Brexit: Economic Impact on North-East England

Viscount Ridley Excerpts

Tuesday 10th January 2017 Lords Chamber

[Baroness Neville-Rolfe]

I am surprised that the noble Lord talks about a London focus because I think this Government have actually changed. We have had the northern powerhouse document, which I hope he has read, which we published at the time of the Autumn Statement. We are undertaking an industrial strategy which I look forward to discussing in this House. The importance of place will come through strongly in that strategy. I note the other points that he has made.

[Viscount Ridley (Con)]

My Lords, would my noble friend consider looking at a proposal from the North East Chamber of Commerce to create a free trade zone in the north-east to build on the continuing success of the north-east economy?

[Baroness Neville-Rolfe]

I am glad to hear from my noble friend, who introduced me to some of the joys of the industry of the north-east. I have indeed seen the North East Chamber of Commerce’s manifesto, which makes very interesting reading. In terms of the future on trade and on Brexit, we are carrying out a range of analysis to inform our negotiating strategy, and I shall certainly bear in mind the points that he made. But I think that you need to look at the United Kingdom as a whole.

National Infrastructure

Viscount Ridley Excerpts

Thursday 22nd January 2015 Lords Chamber

[Viscount Ridley (Con)]

My Lords, I congratulate the noble Lord, Lord Adonis, on securing this debate and on the prize we have just heard about from the noble Lord, Lord Berkeley. I have had huge respect for him ever since his recent very fine report about the north-east of England. I am very sympathetic to much of what he has to say about the future of infrastructure but I will focus my remarks on roads.

Since 1990, France has built 2,700 miles of new motorway. Between 2001 and 2009, under the previous Government, this country built just 46 miles. To use the words of the noble Lord, Lord Adonis, himself, this was a “master class” in underinvestment, although admittedly it was before he was Transport Secretary. The UK has half as much motorway per vehicle mile as other major EU countries. It is not as if the Labour Government did not know that they were underinvesting in this, because in 2006 they commissioned Sir Rod Eddington to look into the road network and make suggestions. He wanted to tackle a number of bottlenecks, build bypasses, widen roads, improve junctions and so on, and he made a number of recommendations which largely were not acted on.

The Institute for Economic Affairs calculates that, over the last decade or so, we have been cancelling road projects that would have an average benefit to cost ratio of 3.2 to 1 and deferring ones with a benefit to cost ratio of 6.8 to 1. Yet at the same time we have been funding public transport projects with much lower benefit to cost ratios averaging about 1.8 to 1. I ask the noble Lord, Lord Adonis, why so little was done to fix the roads when the fiscal sun was shining. Was it just because we were all frit of Swampy in those days? I welcome the fact that, as my noble friend Lord Sassoon said, this Government are planning, under much tougher fiscal conditions, to spend £24 billion on roads between 2010 and 2021 to resurface 80% of national roads, to add 221 lane-miles of motorways and start 52 major road projects. I echo what my noble friend Lady Maddock said about welcoming the dualling of the A1 through Northumberland.

The crucial point is that we need to rethink how we pay for roads. In 2011, the RAC Foundation said that we had fallen behind other nations in the way we fund road building because in both the United States and across Europe contracts to build roads are nearly always, or very frequently, privately financed, often regionally commissioned and invested in by pension funds because there is a capital return through tolls. For example, in the United States, 4,500 miles of new highway infrastructure have been built in this way, using tolls, since the early 1990s. In France, which is hardly a hotbed of free-market economics, they have privatised most of the strategic road network and drivers are now very used to using tolls, particularly because of electronic tolling. That is, of course, why the roads in France are so good and they have been able to build so much more. The RAC Foundation concluded:

“Across continental Europe, toll roads now account for a significant portion of the strategic road network in all of the countries we have reviewed.”

We need to be more radical, open and imaginative if we are to cut congestion, which is a huge drain on business in this country, and boost economic growth.

