Health and Social Care Committee

Debate between Ben Bradshaw and Sarah Wollaston

Thursday 1st November 2018 Westminster Hall

[Dr Sarah Wollaston (Totnes) (Con)]

I would like to present a report on “Prison health” by the Select Committee on Health and Social Care. I start by thanking my fellow Committee members and the Committee staff, particularly Huw Yardley and Lewis Pickett. I also particularly thank all those who gave evidence to our inquiry, both in person and in writing. We visited HMP Isis, HMP Belmarsh and HMP Thameside, and I thank the staff, healthcare staff and all the people in prison who spoke to us about their experiences.

A prison sentence is a deprivation of liberty, not a sentence to poorer health or healthcare, yet sadly that was the picture that we found in our inquiry. Too many prisoners are still in overcrowded, unsanitary prisons with overstretched workforces. Those poor conditions contribute to even worse outcomes and health for those who arrive in prison, who are often from very deprived backgrounds and suffering from serious health inequalities. Violence and self-harm are at record highs, and most prisons exceed their certified normal accommodation level, with a quarter of prisoners living in overcrowded cells over the last two years. Staffing shortages have led to restricted regimes that severely limit prisoner activity, as well as their access to health and care services, both in and outside our prisons.

Too many prisoners still die in custody or shortly after their release. Although deaths in custody have fallen slightly since peaking in 2016 as a result of increased suicides, so-called natural-cause deaths are the highest cause of mortality in prisons and, I am afraid, reflect serious lapses in care. Every suicide should be regarded as preventable. It is simply unacceptable that those known to be at risk face unacceptable delays while awaiting transfer to more appropriate settings. We see that happen time and again, without appropriate action being taken.

Our report refers to the impact of the increasingly widespread use of novel psychoactive substances, not just on prisoners but on prison staff; dealing with violent incidents takes time away from the work that we would otherwise expect prison staff to do. We heard time and again from people in prison who we met of not being able to attend appointments, either within or outside the prison, because there simply were not the staff there, because they had been diverted to other cases.

We have made recommendations for the National Prison Healthcare Board. We would like it to agree a definition of equivalent care, and to tackle the health inequalities that we know prisoners face. It also needs to take a more comprehensive and robust approach to identifying and dealing with the healthcare needs of people in prison. However, many of our recommendations will not be met until sufficient prison officers are in post. That is an overriding issue, because the cut in prison officer numbers—I know the Government are starting to address that—lies at the root of so many problems in our jails.

Health, wellbeing, care and recovery need to be a core part of the Government’s plans for prison reform. It is in all our interests to care about the health and wellbeing of prisoners, because they will later be back in our communities. If more of them become dependent on drugs during their time in prison, and these problems worsen, they will come back into our communities with even worse health issues, health inequalities and mental health problems. I know it is difficult, because it sometimes seems that the public do not care about our prisoners, but it is absolutely in everybody’s interest to care about the health and wellbeing of our prison population.

I am afraid that our report highlights a system in which, time and again, reports from Her Majesty’s inspectorate of prisons are not acted on. We need those reports to have real teeth, and for people to be able to take action, or to be held accountable for not taking action. We heard time and again of governors not having the levers—even if they had the financial powers—to take the necessary action.

We call on the Government to regard the health of our prison population as a serious public health crisis requiring a whole-systems approach that takes root in sentencing and release, making sure that people are only in prison if absolutely necessary, that those with serious mental health problems are transferred in a timely manner and that sees time in prison as an opportunity to act and to address serious health inequalities. That is not only in their interest but in all our interests.

[Mr Ben Bradshaw (Exeter) (Lab)]

Given the picture the hon. Lady just described, she will be aware of the serious problems in Exeter Prison, which the staff there are doing their utmost to try to address. Does she agree that, as we face voting on the Budget later this afternoon, it might have been better, rather than giving tax cuts to the richest 10%, for the Chancellor to spend that money on helping our prisons to deliver the kind of services that she would like to see?

[Dr Wollaston]

I thank the right hon. Gentleman for his contribution towards the report. He identifies that this is an area that is often deprioritised in favour of other issues. However, we absolutely have to prioritise the health of our prison population. I agree that we should address staffing levels. We should also look at the health and wellbeing of our prison staff. Too many leave because of the pressures and the violence that they face in prison.

