Westminster Hall

Wednesday 12th January 2022 Westminster Hall

Wednesday 12 January 2022

[Philip Davies in the Chair]

Access to Radiotherapy

Wednesday 12th January 2022 Westminster Hall

00:00

[Philip Davies (in the Chair)]

Before we begin, I remind Members that they are expected to wear face coverings when they are not speaking in the debate. This is in line with current guidance from the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test before coming on to the estate. Please also give each other and members of staff space when seated and when entering and leaving the room. I call Grahame Morris to move the motion.

[Grahame Morris (Easington) (Lab)]

I beg to move,

That this House has considered access to radiotherapy.

It is always a pleasure to serve under your chairmanship, Mr Davies, and if it is not too late I would like to wish you and the Officers of the House a happy new year.

I am delighted to have secured this vital and timely debate on access to radiotherapy services. On occasion, it may seem like groundhog day: we come here on a fairly regular basis and outline the case for more investment in radiotherapy services. However, the covid crisis has brought many of these issues into sharp focus, and indeed there is a growing cancer backlog crisis that the Government really must address.

I also want to thank the Chamber engagement team for its fantastic work. This is the first time that I have had any interaction with the team, but it has been most helpful in engaging the public ahead of this debate. I am immensely grateful to the team for carrying out a survey over the course of only a few days—over this weekend, really. We had over 800 responses, and I thank all the respondents for taking the time to express and submit their views and experiences. I believe that those contributions, a couple of which I will refer to, will significantly enrich the debate. I am eagerly anticipating what I am sure will be comprehensive and compelling contributions from colleagues in the Chamber, many of whom I have served with and been involved with in debates like this previously.

It is only right that I begin by declaring an interest. I have the privilege of serving as vice chair of the all-party parliamentary group for radiotherapy, and I am also one of the vice chairs of the all-party parliamentary group on cancer. I also want to thank Macmillan Cancer Support and Radiotherapy UK, the charity with which I am associated, for their assistance in preparing for today’s debate. I am immensely grateful to colleagues from the all-party groups who have come along today; I know that there are many pressing demands on Members’ time.

The reason the debate is so important is that cancer will affect all of us at some point in our lifetimes. I want to take this opportunity to mention a good friend of mine, Nick Munting, who, as some might know, is a chef in the House of Commons and has very recently been diagnosed with cancer. I wish him all the very best for his speedy recovery.

I have personally had cancer on three occasions—a type of lymphatic cancer called non-Hodgkin lymphoma. Without the care and treatment that I received from the NHS, I would not be here today. I thank the dedicated staff at the Macmillan cancer centre at the Freeman Hospital in Newcastle, and those working at cancer hospitals throughout the country, for the excellent work that they do in diagnosing and treating cancer patients. I have received a plethora of cancer treatment. I have had the works: surgery, chemotherapy and radiotherapy—including advanced radiotherapy.

There is a reason why I am concentrating on radiotherapy today. Radiotherapy is by far the least understood of the three pillars of cancer treatment, with chemotherapy and surgery far more widely understood and referred to in public life. Despite that, one in four of us will have radiotherapy at some time in our lifetime. I want to begin by highlighting the many advantages of this highly specialised treatment and the major breakthroughs that there have been over the last 10 years.

Unlike other cancer treatments, modern radiotherapy is accurate to within millimetres, limiting damage to healthy cells around the cancer. A specialist in the field and a dear friend, Professor Pat Price, explained in simple terms to me, as a layman, the concept of a banana in a box. Imagine that the tumour is a banana in the box. With older, less precise forms of radiotherapy, the whole box would be irradiated and there would be considerable collateral damage to healthy cells. With modern, advanced precision radiotherapy techniques, just the banana would receive the high dose of radiation, and there would be no collateral damage. That significant advance has come about because of digital technologies and advances in this form of treatment. It is especially useful for treating cancers in areas vulnerable to damage, and it requires fewer patient visits than other treatments. Unlike surgery, it does not take up intensive care capacity, and unlike chemotherapy, it does not impact on the immune system.

Furthermore, radiotherapy is the most cost-effective treatment. Typically, a patient can be cured at a cost of about £6,000. If we contrast that with the cost of some chemotherapy drugs, which for individual treatments may run into hundreds of thousands of pounds, there is a cost argument for expanding radiotherapy, in addition to its effectiveness as a treatment. In many respects, it is a silver bullet. It is often referred to as a “Cinderella” service: it is immensely effective, but it suffers from chronic under-investment and suboptimal clinical commissioning. Let me remind the Minister that the UK spends only about 5% of the cancer budget—I do not mean the entire NHS budget; I mean just the cancer budget—on radiotherapy. Compared with what is spent in many other advanced European countries, that is a very small proportion; the European average is about 10% of the cancer budget.

In England, access to treatment can depend on people’s postcode; often, patients in more affluent, urban areas benefit from the most modern equipment, and from ease of access because of excellent public transport provision. In contrast, patients in less affluent, more rural areas, such as mine—Easington in County Durham—do not enjoy the same levels of access. My constituents make up a proportion of the 3.5 million people in England who do not have a radiotherapy centre within the recommended 45 minutes of their home.

That statement of the situation was supported and confirmed by a number of the respondents to the survey carried out by the Chamber engagement team. If I may, I will refer to a couple of their contributions. A lady called Penelope had positive experiences of accessing the service herself, but feared for others who might not be so fortunate. She said:

“In my experience, which involves my father’s radiotherapy last summer, he did not have to wait long, but he lives in Berkshire…near several hospitals, and I think the situation is very different in other areas of the country.”

Similarly, David said:

“My own wait time…before the covid situation was only weeks, and by that time I had already started other treatment regimes as well. I am lucky to be close to a centre of excellence: the University Hospital Coventry and Warwick. This is not normal though, a close friend, now passed on, had to drive from their home near Boston in Lincolnshire to the Leicestershire Infirmary for treatment, when there was a possible ‘slot’. That was a 4-hour round trip as neither the Boston nor Lincoln hospital had”

radiotherapy

“facilities. Lack of facilities meant the cancer spread out of control and he died.”

Radiotherapy is needed in almost half of treatments, but according to Cancer Research UK, only 27% of UK cancer patients actually receive it. I respectfully point out to the Minister that we will never level up the country while access to life-saving treatment depends on people’s postcode—where they live—entrenching already existing regional health inequalities.

Let me also address some of the workforce issues. The radiotherapy workforce are at breaking point. A survey conducted by Radiotherapy UK and the Institute of Physics and Engineering in Medicine in October 2021 found that almost 80% of professionals were considering leaving their position or knew a colleague who was. That was echoed by members of the radiotherapy workforce who submitted their views to the survey. A lady called Lauren said:

“Most radiotherapy staff can travel over an hour as that is their nearest radiotherapy centre. Increasing working hours and increasing workload is leading to more staff wanting to leave the profession in addition to the fact most of us have to travel long distances to find a centre to work at. Due to housing not being affordable in the locations of radiotherapy centres,”

which are often in big city centres. The Minister can address that fairly simply, and we have a solution—investment in IT networks, which I will come to in a moment—that we have put to successive Ministers who have occupied the post.

The tariff system generating income to trusts is based on the number of patient visits. Those perverse tariffs mean that radiotherapy trusts with advanced machines that can treat patients in fewer sessions are incentivised to treat patients less effectively over more treatments. That is a ludicrous, perverse incentive that I am sure the Minister could do something about.

Similarly, trusts seeking to replace ageing machines—the advice is to replace radiotherapy machines after 10 years—are required to conduct 9,000 treatments even to be considered for funding. The pandemic saw referrals plummet and services overstretched, so centres are not reaching that threshold and are therefore blocked from providing patients with access to the latest life-saving technologies. We have poor patient access and exhausted, demoralised staff, with senseless bureaucracy and a tariff system promoting less effective treatment. That is a pretty poor report card.

That was the state of radiotherapy even before the covid-19 pandemic. Holly, a radiotherapy professional, said:

“Currently we are having to delay patients due to poor staffing levels, this started way before the current surge in omicron cases. We have been understaffed for some time, and this has been made so much worse by omicron, we are having to close machines to make sure we have staff to cover”

the covid patients. She added that

“those that are in are getting burnt out by having to work longer, more days and harder each shift, meaning it’s a cycle of being off ill.”

Covid has created a cancer crisis that the current system cannot effectively manage. On that note, I want to pay tribute to the Catch Up With Cancer campaign, which was launched in conjunction with Craig and Mandy Russell, who very sadly lost their daughter Kelly to bowel cancer when her treatment was delayed owing to resources being transferred to the treatment of covid patients. Some of us here today handed in to 10 Downing Street a petition, signed by more than 300,000 members of the public, calling for action on the issue.

Of all the health backlogs, the cancer backlog is the most time-sensitive because, for every month that diagnosis of treatment is delayed, cancer survival rates can drop by as much as 10%. These are life-and-death issues for many tens of thousands of people. Without urgent action, cancer experts predict that survival rates in the UK may fall back to where they were 15 years ago, resulting in tens of thousands of extra cancer deaths. I know the Minister is new to her post, and I do not want to be unfair, but there is a crisis. I have been with colleagues to see a succession of Health Ministers, on many occasions, to set out proposals to improve the position. The lack of action is frankly lamentable, and many thousands of people will pay the price.

Before the pandemic, the all-party parliamentary group for radiotherapy branded radiotherapy “Britain’s secret lifesaver”. Ministers and NHS leaders need to recognise that it could be a game changer; it could have an immense impact on tackling the covid-induced cancer backlog, but to do that, it needs sufficient investment.

The all-party group has put together a six-point covid-19 recovery programme. I urge the Minister to look at that and to implement its proposals, which were developed not by me or other parliamentarians but by experts in the field—radiotherapy specialists and oncologists—who understand their patients and understand the service and how we can improve it.

The first point in our six-point plan is that we need to appoint a Minister in charge of and accountable for the transformation of radiotherapy. We need to invest in IT solutions to modernise radiotherapy. The problem that radiotherapy is available in only relatively few urban centres could be mitigated, to a degree, with modern IT that allowed specialists hundreds of miles away to interpret digital imagery and advise on the appropriate treatment.

We need to replace ageing machines—those that are more than 10 years old—and forget the bureaucratic nonsense about machines having to have done 9,000 treatments, because referrals for treatment have reduced due to covid. We need to invest approximately £200 million in the highly specialised workforce, where staff redeployment will be insufficient to fill the gaps.

We need to improve capacity and access by placing radiotherapy machines in some of the planned new diagnostic hubs. Ministers often respond to debates such as this one by referring to the £130 million that the Government promised to improve diagnostic services. That is welcome, but we need to address not just diagnosis but treatment. Radiotherapy is a quick and highly effective treatment, so I urge the Minister to consider using these machines in the diagnostic hubs.

Finally, we need to raise the profile of radiotherapy, ensuring full awareness among the public of the treatment’s curative and palliative potential. The six-point plan is underpinned by a need for a national strategy. The lack of a cohesive national approach has caused unacceptable inequality and disparities between trusts in different parts of the country.

It comes down to this: every day, every week and every month that the Government fail to take sufficient action, the public suffer, money is wasted and patients die. The Government are in denial about the situation and there is a huge disconnect in ministerial statements. Just last week, I heard the Leader of the House say that the situation had been normalised, but that is far from the truth. We cannot ignore the cancer crisis any longer.

I want to ask the Minister a number of questions, which I hope she will address in her response. I hope she understands the frustration felt by radiotherapy staff, but I want her to make a commitment to investigate the bureaucracy that is holding back radiotherapy trusts and denying patients the most effective treatment. Will she act urgently on that? Is she aware that the Government have not reported radiotherapy-specific data, which we refer to as the radiotherapy datasets, since May 2021? Will she publish the datasets that are available next month? Those will show clearly the levels of treatment that radiotherapy machines have been involved in during this period compared with previous years. That will make perfectly clear the level of the backlog, which estimates from the frontline put at between 50,000 and 60,000.

Will the Minister outline the plan in the event that radiotherapy services find they are no longer able to cope? Finally, will she agree to a meeting with radiotherapy commissioners, the Secretary of State and representatives of the radiotherapy community, in order to address these essential life-or-death issues? It has been useful for me to open the debate, but I know colleagues have issues that they would like to put to the Minister, so with that, I will conclude.

09:50

[Mohammad Yasin (Bedford) (Lab)]

I thank my hon. Friend the Member for Easington (Grahame Morris) for securing this important debate. The Mount Vernon Cancer Centre in Middlesex provides non-surgical specialist cancer care to a population of more than 2 million in the UK. About a third of the Bedfordshire clinical commissioning group’s cancer patients attend the service to receive radiotherapy. My constituents have to travel more than 50 miles to access treatment. Between 2019 and 2020, 800 patients undertook the three-hour round trip across Bedfordshire multiple times to reach lifesaving care.

A survey undertaken by the Mount Vernon Cancer Centre heard from many patients who have chosen not to have radiotherapy. The biggest factor in people’s decision on whether to go ahead with the lifesaving treatment was the location of the treatment centre. Some patients simply cannot afford to travel so far, others are in too much pain, and some could not find the time due to family and work commitments.

The inaccessibility of radiotherapy is stopping people getting the care they need. One patient with stenosis of the spine found it so difficult to travel that they opted for a watch-and-wait approach rather than radiotherapy. Another reported a journey time of five hours door to door. The average radiotherapy uptake in Luton and Bedfordshire sits at under 35%, which is lower than many other CCGs. There is an undeniable crisis in the accessibility of radiotherapy in the UK, and lives are literally on the line.

Many of us will be familiar with the heartbreaking statistics being shared. Fewer referrals to a specialist doctor mean that the proportion of cancers diagnosed while still highly curable has fallen to 41%. Waiting lists stand at a record level and the backlog of care is only growing. Of course, the pandemic has had a major impact on NHS waiting times, but the cancer waiting time crisis is rooted in underfunding, under-resourcing and understaffing. The pandemic has only illuminated the problems. The 18-week waiting time target has not been met for five years. This is not new, but it is getting worse.

There are proposals for a more local additional cancer care unit, alongside Mount Vernon Cancer Centre, to offer treatment services that are more accessible for those in need, but that requires equipping new centres, recruiting more doctors and tackling chronic staff shortages. Cancer care needs proper investment. Funding is at the crux of whether patients can receive radiotherapy and whether they survive. It is down to the Government to step up and ensure that cancer patients can access the care they need and deserve.

09:54

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

It is a huge pleasure to serve under your chairmanship, Mr Davies. I pay tribute to my friend, the hon. Member for Easington (Grahame Morris), for securing this debate and for an excellent speech, which contained some points that I make no apology for repeating because this issue matters hugely.

I lost my mum at the age of just 54. Eighteen years on, of course I still miss her massively; I miss especially the grandmother she would have been. Few issues that we deal with in this place are more personal than cancer. Half of us will have the disease at some point in our lives. Cancer touches absolutely every family.

The good news is that, increasingly, cancer is a disease that need not be a death sentence, partly because of the advances in radiotherapy. Radiotherapy kills cancer cells through radiation targeted at a tumour. It is becoming more and more precise, and is able to cure cancers that would otherwise be untreatable, with fewer side effects, as the hon. Member for Easington set out.

Just over 50% of people with cancer should expect to receive radiotherapy, yet, as has been said, Cancer Research UK estimates that only 27% of cancer patients in the UK actually receive it. The clue to why that is is that the UK spends only about 5% of the cancer budget on radiotherapy. The equivalent average spend of similar countries in Europe, Australia and so on is about 11%. The total budget for radiotherapy each year is £383 million; compare that to the £2 billion spent on cancer drugs every year, even though radiotherapy is eight times more likely to be curative than chemotherapy.

That historic underinvestment—the responsibility of lots of Governments of all colours—is undoubtedly a reason why the UK has some of the worst cancer survival rates in Europe. Lives are being lost needlessly because the UK is so painfully slow at keeping up with and grasping the opportunities that radiotherapy provides. That is why we set up the all-party parliamentary group for radiotherapy, which I am privileged to chair. I send huge thanks to Members from all parties, especially the hon. Member for Easington, to leading clinicians across the country and to the charity Radiotherapy UK, which is led by the rightly much esteemed Professor Pat Price, who has already been mentioned.

We set up the APPG in spring 2018. We booked a room in 1 Parliament Street. A handful of MPs turned up, but 50 or 60 of the leading oncologists in the country turned up and crammed into the room—they would not be allowed in today because of covid restrictions. Why had those people left their massively important jobs for the day, just to come to London for that meeting? It struck me then that it was because there is no radiotherapy lobby. I am not in any way going to criticise pharmaceutical companies, but we know that they are large and they have large coffers. We all get letters most weeks from constituents asking for this drug or that drug to be commissioned, and very often that is right. There is no such lobby for radiotherapy.

Lobbying, in its purest and most fair form, is about being in the room with the people who make the decisions. Radiotherapy has not had someone in the room with the people who make decisions. That is the best I can come up with as an excuse for why this Government and previous Governments, including the one I was part of, have not taken radiotherapy anything like as seriously as it should be taken, why we are investing such a paltry amount in radiotherapy, and why we are so far behind comparable countries.

At the local level, a bad situation is made worse because access to radiotherapy is simply not fair or equal. In south Cumbria, cancer patients have to travel each day all the way to Preston to our nearest radiotherapy centre. The Rosemere unit at Preston is excellent, but dangerously distant. The National Radiotherapy Advisory Group stated that it is bad practice for patients to have to travel for more than 45 minutes for treatment, yet not a single person in my huge constituency reliably lives within 45 minutes of radiotherapy.

Over the years, I have had the privilege of driving constituents to Preston for their treatment. I have seen how people from Kendal, Windermere, Grasmere, Grange, Coniston, Sedbergh and other communities have to make round trips of between two and four hours every day for weeks on end. I have seen their exhaustion and the impact on their health. I have seen people whose lives would have been longer if they had had radiotherapy turn it down, because they physically could not cope with the travelling. I have seen clinicians who have chosen not to refer people for radiotherapy, understandably but sadly, because they knew that their patient’s condition would be made worse by those long, gruelling journeys. In Cumbria, because NHS England and the Department of Health and Social Care will not act, those longer journeys mean shorter lives.

For 13 years, we have run a campaign collectively in Westmorland, calling relentlessly for a radiotherapy satellite unit to be placed at Westmorland General Hospital. We also campaigned to bring chemotherapy to Kendal and were successful in that fight. I am proud of everyone who supported our radiotherapy campaign, but we have submitted petitions with more than 10,000 signatures; I have had numerous Westminster Hall debates; I have met countless Ministers from all three parties that have been in government during my time in Parliament; we have marched for the hospital in our thousands; a team walked from Preston to Kendal just to make the point; 1,000 people wrote detailed, personal, heartbreaking stories to explain why we need the unit in Kendal; and we have demonstrated that there is clearly enough demand for at least one linear accelerator at Kendal, drawing patients from the south lakes, Furness and the western dales. With an ageing population in our community, there is also clearly a growing need.

We have the space at the hospital, designs have been done, the bid has been written and rewritten, and the inaction of managers in NHS England and Ministers in the Department of Health is inexcusable. It is a reminder of why rural communities feel so taken for granted and ignored by the Government and by NHS bosses nationally and regionally. Talk of levelling up the north is meaningless when Ministers appear not to realise that there is 100 miles of England north of Preston until the next nearest cancer centre.

Networked satellite radiotherapy units have been a huge success elsewhere in the country and, once they open, have been shown to increase the number of people able to take up that life-saving treatment. Satellites save more lives. Today, I ask the Minister to instruct NHS England to work with our local trusts in Cumbria and Lancashire finally to deliver our long-awaited satellite radiotherapy unit at Kendal. Our community will listen carefully to her response.

Radiotherapy, as the hon. Member for Easington said, provides the Government and the NHS with their best way through the cancer backlog. Owing to the pandemic, 740,000 cancer referrals have been missed. Therefore, at least 60,000 people are out there with cancer, but undiagnosed. That is terrifying. There is also an enormous backlog for treatment, with people dying as a result. In the Morecambe bay area, about half of cancer patients are having to wait for more than the scheduled 62-day limit to get their first treatment. As the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt), rightly said, it would take the NHS working at 120% of its existing capacity for two solid years just to get back to where we were in March 2020. The need for an urgent and ambitious boost to cancer care is therefore obvious, but we see next to nothing specific from the Government.

Money was pledged for diagnostic hubs, but just on Monday this week, I discovered that in South Lakeland we will not see ours until next year. Where is the urgency? The Government and the NHS have done so well—commendably—on the vaccine roll-out. Why will they not treat cancer and the cancer backlog in the same way, with a ring-fenced and targeted programme to catch up with cancer?

Radiotherapy is covid-secure and non-invasive, carries no infection risk, does not need intensive therapy unit beds or precious operating theatre time, does not compromise one’s immunity, is curative, palliative and, per capita, incredibly inexpensive. We could massively increase capacity very quickly. It has been the stand-out treatment in covid, often substituting for surgery, and it is the obvious first choice for getting through the backlog of cancer cases.

As an all-party group, we first wrote to the Secretary of State on 1 April 2020 to highlight the key role that radiotherapy needed to play to tackle the covid-induced cancer backlog. Since then, multiple spending reviews and Budgets have been passed with no significant investment in radiotherapy. The oft-repeated £130 million announced in 2016 as part of the long-term plan was spent long, long ago, so I hope that the Minister will not trot that out again. Yet a relatively modest investment of £850 million over three years could have a guaranteed and dramatic impact on cancer survival. I hope the Minister will take up the hon. Member for Easington’s request that she meet us as an all-party group and, more importantly, the clinicians, so that we may talk her through this all-party plan backed by the clinicians, which will help her out and help her deal with the backlog.

The Minister should tackle perverse tariffs that do active harm to cancer treatment, and she could do so at no cost whatsoever to the taxpayer—it is about spending the money differently and less foolishly. Staff are restricted from using centres with more modern, precise kit that can treat patients in fewer sessions; instead, they must treat less effectively and over more sessions because, stupidly, the tariff rewards the number of visits, not the precision or effectiveness of treatment. The Government must be pragmatic and accept the offer from the private sector to centrally commission its capacity—at cost and not for profit—to deliver treatment on the NHS to clear the backlog and to save lives.

We must especially care for, value and boost the work- force. Radiotherapy oncologists, radiographers, engineers and physicists—dedicated, passionate professionals —are close to breaking point. The survey by Radiotherapy UK and the Institute of Physics and Engineering in Medicine, to which the hon. Member for Easington referred, showed that 75% of those professionals believe that their unit could not meet pre-covid capacity with the kit they have. Some 80% reported seeing more advanced tumours than ever before in their careers and, as has been said, nearly 80% had thought about leaving the profession.

In Cumbria and right across the UK, radiotherapy treatment and the outstanding workforce have so much more to offer in the fight to save lives than successive Governments have seen fit to acknowledge. All parties bear responsibility for that. I ask the Minister to be a laser trailblazer and to deploy radiotherapy at its full capacity, so we can end needless deaths and catch up with cancer.

10:06

[Chris Bryant (Rhondda) (Lab)]

I congratulate my hon. Friend the Member for Easington (Grahame Morris) on securing this important debate, and not for the first time—he is a repeat offender. His determination and laser focus on this issue are really important in trying to save lives.

I hope it is not too mawkish if I say a few words about my own experience of cancer, even though I have not had radiotherapy, because radiotherapy is not normally used to treat my form of cancer—melanoma—although it is for other forms of skin cancer such as squamous and basal cell carcinomas. The timing of my cancer was amazingly fortunate. It was three years ago yesterday that I went to my GP with a dodgy mole—I urge anyone who ever worries about a mole to get it checked out, because my hon. Friend is absolutely right that early detection saves lives. I was very fortunate that my GP sent me straight to a dermatologist, who cut it out for the first time within 10 days. The second bout was two weeks after that.

I was fortunate that all that could happen very quickly. If I had gone to the doctor on my birthday last year or this year, I do not think I would have got the same speedy response. I had a stage 3B melanoma—incidentally, I must say to the hon. Member for Westmorland and Lonsdale (Tim Farron) that satellites are not always good. A microsatellite from a melanoma is a really bad thing. If I had left it another three months, it would probably have been a stage 4, and there are only four stages.

