Its emergency facilities closed many years ago; I think that I was almost one of the last babies to be born there. Services were moved up to Arrowe Park on the border of the Birkenhead and Wirral West constituencies. I well remember, when I was young, how far away Arrowe Park felt and, when members of our family were ill, what a long distance it seemed when getting there.

Under the previous Labour Government, with my predecessor’s support, Eastham walk-in centre was opened in south Wirral, near the Cheshire border. That walk-in centre has been a rip-roaring success. It treats people effectively. They can turn up at hours that are convenient, such as out-of-work hours. It is open at the weekends and until 8 o’clock at night on a weekday. I declare an interest as a parent of a young child who always seems to manage to get herself unwell at the most inconvenient times. Eastham walk-in centre has been there for us, and my constituents value it greatly.

Under the reorganisation, the new clinical commissioning group took over. In Wirral, we had a bizarrely complex structure of three federated CCGs for a population of about 350,000. Having three CCGs in Wirral was total madness. Twenty-five million quid was wasted on a reorganisation that nobody wanted and nobody voted for. The first thing the CCG wanted to look at was urgent care, and it put our walk-in centre under threat of closure. This is an incredibly important facility to the people of south Wirral. It brings the NHS to their doorstep. It totally changed the availability of out-of-hours facilities for people in my constituency. The CCG, in its lack of wisdom, thought it was just fine to say, “We’re not sure we need that. We can re-provide those services at GP surgeries, never mind whether they are open at a convenient time.”

The CCG never went through with those proposals, and rightly so. Since then, however, there has been a constant threat and a worry in my mind about Eastham walk-in centre. I want to make it clear to the Minister that if there is any risk at all of that walk-in centre closing, he will receive representations from me pretty quickly, because it is an absolutely vital service. Unless we again conceive of the NHS as being there for patients and the public first and think about how to bring these facilities close to people, we will never get an efficient and effective service fit for the next generation. Walk-in centres are absolutely vital. It sends a chill down my spine to hear the shadow Secretary of State say that one in four has closed; if anything, we should be opening more.

Secondly, I want to talk about social care and older people. We all know that we have the benefit of an ageing population in our country. With an older population, we will have a more experienced and expert population. I take it to be a good thing that people’s grandparents and valued members of their family are living longer, but with that comes a responsibility to look after them properly.

I ask Ministers what has happened to the better care fund. What evidence is there that it has been used to find solutions that are really working? All I see on my patch is council cuts and then the consequences turning up at the door of the hospital. Older, more seriously ill people in our community are turning up at A and E, with the distress to them of being there, the consequential responsibility on staff and the worry for families as people lie on trolleys.

We need a much more radical approach. Integration is clearly the answer, but I would like us to go further: I want us to truly address the work force issues in social care. It is not good enough that poverty pay is endemic among those who look after the most senior members of our community. That is not acceptable; nor is the zero-hours culture. We once had that problem in child care, but as a country we took on the responsibility of changing the culture in the work force for the good of our children, and we must do the same for the benefit of our older people.

I will not speak for much longer, Mr Deputy Speaker, but I want to say something about mental health, which should be part of the strategic approach that we must take to change the NHS for the benefit of the next generation. Parity of esteem is of course correct and absolutely right. I take it that there is now cross-party consensus on that issue and that everyone in the House thinks that we should treat mental health as seriously as we do physical health, with no barriers to getting proper treatment. However, I want us to do something else: we need to recognise the interconnected nature of physical health and mental health. It is not just that we also need to treat mental health, but that if we sort out people’s mental health issues and conditions and empower them to live better and happier lives, they will have better physical health and will make better use of the NHS’s scarce resources.

[Chloe Smith (Norwich North) (Con)]

I warmly welcome the hon. Lady’s last point, but why did she not prevail on her Front-Bench colleagues to include it in the motion?

[Alison McGovern]

I have many conversations with my right hon. and hon. Friends on the Front Bench, but they do not always ask me for a full briefing before they draft their motions, as I am sure the hon. Lady appreciates.

I conclude by saying that with the appropriate use of walk-in centres, a radical approach to social care and real consideration of the interconnections between physical and mental health, the difference we can make to our NHS will be excellent.

16:11

[Chris Skidmore (Kingswood) (Con)]

I thank the Department for recent rises in health care funding in South Gloucestershire. Only yesterday, I received a written answer to a parliamentary question showing that South Gloucestershire CCG will receive £263 million for 2015-16, which is up from £249 million in 2014-15 and from £239 million in 2013-14. That 7% increase in per person funding, from £921 in 2013 to £997 today, is the 16th largest rise out of 211 CCGs. Tomorrow, I will attend the opening of the Leap Valley medical centre in Emersons Green, which is a brand-new, multi-million pound GP centre for the benefit of my constituents in Downend and Emersons Green. Things are therefore looking up for NHS funding in South Gloucestershire and Kingswood.

I was pleased to have a meeting with the Chancellor at which my hon. Friend the Member for Filton and Bradley Stoke (Jack Lopresti) and I convinced him to give £1 million from LIBOR funds to the Great Western air ambulance, about which the chief executive has said that he is absolutely delighted. As the local MP, I have been pleased to be able to push for such improvements in health care.

I want to raise my concerns about the health care situation in Bristol, particularly in relation to Southmead hospital, a brand-new hospital under a £500 million private finance initiative contract that was signed and sealed under the previous Government. As a consequence of the opening of Southmead hospital, Frenchay accident and emergency was closed. It is no coincidence that Southmead has struggled since that closure. As a candidate and as an MP, I fought to keep the A and E open, after the decision to close it was taken in the Bristol health services plan for 2004 to 2006.

I still believe that the closure of Frenchay A and E was an absolute disgrace for our local community. We all know that it happened when the local North Bristol NHS Trust decided to prioritise Southmead over Frenchay because Frenchay’s more expensive land could be used to build a housing estate. We are now seeing the consequence of the reorganisation that took place under the previous Government. It happened despite the fact that 50,000 people signed a petition to get the then Secretary of State, Patricia Hewitt, to refer the decision to the Independent Reconfiguration Panel, which she refused to do. It was a total mistake for the previous Government to decide to prioritise Southmead over Frenchay.

Cossham hospital, another hospital in my patch, was threatened with closure in 2004. The Save Cossham Hospital campaign group was fantastic in opposing that potential closure by the health chiefs of North Bristol NHS Trust as part of the disastrous Bristol health services plan. As a result, Cossham hospital has had a £19-million refurbishment and looks fantastic. I believe that the shadow Secretary of State visited it a couple of months ago.

However, there is a gaping hole, because the minor injuries unit that was promised for Cossham hospital is yet to be delivered. Along with all the parties and the fantastic Save Cossham Hospital group, which is led by Reg Bennett, we have collected well over 17,000 signatures to call for the minor injuries unit. I have secured several debates in Parliament, as the Minister well knows, to call for a Cossham MIU. Regardless of the status of the minor injuries unit, we were promised it because Frenchay A and E was closing. That decision was taken by the previous Government, as I said, and the final contracts were signed in February 2010.

Having been promised this health resource in Kingswood after Frenchay A and E closed, we deserve to get it. It is too far to get round to the other side of Bristol and there are no proper bus services to Southmead hospital. We must remember that NHS services are funded by the taxpayer, so every taxpayer deserves equitable treatment and access to local health care services. I do not believe that my constituents are getting that because Frenchay A and E has closed and Southmead is too far away. We need our minor injuries unit at Cossham hospital.

Only today, there was a meeting of the public health and health scrutiny committee of South Gloucestershire council. On 19 November, I spoke at the committee in person to call for the decision about the minor injuries unit to be referred to the Secretary of State. The committee agreed in principle. I contacted the Department this week, having had regular meetings with the Health Secretary to discuss Cossham and Frenchay, only to find that no letter has been sent by the committee to the Health Secretary. The Department of Health simply has not received such a letter. Today, it turns out that the committee is yet to refer the decision to the Health Secretary. Without that official referral by the committee, the Health Secretary cannot refer the decision to the Independent Reconfiguration Panel.

I call on South Gloucestershire’s public health and health scrutiny committee to get a move on, pull their finger out and send the letter to the Health Secretary. I hope that Ministers will confirm that once they receive the letter, they will be able to refer the decision about Cossham minor injuries unit to the Independent Reconfiguration Panel. It is simply not good enough for the committee to have this month-on-month delay without sending the referral letter to the Health Secretary. People in Bristol have waited too long. They saw Frenchay A and E close, which was a disgrace and will always be Labour’s worst legacy in my local area. We need the minor injuries unit at Cossham hospital and I will continue to fight for it every single day.

16:17

[Sir Gerald Kaufman (Manchester, Gorton) (Lab)]

The national health service is, without doubt, the most precious asset this country possesses. It was created by a Labour Government against, as we should recall at all times, the votes of the Conservative party in this House of Commons.

The Minister who created the national health service was Aneurin Bevan. He did so by immense negotiation, including with the British Medical Association, which he got on board to support and participate in it. As well as having administrative abilities and abilities of persuasion, Nye Bevan was the greatest orator I have ever heard. I met him on a number of occasions and heard him speak. I remember one speech that he made at Labour party conference when a Conservative Government were in power, in which he said of a Minister, “The Marquess of Salisbury has an ancient lineage. It is almost as old as the Poor Law itself.” Nye Bevan would be horrified that in far too many ways, the national health service has descended to Poor Law levels.

Margaret Thatcher said:

“The National Health Service is safe in our hands.”

This Government’s hands are throttling the national health service. Under this Government, the NHS has had an extremely costly reorganisation that cost £3 billion and provided no benefit at all.

A recent survey of GP services—we all rely on our GPs; heaven knows that I would not be standing here today had it not been for my GP referring me to the national health service—showed that ratings have declined for every aspect of trying to see a GP, including opening hours, waiting for an appointment, and waiting in the surgery. Looking at causes, it pointed out that general practice has had its funding reduced over the past five years, and it is five years since this Government came to power. Too often, the system is blocked by bureaucracy that prevents it from operating effectively at the point of use.

Like other hon. Members, no doubt, I get a constant stream of letters on this issue from constituents, and this morning I received a letter from a constituent about his son:

“I have a son…who has psoriasis and he has had this for up to a year now. He has been putting up with it, but it has come to the stage now that it’s unbearable. It’s all over his body including his private parts too. He had to finish work due to that. He can’t sit down with it…He is not sleeping at night. He is bleeding all the time. He can’t go out. He is always in his bedroom…he is in pain day and night.”

My constituent’s GP referred him as an urgent patient to a local hospital, and he has an appointment for 28 March. He is going through hell, and he will go through two more months of hell before he is seen, let alone treated.

Again and again we get such cases. There was a recent debate and meeting about blood diseases. I have a constituent who has a blood disease. He has HIV and is making no progress at all. It is heartbreaking to read such letters, but it is far more heartbreaking to live through such a situation than it is to read about it or even try to help.

The situation is not only affecting the patients, or in some cases would-be patients. Without the essential contribution of NHS workers the service could not function, but they are being victimised. This year, 60% of NHS workers will get no cost of living pay increase at all. They have had a two-year pay freeze, followed by a 1% pay rise. National health service workers’ pay has fallen by 12% to 15% in real terms since this Government came to office.

As a result of the shortage of funds available to the national health service, very bizarre things happen. I want to draw the Minister’s attention to something that is happening in my constituency and ask him to look into it. I have no great confidence that I will get any response, because at recent Health questions I raised two cases and was told by the Minister that they would be looked into. That was the last I heard from the Department of Health on the subject.

I describe this situation because it is not only a major health issue, but a major community issue. Currently, there is no landing site available in Manchester for helicopter ambulances for either the Royal Manchester adult major trauma centre or the Manchester children’s hospital paediatric major trauma centre. There is a lack of money to provide a landing ground for air ambulance centres to do their vital work—heaven knows I praise them for it—so there is a plan to have a landing site in a park in my constituency.

Friends of Birchfields Park, the organisation of local residents that looks after the park, had a meeting on Saturday. I promised them that I would raise it in the debate. There will be a landing site in the park, but it is a small park and part of it will be lost. It will be used something like every three days, so there will be disruption the whole time. Apart from the disruption in the park, the site is next to two schools, one of which is extremely near to the proposed landing area. It is a heavily populated area. A ground ambulance must go the site to pick up the patients who are landed, which will affect traffic on an extremely busy road.

One of the most odd things of all is the effect on the park’s nature. Those responsible for suggesting that landing site say:

“The majority of wildlife will evacuate the area proximate to the aircraft due to the noise and displacement of air and downwash during landing and take-off.”

Apart from the affect on the wild creatures, which share this planet with us and ought to have as many rights as we have, the thousands of people who live in the area will be affected. I am not in any way belittling the air ambulance service—it is vital, essential and dedicated—but it is extraordinary that it will be reduced to using Birchfields park as a landing site because it does not have the money to create its own.

All hon. Members pay tribute to the national health service. As I have said, heaven knows I have a greater duty than most in the House to thank the NHS for what it has done. Everybody needs it. It is just about the only service in this country apart from education that absolutely everybody needs. It ought to be given priority, but it has been severely damaged by the Government. That is accepted by the electorate. Every opinion survey shows that the Government are blamed for what is happening to the NHS, and that the electorate are worried about it. Roll on 7 May.

16:29

[Mr Simon Burns (Chelmsford) (Con)]

It is a pleasure to follow the right hon. Member for Manchester, Gorton (Sir Gerald Kaufman), although he would not expect me to agree with everything he has just said.

I listened to the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) with considerable interest. One thing that struck a chord with me was when, at the beginning of his speech, he said, basically, that the NHS should not be a political football. I could not agree more. It does a great disservice to the people who work so hard—the doctors, nurses and ancillary staff—to provide health care for the citizens of this country, to see it turned into a party political football. Let me explain what I mean by a political football.

The Opposition have, of course, a democratic right to hold the Government of the day to account for their stewardship of the health service, as they do on education or anything else. Of course, every individual Member of Parliament, regardless of party, has a right to fight for the interests of their constituents with regard to health care if they feel that it is failing their constituents.

[Ian Austin]

Will the right hon. Gentleman give way?

[Mr Burns]

No, I will not, because I only have eight minutes.

What I decry, however, is when, in the generality, the health service is used to attack a political party, whether the Government or whatever, simply to try to score cheap party political points. That does a grave disservice to the NHS. As the right hon. Member for Manchester, Gorton said, people in this country love the health service. They believe in it, free at the point of use for all those who are eligible to use it. I, like I imagine millions and millions of taxpayers, have no objection to paying our taxes to have a free health service. To appropriate the four freedoms of Franklin Roosevelt, there is a fifth freedom: the freedom from fear of a medical bill dropping on one’s mat and financially ruining one’s family.

Where I see the greatest and, to my mind, the most disgraceful attack is in the accusation, which is not new—it was being made in 1979, and, I suspect, before then, but fortunately I am a bit too young to remember exactly—that the Conservative party wants to privatise the health service. We do not and we never have done. As long as I am a politician, and my right hon. Friend the Prime Minister is, we never will. I find it extremely aggravating and hurtful when this cheap shot is made.

One of the examples of privatisation given is the use of the private sector to improve and enhance the health care of our constituents. Let me just explain something. Over Christmas, I read an extremely good new book, which I strongly recommend to the right hon. Member for Leigh (Andy Burnham), if he has not already come across it. “Nye”, by Nicklaus Thomas-Symonds, is the new biography of Nye Bevan. It is a fascinating book, particularly the part about when he was the Minister for Health from 1945 to July 1948 and putting together and negotiating the creation of the NHS. It sets out the arguments he had with the medical profession and others, and the compromises he had to make to establish the NHS. Many people do not realise that even to this day, as a result of those compromises, 95% of GP practices are private small businesses. I do not decry that, because they are treating patients, under the national health service, free of charge.

Historically, a lot of mental health care has been free of charge, but provided by the private sector. In the 1990s, when I was a Health Minister, I remember John Major using the private sector to bring down waiting lists and waiting times for operations. My constituents had no problem whatever with that, providing it was free and kept to the core principle of the NHS. The last Labour Government, the Blair-Brown Government, were quite happy to use the private sector providing it was benefiting NHS patients.

The shadow Secretary of State kindly mentioned—albeit in passing—Chelmsford walk-in centre and suggested it was a great political scandal and the next bandwagon he was going to jump on. May I point something out to him? The walk-in centre was created from the dying embers of his stewardship of the NHS, in March 2010, to be run by a private company. I have no problem with that, if it is serving NHS patients. However, its sole purpose was to reduce pressures on A and E at the local hospital, and I am afraid it has singularly failed to do that. The use of A and E at Broomfield hospital, just down the road, has increased inexorably and, in that respect, the walk-in centre has failed.

[Andy Burnham]

I am listening carefully to the right hon. Gentleman. As he knows, I have huge respect and affection for him, but he is arguing that NHS privatisation is a myth and that our accusation is wrong. If he does not mind, I will quote what he said during the Committee stage of the Health and Social Care Act 2012:

“As NHS providers develop and begin to compete actively with other NHS providers and with private and voluntary providers, UK and EU competition laws will increasingly become applicable.”—[Official Report, Health and Social Care Public Bill Committee, 15 March 2011; c. 718.]

Why, then, is it a myth that he and his Government have exposed the NHS to a greater risk of commercialisation, marketisation and, indeed, privatisation?

[Mr Burns]

First, competition was introduced on the current scale by the Blair-Brown Government, and secondly, there is nothing wrong, per se, with competition to get the best providers providing the best care for patients, so long as they keep to the sole ethos of the NHS, which is that that good care be provided free at the point of use for NHS patients. We saw that under his Government and under the Major Government, and this Government have used the private sector to ensure that patients are treated more quickly. We want them to be treated as quickly as possible, and if there is not enough capacity in the NHS, and if a private provider can provide the capacity, I see nothing wrong with that, and neither do most people in this country, if they are treated more quickly.

Returning to the walk-in centre, there were 40,000 attendances last year, 10,000 of which were by people beyond the Mid Essex CCG area. Of the remaining attendances, one third should have been self-caring or using their community pharmacy or 111, which the CCG is paying for, and another third should have been using their community pharmacy or GP, which the NHS is paying for. The CCG was therefore paying twice for the same care for the same patients, which is an utter waste of money. That money should be being used to care for more patients quicker, which is why the CCG has taken the decision it has. It is a rational decision, because the centre is failing to meet the aims it was set up for and instead ensuring that the NHS pays twice for the same patient to be treated. In place of the walk-in centre, there will now be an urgent care service at the local hospital for those people who should be going there. Sometimes, politicians have to do the right thing, regardless of political point scoring. Where it is in the interest of patients and the configuration of services, they should take the right decision, be reasonable and responsible and explain why it is the case.

In conclusion, I am delighted to see the hon. Member for Hackney North and Stoke Newington (Ms Abbott) in her place. I am fascinated to note that the nub of the motion is a call for an extra £2.5 billion for the NHS, which I am sure she strongly supports. What worries and concerns me—she may have a problem when it comes to voting at 7 o’clock tonight—is that the motion goes on to say that it is going to be

“funded by measures including a tax on properties worth over £2 million”.

Given the battle the hon. Lady had on the radio with a member—a right hon. Member— of her party from a southern Scottish constituency, I imagine that she is in turmoil, wondering how to justify that funding from that source.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I am in no turmoil whatever. I will be walking through the Lobby with pride behind my hon. Friends. We cannot know exactly how much a mansion tax, if levied, would raise towards the national health service. What we do know is that the British people who want to save the national health service from the depredations of Government Members have to vote Labour. We have to vote for my right hon. Friend the Member for Leigh (Andy Burnham) to become Secretary of State for Health—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. We do not need a statement; we have got the message.

[Mr Burns]

In conclusion, it is sad that the hon. Lady has completely undermined the case and the costings of the right hon. Member for Leigh (Andy Burnham). I have no doubt that when she has swallowed her pride and gone through the Lobby today, she will battle as hard as she is renowned for battling and will hit the leader of her party over the head to try to get him to see common sense and abandon this ridiculous policy that she also thinks is ridiculous.

[Several hon. Members]

rose—

[Mr Deputy Speaker]

Order. I have tried to work within the spirit of the previous announcement, but I think the time has come to introduce the eight-minute limit.

16:41

[Mark Reckless (Rochester and Strood) (UKIP)]

My party believes in an NHS free at the point of use and funded out of general taxation. I support much of what is in the motion today. I, too, would question what it states about outsourcing, as it is not quite clear whether outsourcing will be based on hypothecation in relation to how much the mansion tax raises or on how much the Conservatives happen to be spending. I believe we need to decide the right amount to spend on the NHS and then to commit to it, rather than simply say it should be £2.5 billion above however much the Tories spend—either cutting or increasing. We should make a decision about how much the NHS needs and then fund it properly. I support the principle of joining up adult social care with the NHS, and I thought that the shadow Secretary of State made a persuasive case for a single budget.

[Ian Austin]

What does the hon. Gentleman think it tells us about his leader’s instincts when he said:

“I think we are going to have to move to an insurance-based system of health care.”?

Moreover, what does he think it tells us about his deputy leader’s instincts when he said that he wanted to

“congratulate the coalition government for bringing a whiff of privatisation into the…National Health Service…the very existence of the NHS stifles competition.”?

Does that not prove that ordinary people who rely on the NHS cannot regard UKIP as being in any sense on their side?

[Mark Reckless]

It proves nothing of the sort. The hon. Gentleman faces a very strong challenge from UKIP in his constituency from the excellent Bill Etheridge MEP. The policy of our party—[Interruption.] No, let me answer the point. Our policy is determined by our party as a whole. We are committed to an NHS free at the point of use and funded properly out of general taxation. [Interruption.] May I continue? I personally come from a mother and father who met in the NHS; the NHS and supporting it is in my blood. I believe in the NHS as I have described it, and I would appreciate the courtesy of people accepting the sincerity of what I say on that.

I am pleased to see the shadow Secretary of State still in his place as he has been throughout the debate, but when it comes to funding the social care budget, it is a moving target to determine what that budget is. We know the local government settlement for the year ahead, but not for beyond that. We do not know what either a Conservative-led or Labour-led Government might be able to, or choose to, spend on local government, or what proportion might be allocated to public health budgets. It thus strikes me as a significant risk to say, without greater clarity, “This is what the budget will be, plus the sum of £2.5 billion”—the figure selected by the shadow Health Secretary and his party, irrespective of what the baseline is.

[Steve Rotheram (Liverpool, Walton) (Lab)]

Can the hon. Gentleman be absolutely certain of what his party might or might not do should it ever—unfortunately—find itself propping up a Government? Can he assure us that the road to Damascus-style conversion that he is describing represents the view of the whole of his party, and not just his individual view?

[Mark Reckless]

Yes, I can give the hon. Gentleman that assurance. It is the view of my party, it is the view of the whole party, and it is my own personal view, which is core to my politics and what I came to the House to represent.

The Prime Minister said earlier that I came to the House week after week to discuss the NHS in Kent. Following what could perhaps be described as an endorsement of my approach from the Prime Minister, I now wish to raise some of the issues that have arisen in Medway. One of the problems with the motion is that it makes no mention of introduction of the new GP contract in 2004, which I believe has been a significant driver of increased demand for A and E services.

In Medway, where the proportion of single-handed general practices is significantly higher than the national average, the burden of out-of-hours care falls largely on an organisation called MedOCC. While I would encourage constituents to use MedOCC rather than A and E when that is appropriate, I have one or two concerns about the way in which it operates.

Like the hon. Member for Wirral South (Alison McGovern), we had a young child who was ill, and we sought an appointment. My wife telephoned MedOCC and we were offered an appointment at a particular time, but were then told that the wait would be an hour and a half. We said “If the wait will be an hour and a half, why do you not give us an appointment an hour and a half later than the one that you have just given us?” However, that was not allowed. We had to wait for an hour and a half, because that was the procedure, and that was the way it had to be. Although we went to the MedOCC clinic because we thought that that was the appropriate service, I would understand it if a constituent in the same circumstances decided to take his or her chances at A and E, where it might even be possible to be seen more quickly.

It is important for an out-of-hours service—in our case, MedOCC—to be flexible and responsive, and to be operated in a way that makes it an attractive and appropriate alternative to A and E, and I shall develop that point further when I meet members of the clinical commissioning group on Friday.

[Rehman Chishti]

The hon. Gentleman and I share the same hospital in Medway. Will he join me in welcoming the extra £13.4 million that has been given to its A and E department, the extra £6 million of winter funding, and the additional £10 million that has been given to the CCG to help to improve local health services?

[Mark Reckless]

I do indeed welcome those sums; I pressed for them strongly. I was particularly delighted by the provision of that £13.4 million for the rebuilding of the A and E department, which I think is essential. I am now campaigning for the provision of a further sum of approximately £20 million so that the hospital can build what it describes as an “emergency village”, consisting of short-stay medical wards around the A and E to improve the throughput of patients and the quality of care.

I have also helped the hospital with its efforts to ensure that patients are referred more appropriately, and are not necessarily sent to A and E. If a GP refers a patient to hospital and that patient has a known condition, surely it is better for the patient to go to the relevant ward than to be pushed through A and E, which is not an appropriate environment for someone who has already been assessed by a GP. Similarly, A and E is rarely the right environment for people suffering from dementia. It is best for action to be taken at the nursing home or by GPs, possibly based alongside A and E, who can make a speedy assessment and transfer the person to an appropriate treatment area. I am also pleased by the decision to end the so-called Star system in Medway A and E. The idea was that someone would be assessed by a senior clinician before it was decided what should be done, but that was not happening within a sensible time scale. That system has now been replaced by nurse-led triage, which I think will work better.

I am also grateful for the support we have received from other hospitals, notably the Homerton, which has an excellent A and E department. Medway has benefited from secondments there. It is important that those secondments and that support are integrated with the permanent staff in Medway hospital and the clinical director lead for emergency medicine is key.

We have had extra consultants appointed in emergency medicine at Medway hospital, which I strongly welcome, but I must mention the terms and conditions of emergency doctors. It is an extraordinarily demanding specialty and doctors working in it rarely have the opportunity to take on private work, which is a consideration for some but not all doctors when they make their choice of specialty. To encourage more doctors to come in to this field, should we consider changes to the lockstep consultant contract so that doctors in the extraordinarily demanding area of emergency medicine can perhaps receive more pay than others who are in specialties that are not as extraordinarily demanding, to which some might have been attracted by the potential for private earnings that they could not make in emergency medicine?

The Secretary of State tells me that what is actually required is more holidays for A and E doctors. That might be the case, but it would require pulling more doctors in to emergency medicine to cover for colleagues on holiday. I question a system in which high numbers of agency staff are used for a day or a week. Hospitals with problems in A and E and that have problems attracting people can fill places with those staff by paying very high rates, but they do not necessarily gel as a team or provide support in anything but the short term. We need to make emergency medicine attractive for doctors.

Finally, on the question of Monitor and the CQC, Medway hospital is a foundation trust. That happened in a largely box-ticking and financial exercise under the previous Government that ignored the death rate being one in 10 higher than it should have been, as mentioned by the hon. Member for Gillingham and Rainham (Rehman Chishti). Although Monitor has been reasonably sensible in its approach to Medway, it cannot come and run the hospital. We had to look to the board to do that. Similarly, the CQC has made some sensible interventions, for example on A and E, but in 2012 it said that Medway was a good hospital that was meeting all its standards. I believe that many of the problems we are seeing were in place then but were not identified by the CQC. My party wants to replace some of the alphabet soup of bureaucracies and regulators, such as Monitor and the CQC, with directly elected health boards that could, we believe, oversee these things better.

16:52

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

It is intriguing to follow the hon. Member for Rochester and Strood (Mark Reckless). I will leave my intrigue at that point and focus on the debate rather than him.

It is a shame that the shadow Secretary of State has left the Chamber, as I was about to say something relatively pleasant and polite about him—he will not hear it now. When he came up to Lancaster and Fleetwood a few weeks ago he joined me in praising my local A and E department, which had seen 97% of patients within four hours, the fifth best performance in the country that week. That is a superb achievement given the complex health economy in Blackpool. It is very rare that we are at the top of a league table for the right reasons in Blackpool, whether that is for football or for health care, so I welcome that.

It was interesting to note a more hidden and nuanced message in what the shadow Secretary of State had to say. The medical director of Blackpool Victoria says that between April and September 2014, 36% of those arriving at A and E did not need to be there. They could have received their diagnosis or treatment somewhere else, and the cost to the hospital was calculated at £842,000. The message I draw from that is that we still have an immense amount of work to do to ensure that people know where to go for the right treatment at the right time. It is, of course, incumbent on us to ensure that those alternatives are resourced, that people know where to go and that people have confidence in the alternatives.

We have not spoken enough today about pharmacies. Pharmacy trade bodies and the industry put so much into lobbying Members on both sides of the House, but I think it will require another decade or so of intensive lobbying of MPs before we finally get the message that it is far better to have first recourse to the local pharmacist to see whether one needs to go further in seeking appropriate health care. I rely on regular repeat prescriptions for my epilepsy, and I have saved myself many a GP visit by asking a question at my local pharmacy. We are overlooking the most basic corner-of-our-street access point for primary health care, and we should not forget it.

I want to praise another Member of a different political party from mine, and he is sitting on the Government Front Bench: the Minister of State has already been praised today for his approach to mental health care. It is warmly welcomed, particularly in a town such as Blackpool. Our new 74-bed harbour unit is about to open on the edge of the town. It has been long-awaited, and is much-needed following some of the appalling standards of care at the Parkwood unit over the past decade.

The Minister will know that he faces great challenges. I could easily have come here today and read out a number of immensely tragic cases involving young people not getting the appropriate mental health care. He still faces a battle with the profession, because clinicians differ over their assessment of this issue. I see far too many young people with some learning disorder who are somewhere on the autistic spectrum, where the clinician refuses to accept that they can both have a learning disorder and a mental health problem. They fall into that gap and are batted backwards and forwards between different providers. There must be a battle in the medical profession over how to reconcile those two different forms of clinical diagnosis.

Another point I want to raise—I have far more than I will be able to get into my remaining four minutes—was mentioned by my right hon. Friend the Member for Chelmsford (Mr Burns). I was struck by the shadow Secretary of State’s sudden enthusiasm for the walk-in centre in Jarrow—his instant commitment that it would be saved were Labour ever to come to power. We then heard from my right hon. Friend that these things are sometimes trickier than that—that there is more nuance, perhaps. We in this Chamber often think we know it all—don’t we? We think we know everything there is to know and that we can learn nothing from anybody else about anything in our constituency—that we are the sole experts of what is right. Occasionally it would be nice to listen to the clinicians. There might actually be a clinical argument for why a particular unit has to open, close or reconfigure, but all too often debates on the reconfiguration of services become a political football—which is exactly what my right hon. Friend was saying.

A good example is the stroke unit in Blackpool. It has been a controversial addition because it was designed to serve the entire north-west. Patients were coming down the M6 from south Cumbria, past four or five other hospitals, to get higher quality treatment in Blackpool. As the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) chuntered during the Secretary of State’s speech, the important point is that it was about outcomes. People were going to have a better chance of survival if they went to the stroke unit in Blackpool rather than their local A and E. Yet when that was debated, it was very hard to tease out the medical arguments in favour of this innovation, because all too often we were more concerned about focusing on saving bricks and mortar in our own backyards rather than on what is actually best.

[Steve Baker]

Does my hon. Friend agree that the two brands in the NHS that the public really understand above all are A and E and GPs, and all the time we are talking about A and E we are getting away from the fact that sometimes care is better provided in a specialist stroke or heart centre?

[Paul Maynard]

My hon. Friend makes an important point, which is that so many different terms are used and answers given in this Chamber and elsewhere about where patients need to go. What they actually want is reassurance and confidence that when they go somewhere they will get the right treatment at the right time that solves their problem. They do not want it to be overcomplicated, and neither do we.

We have heard a lot of criticisms of this Government’s health reforms—they seem to be very unpopular on the Opposition Benches in particular—but let me highlight two that have been very good. One of them goes back to my younger days—when I had a finer figure, perhaps. My first proper job—Opposition Members will not like this—was as a health policy officer in the Conservative research department in 1999, so I listened with delight to the right hon. Member for Holborn and St Pancras (Frank Dobson) telling me all about the wonders of his time, because I scrutinised it quite carefully on a daily basis. I used to get a monthly present from the Association of Community Health Councils for England and Wales in the form of the London “Casualty Watch”, a monthly census of trolley waits in London accident and emergency departments. It was a pretty thick document. The census detailed page after page of trolley waits of more than 24 hours, and it was a shocking indictment of how Labour was running the NHS at that time.

That situation led to one of the Labour Government’s most shameful decisions: to abolish community health councils. I know that many Labour Members are embarrassed about that even now. One of the great things about our health reforms is that we have brought back Healthwatch, which has proved to be a thorn in the side of local health providers, of Members of Parliament and of the Government. We have brought back the ability of ordinary patients to affect the nature of the care in their communities. That is happening right now in Blackpool, and it is making a difference. I am delighted about that.

Another positive element involves putting public health matters into the local council. As I have said, Blackpool faces immense public health challenges, but putting Dr Rajpura, our local director of public health, into the council has been a tremendous success. It has helped to pull together all the disparate strands within the town as we face those challenges. Again, this has happened only as a result of our health reforms.

Another example that I want briefly to mention is the fact that some of our local nurses at the hospital have spun out their rehabilitation service into a community interest company called Spiral, which is now winning awards for the quality of its patient care. I am concerned that, if Labour were to reverse all these changes, the good things we have achieved would be washed away and lost, and the people who would suffer would be my constituents, including those who have turned to Spiral for their rehabilitation. That is my real concern.

17:01

[John Woodcock (Barrow and Furness) (Lab/Co-op)]

I want to talk about the situation in hospitals across the Morecambe bay area, and I shall start with the inquiry into neonatal deaths at Furness general hospital. The inquiry is led by Dr Bill Kirkup, who distinguished himself as a member of the independent Hillsborough inquiry panel. It has now heard from more than 100 witnesses, of whom I was the first, over a period of nine months. That has involved regular long trips from Barrow to Preston for the grieving families, who have had to relive those deeply traumatic periods in their lives in great and painful detail.

There has been a lot of talk about politics today, and about its relationship with the national health service. I do not think we should deny the real differences between our parties; we should be prepared to debate them and to put the choice before the British people at the election. That will involve disagreement, argument and debate. However, it pains me to hear the Secretary of State accuse me and other Opposition Members of being selective in the way in which we talk about the problems in the NHS. I have to say to him that I do not care if the Morecambe bay inquiry turns out to be politically difficult for any side. As the Minister of State, the right hon. Member for North Norfolk (Norman Lamb), knows, I helped to secure the inquiry on behalf of the grieving families, who, with great persistence and determination, persuaded me of the need for an independent examination to run alongside the criminal inquiry, rather than taking place subsequently. I am determined to get to the truth, and I am determined that lessons should be learned, no matter how painful they might be for anyone.

The Secretary of State is no longer in his place, but if he wants to stamp out shabby political point scoring I advise him to have a word with his colleague, the hon. Member for Morecambe and Lunesdale (David Morris). It is a shame that the hon. Gentleman has not attended this debate to stick up for his own local A and E, which I know is facing real pressures. The last time the inquiry was in the news, the hon. Gentleman used those neonatal deaths—which did not relate to his constituency or to the hospital there—to call for the resignation of the shadow Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham). I am sorry to speak so frankly, but if someone is prepared to use the deaths of babies for this kind of political stunt because someone in Tory central office suggests it or just because they themselves think it is a good idea, there is not much they will not do. So just as the families, who have gone through so much in their grief, will not forgive anyone who does not face up to the full gravity of the findings that are coming, so I will not forgive anyone who uses this inquiry for political sport.

For all the problems, and I understand that the inquiry may well make difficult reading, we in Morecambe bay and at Furness general hospital are not the next Mid Staffs. There will be no excuse for anyone who allows the destabilisation and turmoil that the region has suffered to be recreated in Morecambe bay just because it fits the narrative composed by Lynton Crosby or some election agent in Downing street. I hope I will get some assurance from the Minister on that point in his winding-up speech. It is also important that this inquiry, which I understand is to report in the middle of next month, is dealt with fully but is not allowed to divert focus from the real problems the trust is enduring now and the need for a proper funding solution to put our hospitals on a more sustainable footing.

Let me briefly address the pressures currently being felt in Morecambe bay. Ambulances have been mentioned, and the hon. Member for Blackpool North and Cleveleys (Paul Maynard), whom I have the pleasure of following, spoke of his local hospital in Blackpool. Patients in south Cumbria will often travel by ambulance to Blackpool. Sometimes that is a good thing, because of the real expertise available, but too often recently ambulances have been diverted from where they are needed in south Cumbria to serve the Blackpool area because of shortages there. On 5 and 6 January, two ambulances, one serving Ulverston in my constituency and the other Millom in the constituency of my hon. Friend the Member for Copeland (Mr Reed), had to come to Fylde and the Blackpool area. Obviously, once they were there they were required to serve other patients needing help in the Fylde and Blackpool area, leaving the service in south Cumbria severely stretched—and all this when the beginning of January had seen a 25% year-on-year increase in ambulance call-outs across the north-west. We urgently need from the Government not only action to relieve the pressure on accident and emergency departments, but a recognition that areas such as Furness, which are out on a limb, can end up in a difficult situation because of ambulances being redirected around the country.

There have been real pressures on A and E in my constituency, as there have been across the country. Two weeks ago, when this issue last flared up in the Commons, the University Hospitals of Morecambe Bay NHS Foundation Trust was cancelling all non-urgent operations so as to be able to deal with the crisis in A and E. I have spoken to people in the trust today and they say that the situation has eased a little in recent days but remains fragile. All these problems must be addressed, but I have repeatedly pressed the Government on this. I was so grateful to the shadow Secretary of State, on his recent visit to Morecambe, for the assurances he gave on recognising the unique geographical situation of Morecambe bay and the funding priority it would get under a future Labour Government. Our population of 300,000 is spread out across the Morecambe bay area and the transport links are difficult. If things are to be easier, our area ought to be more compact and served by one big general hospital, and it cannot survive with the three hospitals it has unless very severe cuts in services are made. We are still waiting for an answer from the Government on whether they will recognise that case and provide us with the long-term extra funding that our area needs.

17:10

[Steve Baker (Wycombe) (Con)]

I begin by paying tribute to the staff and leadership of Buckinghamshire Healthcare NHS Trust. The trust went through special measures as a result of the Keogh review, when it was found to have high mortality, and they have done a sterling job of turning the trust around. On my visit recently with my right hon. Friend the Secretary of State for Health, I found a renewed enthusiasm and optimism in the trust, and I am very grateful to the staff and leadership for delivering that outcome.

When the right hon. Member for Leigh (Andy Burnham) opened the debate, he asked for shared solutions, striking a markedly different tone from the usual partisan pose. I shall suggest some shared solutions later in my speech. But normal service quickly resumed. The right hon. Gentleman spoke of stories of failure. There are, of course, some stories of success, and I shall mention a few. England’s NHS has the best measured emergency care performance of any western nation, according to NHS England. Dr Sarah Pinto-Duschinsky, director of operations and delivery for NHS England, said:

“In the week ending December 28th A&E attendances were up more than 31,000 on the same period last year, meaning we successfully treated more patients in under four hours than ever before.”

I will come to why in a moment.

The Government have allocated an additional £700 million to cope with winter pressures. The College of Emergency Medicine said:

“This represents the largest annual additional funding yet seen.”

In the course of this Parliament, the NHS budget will have increased by £12.7 billion in cash terms. This additional winter pressures funding has paid for 2,500 additional beds in acute and community treatment and the equivalent of 1,000 doctors. There are almost 1,200 additional A and E doctors, including an additional 400 A and E consultants and 1,700 additional paramedics since 2010. Some 850,000 more operations are being delivered by the NHS each year compared with 2010, and numbers waiting longer than 18, 26 and 52 weeks to start treatment are lower than they were under the previous Government. It cannot reasonably be said that that is a continuous record of failure. There are considerable successes under this Government.

In an intervention on my hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard), I mentioned branding. One of the things that we could do is continue to tell patients that they should go where treatment can best be provided, but we see that patients stubbornly insist on going to hospital. The brand A and E is well understood; people know that if they have an urgent problem, they can go to A and E. It will take years of persuasion before people behave differently, and I do not think we should keep on persuading people to want something other than the preference they are clearly displaying by their behaviour, which I shall return to.

Let us not forget the legacy that the Government have had to cope with, including the grievous financial position that they inherited. Let us not forget that around the world special monetary measures are still in place to ensure that Governments can keep spending. We have had problems with patient care. I alluded earlier to the turnaround in Buckinghamshire; across the country, there have been special measures and turn- arounds. The BBC reported that a probe into whistleblowing has been swamped by people getting in touch. The Government have had to deal with an enormous range of cultural problems and turnarounds.

That brings me to solutions—first, funding. In Buckinghamshire there are pockets of real poverty. In my constituency in Micklefield, Castlefield, Oakridge, Bowerdean and Disraeli there are—by anyone’s standards —pockets of poverty and deprivation, but we suffer on funding because of how it has historically been calculated. It is time for us to look seriously at where the demands on A and E are coming from, and to reorientate funding towards the human factors producing that demand—that is, ageing. Where there are older populations, they should be properly funded. It is a simple matter of treating people humanely, decently and—dare I say it—equally.