Customs and Borders

Debate between Ben Bradshaw and Sarah Wollaston

Thursday 26th April 2018 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

Outside an effective customs union there is no such thing as a frictionless border. There is no escape from border checks, rules of origin and expensive infrastructure, and that means costs, delays and red tape. There will be implications for future investment, for people’s jobs and livelihoods, and for the stability of peace in Northern Ireland. But there is one area that has not been touched on: the implications for patient safety.

I am privileged to chair the Health and Social Care Committee, and we have been hearing detailed evidence about the implications of leaving the customs union on patient safety. These consequences go far beyond the economic consequences for individual pharmaceutical companies, about which my right hon. and learned Friend the Member for Beaconsfield (Mr Grieve) and my right hon. Friend the Member for Broxtowe (Anna Soubry) have spoken compellingly. In fact, these are consequences that directly affect patient safety.

The Committee heard clear and compelling evidence about the extent to which NHS care is dependent on a network of highly integrated, complex and time-sensitive supply chains for the delivery of medicines. For years, we have taken it for granted that when a prescription is issued, it will be available on the pharmacy shelf. I am afraid that we will not be able to take that for granted in the future, because the complex supply chain—from the research lab right through to the pharmacy shelf—will be disrupted by delays at the border, and that will affect costs.

Delays at the border will also directly affect the delivery of patient care. For example, every year in this country, about 700,000 diagnostic tests take place that rely on the availability of medical radioisotopes, which are very time-sensitive. Very many other products would be affected, such as blood plasma derivatives. There are products and devices that are not manufactured in the UK but which we know from past experience have very fragile supply chains, such as dialysis equipment. We have had problems with this before and it could happen again.

[Mr Ben Bradshaw (Exeter) (Lab)]

Speaking as a member of the hon. Lady’s Committee, can I ask her to confirm that every single witness who provided written and oral evidence to our recent inquiry said that their preference was for us to stay in the customs union and the single market?

[Dr Wollaston]

I thank the right hon. Gentleman; I can confirm that.

There are other very worrying examples. After the Manchester Arena attack, a very rapid supply of 500 highly specialised trauma-related items was flown in at very short notice from a Belgian-based company. There are very many serious patient safety issues.

There is also an issue of cost. A report today from the King’s Fund highlights the increasing cost of drugs to the NHS. The cost of medicines has grown from £13 billion in 2010-11 to £17.4 billion in 2016-17. However, that cost has been held down by the impact of the supply of generics and the way that primary care has actively switched to these products. Generics are pharmacologically equivalent products that become available when a medicine comes off patent. The British Generic Manufacturers Association told us in evidence that once a medicine comes off patent, a dozen to 20 companies will pick it up. The risk is that as costs and other non-tariff barriers go up, some companies will relinquish their licences and their marketing authorisations. Why would they bother with all the red tape and extra costs? That immediately means that the number of manufacturers goes down, and the likelihood of the cost of generics to the NHS increasing goes up.

I am afraid that the fast and unhindered free movement of medical equipment, medicines, devices, organs and blood products between the UK and the EU that has evolved over decades is at risk if we leave the single market and the customs union. I think there will be a huge crunch moment of reality. The public will never forgive us if, after we leave the European Union, people’s drugs and life-saving equipment are not available. This is where we are starting to run into Brexit reality, as opposed to the overly optimistic, unrealistic prospectus that has until now been sold to the British public. It is time for the Government to respond to our request in the Committee to hear when the Ernst and Young-commissioned report on the supply chain will be available. We need far greater contingency planning and a great dose of reality.

A&E Departments: Winter Pressure

Debate between Ben Bradshaw and Sarah Wollaston

Thursday 3rd November 2016 Commons Chamber

[Dr Wollaston]

Of course I welcome the increase in staff in our accident and emergency departments. As the Minister will recognise, there is further to go in this regard.

[Mr Ben Bradshaw (Exeter) (Lab)]

Does the hon. Lady agree that the four-hour A&E target is absolutely vital, because it, more than any other target, shows the overall performance of a hospital, and that the figures are extremely worrying? Does she also share my concern that last winter was very mild, and we were relatively lucky, with the absence of a big winter flu outbreak? If this winter is as cold as this Chamber, the NHS could face a very serious crisis indeed.