I was also fortunate that two weeks before I went to the doctor, the National Institute for Health and Care Excellence allowed the use of immunotherapy for melanoma in an adjuvant setting at stage 3, rather than just at stage 4. I hope the Minister will confirm that NICE is looking at the use of the various kinds of immunotherapy in an adjuvant setting for people with stage 2 melanoma.

I say all that because I was told at the time I had a 40% chance of living a year—three years have now passed so I am very grateful that the immunotherapy I received has dramatically improved my chances of living. I say gently to the hon. Member for Westmorland and Lonsdale that, sometimes, the drugs are a really important part of the cancer treatment package. I do not think there is a competition between different parts of the package; there are clearly instances where drugs, chemotherapy or radiotherapy is the right route.

My anxieties are that, first, we have a massive catch-up job to do, and secondly, that I do not think we had the capacity needed to tackle the problem even before we went into covid. We have a growing population in this country, and a growing number of cancers, but last year’s figures show a nearly 10% fall in the number of people receiving radiotherapy. That is not good news in any shape or form. There may be people whose deaths from cancer are unknown to us because they ended up not being diagnosed and then died with or of covid, so they may not appear in the statistics, but they will certainly appear in many people’s family statistics and life experiences.

There are things that the Government could do immediately, many of which have already been laid out by hon. Members. Something needs to be done about the workforce, because every part of the cancer pathway has a shortage of staff. A lot of staff have been redeployed during covid to help run A&E departments. Nurses, hospital orderlies and receptionists from the same teams have ended up being redeployed to other parts of the operation. They have been very happy to do that, but it has meant that, in nearly every cancer discipline—the one I know best relates to dermatology, obviously—there is now a series of vacancies.

A lot of staff are burnt out, exhausted, demoralised and uncertain whether they want to stay in the profession. I think this is the fifth Minister to whom I make the same plea: that she and the Government look at the series of things we could do to enable people who have recently left the profession to come back. That might include financial rewards. We could do more to enable people to stay all the way through to retirement age. A significant number retire early, partly because of that sense of burn-out. They do not necessarily want a financial reward; they would actually quite like a sabbatical of a couple of months or something like that, simply to recharge their batteries so they can come back into the profession and not retire early. We certainly need to do something about the problem that doing extra hours or sessions is now barely worth it for many people, because the financial reward is minimal. A major issue will come up very shortly relating to pensions and pension funds for many doctors in many of these disciplines.

In all those areas, the Government could do far more to increase capacity now, then they have to look at increasing capacity for the future. One of the most important parts of the process is diagnosis. We do not have enough radiologists, radiographers, histopathologists and pathologists in the UK. There is a massive shortage—something like a 10% vacancy rate. We are not even allowing enough people to train this year to fill the vacancies that exist now, let alone the additional vacancies that there will be in five or 10 years’ time, so we are building up a bigger problem for ourselves.

That takes me to my biggest concern of all. Before covid, every winter we were running the NHS at 95% capacity. It is pretty difficult to run anything at 95% capacity, because the moment you have a crisis of any kind whatsoever, you are stuffed. It is a bit like those baggy gym shorts that have an elastic band in them. When someone gets beyond a 34-inch, 36-inch or 38-inch waist, suddenly there is no more stretch in the pants, as you know, Mr Davies—[Laughter]—because you understand the science of elastic bands, obviously. However, I make a serious point. We have run the NHS far too close to complete capacity for far, far too long, and not only in intensive care units, where we have many fewer beds per 100,000 people than any country in the European Union or any advanced country in the world. We also have many fewer hospital beds per 1,000 people than any other advanced country in the world. We need to look at the long-term issues and say to ourselves that, if we really want an NHS that will not be crippled by a pandemic or by winter, we have to invest significantly in the future. Every single time a Minister stands up, they always say very nice things. The Minister who is here today has lots of clinical experience of her own, and we are enormously grateful for the work that she has done in the NHS during the pandemic. However, in the end, warm words butter no parsnips—not that one really wants butter on parsnips. I love a parsnip, although it is odd that we are the only country in Europe that actually eats them—mostly they are fed to cattle, but that is by the by.

The serious point is that we need to invest in every single part of the NHS. The cancer catch-up is a matter of life and death. I think that, if I had gone to the GP yesterday, my life would not have been saved. That is a distressing thing to be able to say to one’s constituents. I hope that the Minister will come up with some answers for us.

10:15

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate, Mr Davies, and also a pleasure to follow the hon. Member for Rhondda (Chris Bryant). We in this House are very blessed that he is here today because he had early treatment and was able to respond to it. I spoke to him personally at the time, and I know that others did. We are very thankful to God that he is here today and able to participate in this and many other debates in the House on a regular basis. We thank him for that.

I also thank the hon. Member for Easington (Grahame Morris) for setting the scene. We are greatly indebted to him for his leadership, for his interest in this subject matter and for every occasion on which he comes forward. We are also indebted to the hon. Member for Westmorland and Lonsdale (Tim Farron) as well. We are all on the all-party parliamentary group on cancer together, so we have regular contact with one another and with others as well. I give credit to both hon. Gentlemen for their leadership and contributions, and to others on the APPG for bringing this forward.

It is nice to see the shadow Minister, the hon. Member for Enfield North (Feryal Clark), in her place. I always look forward to the Minister’s contribution. I believe that we will get a response that helps us to address the issues that we are raising today. I believe that we are greatly blessed to have the Minister in her place; she has a particular interest in this subject matter and is eager to secure change.

The debate today is about change; it is about making sure that we can move forward. I probably cannot even quantify—the hon. Member for Easington might be able to—the number of times we have asked about radiotherapy services. We have asked about these services before, met the Minister before and sent letters before, but we do not seem to be getting to where we want to be. That is what the hon. Gentleman said in his introduction. That is where we are.

There is a staggering backlog of an estimated 47,000 people missing a cancer diagnosis in the UK, and Macmillan estimates that the backlog of those waiting for a first treatment stands at 32,000 in England alone. Only last week in my constituency—this is not the Minister’s responsibility, to be fair, as it is a devolved matter—I met someone who was eagerly seeking an early meeting with a consultant and doctor about cancer. It is so important that she gets that; she is very worried about her circumstances. When I became aware of them, I was also concerned. We need to address that issue.

Radiotherapy in particular is one of the mainstays of cancer treatment. Modelling suggests that between 40% and 50% of people diagnosed with cancer should receive radiotherapy as part of their treatment. If it is part of their treatment and they cannot get it, we have a severe problem. The difficulty lies in workforce shortages, to which the hon. Member for Easington referred. They remain the biggest challenge facing the NHS and access to radiotherapy today. The Chancellor’s October Budget, unfortunately, missed a key opportunity to tackle this issue. Can the Minister give us some indication of the discussions that she has had with the Chancellor about what can be done to address the shortfall?

Macmillan Cancer Support says:

“The pandemic has both laid bare and exacerbated the terrible strain the cancer workforce has been under for many years.”

I know that the pandemic has exacerbated that incredibly. It is frustrating to know that the waiting lists that we had in 2019 are the waiting lists of 2021—and now 2022. It is essential that the budget for Health Education England is confirmed immediately, ensuring an increase in funding to train the cancer workforce that the NHS desperately needs.

Too few cancer patients have full access to a cancer nurse specialist, which is crucial in reducing costs and improving patient outcomes. It is very clear that in the reform of the NHS priority must be given to training these nurse specialists and ensuring that the funding is there to pay them for the extra responsibility that they take on and for the workload that they take off their colleagues, the doctors. Perhaps the Minister could give us some idea of what is going to happen in relation to that issue in the reform of the NHS.

Again, I am deeply grateful to Macmillan Cancer Support for the information that it has sent me. It estimates that in order to help meet the Government’s NHS long term plan, we need an additional 3,371 cancer nurse specialists, which means doubling the number of cancer nurses by 2030. In introducing the debate, the hon. Member for Easington mentioned that issue and I mention it again now, not simply to repeat it but to underline gently the importance of having those nurses in place. It is a major ask but not an impossible one, or at least it should not be impossible.

How do we get those nurses? First, we get the finance in place. An estimated total of £124 million is needed to train the next generation of cancer nurses by 2030. Again, what has happened in the discussions that the Minister has hopefully already had, or will be able to have, with the Chancellor? That process must begin with bursaries, which give the incentive and encouragement, if it is needed, to enable not just young students but mature students—those with mortgages and debts to pay, and perhaps children to care for as well—to be able to take the step into nursing. I make that comment because of a particular example that I know of. The dream of one of my constituents was to go into nursing. She worked in a shoe shop and her husband worked in landscaping; both of them had low-paid jobs. When she made the decision to follow her dream and go into nursing, she simply could not make ends meet, which is why bursaries are important.

I know this girl personally, so I know that she has endless compassion. She worked to become an intensive care nurse. She is a clever lady who wanted to make a difference in this world, but simply could not do so. She went into care work during covid and is making a difference in a nursing home, but will she ever become an ICU nurse, as she wanted? She thinks not, but I would like to think that the differences we make in this place and the decisions that we take will enable people such as Sarah to do the good that they want to do in the world, because there are many people out there who just love to help other people. We in this House—you, Mr Davies, and the rest of us here—are MPs who wish to help people; indeed, that is our job.

In 2020, the all-party parliamentary group for radiotherapy reported that a fifth of radiotherapy machines were older than their recommended lifespan of 10 years. NHS England must ensure a sustainable future so that machines are upgraded on a rolling basis and when they need to be. That process must be continuous, so we need an action plan to make it happen. Again, I ask the Minister a question: what has been done to address the need for that additional investment? Unfortunately, it is a fact that this comes down to finance.

Additional investment in radiotherapy would be best spent on upgrading existing machines and software rather than on increasing the overall number of radiotherapy machines or centres. Cancer Research UK has said that even if new centres were built, it would be very difficult to find the staff to run them. We need a co-ordinated and strategic plan that considers all the potential issues for the future, especially in rural areas such as the one that the hon. Member for Westmorland and Lonsdale represents. As he often says, in rural areas staff shortages are often the most severe that they are anywhere.

In the long term, consideration must be given to introducing innovative technology to transform care. For example, there are a limited number of magnetic resonance linear accelerators, or MR linacs for short, in the UK. They significantly increase the precision of analysis and therefore the effectiveness of treatment, which is really important. The Government must consider how to manage funding over a long term, to expand access to MR linacs and other cutting-edge technologies. That also includes purchasing new radiotherapy technology to evaluate its efficacy as a cancer treatment.

I will finish with this comment: the fact is that much greater investment is needed. We should remember that radiotherapy is used for half of cancer treatments, so it is critical for addressing cancer. Cancer affects many people and we need to give radiotherapy the priority that it deserves, getting the nurses and the equipment in place urgently. Unfortunately, there are literally millions of people whom radiotherapy can save and thereby extend their life. It seems to be agreed by all those who have spoken in this debate, and I believe that it will also be agreed by all those who will speak after me, that we must do all that is possible to do in this place in that regard.

10:24

[Feryal Clark (Enfield North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Davies.

I start by thanking my hon. Friend the Member for Easington (Grahame Morris), both for securing this important debate and for being such a consistent champion on this issue. We have heard some excellent contributions and I pay tribute to all hon. Members who have spoken—my hon. Friend the Member for Bedford (Mohammad Yasin) and the hon. Members for Strangford (Jim Shannon) and for Westmorland and Lonsdale (Tim Farron)—for raising issues about investment, the workforce and the bureaucracy that surrounds radiotherapy. I pay tribute to my hon. Friends the Members for Rhondda (Chris Bryant) and for Easington, who speak with authority on the issue as a result of their experiences.

We have heard that radiotherapy is a vital tool in our fight against cancer and that it is one of the three pillars of treatment alongside surgery and chemotherapy. The fact that radiotherapy is needed by one in four of us across our lifetime should be a stark reminder of how important today’s debate is. I join my hon. Friend the Member for Easington in paying tribute to the work of charities such as Radiotherapy UK and the Catch Up With Cancer campaign for keeping this important issue on the agenda.

Hon. Members will know the impact the pandemic has had on cancer treatments and the devastating backlog that it has caused. In my own constituency of Enfield North, data from Macmillan shows that 73 people are missing a cancer diagnosis and a further 57 are waiting for their first cancer treatment. The backlog in treatment, coupled with the severe workforce crisis, which every Member has highlighted and which is rapidly stretching across our health service, means that we are facing a situation where outcomes for cancer patients are being put at risk. As we have heard, radiotherapy is a vital tool in our fight against cancer and should play a key part in our work to help overcome the backlog that affects both patients and staff.

As highlighted by all hon. Members, with the pandemic impacting so much of the NHS’s operations, radiotherapy provides a covid-resilient form of cancer treatment by not having an impact on the immune system or requiring admission into intensive care. It is very cost-effective, as mentioned by my hon. Friend the Member for Easington, with the average cost of radiotherapy care ranging from £4,000 to £7,000, making it cheaper than the often costly options of surgery or chemotherapy. Despite that, radiotherapy has been consistently overlooked when it comes to policy, so it has often faced a lack of investment and understanding by policymakers and successive Governments.

As we have heard, just 5% of the cancer budget in the UK is spent on radiotherapy. That means that despite significant global advancements in radiotherapy technology, patients in the UK are continuing to miss out. Half of all NHS trusts are using machines that are older than the recommended 10-year life span.

[Grahame Morris]

I apologise for breaking the flow of my hon. Friend, but these are important statistics. One worth remembering is that in over 50% of cancers, radiotherapy or precision radiotherapy would be effective as part of treatment—perhaps not exclusively. Actually, when I had my treatment, I had everything: I had surgery, chemotherapy and radiotherapy. However, it would be effective in over 50% of cases. It is currently only given to 27% of cases, so even before we start tackling the backlog, there is a huge capacity issue, and I hope my hon. Friend recognises that, and that the Minister will address it.

[Feryal Clark]

I thank my hon. Friend for his intervention; I absolutely agree with him. As was mentioned, many patients do not even have the luxury of being treated by old technology. More than 3.5 million people in the UK do not have radiotherapy centres within the recommended 45 minutes of their home, as mentioned by my hon. Friend the Member for Bedford and others. That has led to a situation where, rather than meeting the international guidance of 57% to 60%, just 27% of cancer patients in the UK are given radiotherapy. Patients are receiving a raw deal at every turn in the UK, putting their treatment and their long-term outcome at risk.

It is not just patients who are feeling the strain; radiotherapy staff, like many of their colleagues across the NHS, are feeling undervalued and under-resourced. A workforce survey carried out by Radiotherapy UK showed that 80% of radiotherapy staff were considering, or knew of someone considering, leaving the profession; 90% felt that the Government did not recognise the significant role that radiotherapy plays in reducing the cancer backlog; and 75% felt that they did not have the capacity to reach a pre-pandemic service level. A plan to improve provision of radiotherapy, or any other treatment across the NHS, will not be successful if there is not a robust workforce strategy behind it.

[Grahame Morris]

We need a plan.

[Feryal Clark]

Absolutely. I ask the Minister what other hon. Members have also asked today: how do the Government expect to tackle the cancer backlog when staff feel like no-one is listening to them? NHS staff have made immense sacrifices during this pandemic; they deserve to be heard and respected instead of having their concerns ignored.

The staff who remain in radiotherapy are met with barrier after barrier when it comes to improving the experience of patients and the effectiveness of treatment. I run the risk of repeating points, but these are key issues and need repeating. In order to justify investment to fund a new and updated machine, NHS trusts are required to conduct 9,000 treatments per year. During the pandemic, when we have seen referrals plummet and services stretched to breaking point, that target is plainly unrealistic for many trusts. It leaves staff with faulty, unreliable equipment that frequently breaks down, and patients with delays, postponements, cancellations and a much more challenging experience of treatment. I join with many other Members who spoke this morning in urging the Minister to carefully examine the situation, and look at what can be done to remove the bureaucracy that is stopping the advancement in equipment that is evidently needed.

When we know that every four-week delay in treatment for a cancer patient increases the mortality rate by 10%, the lack of investment in such a core pillar of cancer treatment is putting lives at risk. The failure to address these issues will leave the 40% of cancer patients who need radiotherapy as a curative treatment, either on its own or in combination with other methods, in a grave situation. Failure will also have a knock-on effect across all treatment pathways, increasing the pressure on already stretched cancer services as well as primary care providers.

Finally I ask the Minister, do the Government accept that radiotherapy needs an increased level of support to properly fulfil the important role it plays in overcoming the backlog in cancer treatments? Furthermore, will the Minister commit to a plan to improve both workforce numbers and satisfaction, given the increased pressure that the situation is producing on services such as radiotherapy? Cancer patients have suffered so much over the course of the pandemic; they deserve better than this. It is about time that the Government acted.

10:34

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Davies. I should declare an interest before I start: I am still working as a cancer nurse in the Royal Marsden Hospital in London. I have spent 20 years looking after patients who are having chemotherapy, radiotherapy and surgery, so no one is more passionate than I am about this issue.

I congratulate the hon. Member for Easington (Grahame Morris) on securing this important debate, raising the profile of radiotherapy and the important work that the all-party parliamentary group does. Very few of us have not been impacted by cancer in some way, whether as a patient—the hon. Gentleman and the hon. Member for Rhondda (Chris Bryant) eloquently described their experiences—or as a relative, friend or healthcare professional. We know the devastation that cancer can bring, whether through the diagnosis and living with the disease, experiencing the side effects of treatment or, unfortunately for some, the effects it can have on life expectancy.

I reassure colleagues that during the pandemic, cancer has remained an absolute priority. We have kept cancer services going throughout periods of lockdown. There is no doubt, though, that patients were reluctant to come forward with signs and symptoms, particularly during the first lockdown. We actively encouraged many patients with a cough not to come and see their GP as a first point of contact. Since then, however, an absolute tsunami of patients has come forward—so much so that we are working through more than 10,000 cancer referrals a day.

I encourage Members to look at the data for actual treatment. Data such as that about the 62-day rule shows that the cancer backlog is not necessarily in treatment—in patients waiting for surgery, chemotherapy or radiotherapy—but in the diagnostics procedures. They are where the greatest pressure is at the moment.

[Grahame Morris]

I appreciate the Minister’s giving way. Statistics are important as a tool to identify where the obstructions are in the system. I completely agree about the importance of early diagnosis, but will the Minister publish the radiotherapy datasets that will be available next month, so that we can see the true nature of the backlog?

The profession—the frontline—tell a story rather different from the impression that the Minister has just given: that there are issues with treatment, and not just with diagnosis. The radiotherapy datasets, which have not been published for over a year but are available, will clarify that position.

[Maria Caulfield]

I thank the hon. Gentleman. I am not saying that there are no pressures on the treatments for cancer patients, but the greatest pressure is at the diagnostic end. We will be publishing data, but I caution Members on the data for radiotherapy. A lot of the cancer data is based on first treatment and, as Members will know, radiotherapy is often an adjuvant treatment given further down the line. The measurement of access to radiotherapy, compared with treatments such as surgery or chemotherapy, is much more difficult to establish.

I also caution colleagues, a number of whom have said similar things in this morning’s debate. Radiotherapy is a specific specialist treatment. As the hon. Member for Rhondda pointed out, for many cancers it cannot necessarily be given instead of surgery or chemotherapy; it is part of a package of treatment and these are clear, clinical decisions that need to be made jointly by the oncologist and their patient.

[Grahame Morris]

We have a little bit of time and these are important points. Many of us have been making them, not just to this Minister—who, to be fair, is newly in place—but to her predecessors.

There are points of contention about the effectiveness of radiotherapy, but there have been some incredible advances in recent years. I am not claiming expert technical knowledge, but radiotherapy has been applied very effectively against lung cancers; that was never the case before. There is now a possibility of expanding the service to provide much more effective treatments, for cases which previously could be treated only through surgery and chemotherapy.

[Maria Caulfield]

I do not disagree with the hon. Gentleman. I may be a new Minister, in post for weeks rather than years, but I have 20 years of oncology experience, and in my experience radiotherapy has a fantastic role to play. It is indeed the case that significant progress has been made, particularly in the field of lung cancer, with stereotactic radiotherapy to specific areas. However, radiotherapy will target a specific area; it will not give systemic treatment, like adjuvant treatment to prevent recurrence or neoadjuvant treatment for metastatic disease, where the disease is in multiple parts of the body. As Members of Parliament, we need to be cautious that we do not give patients the impression that they should be asking for radiotherapy instead of surgery and chemotherapy. There needs to be a discussion with their oncologist and their medical teams as to the appropriateness of radiotherapy. Yes, it is often cheaper than chemotherapy to give. Yes, it is a quicker treatment and sometimes—not always—has fewer side effects. But it has to be a clinical decision. There are important reasons why radiotherapy is given to some patients and not others. That is something that patients really need to have a discussion—

[Chris Bryant]

We all understand that clinical decisions have to be made. Our anxiety is that clinical decisions sometimes end up being made because there is not enough availability of facilities or staff, or—the third aspect to this—because lots of patients simply are not presenting at the moment. They are not coming in the doors of the NHS because of covid. That potentially means—for instance, in relation to bowel cancers, lung cancers and melanoma—that we will see people presenting much later and therefore there will be a much more dangerous prognosis for them.

[Maria Caulfield]

I absolutely take that point on board. There are clinical reasons, if a patient has presented later, why radiotherapy may or may not be suitable. Again, they are clinical decisions that a patient needs to be discussing with their oncologist.

The hon. Member for Westmorland and Lonsdale (Tim Farron) raised the issue of satellite units. Again, I would just be slightly careful. Cancer alliances are mapping out cancer services in their areas, and I am very happy to meet colleagues who would like better provision in their local area, but they also need to meet their cancer alliances, which are looking at service provision locally.

I would just caution Members on the issue of having multiple sites for radiotherapy. These are specialist treatments, needing specialist equipment and specialist staff. I went into oncology more than 20 years ago, when surgery was done by general surgeons. They were doing mastectomies on women and colostomies on bowel cancer patients. Moving surgery into being a specialist field, with specialist provision, has transformed the way that we are able to look after women who are going through mastectomies, and bowel cancer patients, who may not necessarily need a colostomy now, because surgical treatments have advanced so much. There is sometimes a rationale for those services to be offered by specialist units, rather than multiple satellite sites.

[Tim Farron]

I want to answer a point that the Minister made earlier. Obviously, during the pandemic, radiotherapy has been used as substitutionary treatment for people who would otherwise have had chemotherapy or surgery, because it is a covid-secure treatment. But my main point is with regard to what the Minister just said about satellites. Has she looked at the data and evidence from those satellite centres that have been opened in the last few years?

For instance, at Hereford, we saw a doubling of the number of patients being treated at that new satellite centre. Why? Well, there was an assumption that the parent centre people, from that postcode, were simply transferred to Hereford. No, it turned out that a lot more people, who would not travel or who were not referred because of the travelling distance for treatment at the original place, were then referred for treatment and therefore had a longer life expectancy because of the satellite centre. With more networking capability, it is of course possible now to treat in specialist ways, with the best people, remotely and through these satellite centres. The Christie has just opened its third satellite, so surely, for more rural communities such as mine, and also in east Lancashire, the time has come to ensure that no one is left behind.

[Maria Caulfield]

There are satellite services—absolutely. We have seen them not just for radiotherapy, but for chemotherapy and even surgery. But it has to be a local decision, because local oncologists have to feel that they are able to support the multidisciplinary team who support the radiotherapy process, ranging from diagnostics through to the treatment itself. That has to be in place, so it does absolutely need to be done on a local basis, but I am happy to meet colleagues if they feel that the case is not being heard locally.

I want to emphasise this point, because a number of hon. Members talked about the commitment to cancer services. Our elective recovery programme has committed £2 billion this year and £8 billion over the next three years to step up activity and tackle backlogs. That will have a knock-on effect in improving radiotherapy access, because some patients cannot have radiotherapy until they have had surgery. Ensuring that we are tackling some of the backlogs to treatment resulting from covid is absolutely important.

There have been huge improvements in radiotherapy over recent years, not just in provision but in technique. We are able to deliver more targeted treatment, resulting in fewer hospital visits, because we can now give radio- therapy to a more targeted area of the body, resulting in fewer side effects from the treatment, and also give fewer fractions of radiotherapy, so that patients can get their total dose much more quickly. That maximises service capacity and minimises patient time in hospital.