Secondly, it is time for us to take seriously the documents of NHS England. I am talking about not just the urgent care review, which I have in my hand, but the “Five Year Forward View”. What we see emerging now is a clear vision of where places such as Wycombe should go. It is becoming increasingly obvious to me that we will never manage to achieve the return of an old-style A and E to Wycombe hospital. The clear reason for that, as set out by NHS England, is that the NHS is moving in a different direction. The urgent care review includes a clear model of future urgent care, with major emergency centres, emergency centres and urgent care centres.

I am not able to tell the hospital trust and the clinical commissioners what they should do, but if I could I would now have a clear understanding from NHS England’s own documents of what should be done in Wycombe. We have a very expensive public finance initiative hospital, and we need to make the most of it for the 20 years-plus that are left to run on it. We should have an urgent care centre, an enhancement of the current minor injuries unit, a pharmacy, GPs, social services, nurse practitioners, and a full set of services and diagnostics in Wycombe named in a way that the public can understand. We should be proud of the centre and encourage people in Wycombe to present there if it is the best thing for them to do. We should not turn off the 111 service, and we should provide the services that people need in the places where they present.

We cannot go on for ever pretending that we will re-educate the public to want something different; that is not going to happen. I am not suggesting that we have an enormous new surge in admissions—nobody wants that. What we should recognise is that the vast majority of people, when they are in difficulty, want quick reassurance. If the people of Wycombe were in charge, they would want our hospital to have a full range of diagnostic and treatment facilities available to them all year round, giving them peace of mind. They would not want poor quality care. I think most people would accept being stabilised and moved to the place that could give them the best care.

We have a heart attack and stroke unit. I do not suppose that many people in Aylesbury, where there is an A and E unit, would be very happy if they realised that in the event of a heart attack or stroke, they would be coming to Wycombe. But that is the point. A huge amount of confusion, waste and anxiety is being wholly unnecessarily created despite the fact that NHS England, through the forward view document and the review of urgent care, has set out a clear trajectory on how to give the public peace of mind and the right treatment in the right place—yes, close to home, but also making best use of the PFI hospitals, which are a millstone around the NHS’s neck. We should do the absolute best we can to get best value for money, which means a new generation of urgent care centres in places such as Wycombe.

17:17

[Angela Smith (Penistone and Stocksbridge) (Lab)]

I feel privileged to take part in this important debate, which has focused on how the state of the NHS is playing out in Members’ local areas. The contribution of my right hon. Friend the Member for Manchester, Gorton (Sir Gerald Kaufman) encouraged me to reflect on just how recently the NHS was formed. It was launched by Nye Bevan on 5 July 1948, which means that anybody alive today who is in their late 60s or older would have been born before the NHS was created.

My parents, for instance, were war babies, born well before the NHS was launched. That reflection serves as a reminder not just of how recent the NHS is, but of how easy it might be to let the NHS slip away from our grasp. It is not something that we can take for granted. It is the responsibility of all of us in this place who truly believe in the NHS not only to fight for its survival—that is not good enough—but to see it strengthened and always fit for the challenges of our time. Currently, those challenges are many.

In an intervention earlier, I referred to the sickness and absence levels beginning to emerge across the country, including in Barnsley, in my constituency, and in Sheffield, and how much that is costing the NHS, but also how much it reflects the problems that the NHS faces.

I want to focus briefly on ambulance services, because they have not featured very much in today’s debate yet they are a pressing issue in my constituency. I represent an outlying area of South Yorkshire, which extends well into the national park. It is predominantly rural and is suffering from serious problems. I will use two cases to demonstrate the problems that we are facing.

Mr Offord collapsed on 16 April 2013, at approximately 11 pm. A 999 call was made, but a double-staffed ambulance did not get to Mr Offord until 11.25, by which time he was in respiratory arrest. On being transferred to the floor from the sofa, he was determined to be in cardiac arrest. He died the following day. The coroner ruled that there was a serious lost opportunity in the failure to consider alternative sources of support for a lone paramedic—the first response to the call—and that Mr Offord would probably have survived if he had received medical attention earlier. Mr Offord’s family, obviously very distressed, have settled that case out of court, but they want a wider justice for their son and brother. They want to see ambulance services and response times improved.

Mr Bailey, who I mentioned in my parliamentary question earlier today, collapsed in a shop. As I said, it took an hour and four minutes—and it was a Red 2 priority call—for an ambulance to get to him, despite the fact that the symptoms described in the emergency call were apparently those of a stroke; indeed, he had suffered a major stroke. This detail is horrific, but I must place it on the record: he had to have part of his skull removed because of the severity of the stroke. In summary, the dispatcher made two errors, which contributed to the delay in an ambulance attending to Mr Bailey, and—these are the words of the Yorkshire ambulance trust itself—“no checks” were

“made for an available ambulance from 13:31 until 14:03; and no allocation”

was made

“of one of the nearer ambulances identified at 14:11.”

All the ambulance trust has to say is:

“Please pass on my sincere apologies to both Mr and Mrs Bailey for the errors and the delay caused.”

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I am so pleased that my hon. Friend has raised this important issue. I have had so many people write to me about the state of the ambulance service. One gentleman, over a year ago, had to wait for two hours. I have also been contacted by a whistleblower from the call centre who is discouraged from sending ambulances—they have to dig and try and find any way. Does my hon. Friend agree that this is desperate and needs to be sorted out?

[Angela Smith]

I thank my hon. Friend for that intervention and I am really sorry to hear of the cases she raises. The situation really does need to be sorted out, because the Yorkshire ambulance trust goes on to say that

“the service was experiencing a high level of demand in the South Yorkshire area around the time of Mr Bailey’s incident. Overall, demand was 12% above predicted levels and the level of ‘Red’ call demand was 55% above predicted levels…Rising demand on all health care resources continues which requires changes to deliver improvements in urgent and emergency care.”

I shall say no more about Mr Bailey’s case because it will be referred elsewhere and it may well go to law—I have simply set out the facts of the case as they have been put to me—but the point is this: why are we experiencing these problems with response times in the ambulance service? Why are we hearing, week after week in Prime Minister’s questions and on the Floor of the House in other debates, that the ambulance service is letting people down—even in the most serious cases, when people are going into cardiac arrest or having a major stroke?

We need to establish the reasons, and I suggest that there are three obvious ones. There may be more—there may be problems with the management of ambulance services, and in many cases there clearly is a problem in the case of YAS—but I would suggest that there are three obvious problems. One problem is the increasing difficulty that people have in getting access to GPs’ surgeries. The evidence was laid before the people present for this debate earlier, by the shadow Secretary of State, so I will not go through it again.

Secondly, there has been the closure of NHS Direct and the establishment of NHS 111. There is no way that NHS 111 can be compared with NHS Direct; it is like comparing apples and pears. I have used NHS Direct in the past. It was a superb service that enabled me to decide which was the appropriate place to go to for my treatment and to get the right treatment at the right time. I can assure hon. Members that the one place I did not end up, having used NHS Direct, was A and E—that would have been the last place I had to go to.

Thirdly, social care cuts represent one of the most fundamental problems of our time. As my right hon. Friend the Member for Wentworth and Dearne (John Healey) said, £1 in every £10 has already been cut from social care budgets. It is obvious, even to the most disinterested observers of the debate on health, that cutting social care budgets at local authority level will ultimately impact on the health service. I was in local government for 10 years, and I saw for myself the importance of the local authority and the local NHS working together to enable elderly people to stay in their own homes and to keep them out of the health system—the acute health system, in particular—as much as possible.

The shadow Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham), outlined what needs to be done in the very long term, strategically, to get the NHS in the right shape. He also outlined the more immediate actions that a Labour Government would have to take if they gained power in May: providing more clinically trained staff to handle NHS 111 calls; restoring the GP guarantee of an appointment within 48 hours; and ensuring that councils, the NHS and the local voluntary sector work together to identify older people at the highest risk of hospital admission and link them up with the right support. I cannot wait for 8 May to see that strategy for the short term being put in place.

Ambulance services are crucial to the trust that people have, and need to have, in their local health services. One can broadly measure the trust that people have in their local health service by how much they can rely on their ambulances. Everybody likes to think that if they need an ambulance they will get one, and get it quickly. I was disappointed this afternoon that the Prime Minister used my question to indulge in petty political point-scoring. These issues are too serious for that. He did not even express sympathy for the family affected and instead made a cheap point about NHS staff. That was disgraceful. It is not good enough, and it is not good enough—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order.

17:27

[Jeremy Lefroy (Stafford) (Con)]

It is a pleasure to follow such thoughtful speeches, in general, on this subject. I thank all the staff at the accident and emergency departments that serve my constituents, whether at County hospital in Stafford, Royal Stoke University hospital, New Cross hospital in Wolverhampton, or Manor hospital in Walsall.

On many occasions in the House over the past few years, the tragic events in my constituency have been referred to. Whenever they are referred to from now on, I would like people to acknowledge the enormous progress to improve health services that has been made in Stafford at what is now County hospital and throughout my constituency. It is absolutely vital that we remember what is happening now as well as where we have come from. Let us not forget that out of the Francis report has come the tremendous emphasis on patient safety and compassionate care that is vital for all our constituents. I do not want Mid Staffs to be used just as shorthand for something that was clearly very poor care; it should also be shorthand for the huge improvements that have been made by the people working there and the NHS staff in many other hospitals throughout the country.

I would like to look in a bit more detail at what this motion proposes and the reasons we are currently suffering from the huge demand on accident and emergency services, particularly in relation to out-of-hours GP services and delayed discharges. Regarding the pressures on A and Es, it has rightly been said that there are 600,000 more attendances every year, but we are finding that there are 4,000 more admissions every week—some 200,000 a year. That indicates the seriousness of the situation, because people are not admitted to hospital unless they are in a fairly serious state or seriously unwell. It shows that we are now entering a phase in which the baby boomer generation needs more acute care. We welcome the fact that people now live a lot longer, but the fact is that when people get ill in later life, they tend to be acutely ill and to have complex needs, and that results in their admission to hospital.

The right hon. Member for Holborn and St Pancras (Frank Dobson) mentioned the ratio of beds to population in the UK. We have one of the lowest ratios in Europe—we have a very efficient health service—but the idea that we can get an even lower figure is pie in the sky. In fact, we ought to go marginally in the opposite direction. We should certainly consider increasing the number of beds. Let us not forget that our patient stays in hospital are shorter than most comparable figures across Europe.

We need to bear in mind that we will get more and more admissions, and we need to have the capacity for that. As I remember only too well, I argued a few years ago that the design for the new hospital in Stoke-on-Trent would make it too small; indeed, it is too small, and we are now increasing the number of beds there.

The King’s Fund has said that only 55.4% of patients say that they know whom to contact for out-of-hours services, and such a lack of information or lack of clarity has already been mentioned. We need something straightforward and simple, and frankly, it must be available 24/7, because emergencies happen 24/7. That is why I have pushed for my A and E to reintroduce 24/7 care, rather than its current 14/7 care. People have to look at the clock to check whether it is nearly 10 pm, and then ask themselves whether the A and E will still be open or whether they will need to go elsewhere. They avoid going to another hospital because our A and E is so good, so they delay going until 8 am, by which time they may be in a worse condition. If the facility is for emergencies, it needs to be open 24/7. I welcome the fact that we will soon get an overnight doctor service. A and E needs to return to 24/7 not only in my case, but in other centres that do not offer a full-time service.

[Steve Baker]

Does my hon. Friend agree that putting GPs into such centres provides the possibility not only of having integrated care, but of treating most people who present overnight, when an A and E consultant might not be available?

[Jeremy Lefroy]

I entirely agree, which is why I welcome the introduction of an overnight doctor-led service at the County hospital in Stafford, even though I would like such services to go further. A parent whose child is sick with a temperature may not want to be a burden on the ambulance service by calling one out but will still want to be seen at that time, rather than having to wait until morning, so being able to go to such a service gives them reassurance. If the child is particularly unwell, they can then be referred to a specialist centre, but otherwise the parent can be reassured that they can wait until the morning. Such matters are vital for our constituents.

It is, indeed, a problem to get GP appointments, and it is vital that the issue is sorted out. There are wide discrepancies. In the practice I attend, I can get an appointment the next day not just because they want the local MP to be seen, but because they are very well organised and their patient load is not huge. That is simply not the case in other practices, and some people in my constituency have to wait two or three weeks for an appointment. The problem must be sorted out, and there must be evenness across the country.

GP surgeries put an additional pressure on A and Es. The statistics show that the patients of some GP surgeries attend A and E far less often than those of other surgeries, because such GPs take the time to have longer appointments and take the trouble to go through problems and deal with them on the spot, whereas others are more inclined to say, “I haven’t got the time, so you had better go to A and E.” The statistics show that for some GP surgeries the ratio of patients attending A and E is almost twice that of others in the same area and with the same demographic.

Delayed discharges have often been referred to in this debate. The figure was relatively stable until the start of 2014-15, but since then the total number of delays has risen by 19%. The King’s Fund analysis suggests that delays attributable to NHS services have risen from 60% to 68%, whereas those attributable to social care have fallen from 35% to 26%. It states:

“This suggests that capacity and workforce issues, particularly in nursing homes and non-acute services”

—within the NHS—

“are becoming more important than social care funding”.

I find that very interesting. I do not know on what evidence it is based, but the King’s Fund is a respected institution and we must look at what it says. It implies that there is an issue with integration not just between the NHS and social care, but between acute NHS services and non-acute NHS services.

So what should we do? First, we have to recognise that there will be increasing demand for complex acute care and, hence, for accident and emergency services. A and E departments therefore need to remain open and to expand. I welcome the fact that the A and E in Stafford will double under the investment plans. Secondly, we need clear pathways for out-of-hours care, rather than complicated pathways that are difficult to understand. Thirdly, we need clear information relating to those pathways. Fourthly, we need to do much more work on access to GPs and must look much more closely at the results of GPs in avoiding A and E admissions among their patients. Finally, we need to make integration a reality, not just between health and social care, but within all NHS services and social care.

17:36

[Ian Austin (Dudley North) (Lab)]

It is always a pleasure to follow the hon. Member for Stafford (Jeremy Lefroy).

I ask Ministers to look at the situation at Russells Hall hospital in my constituency. Like anyone who lives in Dudley, I queue up at Russells Hall when I am ill. I know how hard the doctors, nurses, midwives and all the other staff at the hospital work. Over Christmas, they battled heroically to tackle unprecedented demand in A and E. The chief executive herself pushed trolleys around as they fought off the crisis that has been seen in hospitals elsewhere. I place on the record my appreciation for all their hard work over these difficult weeks.

Last week, we had the shocking news that 400 of Russells Hall’s 4,200 staff—that is one in 10—will have to go, including 200 over the next couple of months. In common with other NHS trusts, the Dudley Group NHS Foundation Trust is required to make efficiency savings of 4% a year, which equates to £12 million each year. At the same time, the hospital is facing cost pressures that are caused by increasing demands on emergency services and the need to provide seven-day services. As a result, the hospital is predicted to face a deficit of more than £7 million by the end of March. I want Ministers to see what they can do to address that issue.

As a first step, the hospital is looking to make voluntary redundancies. Depending on how that goes, it might have to make compulsory redundancies. Like at any hospital, managers at Russells Hall have to ensure that every penny is spent wisely and that every possible efficiency is made before they cut staff and front-line services. People in Dudley agree with me: two-thirds of the hundreds of local people who responded to my survey this week think that front-line staff must be the priority. Community GP practices were their second priority.

Everyone agrees that savings should first be sought among management and back-office functions. However, even if every manager at Russells Hall was sacked—obviously, that cannot be done—it would not come close to the savings that the hospital needs to make. Instead, the redundancies that the hospital is making might include theatre staff, radiologists and staff who deal with things such as blood tests. Even some midwives will be able to apply for redundancy. The trust says that it will do everything it can to protect the service that patients receive, but no one can pretend that our hospital can lose almost one in 10 of its work force without it having an impact on front-line patient care. We just need to look at the pressures that they have faced over the past few weeks. How will they deal with a situation like that after losing so many staff?

Local people share my concerns. I asked thousands of them about this issue this week and 98% said that they thought care would get worse if the job cuts went ahead and eight out of 10 said that they were already noticing longer waits for treatment locally.

I have raised this issue in the House with Ministers before. I warned them last year that more resources were needed to deal with waiting times and with the deficit. I ask Ministers to look at this situation and to ensure that our hospital has the resources it needs to serve my constituents and not lose those members of staff.

My second point contrasts the current Government’s record with that of the previous Labour Government. The previous Government built a brand new £300 million hospital in Dudley, with more doctors and nurses treating more patients more quickly than ever before. Despite promising no top-down reorganisation, this Government squandered billions that should have been spent on front-line patient care—£20 million in Dudley alone—on a bureaucratic shake up. As a result, local people are facing longer waits at A and E, cancelled operations are at their highest level for decades and waits for vital tests and treatments are increasing. We need a Government who put patients in Dudley first. That is why I welcome our plans to tax homes worth more than £2 million to pay for 20,000 more nurses, 8,000 more GPs, 5,000 more home care workers who have time to look after the elderly and vulnerable people they care for, and 3,000 more midwives.

My third point—it is a shame the hon. Member for Rochester and Strood (Mark Reckless) has left the Chamber—contrasts our proposals with what UKIP has said about our NHS. Nigel Farage said:

“I think we are going to have to move to an insurance-based system of healthcare.”

His deputy, Paul Nuttall, said that he wanted to

“congratulate the coalition government for bringing a whiff of privatisation into the beleaguered National Health Service”

and that the

“very existence of the NHS stifles competition”.

That is what senior people in UKIP believe.

Just this week, Nigel Farage suggested that the NHS might have to be replaced by a system of private health insurance within 10 years and that his party will return to that idea after the general election in May. When I challenged the hon. Member for Rochester and Strood about that, he said that his parents met in an NHS hospital, as though that trumps what his leader and deputy leader have said about how the NHS should be organised. Utterly ludicrous. UKIP must be the only political party in history that, when asked about its policies, asks us to discount what the leader and deputy leader have said. It is completely nuts. The serious point is what it says about UKIP’s instincts and values that it wants to replace our NHS with a US-style insurance system in which the treatment and care someone gets depends on the cover they can afford, because that is what Nigel Farage’s plan would mean.

In the US, insurance can cost families up to £10,000 a year. It can cost almost £20,000 to have a baby privately, and treatment for a knee operation can cost £11,000. Imagine the crippling impact that treatment for life-threatening diseases or emergency treatment could have on the finances of an ordinary family in Dudley. Local people are overwhelmingly against that kind of privatisation, and nine out of 10 people told me in this week’s survey that they are totally against any introduction of a US-style health insurance system.

When I asked the hon. Member for Rochester and Strood about that, he mentioned my constituency and the forthcoming election. If he were here now, I would tell him that I will be telling people in Dudley what UKIP’s policy for our NHS would mean for them every day between now and polling day. When people in Dudley compare our plans for more doctors, nurses and care workers, quicker GP appointments and faster cancer tests and results with the Government’s plans for increased savings, longer waiting lists and redundancies, or with an insurance-based system and more privatisation from UKIP, I am sure they will know who is on their side.

17:43

[Chloe Smith (Norwich North) (Con)]

It is instructive, as always, to follow the hon. Member for Dudley North (Ian Austin), and I thank him for his exposition of the positions set out around the Chamber this afternoon. I also welcome the comments of my hon. Friend the Member for Wycombe (Steve Baker) in picking up on the needs of areas that might not normally be viewed as deprived, but that need attention none the less. Norwich is one such city, because it contains wards and areas of serious deprivation. I have argued on behalf of GP surgeries that serve those wards, and there is a genuine question about the way our national structures and funding serve those areas.

[Steve Baker]

Is it not odd how people who are obsessed with inequalities take levels of aggregation that hide the real suffering of individuals and families?

[Chloe Smith]

My hon. Friend makes a wise point.

Tomorrow, I am visiting a walk-in centre and the hospital that serves my constituents. When I am there, I shall be explaining, as I have several times in the House recently, my support for the NHS in Norwich and across Britain, my thanks for what the staff are doing and my understanding of what the patients, my constituents, need from the NHS.

I want to make three points in the debate. My first point is that, as many hon. Members have said this afternoon, the NHS is under unprecedented demand. It does it no disservice to acknowledge that and bring it into the debate. I for one welcome the decisions that allow for increased numbers of doctors and nurses in urgent care—that is true in the Norfolk and Norwich University Hospitals Trust; for an increased number of operations to be carried out each year—that is true everywhere in the country; and for increased hours at GP surgeries. I recently learned to my pleasure that Norwich doctors will apply for the next round of the access fund. They have not done that before and it is very welcome. The Government have made the fund available and it could be of great benefit to patients in my area.

I am also grateful to the Government for the decisions made early—earlier than ever before—that have allowed for winter pressures to be dealt with. Again, that directly benefits the area of Norfolk that contains the Norfolk and Norwich hospital. I am particularly pleased that the use of that funding will be planned jointly with local authorities through the system resilience group. That is incredibly important. I will turn to that kind of joined-up working in my final remarks.

Let me make a point about the motion. We have heard wise contributions from Back Benchers on both sides of the Chamber. For example, my hon. Friend the Member for Stafford (Jeremy Lefroy) rightly asked us not to use the name of his area as a shorthand. He is right that we ought to look much deeper. As a further example, the hon. Member for Wirral South (Alison McGovern) rightly spoke eloquently about mental health. Unfortunately she is not in the Chamber, but I am sure she will be back before the winding-up speeches. I intervened on her to ask why the motion does not refer in its own right to mental health; it is a great shame that it does not. The motion is 10 lines of overblown and fly-blown rhetoric. It asks for an NHS that is “fit for the future”, but makes no mention of mental health being equal to physical health, which I believe strongly. Mental health and physical health should be equal in word and deed, and in budgets. Indeed, I have been discussing that with the Minister recently through parliamentary questions.

The truth is that the motion is rather sad and inadequate. It betrays even the usual standards of political football that are played on Opposition days. The right hon. Member for Leigh (Andy Burnham) said in his opening speech that it is time for honesty. To that end, we would like to know whether his party leader believes in “weaponising” the NHS. To that end, we would like an end to the shabby leaflets on the NHS that go around the country.

I would have liked mental health, which is an important topic, to replace the waste of words in the motion. The motion is a pathetic reuse of the tired and crumbling money-making policy—the mansion tax—that not even all Opposition Members agree with.

[Liz Kendall (Leicester West) (Lab)]

Will the hon. Lady give way?

[Chloe Smith]

Perhaps the hon. Lady will explain whether the mansion tax will be spent once or 20 times over, like Labour’s bonus tax.

[Liz Kendall]

Why is the NHS as a whole not one of the hon. Lady’s Government’s five priorities?

[Chloe Smith]

The hon. Lady will have heard the Secretary of State speak eloquently on the topic of the Government’s priorities. The point I was about to make is that economic competence allows us to run an NHS securely and strongly for the future. It is the Conservative party and this Government who are demonstrating such economic competence, thus allowing the NHS to be a priority for the future.

My final point is much more important than this political to-ing and fro-ing. My hon. Friend the Member for Blackpool North and Cleveleys (Paul Maynard) made a sensible point about the good that can come from local commissioning and joined-up working. I would add a third point, to make a kind of trinity. The third important thing we all want to see in our local health services is the making of decisions in good time. For example, the walk-in centre in Norwich has recently had to move. As I mentioned, I will be there tomorrow discussing this further with staff and patients. There was no need for the decision to relocate to be made at the last minute. It is a source of great frustration to patients locally that the decision was not confronted earlier on. It was there in black and white in the centre’s rental lease contract, so it was not too hard to spot.

Patients look to health officials—both locally and, where it applies, nationally—to make sensible decisions on time, and for those decisions to be made locally, wherever possible, and in a joined-up way, as my hon. Friend the Member for Blackpool North and Cleveleys rightly said. I would like the walk-in centre to look to its future by assessing its relationship with accident and emergency, GPs, physical health, mental health and all types of provider, including the voluntary sector, which has not been mentioned in the debate so far. I would particularly like decisions about the walk-in centre to be made in good time. There can be no forgiving decisions taken right up to the wire, which fail to deal with the real world as it stands in terms of rental contracts and, most importantly, fail to serve patients best.

17:52

[Kevin Barron (Rother Valley) (Lab)]

It is a pleasure to speak in the debate, and to follow the hon. Member for Norwich North (Chloe Smith).

My hon. Friend the Member for Dudley North (Ian Austin) mentioned private health insurance. In America, 80% of the population have great health care through private health insurance, but for the many people who cannot afford any private health insurance and rely on charity, it degrades very steeply. My parents used to have to rely on charity in the 1930s in this country. If any so-called political party is talking about returning to health insurance, I have to say that people will get what they can afford and the bulk of people will get very little. What Nigel Farage said the other day was completely consistent with UKIP’s 2010 manifesto— I have a copy of it.

I want to talk briefly about the pressures on accident and emergency. It is no coincidence that when the economy is being run more “efficiently”, as I think the hon. Member for Norwich North put it, through cuts and austerity, there will be an effect on services. Figures from an Age UK report that came out this week show that despite rising demand from growing numbers of people in need of support, the amount spent on social care services for older people has fallen nationally by £1.1 billion, or 14.4%, since 2011, even accounting for additional funding from the NHS, and by a total of £1.4 billion, or 17.7%, since 2005-06. That is quite a large cut.

According to the Health and Social Care Information Centre, between 2010-11 and 2013, the number of older people receiving home care fell by 31%, from 542,000 to 370,000; the number of day care places plummeted by 66.9%, from 178,000 to 59,000; and the number of older people receiving vital equipment and adaptations to help them remain safely at home dropped by 41.6%. This is the austerity that the people on the Government Benches say our economy needs.

[Sarah Newton]

rose—

[Kevin Barron]

In a few minutes—let me get to my third page, and I will gladly give way.

Spending on home care has dropped since 2011 by 19.4%, from £2.2 billion to £1.8 billion, while the amount spent on day care has fallen even more dramatically, by 30%, from £378 million to £264 million.

[Sarah Newton]

I read the Age UK report with great interest, but the data, which the hon. Gentleman has cited, is aggregated information from across England. Not all local authorities are cutting social care. Some really good local authorities are coping with the reductions in funding from central Government, prioritising the needs of the most vulnerable people in their communities and finding innovative ways of working with the NHS and the voluntary sector to improve the self-reported well-being of the people they serve. It is not the blanket situation across the UK that he describes.

[Kevin Barron]

That is not a denial that the figures are true. They are true. These are the facts and figures of what austerity under this Government has introduced to local government and social care.

The cuts have happened at the same time as the number of people aged 65 and over has increased by 1.2 million. Caroline Abrahams, charity director at Age UK, said:

“This devastating scorecard speaks for itself and it lays bare the fact that our state funded social care system is in calamitous, quite rapid decline. Today, many hospitals are finding it hard to discharge older people and commentators are asking why this challenge seems to be growing, year on year. A big part of the explanation is revealed by this scorecard: the marked decline in central government funding for social care and the resultant reduction in support for older people to live independently at home - this at the same time as their numbers are rising.”

She continued:

“Until recently the impact of the decline in social care has been relatively hidden, but social care is a crucial pressure valve for the NHS and the evidence of what happens when it is too weak to fulfil that function is clear for us all to see.”

She maps that out pretty well.

Councillor Izzi Seccombe, of the Local Government Association, said the system was “chronically underfunded”. She said:

“Councils have protected our most vulnerable people as far as possible, often at the expense of other services, and we will continue to prioritise those most in need.”

She continued:

“However, the combined pressures of insufficient funding, growing demand, escalating costs and a 40% cut to local government budgets across this parliament mean that despite councils’ best efforts they are having to make tough decisions about the care services they can provide.”

This councillor is the Conservative leader of Warwickshire county council—not somebody from an urban area but a Conservative who knows exactly what austerity is creating in Warwickshire, and probably elsewhere as well.

On 7 January, following an urgent question on A and E and major incidents, I raised in the House an issue about an elderly member of my family. In response to my right hon. Friend the Member for Leigh (Andy Burnham) and me, the Secretary of State mentioned the better care programme but said little else about the problems facing people in hospital. That member of my family was actually my mother, who was in Rotherham hospital, having been admitted to A and E on 9 December. Two days later, she was told she could go home, as there was no medical need for her to be there. She spent her 93rd birthday in Rotherham hospital on 24 December and was discharged on 5 January—with no medical reason to be in that hospital all the time from 11 December until then.

I have since checked the reductions in my local authority’s adult services budget. This year thus far, the reduction has been over 6%. Over the last full financial year, the reduction was over 8% and previously 4% and 3%. That has a cumulative effect on people’s ability to be looked after in the community. People stand at that Dispatch Box or anywhere else talking about “the need for austerity”, well that shows the price of that austerity. My mum is good; she is back at home with a good care package, and she is fine. She wants to continue on her own as much as she can, but many people cannot do that. If we want austerity, we will have such problems.

On 7 January, no mention whatever was made on the Front Benches about the situation. Yesterday, the Government acknowledged the impact of social care cuts and announced £25 million-worth of emergency funding for 65 council areas experiencing the most severe delays in discharging elderly patients from hospital. No mention at all was made by the Secretary of State when he opened the debate today. It was hidden away, but it is in the national press if anyone wants to look for it. The Government know the situation: they know what problems have been created in A and E in hospitals up and down the land by these cuts, yet no mention was made, even though the motion specifically mentions A and E problems.

I shall finish now, but I must say that if people want austerity and if they want to fight a general election on the basis of being better at the economy than the other side, they need to realise the price paid for it. My mum survived it, but many people in this land are not surviving it. In my view, it is not a price worth paying. We need serious change—and I say that not only to the Government Front-Bench team, but to the Opposition Front-Bench team. We need to make serious changes in this country to look after our most needy people. We are not getting that under this Government.

18:01

[Dr Julian Huppert (Cambridge) (LD)]

It is a pleasure to follow the right hon. Member for Rother Valley (Kevin Barron). We have heard references to Nye Bevan and his amazing work in setting up the NHS. We should talk about Beveridge and his report, too. He was a good Liberal and he did that work during a coalition, albeit a somewhat different coalition that had come about for different reasons.

Let me start by looking at some issues that have arisen in my area of Cambridgeshire over the last month or so. There has been a number of winter challenges to be faced. Among them, I could talk about the ongoing problems with the ambulance service. The real problem that struck us was, I suspect, when the East Anglian ambulance service changed to the East of England ambulance service—and it has never recovered from that.

What has hit people most, I think, has been the problems at Addenbrooke’s hospital—a major incident took place, and a large number of operations had to be cancelled. I have spoken to the managers there and to many of the doctors and nurses. It seemed that there were two main reasons for the big problems. One was that Addenbrooke’s has been implementing the new e-hospital system—an exciting electronic records system that is the largest NHS IT project ever to be implemented. It is not as big as the one that was scrapped, but it was implemented. Although it will be a good thing when it is finally working, there have been many teething problems along the way and lessons that have to be learned. I suspect that other hospitals will want to learn from this: they should look carefully at the bad things, as well as the good things.

The other problem is the shortage of care wards, with delayed transfers of care. That has been a problem for a long time. Addenbrooke’s opened some new wards, but more are needed. I have been campaigning for some time to reopen some wards at Brookfields hospital, also in Cambridge, and I spoke about that in this place last year. I am delighted that, as of 9 February, these wards will be opened at Brookfields hospital. That is very encouraging. It is interesting to note that, in 2007, there were proposals to close down the entire hospital; I am delighted that we are opening up more wards instead.

We are trying to solve the problem for the long term through a new older people’s contract. This is the second-largest tender ever put out for the NHS, as it includes all the older people’s services in the county. I am delighted that the contract was won by the NHS—unlike the largest contract. The acute hospitals, the mental health services and the community work sector will all be working together to solve the problems we are having with things such as delayed transfers of care. That is the long-term fix for older people’s services in Cambridgeshire, and I hope it will be a model for other parts of the country to have a look at.

We have seen the news about Circle pulling out of the Hinchingbrooke hospital. This has been discussed in this place, and it is a shame that the shadow Secretary of State is not in his place, as it is always fascinating to hear him argue that he was in favour of the NHS bid led by Serco. I do not count Serco as part of the NHS, and I do not think that any Opposition Member would wish to do so.

[Andrew Gwynne]

Will the hon. Gentleman give way?

[Dr Huppert]

I will give way once on this issue.

[Andrew Gwynne]

I fear that the hon. Gentleman is, yet again, seeking to rewrite history. He will know that when my right hon. Friend the Member for Leigh (Andy Burnham) became Secretary of State, he changed the “any willing provider” policy to “NHS preferred provider”. That allowed Cambridge University Hospitals NHS Foundation Trust to become a partner of one of the three bidders. It was, of course, the Government whom the hon. Gentleman supports who signed the contract 18 months after the general election.

[Dr Huppert]

The hon. Gentleman ought to get his facts right. The Cambridge university trust put in a bid—it was the sixth last to do so—but then withdrew because the cost of the tendering process under the right hon. Member for Leigh was far too high. It did not have a partnership with Serco. The hon. Gentleman should check the facts and check the record. The trust was driven out by the tendering. The hon. Gentleman should also know that the bid to which I suspect he was referring was led by Serco. What he is saying, in essence, is that the current shadow Secretary of State had to undo the damage that had been done by previous Secretaries of State. That is a bit of Labour misery that I imagine Labour Members can sort out between them.

We know the history, and we know the problems that led to it: the Government had to decide between three private sector-led bids for Hinchingbrooke. What we must do now is work out what to do next, and I think we need to ensure that Hinchingbrooke stays in the public sector. Trying to remove it from the public sector in order to deal with the PFI problems, which was the original idea, simply has not worked. It must stay fully within the NHS.

Last year, before any of this happened, I led a debate about health in Cambridgeshire. I dealt with a number of issues, and I will not go into all the details now, but I spoke about health funding and, in particular, about mental health. I gave a number of detailed examples of some of the many challenges that we have faced and still face. For instance, huge cuts were made five or six years ago. During that debate, I called for a substantial amount of extra money, not just for Cambridgeshire—although I shall say something about that shortly—but for mental health throughout the country. Members in all parts of the House have made some excellent speeches about mental health, but it is not talked about enough. I find it regrettable that the motion does not mention it, and I suspect that a number of Members on both sides of the House do as well. Let us hope that we receive that extra money for mental health.

Cambridgeshire, however, suffers from a number of specific problems. We have been a test bed for experimentation for many years. We had the Hinchingbrooke experiment— the largest tender that the NHS has ever seen. We saw huge numbers of PFI projects not just at Hinchingbrooke, but at Peterborough. Paying off the NHS costs is still taking 18% of Peterborough hospital’s budget. That is only a small proportion of the 138 PFI projects that we saw under the last Government, the costs of which will amount to £11.7 billion over the next Parliament. That money could be used far more productively.

We have been hit hard by that, but we also receive very low funding. We inherited a formula from the last Government, and the process of changing it has been too slow under the present Government.

[Sir Hugh Bayley]

rose—

[Dr Huppert]

The hon. Gentleman can intervene if he wants to talk about why PFI is a great thing, but otherwise I will move on.

The Government have been too slow to move to the new formula, which properly takes account of ageing populations. We know that the elderly cost more in terms of health care. Cambridgeshire receives £961 per head, whereas West Norfolk, for example, receives £1,255. That is a huge difference. I asked for extra money during the debate that I mentioned, and I am delighted that we have managed to secure an extra £20 million as a result of the recent allocation. That will provide much more funding for mental health, on top of the extra £1.5 million that has been provided this year and the extra £2.2 million that will be provided for IAPT—improving access to psychological therapies—next year. That will make a big difference, and will reverse some of the challenges that we face.

We need that extra cash, but we still need more in Cambridgeshire and throughout the country. Simon Stevens called for an extra £8 billion by 2020, after savings and efficiencies had been taken into account. He said that an extra £8 billion, in real terms, was needed if the NHS was to keep going. I think that that is important, and we as a party think that it is the right thing to do. One of the problems with the motion is that it does not deliver what Simon Stevens has said is needed for the NHS. I am not all that keen to support the provision of less than a third of what is needed to keep the NHS going, especially after hearing from the shadow Secretary of State that, despite what the motion says, the money is not all for the NHS but constitutes the entire offer for the NHS and social care, which also needs its own funding. We need that £8 billion.

I voted against the Health and Social Care Act 2012 as I did not agree with much of it. There are some issues, such as parity of esteem, that are very good and that I hope will never be repealed. I also disagree, however, with many of the things that the Labour party did to bring in the private sector in some damaging ways, with people being paid for things that never happened.

The fact is, as was mentioned by the hon. Member for Brighton, Pavilion (Caroline Lucas), under the previous Government medical spending on private provision went from £1.1 billion a year in 1997 to £7.5 billion in 2009-10. That is a vast increase. I have no problem with people who say that they support that and that it was the right thing to do, but to suggest that that large increase was excellent for the NHS while the fact that it has continued at essentially the same rate under this Government is a disaster for the NHS strikes me as a rather bizarre claim.

I have criticisms of this Government, the previous Government and the one before that. I want the NHS to spend more of its time focusing on patients or, even better, avoiding the need for people to be patients in the first place. That needs a trained, motivated and well-paid staff—I think they should get the money from the independent review. It needs a focus on prevention and public health and proper funding—that is, the £8 billion by 2020.

[Paul Burstow]

On that point, does my hon. Friend agree that the better care fund, which is now being launched in April, is a key way in which we can deliver the joined-up care that he is talking about and that we need to have an ambition that by 2018 all CCG budgets, primary care budgets and social care budgets are in that pot?

[Dr Huppert]

My right hon. Friend is right, of course, and I pay tribute to him for the work he has done on this and on many other health measures. We must ensure that that integration happens so things work together and that is why token amounts such as a couple of billion pounds from the Conservatives, who need to go a lot further, and the £2.5 billion across health and social care from Labour—and by the way, please correct me if I am wrong, but according to The Guardian that is from 2017 onwards —will not go far enough. We need integration through the better care fund and we need that £8 billion. That is the proper funding that is needed.

Finally, we in this House ought to have a proper debate about how to fix problems and cut back on the amount of partisan bickering that happens in this place. That does not do us proud. We are all prone to it, including me. It is much better to talk about what we can do to promote health, whether it is physical or mental.

[Several hon. Members]

rose—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I am afraid that I shall have to reduce the time limit to seven minutes and that it will have to be further reduced if people take more than just over six and a half minutes.

18:12

[Sir Hugh Bayley (York Central) (Lab)]

NHS services in the vale of York are provided by well-qualified and hard-working staff and this year they received £367 million to provide their services. Nevertheless, services in my city of York are in crisis as a direct result of coalition Government policy.

The A and E service at York hospital has broken down over the past two months. In December, 71 operations were cancelled at the last minute so the beds could be freed up for emergency admissions from A and E. Between 1 and 11 January this year—11 days—84 operations were cancelled for the same reason. When my right hon. Friend the Member for Holborn and St Pancras (Frank Dobson) was Secretary of State for Health, he created the walk-in centre in York, which he visited with me, and it reduced pressure on A and E. He created NHS Direct, which reduced pressure on A and E. The walk-in centre was closed two or three years ago and NHS Direct has now been closed, so it is not surprising that we face these extra pressures with hundreds of thousands of extra presentations at A and E each year.

The pressures in A and E mean that when ambulances arrive with acutely ill patients they often have to wait a long time before they can pass the patient over to the A and E service. That inevitably has a knock-on effect on ambulance response times. A freedom of information request made last week by the trade union Unite found out that Yorkshire ambulance service failed to meet its national target of responding to 75% of emergencies within eight minutes in 11 of the 12 months leading up to October of last year.

The problems within mental health services are even worse. Last year, the Care Quality Commission highlighted major failings and, following an especially serious incident at Bootham Park hospital, the acute mental health hospital in York, in which a patient died, I wrote to the Secretary of State in April 2014 in support of the local clinical commissioning group and Leeds and York Partnership NHS Foundation Trust, the provider of mental health services in York, to press for urgent plans to replace the 250-year-old Bootham Park hospital. It is a fine grade I listed building, but because of its listed status English Heritage prevents the health trust from removing ligature points or installing anti-barricade doors and makes it impossible to provide clear lines of sight from nursing stations to the patients’ bedrooms.

The CQC’s concerns are not just about adult mental health services. The child and adolescent mental health unit in York, Lime Trees, was constructed more recently. It is a mixed unit for girls and boys, but it does not have sufficient bathrooms to preserve dignity with two genders within the unit. It also has inadequate space for clinical meetings, therapy sessions and family visits, and it only has limited space for the young people themselves to relax and, because of its deficiencies the more acutely ill young people have to be sent away, often to the other side of the Pennines, in order to get treatment. That does not make sense. We have heard from my right hon. Friend the Member for Kingston upon Hull West and Hessle (Alan Johnson) and others today about the pressures on families when acutely mentally ill young people are moved away.

I got a letter back from the Minister of State saying that NHS Property Services was working with local commissioners

“to look at a comprehensive estate strategy for York.”

That was eight months ago, and I say to the Minister—I hope his Parliamentary Private Secretary will tap him on the shoulder now—that I would like him in his response today to say what progress has been made in those eight months in providing a capital package to replace Bootham Park hospital in York. It is urgently needed and he has had a long time to consider it.