[Dr Wollaston]

Certainly, the evidence we heard in our inquiry was that there is grave concern about the level of existing pressure. As the right hon. Gentleman says, if we see a very cold winter, and the flu vaccine does not work as well as it did last winter, we are in serious difficulties. But I stress again that the Committee was very clear that we want to see the four-hour waiting time standard continued, because it is a good measure of whole-system pressure, and if people are facing very long waits that leads to a deterioration in patient safety. So it is a quality issue, as well as an issue about patient experience.

SELECT COMMITTEE ON HEALTH

Debate between Ben Bradshaw and Sarah Wollaston

Thursday 3rd November 2016 Commons Chamber

Dr Wollaston

- Hansard - - Excerpts

Of course I welcome the increase in staff in our accident and emergency departments. As the Minister will recognise, there is further to go in this regard.

Mr Ben Bradshaw (Exeter) (Lab)

- Hansard -

Does the hon. Lady agree that the four-hour A&E target is absolutely vital, because it, more than any other target, shows the overall performance of a hospital, and that the figures are extremely worrying? Does she also share my concern that last winter was very mild, and we were relatively lucky, with the absence of a big winter flu outbreak? If this winter is as cold as this Chamber, the NHS could face a very serious crisis indeed.

Dr Wollaston

- Hansard - - Excerpts

Certainly, the evidence we heard in our inquiry was that there is grave concern about the level of existing pressure. As the right hon. Gentleman says, if we see a very cold winter, and the flu vaccine does not work as well as it did last winter, we are in serious difficulties. But I stress again that the Committee was very clear that we want to see the four-hour waiting time standard continued, because it is a good measure of whole-system pressure, and if people are facing very long waits that leads to a deterioration in patient safety. So it is a quality issue, as well as an issue about patient experience.

Great Western Railway’s Bicycle Policy

Debate between Ben Bradshaw and Sarah Wollaston

Monday 11th July 2016 Commons Chamber

[Mr Ben Bradshaw (Exeter) (Lab)]

I am going to tell the House a story about myself—although it is not just about me but about the thousands of people who use the Great Western Railway service every year, and the many thousands who have signed a petition protesting about its so-called new policy.

I have not owned a car for more than 20 years. Before being elected to the House and every week since then, I have cycled from this place to Paddington railway station, put my bicycle on a train, travelled back to Exeter, taken my bicycle off the train, and gone about my constituency business. At the end of the weekend, I have done the same in reverse. First Great Western—or Great Western Railway, as it has now rebranded itself—has had a perfectly good and workable cycling policy, which has encouraged people to book a space in advance but has allowed people such as me to turn up and, if there is space in the cycling carriage, to put their bicycles on board. There is a designated space at the front of the train, with room for six bicycles.

In the nearly 20 years for which I have represented Exeter in the House, I have generally not reserved a space. I can count on the fingers of one hand the number of occasions on which I have arrived at Paddington or Exeter and not been able to get my bike on to a train because it has been full. There are nearly always spaces in the cycle carriages. So the House will understand why, when I was told by a Great Western Railway employee at Exeter station in April that the company was about to introduce a compulsory booking system for people with bicycles, I was somewhat concerned. I immediately asked to speak to a senior manager, who reassured me that this was not the case, and that discretion would be allowed. However, I took the precaution of writing to the managing director of Great Western Railway asking him to repeat that assurance. I explained to him the scenario that I have just outlined: it seemed to me to be ridiculous—Orwellian, even—that if people turned up at a station with a bicycle and there were spaces in the carriage designed for carrying bicycles, they should not be allowed to take their bicycle with them.

The managing director gave me a very reassuring response. On 26 April, he wrote:

“We understand that there will be times when booking is not possible and space is available on board.”

Booking, of course, is not possible for people like me, and many of the thousands of other people who do not know what train they will be able to catch. The business of the House is very unpredictable, as are my constituency commitments.

The managing director went on to say:

“Station staff have been briefed to allow bikes on board if this is the case, and we are checking that this message has reached colleagues, and you should not therefore have any issues travelling without booking a space for your cycle if there is space on board.”

That was back in April. I have to say that, in spite of that reassurance from Mark Hopwood, I was subsequently inundated with emails, letters, tweets and Facebook messages from other people in my position, who told me that they had encountered difficulty getting their bikes on to a train without a reservation, even when there were spaces on board.

