Regional Transport Infrastructure

Debate between Alex Chalk and Kevin Hollinrake

Tuesday 5th March 2019 Westminster Hall

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is a pleasure to serve under your chairmanship, Ms Ryan, and to follow the hon. Member for Barnsley Central (Dan Jarvis). I thank him for securing the debate. I will touch briefly on devolution, which has proven to be the most intractable political situation in Yorkshire—much more so than Brexit—over the past five or 10 years. However, I am sure that there is a way forward, and I agree with the hon. Gentleman that it is crucial that we find it, so that we can properly exert our influence over central Government on hugely important matters, such as transport investment in our counties.

As the Chancellor admitted in his Budget speech in November 2016, no other major developed country has as large a productivity gap between its capital and its second and third cities as the UK. We are the most regionally imbalanced nation, which is a huge issue that we must deal with. London is 50% more productive than the regions of England—not only the north—and has 50% higher wages, on average, than the north. There is a direct correlation there. This is not about spending for spending’s sake; it is about the prosperity of the people we represent. There is no doubt that infrastructure spending has been disproportionately higher in the capital than in the regions, and redressing that imbalance will transform the economy right across the UK.

[Alex Chalk (Cheltenham) (Con)]

Does my hon. Friend agree that, in seeking to redress that imbalance, it is critical to present an ask, as it were, to the Department for Transport? When the Cheltenham cyber-park needed transport infrastructure, the Department provided £22 million, showing that, where there is a clear goal to improve infrastructure, it is keen to help where it can.

[Kevin Hollinrake]

I totally agree. I will come shortly to the clear ask, which has been set out for us by Transport for the North.

The Government are doing much. By 2021, infrastructure investment spending as a percentage of GDP will be at its highest for the last 30 years, while the national productivity investment fund will increase to £37 billion by 2023-24. The Government recognise that this is an issue. We must always make sure that we spend wisely and, in many cases, the minimum amount, because this is taxpayers’ money.

However, in my view there is a difference between recurrent spending—much of which is important but which we clearly have to keep under control, making sure that we run a surplus, rather than a deficit—and investment spending. A business would treat the two things differently in its accounts. Businesses have balance sheets and they also look at profit and loss. Investment spending goes on the balance sheet. We should look at investment spending in our regions in a completely different light from other types of spending, particularly in the north.

I support Transport for the North’s recent strategic plan. The hon. Member for Barnsley Central rightly referred to £3 being spent per capita in London for every £1 spent per capita in the north. However, it is not all to do with central Government spending or central allocations. Much of it is about local authority spending and private sector investment. It is important that we recognise that difference. Nevertheless, Transport for the North’s strategic transport plan sets out very clearly the £70 billion of spending needed between now and 2050, which would contribute an extra £100 billion gross value added to our economy and 850,000 jobs. That is a compelling case, as my hon. Friend the Member for Cheltenham (Alex Chalk) referred to earlier.

Yes, part of it is about Northern Powerhouse Rail, which is so important to connect Liverpool to Manchester, to Bradford, to Leeds, to Hull and to Scarborough, and to go up into the north-east as well, but when that is delivered is also key. I would like my hon. Friend the Minister to consider, if possible, in his closing remarks when Northern Powerhouse Rail will be delivered, because the key ask in the Transport for the North strategic plan is that it be delivered to coincide with High Speed 2 delivery in 2033, and that would involve bringing forward the very important Northern Powerhouse Rail plan.

I again congratulate the hon. Member for Barnsley Central on initiating the debate. I look forward to listening to further contributions.

Privatisation of NHS Services

Debate between Alex Chalk and Kevin Hollinrake

Monday 23rd April 2018 Westminster Hall

[Alex Chalk]

I am grateful to the hon. Lady. I respect her past record and her contributions to the House. There is an ongoing debate among clinicians—no doubt colleagues of hers—about what the NHS should cover. Most of the clinicians I speak to would welcome a more open, non-partisan and grown-up debate about the full extent of the NHS, but the guiding principle should not be confused. Whatever it is that the NHS can provide, the core principle is that it will provide it to individuals in our country regardless of their personal circumstances. I am at pains to emphasise that, because from listening to some of the contributions of Opposition Members—no doubt made entirely sincerely, but made none the less—one could be confused into thinking that that principle was under attack. It is not, and it never will be.