Furthermore, we have invested £250 million into two proton beam therapy facilities, one based at the Christie in Manchester and the other at University College London. In addition, all radiotherapy centres in England are now able to deliver stereotactic ablative body radiotherapy. Both these treatments are able to target radiation at cancer cells more accurately, improving patient outcomes. I am really pleased to say that, as part of this year’s spending review, £32 million was made available to support the replacement of 17 linear accelerators aged over 10 years, all of which are on order and will be delivered by the end of March 2022.

NHS England is committed to improving the facilities for cancer patients, and has also offered NHS radiotherapy providers the opportunity to participate in a cloud-based technology called ProKnow. To date, 43 of the 49 radio- therapy providers have joined up. This technology, which will help satellite units, enables clinicians to collaborate virtually within and across organisations, to plan treatments, undertake peer-review assessments and participate in large-scale audits and quality improvement processes, ultimately benefiting patients.

A number of Members talked about the cancer workforce, because it is great to have state-of-the-art technology and multiple units providing radiotherapy, but if we do not have the staff to manage them and provide treatment we shall not make progress. Health Education England is continuing to take forward the cancer priorities identified in the NHS’s long-term plan. It is prioritising the training of 250 nurses to become cancer nurse specialists, 100 chemotherapy nurses and 58 biomedical scientists, and it is updating the advanced clinical practice qualification in oncology.

Further than that, particularly around radiotherapy, Health Education England is investing £52 million in the cancer and diagnostic workforce, increasing the number of clinical endoscopists and training more radiographers in image interpretation. That is all part of the radiotherapy process. As of August there have been an additional 4% of doctors working in clinical oncology, which is the field that manages radiotherapy, and there have been a further 5% working in radiology since August 2020.

We are making progress, but it is not just about the numbers of staff; it is about the skill mix and ongoing staff training. Very often, not being able to expand a role or take on exciting and innovative developments can make staff feel frustrated, but the cancer workforce is growing. Between 2016-17 and 2019-20, the cancer workforce grew by 3,342 full-time equivalents, compared with the ambition of 2,943. We are ensuring that there are more staff coming through into the workforce to deliver radiotherapy.

The shadow Minister touched on the importance of not only recruiting staff but retaining and developing them. I fully take on board colleagues’ comments and concerns. We are committed to investing in radiotherapy equipment, the staff that deliver radiotherapy and the innovation in radiotherapy. We are also committed to making it more accessible to patients, and to reducing the side effects—there are side effects from radiotherapy as well—and to making sure it is a fundamental part of cancer treatment, whether that is in the neoadjuvant setting, adjuvant or for those with metastatic cancer as part of the palliative treatment service.

[Feryal Clark]

I thank the Minister for all the information about the machines and investment into radiotherapy. Are the figures that she set out for replacing what is already out of date, or is there a plan to increase investment in radiotherapy treatment? As we have all said, radiotherapy accounts for 5% of the cancer budget. Is there a plan to increase that, or is it about replacement and keeping up what we already have?

[Maria Caulfield]

It is about replacing existing equipment, but also investing in new. Some of the equipment is 10 years old. Radiotherapy has changed a lot over those 10 years, so the replacement equipment can do more than what it replaces. As I pointed out, we are also investing in new radiotherapy equipment, with £250 million into two proton beam therapy facilities at Christie’s and at UCL—new facilities that will be able to provide state-of-the-art radiotherapy treatment. I hope I have reassured Members that we are addressing this as a top priority.

[Chris Bryant]

Will the Minister give way before she sits down? She sounds very like she is finishing.

[Maria Caulfield]

I was finishing, but I will give way one more time.

[Chris Bryant]

The Minister may not be able to answer the question today about adjuvant provision of immunotherapy for people with stage 2 melanoma, but if she could write to me, I would be very grateful.

[Maria Caulfield]

My understanding is that it is available for stage 3 melanoma, as the hon. Gentleman has highlighted, and that it is still in clinical trials for stage 2. It is available within clinical trials. We expect the data to come forward shortly and then a decision will be made. That is where we are with melanoma.

[Tim Farron]

Will the Minister give way?

[Maria Caulfield]

I will give way one more time.

[Tim Farron]

The Minister is being very kind and I really appreciate it. I have two quick points that I do not think she has mentioned. First, will she take up the request from myself and the hon. Member for Easington for a meeting with the APPG for radiotherapy? We would love to meet her.

Secondly, I do not think she referred to the tariff situation. A lot of the issue is that we need more money. We want the Minister to accept—it is not just her fault; it is the fault of every party in this place, over decades—that we are behind comparable countries and we need to strengthen radiotherapy. The reality is that there are lots of state-of-the-art machines out there, in trusts up and down the country, that are not being used because the tariff is stupid. It incentivises trusts to do second-division radiotherapy, if I can put it that way, because more visits equal more cash, rather than targeted and specific radiotherapy—stereotactic, as she mentioned, for many cancers—because the tariff rewards number of visits, not precision or effectiveness of treatment. Would she look at that? It is free.

[Maria Caulfield]

I am very happy to look at the tariff situation, but my experience is that when a clinical oncologist is referring someone for radiotherapy, that decision is not based on whether they have smaller numbers of fractions as opposed to traditional courses. I am very happy to meet the all-party parliamentary group to discuss that further. I reassure patients that clinical decisions are what decide the type and the number of fractions that a patient needs for their treatment.

Radiotherapy is a priority cancer treatment and this Government are absolutely committed to investing not just in the equipment, but in the workforce that provides it. I say a huge thank you to all the staff across the NHS, particularly in cancer services, who kept going through all the pandemic lockdowns, made sure that cancer patients got their treatment, and helped to support them and their families through what is a very difficult time.

10:54

[Grahame Morris]

This has been a really good debate. It is one we have had on a number of previous occasions.

I thank my hon. Friends the Members for Bedford (Mohammad Yasin) and for Rhondda (Chris Bryant) and the hon. Members for Westmorland and Lonsdale (Tim Farron) and for Strangford (Jim Shannon) for their excellent contributions. I also welcome and thank my hon. Friend the Member for Enfield North (Feryal Clark), and pay tribute to her predecessor, my hon. Friend the Member for Nottingham North (Alex Norris), who did an excellent job and had a terrific understanding of the issue. I also thank the Minister for her response.

It has been an honour to open this debate. Once again, I thank those members of the public who shared their experience, and I thank the Chamber engagement team for their excellent work. It is the radiotherapy patients, their loved ones, the workforce, and, indeed, those who live with the everyday reality of this situation, whose interests we serve and whose insight is so valuable.

I hope the Minister, who has not answered all the questions—I know it is difficult—will have a look at the debate in Hansard and respond to them. I am grateful that she has agreed to have a meeting, but I want her to bring an end to radiotherapy’s status as a Cinderella service and give it the time, focus and investment required to put the UK on a path to ensuring that we have truly world-class cancer services.

Question put and agreed to. 

Resolved,  

That this House has considered access to radiotherapy.

10:56

Sitting suspended.

Direct Ferry Links: Scotland and Mainland Europe

Wednesday 12th January 2022 Westminster Hall

09:30

[Philip Davies (in the Chair)]

Before we begin, I remind hon. Members that they are expected to wear face coverings when they are not speaking in the debate, in line with current guidance from the House of Commons Commission. I remind Members that they are asked by the House to have a covid lateral flow test before coming on to the parliamentary estate, and to give each other and members of staff space when seated, and when entering and leaving the room.

I will call Kenny MacAskill to move the motion and then the Minister to respond. There will not be an opportunity for the Member in charge to wind up, as is the convention for 30 minute debates.

[Kenny MacAskill (East Lothian) (Alba)]

I beg to move,

That this House has considered direct ferry links between Scotland and mainland Europe.

It is a pleasure to serve under your chairmanship, Mr Davies.

Connectivity is critical, if not king, in the 21st century. As coronavirus has shown, telecommunications are vital, allowing for home working and for businesses to operate, even during lockdowns. Zoom and Teams have come to the fore, even in this House, and have proven essential for many, but other, more established, physical methods of connectivity are equally vital.

Road, rail and air have shown how essential they are in a globalised world, and have been supported by Governments both sides of the border, even before coronavirus struck. Yet there is one major aspect of connectivity where Scotland has been left high and dry: direct ferry links to mainland Europe. It is not just a long-standing issue, but a long-standing omission. It was a major gap even before the impacts of coronavirus and Brexit, which have simply compounded the existing need.

Road freight has been hit hard, through driver absence and customs nightmares, let alone additional bureaucracy. Trade, which could have gone swiftly and with ease from a safe Scottish harbour, has been struggling to access routes south and, even then, facing delays and backlogs at English ports. The spectre of arterial routes becoming truck parks as lorries backed up and loads rotted in the back would be laughable if it were not so tragic.

At the same time, the cost of fuel has rocketed. Not only have there been challenges with fuel shortages, but profitability has reduced through having to trunk our goods to ports a considerable distance south, whether to the Tyne or Humber—or even far beyond to the channel ports. The former are a considerable distance, but the latter, especially for seafood or other perishable items, already meant an absurd journey, and it is one that has been made so much worse through additional delays and impediments.

There is yet another compelling reason for investing in maritime links, beyond the connectivity they provide. Despite COP26 taking place in Glasgow, little thought has been given to improving maritime links because of their environmental benefit. There are issues with maritime fuel, and action to address that—whether through reducing the pollution from marine diesel or exploring alternative fuels, such as batteries—is essential. However, it is still better for our environment to load freight aboard one ship than to have dozens, if not hundreds, of lorries struggling down congested roads.

These risks were known to be looming on the horizon, as were the opportunities that would be beneficial economically, socially and environmentally. It is not as if many of these events were not foreseeable, even for those who only foresaw sunny uplands for Brexit. Customs delays were always going to kick in and other nations, such as Ireland, prepared, but shamefully that was not done in Scotland, by either the Scottish or UK Governments. As a result, many businesses have paid a heavy price.

It is not as if Scotland lacks access to the seas or is devoid of ports. The nation has the facilities and, historically, the links. Scotland was always linked by sea routes to Europe, which continued even when the major trade moved to the west coast and the Atlantic. Pantiles, on the roofs of many homes in my East Lothian constituency, testify to links with the low countries. Along the shores of the Forth and the port of Leith, where I was born, street names are equally redolent: Baltic, Cadiz and Hamburg, although that name was changed to Hamburgh in the first world war.

More recently, the superfast service that sailed from Rosyth to Zeebrugge was enjoyed by many, benefiting both trade and tourism. That port and the facilities constructed for the ro-ro services still exist. Despite the valiant efforts of the hon. Member for Dunfermline and West Fife (Douglas Chapman), it currently serves as a safe harbour for berthed covid cruise ships with the ro-ro infrastructure moribund, rather than providing a major link for Scottish trade and tourism. There are other options, including in existing harbours and in the potential for a new port at Cockenzie in my own constituency.

The historic links and the infrastructure remain, so why has there been no progress in launching routes over past years when they would have been welcomed, or now, when they are essential? It is not as if the maritime sector globally, let alone in Europe, has been idle. Other nations have acted, and so must Scotland. Ireland, seeing the problems that Brexit would bring, prepared and added significantly to the services already operating.

[Douglas Chapman (Dunfermline and West Fife) (SNP)]

The hon. Member mentioned exports and trade. Is it not time that we had a substantial maritime support policy from the UK Government to support trade post Brexit, as he outlined is the case in Ireland? The low countries, which he also mentioned, have a direct support package to increase trade post Brexit.

[Kenny MacAskill]

I think that is something that should be done by the UK Government, but, as I will go on to say, transport—certainly maritime transport—is largely devolved, which is why my demands are not simply to the UK Government, but to the Scottish Government.

As I was saying, despite distance and sail times being longer, Ireland ensured alternatives to the land bridge that was the previous favoured route for many. That meant sailing to a port in Scotland, Wales or England and then journeying on via the UK motorway network to the channel ports. Not for them a Boris bridge or any other delusional nonsense. Instead, Ireland arranged to sail direct to Europe. Direct freight routes were expanded and passenger services increased, thus avoiding customs backlogs, reducing road journeys, avoiding the difficulties of driver absences through illness or self-isolation, and making environmental gains.

In Ireland, three main operators now offer passenger services. Brittany Ferries, Irish Ferries and Stena Line offer services, with some sailing up to five times a week from Cork, Dublin and Rosslare, heading to Roscoff, Bilbao and Cherbourg, ensuring access to their principal markets and allowing for inbound as well as outbound tourism. Those are not the only routes available across the Irish sea to access Europe. Other services provide for freight only, whether for vehicles with haulage or unaccompanied freight. Since Brexit, services and routes have increased, allowing further options and avoiding the problems that have arisen, especially at the channel ports.

Scotland and Ireland have similar sized populations, and both are dependent on trade and tourism. For both countries, Europe is a big and major market. In several instances, Ireland is a direct competitor, yet Irish maritime links are growing almost exponentially, and Scotland remains tied up in port with increasing paperwork. It is not only Ireland that has been acting to increase maritime links. Countries across Europe have been taking action to address the challenges that they faced—even if not the Brexit-imposed customs debacle—allowing for new opportunities for trade and tourism.

Many have accessed funding from the EU, but all have been financially assisted by government to develop. A tender has been issued to re-establish a ferry link between Greece and Cyprus. Support funding of €5.5 million is being provided for a three-year service, with the possibility of an extension beyond. Other nations have acted similarly. Stockholm in Sweden to Rostock in Germany is to begin this spring. Yes, it is having a state subsidy, but it is saving on CO₂ and other costs—and it is not just in the Baltic, but in the North sea, as a Norway to Netherlands service is to commence in April.

So why are we devoid of action in Scotland? Transport is largely devolved, and therefore much of the failure to date and, indeed, the action that needs to be taken rests with the Scottish Government. They have failed to show any sign of urgency, let alone any sign of ambition for the country. Instead, they have remained thirled to a free market dogma that might be expected of London, but which could and should be rejected by an Administration with Scotland’s interests at heart. Although a four-nations approach may have merit in aspects of health policy, with ferries it leaves Scotland isolated, sucking everything into the ports in England and leaving Scotland marooned.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

Does my hon. Friend share my deep regret that a comparative drop in the ocean of investment would be sufficient to move this project forward? The reluctance of the Scottish Government to do so undermines Scotland’s case for independence and the valiant work and efforts of the hon. Member for Dunfermline and West Fife (Douglas Chapman).

[Kenny MacAskill]

I absolutely commend the efforts of the hon. Member for Dunfermline and West Fife, and I agree with my hon. Friend the Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) that it is a very modest investment that would have significant returns.

However, the UK Government cannot absolve themselves of blame. Their free market dogma has privatised critical infrastructure such as ports, although that is a debate for another day. More importantly, they promised to match or exceed the benefits of EU membership that once applied. The motorways of the sea scheme, which was created to establish maritime links between nations, was once available due to EU membership; it has not been replaced by any scheme, let alone a better one.

Both the UK and Scottish Governments claim they support the establishment of new services but insist that they must be market driven, which means they must be entirely self-funding, with no state support. A new venture is therefore expected to launch without any state ballast—or even a lifeboat to ensure survival—which does not apply to other modes of transportation. No one would dream of suggesting that a haulier was required to provide the road network or that a rail freight operator should build a rail line, even though that is state support—albeit in a different way. Expecting an operator to acquire ships and launch the service without any support is equally perverse. Why should we not give assistance to start maritime links, matching support for road and rails and replicating what is standard in other countries?

The M74 extension, the Aberdeen western peripheral route and upgrades to the A9 are all about improving Scottish connectivity, and they are not left to the haulage sector. Scotland rightly lauded new rail links that have opened—such as Stirling to Alloa and Airdrie to Bathgate, both of which have proven spectacularly successful—while support is being given to reopen new stations, with East Linton and Reston to come. Even aviation has seen support, with bail-outs keeping airlines alive and a route development fund once provided, as I will expand on. Why the preclusion of maritime links?

The UK Government’s market-driven dogma, which neither applies to other transport modes nor is echoed in other lands, might be expected of a Tory Government, but it has shamefully been mirrored by the Scottish Government. Communications from the Scottish Transport Minister have parroted the UK line and ignored the steps that have been taken by other small and even competitor nations, such as Ireland and Norway. As a result, Scotland is losing out.

Two matters make that position particularly perverse. First, Scotland routinely funds ferry services. Considerable financial support is rightly given to back both Caledonian MacBrayne and NorthLink ferries; CalMac receives upwards of £120 million per annum, and even more is provided for boats and piers. Orkney and Shetland services receive approximately £45 million per year in support. No one would question that: it is essential, as they are lifeline services and neither roads nor railways can be provided. It is a sensible provision of public funds.

Why is it legitimate and sensible to support internal maritime links but refuse to do so for external ones? Why should a Government argue that an island nation that has to trade with Europe and encourage European visitors should not support maritime services? Why can maritime services not be supported when, as my hon. Friend the Member for Kirkcaldy and Cowdenbeath said in his intervention, only a fraction of the funds already spent on maritime support would be required and the economic returns would be considerable?

Secondly, Scotland previously operated a route development fund to establish direct air links. That was seen as essential to growing trade and in-bound tourism, as well as, given the environmental impact of aviation, to avoiding an additional flight almost invariably to a London airport. That was supported by all major parties and applied until EU regulations brought it to a halt in 2007. EU regulations no longer apply, so why no Brexit bonus? In any event, as with motorways of the sea funding, the EU and nations such as Ireland and Norway now see the benefit of state support for vital connectivity—and for reducing carbon emissions by reducing road freight and growing unaccompanied trailer use. Scotland is losing out to Ireland and other nations in competitiveness and convenience. Scottish trade and tourism are suffering, and promises from COP26 ring hollow.

Demands on the public purse are many, and resource is limited, especially post covid. However, the UK Government are still able to find funds for High Speed 2, even in a truncated form that will come nowhere near Scotland. Millions were also wasted on seeking to reopen a channel port when ports were available in Scotland and only the ferry service was lacking. That attitude might be expected from a Tory Government thirled to a market-driven dogma and oblivious to Scottish needs, but it is entirely inexplicable for an Administration that claim to have Scottish interests at heart. What does it say when the Administration of Lord McConnell of Glenscorrodale were more radical in providing air routes for Scotland than Nicola Sturgeon’s are in providing maritime links?

Scotland deserves better. It requires connectivity in all forms of transport, as in telecoms. It needs ferry services to Europe. Will the Minister commit to funding an equivalent to the EU motorways of the sea scheme, applicable to all parts of the UK, including Scotland? Finally, the Scottish Government must establish a ferry service route development fund to launch and sustain those routes. Scotland deserves no less.

11:17

[The Parliamentary Under-Secretary of State for Scotland (Iain Stewart)]

As ever, Mr Davies, it is a pleasure to serve under your chairmanship. I start, as is customary, by congratulating the hon. Member for East Lothian (Kenny MacAskill) on securing the debate and making his case so passionately. I also thank the hon. Members for Dunfermline and West Fife (Douglas Chapman) and for Kirkcaldy and Cowdenbeath (Neale Hanvey) for their considered interventions.

The UK Government fully recognise that quality transport links are essential to economic growth, job creation, social cohesion and many other areas, and we are committed to progressing our work on increasing connectivity throughout the entire UK and beyond. I will come to some of the specifics that the hon. Member for East Lothian mentioned, but I first must correct the impression that he has given that there is no interest or investment in improving connectivity throughout these isles. First, specifically on maritime, there is investment going into Scotland, as we speak, to improve port facilities. If he looks to the other side of Scotland from where he represents, at Greenock, there is considerable investment going into the ocean terminal, specifically to boost the tourist offer. Leaving aside the disruption caused by covid, the demand there is increasing enormously. There is investment going in.

More generally, the hon. Member for East Lothian will be aware that the Government commissioned the Union connectivity review—it recently reported—which looks specifically at key transport links by all modes, whether rail, road, air or maritime, right across the UK and beyond, to complement the EU’s Trans-European Transport Network, or TEN-T. That looks at transport corridors as a whole. It might be that, to improve connectivity or capacity between two points, the right intervention is somewhere else. For example, he referred to HS2. It will benefit Scotland by significantly reducing rail journey times from Glasgow and Edinburgh to London.

[Kenny MacAskill]

Does the Minister accept that, even in Northern Ireland, much freight is now heading south to the Republic to take direct ferry access to Europe, rather than following the land bridge? Accordingly, even in Cairnryan, Scotland is losing out.

[Iain Stewart]

I am very happy to respond to that. If the hon. Gentleman reads the Union connectivity review—it is a mark of considerable regret that the Scottish Government, out of pure dogma, refused to engage in the review—a central recommendation was to improve the A75 from Cairnryan to the main motorway network, which is one of the key impediments to freight and other traffic moving between the UK and Northern Ireland. So yes, we are aware of that, and we are taking steps to improve it.

To complete my point on HS2, another recommendation of the connectivity review was to improve connectivity between the HS2 line and the west coast main line, and to upgrade the west coast main line to achieve journey times from Glasgow and Edinburgh to London that mean it will be much more advantageous to travel by rail than by air, improving the environment.

[Douglas Chapman]

The Minister seems to be getting sidetracked by rail. It is important to stick to the maritime issues. We have seen massive investment, as part of the levelling-up agenda that his Government support, in Tilbury, Teesside and, as my hon. Friend the Member for East Lothian (Kenny MacAskill) mentioned, the channel ports, so why are we not getting the same level of investment in maritime in Scotland? Brexit has had a huge impact on Scottish exports. We need to remedy that, and it is up to the Minister to bring forward proposals that will support Scottish exports as we move forward.

[Iain Stewart]

The hon. Gentleman makes a perfectly fair point. I will come on to some of the specifics of maritime in the next eight minutes. However, it is only right for me to point out that the impression that the Government are not interested in connectivity in all its forms is simply not true.

[Neale Hanvey]

Will the Minister give way?

[Iain Stewart]

I will give way one last time and then I must make progress or I will not get round to the maritime points.

[Neale Hanvey]

I thank the Minister for giving way; he is being a good sport. On HS2 and the benefits it may deliver at some distant point in the future, dependent on the project’s development and links, if we are trying to achieve a comprehensive transport strategy, does he not think it would be a useful investment, and small in comparison with the massive investment in HS2, to support the development of maritime connectivity as part of that comprehensive transport link? Will he commit to meet me and my hon. Friend the Member for East Lothian (Kenny MacAskill) at some point in the future to discuss maritime strategy in more detail?

[Iain Stewart]

Indeed. The Union connectivity review is across all modes of transport. I do not think only one single intervention is important. I am always happy to meet the hon. Gentleman and his colleagues. I know the hon. Member for Dunfermline and West Fife has been to see the Secretary of State for Scotland to discuss the specifics of the Rosyth-Zeebrugge route.

Let me make some progress on this. I understand that the proposed ferry link would replace a service that was previously run by DFDS Seaways from Rosyth to Zeebrugge. That started as a combined passenger and freight service in 2002 but was changed to freight-only in 2010 due to insufficient demand. Even after cost-saving measures were taken by the operator, including changing to freight-only and double-stacking the containers, the route continued to make losses, and a fire on board sealed the fate of the service in 2018. I understand the opportunities such a direct ferry link could present, encouraging passengers to use fewer short-haul flights and diversifying the connectivity.

Leaving aside all the other arguments about Brexit—I am sure we could have a fascinating debate about that—it is surely a truism that it is better to have more diversity in transport links, so that if one is constrained for whatever reason, such as industrial action on the continent or whatever, there are alternatives. Indeed, there are services from Zeebrugge to the UK—I think there is a daily service at least from Zeebrugge to Hull. What I cannot do is commit today to one specific route—that has to be a commercial matter. But the infrastructure required is there at both ends so there would be no need for additional infrastructure at Zeebrugge or Rosyth.

The one bit of additional resource that would be required, which is not impossible and I understand discussions have already happened, is to have Border Force manpower at Rosyth to deal with passengers and freight coming in. Those discussions can happen and that could be put in place, but the request must come from the operators who wish to establish such a service.

Let me put this discussion into the broader context of changing international shipping patterns, particularly freight. The hon. Member for East Lothian may not know that I spent seven years serving on the Transport Committee, so this is a subject I have given some consideration to. Looking at the scale and patterns of international shipping, particularly from the far east to Europe, the vessels are becoming larger and larger. Whereas in the past they would come from the far east and serve various European ports and then return, now they tend to come to one port, such as Felixstowe or Rotterdam.