I wrote my letter to Mr Hopwood from a train on which I had put my bicycle, without a reservation, and there were spaces on board. To this day, at many Great Western Railway stations, there are signs and tannoy announcements saying “You cannot put your bike on this train unless you have a reservation”. That is a lie. It is not true. It is not the policy, as Mr Hopwood told me in his letter. But it is still being represented as the policy at stations, in tannoy announcements and in messages. So it is not surprising that there is confusion among GWR staff.

I was then contacted by a constituent of the hon. Member for Bristol North West (Charlotte Leslie), who has also been lobbied on this. Sadly, she is unwell and cannot be here today. Her constituent had received a missive from another GWR management member that completely contradicted the assurance I had been given by Mr Hopwood. He said: “To be clear, we require you to reserve your bicycle on our high-speed trains, as our publicity states.” He went on to say, or to imply, that this was about preparing for the introduction of the new high-speed trains, which we are very much looking forward to serving our part of the world in the far south-west. I understand, however—the Minister may like to clarify this in her reply—that they are not due to come into service for another two years, so I was not quite sure why he was preparing for this event.

Simon Pritchard goes on to explain in his email that the reason they are doing this is that in the new high-speed trains the cycle spaces, instead of being in a designated carriage at the front of the train, will be in three separate areas along the train—two in each area, or more if the train is longer—so in order to try and avoid the chaos and confusion that would ensue from people trying to get their bikes on a train if they had not booked, they were trying to encourage people to book in advance. That is all very well, and I will come back to it in a moment.

Another problem that has exacerbated this whole issue is that it is incredibly difficult, complicated and clunky to book a bicycle on a train. People either have to telephone, although the telephone service operates only within certain working hours, or they can book online, but that can be done only when booking a ticket. So the only way people returning from a journey who already have a ticket can book is by phone, which, as I have said, does not operate for many hours of the week, or by going to a station. Of course, that is massively inconvenient for customers.

I went back to Mr Hopwood to seek clarification. I applied for this Adjournment debate, too, in the hope that this might make something happen. Indeed, as is so often the case when one secures an Adjournment debate, I received another letter from Mr Hopwood today, written last Friday, which is moderately reassuring. He has invited me to a meeting with cycling groups, which I am very happy to take up. He says that this discretion of people being allowed to take their bicycles on a train without a booking will continue, and implies it will do so until the new trains are introduced. He goes on to say they are working on a reservation system that will allow customers to take a bike on a train independently from their ticket purchase at short notice, even after the train has started its journey. Up until now, people have only been able to book a bike on a train up to two hours before that train has started its journey. On the long journey from Penzance to Paddington that is completely impractical because by the time the train has started its journey and someone has decided what time train they are going to get, the train has already left the station at Penzance so they cannot book their bike on. He also says that there will be an online service, a telephone service and service at stations and that they hope to have this facility available to customers by the start of the December timetable.

That is a welcome improvement and concession by GWR, which I am convinced has happened only as a result of the pressure put on it by customers who have used its service over the years. Mr Hopwood then argues that this will provide the flexibility cyclists have asked for and allow bookings to be made much closer to departure. If that is the case, it is an improvement. However, he also goes on to claim that the requirement to book space on long-distance services is not unusual and he says that other railway companies—he quotes more than three, but the three I am concentrating on are the three I know: CrossCountry, Greater Anglia and South West Trains—also have mandated bicycle reservations.

Well, I can tell Mr Hopwood that I took my bicycle on a CrossCountry service on Saturday without a reservation. I have taken it up to Norwich on Greater Anglia in the past six months without a reservation, and I have also taken it on South West Trains without a reservation in the past six months, so what he says is simply not the case. At a time when we should be encouraging people to use sustainable transport and to travel sustainably, rail companies should be bending over backwards to encourage people to use their bicycles.

[Dr Sarah Wollaston (Totnes) (Con)]

I thank the right hon. Gentleman for securing the debate and absolutely agree with everything he has said so far. Does he agree that it was clear from the Get Britain Cycling inquiry that he and I served on in the previous Parliament that active travel to work is a key aspect of encouraging people to get cycling, and that the health benefits that that brings are not in dispute?