Just last week the CQC, in a new report, made further criticism of the Leeds and York mental health trust. Most worryingly of all, it revealed that York receives much poorer services than Leeds, despite the same trust providing services to both places. The local paper in York had a headline story describing it as “A Tale of Two Cities.” The trust chief executive Chris Butler has told me that the reason for the disparity in services is simply because the CCG in Leeds is better resourced than the CCG in the Vale of York and therefore it receives more money per capita for the population served from Leeds than for that served from York. It is simply unacceptable for access to care to depend on a postcode lottery.

Two things have brought about this crisis. First, there has been a squeeze in funding in the NHS. As I pointed out when the Secretary of State was speaking, the NHS budget has fallen from 8.2% of our GDP in 2009-10 to 7.9% in 2013-14, and the situation is getting worse as we will see when the figures for this year are revealed. To put that fall in perspective, the difference between 8.2% and 7.9% of GDP is some £5 billion a year. That is the amount by which this coalition Government have cut the NHS budget.

The Government must address not only the overall level of funding, but the way the funding is split between different health authorities. Within the former North Yorkshire primary care trust area, where all patients used to get the same level of treatment, funding in the Vale of York is just £1,062 per person as against £1,270 in Scarborough and Ryedale. I went with colleagues from neighbouring constituencies to see the Secretary of State to say that parity of funding should be restored, but nothing has happened. This is a Government who talk the talk but do not walk the walk on the NHS.

[Several hon. Members]

rose—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I must reduce the time limit to five minutes if everyone who wants to speak is to have an opportunity so to do.

18:19

[Liz McInnes (Heywood and Middleton) (Lab)]

The pressure that the NHS faces in my constituency under this Government is all too apparent. I have a constituent, Mr Stephen Corfield, who asked me to call on him last weekend. Stephen has been housebound for the past year with severe back, hip and neck pain that results in severely restricted mobility. He lives in his upstairs bedroom and is cared for by his wife. He has not been able to go downstairs for a year. Stephen is in dire need of X-rays to diagnose his condition, yet he cannot get to hospital because the privatised ambulance service in Greater Manchester, run by Arriva Transport, will not come out to take him. Arriva says that all Stephen has to do is to get to his front door, at which point its passenger transport system will do the rest. This completely overlooks the fact that Stephen is totally incapable of getting to his own front door. Is it any coincidence that Stephen’s problems are being exacerbated by the inaction of a privatised ambulance service? Stephen has to sit at home, his health deteriorating day by day, all for the want of an appropriate, decent response to his problems from that privatised service.

Other constituents have been to see me to complain about the withdrawal of the diabetic retinopathy screening service from Heywood. This has resulted in diabetics living in Heywood being asked to travel to Rochdale for an essential screening test. The test leaves them with impaired vision, and therefore unable to drive. They have to use public transport, and often have extreme difficulty in doing so. If ever there was an argument for keeping health services local, the diabetic retinopathy screening test is it. As a result of this cut to the service, diabetics in Heywood are not keeping their appointments because they do not feel confident that they will be able to return home safely after their test. The result of the cut is that patients are missing out on an essential test that helps them to maintain their eye health and keep them out of hospital. This is a false economy if ever there was one.

Sadly, those two examples are all too typical of the patient experience in today’s NHS. Services are being cut and privatised, with an inevitable reduction in quality of care for the patient, and this is all the result of the Health and Social Care Act 2012. The Act was introduced by a coalition Government with no mandate to do so; it was mentioned in neither the Tory nor the Lib Dem manifesto.

I should like to move on to talk about NHS staff. Not long ago, I was one of them. I worked as a health care scientist and I saw at first hand how demoralised NHS staff had become under this Government. NHS staff are not against change. We have spent our careers working with a background of constant change, but what has happened since 2010 has been unprecedented. Services have been cut and privatised, and staff have been made redundant or TUPE-transferred to private providers. I have seen hard-working colleagues burn out, and many people have taken early retirement if they can afford to do so. They were unable to take the pressure of working in today’s NHS.

In a spirit of consensus, I should like to suggest to the Secretary of State—were he here—that one easily achievable thing he could do would be to stop ignoring the recommendations of the pay review body that were made last year, and to pay all NHS staff the 1% pay rise they so richly deserve. I cannot understand why this Government have chosen to pick a fight with NHS staff over a 1% pay rise. They cannot possibly be proud of the fact that they have presided over strikes in the NHS. Any Government who can get the not-normally-militant Royal College of Midwives out on strike must surely admit they are doing something wrong.

NHS staff will strike again next week, simply because the Secretary of State refuses to meet the trade unions to discuss and negotiate the issues. The Secretary of State constantly heaps praise on hard-working NHS staff, yet he refuses to do this one simple thing. If he were to remunerate the staff in this way, it would improve morale, which would have a positive effect on patient care. The NHS is one of this country’s greatest achievements, yet under this Government we have witnessed a decline in the quality of care, growing health inequalities and stressed, demoralised staff. The Secretary of State is presiding over strike action in the NHS, yet the simple solution to the strikes lies in his own hands.

18:24

[Mr Andy Slaughter (Hammersmith) (Lab)]

It has been a dispiriting afternoon, listening to the Secretary of State and Government Back Benchers saying that they do not play politics with the NHS while doing exactly that by blaming a previous Labour Government. They say they respect and care about NHS staff but they are not even prepared to pay them the 1% increase that has been recommended. Most of all, they say that they care about individual incidents but ignore statistics, whereas those statistics are simply the aggregate of so many individual tragedies that are going on at the moment.

Let me explain what I mean by that last point. This week, the Evening Standard has been running a series on the London ambulance service, and yesterday it was revealed that the head of the service had resigned after producing the worst results in the country—in only two thirds of the greatest emergency cases did the ambulances arrive within the target time. On Monday, it was reported that there had been a two thirds increase between November and December in stacking—ambulances waiting more than 30 minutes outside hospitals—across London. What those statistics, bad as they are, hide is shown in the e-mails I get every week from my constituents.

One such e-mail was about an incident where someone on a pizza delivery bike was hit by a car, with the rider badly injured. The police arrived rapidly and administered first aid. They were

“overheard to say that the victim was bleeding from the ear and his injuries may be ‘life-changing’”,

but that the fact they had arrived might itself delay an ambulance arriving. In this case, it took an hour and a half for that to happen. Another e-mail was about an elderly man who fell, cut his head and was lying in blood. The neighbours came out to help, but after an hour, during which time no ambulance had arrived, he was helped back into his home. Another e-mail relates to the case of a constituent who came to the aid of somebody who had come off their bicycle and broken their nose on Shepherd’s Bush road. My constituent was told by a paramedic, who was phoning back, that it would be at least two hours before an ambulance arrived, and they managed to get a police officer to take the injured person by minicab to Chelsea and Westminster A and E. I am sorry to say that I get those e-mails every week.

That is about the ambulance service, but what is happening to A and E? The A and E departments of the Imperial College Healthcare NHS Trust are performing at a level where about one in four people wait more than four hours, but at Christmas it was one in three. In neighbouring hospitals, performance has been as low as having half the people wait more than four hours—for example, at Northwick Park before Christmas. Let me read out what one constituent has written. He is the son of a 94-year-old woman and the following words say it all:

“She was seen by her GP…and he arranged for her to go to Charing Cross A & E department by ambulance and we arrived there at 6 pm. The department was extremely busy with people waiting in corridors due to a lack of beds.

Although it was not ideal I agreed with the doctor to start her treatment while she was sitting in the corridor. I say treatment but it was only preliminary things such as taking blood and inserting a line feed in her arm in order to administer antibiotics.

My mother is incontinent and needs help with going to the toilet. Because the staff were rushed off their feet she could not receive the help she needed in a timely manner.

It is obvious that the closure of the other A & E departments in West London has had an adverse effect on those that remain open.

It was not until about midnight”—

six hours later—

“that she was given a bed and a room of her own…where finally she was given an examination by another doctor.

At 1 am I left the hospital and returned the next morning to be told she was being transferred to Hammersmith Hospital because there were no beds available at Charing Cross.

I think you will agree that this level of care is unacceptable. While I cannot fault the staff at Charing Cross the whole Conservative policy of closures in West London is the worst political decision they have ever made.”

The point is that I could have been talking about anywhere in England, although in reality the situation in west London is much, much worse. Two of our A and E departments closed last September, and A and E figures plummeted after that. At last night’s meeting of the council committee that scrutinises Imperial College Healthcare NHS Trust managers, I asked whether they would now review—not cancel but simply review–their decision to close the A and E department at Charing Cross hospital, demolish that hospital, lose 93% of the in-patient beds and lose the best hyper-acute stroke unit in the country. Still they would not answer. They would not say yes and they would not say no. They are frozen; they cannot do anything but continue. Perhaps that is why the CQC said that all that trust’s hospitals requirement improvement, why the trust’s foundation status bid is on hold at the moment and why I and several of my west London colleagues have written to the Secretary of State to ask him to intervene. I am not holding my breath. Even though we represent more than 1 million people between us, he has done nothing and has not been willing to meet us for the past two years. That is a disgrace.

18:29

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to contribute to the debate. I thank the Opposition for bringing the matter to the House for consideration. The one thing that unites the whole House is a love of our health service. We have different opinions on either side of the House, but we are united by the need for an NHS that delivers services for our constituents.

It is important to look at the regional issues affecting our devolved Administrations, but a nationwide strategy for the overarching issues facing the whole of the UK is of paramount importance. My concerns relate to barriers to accessibility and the quality of NHS provision. I shall focus on the availability of vaccinations and the issue of nationwide strategies. Sometimes we should not be parochial about the NHS, but rather consider nationwide strategies that can be put into practice across the entire United Kingdom of Great Britain and Northern Ireland.

With the undeniable strain on NHS resources and their ability to provide services efficiently, quickly and to the high standard that we strive to meet, in the past few days the Northern Ireland Assembly announced an extra £203 million for the Department of Health, Social Services and Public Safety. That will alleviate some of the pressure, but there are continuing financial demands to provide the new drugs and new technologies that are vital for the provision of essential services. It is a great pity that as a result of Sinn Fein’s delay in agreeing welfare reform measures, fines were imposed, impacting upon the moneys available.

As other hon. Members have mentioned, mental health services are struggling to deliver urgent care, particularly for younger people. Some 17% of young people have been sectioned under mental health legislation since 2010. That is an indication of the issues that permeate our whole society. For those of us of a certain vintage and those of us who are younger, the issues of mental health are clear.

Cancer care is a subject close to my heart. One in every two of us is expected to have cancer. The devolved Administration in Northern Ireland have been maintaining funding for clinical trials that will benefit the whole of the United Kingdom, but it is a challenge to find the money for that. The statistics from Cancer Research UK emphasise the prevalence of the disease: every two minutes someone in the UK is diagnosed with cancer. The NHS must deliver the necessary care.

The Northern Ireland Budget has made promising provision for health. The demand for health care is greater in Northern Ireland than in the rest of the United Kingdom. How we deliver that care, how we manage our services, and what preventive strategies are in place are all crucial aspects. The problems affecting A and E departments in Northern Ireland are as acute as those in some parts of the mainland. Education campaigns in GP surgeries and on television and radio could encourage people to use A and E departments appropriately and to consider using the other systems that are in place.

In Northern Ireland we seek to increase the number of patients participating in clinical trials, but we need to maintain the funding for that and meet the costs involved, among the many other demands on the NHS budget.

I know that the Minister is usually responsive on the issue of cancer drugs, so in his summing up perhaps he will explain why six cancer drugs have been reduced, restricted or withdrawn and how that fits in with the strategy across the whole United Kingdom.

I want to put on record my thanks to our medical practitioners and nurses for the hard work that they do. Will the Minister consider increasing the number of agency staff on a contract basis to assist in alleviating the pressures on NHS services, or will he consider some sort of scheme whereby graduates are brought in to help them gain experience and training? This would not only benefit young people who need experience, but would put more staff on hospital wards and in A and Es, and could be financed from the existing budget.

18:34

[Yasmin Qureshi (Bolton South East) (Lab)]

I wish to start by thanking NHS staff. I agree with the Secretary of State that they should be recognised for all their work, so I ask him to consider giving them the 1% pay rise that has been recommended by an independent body. That would be a real way of recognising all their hard work.

I wish to talk about the Royal Bolton hospital in my constituency; it is the third largest accident and emergency department in the north-west. Last year, it saw 114,510 people. A and E admissions numbered 26,267 and in 2013-14, elective operations stood at 14,865 and non-elective at 1,407. The staff—porters, cleaners, care assistants and clinical staff—do an excellent job in a very difficult situation. My hospital needs more resources.

As I attend regular meetings with the chief executive officer and the chair of the Royal Bolton hospital, I also often visit the A and E department to see the situation at first hand. Recently, the hospital declared a major incident when it could not take in 76 patients. By cancelling non-emergency elective operations, it managed to free 40 beds. However, as a consequence of cancelling those operations, it lost £600,000.

As the hospital will now no longer be able to meet the target of the clinical commissioning group, it will end up getting penalised as well. To meet that target, the hospital may have to resort to using private companies, which may cost it even more. Whichever way we look at it, the hospital stands to lose quite a lot of money. Over the past two years, it has had to make £40 million of cost savings, and it will have to carry on cutting in light of the demands that it is facing.

The main reason for the long waits in A and E was that many people could not get GP appointments or go to walk-in centres, so they had to go to A and E as a first port of call rather than as a last one. Secondly, many elderly and frail people could not be discharged, which then led to bed blocking. There were 94,046 acute delayed days last November, which then created even bigger blockages. The hospital is caught bang in the middle of the problem—there are problems at the start, before people go to hospital, and there are problems at the end, because people are not being transferred or discharged. That situation must change. One reason for the delays in transfers and discharges is the cut in the budget for social services and adult care. More than 300,000 people no longer receive state funding for social care.

In 2009-2010, the Labour Government spent 8.2% of GDP on the NHS, whereas in 2013-14, the figure was 7.9%. It is quite clear, therefore, that less money is going into the sector. It has been recognised in this Chamber that, with more people living longer and with growing health needs, that money has to go up. To say that nothing further can be done with regards to putting more finance into hospitals is completely wrong.

In Bolton, the local authority, the hospital and the clinical commissioning group are trying to work together. When I recently visited my local A and E, 17 cubicles were in full use and two people were on trolleys. The situation is not good enough, because Bolton is an incredibly large area, serving about 300,000 people. People from Wigan and other surrounding areas also use the hospital.

Another problem is the shortage of GPs and the fact that walk-in centres have been closed down. We know that we need at least another 400 GPs and more walk-in centres. If we had an increase in those areas, the problem would not be so acute. Finally, not enough nurses are being trained, which will lead to a big shortage. That is another tsunami waiting to happen.

[Mr Speaker]

I am immensely grateful to the hon. Lady.

18:40

[Liz Kendall (Leicester West) (Lab)]

It is a privilege to speak in this debate, which has seen some passionate and thoughtful contributions about the NHS. Many hon. Members spoke about the pressures on their local ambulance services and A and E departments, including the hon. Member for Strangford (Jim Shannon) and my hon. Friends the Members for Barrow and Furness (John Woodcock), for Penistone and Stocksbridge (Angela Smith), for Heywood and Middleton (Liz McInnes), for Hammersmith (Mr Slaughter) and for Bolton South East (Yasmin Qureshi). The hon. Member for Stafford (Jeremy Lefroy) and my hon. Friends the Members for Jarrow (Mr Hepburn) and for Wirral South (Alison McGovern) spoke about the closure of walk-in centres, and difficulties in getting a GP appointment, which are piling pressure on their local hospitals.

My right hon. Friends the Members for Holborn and St Pancras (Frank Dobson) and for Rother Valley (Kevin Barron) described the terrible impact that this Government’s cuts to social care are having on elderly and disabled people, piling further pressure on the NHS, as Age UK’s excellent report showed yet again today. My hon. Friends the Members for York Central (Sir Hugh Bayley) and for Kingston upon Hull West and Hessle (Alan Johnson) spoke about the problems with child and adolescent mental health services, which have seen their constituents, like mine, sent thousands of miles away from family and friends to get treatment, which is terrible for them, terrible for their families and costs the taxpayer far more.

We have heard time and again during the debate how many of the long, hard fought-for gains achieved under the previous Government are being squandered before our eyes. When we left office, 98% of patients were seen within four hours in hospital A and E departments. Now that is down to 84%, with 180,000 patients having waited for more than four hours in the last month alone. In 2010, 80% of people could get a GP appointment within 48 hours; now one in four waits a week or more or cannot get an appointment at all.

The maximum 18-week wait for treatment has been missed for the last six months. Cancelled operations and delayed discharges from hospital have reached record highs in recent months. The vital cancer waiting target has been missed for the last nine months, meaning that 15,000 people have had to wait more than 62 days to start their cancer treatment. Anyone who has had a family member or friend wait for that treatment to start knows just how frightening that can be.

Ministers repeatedly claim that these problems are nothing to do with them and are simply the result of people living longer. But when our population is ageing, when more people are living with long-term chronic conditions and when the NHS faces the tightest financial settlement of its life, we should not cut the very services that help keep people out of hospital and living at home, which is better for them and better for the taxpayer. We should not remove the very incentives that improved GP access and close a quarter of walk-in centres, so that more people end up in A and E.

We should not slash social care budgets by £3.5 billion, so that half a million fewer of the most vulnerable older and disabled people cannot get help to get up, washed, dressed and fed. Forty per cent. fewer people get home adaptations such as grab rails, which prevent falls, and 220,000 fewer people get meals on wheels. We should not cut 2,000 district and community nurses, who are essential to helping elderly people get back home from hospital, and prevent people with long-term conditions ending up in hospital in the first place. We should not cut training places, so that hospitals are now spending £2.5 billion on more expensive agency staff and hospitals such as mine in Leicester have had to recruit 260 nurses from Spain and Portugal.

Moreover, as my hon. Friend the Member for Dudley North (Ian Austin) and my right hon. Friend the Member for Tottenham (Mr Lammy) so powerfully explained, we should not force through the biggest back-room reorganisation in the history of the NHS, wasting £3 billion, distracting the entire system, making thousands of people redundant only to re-employ them elsewhere in the system, and creating even more layers of bureaucracy, so that no one knows who is responsible or accountable for leading the changes that patients need on the ground.

In case the House needs reminding, I should say that the Government have created not only NHS England, alongside Monitor, the Care Quality Commission and the Trust Development Authority, but regional NHS England teams, local area teams and commissioning support units, as well as clinical commissioning groups and health and wellbeing boards. No wonder there is so little leadership in the system.

Labour Members make no apology for holding this Government to account for their record. After all, their Prime Minister promised people that his top priority in government could be summed up in three letters: NHS. I would hate to see what happened in a service he is not so bothered about.

Labour Members know that people want hope—the hope that there is a proper plan to get the NHS back on track. That is exactly what Labour will deliver. We have set out our plans for immediate action to ease the strain on A and Es by making sure that there are enough GPs in emergency departments and enough clinicians on NHS 111; stopping walk-in centres from closing; getting nurses to return to practice; and making sure that councils, the NHS and voluntary organisations identify the older people who are most at risk of going into hospital so that they get the right support to stay at home.

We have also set out a long-term plan for investment and reform so that our care services are fit for the future. We will provide an extra £2.5 billion on top of this Government’s plans to get the GPs, nurses and home care workers we need to transform services in the community and at home.

[Mr Stewart Jackson (Peterborough) (Con)]

Despite the £40 million structural deficit and a dodgy PFI deal that the right hon. Member for Leigh (Andy Burnham) shackled my local hospital to, in the past four years we have increased the number of nurses by 14% and the number of doctors by 9%. On the subject of apologies, would the hon. Lady like to apologise for her party’s dodgy £63 billion encumbrance of PFI off-balance-sheet deals that have been forced on my constituents and others?

[Ian Austin]

On a point of order, Mr Speaker. Is it in order for someone who has not been in the debate at all this afternoon to stand up and make these sorts of points during the wind-ups?

[Mr Speaker]

There is no breach of order; that is a matter of taste and judgment for individual Members.

[Liz Kendall]

I make no apology for my party’s record on the NHS. When we came into government, people were dying on waiting lists for operations. People could not get to see their GPs, and mental health services had suffered. I would have thought that the hon. Gentleman would be pro reforms that help to keep his elderly constituents at home and oppose the cuts to social care that make that so much more difficult.

We have set out our plans to bring together physical, mental and social care across primary and secondary services in a single service to deliver truly personalised care and support, shift the focus to prevention, and get the best value for taxpayers’ money. We are going to help family carers get the health checks and breaks they need to stop them from reaching crisis point, and give them one point of contact with care services so that they do not have to battle all the different services.

We have a radical programme to improve public health, which is the biggest long-term challenge we face, by helping people to do more to help themselves: setting limits on sugar, salt and fat in food marketed to children; improving food labelling to tackle the impending obesity crisis; and taking tough action on tobacco, which this Government have abjectly failed to do. We have a bold national ambition to transform physical activity in our schools, communities and workplaces. That is what we need to put the NHS on a sustainable track in future by making sure that the health of our population improves.

People want a serious Government who face up to the problems in the NHS, not deny they exist or try to sweep them under the carpet. They want a Government who will deliver the real investment and real reforms we need to make sure that our care services are fit for the future. They want competence, not chaos, and a long-term plan that puts the NHS on the real road to a strong recovery. That is what Labour will deliver. I commend this motion to the House.

18:49

[The Minister of State, Department of Health (Norman Lamb)]

The NHS across the UK, including urgent and emergency care services, is facing enormous challenges. By the end of this Parliament, there will be nearly 1 million more over-65s than there were at its start, which means substantially more patients with more complex health needs, but such pressures are not unique to England. All hon. Members need to think very carefully about how we pursue the debate on the challenges and pressures that the NHS is facing. Patients and the NHS do not need or want cynicism and party point scoring. My right hon. Friend the Member for Chelmsford (Mr Burns) and my hon. Friend the Member for Cambridge (Dr Huppert) were absolutely correct to make that point.

[Sarah Newton]

Does my right hon. Friend agree that the pioneer programme in Cornwall is really leading the way, with the provisional results showing a 41% reduction in A and E and in-patient visits?

[Norman Lamb]

My hon. Friend makes a very good point. The Cornwall pioneer programme is doing the most amazing work making innovative change, involving Age UK alongside local doctors, and it is delivering real results.

Why does the Labour party make constant claims that the NHS in England is in crisis, when the position is so much worse in Wales, where Labour is in power?

[Ian Austin]

Will the Minister give way?

[Norman Lamb]

In a moment.

Why does the Labour party claim that the reforms are to blame when there has been no reform in Wales, yet the position there is worse? What people need and want is an open and honest debate about what should be done to secure the future of the NHS. The motion is about the pursuit of votes, not the interests of patients. If Labour Members—

[Several hon. Members]

rose—

[Norman Lamb]

Let me make this point.

If Labour Members are concerned about the interests of patients, why do they not agree to the suggestion by Professor Bruce Keogh, a respected clinician, for an investigation into safety in the Welsh NHS? Why do they remain silent?

[Andy Burnham]

The Minister accuses us of bringing politics into the NHS, but did not he and his colleagues put politics at its heart when they signed up to a Tory agenda to put market forces at the heart of the national health service?

[Norman Lamb]

That is absolute rubbish. Indeed, one of the right hon. Gentleman’s predecessors, the right hon. Member for Hull West and somewhere—

[Mr Speaker]

The right hon. Member for Kingston upon Hull West and Hessle, rather than “somewhere”.

[Norman Lamb]

I apologise, Mr Speaker. The right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson) spoke very candidly about the role of the private sector under the previous Labour Government, which the shadow Secretary of State constantly seeks to deny.

[Ian Austin]

Will the Minister give way?

[Norman Lamb]

No. I need to make progress, and I have very little time.

In a Guardian debate yesterday, in which I took part, Peter Carter, the respected chief executive of the Royal College of Nursing, spoke of the need for political consensus

“so that we stop this ridiculous points-scoring”,

which

“frankly is destructive and does nothing to enhance the quality of the debate.”

Let us take his plea on board. I have argued for a non-partisan review of NHS and care budgets this year —whoever is in power—which would engage the public. We should all commit to that.

Labour claims that it will increase funding, but its proposed way of doing so appears to be unravelling before our eyes. Lord Mandelson has described the mansion tax as “sort of crude” and “sort of short-termist”. In the debate, the hon. Member for Hackney North and Stoke Newington (Ms Abbott) cast doubt on how much the policy would raise.

Before I address the main issues, I want to pick up the remarks made by the right hon. Member for Kingston upon Hull West and Hessle, who raised important issues about mental health. He talked about the case of his constituent, Beth. It is intolerable that she has been shunted around the country. I have met the right hon. Gentleman, and I am happy to engage with him again. It is unacceptable for this to continue to happen. That is why there is an urgent need for children’s mental health services to be reformed, and our taskforce will soon report on the essential changes that are necessary.

[Liz Kendall]

Will the Minister give way?

[Norman Lamb]

I do not have time.

I am pleased that the right hon. Member for Kingston upon Hull West and Hessle endorsed the case for access and waiting times standards in mental health, which I think will have the same transformative effect as they had in cancer care when his party was in government. As my hon. Friend the Member for Norwich North (Chloe Smith) said, why is mental health not in the motion? It certainly ought to be.

[Liz Kendall]

Will the Minister give way?

[Norman Lamb]

Let me make this point.

I acknowledge that several Members, including the hon. Members for Penistone and Stocksbridge (Angela Smith) and for Barrow and Furness (John Woodcock), raised distressing cases. I offer my personal sympathies to everyone who has been let down by the system. Such cases should motivate us all to strive to do everything that we can to improve how our NHS operates and to address the areas where it falls short.

The Opposition claim that the move from NHS Direct to NHS 111 has increased the demand faced by accident and emergency departments. There is no evidence to support that claim. Only 8% of calls result in a recommendation to go to A and E, and 30% of callers say that they would have gone to A and E if NHS 111 had not been available.

An accusation has been made about the impact of local authority cuts on social care. I remind the Labour party that the Government were faced with a £160 billion black hole in the public finances and had to act to sort that out. There is still no proposal from the Labour party to increase the funding for social care. The claims that it makes are hollow, without the money to go with them.

Let us look at one of the key indicators: delayed discharges from hospital. From August 2010 to November 2014, delayed days attributable solely to social care decreased from 38,324 to 37,000. The position is not as simple as some people suggest. Social care is performing incredibly well under difficult circumstances. In Cambridgeshire, there is the brilliant development of a service for older people to address their needs in innovative ways.

It has been claimed that the closure of walk-in centres has led to the current pressures on A and E. Again, we need to look at the evidence. A report by Monitor found that the reasons why local commissioners decided to close walk-in centres included that they were replacing them with urgent care centres co-located with A and E departments or other models of integrating primary care staff in A and E departments. The situation is not as simple as is suggested by the claim that walk-in centres have been closed and A and E has been left to pick up the burden.

The Opposition have said that the ambulance service is failing. In fact, ambulance services nationally are delivering nearly 2,000 more emergency journeys every day than in 2010. Ambulances respond to the majority of life-threatening cases in less than eight minutes. The Government have provided an additional £50 million to support ambulance services through this winter. It is right to take clinical advice to ensure that target response times are clinically based to avoid the unintended consequences of ambulance crews being driven crazy in the pursuit of targets, when it is patient safety that should be prioritised.

I come to the solution. In the short term, the Government have made an additional £700 million available to the NHS to cope with the pressures this winter. The right hon. Member for Tottenham (Mr Lammy) did at least acknowledge that. In the longer term, we need to focus on stopping the crises from occurring in the first place. We need a much greater focus on prevention, better integration of health and social care, and the implementation of Simon Stevens’s forward view.

I thank NHS staff for the amazing work that they do, often under great pressure, and the tremendous commitment that they make. We owe it to them and to the public to ensure that our NHS is protected and enhanced. Most people who use urgent and emergency care services receive effective, timely treatment. That is as it should be. Patients and their families should get the right advice and should get a response when they need it. We set the toughest standards in the world, and rightly so. We all know that those standards are under pressure across the UK, so let us be open and honest about that.

[Mr Alan Campbell (Tynemouth) (Lab)]

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Main Question accordingly put.

18:59

Division 135

Ayes: 228

---

Labour: 215
Scottish National Party: 5
Plaid Cymru: 3
Independent: 1
Green Party: 1
Democratic Unionist Party: 1

Noes: 312

---

Conservative: 267
Liberal Democrat: 44

Deferred Divisions

Wednesday 21st January 2015 Commons Chamber

Motion made, and Question put forthwith (Standing Order No. 41A(3)),

That, at this day’s sitting, Standing Order 41A (Deferred divisions) shall not apply to the Motion in the name of Secretary Theresa May relating to the Prevention and Suppression of Terrorism.—(Mr Wallace.)

Question agreed to.

Prevention and Suppression of Terrorism

Wednesday 21st January 2015 Commons Chamber

19:16

[The Minister for Security and Immigration (James Brokenshire)]

I beg to move,

That the draft Terrorism Act 2000 (Proscribed Organisations) (Amendment) Order 2015, which was laid before this House on 19 January, be approved.

Seventeen people were killed and a number injured in the appalling attacks in Paris earlier this month, while in December we saw deadly and callous attacks in Sydney and Pakistan. There can be no doubt that the terrorist threat we face is grave and relentless. The threat level in the UK, which is set by the independent Joint Terrorism Analysis Centre, remains at “severe”, meaning that a terrorist attack in our country is highly likely and could occur without warning.

We can never entirely eliminate the threat from terrorism, but we are determined to do all to minimise the threat from terrorism to the UK and our interests abroad, and proscription is an important part of the Government’s strategy to disrupt terrorist activities. The two groups we propose to add to the list of terrorist organisations, amending schedule 2 to the Terrorism Act 2000, are Jund al-Aqsa, also known as the Soldiers of al-Aqsa, and Jund al-Khalifa-Algeria, also known as the Soldiers of the Caliphate. This is the 17th proscription order under the Act.

Under section 3 of the Terrorism Act 2000, the Home Secretary has the power to proscribe an organisation if she believes it is currently concerned in terrorism. Given its wide-ranging impact, the Home Secretary exercises her power to proscribe only after thoroughly reviewing the available evidence on the organisation. The cross-Government proscription review group supports the Home Secretary in her decision making process. Having carefully considered all the evidence, the Home Secretary believes that Jund al-Aqsa and Jund al-Khalifa-Algeria are both currently concerned in terrorism.

Jund al-Aqsa is a splinter group of the al-Nusra front, al-Qaeda’s affiliate in Syria. Since September 2013, the group has acted against the Syrian Government. It is a foreign fighter battalion comprising a variety of nationalities, as well as a native Syrian contingent. The group is primarily operating in Idlib and Hama. It is believed to be responsible for the attack on 9 February 2014 in Maan village, which killed 40 people, of whom 21 were civilians. In July 2014, it supported the Islamic Front in an operation to seize Hama military airport. In August 2014, the al-Nusra front released a document summarising its operations that included details of an attack targeting a resort hotel conducted in collaboration with Jund al-Aqsa.

Jund al-Khalifa-Algeria is an Islamist militant group believed to be made up of members of dormant al-Qaeda cells. It announced its allegiance to the Islamic State of Iraq and the Levant in a communiqué released on 13 September 2014. In April 2014, it claimed responsibility for an ambush on a convoy that killed 11 members of the Algerian army. On 24 September 2014, the group beheaded a mountaineering guide, Hervé Gourdel, a French national. The abduction was announced on the same day that the spokesman for ISIL warned that it would target Americans and other western citizens, especially the French, after French jets joined the US in carrying out strikes in Iraq on ISIL targets.

In conclusion, I believe it right to add both groups to the list of proscribed organisations in schedule 2 to the Terrorism Act 2000. Subject to the agreement of this House and the other place, the order will come into force on Friday 23 January.

19:20

[Diana Johnson (Kingston upon Hull North) (Lab)]

I thank the Minister for his statement and I am grateful for the Home Secretary’s letter to my right hon. Friend the shadow Home Secretary. On the basis of the Minister’s statement and that letter, the Opposition will support the Government’s motion.

We recognise, of course, that events in Syria, Iraq and northern Africa are fuelling a rapidly evolving network of inter-related terror groups who pose a real threat to the UK and our allies. It is absolutely right to use all legal measures to try to counter the spread of these groups and to ensure that they cannot establish themselves in the United Kingdom.

In this case, we have two groups with close links to other proscribed groups. Jund al Khalifa-Algeria is an Algerian-based Islamic militant group, linked to al-Qaeda and hoping to establish a caliphate in northern Africa. The group is affiliated to the Islamic State of Iraq and the Levant. Secondly, Jund al-Aqsa or Soldiers of al-Aqsa is a splinter group of the al-Nusra front, and it is just three months since we proscribed JKI—Army of the Islamic Caliphate, another splinter group of the al-Nusra front. In common with the al-Nusra front, the JAA is largely based in Syria, and as a group has attracted many jihadists from outside Syria. JAA started out as a campaign against the Syrian Government, but in recent attacks the group has seemed happy to target innocent civilians.

At this point in a proscription order, I normally have to conclude that we will take the assurances of the Home Secretary that she has sufficient evidence that the groups are conducting the activities described. This is obviously because the Opposition do not have access to the same intelligence as the Government. In this case, however, there is no need to see sensitive information to conclude that these are terrorist groups. Far from hiding their activities, they are actively boasting about them on social media, using YouTube, Facebook and Twitter to spread images of the most horrendous violence, alongside messages justifying it. These are not groups that want to hide; these are groups that are actively recruiting.

The JAA YouTube channel was opened on the 28 July 2014, apparently replacing a previous YouTube channel that had been closed down. The latest Twitter account opened in September in English, again replacing an account that had been closed down. The English Twitter account—we looked at it just yesterday—has 1,460 followers. Tweets declare fallen supporters to be martyrs, and there are links to YouTube videos and other Twitter pages run by JAA. One of these pages is the official JAA Twitter page in Arabic, which has some 17,500 followers.

The videos on the YouTube channel are even more disturbing. Let us take, for example, the video uploaded on to the official JAA channel on 21 September 2014. This video depicts JAA fighters engaging with Government forces—kicking, hanging, abusing the bodies of the dead and taking part in training exercises. It seems quite clear that this video is intended to glorify grotesque violence as a form of extremist propaganda. This video has been viewed 13,000 times, attracted 40 comments and has been “liked” on the YouTube rating system 96 times.

I have met Google in the past to discuss YouTube’s hosting of terrorist propaganda, and it is supposed to be taking down extremist content when it comes across it. The Home Office’s counter-terrorism internet referral unit is also supposed to be identifying this content and getting it taken down. Here, however, is a whole YouTube channel run by, as we know, a known terrorist organisation and including sermons advocating terrorism and videos of violent terrorist acts attracting thousands of views.

At one level, there is an irony that these extremist terrorist groups, rallying against western consumerism, are happy to use these enormous western companies to spread their message of hate, but there is also a very serious point. As the Minister said in an earlier speech to the House, the

“effect is that a listed organisation is outlawed and is unable to operate in the UK. It is a criminal offence for a person to belong to…support…arrange a meeting in support of a proscribed organisation, or wear clothing or carry articles in public which arouse reasonable suspicion that an individual is a member or supporter of a proscribed organisation.”—[Official Report, 2 April 2014; Vol. 578, c. 948.]

A very brief look at what was available on social media enabled me to come across deeply offensive and worrying videos and tweets. I am very pleased that we are proscribing the organisations that produced them, but I think that the Minister should bear in mind that social media companies are making such videos and tweets available for everyone to see, and consider what more can be done about those companies.

19:25

[Keith Vaz (Leicester East) (Lab)]

I will be very brief.

As is normal in the case of proscription orders, the whole House is united in support of what the Government are doing. As far as I can remember, no order of this kind has ever being opposed, because we trust and accept the good faith of the Minister when he tells the House that dreadful organisations are seeking to propagate terrorism, which is indeed true.

I am glad that my hon. Friend the Member for Kingston upon Hull North (Diana Johnson) raised the issue of the internet. As the Prime Minister said recently, it is the “dark net” that gives so much succour to those who are indulging in terrorist activities. The Home Affairs Committee has tried to encourage internet companies to take firmer action on many occasions, but, as the Minister knows, this material is still on the net as we speak.

Many organisations such as those that we are proscribing today recruit through the net. In the past, there was one-to-one grooming of those who wished to become jihadists; that activity then moved to the madrassahs and then to the universities, and it is now taking place in our prisons. It is, however, the internet through which organisations that seek to change the face of Governments —in Algeria, in particular—are operating.

I hope that the Minister will continue to do what I know he has started to do, and ensure that the net is free from these agents of destruction. I am happy to support the order.

19:27

[Sir Hugh Bayley (York Central) (Lab)]

The hour is late, and I do not intend to detain the House. I think that the Government are right to proscribe Jund Al-Aqsa and Jund al-Khalifa-Algeria. However, as was pointed out by my hon. Friend the Member for Kingston upon Hull North (Diana Johnson), it is important not just to proscribe terrorist organisations, but to work to reduce their influence—and, indeed, that of other organisations that the Government may be forced to proscribe in months to come—on young people in our country.

The protest that took place on the Sunday after the appalling killings in Paris united the whole of Europe, and people from beyond Europe. It is difficult to think of any other demonstration that could have brought together the President of Palestine and the Prime Minister of Israel, who walked side by side. However, if we are to prevent young minds in this country from being poisoned by propaganda of this kind—particularly through the web—it is important for us to work with Muslims in this country. The vast majority of them have absolutely no truck with violence, which they consider to be a denial of the principles of Islam, but we need to ensure that they counter, within their own community, the lies and falsehoods that the terrorists are propagating.

More Muslim parents are talking to me in York, which does not have a particularly large Muslim population. They tell me that they want more to be done to deflect young people from these dangers. I hope that the Minister will say a little about what the Government are doing in relation to Muslims in this country.

19:30

[James Brokenshire]

With the leave of the House, and in thanking right hon. and hon. Members for their support for the order this evening, let me respond first to the shadow Minister, the hon. Member for Kingston upon Hull North (Diana Johnson). Yes, of course we are vigilant in seeking to combat the use of messages on Facebook, YouTube, Twitter or any other social media platform, including the new ones that appear. That is precisely why we have the counter-terrorism internet referral unit with which the hon. Lady will be familiar. It has taken down 72,000 individual items since it was established in 2010. She highlighted a video and the original has been removed, but it continues to be put up in different places. That is why we have the CTIRU to flag that and to work with industry to take it down.

The hon. Lady and other right hon. and hon. Members made a broader point about the role and responsibility of the internet industry. We are obviously flagging these items, but the industry has a responsibility to take action when it identifies such images. A number of companies do that, but there is more to be done for them to realise their responsibilities and take further action. Indeed, the Prime Minister’s comments on this subject after the publication of the Intelligence and Security Committee’s report on Woolwich identified that challenge and how we all need to do more. The social media companies and the internet industry certainly need to do more.

I entirely endorse the comments made by the hon. Member for York Central (Sir Hugh Bayley) about working with communities. That is precisely the approach the Government take. We are seeking to ensure that we challenge ourselves on what more we can do and that is why the provisions in the Counter-Terrorism and Security Bill, which is currently in the other place, put on a statutory basis our work on counter-radicalisation and the Channel de-radicalisation programmes.

We are doing work in government, but there is also work in communities. Some incredible British Muslims are taking a stand and showing leadership, such as the 100 imams who wrote a letter condemning the actions of ISIL and groups such as Families Against Stress and Trauma. Through their programmes, there is an outlet that prevents people from being radicalised and going down that pathway. This is clearly a broader and wider debate. We have debated some of it on the Counter-Terrorism and Security Bill, but proscription can be an important way for the police to get further evidence, which can lead to prosecution of those who belong to groups that are not proscribed.

I am grateful to the House for the support it has shown this evening. I hope that we will remain vigilant, whether online, in communities or more broadly, to ensure that we do our utmost to protect our country and our citizens and to confound and confront those who would do us harm.

Question put and agreed to.

Business without Debate

Wednesday 21st January 2015 Commons Chamber

Delegated Legislation

Motion made, and Question put forthwith (Standing Order No. 118(6)),

Social Security

That the draft State Pension Regulations 2015, which were laid before this House on 26 November 2014, be approved.— (Mr Wallace.)

Question agreed to.

[Madam Deputy Speaker (Mrs Eleanor Laing)]

With the leave of the House, we shall take motions 5 to 8 together.

Motion made, and Question put forthwith (Standing Order No. 118(6)),

Social Care

That the draft Care and Support (Market Oversight Criteria) Regulations 2014, which were laid before this House on 3 December 2014, be approved.

That the draft Care and Support (Business Failure) Regulations 2014, which were laid before this House on 3 December 2014, be approved.

That the draft Care and Support (Eligibility Criteria) Regulations 2014, which were laid before this House on 3 December 2014, be approved.)

That the draft Care and Support (Children’s Carers) Regulations 2014, which were laid before this House on 3 December 2014, be approved. —(Mr Wallace.)

Question agreed to.

Motion made, and Question put forthwith (Standing Order No. 118(6)),

Road Traffic

That the draft Motor Vehicles (Wearing of Seat Belts) (Amendment) Regulations 2015, which were laid before this House on 8 December 2014, be approved. —(Mr Wallace.)

Question agreed to.

[Madam Deputy Speaker]

With the leave of the House, we shall take motions 10 to 12 together.

Motion made, and Question put forthwith (Standing Order No. 118(6)),

Energy

That the draft Renewable Heat Incentive Scheme (Amendment) Regulations 2015, which were laid before this House on 15 December 2014, be approved.