[Douglas Chapman]

I think there is a case to have a regional ferry port serving a major international port such as Zeebrugge or Antwerp. That is where the links are made: containers and lorryloads of goods are moved to those larger ports to be distributed from there. For the life of me I cannot understand why the receiving port in this case—Zeebrugge—has access to a Brexit resilience fund, while we in Scotland do not have a similar fund to go to. It seems logical that, if we are making a huge change, through Brexit, to our trading patterns, the UK Government should put something in place to help us deal with that.

[Iain Stewart]

The hon. Gentleman actually finished my point for me. By having that one stop in Europe, there have to be additional feeder services. Felixstowe and Port of London are massively expanding their operations—a lot of the ferries are going though. These are commercial matters. It is not for a Government to say, “We want this route rather than that route.” Through the connectivity review, we are looking at transport connectivity in the round.

I am conscious of time, but I want to mention the environmental aspect. We have the Maritime 2050 strategy; the industry is making considerable advances to decarbonise its operations. That is a UK Government-funded scheme, to help that transition and realise some of the ambitions from COP26 in Glasgow. I understand the tourism point, too. As international travel hopefully returns to normal levels in the near future, that could be an attractive destination and boost the visitor economy in Scotland and throughout the UK.

As the hon. Member for East Lothian said, it is primarily a matter for the Scottish Government if they wish to develop this specific route. My understanding is that the Scottish Government have said it needs to be on a commercial basis, but there is no objection from the UK Government to that sort of route being reinstated. I am more than happy to have discussions with the hon. Gentleman and his colleagues to see what the way forward is. The specifics that we are responsible for, such as Border Force, are not necessarily an impediment. Clearly, there are lead times for recruitment and the other requirements for installing that service, but that is not a block on the project being taken forward.

I wish the hon. Gentleman and his colleagues well in pursuing that ambition, which would be to the benefit of Scotland and the whole of the UK. I am very happy to meet him offline to discuss it further.

Motion lapsed (Standing Order No. 10(6)).

11:29

Sitting suspended.

Youth Crime and Antisocial Behaviour

Wednesday 12th January 2022 Westminster Hall

[Mr Laurence Robertson in the Chair]

14:30

[Mr Laurence Robertson (in the Chair)]

Before we begin, I have a few notices. I remind hon. Members that they are expected to wear face coverings when not speaking in the debate, in line with current Government guidance and that of the House of Commons Commission. I remind hon. Members that they are asked by the House to have a covid lateral flow test before coming on to the estate, and to give each other and members of staff space when seated and when entering and leaving the Chamber.

In this debate, hon. Members should not mention any active legal cases. There will be an advisory six-minute limit on Back-Bench speeches.

[Matt Vickers (Stockton South) (Con)]

I beg to move,

That this House has considered youth crime and anti-social behaviour.

It is a privilege to serve under your chairmanship, Mr Robertson. I thank all hon. Members for attending the debate. It is encouraging to see such wide interest in this issue. Clearly it resonates deeply not just with me and the people of Stockton South, but with MPs and constituents up and down the country.

I chose the wording of the motion carefully and deliberately. This is not just a debate on antisocial behaviour, because often what starts as mindless antisocial behaviour goes on to become crime. In areas of my constituency, that is exactly what is happening. Many of my constituents are rightly angry when abuse, broken windows, missiles and assault are badged as antisocial behaviour. They identify the perpetrators and report them to the police, only to be left feeling that nothing is being done about it.

Often when we talk of youth crime and antisocial behaviour, it can be trivialised, downplayed and dismissed. We tend to assume that it is simply a few young people drinking a couple of cans in the park. That is not to say that that does not happen, but the other side of youth crime is more vile and sinister. In my constituency, there continues to be repeated, sustained and violent abuse of persons and communities, which go on not just for hours, but for days, weeks and months at a time.

Youth crime appears in many guises. In Stockton South we have seen car windows smashed, arson, verbal abuse, emergency workers spat at and pelted with missiles, teenagers beaten and robbed, vandalism and destruction of property. Across the UK there are people afraid to leave their homes after dark, scared to go to the shops, terrified to live their lives. That cannot go on.

It would be wrong to say that we have not made any progress on the issue. Locally, I invited residents to meet me, alongside local police and the council. Together, we have managed to identify individuals who were responsible, put additional CCTV in place and increase police presence in hotspots at peak times. The council’s youth and antisocial behaviour teams have undertaken work with the youngsters in an effort to teach them the error of their ways and redirect their energies.

The number of first-time entrants into the youth justice system is down significantly since 2010, but that is little comfort to those whose lives continue to be made a misery by the actions of this rogue minority of young people. All too often, it feels that the system is stacked in favour of the perpetrators rather than the victims. Today, with her permission, I will share the plight of one of my constituents, though for her own safety she will remain nameless.

This constituent is a mother and a pillar of her community. For about two years, she has suffered abuse and intimidation from a group of youths. Throughout, she has shown both bravery and incredible determination to improve her community. The catalyst for this episode was when she initially reported an example of antisocial behaviour to the police. The youths in question found out she had reported them and labelled her a grass, and went out of their way to ensure she was punished for fulfilling her role as a good citizen.

The abuse has involved her children being attacked and assaulted, stones being put through her windows, and adolescents showing up at her house to intimidate her, filming the abuse, uploading it to TikTok and broadcasting live videos on social media as they try to damage her property. It is abhorrent, disgusting and an utter disgrace. The police have tried to help. They put a van outside her home for a time. Although that temporarily stopped the issue, the second the van left, the abuse started again. The police quite simply do not have the powers or resources to deal with this. It is clear that the system does not work.

I am sure that all Members here today would agree, in the strongest possible terms, that that example and stories like it are far too commonplace. In Ingleby Barwick and Thornaby in my constituency, separate groups of young children have been causing havoc. People have been abused and intimidated in the street, and there are concerns over the prevalence of drug use. When one veteran tried to confront youngsters over their behaviour, he was assaulted and hospitalised—an incident that has rightly disgusted the community in what is considered an affluent area.

I do not believe these children have been born inherently bad. They are not evil or demonic. I also do not believe that because a child is born in one estate or another, they will inherently be drawn to such behaviours. I believe this is an issue that affects children of every class, creed and colour.

Youth crime is a complex matter that requires a multifaceted, co-ordinated and often localised response. The causes of youth crime are diverse: education, family breakdown, poor parenting, a lack of creative output, and poor outlooks and opportunities. There is no one-size-fits-all approach to this problem. However, I believe it is the Government’s moral obligation to take serious steps towards fixing this issue; for it is their duty to ensure that children have the opportunity and ability to get the best from life. It is only through adequately resourcing and empowering all the agencies in this arena that we can make a real difference.

If nothing else, we can easily advocate action on the basis that to combat such behaviour early is to improve the quality of life for many, save police time and money, and free up our courts and prisons. Prevention is better than rehabilitation. It is better that we stop children getting into violent, antisocial behaviour in the first place, than to rely on excessive punishments in an attempt to deter those who will not be deterred.

Often, those who engage in antisocial behaviour do not fear punishment and, worst of all, do not have hope for their own futures. We need all local partners to start collaborating and getting youngsters engaged in youth activities, sports and initiatives to prevent them from turning to antisocial behaviour and crime. We must give youngsters something to do, with a meaningful outlet for their energies.

It shocks me that records on the use of antisocial behaviour powers and orders are not collated nationally, limiting any meaningful assessment or discussion about their use or effectiveness. By collating data nationally, we can ensure that successes and failures in relation to antisocial behaviour can be studied by policy makers, which, importantly, will enable informed improvements to make sure that the orders are fit for purpose and meet the challenges of evolving antisocial behaviour.

Of course, there are differences in how neighbourhood policing works in Thornaby, Twickenham and Tower Hamlets, but good policy lessons can still inspire and enable conversations that lead to material and substantial improvement in the lives of people across the United Kingdom. Creating a national framework would help not only those communities plagued by youth crime, but those children who have been sucked into a cruel cycle of perpetual reoffending.

I also believe that we need to look again at the burden of proof that is needed before civil authorities can intervene to compel educational courses and proactive measures. When sitting around the table with frustrated residents who feel nothing is being done and authorities who tell us that they need a greater catalogue of evidence to take something forward to court, there appears to be an impasse that leaves communities to suffer for longer than need be. Nobody wants to see youngsters criminalised unnecessarily, but neither should residents be left to suffer for months, waiting for enough offences to take place to build a case.

Not only is the burden of proof creating a challenge for authorities, but the speed at which youth crime and antisocial behaviour cases are progressed and resolved is just too slow. The process by which justice and corrective action are administered is in desperate need of acceleration. I believe that this should be central to any plan on youth crime. For the communities affected, the long delays feed into the narrative that nothing is being done and that the system is not on their side.

For youngsters, this can leave them with months of anxiety and an inability to focus on self-improvement. I spoke to someone from the youth offending team, who said that often by the time a young offender reaches them, the youngster has forgotten the details and the context of their offence and what they have done, and is likely to have gone on to commit further offences.

We need those in affected communities to see that action is taken quickly and that those who fall foul of their communities are brought to account. Waiting a year or more for action to be taken is unacceptable. We need to end the perception that youth crime and antisocial behaviour will be met with non-action and that perpetrators have impunity to act at whim.

It is important that we actively take steps to educate parents, who play such a crucial role in shaping their children. The number of parenting orders being issued is thought to be falling. If that is the case, I would like the Government to examine why that is and consider whether there is room for improvement in the relevant legislation.

[Scott Benton (Blackpool South) (Con)]

My hon. Friend is making a brilliant speech. One of the main problems that we have in Blackpool is that, when parenting orders are issued, often the police are exasperated that the council cannot hold those families and young people to account and make them abide by the conditions of those orders. Does he agree that that is a problem and that we need to see how youth offending teams and local authorities can work with the police to ensure that the orders are adhered to?

[Matt Vickers]

I could not agree more. Actually, it is about sharing best practice. All these problems require every agency to work in collaboration, which is probably what makes this issue such a difficult one—it is about education, schools, local authorities and policing. The sharing of best practice and the collation of data nationally would help to inform the decisions that are made.

Some families need support in managing their children, but all too often I hear concerns expressed at my surgeries about parents who just do not care what their children get up to. In such cases, there needs to be tough action. I firmly believe that parents should be held accountable if they fail to engage with the authorities in efforts to control and help their children.

To conclude, enough is enough. I ask the Government to consider how we collate records on the use of ASB powers and orders, so that we can make a real and meaningful assessment of their use and effectiveness, and empower our police and local authorities. I think we should look again at the burden of evidence and the speed of our justice system, so that our communities see prompt action and offenders are held to account more quickly. Yes, some families need support in dealing with troubled youngsters, but those families who fail to engage with the authorities to help and control their children should be held responsible, either legally or financially.

It is imperative that we, as a country, start taking this issue seriously. We are talking about our children and our communities—the very fabric of our nation. The Government must act. They must show that they care and have the courage to tackle this problem head-on, whether for the young family who worked hard, saved up and bought a dream home, only for it to become a nightmare, or for the elderly lady who dare not leave her house after dark. Will the Government look again to see what more we can do to prevent a minority of youngsters from making people’s lives a misery?

14:42

[Alex Davies-Jones (Pontypridd) (Lab)]

I am very grateful for the opportunity to speak in this debate and to be called so early.

Antisocial behaviour is one of the issues that I am contacted about most by constituents—not just the antisocial behaviour in Downing Street, but the antisocial behaviour affecting all our communities. In communities in my constituency such as Beddau, Tonyrefail, Church Village, Rhydyfelin and Ponty town, instances of graffiti, damage to football pitches, joyriding, drinking, drug taking and threatening behaviour are causing huge problems. For people living under the shadow of such antisocial behaviour, the situation seems to be getting worse rather than better.

Labour’s analysis of official statistics found that 13 million adults across the UK had witnessed antisocial behaviour in the past year, which is about one in five of us. Meanwhile, the number of people who say they never see police out on the streets has doubled. Put simply, people in my community do not feel safe on the streets, which absolutely should not be the case. Although I know that South Wales police, my own local force, is working incredibly hard to respond to the rise in antisocial behaviour, it is massively overstretched and the pressures of the pandemic are only making that situation worse.

When we talk about antisocial behaviour and youth crime, the focus is often, importantly, on the victims. However, we also need to consider what is driving antisocial behaviour and what support is on offer to young people. It is wrong to try to have a meaningful conversation and debate about antisocial behaviour and youth crime without considering the impact of the pandemic on young people.

All of us across the House know that the pandemic and the measures that were necessary to control the spread of the virus, including social distancing and school closures, have had an enormous impact on young people. I have visited schools in my constituency and heard young people of all ages talk about their feelings of loneliness and isolation. More and more of them are struggling with mental health problems.

Criminalising young people is not the solution to this issue. A multi-agency response is vital in supporting young people, and particularly important before a young person even has contact with the police. I would very much like to hear more from the Minister today about what her Government are doing to foster a multi-agency approach to tackling youth antisocial behaviour.

Everyone deserves to feel safe in their community, and when we talk about antisocial behaviour, I think that a lot of the time safety is actually what people are concerned about. In debates such as this, it is possible to be over-zealous in talking about more criminalisation; what people in my community actually want is to feel safe and to feel that they are being listened to.

I have to say that South Wales police really is doing its best in very difficult circumstances. Over the last year, my constituents and I have raised serious concerns about incidents of drag racing, and specifically the use of modified cars. That has been happening across the countryside in my area. I recognise the efforts of South Wales police, which recently launched Operation Buena in an attempt to tackle this problem. I have raised this matter with the Government on multiple occasions. Cars that are modified to backfire loudly are causing huge worry. Constituents of mine have compared it to the sound of a shotgun going off; it really can be terrifying, especially for elderly people. It is vital that steps are taken to bring an end to these modifications that cause huge anxiety to people living in the community. People often feel unable to report such matters to the police, and it is hardly possible to rush out and take down a number plate when someone is speeding past. What does the Minister suggest my constituents do?

Often, the young people who are involved in such behaviour do not understand the impact it has on the community. A constituent wrote to me recently to describe how the problem has become worse because of the pandemic. At a packed meeting in Talbot Green, a young man who had been involved in some of the racing was in attendance. He explained that he was just driving for fun, and that he and his friends really did not have anything else to do—as hobbies go, this one was at least cheap. When he realised the impact on the local people, he apologised and explained he really had not understood the impact of his actions and the anxiety that they caused. That highlights the importance of engaging holistically with young people to ensure that they have meaningful alternative ways to spend their time. We also need to ensure that the police have the right levels of support available to help with the problem in the meantime.

With the UK Government yet to make good on their promise of 20,000 new police officers on our streets, I am worried that it will be some time before we see any progress. If the Government are serious about keeping our streets safe, I urge them to work closely with the devolved nations, local authorities and police forces to tackle these problems head-on.

14:46

[Robbie Moore (Keighley) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank my hon. Friend the Member for Stockton South (Matt Vickers) for securing this important debate. I, like many other Members in the House, like to be able to sing from the rooftops all of the good things that are going on in our constituencies, but it would be completely wrong of us to dodge the criminal activities and antisocial behaviour that continue to haunt our constituencies. I am afraid that Keighley and Ilkley is no different. It is only right that we are able to raise these concerns in this place, so that we can lobby hard and make sure that these issues are dealt with.

I am sad to say that Keighley experiences its fair share of antisocial behaviour. As my hon. Friend the Member for Stockton South said, this is not just antisocial behaviour—it goes on further into organised crime and the like. The types of experiences that we are having include recreational drug use, which is a huge problem in my constituency, particularly with young people in parks and public places. I am sad to say that in Keighley, Ilkley and Silsden, young people are taking drugs and leaving used needles and empty canisters behind. These people are treating my constituency—my town of Keighley—like a playground, with no respect whatever for the wider community.

I could go on. Some of the other issues that we are experiencing include: fireworks being let off late at night and at all hours; people using our roads like a racetrack or a game, with modified cars and loud exhausts, and really annoying many of my constituents; and worst of all, such behaviour can turn violent and directly involve innocent members of the public who just want to go about their lives. Too often I receive heartbreaking pieces of correspondence from constituents, telling gut-wrenching stories about going about their own business only to be assaulted and mugged in Keighley by mobs of thugs wearing balaclavas. That happened only this month, and in the last two weeks several constituents have raised these concerns.

What is worrying is that although I have many fantastic independent local businesses right in the centre of Keighley, wanting to encourage people into the town to drive economic prosperity, people are being put off from coming in because of these issues. One constituent, Laura Kelly, who owns a fantastic business in the centre of Keighley, is doing a great job standing up for local businesses and making the case that more should be done about antisocial behaviour.

I am aware that there are many reasons—often complex—why young people could be drawn into committing crimes such as the ones that I have mentioned. They might have had a troubled upbringing, with little family care or support, or have had negative influences around them from an early age. Solving such issues is not easy, but the key thing that we must do is offer young people different pathways to a life out of crime, so that they are not dragged into those circumstances. We must provide a way out for them and their friends, so that they do not get drawn into drug dealing, which is a huge challenge.

Youth services and youth workers play a vital role in helping those in disadvantaged positions. They help provide great services to many of the young people in my constituency. Those services allow people to access a network of new environments, to gain new hobbies, to get involved with sports and to learn more skills, all of which can help them get out of crime.

At this point, I must mention Keighley Albion and the Keighley Cougars, local sports groups—rugby groups—that have tried to get young people out of their day-to-day habits of driving using Keighley as a racetrack, and get them more involved in other activities. I was delighted to hear my right hon. Friend the Chancellor of the Exchequer announce an extra £560 million for youth services in last year’s spending review, but I must make it clear that that money must go directly to those areas and to provision such as youth services, to get it to those who need it most.

As I said, my constituency unfortunately has an undeniable problem with youth crime. It is my sincere hope that if we continue to open up, to talk about such issues, we can show young people a different option out of crime, to move our community forward. I finish by asking the Minister, can we ensure that for those who are convicted of crimes, justice is served quickly, so that my local businesses and residents feel that justice has been served in a timely manner?

14:52

[Ms Lyn Brown (West Ham) (Lab)]

It is an absolute pleasure to serve under your chairmanship, Mr Robertson.

I thank the hon. Member for Stockton South (Matt Vickers) for giving me the opportunity to talk again about the county lines difficulties that we have in my constituency and elsewhere in the country. Much of the really violent crime and antisocial behaviour committed by young people in my patch is linked to the lines drug gangs. Just before Christmas, I introduced a ten-minute rule Bill, in which I had a number of asks, including a national strategy to end county lines criminal exploitation for good.

I became aware of county lines back in about 2015 or 2016. I was introduced to some mums of children who were being exploited. Have no doubt: those mums were amazing—they are courageous, strong and brave—and they showed me so much to enable me to understand what is happening in my constituency.

One of those women—I will call her Ashley—told me about her son, Kofi. When Kofi was 15, his neighbour started to build a relationship with him, and at first it all seemed okay. The neighbour was often to be found at Ashley’s house, watching TV and playing PlayStation. Slowly, however, Ashley realised that this man was turning her son away from school and away from her. Then, three days before Christmas, Kofi did not come home.

The next night Kofi called her, whispering. Some men had him—he did not know where he was and he was absolutely terrified. When Kofi finally returned, Ashley again called the police, and made him go to the police station, despite threats of violence against both of them. It was an extremely brave thing to do.

What Ashley told them, however, was ignored, and Kofi was treated as a criminal, not a victim. He was 15 years of age. The men who had groomed, exploited, traumatised and threatened him were, as far as Ashley knows, left alone, and no one came to check on Kofi afterwards to ensure that he was okay. Ashley told me that Kofi was never the same after that experience—his trust and hopes had been absolutely crushed. He had no support for his trauma, and the pattern continued.

A year later, Kofi was about to be accepted into the Army, to change his life for the better. But in that moment of hope, historical robberies were laid at Kofi’s door. Ashley believes it was because he was of an age to be sentenced as an adult. Ashley tells me she has seen Kofi’s groomers walking the streets, flashing the cash they made destroying children’s lives.

Five years ago, there was a bit of an excuse for not understanding what the lines were doing to our children; but there is no excuse now. The police, teachers and others have become more knowledgeable but, sadly, our response to the lines is still not based on evidence. The Government do not know how many children supervised by youth offending teams have gang memberships or criminal exploitation noted as an issue. The Government do not know how many of those known to children’s services have criminal exploitation as a risk factor, or how many slavery and trafficking prevention orders have been made to stop the exploitation of children. They do not know how many local safeguarding partnerships even have a child criminal exploitation strategy, let alone the effectiveness of those strategies.

It is only by having a real understanding of the complexity of the lines that we will make progress. We need our social workers and our police to be empowered to work with the people best able to reach the children in trouble. That means trusted community groups and charities who know their patch, but it means parents, too. The mums I have worked with over the years have been so very impressive in their dedication and perceptiveness about what has gone wrong. Social workers, police officers and even teachers sometimes have a bit of suspicious attitude towards the mums, and that has to change.

The Commission on Young Lives is working on this issue and will publish a report in the coming weeks. I want the Government to actively engage with it. If the Minister is able, I would like her to commit to meet me, Barnardo’s and the Children’s Society to talk about a statutory definition of child criminal exploitation ahead of the victims Bill. The role of a parent in a young person’s life is limited, especially once a groomer has got their hooks in them; but they are so often the best ally that we have, and they must be listened to and respected. Family has to be treated as part of the solution for preventing youth crime.

14:47

[Tom Hunt (Ipswich) (Con)]

It is a pleasure to serve under your chairmanship, Mr Robertson. It is surprising to be called so early in the debate. I thank my hon. Friend the Member for Stockton South (Matt Vickers) for sponsoring this debate, which is of relevance to many right hon. and hon. Members in this place.

Sadly, Ipswich has been at the heart of much crime and antisocial behaviour, some incredibly serious, and some seemingly less serious but perhaps connected to the most serious crime. We have had some tragic incidents in Ipswich over the last few years. Tavis Spencer-Aitkens was brutally murdered three years ago outside his father’s home, as a result of county lines and gang violence in Ipswich. Richard Day, an Ipswich man, was killed in the town centre in tragic circumstances.

There are some things we can do that some may say involve us getting tougher with crime, particularly when it comes to sentencing, to make sure that those who commit the most serious crimes are appropriately punished. From time to time Members will see me speaking to that. But it is not just about having a tough approach to sentencing. We also need to spend some time thinking about the lives that a lot of these individuals lead, to put ourselves in their shoes and to imagine that we are them, and that we are in a school where we are not successful, perhaps because we have learning disabilities—we know that the proportion of those in prison with learning disabilities is incredibly high.

If an individual does not feel like a success at school because they are not getting the success that they need, their needs are not being met, and they go back home and potentially there are problems with their home life, and there is nothing to do in their local area—no club for them to join, and they cannot get a sense of belonging from anywhere—the brutal reality is that, for some, joining a gang does give them that sense of belonging. The way to tackle that is to give them a positive sense of belonging. If we put ourselves in their shoes, we want to have the positive pulls and less of the negative pulls.

What I actually want to talk about today is the seemingly less serious antisocial behaviour. We say “less serious”, but in the minds of many of my constituents it is very serious. I lose count of the number of times that I talk to constituents—long-term Ipswich residents who have lived in Ipswich their whole life—who are critical of the town centre. Often I think they can be unfairly critical of the town centre, because we have some fantastic businesses in the town centre that work incredibly hard to make it an attractive destination. Most of the residents’ concerns are to do with antisocial behaviour and not feeling safe in the town centre.

If we are to have a conversation about regenerating our town centre, by all means let us engage in a debate about business rates reform, town deals and levelling-up funds, but we also need to have a conversation about crime and the fear of crime, because if that is deterring people—my constituents—from going into the town centre to spend money, we need to deal with that as well.

I want to touch now on an issue on which not everyone will agree, which is to do with large groups of individuals—more often than not young men—who congregate in and around the town centre, more often than not drinking alcohol, often leaving litter afterwards, and acting in an incredibly antisocial way. Constituents get in contact because they, or often their daughters, have been on the receiving end of inappropriate comments and have been made to feel intimidated while going about their business. That is simply unacceptable.

I often talk to the police and ask, “What opportunity is there to disperse these groups?”, because I think that should be part of the police’s remit, and they often say, “Unless they are clearly breaking the law and it is really obvious, there is nothing we can do.” I would personally like to see the police empowered to play their role in making our public spaces safe, secure environments in which the law-abiding majority feel safe, and that they want to go to.