[Mr Bradshaw]

Yes, I completely agree. I have described the system as Orwellian partly because of the confusion and the contradictory messages that are being given to the public, but the hon. Lady is exactly right that this is a moment in our history when we should be encouraging people to use sustainable transport and to take their bikes on trains. If there is space on trains, people should be allowed to put their bikes on to them.

This is a classic example of a big organisation announcing a policy without consulting any of the people who use the service and without thinking through its implications and repercussions. It then has to backtrack and try to clarify the situation, but does not really clarify it properly. It ends up thinking, “Oh dear, we’ve got ourselves into a bit of a mess here. How are we going to get out of this?” If only it had consulted the people who actually use the service, it could have avoided this situation. I can think of many examples of this happening in public life. I am sure that the Minister, who has a lot on her plate at the moment, can think of some as well.

The company has introduced this mandatory reservation system, which turns out not to be mandatory, in advance of the introduction of the new trains, but why on earth did it not wait until the trains were actually introduced? Instead, it has introduced the policy now, which has been confusing and might put people off taking their bikes on trains. It is okay for me because I have this letter from Mr Hopwood saying that I can take my bike on a train without a reservation if there is space for it. I have put a copy of it on my iPhone so that if I ever have any problems, I can flash it at the guard and say, “Look, I have an assurance from your boss that this is okay.” I have also put a photograph of the letter on Twitter and elsewhere. For the ordinary tourist or non-regular traveller, however, the policy will be a real deterrent to their doing exactly what the hon. Member for Totnes (Dr Wollaston) has said is the right thing to do.

I ask Great Western Railway to issue a clear, comprehensive clarification of its policy, and to make it absolutely clear publicly in the notices that it puts in railway stations and in the announcements on the tannoy, which are still inaccurate, that people can still put a bicycle on its trains without a reservation until the new trains are introduced. Also, as I mentioned a moment ago, Mr Hopwood is wrong about the practice on CrossCountry, Greater Anglia and South West Trains. Those trains already have a system whereby bicycles can be accommodated, with two at the front, two in the middle and two at the back. That is the system that Great Western is about to introduce. It is not difficult for someone to put their bicycle on a train if there is a space for it; they just need to move up and down the platform and put it into the space. This idea that people should be required to book in advance because of the new configuration of the trains, even if no one else has booked and spaces are available, is Orwellian and against the whole thrust of Government policy.

I hope that the Minister, given all the other problems on the railways that she is facing, will be able to have a quiet word with Great Western Railway and sort this issue out to reassure people who, like me, have been using the system perfectly happily for many years. This unnecessary change has created an almighty mess and confusion, and I hope that she will be able to get Great Western to see sense.

Great Western Railway Routes

Debate between Ben Bradshaw and Sarah Wollaston

Monday 8th February 2016 Commons Chamber

[Mr Ben Bradshaw (Exeter) (Lab)]

I apologise to you, Madam Deputy Speaker, and to the hon. Member for Torbay (Kevin Foster) for arriving a few seconds after he rose to his feet. The previous business finished rather earlier than a lot of us expected or had been forewarned about, but I congratulate him on being the driving force behind this timely debate.

At the end of the week, when I get into carriage A at Paddington with my bike in the bike space just in front of it—carriage A is the quiet carriage—I sit down, and I usually have the best two hours of my week. Every time I am on that journey, I give thanks to Isambard Kingdom Brunel and the brilliance of the line that he created back in the Victorian age, from which we are still benefiting. It still think it incredible, given that very little has happened since, that on a good day someone can get from London to Exeter—quite a long way, as I am sure hon. Members who know their geography realise—in under two hours, and that is very much thanks to Brunel.

I completely agree with the hon. Member for North Wiltshire (Mr Gray), because for all its frailties, Great Western is my favourite railway line. I travel across the UK quite a lot, and it is certainly better than the new franchise owners on the east coast main line, and the pokey little carriages on Virgin and the west coast main line. Great Western is comfortable and bright. The loos do not work, and when they do they flush straight on to the tracks. That is completely intolerable and unacceptable in the modern age and must change as a matter of urgency. The ventilation is idiosyncratic, and one can often find a carriage that is far too hot or far too cold, but the staff are always delightful and friendly, and the service is excellent.