The debate is about the delivery of a common goal. Many take the view, with some justification, that we should be open to solutions that deliver that goal most effectively for patients. Last year, the respected and politically independent King’s Fund wrote in its report:

“Provided that patients receive care that is timely and free at the point of use, our view is that the provider of a service is less important than the quality and efficiency of the care they deliver.”

When debating this important question, we should not rewrite history. As the hon. Member for Ealing North (Stephen Pound) has conceded, it is a fact that certain services have been provided independently since the NHS’s inception 70 years ago. Most GP practices are private partnerships; the GPs are not NHS employees. Equally, the NHS has long-established partnerships for the delivery of clinical services such as radiology and pathology, and non-clinical services such as car parking and the management of buildings and the estate. To give an everyday example, the NHS sources some of its bandages from Elastoplast. That is common sense. It would be daft if public money was diverted away from frontline patient care to research and reinvent something that was already widely available. It would be just as daft if the NHS had to do the same for its water coolers or hand sanitisers.

As the King’s Fund put it in its 2017 report:

“These are not new developments. Both the Blair and Brown governments used private providers to increase patient choice and competition as part of their reform programme, and additional capacity provided by the private sector played a role in improving patients’ access to hospital treatment.”

Throughout Europe there are healthcare systems that offer high-quality care, free at the point of use, and make use of far greater numbers of private providers than the UK.

I want to say a few words about the impact on my constituents in Cheltenham. I will give three brief examples. First, Cobalt is a Cheltenham-based medical charity that is leading the way in diagnostic imaging. It provides funding for research, including into cancer and dementia, which it does as part of a research partnership with the ²gether NHS Foundation Trust. It assists with training for healthcare professionals, and it even provided the UK’s first high-field open MRI scanner, which is designed for claustrophobic and larger patients. Are we seriously suggesting that is an affront to patient care in Cheltenham? Not a bit of it. Are we seriously suggesting that getting rid of it would be a good idea? Emphatically no.

Secondly, we have the Sue Ryder hospice at Leckhampton Court, which is a 16-bed hospice that delivers truly excellent care in the Gloucestershire countryside. It also provides hospice-at-home services. It also supports, as I know, family, carers and close friends. It is part-funded by the NHS and by charitable donations. It shows astonishing compassion, but also creativity and innovation in how it delivers care. The third example is Macmillan and its nurses. I need say no more about it—it is a fantastic organisation. To suggest that these independent providers and charities are somehow not good for patient care is to stretch a political principle beyond breaking point.

We also need to slay the myth—there was just a glimmer of it today, but it was not really developed—that somehow different types of providers are held to different standards. All providers are held to the same standards and given rigorous Ofsted-style inspections and ratings by the Care Quality Commission. For my constituents in Cheltenham, I want to see resources allocated as effectively as possible to free up resources for facilities such as A&E at Cheltenham General Hospital, which can only be delivered there. There is growing demand for A&E in Cheltenham, and the service needs to be 24/7.

It is right to say, however, that there are some legitimate concerns that can be properly addressed. The experience of Carillion has laid bare the chaos that can be caused when private providers take on significant contracts and then fail to deliver. We have to recognise that the consequences of failure in health services would not simply be an unfinished construction project, important though that is, but could be a decline in the quality of patient care. I mention that only because community services are disproportionately served by independent providers, but let us keep this in context. Based on a survey of 70% of CCGs in 2015, Monitor published analysis in its report, “Commissioning Better Community Services for NHS Patients”, showing that independent providers were responsible for just 7% of contracts. We should be vigilant, not dogmatic and quasi-religious in our approach. The NHS as a whole must ensure that no contract ever becomes too big to fail and that contingencies are always in place to cater for such an eventuality.

[Kevin Hollinrake]

My hon. Friend is making a very fine speech. He mentioned the failure of Carillion. There are many lessons from that and many reasons behind the failure. One is that Carillion worked on wafer-thin margins in its contracts, which illustrates that the taxpayer gets very good value for money because of the competitive nature of the bidding process.