There is an element here of tolerance, which is important, but I think we should be intolerant of antisocial behaviour. I do not care who it is who is forming in large groups, acting in an antisocial way, making people feel uncomfortable; I do not care where they are from. If their behaviour is not acceptable, it needs to be communicated to them.

There is a number of things that we can do, and I have touched on one of them, which is the police having more of a remit to disperse groups of young men who are having a detrimental impact on the town centre in Ipswich. We also need fair police funding in Ipswich. We know that Suffolk is one of the most unfairly funded police authorities in the country, so we need a commitment to review the national police funding formula as soon as possible. I must stop going on and draw my comments to a close. Thank you for indulging me, Mr Robertson, and allowing me to go over the time limit.

15:03

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I congratulate the hon. Member for Stockton South (Matt Vickers) on securing this debate. I know that hon. Members across the House will agree that it is the sense of community—that coming together of people, and the genuine care and compassion that we show each other—that makes our communities great. One benefit of having such an amazing community in Newcastle upon Tyne North is that we have some fantastic community groups, such as the D2 youth project in Newbiggin Hall, the Denton Youth and Community Project in West Denton, and Inspire Youth. Those and many more organisations work incredibly hard to keep young people off the streets and prevent them from falling into crime—something that I know is a major focus for our police and crime commissioner, Kim McGuinness, in Northumbria, who helps to fund many of these projects.

Yet we have to accept that there is a limit to what local agencies can do and what the police can do, despite the bravery and hard work of officers, when we have seen 10 years of devastating cuts to our policing and criminal justice system under Conservative Governments.

Significant pockets of antisocial behaviour simply blight parts of my constituency, in areas where decent people are just trying to get on with their lives. We continue to see significant issues in Newbiggin Hall, with persistent crime and vandalism affecting the day-to-day lives of many people. There are also general concerns about antisocial behaviour across Newbiggin Hall, including motorcycle disorder and drug dealing. West Denton has also seen a significant increase in antisocial behaviour in recent years. In just one week last year, the fire brigade was called out on six out of seven days for fires in the same street. While constituents most frequently raise problems with Newbiggin Hall and West Denton, I know that other neighbourhoods struggle with antisocial behaviour issues. It is unacceptable that any of our constituents should feel unsafe in their own homes, or feel they have to watch their backs when they walk to the shops or worry that their children are sliding into a life of crime, but unfortunately that is the reality for many of my constituents.

The Government have no shortage of rhetoric on crime. Ministers like to tell us how tough they will be and how harshly they will punish the criminals that we manage to catch, but for all the tough talk, the truth is that Conservative cuts to frontline policing and the criminal justice system have caused the proportion of reported crimes ending in prosecution to plummet over the last 10 years. For example, in 2013-14, more than a quarter of violence against the person offences recorded by police in England and Wales ended in prosecution; in 2016, it was around 17%. By 2019-20 and 2020-21, it had fallen to just 6% and 9% respectively.

Tough talk and harsh punishments will not stop these people making our constituents’ lives a nightmare while the Government refuse to give the police the resources to catch them in the first place, and the justice system the ability to see it through. I am afraid to say that this has created an environment where antisocial behaviour can be seen to take place with relative impunity. That is incredibly frustrating for those on the receiving end of it. We know that the police are recruiting 20,000 new officers to partially compensate for past cuts, but Ministers have shown far less interest in replacing the backroom staff essential to supporting their colleagues out on the beat. That means that police officers will still be pulled into administrative duties that do not require a trained police officer.

The first duty of any state is to ensure the safety of its people. After 10 years of various Conservative Governments hollowing out the police and criminal justice system, the British state, for many of my constituents, is simply failing in that duty. We need a Labour Government that will put community safety first. That means more police out there tackling crime, antisocial behaviour and dangerous driving—the things they came into the force to do. It means funding and restoring youth projects and treatment services that prevent crime. It means providing real support and justice for victims.

15:08

[Jacob Young (Redcar) (Con)]

I thank my fellow Teessider, my hon. Friend the Member for Stockton South (Matt Vickers), for introducing this debate on this vital issue. It is a privilege to serve under your chairmanship for the first time, I believe, Mr Robertson.

Antisocial behaviour is a significant issue in Redcar and Cleveland, endangering lives, perpetuating crime, damaging protected habitat and ruining the life chances of young people. A particular element of antisocial behaviour in Redcar and Cleveland is a result of the illegal use of off-road motorbikes, unlicensed and uninsured, incidents of which have been making people’s lives miserable, particularly in areas such as Eston, Normanby, Teesville, Grangetown and South Bank. There have been widespread reports from local people of these off-road bikes being used to ferry drugs between dealers, sometimes sadly exploiting young children in the process, as the hon. Member for West Ham (Ms Brown) outlined in Kofi’s awful story. This exploitation is abuse, tragically ruining the lives of young people, greatly endangering public health and damaging the living environment of the people I represent.

Despite attempts by Redcar and Cleveland Council to block off the unofficial routes that these criminals use, including more than £15,000 spent trying to protect Eston Hills alone, the problem persists. Additionally, efforts by Cleveland police to tackle the problem have been largely fruitless, often hampered by the sheer scale of the task, with police resources spread thin over such a wide area.

Many people feel powerless, to the point where some of my constituents have ceased even reporting incidents of this criminality. There is the feeling that nothing will be done. This must change. I want to make a plea to my constituents who experience or witness this type of antisocial behaviour. It is imperative that they report it. Each phone call helps the police colour their picture and enables them to better pursue the individuals responsible.

Beyond the menace of off-road bikes, another antisocial behaviour problem in Redcar and Cleveland is kerbside gangs. Gangs of youths are causing minor criminal damage, while terrorising estates, and there are vulnerable people, such as the elderly or disabled, living on these estates. I support Cleveland police in wanting to see the courts become more stringent in pushing parental orders, whereby parents can be held responsible for their child’s behaviour, and that goes to the heart of the problem.

Although we have a Home Office Minister responding to today’s debate, and although antisocial behaviour often involves criminal behaviour, this is not a problem that the police or Government alone can resolve. I believe that it is for us as a society to create spaces where young people, especially young boys, are able to find purpose and self-worth. Frankie Wales’s boxing club in Redcar is a perfect example. He helps young boys in Redcar and Cleveland not only to learn to box, but to achieve their potential and value their community, belonging to a positive gang. My hon. Friend the Member for Ipswich (Tom Hunt) touched on that in his comments.

Alongside his boxing club at Coatham Memorial Hall, Frankie hosts inter-generational events, where the young people he engages with on a day-to-day basis serve local care home residents and elderly people. In so doing, they learn the value of supporting their wider community. This surely is a shining example of the third sector helping to tackle issues of antisocial behaviour in a way that national and local authorities and the police never could. It may be charities, churches or community groups, such as Frankie’s boxing club, the Chris Cave Foundation or the Ladies of Steel youth club in Dormanstown. They demonstrate that it is only by coming together as a society that we can tackle antisocial behaviour. I believe we should do all we can to support them.

15:12

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mr Robertson, and I pay tribute to the hon. Member for Stockton South (Matt Vickers) for securing this important debate.

I have listened to hon. Members talking about issues that affect a number of our constituents. Left unresolved and untreated, these issues can get out of hand and can, unfortunately, result in dangerous events, including murder. We have to be honest: for a number of our young people up and down the country, the opportunities available to them are disappearing fast. The opportunities that existed in our youth clubs and after-school centres have been cut due to the successive underfunding of our local government. We need to address that if we are going to tackle antisocial behaviour.

Last July, I attended the memorial event for Jahreau Shepherd, a champion mixed martial arts fighter, who was tragically stabbed near Sancroft Street in my constituency. There were a number of his family members there that day. I will not forget speaking to his mother; I heard her pain, loss and suffering from losing a loving son. He had got his life back on track and was an inspirational figure in the community. Tragically, Jahreau was stabbed by his own half-brother, who he had acted like a father figure to, encouraging him to sort out his life and fix up. However, his half-brother suffered from major mood swings and was sentenced for manslaughter with diminished responsibility at the Old Bailey.

As the MP for Vauxhall, which is just across the river from here, I am never heartbroken or struck by those tragic cases that I unfortunately have to hear, because sadly, in my short two years of being an MP, I have had too many of those conversations. I have had to comfort mothers and fathers, brothers and sisters, aunties and uncles, and grandparents. Too many have seen the shocking impact of youth crime and antisocial behaviour when it spirals out of control. I have talked to them when they are saying goodbye to their loved ones, thinking about the future that some of those young people could have had, sitting in front rooms and looking at pictures on the wall of those innocent young children—because they are children.

We have to be honest and identify the causes of youth crime among our young people, which are complex and varied. It is not just a matter of victims versus criminals; a case of just lock them up, go hard on them and throw away the key. Many of our young people who tragically fall into this are actually victims of crime themselves, and have gone through such difficult childhoods. Some hon. Members state that we just need parents to be tougher, but those parents are struggling as well. Those parents had complex childhoods and need help. That is the pattern. If we do not fund properly, we will keep seeing this repeated over and over again for generations.

We have to address the issue of childhood trauma, because many of those children, as my hon. Friend the Member for West Ham (Ms Brown) highlighted, are being exploited. They are victims of older people exploiting them, in some cases children as young as 10. We have to look at how we address that. We cannot keep treating the issue as them versus us. We need to look at how we support some of our young people, instead of trying to push them into a punitive justice system. We need to stop pigeonholing these young people, some of whom are barely out of school.

I am grateful to the many youth workers and youth clubs across my constituency who do fantastic work with our young people and their families, including the Black Prince Trust, Bright Centres and Young People Matter. They are working day in, day out to ensure that those young people do not get caught up in youth crime or antisocial behaviour, but the reality is that they groups cannot do it on their own. They have suffered massive cuts over the past few years. Just last Friday I was with Young People Matter, trying to save the community group it has been operating in for a number of years. The housing association is trying to force it out and the alternative provided is not suitable. Will the Minister recognise the vital work that such groups do? How will the Government support them in delivering the funding so that they can continue working in this area?

Shortly after I was elected in 2019, I was one of the first people on site when a stabbing took place outside Kennington station, just over the border of my constituency, on 7 January 2020. I was one of the first people to help that young boy, who was just 15, by putting pressure on the wound. I said in my maiden speech that we cannot allow ourselves to become desensitised to the issue of violent youth crime.

We have to look at how to get adequate funding for mental health services for our young people. We have seen the devastating impact of covid-19 on mental health services for our young people. Will the Minister please ensure that there is vital support for young people? This is now a priority to help all of us—families, young people, practitioners, the police and the wider community—effectively address youth violence and antisocial behaviour.

15:18

[Gareth Thomas (Harrow West) (Lab/Co-op)]

I am grateful to the hon. Member for Stockton South (Matt Vickers) for securing this debate, although, as a father of two young children, I find it slightly unnerving to be reminded of my parental responsibilities for their future behaviour.

I have been fortunate to listen to some great speeches and, as a result, intend to be entirely parochial in my comments about the needs of my constituency. My constituents, who are worried about antisocial behaviour and youth crime, want to see five things. First, they want more police and, crucially, more sympathetic policing. We are fortunate in having strong local leadership across the three boroughs of which Harrow is part, but we certainly do not have the level of local policing that we had under the previous Labour Government, when each ward and community had a sergeant, three police constables and three or four police community support officers, able to take real local intelligence and use it in a sensitive way to get better police outcomes.

I would like to see stronger action by the British Transport police around the many transport hubs in my constituency. We need to see enforcement activity that people know about, and that helps to offer comfort to people who are worried that they might be victims of antisocial behaviour around those transport hubs. I think particularly about some of the comments that young women have made to me about the sexual harassment that they have faced in one or two of those transport hubs in particular.

A national point that I would make, which is reflected in Harrow, and echoes a point made by my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell), is about the justice system. Quicker action by the courts to process the cases of young people accused of wrongdoing is essential. I was struck by the report by Her Majesty’s inspectorate of probation, which found that at the end of 2020 the backlog of children awaiting court appearances in England and Wales had increased by more than 50% compared with the same period the previous year. One can understand that in the context of covid a little, but it is striking that the pattern of such backlogs has been increasing since 2010.

The chair of the Criminal Bar Association has made a similar point—that there were cases of 17-year-olds awaiting trial who were not likely to have their cases come to court until next year at the earliest. Those delays can only mean anguish and fear for victims, more uncertainty for those accused children, and the sense that there is somehow impunity for the worst cases of antisocial behaviour.

As other Members on both the Government and Opposition Benches have alluded to, we need more support for schools to support young people who are at risk of being bullied and who are at risk of getting in with gangs, and more support for activities that they can join in the holidays or after school. Too many of those activities, because of austerity over the last 10 years, are no longer available.

On a more general point, we need action on the poverty that too many young people in my community in Harrow are experiencing, which prevents them being able to do their homework when they want to or being able to take part in other activities that my children will take for granted, because their parents simply cannot afford them.

Action is essential going forward. What specific action does that mean? Harrow missed out in the announcement by the Metropolitan Police Commissioner in October last year on getting a dedicated police team for the centre of our area. I hope that will be rectified as a matter of urgency. Harrow town centre has many redeeming features, with many great businesses, but it is still scarred on occasion by antisocial behaviour. Having a dedicated police team for that town centre to mirror the one in the Prime Minister’s constituency in Uxbridge would be extremely welcome.

As I already alluded to, the British Transport police have to take stronger action and be a stronger presence around Harrow-on-the-Hill station and Harrow and Wealdstone station, which young people and older people consistently report as places where they are worried about being attacked or do not feel safe.

Lastly, I want to praise the work of the Young Harrow Foundation and its excellent chief executive, Dan Burke. Working with Harrow Council, Harrow schools, the police and the NHS, he has set out in some detail the concerns of young people in Harrow aged between nine and 18. Some 6,000 of them were interviewed about the challenges they face, and issues around support for their mental health and for more activities that they can take part in during holidays and after school are urgent. More support for those types of organisations, which want to bring funding into my constituency, would be extremely welcome.

15:25

[Jim Shannon (Strangford) (DUP)]

Thank you, Mr Robertson, for enabling me to speak in this debate. I thank the hon. Member for Stockton South (Matt Vickers) for securing and leading the debate, and for his comments. I have three things to say. First, I support what he is putting forward and his contribution—and the contribution of others as well. Secondly, I want to offer a Northern Ireland perspective, as I always do. The Minister does not have responsibility for Northern Ireland, so she will not have to answer the points of view that I will put forward, but they are to add relevance to this debate and to put forward some ideas for how we can improve. Thirdly, I will refer to one very active organisation in my constituency of Strangford, and suggest to the Minister and others here that that organisation could work alongside the police, community groups and community leaders to address the issues. It has done that in my constituency, which is why I want to talk about it.

To say that I am somewhat concerned about the rates of antisocial behaviour and youth crime is an understatement. The rates have increased significantly because of the covid-19 pandemic, and some of the figures that I will give are quite significant and worrying. Powers must be given to local authorities to help address that. I have heard the hon. Member for Keighley (Robbie Moore) speak a number of times about antisocial behaviour, and not just in Westminster Hall but in the main Chamber. He referred to those who race about in cars, and others have referred to that issue as well. Sometimes they use their Twitter or Facebook accounts to tell people where to be. Back home, the police monitor those sites and are able to be there when the young people arrive. I am sure that has been done. If it has not, it should be, because it is another method of addressing the issue.

Antisocial behaviour encompasses the criminal and nuisance behaviour of all kinds, most notably noisy neighbours, public drunkenness, street drug dealing, littering and loitering, which other hon. Members have referred to. Pre-pandemic, in 2019, the United Kingdom’s antisocial behaviour crime rate was 22 per 1,000 people. For 2020, the first full year of living with covid, that figure increased to 29 per 1,000, so it is quite clear that the pandemic has, as with nearly everything in life, changed things dramatically—and not for the better.

For Northern Ireland, instances of antisocial behaviour and youth crime have also been increasing, according to the Northern Ireland Statistics and Research Agency. The rise has been described as “substantial”. In the 12 months from March 2020 to February 2021, there were almost 74,000 antisocial behaviour incidents in Northern Ireland, which is an increase of almost 19,000, or 34.1%, on the previous 12 months. On the mainland, incidents are up 24%. That is quite worrying. Northern Ireland’s figure is the highest rolling 12-month figure since the period of June 2010 to May 2011—some 11 years ago. In addition to this, all 11 policing districts showed high levels of antisocial behaviour. We cannot simply blame the pandemic for the increase in antisocial behaviour and youth crime in society; I believe that it goes deeper. The Minister will obviously respond to the comments that others have made.

Antisocial behaviour has been an issue in my constituency for as long as I have been an elected representative, which is not since yesterday—I first started as a councillor in 1985. I served on the police partnership board at that time. I believe that we made some significant steps in trying to address antisocial behaviour. Not only did we employ officers in the council to liaise and work alongside the police service in Northern Ireland; we also engaged with other community groups to try to address those issues—such factors as family environment, domestic violence and struggles in young people’s education. Others, including the hon. Member for Vauxhall (Florence Eshalomi), referred to those. Studies found that children who struggle in domestic settings or in school are more likely to be involved in crime and partake in antisocial behaviour. I thank my neighbourhood policing teams and council officers for what they do. Ards and North Down Borough Council policing teams do brilliant work in reducing the rates of antisocial behaviour in Strangford.

I am conscious of time, Mr Robertson, which is going by quicker than I had realised. Street pastors have been significant in my constituency, and have worked alongside the police and the council antisocial officers. They ensure that people who are intoxicated, or whatever it may be, get home. They are there to provide help to ladies who lose their shoes—it happens—or those who need a drink of water, or those who just need somebody to talk to. I am sure the Minister and other hon. Members already know this, but Street Pastors is one of the organisations that can help. It wants to help and, in my constituency, it has.

To conclude, I urge the Minister to undertake discussions with the devolved Administrations to see what we are doing, in order to share and learn, which is what we want to do as well, and to put in place more police to deal with the rise in antisocial behaviour in our constituencies. I encourage the Minister to look at the prison system, to see if improvements could be made to make prison a beneficial time for young people, to educate them and make reoffending an unlikely route for them to go down.

15:31

[Ian Byrne (Liverpool, West Derby) (Lab)]

It is an honour to serve under your chairship, Mr Robertson. I thank the hon. Member for Stockton South (Matt Vickers) for securing this incredibly important debate.

I start by paying tribute to constituents, families and young people in Liverpool, West Derby who are living through the real-life consequences of austerity. It has decimated the provision of youth clubs, youth workers and the services that helped to shape my life experiences, and those of so many others like me, growing up in Thatcher’s Britain in the 1980s. I owe such a debt of gratitude to the youth workers who guided me and so many others through such a difficult period in our city’s history. The relationships we formed with those youth workers, and their guidance and wise counsel, are the reason I can stand here today participating in this debate. It was interesting to listen to Ian Wright say something extremely similar on TV on Saturday.

That crucial safety net has now been removed, and our communities are living through the consequences. Youth provision is almost non-existent, with vulnerable children roaming the streets, getting into gangs and trouble. We have recently seen fatalities in Liverpool due to knife crime, with children killing children, devasting whole communities and families. Youth centres are shut, and sometimes the only sporting facilities available in my constituency are privatised facilities that charge £70 an hour to families struggling through austerity and now a cost-of-living crisis. Many of our children have not got a chance if opportunities and facilities are not available to all.

I place on the record my thanks to all the service staff, teachers, parents, community groups and police across West Derby, especially Anfield Sports and Community Centre, Action for Children, the Young Person’s Advisory Service and Alder Hey staff, and I acknowledge the work being done by the No More Knives and Real Men Don’t Carry Knives campaigns. These people are doing so much across our city to support young people through such difficult times.

There is a massive effort being made across Liverpool to support and nurture our young children, but we desperately need funding and policy changes from central Government. Since austerity began in 2010 under the Conservative-Lib Dem coalition, Liverpool City Council has seen its funding reduced by 65%. Despite the Government declaring that the age of austerity is over, the cuts to our funding continue, and the consequences for our young people, and the youth services and facilities they need, continue to be felt.

According to research by the trade union Unison, between 2010 and 2019, youth services in the UK suffered cuts of £400 million. That will have meant the loss of 4,500 youth work jobs and the closure of more than 760 youth centres since 2012. It is shameful. According to a February 2021 survey by UK Youth on the impact of covid-19 on youth services, 66% of the 1,759 organisations surveyed said there had been an increase in demand. Despite the greater need for their services, 83% reported that their funding had decreased, while 64% said they were at risk of closure in the next 12 months. Research by the British Association for Counselling and Psychotherapy found that 80% of young people say that their mental health has worsened during the covid-19 outbreak.

As I have said, we desperately need the funding and policies from the Government to support, nurture and invest in our young people. In her response, will the Minister commit to providing the vital funding that councils need to invest in youth services and facilities for our young people? As I have mentioned, so many facilities have been lost in the last decade, and I do not doubt the positive outcomes they would have had for so many young people had they remained open.

Will the Minister explain the Government’s strategy to support pupils and schools so that young people do not face exclusion and the lifelong damage that can cause? Will she also commit to funding young people’s mental health services, as well as early intervention mentoring programmes and specialist children’s services? This should not be a postcode lottery. We need provisions for our youth and preventive measures put in place as an investment to ensure that all our children have a level playing field and a bright future.

I hear the words “levelling up” a lot from Government Members. Let us put it into practice and restore the youth provision we have lost to all, so that the phrase actually means something to our children.

[Mr Laurence Robertson (in the Chair)]

We need to leave a couple of minutes at the end for the mover of the motion to respond. I call Sarah Jones.

15:36

[Sarah Jones (Croydon Central) (Lab)]

Thank you, Mr Robertson; it is a pleasure to serve under your chairmanship. I congratulate the hon. Member for Stockton South (Matt Vickers) on securing the debate, which has been interesting; I agreed with virtually everything he said. Antisocial behaviour has been trivialised, downplayed and dismissed in recent times. He said that we have a moral obligation to ensure that every child gets the opportunities they need to make the best of their life, that this is about more than just policing—it is about schools, local authorities and youth work—and that enough is enough. I think he will get a shock when he realises that his party has been in government for the last 11 years and has caused significant cuts that have driven a lot of the problems we face today.

I congratulate all hon. Members on their speeches. My hon. Friend the Member for Pontypridd (Alex Davies-Jones) talked about the impact of covid, which is really important in how we look at this issue. The hon. Member for Keighley (Robbie Moore) talked about youth workers and how important they are, and we heard from my hon. Friend the Member for Liverpool, West Derby (Ian Byrne) just now about the impact of cuts to youth work across the country. My hon. Friend the Member for West Ham (Ms Brown) is such a fantastic campaigner on county lines and has been for a long time, and I add to her plea for the Government to look at the issue of defining child criminal exploitation. As it happens, an amendment calling for a definition is going through the House of Lords as we speak, so there is an opportunity in the Lords for the Government to support my hon. Friend’s cause, and we would welcome that.

The hon. Member for Ipswich (Tom Hunt) represents an interesting area; some good progress has been made on county lines in East Anglia. It is one of the only areas in the country where there has been some progress, but there is still a lot to be done. My hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) spoke about the wonderful police and crime commissioner, Kim McGuinness, and the work she is doing. I was up there just before Christmas and worked with her; I went to St James’s Park and saw the wonderful youth work the football club is doing to try to ensure that people have opportunities. The hon. Member for Redcar (Jacob Young) represents an important part of the country; a lot of the problems that are being debated now existed 20 years ago when I was working for Mo Mowlam.

My hon. Friend the Member for Vauxhall (Florence Eshalomi) spoke movingly, as always, about the really big challenges we face with youth violence, which I have in my constituency as well. My hon. Friend the Member for Harrow West (Gareth Thomas) talked about those massively long waiting times. We cannot expect our young people to understand justice when the justice system does not work; it makes no sense and it cannot be done. The hon. Member for Strangford (Jim Shannon) spoke about council workers and the importance of tackling antisocial behaviour through local councils. Of course, our local councils have been absolutely decimated, so that is very difficult. Finally, my hon. Friend the Member for Liverpool, West Derby told a personal story about how important youth work is. I think we all collectively agree with all of that.