That the draft Domestic Renewable Heat Incentive Scheme (Amendment) Regulations 2015, which were laid before this House on 15 December 2014, be approved.

That the draft Renewable Heat Incentive Scheme and Domestic Renewable Heat Incentive Scheme (Amendment) Regulations 2015, which were laid before this House on 15 December 2014, be approved.—(Mr Wallace.)

Question agreed to.

Rules on marches and demonstrations

Wednesday 21st January 2015 Commons Chamber

19:34

[Sarah Champion (Rotherham) (Lab)]

I am presenting this petition on behalf of the businesses and residents of Rotherham who have signed a paper and online petition to try to get the Government to recognise the devastating impact repeat marches in our town centre on Saturdays are having on our economy and sense of community.

The petition states:

“The Petitioners therefore request that the House of Commons urges the Government to consider the rules regarding marches and demonstrations, including looking specifically at the thresholds that are used to ban marches and demonstrations so that they include a provision to consider the economic impact of such marches as well as looking at the restrictions that are in place on the frequency, location, time or date of marches and demonstrations.”

Following is the full text of the petition:

[The Petition of residents of the UK,

Declares that the threshold to ban marches and demonstrations is currently measured in terms of public safety, not economic impact; further that there are currently no restrictions on the frequency, location, time and date of marches; further that the Petitioners believe that marches and demonstrations are having an impact on the lives and trades of residents in Rotherham; further that the Police and local council in Rotherham have tried their best to minimise the disruption to traders in Rotherham of marches and demonstrations to ensure that businesses stay open; further that when marches and demonstrations occur in Rotherham significant parts of the town have to close; further that the Petitioners believe such protests and marches are having a devastating impact on local communities; and further that a local petition in Rotherham on this subject has received nearly 300 signatures.

The Petitioners therefore request that the House of Commons urges the Government to consider the rules regarding marches and demonstrations, including looking specifically at the thresholds that are used to ban marches and demonstrations so that they include a provision to consider the economic impact of such marches as well as looking at the restrictions that are in place on the frequency, location, time or date of marches and demonstrations.

And the Petitioners remain, etc.]

[P001425]

Standardised Packaging (Tobacco Products)

Wednesday 21st January 2015 Commons Chamber

Motion made, and Question proposed, That this House do now adjourn.—(Mr Wallace.)

19:35

[Ann McKechin (Glasgow North) (Lab)]

There are now only a few weeks until Parliament dissolves, but tonight I want to urge the Government, even at this eleventh hour, to do something that can save hundreds, if not thousands, of people across the country from a premature death. They still just have the time to undertake one major reform that they promised long ago: the introduction of plain packaging for cigarettes. However, despite almost three years of consultations and reviews and clear evidence both at home and abroad to support regulation there has been a deafening silence for over eight months. Why is the Prime Minister prevaricating? I hope the Minister can answer that question this evening and show her resolve to be serious about this nation’s public health.

We have debated this issue many times but the need for tonight’s debate is simple: plain packaging works. Too many people suffer from diseases brought on by smoking and too many young people are still picking up the habit for the issue to be ignored until after the election.

Sadly, my own city, Glasgow, has one of the worst records for smoking-related premature deaths in the country. Of those who take up smoking, only about half will manage to stop before they die, and two thirds of current smokers started before they were 18 years old, so the early teenage years are the key period to hook people into the habit.

The cost to patients, their families and our NHS is still too high despite the considerable improvements in treatments and drugs over recent years. In Glasgow, according to the latest Scottish Public Health Observatory’s tobacco control profile there were over 1,900 deaths from lung cancer in 2012 alone and almost 47,000 smoking-attributable hospital admissions over that year. Almost 28% of the city’s population smokes against the Scottish national average of 23%. Even a small percentage drop in those figures would make a really big difference to a lot of people, save lives and alleviate the pressure on our health services.

Successive Governments over recent years have put in place a range of measures to assist public health. Duty on cigarettes has been routinely increased in Budgets above the prevailing rate of inflation and this has undoubtedly made a significant difference. However, the impact is clearly plateauing and there is evidence that in the poorest communities in particular the rise of the black market in cigarettes could be acting as a block on further smoking reduction.

Increasingly, non-economic measures need to be introduced to further limit the habit, the most obvious being the ban on smoking in public places. It was not without controversy when introduced, but with Scotland taking the lead it has transformed our communities, reducing overall smoking levels. It has been of benefit to workers and non-smokers alike, but if we are honest the smoking ban has also led to more people switching their drinking, and in turn smoking, habits to a domestic setting, rather than necessarily quitting.

Cessation services via GPs and local councils have become better organised and more comprehensive. The Local Government Association in England is producing a new report this weekend on cessation services, but has informed me that councils are committed to spending over £140 million in England on cessation services this year, and this is undoubtedly a sound investment.

The Government are to be commended for taking forward the legislation introduced by the previous Labour Government to prohibit the display of tobacco products at the point of sale, with all shops being subject to the ban by April this year. This, along with the ban on public advertising, has helped to change perspectives about the normality of smoking.

We know that children and young teenagers can be influenced by a complex range of factors and we must do more to protect them against the harm that smoking brings. Attractive colours and packaging have a strong influence on young people, and tobacco companies have not been slow to find other, indirect ways of promoting their products. In a presentation to an industry conference back in 2006, Imperial Tobacco’s then global brand director, Geoff Good, acknowledged that the tobacco advertising ban had

“effectively banned us from promoting all tobacco products”,

but noted that

“the marketing team have to become more creative…We therefore decided to look at pack design.”

In fact, the industry was even happy to admit this in its response to the Government’s consultation on the future of tobacco controls. Philip Morris stated in its response that

“packaging is an important means…of communicating to consumers about what brands are on sale and in particular the goodwill associated with our trademarks, indicating brand value and quality…placing trademarks on packaged goods is thus at the heart of commercial expression”.

I struggle to imagine what the good will of a cigarette might actually amount to, but there is no doubt that the industry has exerted enormous pressure to stop this move.

It is no coincidence that the colours and graphics used on these packs are designed to attract new and younger users, and research shows that this increased emphasis has had an effect. Between 2002 and 2006, there was an increase in the proportion of young people aware of new pack design from 11% in 2002 to 18% in 2006. As the Minister is well aware, the systematic review commissioned by her own Government of 37 different studies provided evidence of the impacts of plain packaging. Each of the 19 studies that examined perceptions of attractiveness found that standard plain packets were rated as less attractive than branded packs. The studies also showed that the awareness of health risks was higher with standard packaging. Younger respondents were more likely to perceive that standard packs would discourage the take-up of smoking. All those findings back up the case that such a change would have an impact on young teenagers who were tempted to smoke.

In Australia, where plain packaging legislation was introduced in 2012, smoking rates have fallen dramatically. Daily smoking levels are at an historic low of 12.8%, and the average number of cigarettes smoked is now just 96 per week, compared with 111 in 2010. Fewer young people in Australia are trying cigarettes, and those who do so start at a higher age than in the past. Opposition to plain packaging among the public has also fallen steeply since the legislation came into force.

Some have argued that such a move will open the doors to a massive black market, and I note that that allegation has been reported in The Daily Telegraph in the past week. However, the main driver of black markets is economic: the difference between the actual value of the good and the price set for the consumer. It should not be beyond the wit of the authorities to devise a form of unique marking to stem counterfeit products. As the Minister will be aware, Sir Cyril Chantler stated in his report last year that he had found

“no convincing evidence to suggest that standardised packaging would increase the illicit market”.

The Trading Standards Institute has helpfully advised me today that, having reviewed the proposed regulations, it understands that standardised packs will retain the same security features as those found on existing tobacco packaging. It is the institute’s professional view that standardised packs would provide no new challenges in terms of detecting illicit products.

We know from what has occurred in Australia that tobacco companies have been forceful in pursuing their opposition at every step of the way. On the day that the Australian Government passed their legislation, Philip Morris and a number of other producers immediately launched a lawsuit to challenge the law. That challenge was rejected by the Australian domestic courts in 2012, but Philip Morris was not prepared to give up. In addition to taking the domestic action, it rearranged its assets in order to become a Hong Kong investor and use the 1993 bilateral trade agreement between the two countries to initiate an investor dispute arbitration. That case is due to be heard next month in Singapore, behind closed doors.

In addition, the company helped to finance a separate World Trade Organisation action brought against Australia by five tobacco-producing states. Australia refused each of those countries’ first requests, as allowed under WTO rules, but Ukraine made a second request in September 2012, which led to the establishment and composition of a dispute panel. The panel was composed in May 2014, but no report has been adopted and this matter is still outstanding. Similar industry pressure in New Zealand led by British American Tobacco has led to a long postponement, despite the fact that the legislation was introduced in its Parliament more than a year ago.

Using the same ISDS dispute procedure that the UK Government are so keen to support in the current EU-US negotiations on the Transatlantic Trade and Investment Partnership—TTIP—Philip Morris is suing tiny Uruguay over its decision to increase the size of health warnings on cigarette packets from 50% of the cover to 80%. We now await the outcome of this David and Goliath struggle, but it does raise the question as to why our Government are not more questioning of the possible impact of investor-state dispute settlement clauses on our public health policy, given the lengths that the tobacco industry is clearly prepared to take.

We need the UK to be brave—to face up to the industry giants and act in the interests of the public we serve. The Minister will be aware that the Scottish Government have sensibly agreed that legislation should be brought in throughout the UK at the same time and have given their assent to regulations being brought in by this Government covering Scotland, too. I want her assurance tonight that she will act on this agreement to give the boost to public health that is so needed in my city.

Over the past few years there have been several well-supported public campaigns calling on MPs to act, and recent polling has shown that a majority of the public are in favour of this proposal.

[Sir George Young (North West Hampshire) (Con)]

The hon. Lady will be aware that a range of views may be held among Government Members, but may I assure her that within my party there is a strong body of opinion supporting what she is saying and joining her in urging the Government to take action?

[Ann McKechin]

I am grateful to the right hon. Gentleman for his support tonight. This matter should, I hope, elicit cross-party support, because the health of our young people is a key issue that all of us should be deeply concerned about.

[Mark Lazarowicz (Edinburgh North and Leith) (Lab/Co-op)]

I am grateful to my hon. Friend for making a powerful speech tonight. May I take her back to an earlier point at the beginning of her speech and highlight the fact that if this measure is not introduced by the Government soon, it will be delayed until probably after the summer, as a result of which, indirectly, thousands of lives will be lost?

[Ann McKechin]

Yes. As I have said before, half those who take up smoking will not be able to stop, and we know that every week hundreds of teenagers across the UK take up the smoking habit. So every week that we delay has a direct health impact in our local communities.

The Minister’s own review, the Chantler review, concluded when it reported in early April last year that branded packaging plays an important role in encouraging young people to smoke and in consolidating the habit, irrespective of the intentions of the tobacco industry and that the body of evidence showed that plain packaging is very likely to lead to a modest but important reduction over time on the take-up and prevalence of smoking. The Minister is already on the public record as accepting that standardised packaging is

“very likely to have a positive impact on public health”—[Official Report, 3 April 2014; Vol. 578, c. 1018.]

and as wanting to proceed as swiftly as possible. I have no reason to doubt her intentions, but time is running out.

The Prime Minister must allow Parliament to vote on plain packaging regulations before the election. He must heed the advice of health professionals, 4,000 of whom signed an open letter to The Guardian demanding urgent action, and ignore the protestations of his Australian spin doctor Lynton Crosby, whose tobacco industry links are said to have scuppered the push for plain packaging in 2012 when the Government pushed the issue into the long grass. Too many people are needlessly dying prematurely because of smoking and too many young people are still being hooked.

[Paul Burstow (Sutton and Cheam) (LD)]

This is a very important debate. As the chair of the all-party group on smoking and health, may I say to the hon. Lady that what we need to hear from the Minister tonight is that the Government write-around has started and that the regulations will be laid, so that we can have a vote?

[Ann McKechin]

The right hon. Gentleman is right about that, because these regulations, which need to be laid by the end of this month if they are to be approved in time by the Joint Committee on Statutory Instruments and the Secondary Legislation Scrutiny Committee. That is why we need to use the precious time that we have in this Parliament between now and the end of March to save lives and reduce the burden on the national health service. I hope the Prime Minister, his Government and the Minister who responds will listen to that call and start to act on behalf of everyone.

19:49

[Dame Angela Watkinson (Hornchurch and Upminster) (Con)]

I draw Members’ attention to my entry in the Register of Members’ Financial Interests. I thank the hon. Member for Glasgow North (Ann McKechin) for allowing me to make a brief contribution during her debate—doubly so, because she did not withdraw her permission when I told her that I was going to disagree with her. Similarly, I thank the Minister.

I speak as a lifelong non-smoker. That is my choice, and it is a choice open to everybody. Nobody is forced to smoke. The Government have already invested heavily in existing strategies: television adverts, which were extremely effective—particularly the one about not smoking in front of children in one’s car—street hoardings, newspapers and magazines, smoking cessation treatment free of charge in GP surgeries and pharmacies, and anti-smoking advice in schools. My own schools are very effective in giving citizenship classes warning about the health risks of smoking. There cannot be anyone in this country, young or old, who does not know about the health risks of tobacco. Nobody smokes in ignorance.

Plain packaging has the laudable purpose of deterring children from starting smoking and helping smokers who wish to quit, but there is no reliable evidence that plain packaging will influence smokers in general or children in particular. In Australia, where plain packaging was introduced in 2012, both youth smoking and sales of illicit tobacco increased in the following year. There are many complex social reasons that lead to youth smoking, but packaging is not one of those factors. Currently 3% of under-15s smoke in the United Kingdom—the lowest percentage in a generation. I have asked people who were buying cigarettes in my local newsagent whether plain packaging would influence their tobacco purchasing habits, and they find the idea laughable.

Standardised packaging would be bad for exports, bad for retailers, particularly small shops, bad for jobs in warehousing, distribution, marketing, design and packaging, and bad for the Treasury, but very good for criminals, making the illicit trade much easier. What would follow—bottles of wine with plain labels, or bars of chocolate in plain packages as we are controlled and someone else makes our decisions for us?

Let us try to be positive and sensible. Let us clamp down on illicit sales of smuggled cigarettes in our neighbourhoods, and enforce a new ban on purchasing tobacco for under-18s, as with alcohol. Let us support shopkeepers in their role as gatekeepers to age-restricted products, encourage “No ID, no sale” signs in shop windows, and enforce stiff penalties against retailers—

[Madam Deputy Speaker (Mrs Eleanor Laing)]

Order. I hesitate to interrupt the hon. Lady, but time is very short. I hope she will draw her remarks to a close because the Minister has a speech to make.

[Dame Angela Watkinson]

I am very aware of that, Madam Deputy Speaker.

Let us enforce stiff penalties against retailers caught selling cigarettes knowingly to children and let us not forget the responsibility of parents to know how much pocket money their children have to spend and what they spend it on. In short, the policy of plain packaging is well intentioned but misguided. It will do more harm than good. It will not work and I oppose it.

19:53

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I am pleased to have the opportunity to respond to this important debate and I congratulate the hon. Member for Glasgow North (Ann McKechin) on securing it.

As other Members have said, tobacco use remains one of our most significant public health challenges and reducing smoking rates is a key public health priority for this Government. The burden of smoking places enormous strain on the NHS and holds us back in the battle against cancer. This is why the Government have committed to and delivered on a comprehensive set of tobacco control measures, which include a ban on smoking in cars with children present, making it illegal for adults to buy tobacco products on behalf of children, outlawing displaying tobacco in shops and working to introduce age of sale requirements for e-cigarettes. Standardised packaging is part of this strategy and I am grateful for tonight’s opportunity to provide the House with an update on this policy.

It is important to acknowledge the enormous progress that has been made so far. Smoking rates in England are at their lowest level since records began. Today, around 18% of adults are smokers, down from around half of adults in the 1970s. Almost 2 million fewer people in England are smokers compared with a decade ago. Assuming that the downward trend of the past years continues, that equates to around 15,000 smoking-related deaths avoided during the course of this Parliament.

We know that most smokers start young, and we want our children to grow up free from the burden of disease that tobacco inflicts. The very good news is that the rates of regular smoking by children in England are also falling, with 8% of 15-year-olds smoking now compared with 15% in 2009, achieving the target set out in our tobacco control plan two years early. However, around 8 million people in England still smoke, so there is no room for complacency. The hon. Member for Glasgow North is right to draw attention to regional differences in smoking rates—including in her own area, where more than one in four people smokes. I think that she will agree with me that there is a concerning link between those rates and deprivation.

I wish to pick up on what the hon. Lady said about prevarication and delay. I have always been clear about the need to follow a robust process and ensure that all issues relevant to the introduction of standardised packaging are properly considered. That includes the implications for illicit trade, as my hon. Friend the Member for Hornchurch and Upminster (Dame Angela Watkinson) mentioned, as well as the legal issues.

[Nick de Bois (Enfield North) (Con)]

Will my hon. Friend give way on that point?

[Jane Ellison]

I am afraid that I am really short of time.

[Nick de Bois]

Just a brief question.

[Jane Ellison]

I am very sorry, but I have been left very short of time.

The challenges that the tobacco industry is likely to bring to the regulations have also been carefully considered. It is vital that all stakeholders are heard and all evidence is carefully considered and evaluated. Ministers must ensure that that is done as thoroughly as possible so that any decision taken is solidly based on the available evidence.

Over the past few weeks and months, the Department of Health has carefully considered all responses to the most recent consultation and taken into account all the information and evidence on the public health implications as well as the wider issues, including the legal ones. I commend my officials, who have worked tirelessly to provide me and my ministerial colleagues with essential and valuable advice with which to make a decision.

As the House has already heard, I asked Sir Cyril Chantler, an eminent paediatrician, to undertake an independent review of whether the introduction of standardised packaging is likely to have an effect on public health, in particular in relation to children. I would like to thank him again for delivering such a thorough report.

Sir Cyril’s report concludes that, if standardised packaging were introduced, it would very likely have a positive impact on public health and that the health benefits would include health benefits for children. Following the publication of his report, we also held a final short consultation in summer 2014, seeking new and additional information, relevant to the policy, that had arisen since the last consultation.

Earlier this month, the chief medical officer and chief scientific adviser, Professor Dame Sally Davies, provided me with her review of the evidence and also of the criticisms of the Chantler review that have been put forward by the tobacco industry. Dame Sally has made it clear that she

“does not believe there is evidence to show that the process or the conclusions of the Chantler review are flawed and there is now accumulating evidence to support the conclusions of the review.”

It is her view that the evidence does support the introduction of standardised packaging.

There have been particular concerns that standardised packaging would increase illicit trade. In his review, Sir Cyril addresses those concerns and concludes:

“I am not convinced by the tobacco industry’s argument that standardised packaging would increase the illicit market, especially in counterfeit cigarettes.”

Her Majesty’s Revenue and Customs has also undertaken a detailed assessment of the potential impact of standardised packaging on the illicit market. It concluded:

“We have seen no evidence to suggest the introduction of standardised packaging will have a significant impact on the overall size of the illicit market or prompt a step-change in the activity of organised crime groups.”

The assessment is expected to be published in full soon.

We are also giving careful consideration to any and all potential legal challenges that may be brought against the Government as a result of introducing standardised packaging. As the hon. Lady knows, litigation by the tobacco industry is always a risk when introducing tobacco control legislation.

The Government are committed to reducing the numbers of young people taking up smoking and to helping smokers who are trying to quit. Our comprehensive approach to tobacco control is working. Fewer people than ever now smoke and cancer survival rates are at record highs. However, we cannot be complacent. We all know the damage that smoking does to health. Tobacco causes over 80,000 deaths a year, and around 600 children in the UK start smoking every day, as the hon. Member for Glasgow North said in her opening remarks.

The Government are completely committed to protecting children from the harm that tobacco causes. That is why I am announcing today that we will be bringing forward legislation for standardised packaging before the end of this Parliament. A consultant respiratory physician told me last year that he is confident that the introduction of standardised packaging will end up saving more lives than he would be able to in his entire career.

I thank all the people who have campaigned for this policy and all those who have contributed to the consultations—the 2012 consultation and the 2014 consultation. I hope that the thousands of other clinicians who have written to me, and to colleagues, over the past weeks and months will welcome this important progress. I want to reassure the House that I will provide further details about the introduction of the policy in due course.

Legislation—even new laws on packaging—will not solve all the problems relating to tobacco. Effective tobacco control depends not just on Government action; local authorities also have a key role, which is why we gave local government responsibility for public health. It is best placed to take forward local plans, based on local circumstances. We see a wide variation between the levels of smoking in our nation—during pregnancy and among young people—and we see that the policy of local action has been vindicated. Local authorities, supported by Public Health England, can advise on effective local action and share experience of what works.

Standardised packaging has the potential for huge public health benefits, but we must not forget that other measures will also contribute to reducing smoking rates. I remind the hon. Member for Glasgow North that Sir Cyril Chantler’s report advises that any policy of standardised packaging must be seen in the round as part of a comprehensive policy of tobacco control measures, and that is how I see the potential for standardised packaging working in this country. Effective tobacco control depends on taking a multifaceted approach, and that is what we are doing.

Only this morning, I was speaking to a number of local government leaders and hearing their reflections, and I know that many local authorities as well as health charities have also addressed the Government on this subject. Legislation to end tobacco displays has already been implemented for large shops such as supermarkets, as I mentioned. All other shops selling tobacco, including corner shops, will need to end their displays of tobacco on 6 April. The display of tobacco products in shops can promote smoking by young people and undermine the resolve of adult smokers trying to quit—and we know how many adult smokers are trying to quit.

While I have the Floor, I can give the House an update on smoking in cars. We laid the regulations to end smoking in private vehicles carrying children on 17 December 2014. The regulations have been considered by the scrutiny Committees, and I expect that we shall have a date for the debate soon. The regulations make it an offence to smoke in a vehicle if a child is present, and for a driver to fail to stop someone smoking in such situations. They provide for the police to be able to enforce against these offences and, if approved by Parliament, the regulations will come into force on 1 October 2015—again, as part of a comprehensive tobacco control strategy. We will also continue social marketing work in this area, with Public Health England running campaigns to raise awareness of the health harms and of the new offences. It is not my desire that people should be fined as a result of ignorance, and I want to ensure that as many people as possible are aware of the new policy.

As I mentioned earlier, we have also introduced legislation to make it illegal for an adult to buy or attempt to buy tobacco for anyone under the age of 18. Through regulations we plan to extend the scope of this offence to cover e-cigarettes. The Department is currently consulting on those draft regulations to introduce age-of-sale requirements for electronic cigarettes, as we already have for tobacco, and that consultation will close on 28 January.

I thank colleagues who have attended the debate, many of whom have expressed strong views about this policy. All of those views have been extremely carefully considered. The hon. Member for Glasgow North referred to the desire to make UK-wide legislation. I can confirm that I will be speaking to my ministerial colleagues in the devolved Administrations and I hope they will follow us to make this a UK-wide measure.

We will bring the regulations before Parliament in this Parliament. Should Parliament support the measure, we will be bringing the prospect of this country’s first smoke-free generation one decisive step closer. I thank the House for its attention tonight and colleagues for all their input into this policy making. I commend the policy to the House.

Question put and agreed to.

20:04

House adjourned.

Ministerial Corrections

Wednesday 21st January 2015 Ministerial Corrections

Wednesday 21 January 2015

Justice

Wednesday 21st January 2015 Ministerial Corrections

Probation Service

The following is an extract from the Westminster Hall debate on the Probation Service on 13 January 2015:

[The Parliamentary Under-Secretary of State for Justice (Andrew Selous)]

All the existing expertise of our fantastic public sector probation staff is still there in the system. Most people are working at the same desk, doing the same job as before. That is highly valuable. I should point out that the report of Her Majesty’s inspectorate of probation goes up to September last year, and there have been significant improvements since then on a lot of the issues that Members have quite properly raised. To give just one example, the rate for completion of the risk of serious recidivism report within two days is now at 80%, which is a significant increase. We have every confidence that that figure will carry on increasing, and I hope that that reassures Members.

[Official Report, 13 January 2015, Vol. 590, c. 242WH.]

Letter of correction from Andrew Selous:

An error has been identified in the response I gave to a point raised in the debate by the hon. Member for Stretford and Urmston (Kate Green).

The correct response should have been:

[The Parliamentary Under-Secretary of State for Justice (Andrew Selous)]

All the existing expertise of our fantastic public sector probation staff is still there in the system. Most people are working at the same desk, doing the same job as before. That is highly valuable. I should point out that the report of Her Majesty’s inspectorate of probation goes up to September last year, and there have been significant improvements since then on a lot of the issues that Members have quite properly raised. To give just one example, the most recent figures show that 82% of cases are allocated within two working days after sentence and the risk of serious recidivism assessment is recorded as completed in 80% of cases, which is a noteworthy increase. We have every confidence that that figure will carry on increasing, and I hope that that reassures Members.

Deputy Prime Minister

Wednesday 21st January 2015 Ministerial Corrections

Electoral Roll

The following is an extract from Questions to the Deputy Prime Minister on 6 January 2015:

[Graeme Morrice]

Can the Minister tell the House how many fewer voters there were on the electoral register for England and Wales in December 2014, compared with the previous year, and whether he is alarmed at the reduction?

[Mr Gyimah]

The full December register has not been published yet so it is impossible to tell the state of the register as at December. As the hon. Gentleman knows, individual electoral registration is a two-year project. We are mid-way through it and it is proving very successful. Nine out of 10 electors were transferred to the electoral register, and online registration is proving very successful.

[Official Report, 6 January 2015, Vol. 590, c. 142.]

Letter of correction from Mr Gyimah:

An error has been identified in the response I gave to the hon. Member for Livingston (Graeme Morrice) during Questions to the Deputy Prime Minister.

The correct response should have been:

[Mr Gyimah]

The Electoral Commission’s evaluation of the December registers has not been published yet, so it is impossible to tell the state of the register as at December. As the hon. Gentleman knows, individual electoral registration is a two-year project. We are mid-way through it and it is proving very successful. Nine out of 10 electors were transferred to the electoral register, and online registration is proving very successful.

Women and Equalities

Wednesday 21st January 2015 Ministerial Corrections

Homophobic Bullying

The following is an extract from Questions to the Minister for Women and Equalities on 15 January 2015:

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

According to Stonewall’s latest figures, more than half of secondary school teachers fail to challenge homophobic bullying, while 17% feel they are inadequately trained to tackle such bullying. Therefore, does the Minister acknowledge that the Government’s failure to make sexual relationships education compulsory in the curriculum in mainstream teacher training has failed lesbian, gay, bisexual, and transgender young people, as teachers feel ill equipped to deal with homophobia in the classroom, or to advise children who approach them in confidence?

[Jo Swinson]

Sexual relationships education is compulsory, but the hon. Lady raises an important point about training, and about ensuring that teachers feel comfortable in discussing these issues and know the best way to do so. We recognise that more can be done; that is why we have announced the project to develop that evidence base, so that teachers can see what best practice is, and how they can develop the confidence to tackle these issues effectively in the classroom.

[Official Report, 15 January 2015, Vol. 590, c. 1006.]

Letter of correction from Jo Swinson:

An error has been identified in the response I gave to the hon. Member for Washington and Sunderland West (Mrs Hodgson) during Questions to the Minister for Women and Equalities.

The correct response should have been:

[Jo Swinson]

Sexual relationships education in maintained schools is compulsory, but the hon. Lady raises an important point about training, and about ensuring that teachers feel comfortable in discussing these issues and know the best way to do so. We recognise that more can be done; that is why we have announced the project to develop that evidence base, so that teachers can see what best practice is, and how they can develop the confidence to tackle these issues effectively in the classroom.

Petitions

Wednesday 21st January 2015 Petitions

Wednesday 21 January 2015

Sri Lanka & UN Security Council decision

Wednesday 21st January 2015 Petitions

To the Honourable the Commons of the United Kingdom of Great Britain and Northern Ireland in Parliament assembled.

The Humble Petition of residents in Wellingborough, Northamptonshire and the surrounding areas,

Sheweth,

That the Government of Sri Lanka has officially proscribed 16 Tamil Diaspora Organisations and 424 Tamil individuals, many of whom are in the UK, through a government notification as a retaliatory response to “Resolution A/HRC/25/L.1/Rev.1: Promoting reconciliation, accountability and human rights in Sri Lanka” which was passed by the UN Human Rights Council in March 2014; further that Sri Lanka has rejected the UN resolution outright and declared that it will not co-operate with the UN investigation and proscribed diaspora Tamil Community organisations that are championing the cause of justice for Tamil people; and further that the Petitioners believe that by doing so Sri Lanka is abusing UN Security Council resolution (UNSCR 1373) and criminalising the Tamil Community in the UK and around the world.

Wherefore your Petitioners pray that your Honourable House urges the Secretary of State for Foreign and Commonwealth Affairs to take Sri Lanka’s decision to reject the UN Security Council resolution (UNSCR 1373) up in the international forum to remove this unlawful ban on the Tamil Community.

And your Petitioners, as in duty bound, will ever pray, &c.

[P001428]

Westminster Hall

Wednesday 21st January 2015 Westminster Hall

Wednesday 21 January 2015

[Sir Roger Gale in the Chair]

Personal Independence Payments

Wednesday 21st January 2015 Westminster Hall

Motion made, and Question proposed, That the sitting be now adjourned.—(Damian Hinds.)

09:30

[Teresa Pearce (Erith and Thamesmead) (Lab)]

It is a privilege to have this debate under your chairmanship, Sir Roger. I am pleased to see other Members here today to discuss such an important issue. I will try to keep the length of my speech to a minimum since I have several questions that I would like the Minister to respond to. I will start by reflecting on what a personal independence payment is and what it is meant to do.

The Welfare Reform Act 2012 legislated for the introduction of personal independence payments to replace disability living allowance. PIP is a benefit for people with long-term health conditions or impairments, whether physical, sensory, mental, cognitive, intellectual, or any combination of those. It is intended to provide support for the disabled people with the greatest needs who face the greatest challenges to remaining independent and participating fully in society.

The PIP assessment measures the impact of a person’s health condition or impairment on their ability to participate, rather than focusing solely on the health condition or the impairment itself. PIP is paid as a contribution to the extra costs that disabled people may face to help them lead full, active and independent lives. To put it more simply, it is support for people who would trade anything to have the privileges that we too often take for granted: our work choices, our life choices and our independent living. So PIP is potentially a vital mechanism to help some of the most vulnerable and disadvantaged members of our society, yet like so much of the benefit revolution, PIP’s implementation has been beset by problems and has caused additional hardship, anxiety and uncertainty to our vulnerable and disadvantaged friends.

There are key dates in the history of the implementation of PIP. From 8 April 2013, the Department for Work and Pensions started to replace disability living allowance for people aged 16 to 64 with PIP. On 8 April 2013, PIP was introduced, in a controlled start, for new claims from people living in a limited geographical area in the north-west and part of the north-east of England. On 10 June 2013, PIP was introduced for new claims for the remaining parts of Great Britain. From 28 October 2013, the DWP started to invite DLA claimants living in certain areas to claim PIP.

So how is it all going? Appearing before the Select Committee on Work and Pensions on 10 September 2014, the Minister for Disabled People said:

“It is fair to say that, yes, in terms of the delays to the assessment process it is not in good shape...I absolutely accept there is a problem; it is literally my top priority and I have been spending a lot of time working on it since I was appointed on 15 July”.

I and my fellow members of the Work and Pensions Committee were pleased to hear that the Minister had made it his top priority.

How many disabled people are being affected? Last December, the DWP published a third set of official PIP statistics. They showed that between April 2013 and October 2014 some 669,200 claims for PIP had been submitted, but only 382,000 decisions had been made. That leaves 287,200 disabled people stuck in a backlog. However, on 15 December in the other place, Lord Bourne of Aberystwyth seemed to be in denial about that figure. He said:

“My Lords, I dispute those figures. The backlog stands at 107,000 at the moment, and 65,000 claims are being processed every month.”—[Official Report, House of Lords, 15 January 2015; Vol. 758, c. 894.]

Will the Minister clarify those figures and explain why there are two different numbers? Whatever the number is, there is still a long way to go.

The figures are simply dry statistics. They do not tell us about the real-life consequences of delay. For the individual, they translate to anxiety and hardship at a time when they are at their most vulnerable and ill-equipped to cope. I have personally spoken to many constituents who have been waiting for six months—in some cases, a year—for a home assessment. They have often taken every possible step to ensure that information is submitted on time, yet they are kept in the dark about their claims. They do not know who to call. When they get through to someone, they are not given a time scale. They replace the receiver feeling as ill-informed as they were at the start, and that is unacceptable.

As MPs, we all have our postbags. I was contacted in October 2014 by the mother of a young disabled woman living in my constituency. She works part time as she cares for her daughter. Her daughter had been waiting for a home assessment since August 2013. She told me that they had been threatened with eviction because money was so tight. She was upset, desperate and scared. She said that her daughter had received no update on her application since she had called in September 2013 to check that the claim had been received.

I contacted Atos and was told that a call had been made to my constituent in May 2014 to arrange a home assessment, but the adviser was told that the constituent did not live at that address. As a result, the daughter’s case had been withdrawn and closed without her knowledge. It transpired that the Atos adviser had called the wrong number. Atos blamed the DWP, but it was the PIP office that had made a mistake when typing the number into the system. It got the wrong number and closed the case.

Such things do not happen only in my constituency. I have heard from Malcolm, who lives in Southwark and is 55. He applied for PIP in March 2014 when he was diagnosed with cancer, and he has still not had an assessment. The delays have affected his ability even to travel to and from hospital for appointments.

Bernadette lives in Wales. Her son is 15 and has autism, and he was receiving DLA. In November 2014, she had a letter from the DWP about transferring to PIP in April 2015. A home visit was set for 16 December. The son stayed off school for the day, but no assessor turned up. The visit was rearranged for 19 December. Another school day was missed and again no assessor arrived. A home visit finally happened on 23 December. Bernadette was assessed as being able to handle finances for PIP, but no date was set for the PIP assessment. She was told it would be any time within the next 12 to 18 months. Despite there having been no assessment, the January DLA payment was stopped. She was knocked out of the system, yet no PIP assessment date had been set. The family were thrown into financial difficulties and are now even worse off, because they face bank charges for being overdrawn.

It is not only MPs who are raising such issues. In December 2014, Macmillan Cancer Support stated that the system for PIP is

“riddled with delays...it remains an absolute disgrace that thousands of people with cancer have been forced to wait six months or more...to find out whether they were even eligible...A recent survey of Macmillan...advisers reveals shocking statistics: nearly a third...know of someone who has died while waiting for their benefits, almost one in two...have come across patients who cannot afford to feed themselves properly, and around three in five...say delays have left people unable to heat their homes....No one should have to face these situations simply because they have been diagnosed with cancer.”

Parkinson’s UK conducted a survey that showed that the people it supports have been waiting, on average, longer than six months for a PIP assessment. More than half report an average wait of nine months or more. According to the London-wide anti-poverty charity the Zacchaeus 2000 Trust, commonly known as Z2K, such lengthy delays have a severe impact on its clients in a number of ways. It says that almost all its PIP clients rely on state benefits as their only source of income. Because PIP is paid in arrears, claimants who do not have other sources of income experience severe impoverishment as a result of delays. Many have turned to food banks. That has a knock-on effect, because PIP often acts as a gateway to other benefits and entitlements.

Against that backdrop has come Paul Gray’s independent review of PIP assessment. In the foreword to his review, Paul Gray recognised the limitations on what he could review. He stated:

“The timing for Independent Reviews of the Personal Independence Payment...assessment...was laid down in the 2012 Welfare Reform Act. In accepting the Secretary of State’s invitation to conduct this first Review I was conscious that, with implementation being less advanced than originally planned, this is too soon to draw definitive conclusions on many aspects. The evidence is simply not yet available to do so reliably or robustly.”

That in itself is an indictment of the all-too-familiar lack of implementation. It is a good idea to review what is in legislation, but if the thing being reviewed has not been implemented properly, there is nothing to review. Paul Gray continued:

“Equally it was clear that the primary focus of early comment and attention on PIP has been the unfortunate reality of long delays and backlogs in the assessment process. These have had a major impact on many claimants for PIP so far. It is essential for remedial action to be completed and to avoid similar issues recurring in the future. I have taken it as given this will be done.”

The findings and recommendations of the review include short, medium and long-term measures and fall into three main themes: the nature of the claimant journey; the way in which further evidence is collected; and the overall effectiveness of the PIP assessment. I am interested in what the Minister has to say about the review and its recommendations and what his Department intends to do in response.

Turning to the claimant journey, there can be few MPs who have not encountered numbers of constituents who have found the claiming and reassessment process extremely stressful. Impacts can range from a lowering of self-esteem and dignity to an increase in anxiety and a worsening of mental state. It is disappointing that the review did not thoroughly address the effect of interventions, which involve reassessing people for PIP before their award has even expired. Given the significant struggles that people face to be awarded PIP in the first place, it is of some concern that some recipients are already being reassessed in such a way. Interventions place unnecessary pressure on claimants and assessment providers, who already struggle to meet demand. Interventions also suggest that the DWP does not trust the initial decision delivered by its own assessment process.

The first independent review of PIP has recognised some of the serious flaws and failures of the new system and provides the DWP with the opportunity to address those systemic failures as a matter of urgency. Integral to implementing the recommendations of the report, however, will be dealing with the backlog to ensure that all claimants are provided with the best possible service. For many people, PIP delays are causing their conditions to worsen and having an impact on the quality of their lives. That cannot continue, so where areas for improvements in the claimant journey are identified, it is vital for the DWP to respond positively.

I have nine questions for the Minister about the review recommendations. First, the review suggested that the DWP should make better use of digital technology, and that a website allowing claimants to track the progress of their claims would improve communication. Does the DWP have plans to introduce a tracking system that can be accessed by claimants?

The review stated that the

“potential for sharing information already held by the Department and across the wider public sector should be explored”

to improve the evidence-gathering process. What are the DWP’s plans to improve the additional evidence-gathering process, and what is the time scale?

Will the Minister confirm the policy intent behind interventions, and how will the Department ensure that they are not simply a repeat of the reassessment process before a claimant’s award has ended? What assessment has the DWP made of the impact of interventions on the existing backlog of PIP claims? The report stated that the Department should:

“Ensure the consistent application of existing guidance for health professionals on reliability and fluctuating conditions.”

How and when will the DWP reinforce guidance on assessing fluctuation to ensure that all assessors are adequately addressing that issue? Furthermore, how will the DWP measure assessor performance in addressing that issue?

I understand that the Government plan to publish data on clearance and waiting times from March 2015. Has the DWP set a precise date for the publication of those data? In light of the review, will the Minister confirm whether the DWP intends to proceed with the main reassessment programme in October 2015, and whether the backlog of claims will have been cleared by then? Finally, when will the DWP publish its response to the independent review?

I hope that the Minster can answer those questions, and I look forward to revisiting some of the debate a week today when he appears before the Select Committee on Work and Pensions to look at this issue.

09:43

[Dr Eilidh Whiteford (Banff and Buchan) (SNP)]

I congratulate the hon. Member for Erith and Thamesmead (Teresa Pearce) on securing the debate. She has been assiduous in highlighting the impact of Government policies on disabled people, including the introduction of the personal independence payment. The debate is timely given last month’s publication of Paul Gray’s independent report.

My own experiences with the introduction of PIP have not been happy. Some months after the new system was first introduced, a number of constituents got in touch with me regarding the interminable delays that they were experiencing in accessing the support to which they were entitled. All those people had been waiting more than six months for an assessment by the time they got in touch with me; some had been waiting more than nine months and in one case a person took more than a year to get PIP.

The impact that that was having on those people and their day-to-day lives is worth restating. The people making the claims were all living with long-term disabilities or health problems. For all of them, their ability to work, socialise or participate in day-to-day activities was affected to some extent. For some, their conditions prevented them from working altogether, or even from going out without considerable support from families or friends.

A six to nine-month delay in dealing with those people’s PIP application caused not only unnecessary stress, uncertainty and anxiety, but real financial hardship for some and serious cash-flow problems for others. In some cases, the delays also put a financial strain on relatives, who felt that they had to step in with money to pay additional costs associated with the loved one’s disability. In other words, the inordinate and unacceptable delays in the process actually reduced the personal independence of the claimants.

I am conscious that we, as MPs, only see those cases brought to us. I wonder to what extent what we see in our constituencies is the tip of the iceberg. How many more people affected by the policies are also experiencing similar levels of delay, but have not come to an MP to move the process forward? I pressed Ministers on such issues at the time, and steps have since been taken to deal with the backlog, but I noted that Paul Gray said in his review:

“Whilst steps to resolve delays and backlogs are clearly necessary they are not of themselves sufficient and there are other underlying issues to address.”

The debate today is an opportunity to address some of those underlying issues.

I have read the report, and Gray makes various observations about PIP and a number of recommendations, mostly related to the application process. Given that today is the first opportunity that we have had to debate PIP since the publication of the report, I am looking forward—like the hon. Member for Erith and Thamesmead—to what the Minister has to say. I think it is fair to point out that the independent review is pretty critical of claimants’ experiences of claiming PIP, aside from the delays, and has made a range of practical suggestions about how the journey could be improved.