Health and Social Care in England

Viscount Ridley Excerpts

Thursday 11th July 2013 Lords Chamber

[Viscount Ridley]

My Lords, I also congratulate the noble Lord, Lord Patel, on the timely nature of this debate, and it is an honour to follow the noble Lord, Lord Kakkar. They are a reminder of the great expertise that this House has on this subject.

I have learnt a lot already this morning, and expect to continue to learn more. I am particularly struck by the consensus among the noble Baronesses, Lady Jolly and Lady Boothroyd, who said that things cannot continue as they are. However, I want to come at this from the bottom up, as it were—from how technology and patient expectation will drive changes both to the structure and, by necessity, to the funding of healthcare services, and in particular, how digital and genomic innovation will have an effect on the National Health Service. It is a subject that has been much discussed at the International Centre for Life in Newcastle, of which I have the honour to be honorary president, and I declare my interest therein.

It is not all bad news. We are likely to see huge reductions in the cost of certain procedures as a result of innovation. IT, 3D printing in surgery and new materials are all helping to drive down various costs. I believe that the cost of a cataract operation has come down dramatically because of an increase in the speed of doing it and a decrease in the cost of the materials. This is, of course, bringing operations within the reach of the poor in other countries as well as in this country.

Genomic sequencing has come down from costing billions to thousands in the past decade alone. As we know, however, if we make things cheaper, people will want more of them. I suspect that, through new technology, we will soon be putting enormous demands on healthcare services. We will use our smart phones to find out precisely what kind of lurgy we have, rather than just accepting that we have one; what kind of allergy we have; which drugs work best for our particular condition; and indeed, checking our blood for early precursors of cancer. At the very least doctors will have to get used to dealing with us online. I have a friend who over lunch checked his electrocardiogram with a device on his iPhone and sent it to his cardiologist.

We would be sticking our heads in the sand if we hoped to prevent this end-user innovation, as it is called, turning medicine upside down, as it has done to so many other industries, and if we continued to think of medicine as a top-down business in which the doctor knows best. In the past, treatments have too often been designed to treat the population rather than the individual. For the patient, the change will be great in many ways, and there will no doubt be some savings. For example, we can have many more virtual appointments. As Eric Topol, who has written a book about this, says:

“I expect some 50% to 70% of office visits to become redundant, replaced by remote monitoring, digital health records and virtual house calls”.

This will keep down hospital-acquired infections as well. Overall, however, it will vastly increase costs because personalised medicine means not only more demand but more expensive sorts of demand. That is bound to push up costs well beyond what any pooled system can bear in terms of cross-subsidy, whether from the rich to the poor or through insurance. It will undoubtedly raise ethical issues. If precise genomic diagnosis or drug toxicity information is available to some individuals and not others, it will put enormous strain on the budget of the NHS and the principle of common access to it. There will then effectively be a form of rationing. Added to that, of course, is the growing burden of us all living much longer, as the noble Lord, Lord Filkin, said, and of having up to five conditions when we are old, which I believe is the average, not to mention the obesity epidemic which my noble friend Lord McColl mentioned.

It is obvious that we face rising healthcare costs as a proportion of household budgets. That is why it is vital to turn the NHS as far as possible into an organisation that tries to drive down its costs in a ruthless fashion. The Government have made a good start on this. The NHS is on track to make £20 billion of efficiency savings by 2015 and, we hope, more beyond that. However, as many noble Lords have said today, this will prove to be a drop in the ocean. Not even the NHS’s most ardent champions would at the moment call it a ruthless pursuer of cost-efficiency. It has none of the usual levers such as competition or fear of losing business to other providers that drive up efficiency and quality in the commercial world. No amount of top-down diktat will substitute for those trends. To meet the bottom-up challenge coming from patients and from technology, health funding needs to experience a form of bottom-up reform. Sixty years on from the founding of the NHS, as the noble Lord, Lord Patel, said, we need to be open-minded about all the models available for discussing the future of health reform.