I am pleased to follow so many good speeches. Since becoming an MP, I have spent five years campaigning against knife crime, and in my role as shadow Policing Minister I have been around the country in the past few months, looking at antisocial behaviour and seeing a lot of the issues. We can see how antisocial behaviour, which is defined as low-level but which I do not think is low-level at all, can spread and become more serious crime over time, exactly as hon. Members have said.

Everyone has a basic right to be safe in their community. Sadly, after the past 11 years our streets have become less safe. We have talked about prosecution rates; criminals are literally getting away with it under this Government. Only 6.5% of all crimes—a little over one in 20—lead to a prosecution, and the charge rate has halved over the past five years. Those figures are extraordinary. Criminals can pretty much get away with it.

[Ms Lyn Brown]

They have never had it so good.

[Sarah Jones]

Exactly. Whether people live in the city or in the country, they worry about their kids going out on the streets and getting into drugs. People can go online and buy any drug they want; on the “Today” programme only this morning, Claire Campbell spoke about her son, who died of an overdose after buying drugs online. There is a whole world of problems. Police struggle because they have to become social workers due to the impact of mental health cuts and the like. Serious organised criminals have got a real grip, and the UK is Europe’s largest heroin market—I think that statistic is extraordinary and shows how much work we have to do.

Antisocial behaviour is up 7% in the past year, with 1.8 million incidents recorded. To say that it is ignored by this Government is an understatement. There is no way of measuring the problem because it does not form part of the statistics under the Home Office’s counting rules. The way local authorities treat antisocial behaviour varies: some areas are good, while some are hopeless. I have made a series of freedom of information requests; I will not go into them all now, because they will come out shortly, but one council had 248 recorded incidents of antisocial behaviour and did 150 investigations, which resulted in no enforcement action whatever. Some boroughs really are struggling to do anything, and some are doing good things.

When I was going around the country, I saw a lot of good activity on antisocial behaviour. Rhyl was a particular favourite: for a start, there are more police community support officers on the street there, because the Welsh Government have funded more PCSOs over and above Government funding and they are crucial to preventing antisocial behaviour. There was a wonderful project with people you would describe as hoodlums out on the street, doing whatever they were doing. Youth workers went out to where they were, got involved with them and got them involved in sport. They took them up Snowdon, which was completely out of their comfort zone—they had not done anything like that before—and now they are doing their Duke of Edinburgh’s award. It was a complete transformation—how wonderful.

I went to see the Peel project in Hull. A park had become a horrible place for antisocial behaviour, with drug taking and kids hanging around, but the police gave a local organisation some shipping containers. It put a load of sports stuff in and based a little office in the park, and now the park is now a lovely place where people do sport and come together because there are adults, some structure and some things to do. It is not rocket science, but in so many places it is simply not done because the funding is not there.

Let me move on to youth crime. A 15-year-old boy, Zaian, was murdered in my constituency just before new year’s eve in the park I used to play in. On the same day, another boy became the 30th teenager to be murdered in London last year. Research from the organisation Crest shows that between 2014 and 2019 there was a 56% rise in knife possession offences for 10 to 17-year-olds, which is extraordinary. The organisation says that those who commit robbery and use weapons before the age of 18 are much more likely to have long criminal careers than young people who commit less serious crimes. Arrests of 10 to 17-year-olds make up a growing proportion of arrests for robbery—the statistics go on.

Anne Longfield, who was such a brilliant Children’s Commissioner, brought out a report this week that shows that spending on early intervention has reduced by almost two thirds over the past 10 years. What can we do with a third of what we had before? We know that these problems start young, and the Sutton Trust tells us that 1,000 family centres closed over the same period. Youth services were cut by about 40%—and by much more in some parts of the country—and the number of children given treatment by child and adolescent mental health services was massively reduced and they had to wait for long periods. We know what the problems are.

On top of that we can add the fact that we have so few police officers compared with what we need. Some 50% of PCSOs have been cut, and the Government have no plans to bring any of them back. We are still 10,000 short of the number of officers we used to have and, as was pointed out, a lot of officers are spending time doing other roles because of the cuts to police staff.

Labour says that there is nothing more important than keeping people safe, and we have a plan to provide new police hubs that will be visible in every community as a place where the public can go and talk to the police and other agencies in person. We will have new neighbourhood prevention teams to bring together the police, community support officers, youth workers and local authority staff to tackle crime. These teams would prioritise being visible and would pursue serial perpetrators of antisocial behaviour.

I appreciate that I need to end my speech, but I will just ask the Minister a series of questions. Will she consider bringing back the 50% of PCSOs we have lost? Will she speak to the request from the hon. Member for Stockton South for antisocial behaviour to be measured nationally in a better way? Will she address the request from my hon. Friend the Member for West Ham for child criminal exploitation to become a priority, and will she look at tackling crime and antisocial behaviour with real force from the Home Office? The Home Office too often blames local police forces and does not provide leadership, and often it is not one step ahead of the criminals but one step behind. We need real leadership from the Home Office and cross-Government working to tackle these very significant and increasing problems.

15:47

[The Parliamentary Under-Secretary of State for the Home Department (Rachel Maclean)]

It is a huge pleasure to serve under your exemplary chairmanship, Mr Robertson. I thank my hon. Friend the Member for Stockton South (Matt Vickers) for securing this important debate. It has been a wide-ranging debate touching on vital issues that affect all our constituents and all our communities. I thank him very much for bringing to my attention and to that of Home Office officials the courage of the individuals in the cases he mentioned. All the Members in this debate have brought personal stories to the fore, and I commend them for doing so and their constituents for coming forward.

We would think from listening to the hon. Member for Croydon Central (Sarah Jones)—it is a pleasure to follow her, and we do have a good debating relationship—that the Government are doing nothing on this, so let me start by saying that this Government have put beating crime front and centre. It is a key part of the levelling-up agenda to tackle antisocial behaviour, youth crime and wider crimes. At no stage do we believe or think that this is low-level behaviour; we never underestimate the impact that it has on communities, public spaces and the law-abiding majority who want to go about their business. We have seen so much in the pandemic that the enjoyment of public spaces is vital for mental and physical health, and we are firmly and fully committed to tackling and preventing crime, youth crime and antisocial behaviour.

In the constituency of my hon. Friend the Member for Stockton South alone, Cleveland police has recruited 194 additional police officers and will be receiving £157 million in funding, which is an increase of up to £7.7 million on previous years. That is replicated around England and Wales. Across the country, we have recruited 11,053 officers towards the 20,000 target, which was set out at the last general election, for England and Wales. Some Members from Wales are here, and I am sure they will welcome that funding from Conservative central Government. The police across the country will receive £15.9 billion for this financial year. I am sure we can all agree that these are significant amounts of public money being dedicated by this Conservative Government to this vital priority.

If we are to successfully address antisocial behaviour and youth crime, it is vital that Government, local authorities, frontline professionals and voluntary sector partners work together. That is at the heart of our plan. I commend all the Members who mentioned the community groups and various charities that are working so hard in this area. I have the same experience in my Redditch constituency. Those groups can do some things that the state cannot, no matter how well-funded and well-meaning it is. As the hon. Member for Liverpool, West Derby (Ian Byrne) eloquently said, they can reach people who are out of reach, and it is vital that they continue to do so.

[Jim Shannon]

In my contribution, I referred to Street Pastors as one such organisation. I am aware that it works in the constituency of the hon. Member for Vauxhall (Florence Eshalomi), as it does in others. What discussions has the Minister had with Street Pastors about using that voluntary service for the betterment of all the community?

[Rachel Maclean]

I thank the hon. Gentleman so much for raising that. I strongly support that service with all my heart. I have seen how Street Pastors works effectively, especially in the night-time economy. We have debated violence against women and girls, and the Home Office has funded a number of such schemes and enabled local authorities to roll them out in their local areas.

Antisocial behaviour comes in various forms and guises. It differs from community to community, which is why it is important that there are flexible local powers that can be used, along with local knowledge of an area from local communities and the other agencies in it.

Members will be familiar with the changes that were made following the introduction of the Anti-social Behaviour, Crime and Policing Act 2014. A number of tools and powers were introduced at that time. Some of those powers can be issued by a court, and they impose positive restrictions or requirements on an individual convicted of a criminal offence who has engaged in behaviour that has caused, or is likely to cause, harassment, alarm and distress. One of those powers is a community trigger, which is a vital safety net. My hon. Friend the Member for Stockton South made a point about the burden of evidence on communities. I encourage him to come back to me to have a detailed discussion with my officials. We are very keen to hear how we can improve that so that these powers work effectively for his community and others.

I do not have a huge amount of time left. I want to focus my remarks on parenting orders, which Members have raised.

[Ms Lyn Brown]

Will the Minister give way?

[Rachel Maclean]

I am really sorry, but I—

[Ms Brown]

I just want to get a commitment to a meeting.

[Rachel Maclean]

I will save the hon. Member the trouble; I will happily meet her. However, I want her to know that the Home Office is working with and funding the Children’s Society on many of the issues that she rightly touched on. Modern slavery is a vital part of the Government’s plan.

A parenting order is not the only way in which we can require families to engage with the authorities and tackle this behaviour at the source. Very often, youth offending teams work with parents on a voluntary basis. The experience is that parents often engage readily and take part in specific programmes, including parenting programmes, and that can have a very helpful, positive outcome. However, when that does not work, youth offending teams can ensure compliance and encourage engagement by issuing warning letters and using compliance panels. Consistent non-compliance without a good reason can lead to a police investigation and proceedings in court. Non-compliance may lead the court to issue a fine of up to £1,000, a probation order, a curfew order or an absolute or conditional discharge.

The hon. Member for West Ham (Ms Brown) raised county lines. I have a huge amount of respect for her, but unfortunately, she did not credit the work that has been going on nationally on county lines. I want to update her: since 2019, the police have closed more than 1,500 county lines, made over 7,400 arrests, seized £4.3 million in cash and drugs and safeguarded more than 4,000 people. Whatever party Members are from, I am sure that they can welcome that achievement.

[Ms Lyn Brown]

Will the Minister give way?

[Rachel Maclean]

I am afraid I will not. I have such a lot to say and I have had less time than the Opposition spokesperson, the hon. Member for Croydon Central, and other Members.

We are investing £560 million in youth services in England over the next three years, including the youth investment fund, to transform the Government’s offer to young people and to level up opportunities right across the country. To kick-start the youth investment programme, an additional £10 million will be spent this year in key levelling-up areas to enable local youth providers, such as the ones that many Members have mentioned, to invest in projects and expand the reach, number and range of services that they currently offer. I think that we all agree that these types of crimes have complex roots, and they often go back generations. We must tackle the causes of crime as well as having the appropriate powers, enforcement and sentences.

I will touch briefly on the safer streets fund, as it is extremely relevant to many of the issues raised by Members. I am sure that my hon. Friend the Member for Stockton South knows this, but may I remind him that Cleveland police have £366,289 from the safer streets fund, and that that project will carry out a variety of crime prevention measures, including 30 new or upgraded CCTV cameras, refurbishment of four alley gates and bespoke target-hardening measures for residents’ homes. It is these basic safety measures that can give confidence to communities that the presence and the security are there.

Overall, across the country, the Government have invested £70 million in the first three rounds of the safer streets fund. This financial year alone, the fund is supporting 107 local crime prevention projects to implement interventions such as improved street lighting, increased CCTV, increased presence of “guardians” to deter crime, and, pivotally, training to change attitudes and behaviours.

Most of these measures are set out in the Government’s beating crime plan. I encourage all Members to read the plan. It is a key manifesto commitment of this Government to get crime down and to set out how we will tackle crime and the causes of crime. It is a targeted approach to places, people and the business of crime underpinned by getting those basics right. The whole plan is supported by an unwavering commitment to the police that we will do everything in our power to combat crime and work out what actually works in keeping our country safe.

We are working with practitioners and experts who deal with this issue day in, day out. In a further strand, which is vital, we are working across the country with partners to establish principles for a strong and effective partnership response to antisocial behaviour. That is why we have undertaken the police and crime commissioner review to equip PCCs with the tools and levers that they need to drive down crime and antisocial behaviour in their areas. As I said at the start, we recognise the damage and distress caused by antisocial behaviour. We recognise the devastation to lives caused by youth crime, both to the perpetrators and the victims, and I am absolutely committed, as are my Home Office colleagues, to tackling this issue head-on.

15:57

[Matt Vickers]

I thank Members for their wide-ranging and insightful contributions. It is clear that youth crime and antisocial behaviour has a huge impact on the lives of people across the country, and it should probably feature in discussions in this place more often. We have heard examples of and gratitude for the amazing police officers, the people who work in our local authorities, the people who work in the voluntary sector, and the people who work in our schools and youth services who do so much to make our communities safer.

We have heard all the manifestations of youth crime and antisocial behaviour whether it is the modified cars, the off-road bikes, or the issue of county lines. We have also heard that it affects businesses as well as the lives of people, and we have heard about the exploitation of young people and the horrific and tragic outcomes that this can have for them and their families. I think that we all agree that we need to open up opportunities for young people who are often the victims as well as the perpetrators.

I thank the Minister for taking the time to hear the many challenges that this issue creates across the country. I welcome the Government’s focus on tackling crime and antisocial behaviour; I welcome the thousands more police officers that we have across the country, including 194 in Cleveland; I welcome the huge uplift in police funding, including £157 million more for Cleveland; I welcome the opportunity to discuss the specifics around some of those antisocial behaviour powers; and I welcome the huge increase in youth services and the safer streets funding, which we are delighted to welcome in Cleveland.

Question put and agreed to.

Resolved,

That this House has considered youth crime and anti-social behaviour.

Access to GP Appointments

Wednesday 12th January 2022 Westminster Hall

[Relevant document: e-petition 587701, Create a legal right for patients to receive timely face-to-face GP appointments.]

16:32

[Theresa Villiers (Chipping Barnet) (Con)]

I beg to move,

That this House has considered access to GP appointments.

It is a pleasure to serve under your chairmanship, Mr Robertson.

GPs are at the heart of our health service and our communities, and I thank them all for their dedicated work. They have been at the frontline of one of the most successful vaccination programmes in the world, thanks to which we have some of the lightest covid restrictions and one of the most open economies. Family doctors have also delivered an incredibly rapid adoption of new digital means to interact with patients when lockdown meant that it was vital to be able to give health advice without vulnerable patients having to visit a surgery. This is quite a switch for a health service that just a few years ago was still using about 9,000 fax machines.

Phone or digital consultations are here to stay, and for many they are a great way to get help from their GP, but not for everyone. In particular, many elderly people, people with learning disabilities or other cognitive impairments and those with language barriers may not be able to cope easily with digital communication. They may find anything other than a face-to-face meeting difficult. It is vital that these vulnerable people can still see their doctor, and there has been some real progress in recent months. There are now more appointments in general practice than there were before the pandemic, and, judging by the latest figures, about 65% of those were face to face.

[Jim Shannon (Strangford) (DUP)]

I was interested when I saw this issue on the agenda for Westminster Hall. I am interested in lots of things that are debated in Westminster Hall, but this is one in which I have a particular interest. Does the right hon. Lady agree that for many people who are not comfortable about describing their symptoms over the phone, or eloquent enough to do so, it is essential that they can request to see their GP without having to prove to the receptionist the reason why they need to?

[Theresa Villiers]

That is of course correct. Phone calls are important in triaging and assessing the extent to which a face-to-face meeting with a doctor is appropriate, but it is essential that those who need face-to-face appointments are given them.

We are seeing some progress, and this has been delivered at the same time as millions of booster jabs. I give credit to GPs, NHS England and Ministers for that recovery in general practice, but it remains the case that many of us will have heard from constituents about problems in getting in to see their GP. I thank the 19,302 people who signed the online petition on Parliament’s website expressing concern about this.

[Taiwo Owatemi (Coventry North West) (Lab)]

The right hon. Lady makes a really important point about constituents trying to get in contact with GP surgeries. I have the same issue with one of my constituents who tried to get in contact with her surgery and had to call every day for three weeks in order to get an appointment. By the time she did get an appointment, she experienced delays in accessing the treatment she needed. Does the right hon. Lady agree that further action is desperately needed to ensure that we have a plan in place to address staff shortages and resource shortages across our NHS and across our GP surgeries so that our GPs can continue to provide the healthcare that is needed?

[Theresa Villiers]

I agree that we need more general practice capacity and I will come on to explain how we could do that.

There can be no doubt that GP surgeries are under immense pressure. The Royal College of General Practitioners says that the workload has never been greater. A GP in my constituency told me that as well as colleagues leaving the profession, it has become increasingly difficult to recruit new doctors. He said:

“Those of us left behind feel that we are holding up a broken system.”

In GP surgeries, as is the case across the NHS, demand has spiralled partly because, as we grow older as a population, we have greater healthcare need, partly because of pent-up demand from people who felt reluctant to seek help during the pandemic, but also partly because the decision by NHS leaders to push a range of treatments out from secondary to primary care has left GPs dealing with more serious and complex cases than in the past. As a result, one High Barnet GP told me that primary care was in a precarious position even before the pandemic. Of course, delays in accessing GP appointments have been an issue for some years in many areas, including my Chipping Barnet constituency. My concern has been intensified by the predatory demands of developers seeking to build blocks of flats in multiple locations in my constituency. The Mayor of London wants to see over 23,500 new homes built in Barnet over 10 years. That is a massive increase in population, yet GPs are struggling to serve the population we already have.

We have seen the number of doctors in hospitals increase to record levels—and that is a great achievement—but the same cannot yet be said of GPs. I have been campaigning to expand GP capacity in Barnet as part of the Government’s wider commitment to boost primary care. I very much welcome the £250 million announced in October to tackle immediate pressures on the system. This promised new cloud-based phone systems, a reduction in routine paperwork such as sick notes and Driver and Vehicle Licensing Agency checks, and additional staff to support GPs. Well, I think we probably all know that better phone systems are urgently needed in many practices, but the need to reduce unnecessary bureaucracy is also pretty obvious.

[Damien Moore (Southport) (Con)]

My right hon. Friend is making an excellent speech. On patients phoning up trying to get an appointment, does she agree that there needs to be more capacity in phone systems so that people are not waiting on the phone for hours on end to get an appointment with a GP?

[Theresa Villiers]

I think that is right, which is why it was a good decision in the Government’s October announcement to focus on an upgrade to phone systems. I really hope that the Minister will update us on how that is going and when it will be delivered, so that our constituents can experience it directly.

Returning to the issue of GP paperwork, a Barnet GP told me that

“the amount of bureaucracy and red tape has increased exponentially despite various assurances that this would be cut. Increased regulation and monitoring, whilst important from a governance point of view, seems to have generated endless form filling, policy updating, mandatory training, appraisals and paper chasing.”

When this issue was debated in this Chamber last October, the Minister repeated promises that paperwork and form filling would be reduced. Has that happened? If not, why not? It is far better for a GP to spend time with patients, rather than writing sick notes or ticking boxes.

The third element of the Government’s plan seeks to strengthen the multi-disciplinary teams in general practice, so that, where appropriate, patients can seek other professionals such as nurses, pharmacists or physiotherapists. This is intended to free up GP time for them to see sicker patients. I welcome the fact that 10,000 new staff have been recruited of the 26,000 promised in the Conservative manifesto, and I commend the work of North Central London clinical commissioning group, which is due to recruit 177 more primary care staff under the programme. However, more could be done, for example, to enable pharmacists to take a bigger role, including in prescribing. We must also ensure that GPs have a strong voice in the new integrated care boards, so that primary care is at the heart of NHS decision making. It is vital that part of the massive capital investment that the Government have promised for the NHS goes into improving GP surgery premises, which in some instances are just not fit for purpose or not physically large enough to cope with increased healthcare demand.

[Tahir Ali (Birmingham, Hall Green) (Lab)]

Many of my constituents, and constituents across the country, are concerned about how quickly they can get face-to-face appointments, especially those mentioned earlier: the vulnerable, the elderly, and those who cannot do online or telephone appointments. The investment in surgeries is most welcome, but we need immediate action to address the shortfall in patients being seen by doctors where they need to attend a face-to-face surgery.

During covid-19, elected Members received an uplift to our budgets to help us to deal with our constituents. The same needs to be done for GPs, who are under huge pressure to deliver services, and that needs to happen now rather than later, because such investment can take time to come through and we do not have time.

[Theresa Villiers]

I agree that we need action now to make it easier to get GP appointments, and we also need action for the longer term. Even if everything that I have spoken about is delivered, and the October package is delivered in its entirety, we still need more GPs—it is as simple as that.

It is really welcome that this year more people have entered training to become GPs than ever before, because the Health Committee identified workforce shortages as the “key limiting factor” in tackling the covid backlog successfully. In its annual report on the state of health and social care in England, the Care Quality Commission concluded that by mid-2021 there were likely to be fewer full-time equivalent GPs in total per 100,000 patients than there were in 2017.

In July 2021, the then Care Minister commissioned Health Education England to review long-term strategic trends for the health and social care workforce. That review is very welcome, but we need to see it deliver results. As the Health Committee has called for, we need an objective, transparent and independently audited annual report on workforce projections that cover the next five, 10 and 20 years, including an assessment of whether sufficient numbers of staff are being trained.

[Damien Moore]

My right hon. Friend is being very kind in sharing her time. Does she agree that universities that have medical placements and more capacity should be allowed to extend that capacity, so that we can train more people and have more people entering the profession?

[Theresa Villiers]

It is essential that we expand the capacity of training places for GPs, and I welcome the new medical schools and the progress that has been made. However, because it takes years to train up a professional, the effect of those developments is not yet being felt in local surgeries.

We need to ensure that the NHS visa scheme is used effectively to recruit skilled GPs from around the world in order to meet immediate pressures, and we have to get better at retaining the GPs that we have. A vital first step in doing that is to implement measures to relieve the stresses on GPs that I have spoken about and to address spiralling workloads.

An effective workforce strategy also needs a better plan to encourage women to stay in the profession. We need to give more thought to how we persuade women who might have chosen to work part-time while caring for children to consider coming back to work full-time.

Also, what about all those retired or non-practising GPs out there? At the start of the pandemic, the Government rushed through legislation to enable retired professionals to return to the workforce to help battle that first covid wave. Clearing the covid backlog and expanding GP services is another great national challenge and we really should try to do more to enlist the talent of doctors who have retired or moved on to other careers.

[Damien Moore]

Will my right hon. Friend give way?

[Theresa Villiers]

I will just make a little progress now, because I want to give the Minister time to respond.

That means fixing the problem with doctors’ pensions. I know that efforts have been made in that regard. However, it is still worrying that it seems that once a doctor has been in practice for many years, they can face a big tax bill for their pensions. Of course, the last thing we should do is push GPs into early retirement because of punitive pension taxes. We want them to stay in practice and not retire.

In conclusion, pressure on GP surgeries is leading to appointment delays, which will only generate yet higher numbers of people showing up at accident and emergency departments that are already busier than at any time in the history of our national health service, as graphically shown on Sky News in relation to Barnet Hospital just a week or so ago.

GP services are a crucial gateway to treatment by other parts of the health service. If this gateway gets blocked up, the consequence will be that lives are lost, for example to cancer, because symptoms were not picked up early enough. So this matter is not just one of convenience; it is a matter of ensuring that we are doing everything we can to deliver the best healthcare.

The Government rightly promised 50 million more appointments in GP surgeries every year. It is essential that we deliver on that promise, so that my constituents can get the care they need within a reasonable timeframe. We must see the NHS long-term plan and the Government’s record £33 billion investment in the NHS deliver more GPs in local surgeries in places such as Barnet. It is as simple as that. We cannot carry on as we are. When he recently gave evidence to the Health and Social Care Committee, the Health Secretary said that plans to recruit 6,000 additional GPs by 2024 are not on track. I appeal to the Government to get them on track and to do all they can to expand capacity in GP practices in my constituency and across the country.

16:15

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I thank my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) for bringing the debate to the Chamber. I echo much of what she says, and the Government are delivering on much of it, so perhaps this is an opportune moment to update Members on the progress we are making.

We owe a huge amount of gratitude to general practice staff for their efforts throughout the pandemic, stepping up to run vaccination programmes, continuing with flu vaccinations, looking after house-bound patients and continuing their day-to-day work. They have been absolutely outstanding. Since 30 November last year, more than 52 million covid vaccinations have been delivered by general practice, which is an amazing achievement. They are incredibly busy and have been throughout the pandemic, as reflected in appointment data. In November, general practice delivered an average of 1.39 million appointments nationally per working day, an increase of 6% compared with November 2019. Once covid vaccination appointments are factored in, the increase is greater than 20%. GPs and their teams have been working incredibly hard.