I also note that Gray draws attention to the need to understand better how the process is working for people with mental health problems and for people with learning disabilities. There have been serious shortcomings in the work capability assessment which, like the PIP assessment, is made on the basis of functional impact on people with such types of disability. I have had extensive dialogue with Ministers on that in connection with the WCA, so the fact that concerns flagged in the report are similar for PIP makes me wonder whether the type of assessments are suitable for those claimants. Paul Gray points out that such assessments are “not a precise science”—there is a lot of subjectivity in the process—and that that inevitably disadvantages folk whose conditions are less visible, which fluctuate, or which people find hard to communicate. Some of the recommendations that he makes about exploring how there might be greater input of information and evidence from clinicians mirror the kind of suggestions that health care advocacy groups have been making in relation to the WCA, so I hope that the Government will listen, take that on board and look closely at how improvements might be made for the claimants.

One of the issues that the independent review explicitly does not address in detail is that of the contractual arrangements, which have been a matter of wider public concern and merit some scrutiny. I am conscious that responsibility for PIP is one of the policy areas that the Smith commission has recommended be devolved to the Scottish Parliament. Draft proposals are due to be published later this week, and I await them with great anticipation. Given the serious problems with implementation of PIP so far, I would welcome the opportunity to improve the policy in the Scottish context and to make the changes necessary to deliver a workable system that supports disabled people to live dignified, independent lives.

Honest and rigorous evaluation of the existing scheme is therefore essential. I heartily support the recommendations in Paul Gray’s report on better, more detailed and more robust evaluation of the PIP implementation to date. Gray highlights the lack of evidence available and how that inhibited his ability to conduct the independent review. That is all the more important as we are looking to devise a new and improved policy approach, so we need the evidence for what has been problematic in the PIP arrangements.

The Government have not covered themselves in glory as far as the implementation of PIP is concerned. It has been beset by problems, but as a replacement benefit for the disability living allowance PIP is important, enabling people with serious disabilities and health conditions to participate in society, to get around, to get to work, to go shopping and to socialise with friends—activities that able-bodied people take for granted. The benefit promotes independence and counters some of the disadvantages faced by disabled people. The Government need to do an awful lot more to make it work.

09:49

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger, and to follow the hon. Member for Banff and Buchan (Dr Whiteford), after the excellent introduction to the debate by my hon. Friend the Member for Erith and Thamesmead (Teresa Pearce).

This Government have presided over a miserable few years for those who need to turn to the state for help. Those who do not find the door slammed in their faces still have to deal with the incompetence at the DWP that has led to benefit delays of as much as a year in some cases. Those people are genuinely terrified of what the future holds for them.

The Gray review echoes a lot of the concerns that Opposition Members have been raising for some time now, along with the hardship that the problems have caused for our constituents. But the review does not go far enough. My constituent Mr Mark Douglas has Parkinson’s, and applied for PIP in November 2013. After two months he had heard nothing from either the DWP or his assessor. When I chased Atos, it said it could not confirm an assessment date. It took persistent chasing from Parkinson’s UK and me on Mr Douglas’s behalf to get an appointment scheduled at the end of January, nearly three months after he had begun his claim.

It took a further three months and numerous letters for Mr Douglas to get a decision. All the while he had no updates from his assessor or from the DWP. The replies I was able to get from the Department were so vague as to be completely useless. When I asked when Mr Douglas would be notified of the DWP’s decision, the response was:

“We aim to make and notify decisions on most cases within 3 weeks. However, it may take less time than this, or longer.”

In other words, the Department was completely clueless. When I raised another constituent’s delay with the Prime Minister, he admitted it was unacceptable, but that was, sadly, nine months ago, and PIP claimants are still experiencing the same unacceptable problems. When on earth are the Government going to get a grip on this issue?

The overall PIP journey is an unpleasant one. The quality of assessments is uneven, assessors do not properly understand people’s conditions, communication with claimants is poor and decision letters are often unintelligible. All that will sound familiar to some of us: we have seen it all before from this Government with work capability assessments. WCAs do not take account of people’s fluctuating conditions. They may appear to be physically fine at their assessment but on a different day might be housebound; as a result, those people are wrongly declared fit for work. We are likely to see a lot of inaccurate PIP decisions appealed, just as we have seen one in three decisions on employment and support allowance appealed because of the poor quality of assessments.

The real problem, however, is one of delays. It is disappointing that the review does not go into further detail in that regard. Mr Gray explains in his foreword that he has “taken it as given” that the Government will be taking action to speed up the process, but sadly this Government’s record means that Opposition Members are unable to do the same.

I hope the Minister will explain what is being done to address the backlog. Will he share the data on the current lengths of time that people are waiting for their PIP claims to be processed? The delays must be the urgent priority, because later this year PIP will be opened up to all existing long-term DLA recipients. Until now, the PIP system has been dealing only with a minority of eligible people, so if it is in chaos now, how bad will things be in October?

Does the Minister not think that it would give a clear message to PIP recipients that the Government actually cared if they decided to halt the roll-out until they got the system right? Should the Government not be setting out clearly the monitoring arrangements they have in place for the estimated 500,000 disabled people who are going to lose out in the transition from DLA to PIP?

The review shows that the experience of claiming PIP is a nightmare. People do not have confidence in the assessments, or in the DWP’s ability to process their claims on time. These individuals are in many cases totally reliant on Government support, but right now the Government are showing that they cannot be relied upon. The DWP has failed to learn the lessons of the Work programme and universal credit, and is presiding over another disaster in PIP, yet it is our constituents who continue to pay the price under this heartless and shambolic Government.

09:54

[Jim Shannon (Strangford) (DUP)]

I am grateful for the chance to speak today, Sir Roger. I was wondering whether this sitting of Westminster Hall constitutes a record, as we are on our fourth speaker before 10 o’clock. I will try to prolong matters a wee bit, if I may—I joke.

I congratulate the hon. Member for Erith and Thamesmead (Teresa Pearce) on bringing this matter forward for consideration. It is always good to speak on these issues as they are bread-and-butter concerns for people in my constituency and across the whole of the United Kingdom, as we move from the disability living allowance to personal independence payments throughout the United Kingdom. Since PIP is only in its early stages and has not yet taken over from DLA everywhere, the independent review comes at an ideal time, when improvements can still be made. That is vital.

In a debate on this issue in November, the Minister was able to state clearly with regard to Northern Ireland that welfare reform was not yet in place, but all parties in Northern Ireland have now agreed to bring in that reform, and measures on the reforms will come in during the next two weeks, as I understand from my hon. Friend the Member for East Londonderry (Mr Campbell). After that, PIP will be in place across the whole of the United Kingdom.

This debate is important. The background information that was prepared for it is very detailed. I congratulate those who put it together, as the amount of information has made it easier to assess and understand the issues—for me, at least. In Northern Ireland we have been looking at the two-year process and the delays; the delays are what I want to talk about, because it is important that we in Northern Ireland learn from what has happened in the rest of the United Kingdom and introduce the system in a much better form.

[Mr Gregory Campbell (East Londonderry) (DUP)]

On the issue of lessons that may be learned, does my hon. Friend agree that in Northern Ireland we are looking at this matter with some trepidation, given that we have significantly higher numbers of people on DLA per head of population? I hope that the Minister will be able to tell us that the information gleaned over the course of the past two years will be of some assistance in trying to minimise the problems and errors that the process has been fraught with.

[Jim Shannon]

My hon. Friend’s intervention clearly illustrates the issue for us in Northern Ireland. I have a member of staff in my constituency office who now does nothing else but deal with benefit issues and issues with the DLA; I spoke to her this morning to talk over some of the issues. We have a higher proportion of claimants in my constituency and a higher proportion of contact with them. The Government have offered Members’ staff the opportunity to have training on the new system, which my staff took up, and I hope that the information that they have gleaned from the training classes here in London will be sufficient to enable the change to be managed more easily in my constituency. That is one of the really good things that the Government have done.

PIP retains key features of DLA, which is important for a smooth transition. It is not means-tested and is non-taxable and non-contributory. It is intended to provide financial support for disabled people who face the greatest challenges in remaining independent—it is important to help those people hold on to some of their independence. It is payable to people both in and out of work and has two components—daily living and mobility—with different levels of award for each based on the assessed level of need.

The benefit has been changed and improved, however, in the sense that it encourages a move to a more transparent and objective assessment of need, with assessments by health professionals employed by contracted providers. I know that there is a lot to be learned from the past two years here on the mainland, but the PIP system itself is something that most of us can welcome, because on paper it has the potential to make lives better and be better at helping people. However, there have been recurring problems and I want to make some observations about what has happened.

The assessment places a stronger emphasis on the functional impact of claimants’ underlying disabling and medical conditions, not on the conditions themselves. That is vital, because people are affected by conditions in different ways. We see that in my office every week. What one person may need might not be needed by another person, so that is one element that I was happy to see changed; it is one of the new system’s pluses, at least on paper. A points-based system to assess eligibility for awards will also be included, with more regular reviews of eligibility for those receiving awards. Finally, there is greater focus on the needs of claimants with mental health conditions.

Over my last four and a half years as a Member of Parliament, I have become more aware of the needs of people with mental health issues. I do not know what it is about society, or whether it is a combination of things, but more people today have mental health conditions, and we need a system that understands the issue. In Northern Ireland, we had a conflict over 30 years, which may have contributed to mental health problems, and we have concerns about that.

[Mark Durkan (Foyle) (SDLP)]

The hon. Gentleman will probably recognise that those of us who have concerns about the implementation of welfare reform in Northern Ireland have raised the particular needs of victims of the troubles, and the issue was raised as part of the Stormont House agreement. They were given DLA awards—perhaps for life—because of their condition, and there was concern about the difficulties they would face in being subjected to reassessment and in perhaps having to retell their story, whether the trauma they carried was physical or mental. We have been assured that we can get extra consideration on that.

[Jim Shannon]

I thank the hon. Gentleman for that valuable intervention—he is right to raise the conflict over 30 years and its repercussions. Those who have lived with trauma have filled in the forms and been given a definite award, but they have then had to go through it all again. It is important that those points are addressed, and it seems, from the Stormont House agreement and the discussions with the Secretary of State and other Ministers, that they are.

As I mentioned in last November’s debate about PIP, the delays and backlogs are worrying. It is unsurprising, therefore, that the independent review expressed the same concerns. The hon. Members for Erith and Thamesmead, for Banff and Buchan (Dr Whiteford) and for South Shields (Mrs Lewell-Buck) have mentioned the delays, and it is important that they are addressed. As PIP is rolled out, serious delays have occurred, which means that some of the most vulnerable have been left without the help they need for too long. For example, of the 220,300 disabled people who applied for PIP from 8 April 2013 to 31 December 2013, only 34,200 received news of their claim by February 2014. That delay is absolutely unacceptable.

Obviously, that was not good enough, so the review suggested having better and more concise communication. The format of decision letters was claimed to be unclear, confusing and of variable quality. It has been suggested that the letters begin with a clear statement of the decision, followed by the award, payment details, a simpler explanation for the reasons and the next steps. I would definitely support that in my constituency, as we role out PIPs in the next month or so.

A large number of claimants have difficulty understanding reply letters. On more than one occasion, my office has had to relay to them what has been written to help them. It is good that my staff have the understanding to do that, but it would be better if the letters used words that people could understand.

I mentioned in our last debate—this has also been touched on today—my concern over the reliability criteria, which measure whether activities can be undertaken safely, to an acceptable standard and repeatedly. I was pleased that the review recognised that conditions and their impact can often fluctuate over time—people can have changing conditions. Although the review saw examples of good practice, respondents expressed concern over whether the criteria were being applied appropriately. There is an issue about how people are assessed and how measures are put in place.

In the same way that a condition affects different people in different ways, people’s ability to carry out particular activities can vary. It is therefore difficult to apply the reliability criteria over a set period. However, regular reviews might allow the same tests to be carried out each time, which would help to monitor whether someone had remained the same, deteriorated or, indeed, improved. That, in turn, would mean that fairer assessments and payments could be given than under the system. Provided that the right safeguards are in place, that could be a good idea; if it is done in the right way, it could bring benefits.

The review set out short-term, medium-term and long-term solutions to make PIPs work better. Those include short-term actions to address delays and backlogs before the start of managed reassessment; medium-term actions to improve both evaluation of the accuracy and consistency of award outcomes and the collection of further evidence; and longer-term actions to redesign the PIP delivery model in terms of claimant experience and business effectiveness. In his response, perhaps the Minister can tell us whether changes to make the system better can still be implemented even at this late stage.

Ultimately, I am pleased the review has concluded and can now address some of the main issues with the new PIP model. PIP has the potential to improve on DLA, but it needs to be fairer and more objective, and it must meet the needs of people more than has been the case. I welcome the findings of the review, which will mould a new system that can work better. I hope that its suggestions will be taken on board.

10:05

[Mark Lazarowicz (Edinburgh North and Leith) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Sir Roger. I congratulate my hon. Friend the Member for Erith and Thamesmead (Teresa Pearce) on securing the debate, which is certainly timely. Like other Members, I was impelled to come to the debate by the experience I have had in my constituency surgery, where I have seen case after case, week after week, of people suffering from delays in PIP assessments, with all the difficulties that arise from that.

In passing, I should say that I am surprised that there are no Members from the Government parties in the debate. I am not one of those MPs who jump to conclusions as to why Members are not present in debates, or who accuse them of base motives, but it is hard to believe that no constituencies represented by Conservatives or Liberal Democrats have similar problems. I will charitably assume that Government Members have raised these issues with Ministers—I am sure they have—and that they are too embarrassed to come along today because they know they cannot defend the delays and the chaos, and because they would have to mention the types of experience that we have had in our constituencies. People have certainly had a bad experience, and the Government need to address that much more directly and seriously.

[Jim Shannon]

Perhaps they are away campaigning.

[Mark Lazarowicz]

Perhaps they are. If they are, perhaps they will hear from people on the doorsteps about some of the problems the Government’s policies are causing.

Like all Members here today, I have a fat file of cases, and if I were to read out all of them I would take up all the time available to me. However, I want to highlight three cases that demonstrate some of the wider problems affecting the system. The first is that of a constituent who wrote to me just before Christmas, saying:

“I am currently a student nurse who works part time as a chef. As a result of my PIP assessment waiting time I have been forced to sell my house and am unable to claim housing benefits to help towards my rent.

I am epileptic and am unable to work more hours to make ends meet. I am already far into my overdraft and I have been told I have to wait around 26 weeks for my assessment.”

Obviously, I took up that case, and things were moved forward a little. However, that is an example of how people’s lives are being turned upside down by the delays all of us experience in the system up and down the country.

Another case, which is quite interesting for a reason that will become apparent, involves a constituent who told me that he had made a claim for PIP in February 2014, following a heart attack in November 2013. In January this year, he told me that a decision had still not been made on his application. He is on a heart transplant list. In the meantime, he has a pacemaker, which is due to be replaced in Glasgow, but he is worried that he will not be able to meet the travel costs for hospital appointments. Again, that is an indication that financial costs and difficulties lead to other stresses and difficulties for those who suffer under this process.

I refer to that case because it illustrates the delays that affect so many people. The response I received from the DWP when I took up the case with the complaints resolution service was interesting. I have to say that DWP staff are normally very helpful when I get in touch with them, and they try to move cases forward, and the same is true of the Minister and his office. However, the reply I got from DWP staff said there had been some issues at the beginning of the case because there were not always up-to-date address details for the constituent—I do not have enough details to know whether the delay could be ascribed to the DWP, my constituent or Atos. In any event, I was told that the uncertainty

“resulted in the request for an assessment”—

presumably by the DWP—

“only being made on 3 October 2014. Although it was a little early for us to try and push for an appointment I got in touch with Atos”.

I was then told that a home consultation had been booked for 4 February.

As to the comment that

“it was a little early for us to try and push”

for an assessment, here was a case where somebody applied in February and, for whatever reasons, there was some delay in the process; but someone in the DWP felt that they had to allow it to go on a bit longer, no doubt because they knew that there were so many cases that they could not just press for an assessment. When an assessment was finally allocated, it was only at the end of a 16-week period, which as we know is the Government target.

The third case that I want to refer to highlights the difficulties of a constituent who was previously on the higher rate of the care component of DLA, but did not have the mobility component. He applied for PIP on 14 March 2013, and he was finally awarded it on 25 September 2014, about 18 months later. He was awarded the higher rate of both components of PIP, including the mobility component, but of course the higher rate could not be backdated by more than 28 days. We see such situations time and again, of course, and that shows the problems with the system. The idea that if someone gets the higher rate it is not backdated, but if they get the lower one they do not get money taken off them, sounds fair—at least, it sounds a simple approach to delays. However, surely no one can think it acceptable when people experience delays of not just 16 weeks but six months or a year.

The situation might not be particularly unfair if those assessed at the higher rate had it backdated but those assessed at the lower rate did not have their previous higher-rate payments taken away from them. We are not talking about large sums of money—well, we are talking about large sums of money, but not for the people receiving the benefits. That should be an incentive to the Government to get their act together and ensure that cases are dealt with more quickly, to prevent a situation in which someone assessed at a higher rate—in my example, for 18 months of the mobility component—is deprived of what they should have had over the relevant period because of delays that are no fault of theirs.

In that context, Paul Gray’s review is welcome. I think the limited scope of the recommendations disappointed many people, but that is not Mr Gray’s fault. It is the fault of his remit and the way he felt obliged to address the issue, given the time scale he was given and other factors such as the timing of the election. However, the fact that people are disappointed means that there is a need for a much more direct Government drive to deal, above all, with delays and associated problems. Let us not forget that the Government must take the blame for delays and failures.

Hon. Members will be aware of the damning report of the Public Accounts Committee. Its Chair said:

“The implementation of Personal Independence Payment has been nothing short of a fiasco. The Department of Work and Pensions has let down some of the most vulnerable people in our society, many of whom have had to wait more than 6 months for their claims to be decided.”

That is true. The Committee’s report said:

“Critical assumptions about the process were not fully tested and proved to be incorrect, resulting in significant delays to benefit decisions and a backlog of claims.”

That is a failure. It is a failure of Government, and the Government need to accept that responsibility.

We want, however, to deal with the problems. I am sure that we all want much more comprehensive action to deal with the delays that affect so many people. The present arrangement, whereby higher awards are not backdated beyond 28 days, needs to be replaced with backdating to the time when the application was submitted. I am sure that other hon. Members have received a briefing from Leonard Cheshire Disability, as I have, urging the Government to consider providing financial help to those who are in difficulties precisely because of delays in dealing with their applications.

Many hon. Members will be aware of a current and well-known campaign in Scotland led by Gordon Aikman—I am sure that the hon. Member for Banff and Buchan (Dr Whiteford) is aware of it. Gordon Aikman is suffering from motor neurone disease and is using the last few months of his life to campaign for better treatment for sufferers in many areas. One of the issues that he has raised is the fact that delay in assessment has a particularly serious effect on those whose condition is terminal, but whose prognosis is not that they will die within six months. Someone whose life expectancy is six months or less will be given an accelerated assessment, but I understand that the average prognosis for people with MND is 14 months, and those people are not given an accelerated assessment. However, it is clearly unacceptable that they should wait a year or so. The Minister should look at providing an accelerated assessment process for people whose prognosis includes limited life expectancy.

Leonard Cheshire Disability also proposes a general halt to further plans to extend benefits to more people until the assessment system is fit for purpose. That seems sensible to me, and it brings me to my final point, which is about the implications of recommendations to devolve PIP to the Scottish Government and Parliament. As the hon. Member for Banff and Buchan pointed out, the Smith commission’s report included those recommendations, and it is widely known that the Government will put forward details of the next stage in that process on Thursday. I accept that the Minister may not be able to respond today with reference to an announcement due on Thursday, but I hope that he will recognise that it would be crazy to continue to roll out PIP in Scotland under the present arrangements, with all their difficulties, just when we are about to provide for full devolution of PIP to Scotland with the agreement of all the parties.

[Jim Shannon]

In the context of the devolution of welfare reform, it is important to look at other parts of the United Kingdom, such as Northern Ireland. Sometimes we should be careful what we wish for.

[Mark Lazarowicz]

That is an interesting point, but all the parties want devolution, and we will have to live with the consequences. I welcome the devolution of large elements of the welfare system to Scotland. I think it will be better for Scotland, for those on benefits there, and for the UK, but I hear what the hon. Gentleman says.

My final point is that, as has been pointed out, one difficulty in making a judgment about the failures of the PIP system is the lack of data about the extent of the problems and the length of time people must wait for assessments. As the hon. Member for Banff and Buchan pointed out, we get the tip of the iceberg in our constituency offices. We take up cases and hopefully get them moved forward, but of course people tend to come to us only when they have gone through every other avenue and have not been able to resolve their problems. I suspect that there are still people who are not even coming to MPs or to benefit advice centres, and they are probably suffering worse than those who come to us, whose problems we can at least try to resolve.

We need action from the Government, and answers. I would like a commitment from the Minister on the situation in Scotland. I hope that the Department will give a statement quickly after Thursday’s expected announcement, explaining how PIP roll-out will be carried out in Scotland as the Smith commission proposals go into their next stage of delivery, which we know all the parties want.

10:18

[Mark Durkan (Foyle) (SDLP)]

It is a pleasure to serve under your chairmanship, Sir Roger. Like other hon. Members, I commend the hon. Member for Erith and Thamesmead (Teresa Pearce) on securing this debate on the independent review of personal independence payments, which are a significant part of the concern expressed by Members across the House about how welfare reform will work in practice. They are also pertinent to the delay in legislation on welfare reform in the Northern Ireland Assembly.

Devolution of social security in Northern Ireland is devolution up to a point. The parity principles and the exacting way in which the Government have enforced them mean that, essentially, the Assembly passes karaoke legislation: we can perhaps provide a bit of our own accent, but we cannot change the words and music very much. The key issue of the rules, the rates and the existence of benefits stems from legislation as framed in Westminster. There is something of a blur which, even after the Stormont House agreement, will continue in future. The issues that were brought out in the review of personal independence payments show that an awful lot rests on implementation, proper planning and preparation, as well as the capacity to deal with numbers, volumes, complexities, particular situations and, in some cases, the pattern of issues that have arisen.

Many of us are concerned, in the light of the Gray review, about the implications of further welfare reform. Significant changes can be made in the next Parliament under the Welfare Reform Act 2012 without the need for new primary legislation. Many of the assumptions or givens that need to be improved according to the review might be changed.

The welfare cap will bite into that as well, as it could mean that decision makers and those who process the applications, whether at the assessment provider stage or in the civil service—the Department for Work and Pensions on this island; whoever does it in Scotland under a future regime; and the Social Security Agency in Northern Ireland—will be working against new, fixed envelopes. They could have a fixed budget against which to assess how many people can receive benefits. That would change the nature of assessment decisions and the number of claims that can be approved. That issue was not resolved by what was agreed or understood between the parties when the Stormont House agreement was reached. It is important that we do not pretend that those possible adverse changes will not present real challenges to parties in the Assembly and the Executive in future.

Let me turn to an issue that stems from the evidence that was given to the independent review. In the context of the Stormont House agreement, the parties were concerned that the numbers might fall off in the transfer from disability living allowance to PIP in Northern Ireland, and that some of the decision-making processes might have adverse effects. They were assured that, compared with England, where there were delays in outcomes, the problems were not as grave, and that the Social Security Agency has learned from the experiences in England. Those assurances became working assumptions, but that could change.

Ministers here, probably in absolute good faith, made assumptions about how well PIP was going to work and how smooth the transfer would be. Clearly, those assumptions did not turn out to be correct, so we need to work hard in Northern Ireland. The relevant Committee in the Assembly, the Minister and the staff of the Social Security Agency must work hard to apply lessons learned in the light of the review. They must listen to the concerns that I have heard today and on other occasions, both here and in the main Chamber, from many hon. Members who have more direct and immediate experience of this issue, and whose constituents have told them about their frustrations and difficulties.

In an intervention, I spoke about the victims of the troubles, who are worried about having to repeat their stories to assessment providers, civil servants or whoever else. They are worried about making their experience the subject of a review argument. They do not want to be put through those difficulties and talk about such sensitive things. We have made many promises to victims in Northern Ireland. We have set up victims units and victims commissioners to ensure that, when public bodies and agencies deal with them, their needs are given due consideration. It would seem strange if we were to completely confound the position of victims in relation to personal independence payments and treat them in a way that differs from the particular provision that, understandably, has been made by the Government here for people who have served in the armed services and whose disability stems from their experience and the injuries that they received in that context. If consideration is rightly given to people in that situation, it is important that we have bespoke consideration in Northern Ireland. Hopefully, that is being further worked on.

Personal independence payments are not the only thing that affects the future of DLA. In the House last week, we saw the launch of “Right from the start”—essentially the manifesto pitch of the combined campaign, Every Disabled Child Matters. It expressed worry about what would happen to DLA for those under 16, given that under the Welfare Reform Act, Ministers in the next Parliament will have the capacity to “disappear” DLA for under-16s without recourse to primary legislation. That is a live concern for a number of the groups in the policy community that deals with children and families coping with disabilities.

We are glad that lessons are being learned and that they have been reflected in the independent review. However, it is not clear that all the lessons and the issues that hon. Members have raised have been fully reflected and addressed in the review, so more needs to be done by the Department and Ministers. In the specific Northern Ireland context, we can use the light of the review to guide us, but we should not pretend that the path will be straight or smooth, or that we have cracked it. Under the Stormont House agreement, the Executive have been allowed to use some of their block grant resources to provide a hard shoulder to mitigate the impact of the change and its implications. Of course, if the welfare cap and other changes materially change the numbers and the issues, the Executive are not going to be able to find more hard shoulder from the block grant. The situation that the Executive face is different from the situation outlined in the Smith commission report. That difference needs to be understood by both places, and it needs to be understood here.

I again thank the hon. Member for Erith and Thamesmead for giving us the opportunity to hear about the issues directly from her and others. It is a good alert for us. I hope that my colleagues and I can ensure that our colleagues in the Assembly and the Department in Belfast take note of all the issues that have been raised.

10:28

[Kate Green (Stretford and Urmston) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I congratulate my hon. Friend the Member for Erith and Thamesmead (Teresa Pearce) on securing the debate, and I thank all hon. Members for their valuable comments.

For months, claimants have been telling us of problems with the administration of personal independence payments. It came as no surprise to read Paul Gray’s independent report and the concerns that he raised. Gray highlights a disjointed claimant journey, a lack of trust by claimants, a lack of transparency in the process, and a pretty poor experience all round for claimants seeking to apply for PIP. Gray states that

“the primary focus of early comment and attention on PIP has been the unfortunate reality of long delays and backlogs”,

thus reiterating what MPs have been hearing again and again from our constituents over the past few months. It is very clear that the roll-out of this benefit has not gone to plan.

The initial plans for PIP suggested that 500,000 fewer people would receive PIP than DLA by the end of 2015-16, and that all working-age DLA claimants would be reassessed by that time. That is some 2 million-plus claimants, but according to the most recent official figures, which were published just before Christmas and go up to the end of October 2014, the backlog of cases waiting for a decision stood at 287,000, and just 2% of affected DLA claimants had been reassessed.

The Minister has said—we heard it again this morning—that reducing the delays and the backlog in PIP is his top priority. Clearly, that is welcome, and I am sure we will hear from him about the progress that has been made. As my hon. Friend the Member for Edinburgh North and Leith (Mark Lazarowicz) pointed out, on 15 January in the House of Lords, Lord Bourne told peers that the backlog had fallen to 107,000. There has been no official publication of that figure, and I have to say that it really is not acceptable for Ministers suddenly to pull figures out of the hat only a matter of parliamentary days after official figures giving a very different picture have been published. I hope that the Minister will be able to give us more information about the source of that figure of 107,000 and tell us when proper underpinning data about that will be publicly available, so that Members can scrutinise them.

It is welcome to hear that there has been progress in reducing the backlog, but it is also important to remember that the Government have shifted the goalposts. The original intention in the impact assessment was that it would take 12 to 16 weeks from application to receiving a decision. However, in June 2014, the Secretary of State said that the aim was that by the end of 2014 it would take a maximum of 16 weeks for an assessment—not a decision, but an assessment, which is one stage before a decision is made. The Minister reiterated the commitment to a 16-week time scale for assessments when he appeared before the Select Committee on Work and Pensions on 10 September. The DWP’s PIP online toolkit, which I checked last night, also confirms the ambition of a 16-week time scale.

However, even that less ambitious target still has not been achieved for all claimants, as we heard from hon. Members today. I hope the Minister will tell us when and whether the 16-week target has been met. It certainly seems to be being indicated to claimants that it will not be met. My hon. Friend pointed out the case of his constituent, who was told that there would be a 26-week wait, and what is more, that it would be too early to chase until 16 weeks had gone by. That does not suggest to me an ambition to clear that assessment within a 16-week time frame.

It is also very concerning, from another example that my hon. Friend pointed out, that where something is wrong in a claim, the clock seems to be set back to zero. An application that might have been made many months ago, as he described, but with a wrong or missing piece of information is not timed from the beginning of that claim, but only from when that piece of information is received. I understand that the Department will say that it cannot process an incomplete claim, but the consequence for that individual and others like him is that they have waited months and months to get an assessment and to get the money that they need.

I particularly want to ask the Minister about the situation with young people turning 16, as mentioned by my hon. Friend the Member for Erith and Thamesmead. Kath Whittam is a parent living in Southwark, whose daughter received DLA. A letter was received from the DWP in February 2014 as her daughter approached her 16th birthday, advising her to prepare for PIP. The family were anxious about the situation, but they put in an application and Kath underwent an assessment to be the responsible fit and proper person to receive PIP payments and administer them for her daughter. However, because of the backlog, the PIP assessment still had not been undertaken by the time of her daughter’s 16th birthday, and because London, where the family live, is not yet in the area affected by migration to PIP, the daughter was no longer in the cohort due to be migrated to PIP, so the family were sent another DLA claim form. The daughter was, in fact, re-awarded DLA indefinitely in September.

That kind of situation is not just appalling for the claimant—and it is; it was stressful for Kath and her daughter, who were anxious about the PIP claim and about having to initiate a claim, and then being told that they had to apply all over again for DLA—it is wasteful of public money. There was all that pointless correspondence, the cost of a wasted assessment to establish that Kath was a fit and proper person, and then her daughter ended up back on DLA.

I asked the Minister in how many cases that had happened, and I received his written answer on 8 January, but it did not address that specific question. Perhaps he will tell us today how many 16-year-olds, or those approaching 16, have been through and successfully completed the PIP claims process, and how many have not and have had to return to DLA.

The cost of administering the benefit has been impacted by the need to draft in resources to deal with the backlog. The Minister, again in a written answer on 8 January, told me that 76 temporary staff have been employed to help, although he ignored my specific question about the rise in cost of staff time. Meanwhile, Paul Gray, in his report, highlights the fact that staff are undertaking evening and weekend work to help deal with the backlog.

There is considerable uncertainty about future costs, about the level of awards, and about the capacity to shift large numbers of reassessments once the full programme of managed reassessments commences. That uncertainty has been flagged up by both the National Audit Office and the Office for Budget Responsibility.

In February 2014, the NAO said that PIP was £140 million behind the projected £780 million savings in the current spending review period, and that the DWP had revised down the projected savings four times between January 2012 and December 2013 due to delays. It said that the administrative cost had risen from £49 for DLA to £182 for PIP, and that average waiting times for DLA were 37 days compared with 74 days for PIP. We do not know the current position on waiting times, because the DWP, as has been noted, will not publish all that information until March.

The NAO also said that the DWP had been set a budget of £101 million for delivering PIP in 2013-14 and £85 million in 2014-15. Will the Minister say whether that sum has been used in full or whether it has been exceeded, and if so, has it been used to deliver fewer of the assessments that had been planned when the budget was set? The NAO concluded:

“Because it may take some time to resolve delays the Department has increased the risk that the programme will not deliver value for money in the longer term.”

In October, the OBR published its “Welfare trends report”, which noted DWP projections:

“16 per cent of the DLA/PIP caseload will be on PIP by 2015-16, rising to 63 per cent by 2018-19. With comparatively little outturn data and a delayed rollout, we adjusted our forecast upward in March 2014 to reflect the emerging outturn data on the pace of the rollout. But it is too early to tell whether that was sufficient.”

Then, at the autumn statement in December, the OBR revised spending upwards by a further £400 million a year as a result of more people being found eligible for the new benefit than had been planned.

The Gray report shows that all those concerns about delays and costs to the public purse are matched by poor claimant experience. Starting right at the time of the application, Gray points out difficulties for some claimants with hearing impairments or learning disabilities using the telephone, and says that there is a need for alternative forms of digital access. Will the Minister say how he will take that forward?

There is a lack of information about the processing of people’s claims. Gray highlights that people are being told to ask the DWP, but the DWP says, “Ask the assessor” and the assessor says, “Ask the DWP.” As he said, that is “not an acceptable level” of customer service for any institution in 2014. He identifies problems with implicit consent; will the Minister say what steps he is taking to clarify that to staff and assessors? There are issues with the complexity of the claim form and the time taken to complete it, and people do not know that they can ask for an extension. As for gathering evidence to support a claim, Gray suggests better information sharing, which I think is a welcome suggestion, and I would like to know what the Minister is doing about it.





Gray also highlights uncertainty about who is responsible for gathering evidence—whether it is the assessor or the claimant. Sorting that out is pretty crucial, because the claimant has one month to gather information and submit a PIP2 claim, and many miss that deadline. In a written answer on 8 January, the Minister told me that there had been 159,000 disallowed claims, of which 48,500 were the result of non-return of the PIP2 form within the time limit. Is the DWP tracking what happens to those people? Do they apply again? That would mean additional cost to the public purse and more stress for the claimant. How many claims are treated as withdrawn, rather than disallowed? Does that include cases in which evidence has not been returned in time, and what impact has it had on clearance figures?

Gray highlights other problems, including appointments cancelled or people not being notified in time, the configuration of the room for assessments, and a lack of understanding by claimants of the purpose of some of the questions; it needs to be made clear that it is a functional, not a medical, assessment. Gray highlights some problems with the substance of the assessment: the descriptors on planning a journey, the use of aids and adaptations, and the problems with mental health conditions, fluctuating conditions and learning disabilities. He also highlights, very importantly, the use of informal observations as part of the assessment process and the need for transparency around that. He draws attention to poor communication of decisions. I am pleased that the DWP will review decision letters. When and how will that be done, and will claimants be involved?

In conclusion, Ministers need to be sure that the process of administering PIP is fair and effective. Better communications with claimants are clearly needed. Gray also suggests better liaison between assessors and claims managers. Decisions need to be timely and fair. Worryingly, Gray notes wide geographic variations in outcomes. He is right to recommend “horizontal” scrutiny of claims to ensure consistency, and a proper evaluation strategy; and he is surely right, in the light of all the delays, costs and confusion, to recommend action to redesign the PIP model regarding the claimant experience and business effectiveness. I hope that the Minister will take this opportunity to answer the many questions that colleagues and I have posed, and I look forward to his response.

10:42

[The Minister for Disabled People (Mr Mark Harper)]

It is a great pleasure to serve under your chairmanship, Sir Roger. I congratulate the hon. Member for Erith and Thamesmead (Teresa Pearce) on securing the debate. In the time available, I will do my best to answer as many as possible of the questions that she and others asked.

A number of colleagues raised the issue of delays and statistics. I think that colleagues got the message that I gave before, because a number of them helpfully repeated it, about dealing with the delays that claimants have experienced. It was and remains the issue on which I am spending a lot of time, to ensure that we resolve it. Both I and officials have been working very hard to do so, as have both the assessment providers.

We have quadrupled the number of assessments cleared each month since January last year, and the number of people with a PIP claim in payment almost doubled between July and October. This morning, the Department has pre-announced that we will publish next Wednesday information on the number of PIP claims processed. I have written to the Chairman of the Work and Pensions Committee, the hon. Member for Aberdeen South (Dame Anne Begg), to inform her of that fact, and I will of course take the Committee through those key pieces of information on the day on which I give evidence.

The normal publication of clearance times and outstanding case times, which we pre-announced in December, will take place in March, and the exact date will be pre-announced in the usual way. That will be the publication of the normal set of statistics, which will then take place on a regular basis. However, there will be an ad hoc publication next week, so that my conversation with the Select Committee will be informed by properly verified statistical information, which I think will be helpful, rather than unverified management information. As I said, I have written to the Chairman of the Committee this morning to let her know.

Hon. Members referred to the impact of the delays. It is worth making the point that PIP is designed to meet the extra costs of someone’s disability or health condition; it is not a benefit designed to meet normal day-to-day costs. In this and other debates, hon. Members have sometimes talked about someone who has had to leave work because of their health condition. PIP is obviously not designed to deal with the costs of that. Those costs will be dealt with by other benefits—for example, employment and support allowance.

All new claims for PIP are backdated to the date of the claim. I recognise, of course, that that presents a cash-flow problem for people, which is why we are working hard to deal with the delays. Of course, in the case of all reassessed claims, people will continue to receive their DLA while awaiting the PIP decision. Other support, which is not tied to receipt of PIP, is available for those on a low income. I am talking about help with energy bills, concessionary bus passes and help with NHS transport costs; and there is the ability to get a blue badge through an assessment, rather than being passported through PIP. Carer’s allowance can be backdated to the point from which PIP was awarded, as well. Again, I recognise that there is a cash-flow issue there, but people are able to backdate the costs.

I thank Paul Gray very much for his report. He did a thorough job. He talked to the assessment providers, to a lot of people who have had experience of claiming the benefit and those who have assisted them, and to many organisations involved in the process. It is a thorough report, and we will of course respond to it in due course. I can say some things today, because some of the recommendations are about things that are already under way. For example, we are reviewing and rewriting all the letters to claimants to make them simpler, easier to understand and clearer. We are also exploring the use of other medical evidence held by the Department. For example—this relates to a question asked by both the hon. Member for Erith and Thamesmead and the shadow Minister, the hon. Member for Stretford and Urmston (Kate Green)—if someone has gone through a work capability assessment and we have an ESA85 report from that assessment, we are using that information to support and help inform the decision to award PIP. Sometimes that will enable us to make a decision without a face-to-face assessment. It may mean that we have enough information to make those decisions on paper—it is obviously welcome if we can do that—or it may help to inform the decision, so we are looking at doing that.

We are looking at using more proactive communications. For example, since last April claimants get a text message to confirm that their form has been received, so that they know that it is in process. We are also building better relationships between the DWP case managers who make decisions and the health care professionals who make assessments.

We have made changes to some of our internal processes and IT to further streamline clearances of claims. We have improved communications to claimants at the beginning, to try to ensure that they know what the best evidence to supply is and how long their claim may take to be assessed, and to stress the importance of sending us information and following the process. We have a dedicated customer claim line for terminally ill claimants. The assessment providers are also providing claimants with better information about how long a claim may take and whom they should contact at each stage of the process.

As a number of hon. Members mentioned, including the hon. Member for Edinburgh North and Leith (Mark Lazarowicz), there is a fast-track service and a dedicated claim line for terminally ill claimants with a prognosis of six months or less. We are clearing those cases in about 10 days, which is in line with expectations, and 99% of the decisions lead to an award. In the review, Paul Gray acknowledged that the process for terminally ill claimants had significantly improved following the work that the Department and my predecessor did with Macmillan Cancer Support.

[Mark Lazarowicz]

I hear what the Minister says, and perhaps he will come to this later, but what about the situation that I described of people whose prognosis is more than six months but still relatively short, who will be hit badly when there are delays of much more than 16 weeks?

[Mr Harper]

The hon. Gentleman makes a perfectly sensible point. The solution is to fix things so that people are not having to wait so long. Clearly, we have to state a time. People have various health conditions and disabilities, and we have to draw a line somewhere, but the real solution for the cases that the hon. Gentleman mentions is to do what we are doing, which is to ensure that people going through the process have an assessment within a sensible time. Then the issue that he set out simply does not arise, because they are getting an assessment, a relatively speedy decision and the support that they need. That is the solution for those with a progressive condition, with a longer prognosis, but obviously for those with a terminal illness who have a very short time to live, we have put in place a much faster process, which is working well.

The hon. Member for Erith and Thamesmead mentioned interventions. The point of them is to ensure that the amount of PIP paid is correct, so that awards can be adjusted upwards if someone’s needs have increased or downwards if they have decreased. That has happened in a very small volume of cases to date. The hon. Lady gave a specific example of one of her constituents. Interventions are set on the basis of when needs change and when awards are made. Given that interventions can go in both directions, it is certainly not in the interests of the Department to review awards more frequently than is necessary, because to do so creates unnecessary work.

The hon. Lady mentioned reassessment. There are two kinds of reassessment going on. For those who have time-limited awards, there is a process called natural reassessment—the names are not brilliantly informative—which is being switched on only in areas where we know that we have the capacity to carry it out. One of the things that I do before I take those decisions is to ensure that our assessment providers have the necessary capacity, and I have been switching the process on only when where there is that capacity.

The hon. Lady mentioned managed reassessment, which has previously been announced as starting in October, under which those with an indefinite DLA claim will be reassessed. We have made it clear that we will roll that out only where and when we have the capacity to do so. It is clearly not in our interest to start reassessing people if the system does not have the capacity to do so. By the way, I thank the hon. Member for Edinburgh North and Leith for his positive comments about DWP staff and staff in my private office, where he has had to raise issues. People do not often say nice things, so I acknowledge his comments on behalf of the Department.

Colleagues from Northern Ireland raised a number of matters. The hon. Members for Strangford (Jim Shannon), for East Londonderry (Mr Campbell) and for Foyle (Mark Durkan) talked about the Stormont House agreement. I have been in correspondence with Mervyn Storey, the Minister with responsibility for welfare in Northern Ireland, and he and I are trying to get a date in the diary to meet. One thing that we will talk about is the progress that has been made on the Stormont House agreement and welfare reform. I am sure that we will both want to talk about the lessons learned from rolling out PIP in Great Britain, which may apply to the roll-out in Northern Ireland.

[Jim Shannon]

I understand that relevant measures will be going through the Northern Ireland Assembly during the next fortnight, so the implementation in Northern Ireland will be in place in time for the Minister’s meeting with Mervyn Storey.

[Mr Harper]

The hon. Gentleman makes a good point. There are two issues: the legislative process—I take his word about the timetable for that—and the implementation and operational matters. The Department and I will provide every assistance to the Northern Ireland Executive to make sure that that goes smoothly. It is worth putting on record—

[Mark Durkan]

Will the Minister give way?

[Mr Harper]

Let me finish my comment, which is about a point that the hon. Member for Foyle raised. The Stormont House agreement states that although the Northern Ireland Executive normally legislate on welfare on a parity basis with Great Britain, they can deviate from parity, partly to recognise the history of Northern Ireland and some of the specific issues that apply. However, the agreement also states that the cost of deviations from parity with Great Britain must be met from the existing Northern Ireland budget. The hon. Gentleman set that out, and I wanted to put that on the record to clarify the position. The Northern Ireland Executive can deviate from the normal process when they legislate to deliver the operational effect.

[Mark Durkan]

Of course, there have historically been some differences in delivery, even within the parity regime, on matters such as housing benefit. When the Minister meets Mervyn Storey, will he ensure that he, as the Whitehall Minister, says nothing to disturb our working assumption that much of the room that we thought would have to be made up from the Executive’s block grant is available to us within our spending remit under the welfare cap? That cap is not really biting at the moment, but it may do so in the future. Can he assure us that our assumptions about not having to rely so much on the block grant, and on the rest of the Executive’s budget grant, will not be disturbed by any meeting that he has with the devolved Minister?

[Mr Harper]

I will certainly make sure that the meetings I have with the Minister are helpful. The hon. Members for Banff and Buchan (Dr Whiteford) and for Edinburgh North and Leith mentioned the Smith commission, which is relevant to the conversations in Northern Ireland and in Scotland. It may not be far in the future, but I cannot anticipate the Government’s comprehensive response to the report published by the Smith commission, for which hon. Members will have to wait patiently a little longer. It is worth saying that we have to be careful, because Ministers have to follow current legislation. All that has been announced in the Smith commission report is what will happen in the future. The Government have made commitments, but no legislation has yet been introduced. When legislation is introduced, the Scottish Government will have to decide what they will do, and our conversation today makes it clear that we will have to think about operational delivery. Ministers have to proceed on the basis of the current law.

[Dr Whiteford]

The point I was trying to make was that in looking forward—obviously, we do not know what is in the proposals—the Government’s evaluation of the current policy is important to inform any future decisions made elsewhere.

[Mr Harper]

I take that point, and Paul Gray’s review will partly inform that. If there are lessons to be learned about implementation when the proposals are published and changes are made, I am sure that officials in my Department and Ministers in the UK Government will want to work in partnership with Ministers and officials in the Scottish Government to ensure that things proceed smoothly. We will publish the response to the Smith commission in the not-too-distant future. As Members have said, a commitment has been made to do so by 25 January. I want to put on record that we will proceed on the basis of existing law.

The hon. Member for Foyle mentioned children. There are no plans to extend PIP to children; we have always said that we wanted to see how PIP for adults worked. If a decision was made to extend PIP to children—I emphasise that there are no plans to do so—it would be subject to consultation and to the affirmative procedure in Parliament, so both Houses would have to be involved in that decision. The hon. Gentleman is right to say that primary legislation would not be required, but parliamentary procedures would have to be followed.

On the question of the transition from DLA for young people, which the hon. Member for Stretford and Urmston mentioned, people cannot claim PIP until their 16th birthday, but we contact people in advance to enable them to prepare and, as she said, to see whether the child needs an appointee to help them through the process. She asked some specific questions, following up on her earlier written question. I will look at the Hansard report of the debate and, if she is content for me to do so, I will write to her and place a copy of the reply in the Library, which I hope will help colleagues.

In summary, I have made it clear that delays, which several hon. Members have touched on, are unacceptable. The Department and providers have been working hard to deal with them. The hon. Member for Erith and Thamesmead mentioned that I will be giving evidence to the Work and Pensions Committee next week—I am looking forward to that, as is she—on a number of issues, including PIP. I will be happy to explain the progress that we have made. We will publish properly verified statistics to make sure that that is an informed discussion.

We have welcomed the Gray review. I have said a little about some of the areas in which we are already working on it, and we will publish a full response. I think I have answered seven of the nine questions asked by the hon. Member for Erith and Thamesmead—we will cover the two that I did not answer in our full response to Paul Gray’s review, which we will deliver in due course. I think I have touched on all the questions that hon. Members have asked. The debate has been helpful, and I am grateful to the hon. Lady for securing it.

[Sir Roger Gale (in the Chair)]

Order. Before I call Mr McKenzie to open the next debate, the Chair has not been notified, but there appears to be a change of Minister. Is that correct?

[The Parliamentary Under-Secretary of State for Energy and Climate Change (Amber Rudd)]

Yes.

Fuel Prices

Wednesday 21st January 2015 Westminster Hall

10:59

[Mr Iain McKenzie (Inverclyde) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I am delighted to have secured this debate, although a longer debate would have given other Members an opportunity to contribute. My constituents are not the only ones to have had problems with fuel pricing, and other Members might have highlighted other areas of the country that are having the same problem.

I will highlight three matters that affect fuel pricing across the country to the detriment of motorists. The first is pricing at the pump and the lack of competition. The second is the supply chain and where profits and investments are being made in that supply chain. The last, but by no means least, as my speech will show, is taxation on fuel.

I acknowledge that, at last, we are seeing average petrol prices going back to the levels last seen in the autumn of 2010. However, we are being told and led to believe that that is due to an intense pump price battle between supermarkets and independent retailers. If that is true, my constituency of Inverclyde is certainly not witnessing it. Our prices remain higher than in areas outwith Inverclyde’s boundaries. My constituents would like to take issue with that, and it would seem that we are not alone. There remains significant variation in petrol prices across the country, even between neighbouring communities. Unbelievably, there can be substantial variation between the price of fuel at the pump over very small distances, and my constituents suffer from that. Fuel prices at the pump in Inverclyde can be 3p to 4p more than at forecourts just 15 miles away, and we are probably not the only area of the country that is witnessing such price differences within such a short distance.

Why are prices so variable from community to community? In the past decade, especially in my area, large supermarkets have moved in to dominate the forecourts, with many independent and even oil company-owned fuel retailers closing their roadside filling stations. The Petrol Retailers Association has told me that 900 independent retailers across the country have closed in the past five years. In Inverclyde, 14 independent filling stations have closed in recent years, leaving only two independently operated BP filling stations and, of course, two very large supermarkets. The supermarkets moved in, sold off fuel cheaper than the small independent fuel retailers and ended the competition from those small outlets.

[Mr Angus Brendan MacNeil (Na h-Eileanan an Iar) (SNP)]

The hon. Gentleman describes the experience of many people throughout Scotland, particularly rural and island Scotland. He probably agrees that the volumes of fuel going through service stations will affect the price that the stations have to charge, but does he further agree that there is a lack of transparency in the whole fuel chain from the refinery to the forecourt? It is opaque, so it is difficult to see what is happening and who is taking what fraction of the cost all the way through.

[Mr McKenzie]

The hon. Gentleman makes a good point, which I will emphasise later in my speech. We need to focus on that issue as much as on competition.

Not all the independent retailers that closed were small fuel outlets; in my area many were owned by well-known oil companies such as BP, Texaco and Esso, whose outlets are now scarce. In fact, some have vanished entirely from our roadsides, and it can be difficult to understand the pricing of those that remain. A classic example is the two BP filling stations in my constituency, which are within three miles of each other. Unbelievably, their prices vary by 3p. Work that one out. However, BP tells me that it franchises the filling stations and allows the franchisees to set their own pump price, and therefore there are differences, although the public will look at the name on the forecourt and assume that they are run by the same organisation. Remarkably, the prices at those two franchise filling stations are always higher than at the supermarkets. How much longer will they be trading?

[Jim Shannon (Strangford) (DUP)]

I congratulate the hon. Gentleman on securing the debate. This issue burns for people in my constituency, because the cost of fuel is enormous for those who need a car to get to work, social activities or school. Does he share my concern that, whenever fuel prices rise, within 24 hours the forecourt prices go up, yet when there is a massive decrease in fuel prices—oil is down by some 60%—we do not see a drop in prices at the forecourt? Why is there such an emphasis on cost when fuel prices go up but not when they come down?

[Mr McKenzie]

The hon. Gentleman makes a good point. We have seen that in the energy market, too. The blame is always placed on the wholesaler, but the problem is that we do not have evidence to substantiate whether that is where the blame should lie. I will go on to ask the Government to investigate the wholesale price of petrol.

The supermarkets have a much-voiced three-mile radius of competition—they tell us that they will match prices within three miles of each large supermarket. Of course, for my constituents that realistically means matching prices with themselves, because there is no one in that radius to challenge them on their pricing. Is that competitive? No, because competition was killed off many years ago.

In early November 2014, Asda, Tesco, Sainsbury’s and Morrisons all rushed out plans to cut prices at the pumps by 1p a litre. In stark contrast, the RAC called for a further 4p cut in unleaded and 2p cut in diesel, to be fair to motorists. The campaign group FairFuelUK has called for a Government inquiry to get to the bottom of the price fluctuations in fuel. Will the Minister consider adopting Labour’s calls for the Competition and Markets Authority to start the process of launching an inquiry into petrol pricing on the forecourts? She might want to support the Road Fuel Pricing (Equalisation) Bill, which the hon. Member for Wyre Forest (Mark Garnier) introduced yesterday using the ten-minute rule. At a time when we are asking the Government to look favourably on protecting dairy farmers from supermarkets, why not protect motorists, too?

The next area that I would like to explore is the supply chain from extraction, refining and transport to the pump. Just where are profits and investments being made? Can we identify where the price is being hiked? As we have seen in the past couple of months, the oil price per barrel has dropped significantly. My rough analysis of the supply chain suggests that exploration costs make up about 5%, capital costs—leasing buildings and rigs, and so on—make up 20%, and paying staff and transport costs and so on makes up 10%. Then there is tax of some 40%, and oil company profits make up the final 25%.

[Mr MacNeil]

The hon. Gentleman is being kind and generous with his time. He has mentioned tax. As the price goes down, tax becomes a larger share, and the Government have a role to play in that. Is it not iniquitous that, in small places with lower volumes of sales and where higher margins are required on each litre of fuel, VAT is also charged? Small rural places are paying more tax per litre—the islands certainly are—than the big cities that have the advantages of large volumes of sales and tough competition between supermarkets.

[Mr McKenzie]

I thank the hon. Gentleman, who mentions the VAT hike that the Government placed on fuel when they came to power in 2010. He also mentions the islands. I was contacted by an islander the other day who said that fuel was being transported to the island to supplement the price.

In the past couple of months, the oil price per barrel has dropped significantly. However, as we have already discussed, the wholesale price—the cost of production and refining—is calculated at 22p per litre on fuel that costs 109p. We need to investigate the supply chain to see whether that is the case.

What of the failure to reduce costs as quickly as they are increased? I have highlighted the problem in the domestic energy sector—we had a debate on that the other week—whereby companies pass on wholesale price increases quickly, but not wholesale price drops. Energy companies always announce their price hikes by blaming the wholesale prices, but when wholesale prices fall, they never seem to pass the savings on to customers quickly. We seem to have the same problem with fuel—reduced costs are apparently not being passed on promptly to the consumer on the forecourt.

Oil prices, as I have said, have fallen by about a third since the summer of 2014. Campaigners say that prices are quick to increase when wholesale costs increase, but when wholesale costs go down, prices decrease slowly. We need to investigate that to see whether evidence shows that that is indeed the case, and whether wholesalers are to blame. The AA has called for transparency in the supply chain and for the Government to make petrol wholesalers reveal their prices. It says:

“Consumers can see the price of oil and they know how much they pay for petrol but they do not know the cost of wholesale, which means that petrol retailers cannot defend themselves when they are accused of not passing on price cuts.”

There was an investigation into petrol prices by the Office of Fair Trading, and in 2013 it published its study, which stated that the fuel market was working fine. However, that was not a formal inquiry, and many motoring organisations were dissatisfied with its conclusions. The Petrol Retailers Association considered the report substantially flawed owing to the fact that it did not investigate anti-competitive pricing by oil companies, or by supermarkets that subsidise fuel with margins from groceries to eliminate competition and enjoy a monopoly in the fuel market.

It is also worth noting that, in August 2013, the European Commission started a high-profile investigation into alleged oil price fixing by certain oil companies and traders. That involved dawn raids on oil companies in places as far afield as Norway, Holland and London. We have heard very little from the Commission on the findings of its investigation and, given the inadequacy of the OFT report, we need to have an open and transparent look at where profits and investments are being made. It looks as if we need to apply something similar to Labour’s proposals for the energy regulator to enforce an immediate, fair and proportionate price reduction.

Finally, I will look at Government taxes levied on fuel. The largest portion of a fuel bill goes to the Government: with petrol priced at 109p a litre, fuel duty is 58p and VAT is 18.2p of that. Fuel duty has been frozen since March 2011 and it looks like it will remain so—hopefully—until at least May 2015, but it still makes up a hefty chunk of the cost. More than 60% of what motorists pay goes to the Exchequer in fuel duty and VAT. According to FairFuelUK:

“The Treasury hides the staggering fact that the UK still has the highest level of percentage taxation on road users in the EU for diesel and the second highest for Petrol. The Chancellor currently takes considerably more at the pumps for diesel in tax than any other EU Finance Minister.”

The Petrol Retailers Association believes:

“The main reason pump prices have not fallen in line with crude oil is due to the high proportion of Government tax levied on fuel.”

What of Labour’s record in office on fuel duty? According to the House of Commons Library, under the previous Labour Government the percentage of the cost of a litre of fuel paid in tax fell from 75% in 1997 to 65% in 2010. In contrast, between 1990 and 1997, under the Conservatives, it rose from 59% to 75%. In government, Labour announced the postponement of fuel duty increases on several occasions—in total we postponed increases or froze fuel duty in real terms 13 times. The coalition is in government now, so I ask the Minister to discuss with her Treasury colleagues at the very least to drop the extra tax from their VAT hike on fuel.

[Mr MacNeil]

I am hearing the hon. Gentleman waxing lyrical about the former Labour Government. I was trying to bite my tongue, but I have to remind him of the fuel duty escalator that they were quite happy to use. Is it now a source of shame to him that his Government did not introduce a rural fuel derogation that would have helped island and remote areas, despite being asked for that for four or five years? They could and should have done that, but they refused. Under pressure, this Government have now done that, but that was an opportunity lost by that Labour Government.

[Mr McKenzie]

As the hon. Gentleman will be well aware, the fuel duty escalator introduced by Labour was a green tax to put funds into green energy. Unfortunately, that idea has never been taken up. We heard from this Government that they were to be the greenest that we had ever seen, but they are not by some margin.

Let me now focus on why we need to reduce fuel costs. Apart from the obvious—reduction in transport costs for goods, and increasing employment—large numbers of workers rely on a car to get to their place of work. They have no choice in that, especially with the price of rail travel as it is today. Petrol and diesel are simply unavoidable, essential costs for millions of motorists and businesses—90% of people in employment say that they have no choice but to use their car to get to work, and 44% also use their vehicle when at work.

In a recent survey of small and medium-sized enterprises, one in 10 said that they were making staff redundant owing to high fuel prices, and two in 10 said that they had stopped recruitment. Car-owning households are estimated to spend a high percentage of their disposable income on running a vehicle. Again, car ownership is not a luxury but an essential part of modern life. Let us not forget that public transport in the form of bus and rail travel must also reduce in price if oil prices are falling.

In conclusion, I ask the following of the Minister. We need an open and transparent inquiry into fuel pricing. We need more parity on fuel prices at the pump and an end to the ridiculously small radius for competition and price comparison. Fuel wholesalers must be made to reveal their prices, because that will allow retailers to defend themselves when they are accused of not passing on cuts.

At the very least, we need a further freeze in fuel duty. In view of the continuing cost of living crisis and the low rate of inflation, there can be no justification for an increase—if anything, there should be a reduction. Finally, the Government should return the rate of VAT on fuel from 20% to the level it was before they came to power in 2010. I am in danger of showing my age here, but if the British motorist was to sit down and work out how much they paid for a gallon of petrol, they would be appalled.

11:19

[The Parliamentary Under-Secretary of State for Energy and Climate Change (Amber Rudd)]

It is a pleasure to serve under your chairmanship, Sir Roger. This has been a very interesting topic to debate. It has attracted a lot of attention, and I hope I can answer most of the questions that the hon. Member for Inverclyde (Mr McKenzie) asked.

Let me begin by saying that the evidence is that at a national level the UK fuel sector represents a very competitive market. It is as a direct result of that competition that we see the fall in crude oil prices being passed on to consumers at the pumps and in their homes. The hon. Gentleman particularly wanted to address the issue of whether competition is working nationally and in his constituency, so I will comment on the role and what I believe is the success of competition in the road fuel market.

The downstream fuel market served by UK petrol stations and forecourts is a market in which competitive forces should operate to deliver a fair deal for customers. It is subject to UK competition law, and the Government do not have a direct role in setting the price of petroleum products in an open and competitive market. As the hon. Gentleman said, in January 2013, the Office of Fair Trading published the results of its call for information, which found no evidence that oil price rises are passed on to motorists more quickly than oil price falls; that issue was also mentioned by the hon. Member for Strangford (Jim Shannon). The OFT national analysis suggests that the so-called “rocket and feather impact”, whereby prices rise like a rocket and fall like a feather,

“does not appear to be a significant feature of the road fuel sector in the UK.”

The OFT report continued:

“Our estimates of the speed at which upstream price changes were passed down the supply chain when upstream prices rose was not found to be statistically significantly different from the speed of pass-through when upstream prices fell indicating that this pass-through is, on average, symmetric, both for diesel and petrol.”

As we have discussed, movements in pump prices are driven by crude oil prices, and analysis by the Department of Energy and Climate Change suggests that, once crude price changes are converted into sterling, they are fully passed through into pumps within six to seven weeks, which largely represents the time required to refine crude oil into petrol and diesel, and to distribute petrol and diesel. Although we have already seen some price falls, I am hopeful that we may see more in the future, after the time lag of six to seven weeks.

[Jim Shannon]

I have not seen that in my constituency. What my constituents have seen is an increase within 24 hours every time oil goes up in price, but certainly not the equivalent downturn when oil prices fall. May I respectfully make a suggestion to the Minister? I am not saying that it is always the case, but in some cases the petrol tanks were full of fuel that was bought before the price increase, and I suggest that that practice would result in exorbitant profits for the person concerned.

[Amber Rudd]

It is interesting to hear the hon. Gentleman’s views and his account of the experience in his constituency. In fact, as I say, it has been six to seven weeks since the oil price fell, so I would be very surprised if he did not start to see that fall reflected in the forecourt price in his constituency. Perhaps he would keep me posted, because the Government are committed to making sure that that happens.

[Mr MacNeil]

The Minister has asserted that these price falls come through within six or seven weeks, and she may well be right. However, the difficulty—it was mentioned by the hon. Member for Inverclyde (Mr McKenzie)—is that that is not apparent or obvious to anyone, including the general public. It should not take a Government Minister to assert that; there should be transparency in the entire system, so that we can see price falls with our own eyes and do not need to go to the Government or any investigative authority for such guarantees.

[Amber Rudd]

I beg to differ. There has been quite extensive coverage in the newspapers—there certainly has been in my local newspaper—about where there are different prices for petrol, and the fact is that people are seeing a reduction in the price of petrol. The hon. Gentleman will be aware that although the price of oil has a big impact on the price of fuel, it is not, as the hon. Member for Inverclyde said, the only element in the price of petrol. Duty also plays a large part, and I will make some comments about that in due course. Nevertheless, the oil price fall is beginning to have an impact. I am delighted to take part in this debate today, but it is wrong to suggest that the public are not aware of the changes.

[Mr McKenzie]

Is it not the case that the evidence the Minister is basing her argument on—the investigation by the OFT—has been criticised for being flawed?

[Amber Rudd]

I am afraid that the evidence tends not to please everybody. If the hon. Gentleman disagreed with the evidence, I am sure he made that clear at the time. There are groups that would disagree with it; whether that is because they do not like the conclusions of the report or because they doubt the evidence is always open to debate.

Let me say a little more about the 2013 call for evidence; it is relevant to this debate, because it reassures hon. Members and members of the public that we have addressed this issue and looked into it. The OFT analysis found that in August 2012, for example, there was a difference between rural and urban prices; I know that is of particular concern to the hon. Gentleman. Her Majesty’s Treasury engaged with the European Commission to approve the Government’s application for 17 of the most rural areas on the UK mainland to receive a 5p per litre fuel duty rebate. That rebate is targeted at remote areas of the UK that face particularly high pump prices.

[Mr MacNeil]

Hear, hear.

[Amber Rudd]

The Scottish islands and the Isles of Scilly have benefited from that rebate since March 2012, and the story about the rebate appeared in the press recently; there was a reference to it yesterday.

[Mr MacNeil]

The rural fuel derogation is indeed very welcome; it has been good. However, the money set aside for it was not all spent and I wonder whether there is a possibility of increasing the amount of the derogation as time goes on. It is currently 5p per litre, but could 7p or 8p per litre be considered?

[Amber Rudd]

I understand that the hon. Gentleman is ambitious to gain a further discount for his constituents. At the moment, however, the derogation is likely to remain the same, although I am sure that members of HMT will always keep it under review.

Time is short, so I will address a couple of the other points made by the hon. Member for Inverclyde, who called this debate. There was a comment about the supermarkets. The big four supermarkets have increased their share of the road fuel sold in the UK, from 29% in 2004 to 39% in 2012. The growth of supermarkets in this sector appears to have had a positive impact for motorists. Supermarkets are able to buy wholesale road fuel more cheaply than other retailers, and the high volumes that they sell allow them to operate on lower gross margins. I am hopeful that the entry of the supermarkets into this sector on such a large scale will have a positive effect on delivering improved prices for our consumers.

[Mr McKenzie]

I encourage the Minister to comment on the supermarkets’ radius of competition; as I highlighted, in certain parts of the country it is ridiculously small. In those areas, they are competing with themselves, and only themselves.

[Amber Rudd]

The hon. Gentleman’s point about supermarkets is interesting. However, the same is true of fuel as of other products, and the fact that supermarkets compete with one another demonstrates that competition is effective and keeps prices low.

I will just make a quick comment about fuel costs, as the hon. Gentleman commented on the role of the previous Government. In 2011, the Government abolished the previous Government’s fuel duty escalator; we cut fuel duty by 1p a litre in March 2011; and we have scrapped four planned increases in fuel duty during this Parliament. By the end of this Parliament, fuel duty will have been frozen for nearly four and a half years, which will be the longest fuel duty freeze for more than 20 years. The Government are taking action to protect the consumer by keeping fuel duty at a manageable level while ensuring that we concentrate on the overall need to stimulate our economy and constantly reduce the deficit.

[Mr McKenzie]

Will the Minister give way?

[Amber Rudd]

I have a few more points to make, so I hope the hon. Gentleman will forgive me for not giving away.

I reassure hon. Members that, although the price drop is being passed on, we expect more from the fuel providers. We will watch oil companies carefully to ensure that they continue to pass on the falling oil price, which benefits both consumers and the wider economy. Consumers and motorists are entitled to the best value for money, and the Government are determined to ensure that they get it. We will keep this issue constantly under review, and we welcome the impact that it is having on consumers and their weekly costs.

11:28

Sitting suspended.

Homeless Young People

Wednesday 21st January 2015 Westminster Hall

[John Robertson in the Chair]

14:29

[Stephen Gilbert (St Austell and Newquay) (LD)]

Mr Robertson, it is a pleasure to serve under your chairmanship in this important debate. I warmly welcome right hon. and hon. Members who have joined us here. May I ask if it is in order for me to also welcome to the debate people in the Public Gallery, some of whom are former homeless people?

[John Robertson (in the Chair)]

You have just done it.

[Stephen Gilbert]

Thank you, Mr Robertson.

As we know, homelessness is a crisis. It is devastating, and it should not happen to anyone. We should all be clear that we are just a few steps away from finding ourselves with nowhere to go, whether through the loss of our jobs or our health, or relationship breakdown. Homelessness can be an isolating and frightening experience. Homeless people often feel that they are invisible, ignored and forgotten. At worst, homelessness can mean sleeping rough on the streets. Of course, we all know that the problem of homelessness is much bigger than the problem of rough sleeping. It is clear that, after years of declining trends, all forms of homelessness have risen due to the shortage of housing and the ongoing effects of the worst economic recession for 100 years.

I register my thanks to Crisis, Shelter, Homeless Link, Centrepoint, the local government ombudsman, Depaul UK, Generation Rent, the Children’s Society and Gallery Youth, as well as to the House of Commons Library for providing supporting information for this debate. I acknowledge the profoundly good work done by many smaller charities across the country, such as St Petroc’s Society and the St Austell community kitchen, in my constituency, and many religious groups that seek to help people who find themselves with nowhere to go.

Crisis points out that almost one in 10 people say they have been homeless at some point, with a fifth of those people saying that it has happened in the past five years. I spent a period after a relationship breakdown out of the flat that we had been in and sofa-surfing with my friends. Although that is not rough sleeping, it is a form of homelessness. The experience was traumatic for me and even more traumatic, I suspect, for the friends I was imposing on. I remain very grateful for their help.

It happened to me later in life, but, alarmingly, half of all homeless people first become homeless aged under 21, with the majority facing the experience again and again because they cannot get the help that they need. Indeed, the Children’s Society tells us that every year about 14,000 children aged 16 or 17 present themselves as homeless, and many are placed in inappropriate accommodation such as bed and breakfast and short-term lets.

Last year, about 3,400 16 or 17-year-olds left care and found themselves in need of accommodation. Soon-to-be-published Children’s Society research shows that more than two thirds of children assessed because of a risk of homelessness are not offered any help, and that a quarter of 16 to 17-year-olds assessed are housed in unsuitable accommodation after presenting themselves.

[Alex Cunningham (Stockton North) (Lab)]

I congratulate the hon. Gentleman on securing this important debate. I, too, recognise the plight of young people leaving care. I hope the hon. Gentleman agrees that it should be Government policy to ban the use of bed-and-breakfast accommodation for such people.

According to Crisis, only 15% of Members of Parliament believe that people get proper support on homelessness; two thirds of MPs think that there should be clearer duties placed on local authorities to do more; and three quarters of MPs believe that it should be a priority for Government. Does the hon. Gentleman agree that a specific and wider duty of care for homeless people needs to be placed on local authorities and that they should also have the resources they need to deliver a proper service?

[Stephen Gilbert]

I could not agree more, both about the inappropriateness of bed-and-breakfast accommodation for vulnerable young people—I will mention that later—and about the need to remove the two tiers in the system at the moment for those who are in priority need and those who are not. Experience in the rest of the United Kingdom shows that reform is possible. The mantra in this debate should be that nobody is turned away when they present themselves as homeless.

We know that the increase in the number of homeless young people is despite the fact that 16 and 17-year-olds are supposed to be protected by both the Children Act 1989 and the Housing Act 1988. Charity advocacy services say that they often have to help young people who are not given the adequate protection that this House has asked local authorities to provide under those statutes. It is not just charities saying that. The local government ombudsman says it, too, stating:

“The use of bed and breakfast accommodation often leads to families and young people living in cramped conditions and sharing facilities with adults who may be vulnerable or have significant social problems.”

Research, both from the Minister’s Department and from Crisis, has found that young people who experience homelessness are considerably more vulnerable as a group than other homeless people. They often first experienced homelessness at a very young age, with a third of young people surveyed having become homeless for the first time before the age of 15. Homelessness at a young age that is not resolved can lead to an ongoing cycle of homelessness, with a significant minority of all homeless people—four in ten—having first become homeless before the age of 20. It is critical that we prevent that cycle before it begins.

[Ms Karen Buck (Westminster North) (Lab)]

I, too, congratulate the hon. Gentleman on securing this important debate. Does he recognise the experience of many hon. Members in dealing with homeless young people who have had a harsh experience of gatekeeping when approaching local authorities? In one example that I am still dealing with, we are now in the third calendar year of the local authority, Westminster, resisting an application regarding homelessness from a young man with psychosis, in the course of which we have had to go to court at least once. The total cost to the local authority of refusing to accept homelessness must vastly outweigh what would have been invested if that young man had been able to get a home in the first place.

[Stephen Gilbert]

I am aware of the excellent work that the hon. Lady has done in campaigning on the issue in general and on the specific case that she mentions. I know that she has fought strongly for that individual’s right to access proper services. I think we are all aware that local authorities are the key gatekeeper in this process. The duty that this House puts on local authorities needs to be clear, and their pathways need to be certain to lead to help for the young people who approach them.

[Sir Alan Beith (Berwick-upon-Tweed) (LD)]

Is my hon. Friend aware that although ring-fencing is not something that we generally encourage, its removal had quite a significant effect in Northumberland, for example in the move from block-booking supported accommodation from providers to spot-purchase? That is difficult for charities such as Gallery Youth and Berwick Youth Project to cope with.

[Stephen Gilbert]

My right hon. Friend is right. After the ring fence was removed by the previous Government, the impact was felt in Cornwall under the current Government because of the difficult decisions that they had to take to rebalance the books. Supporting People was one of the first areas of funding to be cut in Cornwall. I found myself sleeping outside county hall overnight, with a cohort of vulnerable people, in protest at that decision. I understand exactly the impact of the removal of the ring fence and the budget constraints on providing such vital services.

The point is not simply that the street is an unsafe and unsuitable place for young people. Most young people who present to statutory services as homeless do so because another strategy for coping with having no safe permanent place to live has broken down. The places young people sleep in an effort to stay off the street are often unsuitable for them as vulnerable individuals.

A third of young people Crisis spoke to during a survey admitted to committing a minor crime in the hope of being taken into custody for the night; 17% had avoided bail or committed an offence to receive custodial accommodation and therefore a bed for the night; almost 20% had attempted to admit themselves to accident and emergency departments to get a bed for the night; and, alarmingly, 10% had entered into a sexual relationship to get a bed for the night. These are not safe havens for young people: they put them in danger of further exploitation.

[Steve Brine (Winchester) (Con)]

Well done to my hon. Friend for securing the debate. He is talking about vulnerable young people. Winchester Churches Nightshelter contacted me in advance of the debate and said that the complexity of its guests’ needs had significantly increased in recent years. Many referrals have a mental health issue, a substance abuse issue or both. Although many of the services are there, they are not working together to meet such complex needs. Does he agree that the next frontier in tackling homelessness among young people must be a national focus by the next Government, of whichever colour, on addressing multiple needs?

[Stephen Gilbert]

I completely agree with my hon. Friend. We see a cohort presenting with complex needs that are often associated with substance abuse—whether that is alcohol or illicit drugs—mental health issues and, perhaps, abuse in the family background. As well as having a mantra of nobody being turned away, we have to get to grips with the fact that we need to provide joined-up services in a holistic way to deal with the underlying issues that people present with.

[Mr George Howarth (Knowsley) (Lab)]

I congratulate the hon. Gentleman on securing this debate, which is timely and important. I apologise that I am unable to stay for the whole debate because of other commitments.

Within the hierarchy of needs that the hon. Gentleman describes, does he accept that a number of children coming out of care, or in circumstances in which their care arrangements have broken down, seem to fall off the scale altogether as far as the appropriate authorities are concerned? That needs addressing, too.

[Stephen Gilbert]

The right hon. Gentleman puts an important point on the record. If the state is taking care of young people for a period of time for whatever reason, surely one of its first duties as a guardian is to ensure a smooth transition from the care setting to an environment in which they can flourish and look after themselves. For many, the process becomes a cliff edge when their care package runs out without ongoing support, placing them in a position that means they are unable to manage their finances and understand the situation around them or their obligations. They do not have the ongoing support that they need to adapt in the way that someone with a family could. The right hon. Gentleman’s point is entirely right.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

The hon. Gentleman is being extremely generous in giving way. I, too, congratulate him on securing the debate. On his point about vulnerable children, does he agree that situations of domestic abuse and domestic violence, which might well result in children becoming more vulnerable, should be considered in relation to wider policies, whether in local government or support services?

[Stephen Gilbert]

The hon. Lady makes a perfectly valid point. Abuse can come in many forms, whether violent, sexual or psychological. Often, family breakdown has a lasting negative impact on people’s mental health. I have a constituent who was turned away by his family and booted out the door because he came out to them as gay. That had a devastating impact, and when he presented to Cornwall council as homeless and was unable to get any support, it felt like a double whammy. Ultimately, we were able to secure support for him, but the hon. Lady makes exactly the right point—many of the individuals who present as homeless have complex underlying needs. We do not do them or ourselves a favour if we do not address those needs.

The first place where many people present with complex needs is their local council. Councils are in a unique position to assist people, but when they fail to do so, people in need of help can be left with nowhere to go and their experience can quickly spiral deeper and deeper into chaotic homelessness. Evidence shows that while the number of young people accepted by local authorities as statutorily homeless is going down, the number of young people accessing homelessness services is increasing.

[Duncan Hames (Chippenham) (LD)]

I congratulate my hon. Friend on securing this exceptionally important debate. Does he agree that there is a risk that the figures he cites underplay the extent of the problem? I have a constituent who for immigration purposes has no recourse to public funds. Her baby daughter—the daughter of a British man who through violence is no longer part of that household—desperately needs adequate housing, yet the council takes the view that it is not obliged to meet the housing need of the mother or that little girl.

[Stephen Gilbert]

My hon. Friend is a passionate campaigner on these issues for his constituents, and he makes exactly the right point. The official statistics belie the reality of the situation. We know the numbers presented by the Minister, the Department and third parties, such as Crisis, but we are all aware that the housing crisis is such that many thousands more people than the official figures suggest are in inappropriate or overcrowded accommodation or stuck at home in difficult relationships or sofa-surfing. Part of the answer, as I am sure my hon. Friend will appreciate, is getting on and building more homes, but it is also about making the pathways easier for those presenting as homeless.

One of the tragedies is that most single homeless people are not considered to be a priority by local authorities, meaning that the council has no legal duty to find them housing. Many are ignored and given little or no help. Crisis recently carried out a mystery shopper exercise called “Turned Away”, in which eight formerly homeless people visited 16 local authorities to examine the quality of advice and assistance provided to single homeless people. In well over half—50 of the 87 visits—the help offered was inadequate. In 29 cases, they were simply turned away without any help or the opportunity to speak to a housing adviser. That included situations where the mystery shoppers were portraying very vulnerable characters, such as a victim of domestic violence or a woman with serious mental health problems.

That is the result when single homeless people actually get in front of the local authority, but many can be deterred from approaching their local authority at all because of previous negative experiences or low expectations on the outcome. A third of single homeless people who had previously approached their local authority for help said that they did not do so during their most recent episode of homelessness because of the lack of help offered the first time round.

When homeless people do approach their council, the consequences of being turned away with no support can be disastrous. Many are left with no option but to sleep on the floors of friends and family, squat in abandoned buildings or, in the worst examples, sleep rough. That can lead to their falling into a situation where support needs and other issues develop, resulting in their being trapped in homelessness for far longer. We all know that rough sleeping is a traumatising experience that impacts hugely on an individual’s health and well-being. Mental and physical health problems can be exacerbated by rough sleeping. Homelessness is also dangerous, with homeless people 13 times more likely to be victims of crime than the general public. Indeed, the average age of death for someone sleeping rough is just 47, which is 30 years younger than the national average. Homelessness is also expensive. As well as the huge personal cost to individuals, the financial costs are significant. The annual cost of homelessness to the Exchequer is estimated to be £1 billion.

We need to take action now to ensure that homeless people get the help they need. The law creates a two-tier system, with one level for those in priority need who are owed the full homelessness duty by their local authority and another for those who are judged not to be owed that duty and can be turned away with little or no help. I want to see all parties in the House commit to carrying out a review of the support given to single people under homelessness legislation in England.

Over the years, Governments of all colours have tried to resolve the persistent problem of single homelessness, but the law has always held back progress. The devolved Governments in Scotland and Wales have taken different approaches. In Scotland, priority need has been abolished, meaning that all homeless people are entitled to accommodation. The Welsh Government have recently introduced a new duty for local authorities to take steps to prevent homelessness for anyone threatened with losing their home, regardless of their priority need status. That shows that reform is possible. The next UK Government should consider what lessons can be learned to reform the law in England.

As the hon. Member for Stockton North (Alex Cunningham) said, there is a lot of support for tackling homelessness—56% of the public agree that the Government should do more and 78% of MPs believe that tackling homelessness should be a priority. We regularly hear from colleagues in the Tea Room about the difficult experiences we all have in getting help for the very vulnerable people who approach us. The hon. Member for Westminster North (Ms Buck) made that point. Homelessness is a devastating experience that should not happen to anyone in the 21st century.

[Ian Lavery (Wansbeck) (Lab)]

I congratulate the hon. Gentleman on bringing this extremely important issue to the House. A delegation from Youth Homelessness North East came to the House of Commons last week—the right hon. Member for Berwick-upon-Tweed (Sir Alan Beith) was in attendance—and we had an excellent meeting. The prime reason for youth homelessness is the parents being no longer willing to accommodate them. However, there are other important reasons: welfare reform; the bedroom tax; the extension of the shared accommodation rate; and sanctions. Those are all part of a welfare reform package, introduced by this Government, that has been devastating for young people in our communities. What will the Government do to row back from that and help the young people highlighted in this afternoon’s debate?

[Stephen Gilbert]

I thank the hon. Gentleman for the point he makes. I visited a project in Newcastle called Outlook, which helps to house homeless lesbian, gay, bisexual, and transgender youngsters who find themselves kicked out of their home when they come out, so I am aware of some of the very good work that happens in his part of the country. On welfare reform, my party and I have no truck with anybody who seeks to remove housing benefit from the under-25s. Difficult decisions have been necessary to rebalance the public finances, but such a measure would simply punish further a group of people who are often very vulnerable.

[Mr Andy Slaughter (Hammersmith) (Lab)]

There are some fantastic organisations such as St Mungo’s Broadway, which is based in my constituency. Another problem that needs to be dealt with is the lack of accommodation: move-on accommodation, first-stage accommodation, hostel accommodation, and permanent council accommodation. I know that the hon. Gentleman’s area of the country has problems as much as mine does, and such problems must be tackled by any incoming Government.

[Stephen Gilbert]

The hon. Gentleman is exactly right. He may be surprised to know that I have visited St Mungo’s Broadway in the past five years to see the very good work that it does in transiting people from rough sleeping into intensively supported accommodation, then making the transit to more independent living. As a project, it is an exemplar. The very good work that goes on in his constituency should be commended.

[Jake Berry (Rossendale and Darwen) (Con)]

I thank the hon. Gentleman for being generous with his time, and I congratulate him on securing this important debate. I am sure he will acknowledge that one of the things the Government have done to enable local authorities to discharge their homelessness duty is give local authorities a power to discharge that duty to the private sector, which has seen more people being housed.

The hon. Gentleman asked how many MPs want to tackle this scourge in our society. Is he aware of the story of the good Samaritan? When I walk into Parliament, I occasionally see people sleeping rough in the tube station. They are passed every day by hundreds of MPs. How many colleagues, like me, have seen them and phoned the “No Second Night Out” line to report them as homeless, and how many colleagues simply pass by on the other side, rather than take responsibility to try to help tackle the issue?

[Stephen Gilbert]

My hon. Friend makes a very important point. Phoning the “No Second Night Out” scheme is something that we can all do—certainly in London—every time we see somebody sleeping rough.

I have visited Centrepoint in London, St Mungo’s, Outlook and other projects around the country, and I know that although Members of Parliament may not be putting out press releases and tweeting about their actions in this area, colleagues from all parties do a lot of good work in this area. The matter is urgent and we need to bring homelessness in the United Kingdom to an end, particularly homelessness among very vulnerable groups such as young people.

14:53

[Simon Danczuk (Rochdale) (Lab)]

I thank the hon. Member for St Austell and Newquay (Stephen Gilbert) for securing this important debate. He made an excellent speech. That is not a compliment that I throw around lightly; I truly mean it. He made a great contribution on an exceptionally important issue.

It can often seem that modern politics is swamped by statistics, but some statistics really cut through and tell us something about modern Britain and the society in which we live. The current figures on the number of young homeless people fit that description. They tell us something about our society that we probably do not want to hear.

We live in one of the richest countries in the world—that is the reality—but last year more than 100,000 people approached their local council as homeless. We know that many of them are young single people with nowhere to turn and no one to rely on. Figures from the charity Homeless Link show that 53% of people using homeless services in England are between the ages of 16 and 25. That is a shocking percentage. For me there is only one word to describe the current situation: failure. I am sure all hon. Members would agree there is nothing that anyone could have done to bring homelessness upon themselves at the age of 16. When we see a young homeless person, it is a sign not of their failure but of our failure.