The focus on the booster programme has meant some patients experiencing delays in getting an appointment, but that does not mean that general practice has been closed. GPs and their teams will always be there for patients, alongside NHS 111 and community pharmacy teams. It is important that people do not delay coming forward. We saw patients stay away during the first lockdown, and so unfortunately there was a delay in starting some of their treatment, so it is important that we all get out the message that GP practices are open for business. In my right hon. Friend’s constituency, under North Central London CCG, excluding covid-19 vaccinations, approximately 16% more appointments took place in November last year compared with November 2019, of which 57% were face to face. The crux of the matter that we hear from many constituents is around face-to-face appointments. That is why, in October, the Secretary of State launched the winter support package to tackle many issues my right hon. Friend mentioned. I will just touch on several.

First, we are improving telephone access, because sometimes the problem is that patients cannot get through by phone, rather than their not being able to see a GP. My hon. Friend the Member for Southport (Damien Moore) touched on that. Part of the package is a cloud-based telephony system to help increase that capacity for GPs, who may only have one or two receptionists and a couple of phone lines that get busy pretty quickly as soon as 8 o’clock hits. The improved functionality has the potential to free up existing telephone lines for incoming calls and will be available at no additional cost to practices. We will require GP practices to sign up to this cloud-based telephony system, which will be up and running pretty soon. All those that expressed an interest have been contacted, and we expect many to go live fairly soon. Some practices are already tied into existing contracts, so there may be a slightly delay in roll-out there, but where we can get them up and running, we absolutely will.

Secondly, we are encouraging GPs to offer face-to-face appointments. However, it will not always be a GP that a patient sees. There are a range of healthcare professionals in primary care, from nurses—they do an amazing job, if I say so myself—to paramedics, pharmacists and physios, and the GP is not always the best person for a patient to see. Face-to-face appointments are available, and our message to patients is that they will not always see the GP face to face, but that does not take away from the care that they receive.

On finance, £250 million was announced in the winter support package, which can be used by GPs in a range of ways—whatever suits their local area. For some, it will be a physical expansion of their practice so that they can see more patients. For others, it may be to take on locums, where they are available—that is also a pressure point—or other healthcare professionals or an extra receptionist, or to extend opening times. The money can be used on whatever will help GPs to expand their ability to see patients.

My right hon. Friend touched on bureaucracy and red tape, which is a massive ask for GPs. We have made some temporary changes during the omicron vaccine roll-out period to free up capacity, including extending the sickness self-certification period for people accessing statutory sick pay and suspending requests for medical information from bodies such as the Driver and Vehicle Licensing Agency. We are bringing forth secondary legislation to allow other healthcare professionals to do some of those checks—statutory instruments are going through the system as we speak—and having discussions with other Departments about moving away from always expecting GPs to do medical reports, whether for the Department for Work and Pensions, the Department for Transport or for schools. Patients can do a lot for themselves and a medical report from a GP will not always be required. We are also improving digital technology so that handwritten letters and reports, which take so much time for GPs, can be digitised and made much easier.

One of the most exciting innovations in the package is the promotion of pharmacists, which my right hon. Friend touched on. We have a community pharmacist consultation service whereby patients who phone 111 or contact their GP can be referred direct to pharmacists, who are taking on prescribing skills so that they can prescribe as well as dispense. We are looking towards a more pharmacy-first model as in Scotland and Wales, where patients can go direct to pharmacists without necessarily going first to the GP, opening up primary care and making it much more accessible. I hope that, through a number of the points that I have addressed, it can be seen that we are moving at pace.

Workforce was touched on, and I am pleased that we are making progress on that. We have already recruited 10,000 of an additional 26,000 staff who will be working in general practice by the end of 2023-24. In the North Central London CCG area, 327 additional staff have been recruited to date, with a further 114 anticipated.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I congratulate my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) on bringing the debate to the Chamber and draw attention to my entry in the Register of Members’ Financial Interests as a practising NHS doctor. In 2015, the then Secretary of State said that we would recruit an extra 5,000 GPs to the workforce. Can the Minister update us on how many extra full-time equivalent GPs are working in the NHS?

Pensions is also a real issue that is stopping the current workforce extending their careers as they face punitive tax penalties. Will she please commit to addressing that and raising it with the Treasury?

[Maria Caulfield]

Absolutely. I was going to come to the number of GPs. I am pleased, as is my right hon. Friend the Member for Chipping Barnet, that we have 4,000 doctors in GP training places this year, which is an increase from 2,671 back in 2014. We are getting more GPs through the training process. However, in terms of GPs in place, there were 1,841 more full-time equivalents in September 2021 compared with September 2019, so we are seeing increases coming through.

However, there are issues with retention as well as recruitment. I think my right hon. Friend touched on issues with the Home Office and GP trainees once their visas expire. We met Home Office officials just before Christmas and there is better working now between the NHS and the Home Office to help facilitate those who come on a visa and need help to get into the workforce, get their visas extended or their training finished before their visa expires.

My hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) made a very valid point about GP pensions. We have discussed that, and we are setting up a meeting with Treasury teams to look at that in more depth. There is no doubt that that is a disincentive to stay in practice, and we will certainly be looking at that further.

I will finish by asking all colleagues to support local GPs. They have had a very tough time. We are taking a zero-tolerance approach to any abuse they receive. That also applies to pharmacists. They have had a difficult time and continued to stay open during the pandemic. Face-to-face appointments were a challenge. We are doing everything we can to support them with the asks to break down some of those barriers. I am optimistic that we will see progress and that patients, who are the most important people in this debate, will see improved access to services in primary care.

Question put and agreed to.

Transport Connectivity: Merseyside

Wednesday 12th January 2022 Westminster Hall

16:30

[Mr Laurence Robertson (in the Chair)]

Before I call the mover of the motion, I ask Back Benchers to limit their speeches to between four and five minutes in order to get everybody in.

[Mick Whitley (Birkenhead) (Lab)]

I beg to move,

That this House has considered transport connectivity in Merseyside.

It is a great privilege to serve under your chairmanship, Mr Robertson. I warmly thank my hon. Friends for attending a debate that has such enormous implications for our region. I also thank the Minister and the shadow Minister for joining us. I have no doubt that today’s proceedings will benefit immensely from their expertise.

Draughty trains that creep at a snail’s pace towards Warrington and Manchester, private bus operators that leave those communities most in need cut off and isolated because they cannot turn a profit, and fares that rise year on year—that is the bleak reality that confronts the people of Merseyside every single day. More than eight years since George Osborne revealed his vision of a northern powerhouse, little has changed for the people I represent. Indeed, some things are far worse.

Today, it is quicker to get the train from London to Paris than it is to travel half that distance, from Liverpool to Hull. For all the talk of levelling up and building back better, spending per head on transport in London continues to be double what it is in the north, as it has been for 30 long years. Even as the scale of the climate crisis underscores the importance of getting cars off the road, the parlous state of public transport means that it is simply not an option for people who have to get to work on time, or to hospital, when there are no buses to take them there.

That has been the scandalous situation on Merseyside and across the north for so long that some of my constituents could be forgiven for thinking that things were always like this, and improvements are impossible. Others, however, have written to me, asking why a viable bus route from their home has been axed or why trains to their workplace are better suited for cattle than for people.

[Margaret Greenwood (Wirral West) (Lab)]

My hon. Friend is making a really good speech. I am pleased he has raised the issue of buses being axed without notice. I had that issue in my constituency some time ago in relation to buses from Irby, which is essentially a small village. That impacted a huge number of people, particularly elderly people, people with children and people without cars. Does he agree that bus services need to be reliable and people need to know that they are going to be there? There is no point calling it a service when it is an intermittent arrangement that private providers can cut or deliver as they choose, according to the profit motive.

[Mick Whitley]

I agree with my hon. Friend and will try to cover that point a bit later in my speech.

I secured the debate today because I believe that our constituents deserve better, and to talk about some of the steps that we should be taking to change transport in Merseyside for the better. From investing in Northern Rail to improving bus services and empowering local leaders to make a real and lasting change, last year’s integrated rail plan provided the Government with a historic opportunity to make good on the promise of a rail revolution in the north of England.

Transport for the North’s recommendation for a new line connecting Liverpool and Manchester had the potential to transform Merseyside. It would have dramatically cut journey times to our largest neighbour, brought 100,000 jobs to urban areas across the north and contributed a gross value added uplift of £3.4 billion by 2040.

It would not just have been the two big cities that reaped the benefits. Research by the Northern Powerhouse Partnership has clearly illustrated that towns like Birkenhead stand to make enormous gains from improved connectivity between major urban areas. My constituents would have counted among the nearly 4 million people to be brought within 90 minutes’ reach of at least four major northern cities, opening them up to exciting new possibilities.

[Maria Eagle (Garston and Halewood) (Lab)]

I congratulate my hon. Friend on obtaining this debate. In view of what he has just said about the opportunities of the programme proposed by Transport for the North, does he agree that it is deeply disappointing that the actual outcome is a watered-down version of the absolute worst option, which means that the city region itself is going to have to find £1.5 billion to build a new mainline rail hub, which is just not realistic?

[Mick Whitley]

I totally agree with my hon. Friend. I will try to cover that issue a little later on.

That was why local leaders were so emphatic in urging Ministers to commit to the development of a brand new line: it was a once-in-a-lifetime chance for the Government to show that they were serious about honouring the commitments they made to the electorate in 2019. Those broken pledges have been shunted into the sidings. Instead of pushing ahead with the transformational changes that communities across Merseyside and the north urgently need and deserve, the Department for Transport has pushed ahead with an option that has rightly been rubbished by the metro Mayor, Steve Rotheram.

[Mike Amesbury (Weaver Vale) (Lab)]

My hon. Friend is making a powerful speech thus far. Does he agree that after 11 years in government, this plan demonstrates the hollowness of the Government’s so-called levelling-up agenda? In the words of the metro Mayor, Steve Rotheram, this is a “cheap and nasty solution”. It is no solution at all.

[Mick Whitley]

I totally agree with my hon. Friend: my next sentence was going to include the words “cheap and nasty”. This is levelling down, rather than levelling up.

The electrification of the Fiddlers Ferry route and its incorporation into the national rail network was included in the plan. That option on its own will do nothing at all to improve journey times. Instead of improving economic connectivity, this development threatens to cost our city region an estimated £280 million in disruption over the course of six years. At a time when we badly need to cut emissions and take action on air pollution, it will force an additional half a million cars on to the roads each year and critically undermine freight capacity.

We have been told that the costs of any new station in Liverpool will have to be met locally. A new station would serve as an essential cornerstone of any further expansion of the rail network, and would be indispensable in improving travel times on the upgraded line. However, with an estimated cost of £1.5 billion, it is an expense that our region—one of the most deprived in the country—can ill afford.

The Government’s inability to live up to their lofty rhetoric and deliver the rail revolution that the north was promised exposes monumental failings at the heart of their levelling-up strategy. Whether on transport, education or energy, the Government are simply not willing to put their money where their mouth is. The task before us is enormous: we are attempting to address decades of under-investment, managed decline, and neglect of our transport network.

I eagerly anticipate the Minister’s contribution today, and while I have no intention of prejudging his remarks, I am sure that he will point to recent spending announcements from which our city region has benefited. Of course I welcome that additional funding, but the Government still do not seem to grasp the scale of the challenge ahead, as the scrapping of the Liverpool to Manchester line clearly demonstrates. Individual spending announcements and piecemeal policies are not enough; there needs to be a transformational, long-term project with real buy-in from Westminster.

That is all the more important given the devastating impact that local government funding cuts have had on local transport networks. Wirral Council alone has seen its central Government grant fall from £260 million in 2010 to a measly £37 million this financial year, and now—like many local authorities on Merseyside—it finds itself in the midst of a deepening financial crisis. When we look to the future of transport, we must never forget the 10 years lost to Conservative austerity. For transport, as for so many services, this was a decade of destruction that will take a lot more than piecemeal handouts to rebuild.

Moreover, the levelling-up agenda has no chance of success if local voices remain stifled and local leaders remain powerless to take a lead in effecting change. Mayor Rotheram, the combined authority’s transport lead, and the leaders of Warrington Borough Council and Cheshire West and Chester Councils were unequivocal in their repeated warnings that option 5.1 was not right for our region. We must ask why they were not listened to, and why it is that policy makers in Whitehall continue to ride roughshod over local leaders who know the needs of their communities best.

In Merseyside, ambitious plans for a London-style transport network hint at what is possible when local leaders get the financial support and political freedom they need. As Mayor Rotheram has said, we cannot wait for national Government to act, because it will never happen. Instead, the Liverpool city region is forging ahead with plans to fundamentally reform our region’s transport network so that everyone on Merseyside has access to the affordable, accessible and green transport they deserve. The city region has already invested over half a billion pounds in a new fleet of state-of-the-art trains that will begin service later this year. Ambitious plans are also under way for the development of new stations and improvements across the region that will radically expand access to the network. The steps being taken to improve accessibility across the network will be particularly welcomed by my constituents in Rock Ferry, whose local station has for too long been inaccessible to wheelchair users and people with limited mobility.

However, rail is not the only sector in dire need of reform. Trains may connect our towns and cities, but buses bring communities together. Bus services are a vital lifeline for millions of people across the north, especially in areas like Merseyside that have such high levels of deprivation and low rates of car ownership. In the city region, 80% of all journeys taken on public transport are by bus, but since the deregulation of bus services in the 1980s, my constituents have been dependent on a fragmented and privatised system in which bus operators compete against each other while ignoring the needs of the local community.

A recent investigation into the provision of bus services on the Wirral exposed the scale of the problem that my constituents face. Residents reported having to catch two or three buses to travel even relatively short distances, and many expressed frustration at the difficulties they encounter in trying to reach Arrowe Park Hospital, which serves the entirety of our peninsula. Some of the most impoverished communities in my constituency, such as the Noctorum estate, feel all but cut off from the rest of Wirral, while other areas have no bus services at all, as operators deem those routes to be unprofitable.

Covid continues to have a negative effect on provision, with some services having not resumed since the darkest days of the pandemic. Here, again, the combined authority is taking decisive action. Using powers afforded to him by the Bus Services Act 2017, Mayor Rotheram is working to re-regulate the bus network across the city region to guarantee that commuters get the quality of service they deserve. The metro Mayor has also submitted a £667-million bid to central Government to increase services across the network, begin the roll-out of new zero-emission hydrogen vehicles and slash fares.

[Navendu Mishra (Stockport) (Lab)]

I congratulate my hon. Friend on securing this important debate. In my own constituency of Stockport and across Greater Manchester, Mayor Andy Burnham has pioneered the bus franchising model, which will deliver lower fares and improved connectivity, and prioritise passengers over private profit. Will my hon. Friend join me in congratulating Mayor Burnham and encourage people to use this model across the nation?

[Mick Whitley]

My hon. Friend is right to highlight the important work that Mayor Burnham is doing to reform services in Greater Manchester.

[Sir George Howarth (Knowsley) (Lab)]

I congratulate my hon. Friend not only on securing the debate but on the excellent way that he is presenting our case. Would he acknowledge that city region Mayor Steve Rotheram, to whom he has referred a few times, has made it clear that he would be willing, along with Andy Burnham and other local government leaders, to sit down with the Government and try to work out a compromise deal that would be better than what is on offer at the moment? Does he agree that the Minister should be encouraged to take up that offer? The future of our city region hinges on it, in the way that he has described.

[Mick Whitley]

I totally agree with my right hon. Friend, and I obviously hope that the Minister takes cognisance of the points he made.

Whether in Greater Manchester or Merseyside, local leaders should be commended for working hard to turn the tide and undo the ruinous legacy of 40 years of privatisation. However, I am very concerned that the Government have tied the hands of local government and are still preventing it from taking the bold and decisive action that is needed. In Merseyside and across the north, there is widespread recognition that our transport network should serve public need, not private greed.

However, in England, the Railways Act 1993 continues to prohibit the public operation of train services. With the devolved Governments in Wales and Scotland working to bring rail back into public ownership, surely it is time for combined authorities in England to be given equivalent powers, so that essential services such as Merseyrail can be brought into public hands and run on a not-for-dividend basis.

Given the widespread issues with bus services in Merseyside that I have mentioned, I would welcome an update from the Minister on any steps the Government might be taking to review the Bus Services Act 2017 to allow for the establishment of municipal bus companies. I am conscious that we are pressed for time, and I am looking forward to hearing the contributions of other hon. Members, so I will conclude my remarks.

16:45

[Conor McGinn (St Helens North) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. I know that you are a frequent visitor to the city region, and I was delighted that you were in my constituency at Haydock Park just before Christmas. It is also a pleasure to follow my hon. Friend the Member for Birkenhead (Mick Whitley), who secured this debate, and to be part of this formidable red wall from Merseyside, with even a usurper from across the DMZ in Greater Manchester.

St Helens is often seen as being on the periphery of one city region, but we see ourselves as sitting at the heart of two—Liverpool city region and Greater Manchester—and acting as a key bridge between them. Therefore, harnessing every chance for growth and for local opportunities obviously requires transport connectivity.

We have already made important improvements to our road infrastructure along the A580, known locally as the East Lancs road, at Windle Island and Haydock. Newton-le-Willows station is now the second busiest on the Manchester-to-Liverpool line. It is being transformed into a leading regional transport hub. Six hundred kilometres of new cycling and walking networks are planned for the next decade, with a new 7 km route linking St Helens to Burtonwood and additional capacity on the Sankey Valley cycle route, which I and my family use on an almost weekly basis.

Cross-boundary bus services and links to Liverpool, Manchester, Warrington, Wigan and beyond are a particular issue for us. These are all progressing. We want our services to be enhanced and to see an end to the extortionate prices that are driven by profits for private companies. Wider innovations, particularly in green transport, are helping in our fight against climate change. Having Liverpool city region’s publicly owned hydrogen buses on the route between the city and St Helens will mean the first green bus route in our region.

It is important to say that all this is being done by Labour councils, supported by Labour MPs, and the Liverpool city region Labour Mayor, Steve Rotheram, because we are ambitious for our city region and for our constituents. That stands in stark contrast to the Government. The integrated rail plan published in November was, we were told, a once-in-a-generation opportunity to push this agenda forward and transform transport for us in the north. But what did we get? We got a plan that is not even fit for the present, never mind the future.

The plan betrayed us and our communities again. It will sacrifice direct connections from Newton-le-Willows station in my constituency for the sake of a two-minute improvement on journeys from Manchester to Liverpool. There are no plans to improve local services from Garswood, for example by improving disabled access, or Rainford, and there is nothing about the future of the proposed new station at Carr Mill. The plan says nothing about developing the link between St Helens junction and central stations, which would open whole new possibilities for the town and our whole borough. This all comes as revised rail timetables for December 2022 propose reduced services from all those stations, meaning that we will have more overcrowding and constraints on passenger numbers.

In recent months, the Mayor of Greater Manchester, Andy Burnham, and the Mayor of the Liverpool city region, Steve Rotheram, came to St Helens for a transport seminar with our local council and colleagues from Wigan and Warrington. We will continue to press for a better deal—the best deal for our region and constituents—because I and my colleagues are focused on transforming transport for our people. We know that that is critical for our economy and our climate, but also for our connections to each other and our places. I urge the Government to catch up and support us in the work we are doing.

16:49

[Paula Barker (Liverpool, Wavertree) (Lab)]

It is a pleasure to serve under your chairship, Mr Robertson. I congratulate my good and hon. Friend the Member for Birkenhead (Mick Whitley) on securing this hugely important and topical debate.

I will avoid wasting any time mincing my words and get straight to the point: the Minister’s Department, the Secretary of State and the Government are badly letting down the people of Liverpool city region. For all the talk of levelling up, excluding our city region from the Northern Powerhouse Rail network and introducing the integrated rail plan is an abject failure to support economic growth in one of the great cities of the north. Our metro Mayor Steve Rotheram called the new plan “cheap and nasty”, and those are words I echo without equivocation.

Alongside Members from the city region, the metro Mayor and the portfolio holder on the combined authority, I wrote to the Secretary of State in December to make our position clear. For the purpose of today’s debate, I will reiterate that the IRP will be remembered for what it does not deliver for Merseyside.

There will be no new line connection to Liverpool. That fails to integrate us into the High Speed 2 and Northern Powerhouse Rail networks. Upgrades to existing lines in and out of Liverpool will cause up to six years of disruption, which will be significant for the Liverpool city region, causing an economic hit of at least £280 million each year. The plan will fail to deliver transformational extra capacity, as it includes using the already congested west coast mainline into Liverpool. That means little ability to grow local services. In fact, some services will be lost.

There will be a detrimental impact to freight, as 88 freight trains will be unable to operate each week during the upgrade phase. That freight traffic may never return to Liverpool. The plan will constrain the port of Liverpool’s growth as the main deep-water port on the west of the British mainland. There will be no new station for Liverpool, which is vital to ensure the capacity for more long distance and local services. As the plan does not intend to commence work until the 2040s, there will be a slower delivery time. There are multiple caveats regarding the approvals and further progress. Do the Government have any intention of delivering anything beyond phase 2b to the west, and the west to east midlands link? Everything I just mentioned will prohibit the city region’s ability to achieve net-zero emissions.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

The original Transport for the North NPR plans proposed a real levelling up of the north of England, meaning that people in Liverpool city region and Merseyside could have economic opportunities in Manchester, Leeds and Bradford. It would have taken millions of cars off the M62, but these new plans bring us right back. The whole of the north will suffer, as will the whole of our economy, once again at the expense of London and the capital. Does my hon. Friend agree that these plans are letting down the whole of the north?

[Paula Barker]

My hon. Friend makes incredibly salient points, all of which I agree with. It is the whole of the north that will suffer under these detrimental plans.

As I was saying, support for HS2 in the north is largely predicated on delivering NPR in full, as promised, so that LCR and our regions can realise its full benefits. It is clear from the reply I received from the Department that cost is the driving factor in this deal, not the transformational change that Northern Powerhouse Rail would have brought. The IRP represents another broken promise from a Government who are intent on talking the good game of levelling up while delivering nothing of the sort. The consequences for the Liverpool city region and beyond in the north will be grave.

16:53

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Mr Robertson. I thank my hon. Friend the Member for Birkenhead (Mick Whitley) for securing this important debate. Although my constituency is in Cheshire, we are very much in the hinterland of Merseyside. We are less than 10 miles away from Liverpool city centre, and our economic, educational, cultural and family connections mean that there are many people travelling across Merseyside on a daily basis. Sadly, it seems that we are an afterthought, suffering poorer services and higher costs.

I will not repeat the legitimate arguments made by my constituents about the two-tier charging system they face when they cross the River Mersey in their car through the tunnel or the over the bridge. What I will say is that we are now coming up to seven years since the then Chancellor George Osborne promised my constituents that they would not have to pay a fee to cross the bridge at Runcorn. Will the Minister tell us when that promise will be kept?

Constituents of mine travelling by train have a similar experience at the moment, as the Wrexham to Bidston line is operating a reduced service due to short staffing, which is understandable. For my constituents in Neston, that is the only route by public transport into Liverpool. We were expecting a half-hourly service by now, but the pandemic seems to have delayed that. The current service runs once every two hours, which hopefully will be put right shortly, but it seems extraordinary to me that the 7.10 am and the 9.10 am train have survived, but the 8.10 am train has been cancelled. Surely, as the peak morning service, this is the last journey that should be cut.

We are waiting for answers about this from the current operator, but when the Minister responds I hope he can say when we can get the half-hourly service that was specifically promised in the franchise agreement. Ultimately, passengers on this line need an end to the need to change at Bidston, and to get the direct line to Liverpool installed. That would deliver the true connectivity that we need in Neston.

My constituents in Ellesmere Port, on the other side of the constituency, already have a half-hourly service to Liverpool, although the price of tickets is an issue. We all know the cost of rail travel is going up, and indeed the cost of everything else is going up, but we seem to be paying more than others.

The cost of a ticket into Liverpool from Little Sutton is 30% more expensive than from a station just two stops further down the line, and three times as much as it would cost for a similar journey in London. I do not understand why those price differentials exist, and I would be grateful if the Minister could provide an answer as to why prices are so much more expensive for my constituents, or at least commit to looking into that.