The main point I want to make is that we need to do more to prevent young people from becoming homeless in the first place. I want to pay tribute to the many organisations that help support young homeless people and keep them safe. In Rochdale, fantastic work is being done by Petrus, a charity that deals with young homeless people throughout the borough. Petrus is a real force for good. For example, it has been instrumental in helping young girls who have been at risk of on-street grooming in the town. In one case that I heard about, Petrus helped a girl who was described as “the most at-risk young person in Rochdale”. Petrus staff built trust with her, helped her realise she was being groomed and got her to a safe place out of town, but the work of Petrus goes far beyond simply keeping people safe. Its approach is to help young people rebuild their lives and give them opportunities to move on.

In another case, Petrus helped a young girl who was extremely vulnerable and difficult to deal with. Initially, it took her in for a weekend, but she ended up staying for a year. By the end of that year, the girl had become the only young person in the north-west to complete a work experience programme with AstraZeneca, which involved her travelling up to 90 miles to get to work. She progressed to such an extent that she even came here and spoke about her experience as part of the Youth Parliament. It is a really inspiring story and a testament to the fantastic work of the staff at Petrus.

However, even great charities such as Petrus are struggling to cope with the numbers of homeless people that we are seeing at the moment. Figures supplied to me by the charity Crisis show that in the financial year 2013-14 there were 927 households in Rochdale that made a homelessness application—nearly 1,000 in a small town like Rochdale. It is hard to believe. What is even harder to believe is the rate at which that figure is increasing.

Since 2010, the number of people in priority need in Rochdale has increased by 354%. More worrying is that the number of people found not to be in priority need has increased by 332%. I say it is more worrying because, as the hon. Member for St Austell and Newquay pointed out, many of the people who are not in priority need are young people who then—literally—have to live their lives out on the street. They are single young homeless people. The fact that we have seen such a big increase recently is no coincidence. We have been through a recession, and that has had an effect, but we are now in recovery and still the number of homeless people keeps on rising. It is clear to me that the Government are simply not doing enough to address the causes of homelessness among young people.

Although the theme of the debate is Government support for young homeless people, my view is that the real problems start much earlier. What we need to focus on more is preventing young people from becoming homeless in the first place.

[Yvonne Fovargue (Makerfield) (Lab)]

I agree with my hon. Friend about prevention. Along with the local authority in the Wigan borough, the “Hidden Voices” project has worked with young homeless people to produce a prevention pack for schools, which perhaps dispels some of the myths about how easy it is to live on the streets. Young homeless people can explain why they went on the street and how that can be avoided. Such projects need to be supported.

[Simon Danczuk]

My hon. Friend makes an excellent point, not least because the voluntary sector is at the forefront of innovative solutions such as the one she described, which can dissuade people from becoming homeless or prevent homelessness from occurring. I, too, pay tribute to the organisation in Wigan that she mentioned.

Another key issue for Government action must be the housing crisis. It is no surprise that we have the lowest rate of house building since the 1920s and have seen a dramatic increase in the number of young homeless people —the two must surely be related. The lack of housing supply is causing house prices and rents to soar, often pricing young people out of the market completely. When combined with low pay and insecure work, that creates a lethal cocktail that leaves young people extremely vulnerable. When young people are left exposed in that way, a proper safety net to help them before they end up on the streets is vital.

Under the current Government, some of the structures to support and help young people have been dismantled, such as the local welfare assistance schemes. The money for those schemes was spent directly by local authorities to help the most vulnerable people in their areas, and it could come, for example, in the form of a crisis loan if there was an emergency situation such as a broken boiler or a leaking roof. The loans went to people who desperately needed help and were a real lifeline. Under those schemes, money was also given in community care grants and used to fund charities that work with vulnerable people, such as the Cripplegate Foundation in Islington, which works with marginalised people, including victims of domestic violence. Many of those young people are the most likely to become homeless, and the work done by such charities has been vital in preventing that.

The money for the welfare assistance schemes was clearly a lifeline for many people, but the Government have decided to cut it. At first, of course, they did not admit to cutting it. The Government tried to sneak out the news in the local government finance settlement in late December 2013. They did not get away with that and were challenged by local authorities and charities. Finally, the Government agreed to consult on their proposals for the welfare assistance fund, which I welcomed. The consultation found that if the funding were cut, 75% of local authorities would not be able to afford to fund the schemes from the core grant. Having heard that, and knowing how important the money is, we might have thought that the Government would continue to fund local welfare, but no; they have gone ahead and cut the money.

That is bad enough, but what makes it worse is that Ministers will still not admit that that is exactly what they are doing. Listening to the local government finance settlement in December, it sounded as though £130 million remained available, but that was only smoke and mirrors. The reality is that the money was cut. The £130 million mentioned was simply money that the Government have identified for local welfare, but they expect it to be found by local authorities from the core grant.

[Annette Brooke (Mid Dorset and North Poole) (LD)]

I share the hon. Gentleman’s great concern about the cuts in the local welfare assistance schemes. I very much hope that there is time to achieve at least part of the budget for extra funds before the final announcement on the local government finance settlement. People should speak more about the fund and the excellent schemes that it is used on—it is the post of last resort, which is so important.

[Simon Danczuk]

I am glad that the hon. Lady agrees with me, but the Government and Ministers whom she supports do not. They have not increased the budget; they have simply identified an amount of money, but it is not additional and is expected to come from the core grant. That is not acceptable, not least because the Government’s own consultation showed that 75% of local authorities could not afford to find the money should it be needed, which it clearly is because we have a dramatic increase in homelessness.

When the Minister speaks, I hope that he will admit that the money has been cut and take responsibility for the results of that decision. We know what the results will be: struggling people will not be helped; more young people will be abandoned; and ultimately, more young people will be homeless on our streets.

To conclude, I make the following points. The figures about homeless people speak for themselves. Government policy has contributed to the situation and we need a concerted effort from the Government to combat it. In previous years, we have seen successful Government initiatives such as the rough sleepers initiative. We need to find the determination to do that again.

[Mr Slaughter]

My hon. Friend is making an excellent speech. I am glad that he mentioned London, where there has been a 77% increase in street homelessness under this Government, which is exactly because we do not have such initiatives any more and because deliberate Government policy has been not to build affordable housing or to provide the type of accommodation that young homeless people can live in.

[Simon Danczuk]

I completely take on board that point. We cannot remove such support. The lender of last resort should be the Government, the state or local authorities. A raft of support is always needed at the 11th hour, at the worst point in a person’s life, but it is being taken away completely.

In the short term, steps can be taken. A simple one would be to reverse the cut in local welfare assistance and to allow councils to get support to vulnerable people before it is too late. Spending that small amount of money—£130 million is small in the scale of things—would help to prevent more money from having to be spent for a bigger cost further down the line. Most importantly, it would prevent thousands of young people from ending up on the streets, giving them a chance for a better life.

15:06

[Sarah Newton (Truro and Falmouth) (Con)]

First, may I congratulate my constituency neighbour, my hon. Friend the Member for St Austell and Newquay (Stephen Gilbert), on securing the debate and on his excellent speech, which gave a comprehensive appraisal and thoroughly good analysis of the situation? I associate myself with the comments that he made about the wide range of organisations acting nationally to raise awareness about young homeless people and to provide a range of solutions and services to support them so ably.

I am, however, rather disappointed with the speech made by the hon. Member for Rochdale (Simon Danczuk), who preceded me and introduced party politics. The young people who are watching the debate deserve something rather better from us. We should be making a determined effort to use the data in the Crisis report and other reports to be released shortly, such as the one from the Children’s Society, to work together to do something—

[Ian Lavery]

Will the hon. Lady give way?

[Sarah Newton]

I will make some progress before I take an intervention.

[Simon Danczuk]

Will the hon. Lady give way, given that she made reference to me?

[Sarah Newton]

When I have made this particular point, I am happy to do so.

The Conservative party has a long tradition of campaigning on homelessness. In the 1970s, MPs Iain Macleod and William Shearman were in favour of the first legislation to be introduced to protect homeless people. My right hon. Friend the Member for North West Hampshire (Sir George Young) introduced the rough sleepers initiative, which cut dramatically the numbers of people sleeping on our streets. More recently, Boris Johnson has made tackling rough sleeping in London a central part of his mayoralty.

[Ms Buck]

Will the hon. Lady give way?

[Sarah Newton]

I will give way when I have finished making this point.

As a Cornish MP, I have seen first hand the coalition Government deliver real improvements in services for homeless people. Before I was a Member of Parliament—I came into the House in 2010—for a great deal of my life I volunteered in charities looking after and seeking to help homeless people, whether in New York, where I lived in my 20s and ran a shelter for homeless men, or in my home town of Truro, where I volunteer with Truro Homeless Action Group and help with the excellent work of St Petroc’s Society.

Before I was elected, I participated in the rough sleeper counts. However, the guidance given by the Government of the day made it so difficult to count the number of homeless people that Cornwall was deemed to have a rough-sleeping population of two. Since the coalition came in and properly opened up the rough sleepers count, we have been getting much better data on the scale of the problem. Sadly, although it is no surprise to any of us who live there, Cornwall is now deemed to have the second largest homeless population outside London. Without that honest collection of data, we will never be able to take the steps needed to tackle these issues.

Those reforms were brought in by this Government, which underlines the fact that the issue has all-party support. We all understand that nothing could be worse than being homeless. We may not always agree on every measure, or on how to tackle the issue, but turning it into a party political football does no service to the debate.

[Simon Danczuk]

Let me be clear: before entering Parliament, I carried out research into homelessness issues for 10 or 12 years while I was working for The Big Issue in the North, and I suspect I have met more homeless people and visited more homeless projects than the hon. Lady has had hot dinners, so I know what I am talking about. Let me make it clear that I am all in favour of consensus, but the Government need to be judged on their record on dealing with homelessness, and that record is very poor. I am in favour of consensus, but if the Government fail on this issue, it is right and important that young people see the Opposition challenging that failure and helping to come up with solutions.

[Sarah Newton]

I am not going to lower the tone of the debate and further let down the young people who are watching it by responding to that personal attack. As I have said before, I have volunteered throughout my life on the issue of homelessness—I still volunteer now, and I am well into my 50s. I do not know how many hot dinners the hon. Gentleman has had, but it is silly and demeaning to start personally attacking hon. Members’ motivations. I am in no doubt that hon. Members from all parts of the political spectrum care deeply about homelessness and have been personally committed to dealing with it as volunteers or in other appropriate ways. I really want to carry on with the debate.

I am proud to stand on my record and on the record of what the Government have delivered to help homeless people in Cornwall and prevent homelessness there. One person sleeping rough in my constituency, one person sofa-surfing or one person living in unacceptable accommodation is one too many, and I will continue day and night to do what I can, but there has been significant improvement. Once we had better data from the rough sleepers count, the money followed, and Cornwall council has received considerable sums, which have been fed into really good third sector organisations such as St Petroc’s and Glen Carne, voluntary organisations such as the Truro Homeless Action Group, the statutory sector and the NHS. I could speak for half an hour about the different activities that are going on to prevent homelessness and to help homeless people, so I will stand on my record.

[Ms Buck]

Will the hon. Lady give way?

[Sarah Newton]

I am going to make a little progress.

That is not to say that I am complacent or that much more does not need to be done. I very much welcome the Crisis report, and I support a lot of its recommendations. The ones I would like to discuss today build on the need for a better evidence base for local planners and those making housing decisions.

Under the Government’s planning reforms, each local authority must do a local housing need assessment to make sure its local plan meets the unmet housing need of the people it represents. Having gone through that process in great detail locally, I know that some groups of people, such as young homeless people who are sofa- surfing, are difficult to pick up in the statistics used to form the local housing needs assessment. Assessments must be robust and data-driven, using data from the Office for National Statistics and others, but it would be useful—this is one of the recommendations from Crisis—to look at the guidance given to local authorities as they plan their local housing needs assessment to make sure that those young homeless people are picked up on and that their needs are met.

Following the success of the “No Second Night Out project”, which has done very well in Cornwall, we have much more information about young people and people of other ages who are homeless, but we now need, as part of the planning process, to work out how we can build more appropriate housing for their needs. People have all sorts of complex needs—they may have mental health issues or substance abuse issues, or they may be fleeing domestic violence—and they need supported accommodation, and the Glen Carne charity in my constituency provides it so well.

[Ms Buck]

On data, the hon. Lady made specific reference to London. Since Boris Johnson became Mayor of London, rough sleeping has increased every year. In the summer of 2014, it was 19% higher than in the six months over the summer of 2013. Is the hon. Lady honestly saying that that year-on-year increase in rough sleeping is a consequence of better data? If so, what is the point of having better data and failing to do anything about it?

[Sarah Newton]

Speaking from personal experience in my constituency, I can absolutely say yes. Now we have the tools to go out there and try to get as accurate a count as we can. We will then have a far better understanding of the underlying reasons why people—we are talking not just about numbers, but about people’s lives—are homeless so that we can put in place the appropriate services to help them into accommodation. The money follows the problem, and having those tools has brought extra resources into my constituency. It is vital that we carry on gathering data so that we can better plan to meet the needs of people who are currently homeless and prevent more people from becoming homeless.

The other recommendation from Crisis that I would like the Minister seriously to consider is that we go back to local authorities to see how well the legislation we created in this place is implemented. A key finding of the Crisis report was that the legislation was not implemented consistently. Contained within that was another recommendation—that we come up with an inspection regime. We have done that very well with the Care Quality Commission, which we have asked to inspect providers of health and social care services. Given that a decent home is essential for people’s health and well-being, it would be a good idea to think about how we can extend the CQC’s remit so that it can inspect providers of housing for vulnerable groups and the sorts of accommodation we have heard about today, which take people off the street, providing accommodation that is often supervised in some way, as well as a package of care for a couple of years. That would be really good.

Associated with that, I would like it to become common practice for people in councils and organisations responsible for preventing homelessness and supporting homeless people to be part of health and wellbeing boards, because decent housing is important to health and well-being. Some local authorities have included such people on their health and wellbeing boards, but that is not common practice. Including people on those boards will really help those providing joined-up services locally to understand the complexity of the issues confronting people who face the prospect of homelessness or who are experiencing homelessness. It will also enable those providing services—whether social, housing or health services—to better meet the needs of the particularly vulnerable group we have been discussing.

I know that colleagues want to speak, so let me conclude by saying that the Government have made huge progress, and I have seen that in my constituency. However, I urge the Minister to take seriously the recommendations made by Crisis, which it presented in a non-party political way. We can then take them forward, review what is working, understand what is not working and bring in necessary reforms in the next Parliament.

15:19

[Paul Blomfield (Sheffield Central) (Lab)]

I shall speak fairly briefly, as I had not intended to speak in the debate. I congratulate the hon. Member for St Austell and Newquay (Stephen Gilbert) on securing it.

I want to focus on one factor that drives homelessness, based on my constituency experience. The hon. Member for Truro and Falmouth (Sarah Newton) was in search of political consensus, and in our debate in December the two sides of the House did reach some consensus on the way in which an increasingly harsh benefit sanctions regime is driving people into homelessness.

In the September recess I conducted a community consultation in my constituency. We had something like 63 meetings over three weeks. Individuals and voluntary, community and faith sector organisations working on homelessness raised the issue of benefits sanctions as a significant factor in their work. For example, the cathedral project in Sheffield works with homeless people sleeping on the streets, to get them back into society. On the back of offering a breakfast service, it attracts them in and builds a relationship. It offers support and training and helps people to secure accommodation. It has been successful with such intervention for many years. People from the project reported to me that as a result of the increased pressure from the DWP and the harsher regime of benefit sanctioning, those whom they had helped into accommodation were getting letters whose significance they did not understand, or, in many cases, that they could not read. That would lead to their missing an appointment, and immediately, with no warning—no amber light or signals—their benefits would be cut and they would be unable to maintain their accommodation. When they presented themselves at the DWP the response was, “Go along to the cathedral Archer project. They’ll feed you.” That has transformed the project from a charity that could make a strategic intervention to tackle homelessness into a crisis centre.

That approach to benefits sanctioning has been taken up by Sheffield Citizens Advice. Its social policy group conducted a survey over 12 months and produced a report in May on the experience of JSA sanctions. I want to make it clear that I do not oppose sanctions in principle. Used appropriately and benignly they play a constructive role in encouraging people into work and providing a disincentive to the behaviour of those who do not co-operate with the system. The problem is that they are not being used benignly. To be effective, a sanctions regime must be humane. The report from Sheffield Citizens Advice showed that the system is neither humane nor effective in its avowed purpose of getting people into work and enabling them to afford accommodation.

I was presented with examples from its survey. One person, called Alan, was given a four-week sanction for not actively seeking work. He had limited literacy and numeracy skills and thought it important, so that he could get into work, to enrol on the English and maths course that was offered. He was on it for eight weeks, and thought that because he was on the course provided he did not have to sign on. He failed; he was not given a warning. He was immediately sanctioned.

Tony was vulnerable because of learning challenges and dyslexia. He cannot read or write. Despite getting significant support in looking for work from a local job club, he was sanctioned for not doing enough about his jobseeking. How did the DWP tell Tony that he was not doing enough? It sent him a letter, knowing—because it was on his records—that he could not read. Because he could not read the letter he was sent, he was immediately sanctioned.

[Sir Alan Beith]

A similar example happened to a young person in my constituency. He did not have a mobile phone but was required to give a mobile phone number. He gave his girlfriend’s mobile phone number and was sanctioned because that was not considered adequate.

[Paul Blomfield]

I thank the right hon. Gentleman for that intervention. I am sure we could all cite similar examples from our constituency case load. The question is why we have such a punitive sanction regime. I was out fairly recently knocking on doors, as many hon. Members have been doing lately, and I talked to a constituent who is a jobcentre worker. We discussed her work, and she told me that she and her colleagues were under pressure to impose sanctions and hit targets. In a survey of Public and Commercial Services Union workers representing jobcentre workers, 23% said that they had been given explicit targets for referring claimants for sanctions; 36% said they had been placed on a performance improvement plan for not making enough sanctions; and 10% had gone through poor performance procedures for not making enough sanction referrals.

The Government have said that there is no pressure to sanction, but somehow a culture has been created in the DWP that suggests otherwise. The DWP acknowledges that statistics on sanctions are collated centrally and that managers can be contacted if their performance is out of line with that of other jobcentres. It says that that is a matter of good management and that no league tables are compiled, or targets set. In that case, why is a lower level of sanctions seen as an indication of poor performance, requiring managerial action? We need to recognise the impact of the DWP benefits sanction regime, which is driving up homelessness. I ask the Minister to commit to talk to DWP colleagues about that.

15:27

[Duncan Hames (Chippenham) (LD)]

I congratulate my hon. Friend the Member for St Austell and Newquay (Stephen Gilbert) on securing this debate on a policy area in which he has developed extensive expertise, both while in Parliament and previously. I have great admiration for that.

I am not a housing policy expert, unlike other hon. Members who have spoken. I am a generalist, but like others I have the ability to do something that is at the heart of an MP’s job as a representative: to tell my constituents’ stories to people in power in Parliament, who can do something about them. I mentioned in an intervention a terrible case of housing need, affecting a woman and her family, which not only the council but Government policy refuse to address. I think that beneath that, ultimately, is the desire to create a hostile environment, so as to achieve other policy objectives. However, I want to bring to the debate the stories of three working men: family men in full-time permanent employment, whose families are under all sorts of pressures. Such situations are generally multi-factorial; there is not just one thing to be fixed, to make things right.

The families involved are at risk of being totally undermined by their housing need. That is an important point. House building is often not very popular with some of my constituents and there is great scepticism among them about whether house building will, of itself, serve the housing need in their communities. However, much of the housing need is not visible to them in the way it is to Members of Parliament, who have the privilege of coming to an appreciation of it in our constituency surgeries.

The housing need of the men whose situations I will discuss is well hidden; as I hope to explain through their cases, failure to address it could ultimately generate greater housing need. We are told that family breakdown is one of the causes of increased household formation, which is a major factor driving the need for housing. Although it might not be as easy to consider that issue when debating housing as it is to scapegoat groups of people or blame immigration policy, it is a very real factor in the housing need of our society, and so I hope to shine a light on it briefly this afternoon.

The first case I want to tell hon. Members about is that of a man with a family of seven, with an eighth child who is now at university and so no longer in the household but who is still being supported as well. He is a working man with a full-time permanent job who has been supporting his family. The man was in a private let, with no need for support from the Government, supporting his family and working hard to provide their standard of living. But when that private let came to an end, as the landlord exercised their right to put their investments elsewhere, the man found it impossible to find another for a family of his size.

For the first time, therefore, the man turned to the public sector for support through social housing; private landlords refused to take a family of that size because of concerns about wear and tear on their properties. He managed to get some social housing in Chippenham, but what he got for his family of seven was a two-bedroom flat. They are suffering from chronic overcrowding, and it is proving incredibly difficult to meet their housing need. We all know that if that family were not to stay together great priority would be given to meeting their new housing need, but as long as he keeps his job and they stay together, it is difficult for them to receive the housing that they need to live together as a family.

The next working man whose story I want to tell is a single father who is sharing an open-plan studio flat—although frankly I cannot quite tell what the difference is between that and a bedsit—with his 15-year-old daughter. Given the layout of the flat, he does his best to provide her with some privacy, but it is difficult for the pair of them to share it. It is a private let, and he has a good relationship with the landlord, who does what can be done to make the home affordable.

The truth of the matter is that that family need somewhere bigger, but because the father has to meet debt repayments—repayments that he has been keeping up, on a reasonable loan with a respectable lender—he is not able to afford the housing that they need; nor is he eligible for any help. It is incredibly important to him that his daughter should be able to live with him, but we know that if that family were to break up and she were to live with someone else or seek independent support for housing, she would be a greater priority than if the pair of them were to continue, as is their choice, to live together as a family. By failing to meet his need we not only risk the future of that family unit but could create greater demands for help with housing.

The final story I wish to share is altogether more complicated and illustrates how vulnerable people with housing needs can be refused help because of the complexity of their circumstances. A professional working man came to see me. He and his partner are going through child protection processes because he is a victim of domestic violence from her, and although, as I understand it, she has never caused any harm to the children in the household, she has been told that she cannot stay overnight in the family home in the interests of protecting the children. If the children are not to be taken into care, she can no longer use her home and so is homeless.

That woman grew up with learning difficulties and suffers serious mental illness. Of course the children in that family should be protected. However, she is a vulnerable person who needs help. Instead, the action of one department of the council has created a situation in which she has been forced out of her home. She has been forced to sleep on the sofas of friends and relatives. She has no entitlement to support with her housing need and has been denied any because technically she has a home, even though the council has made it impossible for her to live in it.

These are the difficult and hidden stories of my constituents and the housing needs they have in the otherwise delightful part of Wiltshire in which we have the privilege to live. Those stories illustrate the housing need that we, as a society, have to address. They also illustrate—I hope the Minister will grapple with this challenge—the need to take preventive action on homelessness, so that we do not find ourselves meeting the much greater costs of dealing with the crises and the further housing need that follow family breakdown. Unless we can face up to those difficult challenges, we will find an even greater task ahead of us.

15:36

[Emma Reynolds (Wolverhampton North East) (Lab)]

It is a great pleasure to serve under your chairmanship, Mr Robertson. I congratulate the hon. Member for St Austell and Newquay (Stephen Gilbert) on securing this debate and giving us all the chance to discuss this important issue.

Many hon. Members have spoken of their own personal experiences, including volunteering. The hon. Gentleman gave a good opening speech, in which he pointed out that he had been in a pretty desperate situation himself, doing what is called sofa-surfing, something that sounds better than it is—it is a stressful situation for anyone, as it is just one step away from becoming a rough sleeper.

Today’s debate is about Government support for young people who are homeless, but I want to start by putting on the record my tribute and thanks to the many charitable organisations that do such important work on this issue. Some have representatives here today. Since I became shadow Housing Minister, I have had a lot of help, support and advice from Crisis. Its No One Turned Away campaign is one that we have all read about and, I am sure, are all passionate about. I also pay tribute to Centrepoint, St Mungo’s Broadway, Depaul, YMCA, Shelter, Homeless Link and countless others.

In my constituency and home town of Wolverhampton there are small local charities such as P3, Home Group Stonham, the RMC—Refugee and Migrant Centre—TLC college and the Haven. Churches all round the country also help people, through soup kitchens and also, sometimes, by providing shelter. Only yesterday, in Bedford, I visited the YMCA Beds for All home, which provides housing and support for homeless people of a variety of ages who have just come out of hospital. It was tremendous to see the work that the YMCA is doing to help those people turn their lives around.

My hon. Friend the Member for Rochdale (Simon Danczuk) pointed out that we are one of the richest countries in the world. That is why it is so incredibly tragic and unacceptable that homelessness is with us. We talk about the numbers, but in my opinion one homeless person is one too many. I am sure that homelessness must be a terrifying experience for anybody, but it is particularly so for young people. The youth homelessness charity Centrepoint estimates that as many as 80,000 young people in the UK experience homelessness of some kind every year. As the hon. Member for St Austell and Newquay highlighted, according to research by Crisis, half of all homeless people first became homeless under the age of 21. The majority of those who, unfortunately, first experience homelessness at such a young age face that experience again and again because they cannot get the help they need.

When a person has a number of complex problems, it can take only one thing to tip them into homelessness. When I visited a Crisis at Christmas centre over the Christmas period, I was reminded of that. I asked one of the volunteer chefs, “Why do you give up 10 days of your time during the Christmas period, when there is family pressure on you to be at home, to do what you are doing here?” He said, “There but for the grace of God go I.” That was a stark reminder that it is all too easy for people to reach that tipping point and find themselves in such a situation.

Many hon. Members have already pointed out that many young people are driven to homelessness by a dispute at home or by their families kicking them out. The dispute might be due to overcrowding in the family home, as the hon. Member for Chippenham (Duncan Hames) said, or because the young person or someone in their family has a new or existing mental health problem. All sorts of issues contribute to those tragic situations. If the young person does not have family support, which is vital, although many of us take it for granted, it is all too easy for them to enter a downward spiral.

As many hon. Members have said, young homeless people are much more vulnerable than the rest of the homeless population. Shockingly, two in five have experienced abuse at home and a third have been in care. There are also wider structural causes, such as a lack of affordable housing, the housing crisis, extreme poverty, unemployment and worklessness.

I am proud of the previous Labour Government’s record. We were determined to tackle rough sleeping and homelessness, and during our period in office there was a 70% drop in the numbers. We launched the flagship Supporting People programme, created the rough sleepers unit to reduce rough sleeping, and dramatically reduced the number of people and families in long-term bed-and-breakfast accommodation. When we left office there was still more to do, but I fear that since 2010, for a number of reasons, that progress has been rolled back.

As my hon. Friend the Member for Rochdale said, we have had a deep recession, but apparently we are in a recovery and the economy is growing. However, the number of people who are homeless and sleeping rough has continued to rise. Data from the Combined Homeless and Information Network, or CHAIN—a recording system for the homelessness charity St Mungo’s Broadway —show that 762 people found sleeping on the streets of London last year were under 25, which was a big increase on the 436 it found in 2009-10. For every person on the street, there are thousands without a decent, secure home.

I welcome the Government’s “No Second Night Out” initiative, which builds on some of the things we did in government, but I am afraid that some of their broader actions have made things much harder for young people who are homeless or at risk of becoming homeless.

[Ian Lavery]

Does my hon. Friend share my concern that not one speaker from the Government parties has mentioned welfare reform, which is having an impact on homelessness? Not one of them has talked about the bedroom tax, sanctions or the other things that we have mentioned. We are entitled to disagree about whether this is a political issue, but the hon. Member for Truro and Falmouth (Sarah Newton) suggested that we were lowering the tone of the debate by talking about politics. Politics is about choice, and politicians of all political persuasions are entitled to challenge other politicians. The political decisions that have been made are causing mayhem for young homeless people.

[Emma Reynolds]

And it is the responsibility of the official Opposition to hold the Government to account.

Although we welcome the Government’s “No Second Night Out” initiative, the overall framework within which we are working is worse than it was when we left office. We have had the bedroom tax and the housing crisis—the number of houses being built is the lowest in peacetime since the 1920s. Lower numbers of affordable homes are being built—in particular, homes for social rent, on which many people on low incomes rely. I am concerned about the worrying rise in the use of benefit sanctions, about which my hon. Friend the Member for Sheffield Central (Paul Blomfield) spoke eloquently. The Government deny it, but it seems that jobcentres have unofficial targets for sanctions. In many cases, as has been highlighted, it is being done unfairly and is causing hardship.

Councils such as Wolverhampton, Newcastle, Rochdale and Sheffield are facing the biggest local government cuts in the country, especially compared with wealthier areas. My hon. Friend the Member for Wansbeck (Ian Lavery) is right that political choices have been made. Unfortunately, the Government’s political choices have made the situation worse.

[John McDonnell (Hayes and Harlington) (Lab)]

I agree that we must situate this problem among a raft of policies. There is an association between homelessness and drug problems. We have discovered that last year, as a result of the cuts to the work being done with drug users, there was a 30% increase in deaths associated with drugs.

[Emma Reynolds]

That is truly worrying. Many of these problems are connected with substance misuse and mental health problems. Young people, in particular, must have much earlier access to help. That could be help with fighting an addiction or with mental health problems that sometimes become apparent only in people’s later teenage years, their 20s or further on in their lives.

It is important that the next Government—I hope they are a Labour Government—get the framework right. We have got to build more homes and, crucially, more affordable homes. We are going to abolish the bedroom tax and make renting in the private rental sector much more secure and stable, because at the moment tenants are not getting a good deal. We are one of the richest countries in the world, so it is unacceptable that we have such a high level of homelessness, especially among our vulnerable young people. The next Labour Government will tackle the tragic phenomenon of youth homelessness. We will take the concerted action across government that is desperately needed to get those people the help they need.

15:48

[The Parliamentary Under-Secretary of State for Communities and Local Government (Kris Hopkins)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I am grateful to my hon. Friend the Member for St Austell and Newquay (Stephen Gilbert) for securing such an important debate.

I recognise many of the issues that hon. Members have raised, which is why tackling homelessness and rough sleeping is a key priority for the Government. I have no doubt that being homeless affects every aspect of a person’s life. I do not want to see anybody in the frightening, difficult and challenging situation that my hon. Friend described, particularly because many of the individuals affected are extremely vulnerable.

I understand and share my hon. Friend’s ambition to eradicate homelessness altogether. However, a crisis in an individual’s life can happen at any time. The key things are preventing homelessness and helping individuals who find themselves in that situation. Whichever Government are in power, they can put significant resource into dealing with the issue, and I should put on record that we have put half a billion pounds into tackling homelessness and an additional £445 million into addressing some of the welfare reform issues involved. However, many of the key interventions are undertaken by charities such as Crisis and others, and the vast majority of the work is undertaken by local authorities, which do an enormous amount, and I want to pay tribute to the individuals involved. That half a billion pounds has prevented almost 700,000 households from becoming homeless since 2010, so a significant amount of prevention work is going on. I am sure that my hon. Friend will be interested to know that Cornwall has intervened for 5,000 households and supported those individuals, and I applaud its efforts to look after people who have found themselves in that difficult situation.

We should recognise that despite the tough set of economic circumstances, statutory homelessness is now lower than in 27 of the past 30 years, which is a significant change. However, the Government want to make sure that there is a strong safety net; it is particularly important that families and vulnerable individuals should have a house to live in. We have made sure that when particular authorities have been struggling to keep within the law as far as the six-week window on bed-and- breakfast accommodation is concerned, we have put additional money in to be able to intervene for those authorities. By working with them and with their peer councils, we reduced the number of such instances by 96% by December 2013. Those really high levels of reduction have continued in the years since.

The issue of housing supply was raised, and that could be a political matter—I recognise this is a political arena—but we should recognise that housing supply has not kept up with demand for many decades. Coming out of a recession, it is not just about pressing a button and getting housing going again. We need to have the skill set, the resource and the confidence in the market needed to build houses, and we have to make sure that councils have sufficient land to be able to do so.

However, I want to put on record the fact that 217,000 affordable homes have been built since April 2010, involving £19.5 billion of public and private moneys. The affordable homes programme will deliver 170,000 houses by March this year, and a further project to deliver 275,000 houses with £38 billion of public and private money is en route.

There are two interesting results: first, we have built more affordable homes than were built during any equivalent period in the past 20 years. Although I recognise that all Governments have struggled to deliver affordable homes, we are building a significant number. Secondly, more council homes have been built in the lifetime of this Government than in the 13 years of the previous Administration.

[Emma Reynolds]

Will the Minister recognise that the number of homes built for social rent fell last year to its lowest level in 20 years, and also that the Government have changed their definition of affordability to 80% of market rent?

[Kris Hopkins]

Lots of houses are needed in lots of different formats. The reality is that the houses are being built, and as I said, the number of affordable houses being built is greater now than at any period in the past 20 years. I reiterate the point that I have just made: this Administration have delivered more council houses in their period in government than were delivered in the 13 years of the previous Government.

[Stephen Gilbert]

It is, of course, worth having a debate about what the coalition has achieved over the past five years, but more crucially, I ask the Minister to consider two questions. First, will he issue stronger guidance to local authorities about the use of bed-and- breakfast accommodation for younger homeless people? Secondly, will he commit to having a review of the differentiation between priority need and non-priority need, which sees so many people slip through the net, as my hon. Friend the Member for Chippenham (Duncan Hames) indicated earlier?

[Kris Hopkins]

I have already written to local authorities regarding B and B accommodation. I will continue to do so—not only about B and Bs, but about the standard of accommodation that is out there. When people use public moneys, particularly for private accommodation, I expect them to make sure that the standard of housing is appropriate.

I want to read out some of the points relating to the review, for the simple reason that I chair a joint ministerial group, and we will publish a report shortly and call for evidence from lots of different organisations. There is an opportunity for that review and report to be brought together, so the next Government—of whichever kind, and I hope they are a Conservative majority Government —have a powerful piece of evidence. As my hon. Friend the Member for Truro and Falmouth (Sarah Newton) said, it is important to gather evidence to make determinations about how we spend our resource. The report will provide a substantial amount of evidence based on which a future Government can make choices.

We have recently announced the £8 million “Help for Single Homeless” fund. Thirty-four local authority partnerships have received that money, which will support some 22,000 people. The issue of complex needs was raised by several Members. We are working with Crisis and have provided it with some £14 million. With the support of its access to the private rented sector in particular, we hope to help some 10,000 single homeless people address and sustain private rented accommodation by 2016, and to help an impressive 90% of those sustain that accommodation for more than six months. It is important to ensure that people have a certain period of time in accommodation, not just a few weeks, so that it becomes a home. It is important that we put money into that.

The work of StreetLink has been recognised. It is an extremely powerful tool that every citizen can contribute to, and it has now helped more than 21,000 rough sleepers. My hon. Friend the Member for Rossendale and Darwen (Jake Berry) mentioned the issue of people walking on the other side of the street and ignoring the individual concerned. My experience is that some people do not know what to do to help them, and now they have a tool to do so. If they see somebody and want to intervene, they can, and a local resource will be used to ensure that people do not spend a second night out there. That is a really important way for the citizen to participate.

I have lots more statistics here, but Members raised some really important points, and I want to go through them quickly. I would appreciate it if the hon. Member for Sheffield Central (Paul Blomfield) dropped me a note about the guy who could not read, and I would like to challenge colleagues on that. I know that Ministers in the Department for Work and Pensions have made some changes in the rules relating to sanctions, but I meet Ministers from that Department frequently, and I would like to take those examples, challenge what is going on and make sure that we get the system right and appropriate.

On the point about local authorities’ work being variable, some excellent authorities are doing some great work, but some are placing individuals in accommodation that is not appropriate. There is a gold standard, and we have put £2.3 million into ensuring that there are decent homes. If a local authority is not placing people in appropriate accommodation, we will challenge it.

I want to challenge some of the figures that my friend the hon. Member for Rochdale (Simon Danczuk)—he is a friend—gave.

[Ian Lavery]

Why has the Minister not mentioned once—nor has any Government Member—the impact that welfare reform is having on homeless people? Listen to the homeless people in every—

[Kris Hopkins]

I would like to have time to respond. I did mention right at the beginning the amount of money we are putting in.

On what the hon. Member for Rochdale said, I did not sneak anything out—I am 6-foot-6 and 18 stone. If he looks through Hansard, he will find that I said that there is no more money and we are doing a consultation.

I thank my hon. Friend the Member for St Austell and Newquay for securing the debate, and I am more than willing to answer any other comments and questions that friends from around the House have raised.

Mobile Phone Coverage (East Yorkshire and North Lincolnshire)

Wednesday 21st January 2015 Westminster Hall

16:00

[Andrew Percy (Brigg and Goole) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson, and to have my hon. Friend the Minister here to respond to the debate. The fundamental reason for the debate is to ensure that the good people of the East Riding of Yorkshire and North Lincolnshire do, in simple terms, get what they are paying for from their mobile network operators. I have brought this debate to the House following a large number of complaints from my constituents about coverage across the East Riding of Yorkshire and North Lincolnshire. I myself suffer from this problem, not only in my own home in the constituency but while travelling around the 250 square miles of my constituency. They are 250 square miles of the finest parts of Yorkshire and Lincolnshire, as is broadly agreed. I struggle with my signal at home and with dropped calls and dropped signals when moving from one community to another in the constituency, as do many of my constituents.

I have taken the issues up with mobile network operators. I have written to my right hon. Friend the Secretary of State a number of times, and the responses have been very welcome and very helpful. I have also met Ofcom. However, because of the large number of complaints that I received from constituents, I decided to ask residents across the constituency what their views were, so last month I began surveying thousands of residents. We have surveyed about 6,500 residents to get a better picture of what the problems are locally, because some of the information that Ofcom has provided does not necessarily match what my constituents are telling me. I will return to the survey results.

I am pleased that the Government have agreed a legally binding deal with the networks to improve call and text coverage to 90% of the United Kingdom’s landmass. I think that that represents about £5 billion-worth of investment. It is a more ambitious target than many countries in Europe have agreed and it is at least 5% more than I think the Secretary of State originally planned. The Government were right to use the stick of forcing roaming in order to get the networks to act. It is also good news that the new 4G licence auction commits the network—I think that in this case, it is O2—to 98% coverage for residents.

[Sir Greg Knight (East Yorkshire) (Con)]

Is not the problem in the East Riding that only about 45% of households have access to 3G coverage at home and, on top of that, those are the very households that do not get superfast broadband, so we are dealing with people who are geographically isolated and also, currently, digitally isolated? Does not that need to be addressed urgently?

[Andrew Percy]

I could not agree more, and I thank my right hon. Friend for attending the debate. The problem in our area is compounded by the lack of good superfast broadband. The Government are dealing with that. Millions of pounds of investment are going into east Yorkshire and northern Lincolnshire, and broadband is being rolled out as we speak. Last week, I had some nice e-mails from constituents in Burton who have finally been able to sign up. However, people have the problem that they cannot get a phone signal and cannot get on broadband. I argue that that is basic infrastructure that people can expect to have. They expect electricity and gas—unfortunately, it is not always possible to get gas in my constituency—and power to be provided to their homes.

[Mr Angus Brendan MacNeil (Na h-Eileanan an Iar) (SNP)]

Will the hon. Gentleman give way?

[Andrew Percy]

I will give way to the hon. Gentleman. His constituency is some distance from the East Riding of Yorkshire and North Lincolnshire, but we are delighted to have him in the debate.

[Mr MacNeil]

I am very grateful to the hon. Gentleman. As a member of the Scottish National party, I am concerned about the mobile phone signal that my good friends to the south are receiving. Does he agree that given the data speeds of 4G—this relates to what the right hon. Member for East Yorkshire (Sir Greg Knight) said—those who are not getting broadband by line might get the connections and the access to the outside world if they had proper 4G? There are places that have lost 2G and 3G, but with 4G coming in, they could leapfrog over that. They could get on to the internet on the wireless signal.

[Andrew Percy]

I thank the hon. Gentleman for his intervention. 4G is a potential solution. The figure of 98% of residents having to be covered will be matched, I suspect, by other networks. It is a potential solution, but I still think that we should be able to deliver a good mobile phone signal and also broadband to people.

[Mr Graham Stuart (Beverley and Holderness) (Con)]

I congratulate my hon. Friend on securing the debate. In my home in the centre of Beverley, I lose signal with EE; and I am told by constituents that in the Vodafone shop in the middle of Beverley, there is no signal. It is a woeful level of service, and this infrastructure is critical to business in the area. It sends a message to those outside that we are not open for business. We are open for business. We need the Government to go further and faster to ensure that areas such as the East Riding are well served, not only in towns such as Beverley, where the service is woeful, but in the hamlets, where it is even worse.

[Andrew Percy]

My hon. Friend demonstrates an important point. Often when people think about poor coverage, they think about the very small communities that we have in our area—people who are 2 or 3 miles at the end of a farm track. Although it is true that they are affected, our market towns also have terrible signal problems. In my constituency, Broughton suffers particularly badly. Epworth also does; and in Beverley, the biggest market town in the region, the signal can be pretty woeful. That is not acceptable.

Let me move on to the survey of my constituents. My team has spent an awful lot of time inputting the data, for which I am very grateful. The results of the survey are as follows. About 15% of residents tell me that they cannot send a text or make a call from their own home, and 51% report some form of issue. Often, the signal comes and goes. They get one bar, suddenly no service, then they might be up to two or three bars. When residents are asked whether they can make calls outside or near their home, about half say that they still experience issues. The number of people who report that they have no signal at all is quite significant.