There has been a 20-year campaign for a station at Ledsham, in Little Sutton, which was submitted to the railway renewal fund, but sadly rejected. The overall comment that the Department made was that it was

“a strong proposal with a well-articulated narrative on how the project could unlock growth opportunities in the area.”

It puzzles me somewhat that the application was rejected. Can the Minister enlighten me as to the reasons why it was turned down? The suspicion that we have seen in other areas is that decisions are being made on a party political basis, and not on the merits of the application. Will the Minister advise when there will be an opportunity to submit a further application? The problems that that station would solve are only going to increase.

Finally, I want to mention the crisis in school transport, which particularly affects my constituents travelling to schools on the Wirral. Driver shortages and increased fuel costs mean that some services are being pulled all together, or only offered on a termly basis, at a price that few can afford. As the schools are outside the catchment area, there is no financial support available.

I acknowledge that this will not be a priority for local authorities, with their stretched funds, but I know that this is not an isolated example and the pattern is being repeated across the country. Pupils have had enough disruption to their education during the last couple of years, so I would not want them to have to change schools because travel to the school of their choice has become unaffordable. Can the Minister comment on any assessment he has made on the cost and availability of home-to-school transport? That chimes with what my hon. Friend the Member for Birkenhead said earlier about the paucity of bus services in the area, and the need for places like Merseyside and Cheshire to be given the powers, rules and resources to take back control of their bus networks. That is something I think we would all want to see.

16:57

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

It is a pleasure to work under your chairmanship, Mr Robertson. I thank my hon. Friend the Member for Birkenhead (Mick Whitley) for securing this important debate.

For too long, the Government have been looking for transport companies to turn profit. The main purpose of transport is to get people around more easily. The knock-on effect of this is a boost to the local economy. That is how transport should be looked at and judged.

I will start by talking about buses. Buses provide over 80% of public transport journeys across the Liverpool city region. Across the region, a third of residents do not have access to a car. For many, a bus route is a lifeline to work, for food shopping, to see friends and family, and to the night-time economy.

Liverpool city region Mayor, Steve Rotheram, has submitted ambitious plans to the Government to improve our bus services, which are desperately needed. The plans would create a cheaper, more frequent and overall better bus service. The plans even look to introduce hydrogen buses, which aligns with the Government’s own promises to reduce emissions following COP26.

A reasonably-priced, reliable bus service across the Liverpool city region would make access to jobs and opportunities so much easier for many local residents. For too long, poor transport links have held people back from employment, social activities and culture. In St Helens, there are so many apprenticeship opportunities for young people. Often, the biggest difficulty is getting to them. This bus plan would improve the way that young people and people of all ages go about their lives. That is what a good transport network is all about.

I hope that my Merseyside colleagues will forgive me for using the other M-word—Manchester. St Helens is located between two great cities: Liverpool and Manchester. As many colleagues know, I am a rugby league fan, so I am not involved in any football arguments and drama. For St Helens, connections to both cities are crucial to us—for jobs, socialising, education, shopping and culture. For example, the Christmas markets have recently been enjoyed by so many of my constituencies, but the irregularity of off-peak trains is an issue. Lea Green station has a big free car park, which makes it very popular with my constituents. The trains to Manchester come at nine minutes to and six minutes past the hour. That is two trains within 15 minutes of each other, and nothing for the rest of the hour. They also arrive within three minutes of each other in Manchester. It makes many local residents think, “What is the point?”. Surely there is a better way to spread out the service, especially when there are only two trains an hour.

In Liverpool, the story is the same for trains. From Lea Green and St Helens Central to Liverpool Lime Street, there are two trains an hour within 15 minutes of each other. In fact, sometimes at St Helens Central, the two trains an hour are as close as eight minutes apart and nothing for the rest of the hour. Again, if this service is limited to a certain number of trains per hour, it is important that they are spread out as much as possible.

Public transport should not be about whether transport companies are making big profits for their shareholders. It should be about people getting around more easily and more cheaply to give a boost to local businesses, local high streets and local attractions.

The Government need to stop seeing transport in isolation, and see it as a way to support local economies and communities. We have all seen the impact that Transport for London has had on making London the economic hub that it has become. For decades, millions of pounds of Government support have helped London to become the powerhouse that it is, but here, unless people are in the golden triangle, there seems to be nothing going for them. Each announcement seems to give us a kick rather than a lift. To help other cities across the country, the Government need to start funding us in the way that they have funded the golden triangle.

[Mr Laurence Robertson (in the Chair)]

Please could we drop the length of speeches to three to four minutes?

17:02

[Kim Johnson (Liverpool, Riverside) (Lab)]

It is a pleasure to serve with you in the Chair, Mr Robertson. I join my comrades in thanking my hon. Friend the Member for Birkenhead (Mick Whitley) for securing today’s important debate.

This Government have attempted to make levelling up their watchword of the day, but instead of tackling regional inequalities, they are rolling back on their promises, abandoning northern towns and cities to cope with failing transport infrastructure.

The integrated rail plan was seen as a once- in-a-generation opportunity to tackle fragmentation, deregulation and underfunding in our railways. It recommended a new line between Liverpool and Manchester, which would have transformed Merseyside, promising to bring 100,000 jobs to urban areas across the north and contributing £3.4 billion to the economy by 2040. Instead, the north has once again been failed, with no significant improvements to journey times, compromised capacity for local and freight services, and the promise of severe disruption and delays.

The bleak reality is that, with spending per head in the north half of that spent in London, transport across Merseyside and in the broader region is woefully lacking. People needing to get to work on time or get to hospital appointments are left wanting, forced to travel for hours. In failing to integrate Liverpool into High Speed 2 and the Northern Powerhouse Rail network, this Government have undermined economic growth in the city region. It has condemned us to up to six years of disruption to existing lines coming in and out of Liverpool, costing at least £280 million in every year of that disruption. If this Government are truly serious about levelling up for so-called left behind areas such as my own city of Liverpool, they need to put their money where their mouth is. Instead, they have shown once again that their promises ring hollow.

Labour leaders in the north-west and elsewhere are leading the way in investing in integrated sustainable transport systems. Liverpool’s metro Mayor Steve Rotheram has done some incredible work to roll out state-of-the-art, fully accessible and publicly-owned trains for the Merseyrail network later this year. He has already begun to deliver on a 600 km network of cycling and walking routes for the city region. He has secured £710 million to invest in further infrastructure improvement, including new green bus routes, and he submitted a welcome bid of £667 million to re-regulate and increase bus services across the network, to begin the roll-out of zero-emission hydrogen vehicles and to slash bus fares.

The task before us is enormous. We need radical change to undo the decades of decline of our transport network. The piecemeal policies and additional funding allocated so far do not face up to the scale of the challenge ahead. Instead, we need additional powers for combined authorities to bring services such as Merseyrail into public hands. We need the Government to engage with, support and finance the radical and ambitious transport plans that the metro Mayor is implementing.

17:05

[Ian Byrne (Liverpool, West Derby) (Lab)]

It is an honour to serve under your chairship again today, Mr Robertson. I thank my hon. Friend the Member for Birkenhead (Mick Whitley) for securing this important debate and for all the campaigning he has done on the issue. I also thank all the other MPs from Merseyside and beyond for their powerful contributions.

My hon. Friend outlined in detail the connectivity issues that we face across our transport networks in Merseyside. The environmental impact that this is having cannot be understated. The issues are intertwined. We need a change to the infrastructure if we are looking to reduce emissions, and have an impact on people’s health and wellbeing as well as to their ability to access work and services, and if we are looking to improve the digital economy experience that is vital in Liverpool.

We need long-term solutions—not pop-up cycle lanes or short-term schemes, but thought-out long-term investment infrastructure. We need real action, not soundbites about levelling up from the Government. If they are serious about the levelling-up agenda, the Government must listen, be led by what Merseyside Members, local leaders and our constituents are saying, and provide the resources and policy for the vital transport connectivity needed across our city region.

The integrated rail plan was a wonderful opportunity to revolutionise our country’s rail network, but the north has been offered a “cheap and nasty” deal, as has been much quoted today. My hon. Friend the Member for Liverpool, Wavertree (Paula Barker) made our collective thoughts clear in a letter to the Secretary of State, and there have been the comments made by Members today.

Since the reforms of the 1980s, areas such as Merseyside have been forced to contend with fragmentation, deregulation and underfunding. I thank metro Mayor Steve Rotheram and Liam Robinson for their work to reverse that awful legacy. I look forward to working with them to reintroduce the Bootle branch line. If the Bootle branch line—officially titled the Canada Dock branch—could be opened as a passenger route, it could save a host of Liverpool communities.

That line could run from Lime Street to Edge Lane, Prescot Road, West Derby Road, Townsend Lane, Walton Lane and County Road before going to Bootle. It would be a game changer for connectivity in West Derby and in the north of the city, and it is one that I know my hon. Friend the Member for Liverpool, Walton (Dan Carden) wholeheartedly supports.

In my constituency, the transport connectivity was arguably better a century ago than it is now. The former station buildings remind us of the Cheshire lines that served our community from 1884 to 1960, when passenger services ceased. My constituent Stephen Guy recalled:

“I was 12 when the passenger trains stopped and I recall the ticket office with its little window to pay fares. It was a picturesque line along the West Derby section and many people were saddened by the closure. People filmed and photographed the last trains. West Derby Station was the finest on the line. The station had popular staff who tended beautiful flower beds and hanging baskets—they won awards.”

That is a wonderful memory of civic pride in a publicly-owned railway network. I ask the Minister to look at what we had in the past and to see what can be reinstated; we could connect our city using existing train lines, by bringing stations back into public use and linking them to bus routes. That would offer real solutions, and result in cleaner air and better connectivity.

I am proud to have stood in 2019 on a manifesto that would have ensured that councils could improve bus services by regulating bus networks and taking them into public ownership and have given them the resources and full legal powers to achieve that cost-effectively, thereby ending the race to the bottom in working conditions for bus workers. It would also have delivered improvements for rail passengers by bringing our railways back into public ownership, allowing us to make fares simpler and more affordable and rebuild the fragmented railways as a nationally integrated public service, cut the wastage of private profit and improve accessibility for disabled people.

It is a false economy to waste funds, time and resources on quick wins that do not last. Will the Minister commit to investing in our infrastructure and look at long-term solutions?

[Mr Laurence Robertson (in the Chair)]

Please keep to three minutes.

17:10

[Alison McGovern (Wirral South) (Lab)]

It is a pleasure to serve under your chairship, Mr Robertson. I congratulate my hon. Friend the Member for Birkenhead (Mick Whitley) on securing this debate, which is much needed and very timely, as the number of speakers shows.

I agree with all that has been said about the IRP and the comments of Mayor Steve Rotheram. This issue gets to the heart of the problem with the Government’s transport policy, because we have been promised for more than a decade that the transport issues in the north will be dealt with. I am old enough to remember when the northern powerhouse was championed by the Conservative party; not any more, it seems. We were promised even by the current resident of No. 10 that we would see levelling up, but those promises ring absolutely hollow every time a constituent of mine tries to get a bus.

I will make just a few brief points. In Merseyside and right across the north of England, public transport is straightforwardly an equality issue, because it is people without cars, parents and older people who really struggle. If we are to improve productivity in this country and see a growing economy, dealing with the challenges of our public transport will be at the heart of the solution.

First, buses are massively important. We talk a lot about trains in this country, but the vast majority of people who are at the bottom end of things when it comes to wages get on buses; they have less access to cars, and in Merseyside they live further from train stations. I sound like an old woman today, but I remember when this Tory Government took away the bus support grant; it had a massive impact on the availability of buses in Merseyside and we are still feeling it today. Other hon. Members have talked about what a big deal it is when a bus gets taken away from a community. We have the possibility of some reform now in Merseyside, but what conversations has the Minister had with colleagues in the Department for Levelling Up, Housing and Communities, the Department for Work and Pensions and other Departments about the impact of poor bus services on the employment prospects for people in Merseyside and other parts of the north?

Secondly, our social housing areas in Merseyside are often very poorly served by public transport because of how the rail network was historically built to support a growing economy during the Victorian era. That means that, as many hon. Members have said, we need to go much further to address the imbalance. We need to look at the interconnections between areas of housing that need to grow, particularly for people who are struggling, and put the transport links in. My neighbour and hon. Friend the Member for Ellesmere Port and Neston (Justin Madders) mentioned the Wrexham-Bidston line; I feel like when the world ends I will still be saying we need better services on the Wrexham-Bidston line, so I implore the Minister to look at it.

Thirdly, people without cars need better transport because they need to be able to get to work and have better chances. We all need people to get out of their cars, because we all need to do something about climate change and we know that it will most affect those who have least. It is a matter of our environmental future and a matter of equality. I ask the Minister what conversations he has had with the Liverpool city region about its plans, because we need to supercharge them.

Finally, when devolution came about for Merseyside, we wanted it because we wanted to demonstrate that we could run ourselves—that we could improve life prospects for people in Merseyside right where we are, instead of having to come begging all the time to people in Whitehall, asking them to help us. So far, it is working. I simply ask the Minister to get behind us and let us show what we can do.

17:14

[Mr Tanmanjeet Singh Dhesi (Slough) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Robertson. My congratulations to my hon. Friend the Member for Birkenhead (Mick Whitley) on securing this important debate on transport connectivity in Merseyside. I express my gratitude, too, to my hon. Friends from Merseyside and nearby for the eloquence of their speeches, which amply illustrated their passion for their region. My Slough constituency is a long way from Merseyside—while they have the River Mersey, we have the Jubilee line, and while they have “Brookside”, we have “The Office”—but what I do share with the good people of Merseyside is their desire for better transport, and equality when it comes to transport funding.

For far too long the region has suffered, despite excellent local leaders pushing for better. Merseyside faces unique issues when it comes to transport connectivity. The majority of short trips—under 5 km—are made by car, and as a result the region has a significant air pollution issue. In the Liverpool city region alone, over 1,000 deaths a year are linked to this silent killer. On public transport, 80% of journeys are taken by bus, yet bus fares have risen by 40% and routes have been mercilessly cut nationally. Rates of active travel, such as walking and cycling, are relatively low, making up just 4.5% and 1% of journeys respectively. Given the population and the scale of the region, rail connectivity across the region and further afield is poor.

However, while the landscape of transport might be varied, the solution is simple: providing genuinely affordable, convenient, accessible and good-quality public transport. Indeed, despite this difficult landscape and northern funding facing a shortfall of £86 billion in comparison with London, it is a Labour-led locality that has driven through successes for the region, proving that when we listen to local people and commit to devolution, transport can be transformative.

Serving 1.6 million people, Mayor Steve Rotheram, with whom I had a good chat this week, has been fighting hard to bring about serious transformation of the Liverpool city region’s transport system. Under his leadership, Merseyside’s record on improving transport has been impressive. There is the roll-out of publicly owned trains for the Merseyrail network, and investment in new rolling stock, designed with local passengers’ needs in mind. That has used a direct public ownership and procurement model, which reduces costs and pioneers a new approach. There are the plans to completely overhaul and re-regulate the bus network as part of the bus service improvement plan. There is improved accessibility across the network, including level access from train to platform. Work is beginning on the first phase of a 600 km network of cycling and walking routes for the city region, and in the city region sustainable transport settlement, funding has been secured for new green bus routes and enhanced walking and cycling infrastructure.

Mayor Rotheram and hon. Members here are passionate about their region. A London-style integrated transport system is what they want. True devolution is required from Government, not mere soundbites. Significant funding is needed to meet the challenge ahead. How have Merseyside’s ambitions for transformational change been supported? I am afraid that it is the same old story from this Tory Government. Rather than levelling up, they neglect, betray and short-change the north from their Westminster bubble, ignoring local voices. and marginalising their well-informed views when it comes to decision making.

Nothing epitomises this more than the disintegrated rail plan; “cheap and nasty” is how Mayor Rotheram described the IRP’s weak offering for Liverpool, which will have all the disruption and none of the benefits. Instead of the full Northern Powerhouse Rail plans, as agreed by the cross-party, respected Transport for the North, Merseyside was offered a deal that provides no real or effective improvement to journey times, capacity or connectivity. Despite Liverpool Central station being declared at capacity by the Liverpool City Region Combined Authority, there are no plans for a new station for Liverpool unless it is locally funded.

The port of Liverpool is one of the busiest; it transported 31 million metric tonnes of freight in 2020 alone. Anyone would think that the Government would want to ensure that the port was served properly by the IRP, so that we could move more freight off our roads and on to rail, and reduce inner-city traffic and emissions. I welcome the recent upgrades to the Bootle branch line, but concerns about the disruption that will be caused by up to 88 freight trains a week during construction relating to the IRP have yet to be addressed. I therefore ask the Minister, quite simply: why is Merseyside being short-changed once again as a result of the Government’s rail plan for the north? This matters because the potential of our northern regions is being wasted. I appreciate, acknowledge and understand the huge potential of Merseyside, and it is disappointing that the Government clearly do not feel the same. I urge the Minister to engage with local leaders, hon. Members and the people of Merseyside to ensure that the plans deliver for them, because they will have direct consequences for millions of people for decades to come.

17:20

[The Minister of State, Department for Transport (Andrew Stephenson)]

It is a pleasure to serve under your chairmanship, Mr Robertson, and to respond to the numerous speeches made by right hon. and hon. Members.

I congratulate the hon. Member for Birkenhead (Mick Whitley) on securing the debate on this incredibly important topic. Transport connectivity in Merseyside is important for not just the city region, but the north of England and the whole United Kingdom. Responsibility for much of transport connectivity in Merseyside rests with the Liverpool City Region Combined Authority and the city region’s metro Mayor, Steve Rotheram, who has been referred to by many speakers, and whom I meet regularly, given that my portfolio includes high-speed rail and Northern Powerhouse Rail, as well as the trans-Pennine route upgrade.

Mayoral combined authorities—Liverpool city region was at the forefront of the drive to create metro Mayors—were created in recognition of the strategic importance of joining transport connectivity with activity on economic development, housing and planning, so that we can ensure sustainable economic growth in our great cities and opportunities for the communities in them. Through a series of devolution deals, we have provided mayoral combined authorities with more transport powers and more funding. I assure all Members who have spoken that the Department for Transport and its Ministers, including me, work constructively with the Mayor and all our partners in the Liverpool city region to ensure that its transport connectivity maximises economic growth and supports thriving communities.

[Sir George Howarth]

I am grateful to the Minister for giving way. What does he think about Steve Rotheram’s suggestion, which I repeated today, that the Minister sits down with local government leaders to see if a compromise can be reached that does not have all the downsides we know about, and that would improve the service in the way that many of us would like?

[Andrew Stephenson]

I thank the right hon. Gentleman for that point. I have spoken to Steve Rotheram since the integrated rail plan was published and I am aware of the call from northern leaders for more discussions. I am happy to have those discussions, both with the Mayor and with other northern leaders, to see how we can progress a variety of schemes. It is fair to say that I spoke to all the northern leaders regularly when considering the integrated rail plan and drawing it up. The Secretary of State met northern leaders through the Northern Transport Acceleration Council, which he founded. He also worked with Transport for the North to bring together a wealth of evidence and come up with the plan, but I am more than happy to continue to speak to the Mayor and others to ensure that we take local communities with us as we progress the plans. As we said in the plan, we take an adaptive approach towards investment. We are keen to continue to work with the Liverpool city region and others on delivery of the plans.

Improved transport connectivity within and between our great cities is fundamental to our levelling-up vision, in which we unlock the economic potential of the northern powerhouse, build back better from this awful pandemic, and ensure that the Liverpool city region and the north of England play a key role in a resurgent UK economy. That is why my Department, led by the Secretary of State for Transport, who is also the Cabinet Minister with responsibility for the northern powerhouse, is at the forefront of making that vision a reality.

[Dr James Davies (Vale of Clwyd) (Con)]

I thank my right hon. Friend for giving way and I congratulate the hon. Member for Birkenhead (Mick Whitley) on securing this important debate. For many, Liverpool is the capital of north Wales, yet direct rail services from the north Wales coast ceased in the 1970s. Thanks to the reopening of the Halton curve, hourly services are promised from Llandudno to Liverpool, although not, I think, until December 2023. Will the Minister join me in calling on Transport for Wales to bring that forward if it can?

[Andrew Stephenson]

I thank my hon. Friend for that point, which I will relay to the Minister with responsibility for rail, who I know speaks regularly to colleagues in Transport for Wales. He makes a very powerful point on behalf of his constituents.

Since 2010, over £29 billion has been invested in transport infrastructure in the north, but the Government want to go further, faster. Levelling up all parts of the UK is at the centre of the Government’s agenda as we build back better from the pandemic, and we will shortly publish a levelling-up White Paper that sets out bold new policy interventions giving local control to drive economic recovery. Transport connectivity is fundamental to that.

[Maria Eagle]

The Minister has said that he recognises the importance of transport connectivity and improving the economy of the Liverpool city region. Then why have his Government decided to deliver the worst option—a watered-down version of it described as “cheap and nasty” by the Mayor of the region? It is just not good enough.

[Andrew Stephenson]

It was described by Mayor Rotheram in those terms. However, our analysis has shown that the proposals from Transport for the North and others for brand new lines would have very significant additional costs and environmental impacts, and would deliver minimal additional benefits to passengers. They would also take longer to deliver than upgrades to existing lines.

Many right hon. and hon. Members referred to climate change. I speak as the Minister responsible for high-speed rail, and having spent a lot of time mitigating some of the environmental impacts of the construction of HS2. The embedded carbon in steel and concrete, and building brand new infrastructure through pristine countryside, has a huge environmental impact both on biodiversity and carbon emissions. We have to get the balance right. If in parts of the north of England we can deliver similar passenger benefits with less environmental impact, we have to consider those options realistically. These were the kind of issues we had to balance when we were drawing together the integrated rail plan.

The levelling-up White Paper is being finalised, but we are already making great strides towards strengthening the voice of the north. Mayor Rotheram represents a region that is part of the 60% of the north that is now covered by metro Mayors. We have announced the first allocations from the £4.8 billion levelling-up fund, which will regenerate towns and high streets and allow investment in the infrastructure that people need. This includes £37.5 million for Liverpool city region’s “levelling-up for recovery” proposals, which will deliver a range of transport interventions to support connectivity and economic growth in Liverpool city centre, the Maritime Gateway in Sefton and Birkenhead. Those include the transformation of Argyle Street with a new active travel corridor that will link regeneration at Woodside with a new Dock Branch Park and the enterprise zone at Wirral Waters; and reconfiguring the Kingsway tunnel toll plaza to address congestion and delay on the strategic bus and car route into Liverpool. In addition to this, we have committed £2.35 billion to 101 towns deals, which will invest in local economies; that will affect the constituency of the hon. Member for Birkenhead, but also Runcorn, St Helens and Southport—all in the Liverpool city region. All the towns fund proposals for those areas include measures to improve local transport connectivity.

England’s eight large metropolitan areas, including the Liverpool city region, are the mainstays of our work to level up the UK. We will invest £5.7 billion in the transport networks of those city regions through the city region sustainable transport settlements programme, including £710 million in the Liverpool city region. That funding will provide the Mayor with the flexibility to invest in local priorities, many of which have been applauded by hon. Members today. In Birkenhead, that funding will support further investment in the town centre, including, at Hind Street, the removal of the flyover that links the local highway network to the Queensway tunnel toll plaza and severs the town.

[Mick Whitley]

While I welcome any town or regeneration funds, the funding the Minister mentions is specifically for the regeneration of Birkenhead. What we are talking about is transformational change in transport. I have not heard in the Minister’s response about any changes that are coming any time soon. That is what we are talking about: transformational change to buses and transport on Merseyside and in the Liverpool city region.

[Andrew Stephenson]

In the 26 seconds left, I will say that the national bus strategy, which is part of a £3 billion spend on buses over this Parliament, should address many of the issues about buses raised by hon. Members. Obviously, during the pandemic, we provided £1.5 billion in emergency funding to keep the buses in the region going. We have supplied the region with £710 million in dedicated funding for active travel, and more has been announced by the Chancellor as part of a £2 billion package.

17:30

Motion lapsed, and sitting adjourned without Question put (Standing Order No. 10(14)).