When residents are asked about using internet services on their phone—3G services—34% report no coverage inside their home, 40% report some coverage but experience issues, and just 17% have no issue with their indoor 3G coverage. That is a service they are paying for. The remaining 9% left the option blank, which I assume is because they do not use data services. Outdoors, 3G data coverage improves only a little, with 19% saying that they have no issues. Well over half of respondents report issues or no coverage at all for 2G calls and texts in some areas, and more than 70% report issues with 3G.

Particular problem spots that I have identified in my constituency are Broughton, Burton, Winteringham, Epworth and Haxey, in North Lincolnshire and, over in the East Riding, parts of Snaith and of Rawcliffe. Coverage in the marshland villages can be particularly poor. One constituent, Liz Sargeantson, a parish councillor in Reedness, explained to me that she has to hang out of the window with one arm pointing in a particular direction to get a signal. It is almost a case of one finger in the ear and it might be a bit better. It is a ridiculous situation.

In Burton, 55% of residents said that they had some issues with 2G indoors, and that is not a small village; it is a reasonably sized village and not that far from Scunthorpe, so we are not talking about the back of beyond. It was the case that 13% had no coverage at all and just 31% reported no issues; 46% of residents reported no 3G signal—

[Mr MacNeil]

Will the hon. Gentleman give way?

[Andrew Percy]

I may do later; I would like to continue with my survey results. In Broughton, 11% of people had no 2G coverage indoors, only 22% reported that they had a good signal and 67% reported issues with 2G services. When it came to 3G, just 5% of people in Broughton—the second biggest town in my constituency—said that they had good coverage and 40% said that they had no connection. There are similar issues on the Isle of Axholme, in Haxey. Over in the East Riding part of my constituency, where I live, we have similar problems. In Rawcliffe, 75% of respondents said that they had issues with 2G or 3G coverage. More worryingly, many have reported that the situation seems to have become worse in recent weeks and months. There is a suspicion that masts have been moved, although the networks say that that is not the case.

I am sick of hearing stories about people having to go to the bottom of their back garden to get a signal, because that is not acceptable. Those people are paying a monthly bill as part of a contract for a service that they are simply not getting. The data I receive from constituents conflict with statements by Ofcom, which suggests that 95% of premises in north Lincolnshire are covered by 2G, and 92% in the East Riding. As my right hon. Friend the Member for East Yorkshire (Sir Greg Knight) has said, for 3G the figure drops to 45% in the East Riding and 69% in north Lincolnshire. I am concerned about the fact the coverage appears to be patchier than coverage maps would have us believe. I know that the Minister has secured agreements to improve the signal, but will he look at whether coverage is being correctly measured and provided to consumers? As good Conservatives—I do not include the hon. Member for Na h-Eileanan an Iar (Mr MacNeil) in that; I speak of those of us who are more sensible of mind—we expect consumers to be provided with the right information so that they can make an informed choice.

As my hon. Friend the Member for Beverley and Holderness (Mr Stuart) has said, connectivity is incredibly important for the rural economy and small businesses. Sadly, several small rural business people have told me that because of the problems with getting a signal at home or in the local area, they miss out on business when they are away from their landline. When we are encouraging people, particularly those in rural areas, to start their own businesses, that is a big concern.

[Mr MacNeil]

The good people of Brigg and Goole are well served by the excellent survey that their MP has carried out for them. I have done similar work in the past. Is it not a failure of the UK mobile model that the hon. Gentleman and I face such a situation? Should there not be roaming, so that when networks are falling in and out, people can use one that is working? I know some people who have to carry two mobile phones. Do we need digital SIM cards so that we can easily switch on one handset? Should the model of 90% to 95% coverage apply to each rural local authority area? In the Faroe Islands, where the topography is worse than it is in my constituency or that of the hon. Gentleman, there are 50 3G masts for 50,000 people as a result of the mobile telephone model that they have adopted, which we have not adopted in the UK.

[Andrew Percy]

I thank the hon. Gentleman for the Scottish National party’s endorsement for May, which may resonate with some of my constituents. The examples that he uses are problems that we need to look at. I am a little concerned about the impact of forced roaming, and about whether it might lead to disinvestment in some areas. There are arguments in both directions, but I think that the Government have been right to look at the matter. The hon. Gentleman has reminded me of an e-mail I received this morning from a constituent in Epworth, who said that they had just returned from a cruise—how nice for them—around Spain and Portugal, and they had had better signal at sea on their cruise ship than they did when they returned to their home in Epworth.

What can be done? Improving coverage without masts is important. Some networks provide people with equipment that allows them to use an existing broadband connection in their home to make mobile calls. Some networks offer the necessary boxes for free in areas where coverage is particularly poor, but others charge a significant amount. If people are not receiving in their homes the service that they have been promised, perhaps the Government might push the networks to offer such equipment for free to allow people to get mobile access at home. We all know about the smartphone apps that allow calls and texts to be made over a wi-fi network. EE tells me that it is fully integrating those into the phone’s dialler, in the hope that it will be easy to switch between the mobile network and home internet. That is something on which residents can take action when they select a network or handset.

I would like to ask the Minister about masts. We know about the new technology, but much of the improved coverage will come from the traditional mast infrastructure. There is an issue, however, which is worthy of some consideration. Mobile networks have pushed for a change in the policy surrounding masts, because they believe that the regulation is out of date. The electronic communications code, which was last updated in 1984, is the main piece of relevant legislation—the Minister may be able to say something about that when he responds—and the networks believe that it is no longer fit for purpose.

I am aware of the amendment to the Infrastructure Bill, on which I believe there may have been some movement today; perhaps the Minister can tell us about that. I welcome that change on the whole, but I note that some mobile networks are concerned that it might disapply the terms of the code for third-party infrastructure providers such as the Wireless Infrastructure Group and Arqiva. Perhaps the Minister will have something to say on that, given that such providers account for 40% to 50% of mobile masts. The concern is that if the code does not apply to them, operators would not have enough time to seek alternative coverage arrangements on the ending of a lease, which might be detrimental.

Mobile operators have talked about wanting to make their masts taller. The position of the public on the matter has changed significantly. When I was a local councillor 10 or 15 years ago—

[Mr MacNeil]

The hon. Gentleman is too young for that.

[Andrew Percy]

I thank the hon. Gentleman for his comment. I remember old ladies, who had never engaged in any such activity before, threatening—[Interruption.] I do not know what the Minister thinks that the old ladies were threatening to do. They were simply threatening to lie down in front of diggers; the protests went no further than that. People used to be particularly concerned about masts, but that has changed. In all the survey results that I have received, only two people mentioned that they do not want to see an expansion of masts or improved coverage. We must still leave such decisions to local people, however.

[Mr MacNeil]

Will the hon. Gentleman give way?

[Andrew Percy]

I am not going to give way, because I have quite a lot to get through and the Minister needs to respond. I am told by some of the operators that raising the height of masts from 50 feet to 80 feet might improve coverage by up to 150%. Mast heights can be controversial, however, so I will dip my toe in but say only that that may need to be looked at.

Another area of reform that I would like the Minister to consider is mobile switching. Under the current system, a customer has to contact their existing provider to switch. The consumer group Which? has led a campaign urging Ofcom to introduce “gaining provider led” switching, under which the company to which customers move would deal with the switchover. That would promote competition and allow customers to switch networks more easily.

I have outlined a fairly terrible picture of local mobile coverage, but I commend the Secretary of State, the Minister and the Government on achieving agreement with the networks to provide 90% coverage. The 98% requirement for 4G will, I suspect, be matched by other networks. The money that is coming into our broadband infrastructure is important. Although that deal is welcome, we need to know from the network operators what it will mean for local communities. I urge the Minister to put pressure on the networks to share as quickly as possible their improvement plans for each area.

Thinking about the broadband roll-out, some authorities have been pretty poor at giving people information, while others have been excellent. North Lincolnshire council has been excellent at sharing information on what is likely to happen. I envisage something similar where residents find out from operators—I understand that there are commercial issues as well, so it might not be quite this simple—what improvements are likely to happen in the future, which will allow them to make informed choices.

I am happy to have a Government who are finally trying to tackle the problem. Concerns have been raised about some of the potential changes to the code, but the people of Brigg and Goole are basically asking for the Government’s continued support to make sure that we get the service that we, as customers, are all paying for. Contracts are not always cheap, although compared with some countries, we are lucky when it comes to the level of competition in the market. However, we want the service that we are paying for. The deal that has been announced is excellent news, but residents want to know what it will mean over the next year or two.

[Mr Graham Stuart]

I am sorry to interrupt a fine peroration to a brilliant and powerful speech, but I want to reinforce the points that my hon. Friend is making. When the Minister is looking at how to ensure that rural areas, which might be seen as marginal, are properly looked after, he would do well to consider Hull and the East Riding as a pilot area. We do not have lots of tunnels or lots of hills, so it is an easy area topographically. It is absolutely absurd that residents do not receive the service that they pay for in an area in which it would, technically, be pretty easy to deliver, but it is simply not happening.

[John Robertson (in the Chair)]

I say to the hon. Member for Brigg and Goole that there are about 10 minutes left.

[Andrew Percy]

I am aware of that, Mr Robertson. I will end by saying that my hon. Friend the Member for Beverley and Holderness makes an important point. He is a doughty campaigner for his constituents in the East Riding. He made one slight error when he said that the pilot area should be the East Riding and Hull; he meant the East Riding, Hull and northern Lincolnshire.

[Mr Stuart]

I did indeed.

[Andrew Percy]

I look forward to the Minister’s response.

16:20

[The Minister for Culture and the Digital Economy (Mr Edward Vaizey)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I know you have a strong interest in the Government’s broadband programme. I thank my hon. Friend the Member for Brigg and Goole (Andrew Percy) for securing this important debate. We have enjoyed some trenchant contributions from my hon. Friend the Member for Beverley and Holderness (Mr Stuart), my right hon. Friend the Member for East Yorkshire (Sir Greg Knight) and the hon. Member for Na h-Eileanan an Iar (Mr MacNeil).

[Mr MacNeil]

Good on you.

[Mr Vaizey]

Perfect Gaelic there. We were expecting an intervention from my hon. Friend the Member for Cleethorpes (Martin Vickers), but he is a brooding, silent presence, and one can only speculate as to what is going on in that fine mind.

What unites all those who have contributed to this debate is their incredible work for their constituents, but if I were to pick a winner it would have to be my hon. Friend the Member for Brigg and Goole, who has worked tirelessly with his constituency office over the past few months to engage with his constituents on this important issue, to hear their views—he said that 6,500 constituents have been contacted—and to bring the matter to the House for debate. His constituents will reflect on that hard work as we approach an important date some time in the spring.

One of two things tends to happen in such debates: either we start with the glass half empty perspective from hon. Members who are keen to press for improvements, followed by me putting the case for the glass being half full, or there is a case of violent agreement. My hon. Friends would have a legitimate concern if the case they were continually bringing to the House was that the Government were doing nothing, but my hon. Friends and other hon. Members know that the Government are doing a lot in this area, so my hon. Friends’ case is that the Government are doing a lot but should be doing more or should be doing it better. That is how I intend to respond.

I know this debate is about mobile coverage, but the Government have made great strides on two issues: fibre broadband, which my hon. Friend the Member for Brigg and Goole mentioned, and mobile phone coverage. I will be very brief on fibre broadband because it is not the main topic of debate. In the East Riding, £10.5 million has gone to extend superfast broadband coverage to some 42,000 homes. The Government have pledged £5 million for the next phase, phase 2, which will not get the East Riding the extensive coverage that exists elsewhere because of the area’s very rural nature. Some £30 million has gone to Lincolnshire as a whole, which is obviously a bigger area, achieving almost 90% coverage—almost 120,000 homes—and in phase 2 approximately £4.7 million will take Lincolnshire to 90%. There has been extensive progress on fibre broadband, and nationally the programme is fast approaching 2 million premises, which is a real achievement.

The second issue is mobile phone coverage, on which I want to put a couple of points in context. First, the mobile operators are, of course, private companies. They have built their networks without any Government subsidy and, indeed, the Government have benefited from the extraordinary auction of the 3G spectrum, which put £22 billion into the previous Government’s coffers, and the more recent 4G auction that put approximately £2 billion into this Government’s coffers. Those networks have been built with private money, and the operators face a number of obstacles, such as landlords who might be charging significant rent and the securing of planning permission. Indeed, my hon. Friend referred to militant constituents from 15 years ago. They have since calmed down a great deal, but unfortunately we are all old enough to remember a time when the arrival of a mobile phone mast was greeted with horror rather than glee.

[Mr MacNeil]

As well as landlords, the people who own the rights to the masts can be a choke or a bottleneck on other networks adding their kit to those masts. Anything the Government can do there would be welcomed.

[Mr Vaizey]

We recognise all the problems, and we have made great strides because we recognise that there are a vast number of not spots. We have the fastest 4G roll-out anywhere in the world, and all the operators are committing themselves to 98% coverage of premises. That roll-out should be complete by the end of 2015, but the concerns really relate to geographic coverage, because when people leave their home with a mobile phone, they naturally expect their phone, by definition, to work outside the home. We are talking about areas where there is no coverage at all from any operator, a not spot, or partial not spots where there is coverage from only one operator.

We have started the mobile infrastructure programme, under which there is £150 million to build masts in not spot areas. That has proved challenging because we are talking about remote areas, and one has to remember that we cannot just stick up a mast and plug it in; we have to take power and fibre to the mast. We cannot just arrive and build it; we still have to negotiate with landlords and local authorities. Appropriately, the first site went live in North Yorkshire, close to the constituency of my hon. Friend the Member for Brigg and Goole, in 2013. We are considering 600 potential sites across the programme, and we are currently negotiating on 120 sites. That was stage 1.

Stage 2 was brought forward by my right hon. Friend the Secretary of State for Culture, Media and Sport, when he raised the issue of national roaming with mobile operators. National roaming is problematic. To a certain extent, the operators compete on their networks, but there are potential unintended consequences with national roaming, and it will take some time to introduce legislation. We always said that a voluntary agreement would be our preferred solution, which is exactly what he secured at the end of last year. Stage 2 will put a legally binding coverage obligation on mobile network operators to cover 90% of the UK landmass by 2017, which is a massive change in the way that MNOs relate to coverage in this country. It will guarantee £5 billion of investment in mobile infrastructure and get rid of two thirds of partial not spots and half of complete not spots.

My hon. Friend the Member for Brigg and Goole raised a number of other points. One was the measurement of coverage which, again, we addressed through the mobile infrastructure programme, because where Ofcom says there is coverage and where there is coverage in reality can be problematic. As a result of the programme we have massively improved the way that Ofcom measures coverage. We found that around a fifth of East Yorkshire and about 7% of North Lincolnshire have partial not spots, with a small part of both having complete not spots. We expect that, as a result of the agreement negotiated by the Secretary of State, 99% of East Yorkshire and very nearly 100% of North Lincolnshire will have coverage from all four operators by the end of 2017, which is resolutely good news for his constituents.

After this debate, I hope my hon. Friends will troop down to the Terrace Pavilion, where Vodafone is hosting a reception to promote its rural “open sure” signal. I repeatedly say to Vodafone and the other operators that they should offer that signal as a retail offer to parish councils, which might front up some of the money—it could be several thousand pounds—to establish a local mobile network made up of small cells that people can put in their home.

With Ofcom, we are carefully looking at allowing people to switch between mobile operators more easily, and it is still something that we would consider. On the electronic communications code and the issue of tall masts, we are continuing active discussions with the operators to ensure that we get the code absolutely right in order to reduce their switching costs. We have some of the cheapest mobile phone contracts anywhere in the world, but I point out to constituents that a lot of the contract is spent on buying the very expensive smartphones that are now all the rage—the retail price can be £500 or £600, which is spread across the contract. The actual cost of calls and data is relatively cheap and continues to fall, and it compares very well with our competitors in Europe and elsewhere.

Adult Social Care

Wednesday 21st January 2015 Westminster Hall

16:30

[Mr George Mudie (Leeds East) (Lab)]

It is a pleasure to see the Minister here for this debate as well as you, Mr Robertson. I thank the Speaker for this opportunity to discuss the present and future state of the adult social care sector. This area of local government covers a vital service for the most vulnerable people in the country, with the elderly, the disabled and those with mental health difficulties being among its most prominent users. In the past four years, its future has become more of a concern.

We are weeks away from a general election and the Government are anxious that their fiscal plans are seen to be successful. Central to those plans is the fact that cuts to public services are unavoidable and necessary and that they must continue for the next four years. Before we blindly accept that doctrine, the debate gives me an opportunity to spell out briefly the extent of the damage those cuts are having on the lives of hundreds of thousands of vulnerable people who use the adult care service.

The Government have ring-fenced the health and education budgets, so, with those two huge Departments free from cuts, money has to be found from other Departments. In local government, adult social care services is the next largest budget. The Government have claimed to understand the sensitivity of that work, but nevertheless the 40% cuts in local government spending have made it impossible for the service to escape unscathed.

Age UK, the leading charity in this sphere, states that the sector has lost more than £1 billion since 2010—and that is at a time when, because of demographic changes, with people living longer, the services requires more money, not less. It is good that people are living longer, but when they eventually ask for help, because they are older, their needs are more complex and expensive.

[Mr David Ward (Bradford East) (LD)]

Does the hon. Gentleman accept that cutting that spending is a false economy? If quality care is not provided at the right time—in particular in the home environment—more expensive care will often need to be provided later in hospitals and other care support centres.

[Mr Mudie]

The hon. Gentleman is quite right. I will touch on the sheer lack of connected thinking in the Treasury—I do not think that the Department of Health has much to do with that.

The National Audit Office, which is usually pragmatic and non-political and accepted as objective, pointed out in its review of the service that total spending on adult social care—covering the whole gamut of, I suppose, 18 to death—fell 8% in real terms between 2010-11 and 2012-13. Older adults experienced the greatest spending reduction at 12% in real terms. Interestingly, the NAO stated:

“Rising needs, reducing local authority spending, and reductions in benefits may be putting unsustainable pressure on informal carers and acute health services.”

Chillingly, it went on to say:

“National and local government do not know whether the care and health systems can continue to absorb these cumulative pressures, and how long they can carry on doing so.”

That is from its review last year, yet the cuts have continued.

[Mr Jim Cunningham (Coventry South) (Lab)]

To substantiate the point that my hon. Friend has just made, I can tell him that about a fortnight before Christmas we met local GPs who were voicing concerns about bed blocking in particular, caused by cuts in local government expenditure for social care. That is reminiscent of what happened under the previous Conservative Government.

The other affected area is meals on wheels. When a visitor goes to an old person’s house, they see what condition they are in and often they are able to help but get only 15 minutes to do so.

[Mr Mudie]

My hon. Friend is quite right. When I was a trade union official, I looked after what were termed home helps and I always appreciated that point—as I did as a councillor, just like him. They were invaluable people who went into old people’s homes, met them and formed relationships, and if they were handled and trained properly, they would report back on any change in condition they saw. That was often valuable for the old people.

If the Minister read the excellent newspaper The Independent this morning, he will no doubt have seen the article reporting the comments of the chief executive of Age UK, Caroline Abrahams. The article states:

“Care of the elderly is in a state of ‘calamitous, quite rapid decline’…with…thousands fewer people receiving care than five years ago.”

She spelled out the fact that the number of people receiving home care has fallen by a third since 2010.

Places in day centres, where lonely, vulnerable adults could find warmth and companionship and escape cold, empty homes are down 66%. Incredibly, in the area that my hon. Friend just mentioned—equipment and adaptations such as rails and stair lifts—40% fewer people now receive help. I say that is incredible because everyone accepts that such adaptations and aids help old people stay in their homes. Often, they save their lives, but they are certainly a method of preventing them going prematurely into residential homes or hospital beds, yet the money has been cut and 40% fewer are being helped.

The article continues:

“Ms Abrahams said that hundreds of thousands of older people were being left ‘high and dry’.”

It goes on:

“‘The lucky ones have sufficient funds to buy in some support, or can rely on the good will of family, neighbours and friends. But there are many who are left to struggle on entirely alone,’ she said.”

I remind the House that that is the chief executive of Age UK, the leading charity for old people.

The Care and Support Alliance pointed out that population changes mean that more people need care, but, as we know, fewer people receive it. There have been further cuts to adult social care budgets in recent years, and a 26% reduction in the number of older people receiving state-funded services, despite the Personal Social Services Research Unit having predicted that demand would increase by 17% between 2000 and 2020.

The picture is the same among working-age disabled people, 90,000 of whom lost access to state support for their care needs between 2008 and 2013. The alliance says that there is a “chronic underfunding” of care. With local authorities having had to find significant savings owing to reductions in Government grants, there have been further cuts to social care budgets in recent years. The Association of Directors of Adult Social Services and the Local Government Association estimate that about £3.53 billion has been taken from adult social care budgets during the past four years. In the last year alone, 40% of the total savings made by local authorities were achieved through reducing adult social care services. That is quite an alarming figure, but perhaps understandable. That has resulted in a tightening of eligibility for care at local level and of the size of care packages for those who remain eligible. When discussing the Barker commission’s recommendations for more funds and the options that had been set out, the CSA commented:

“What is no longer an option is to continue the current chronic underfunding of care.”

I hope that in the short time available to me, I have allowed the voice of representatives to be heard and put on the record—not partisan politicians but those working in the service full time, who know the people, the finances and the difficulties. What it all adds up to is something that has been known in this place for some considerable time—the service is underfunded, at a time when it is recognised that there are additional pressures and that there is a need for more money, not less. We all know that. It has been known in this building for at least 10 years, covering two Governments. People told us until they were blue in the face that more money was needed, because there were more older people who were living longer and had greater needs. Yet because of elections, I presume, everybody dodges the column and no one has made the difficult decision about how we put money into the service. There should have been a public debate along those lines, to show people the quiet neglect of vulnerable people that is happening every day, in almost every street in our communities.

[Mr Cunningham]

The situation is a little worse than that. We are really going back to about 30 years ago, when local authorities were forced into doing deals with the private sector for old people’s care homes. Recently, we have witnessed some of those care homes going bankrupt, which means closure and a lack of places for people.

[Mr Mudie]

It is clear that my hon. Friend has read my speech; I was just coming on to the privatisation of adult care services.

I hope that I have highlighted in my remarks the important role of local authorities in the sector. As an ex-councillor, I instinctively have much sympathy with the difficulty they face in having to take some very difficult decisions about priorities in the face of the Government onslaught on their budgets. Leeds, my home authority, has faced a tremendous task in running a city when it has had to find £250 million in cuts during the period of the first spending review. Having achieved that, it is now dismayed to hear the Chancellor threaten—indeed, promise—further cuts until 2018, if he gets back in office. In fact, Leeds has been told that it will face a budget cut of £46 million in 2015-16. Other councils face similar problems, and I simply do not know how the Chancellor feels he can order those huge cuts and still have our major cities being run and our elderly and disadvantaged being properly cared for.

I was alarmed when I was informed that a dementia residential and daycare home in my constituency, The Green, was being closed, and that many hundreds of home care workers were also losing their jobs. When I looked into things, I discovered that, chiefly as a measure to keep the city intact financially, the council had had to act in line with other big cities and had taken two unfortunate steps.

The first, which has been mentioned in passing, was to raise the criteria level at which help should be given. This meant that new applicants would have to meet higher eligibility thresholds than before. Parkinson’s UK and the National Autistic Society are two organisations that have pointed out how the new criteria put their members at a disadvantage when it comes to receiving help. The Government have legislated on that point in the Care Act 2014, and although that meets the Government objective of ending postcode unfairness, it also legitimises local authorities, or rather strengthens them, when they have to turn people down because they have needs that are lower than the criteria require. Those organisations have given evidence on how the quality of life of individuals with either Parkinson’s or autism has been diminished. I hope that the Government’s decisions will be reviewed in happier times.

What is more difficult to review is the point that my hon. Friend the Member for Coventry South (Mr Cunningham) touched upon—the decision to outsource adult care services. That has been done to help meet the shortfall in Government grant. Perhaps I am paranoiac—I probably am, because I think paranoia keeps us safe—but I wonder whether that is what the Government intended. Many people have been outraged by the Government’s propensity to privatise much of the NHS, but thanks to the love that the British public quite rightly have for that unique and wonderful organisation, the Government have backed off from adopting a full-frontal approach and are now taking a more subtle, if not devious, approach.

So quiet has the handing over of care homes and home care staff been that it has rarely been picked up by the general public, except by the clients of those homes and the ex-local government staff themselves. There is a growing awareness of 10-minute visits and the failure to provide elderly people with the same carer; providing the same carer is an important part of home care, so that people can build a relationship with them and trust can develop. The former staff are aware of the loss of local government wages, the use of zero-hours contracts and the loss of payment for travelling time, which accounts for those 10-minute visits.

I will just depart from my script to say that that situation is not surprising. If a council outsources contracts and there is a duty to save money, given that those contracts primarily involve labour, the only way in which money can be saved is to hand them over to a private company. That company would have no compunction in offering lower wages, no travelling time, worse holidays and worse sickness schemes. That is what has happened in the majority of cases.

[Mr Ward]

Does the hon. Gentleman accept that, in many cases, the private sector businesses are effectively offering wages that are below the national minimum wage, as a result of the commissioning process? In some cases, they are being given only enough money to offer no more than £12.50 or £13 an hour, which cannot cover all the costs of travel, transport, uniforms and training. That means that the private sector businesses are often almost being forced out of business.

[Mr Mudie]

I totally agree with that. Now that the local authorities have pocketed the money, it is clear that they are pressing down on the private firms, and we are a step away from the disaster of the private firms just going, “There—that’s it.” What happens when we have closed all our residential homes? There is a real problem building up.

I am sad that financial pressures have forced councils to do that. The care of the vulnerable elderly is a service that, just like hospitals, should remain in the public sector. The various scandals in care services have underlined the temptation—indeed, often the necessity—of people in business to do more than cut corners when looking after people who are helpless. I am less than convinced that the Care Quality Commission, with its proposed risk-based regulation, is any better than its predecessor, which turned out to be disastrous.

In Leeds, thanks to the protests by staff and unions, the public unhappiness over the closures and the sagacity of the council leader, Councillor Keith Wakefield, the decision on care is under review. I understand the pressures that the council faces, but I hope that it makes the right decision.

I will end my remarks by asking the Minister three questions, which, if past debates in this place are anything to go by, I will not receive answers to; I am referring not to this Minister but to his disreputable colleagues. I know that this Minister is a man of honour.

First, is any discussion taking place about putting adult social care, which is closely affected by and connected to hospital care, inside the ring fence? Secondly, are councils under any instruction about privatising or outsourcing adult services? Thirdly, is any Government legislation preventing councils, in commissioning work, from inserting provisions stating that wage and working conditions should be at a specific level?

I know I am crowding the Minister’s time, but I shall take just half a minute more. I was once in a group of people in sheltered housing discussing some problems, and I met an old lady of 90. She said, “I’m 90 and I haven’t had a bath for two years.” I started back. She said, “No, I do my best to wash myself standing up, but every time the door opened and the home care worker came in to bath me, I was getting a stranger. I may be 90, but I have my self-respect and my dignity, and I want to keep it.” That is happening to too many of our older people. They are vulnerable, they are being treated badly and they are neglected. It is about time that not the Minister, but the Chancellor woke up to this.

16:51

[The Parliamentary Under-Secretary of State for Business, Innovation and Skills (George Freeman)]

I thank the hon. Member for Leeds East (Mr Mudie) for raising the important issue of the reorganisation of care pathways in Leeds. I prepared a speech dealing with the reorganisation of health and care and their integration in the town, but I only have nine minutes left and I need to deal with the questions raised by the hon. Gentleman. Perhaps I can write to him with the detail of some important reforms going on in the city.

First, I want to take on the hon. Gentleman’s questions. I reassure him that the reforms in the city are absolutely not the result of any diktat by Ministers. They are in fact being led by hard-working and pioneering health, NHS and social care leaders in Leeds, to whom I pay tribute. My right hon. Friend the Minister of State, who is responsible for care, has publicly commended the work that they are doing locally. They are doing pioneering work in the important mission of integration.

In much the same way that NHS England is autonomous and responsible for delivering health services locally, local authorities are responsible for providing social care services for their communities. As autonomous public bodies, they are best placed to decide the needs of local people. I support the work done in so far as it encourages people locally to contribute to that democratic process.

The hon. Gentleman made some important points. First, he asked whether the proposed closure is due to cuts in Government funding. The answer is no. Public finances are in a precarious position. This year the deficit is still, despite the best efforts of this Government, projected to be over £100 billion. I remind him that when we came to office, debt interest alone was running at £70 billion a year. In Labour’s last year, one in every four pounds spent by the Government was borrowed. We had to get that under control.

It is true that priorities have to be set across the local authority system, but the vast majority of local authorities have prioritised social care. Indeed, in Leeds, work has been done to allocate priorities appropriately. The evidence is encouraging. Despite difficult public spending constraints, spending in Leeds on adult social care is up 3% in cash terms. Importantly, satisfaction with levels of care and support is up 10.8%. I do not recognise the picture of catastrophic collapse that the hon. Gentleman painted.

Secondly, the hon. Gentleman asked whether the Government are doing enough on accident and emergency and about the extent to which that is being driven by the problem in social care. The truth is that we ring-fenced a grant for £25 million to help councils with hard-pressed hospitals. An ageing population—there are 1 million more pensioners this year—is driving increased pressure on A and E. We have set up the Better Care Fund, which I will say a little bit about later.

I cannot let the allegation about privatisation go without a response. Labour’s scaremongering about privatisation has been discredited as a myth by just about every health commentator, including the King’s Fund. Our Health and Social Care Act 2012 made it illegal for any Government to drive the private sector into the NHS, as happened under the Labour Government. It was Labour, actually, that was prepared to pay private sector providers 11% more than NHS providers, and under this Government, led by my right hon. Friend the Secretary of State for Health, that has been made illegal. Under Labour, independent provision comprised 5% of the NHS, but under this Government it is now 6%, which is not an increase of the order that the hon. Gentleman described. Spending on private providers for general and acute secondary care increased by twice as much under Labour as it has under the coalition.

The health service has always been a mixture of private, public and voluntary providers. It ill behoves the Opposition, just before the election, to scaremonger on privatisation. That does not support patients and it is not what the people who work in the health service want to see.

In the few minutes I have left, I want to say something about the reforms to adult social care and the integration of care, and about the work that Leeds has been doing. I know how difficult it can be for elderly patients when health and care services are reformed and changed. That is why it is important that it is done locally, with consultation and led by local professionals.

This morning, I spoke to the interim director of adult social services for Leeds, who assured me that no decision has been made on these proposals. They are still being consulted on and they are part of the council’s wider six-year programme to move more services into the community. I understand that there is plenty of alternative capacity in the area: 123 independent sector care homes in the Leeds area alone would be able to accommodate anybody moving. Furthermore, he tells me that the council has successfully closed a number of its care homes, so if a decision is made to close other care homes, it will use that previous experience to handle those closures sensitively and appropriately.

I want to say something about the context of and pressure on social care and how it is changing. Above all, I emphasise the importance of all services, not just social care, adapting and working together to meet the needs of an elderly population in the 21st century. We are living longer, healthier lives and that is something to be celebrated. The fact that many of us can look forward to reaching 85 and over and many of us—perhaps not me, but perhaps the hon. Gentleman—will live to be 100 is a fantastic achievement. However, it puts pressure on the system. Historically, health and care costs have risen by about 4% every year in real terms. The number of people living with three or more long-term conditions is set to increase from 1.9 million in 2008 to 2.9 million in 2018. One of my former ministerial colleagues, my right hon. Friend the Member for Sutton and Cheam (Paul Burstow), has talked about how care homes need to be made

“fit for the rock and roll generation”.

That is why we have been pushing the integration of health and care and the changes set out in the Care Act 2014.

It would be remiss of me not to admit that in recent decades we have allowed ourselves to tolerate a care system that too often steps in too late and picks up when there is a crisis, rather than acting to prevent one; a system in which there are still too many barriers stopping people getting the integrated care they need; and a society, for which we all take responsibility, that, despite the best efforts of those working in the care sector—professional and voluntary—increasingly has tolerated too much loneliness and isolation.

The case for reform and integration of the care system is not just serious, it is overwhelming. That is why this Government have put such emphasis on integration. People worry that care services will not help them regain their independence and maintain a decent quality of life. It is in all our interests to integrate health and care better. That is why we created the Better Care Fund, the biggest ever financial incentive for the integration of health and social care, providing £5.4 billion of investment in better integrated care from 1 April 2015. Never before has there been a clear legal duty to focus on prevention. The Care Act fills that gap.

I pay tribute to the leaders in social care and health in Leeds, because they are doing great work as a pathfinder area and the Government have supported them. It is a Labour-run council, but it is doing good work in the integration process. I understand that Leeds is opening 37 open access neighbourhood networks. Those schemes are helping around 22,000 older people every year with a range of activities; they have prevented 1,400 older people from going into hospital; and they have supported over 600 older people when discharged from hospital.

Time is against me. I want to close by highlighting the fact that these are not easy issues. The integration of NHS and care services is a challenge across the country, in my constituency as well as the hon. Gentleman’s. The Government have inherited a legacy of neglect in recent decades: I do not just blame the Opposition. We have not integrated properly and we have allowed this problem to go on too long. I believe this Government have attempted to tackle the deficit responsibly. Of course, we all have to tighten our belts.

We have ring-fenced health expenditure. In an integrated system, putting more money into health and driving integration means that there is more money indirectly for social care. The statistics in Leeds simply do not represent this catastrophic picture of privatisation, which has been discredited, or of crisis in the system. I do not pretend for a minute that everything is perfect, but I do believe that we, working with local authorities, are putting the right solution in place for the longer term.

Question put and agreed to.

16:59

Sitting adjourned.

Written Statements

Wednesday 21st January 2015 Written Statements

Wednesday 21 January 2015

Environment Council

Wednesday 21st January 2015 Written Statements

[The Parliamentary Under-Secretary of State for Environment, Food and Rural Affairs (Dan Rogerson)]

My hon. Friend the Parliamentary Under Secretary of State, Department of Energy and Climate Change (Amber Rudd) and I attended the EU Environment Council in Brussels on 17 December. Mark H Durkan, Minister of Environment in the Northern Irish Government and Richard Lochead, Cabinet Secretary for Rural Affairs Food and Environment in the Scottish Government also attended.

After adopting the agenda for the meeting, Environment Ministers reached political agreement on the monitoring, reporting and verification of carbon dioxide emissions from maritime transport. Both Finland and the Netherlands noted the importance of continuing to refine the parameters for the calculation of the energy efficiency of ships, while Malta, Cyprus and Greece opposed the agreement claiming that it would have a competitiveness impact on their industries.

Political agreement was also reached on the ratification package of the Doha amendment to the Kyoto protocol. The Commission supported by Spain, France, Portugal, Austria, Sweden, Germany, Malta and Belgium welcomed the Council’s agreement, and reiterated the importance of progressing with ratification nationally as well as at the European level. The Commission also noted its concern with the wording of a new recital regarding the Union’s responsibility for delivering emissions reductions, but did not oppose the package. Poland expressed its gratitude to Germany, Italy, Denmark and the UK for facilitating negotiation of the new package in the margins of the Lima conference.

Ministers then discussed the establishment and operation of a market stability reserve (MSR) for the EU greenhouse gas emission trading system (ETS). The UK supported by France, Germany, Denmark and Sweden set out the case for strengthening the Commission’s proposal by moving the start date forward to 2017 and placing backloaded allowances directly into the reserve, and noted the importance of these amendments in enabling the market to deliver the low-carbon investment needed most cost-effectively. The UK also noted the importance of the Commission coming forward quickly with proposals to further reform the EU and ETS, including the improvement of carbon leakage protection, once the MSR is agreed.

The Council confirmed an agreement previously reached in trilogue with the European Parliament and presidency on a directive for plastic bags. Ministers also agreed a general approach for a directive on medium combustion plants. However, Finland, the Czech Republic, Bulgaria and Estonia abstained due to concerns that strict emission limit values would undermine the use of domestic fuel sources. The Netherlands also abstained over concerns that the text now lacked ambition. The Commission welcomed efforts made but regretted that the proposal had been weakened. The Latvian presidency said it aimed to secure a first reading agreement with the European Parliament.

The Commission welcomed the Council conclusions on an overarching and transformative post-2015 agenda and stressed the need for this universal agenda to be ambitious. Ministers continued the discussion on the post-2015 agenda over lunch.

Under any other business, Ministers discussed the chemicals policy on the road to a non-toxic environment. The UK argued that the EU chemicals regulation should be driven by wider impacts on a sustainable environment including the need for growth, not least for small and medium enterprises. Therefore, any regulatory controls should be proportionate and justified through a rigorous assessment of risk. Germany and Austria said the Council needed to address citizens’ concerns on endocrine disrupters, nano-materials and ensure that work carried out by industry under REACH was up to scratch. On the elimination of micro-plastics in products, the UK urged the use of voluntary measures.

In addition, the presidency and Commission summed up the progress made at the UNFCCC 20th Conference of the Parties (COP20) in Lima in early December, noting the effective working with the EU and the overall success in terms of reaching the EU’s objectives. Looking ahead, the Commissioner noted the need to make progress ahead of COP21 in Paris in December 2015, particularly on the legal form of the 2015 agreement and on the differentiation of commitments between different parties.

Ministers also discussed the Commission Work Programme 2015. I welcomed the programme’s emphasis on better regulation and said that the UK was looking forward to working with the Commission, European Parliament and other member states to ensure a balanced package of proposals, particularly on air and the circular economy, that were ambitious and feasible for all member states. We registered our support for the national emissions ceilings directive and the Gothenburg protocol, urging the Commission to take forward proposals with urgency and indicated our willingness to work with the Commission to discuss modifications to ensure that the ceilings for 2030 would inject ambition based on evidence.

[HCWS211]

Foreign and Commonwealth Office: Public Records

Wednesday 21st January 2015 Written Statements

[The Minister for Europe (Mr David Lidington)]

In line with the Lord Chancellor’s code of practice on the management of records, the FCO maintains an inventory of its record holdings and carries out regular file audits.

In my statement of 30 November 2012, Official Report, column 36WS, I informed the House of the existence of a large accumulation of legacy records in the FCO known as the “special collections”. On 12 December 2013, Official Report, column 55WS, I explained that the FCO had published a detailed inventory of its archive records on gov.uk. This inventory arose out of a file audit carried out in 2013 which focused principally on the main FCO archive. All of these record series have been incorporated into the FCO’s records release programme. Details are available at: www.gov.uk/archive-records

As a result of an internal management audit, we became aware in July last year that a substantial number of legacy paper files are held outside the main FCO archive. I therefore asked FCO officials to carry out a further file audit across the entire FCO estate covering all departments in the UK and all overseas posts. During this file audit, all identified file stores in the UK were physically inspected by a specialist contract team and every overseas post provided summary details of their legacy paper file holdings. The audit was carried out over September and October last year.

Following this file audit we have identified a number of collections of records across the FCO which contain files overdue for review under the Public Records Act. The total number of files in these record series is just under 170,000. Unlike records held in the main FCO archive, a significant proportion of these files contain copies of original records or routine management, finance, personnel and consular records. Some files, however, are likely to require permanent preservation. We have reported our findings to the Lord Chancellor’s Advisory Council on National Records and Archives and we have also provided full details to Professor Tony Badger, the independent reviewer appointed by the former Foreign Secretary, my right hon. Friend the Member for Richmond (Yorks) (Mr Hague).

The Lord Chancellor has granted the FCO one year’s legal retention for these files while we develop a prioritised plan for their review under the Public Records Act. We will submit this plan to the Lord Chancellor’s advisory council by February. We will ensure that files requiring permanent preservation are correctly prioritised for release and incorporated into our current release programme.

By the end of March, we will publish on gov.uk a new version of the FCO archive inventory incorporating all of the files series identified during this file audit. We will also publish a revised record release plan.

I am pleased to inform Parliament that the first record series from the FCO’s special collections, consisting of 445 colonial reports, were released at The National Archives on 23 December.

The FCO is committed to complying with the Public Records Act and to full transparency with respect to our record holdings.

[HCWS213]

House of Commons Governance

Wednesday 21st January 2015 Written Statements

[John Thurso]

(Representing the House of Commons Commission): The House of Commons Commission discussed the report of the Committee on House of Commons Governance at its meeting on 19 January. In line with the Committee’s recommendations, the Commission invited the existing external members of the Management Board to the meeting.

The Commission welcomed the work that the Governance Committee had undertaken and the dedication and rigour with which it had scrutinised the important matters before it.

The Commission noted that, as recommended by the Governance Committee, the paused process for recruiting a Clerk of the House had been formally terminated.

The Commission is now awaiting the House’s debate on the Committee’s report on 22 January. If the House endorses the report, the Commission will act swiftly to implement its recommendations, starting at an additional meeting on Monday 26 January.

It is of vital importance to the Commission that the House Service is able effectively to meet the changing needs of a modern Parliament. It is also right that the Commission is able to shine light on itself to ensure that it too can meet these needs and more importantly, those of the UK public whom the House exists to serve.

Subject to the House endorsing the Governance Committee’s report, the Commission expects to be discussing implementation of the Committee’s recommendations at future meetings, and will issue periodic reports on progress.

[HCWS212]