I have one plea to all railway companies, which is that they should do much more to publicise a passenger’s right to a full refund if they are delayed by more than an hour. I really think that they are getting away with too much, and far too many people do not realise that they are entitled to a refund. I was an hour and a half late coming back at the weekend because of some of the problems that the hon. Member for Torbay referred to, and, in terms of good customer service, such compensation should be announced on the trains as a matter of course.

[Dr Sarah Wollaston (Totnes) (Con)]

In highlighting the beauty of the line to Exeter, may I encourage the right hon. Gentleman to stay on the train and see how even more beautiful the line gets once it passes along the coast? It is not just about the beauty of the line, which I hope everyone will experience, but the economic importance of the line via Dawlish to the economies of south Devon. Will he join me in saying that whatever we do we must protect the line through Dawlish and protect the economies of south Devon?

[Mr Bradshaw]

I know the line through Dawlish very well. I spent childhood holidays in Salcombe. In fact, my parents used to get a train all the way to Kingsbridge in the good old days before Beeching took his axe to our rural rail network. It is beautiful, but vulnerable. I will come on to say something about it in a second.

Having said all those positive things, we still have rolling stock that was introduced, I think, in the early 1970s. As I have said, travel speeds have not actually increased very much for decades, if not for a century. I mentioned the loos and the heating, and the hon. Member for Torbay mentioned electrification. It is puzzling that Spain and Italy have full comprehensive networks of high-speed electric trains, but in this country we still do not have a network of high-speed trains. We are getting one slowly, but in the south-west we are set to be probably the only major region with big cities left in western Europe that does not have either high-speed trains or electrification. There is absolutely no reason why we should not already have electrification down to Exeter. There have been technical challenges, but having been on electric trains in the Alps that go up steep gradients I have never quite understood what the barrier is to electrification where there are gradients. As the hon. Member for Torbay says, we will very soon have the technology to overcome that.

Accident and Emergency Waiting Times

Debate between Ben Bradshaw and Sarah Wollaston

Wednesday 5th June 2013 Commons Chamber

[Dr Wollaston]

The reality that we face is that there is a limited amount of public funding. We can spend that pot of public money only once, so we must spend it in the right place, and that often means that we need to spend more of it within social care. That is why I welcome the fact that some of the health budget has been shifted to social care, and that is very important. I also commend Torbay. My constituency covers Brixham and Paignton, and Torbay has been nationally and internationally recognised for its work on integrating health and social care. It is no coincidence that it does so well on A and E waiting times, and we should be looking at what it has achieved.

But how will we keep people out of our A and E centres? In the Health Committee, we heard evidence about the effect that paramedic crews have. If the paramedic crew in an ambulance are highly skilled, the person they treat is less likely to need to go to casualty in the first place because the expertise is there to keep them at home. There needs to be better access to records. We need to consider how we can improve IT so that the patient owns their record and every part of the system can safely access their drug and medical history—with their consent, of course.

[Mr Bradshaw]

Given the hon. Lady’s previous distinguished career as a Devon GP, does she, like me, deplore the comments made today by a Government Minister, who sought to blame the current crisis in the NHS on the growth in the number of women doctors?

Cycling

Debate between Ben Bradshaw and Sarah Wollaston

Thursday 23rd February 2012 Westminster Hall

[Dr Sarah Wollaston (Totnes) (Con)]

Some 30 years ago, I fell in love on a tandem. I have to share the tragedy with hon. Members that last week I turned 50. On my last day of being 49, my husband turned up on the front half of my tandem like a knight in shining lycra and whisked me off for 28 miles on Dartmoor and a 3,000-foot climb. Frankly, I could not care less about being 50—it was a wonderful evening.

It would be a shame if we did not add the joy of cycling to this debate. Cycling makes us feel glad to be alive, improves our mood and quality of life. That is important, because we need to get more people cycling. There is safety in numbers, but we do not want to frighten people away from cycling—we need to send that crucial message. I cycle to work most days in Westminster. When I first started cycling in London 30 years ago, I felt a bit of an oddity, but now whole pelotons sweep past me. Maybe that is because I am getting slower, but it certainly feels a lot safer when there are more cyclists around.

I welcome the campaign from The Times, but I would like it to be broadened to include rural cycling. I represent a rural constituency. Some 36 people were killed on rural A roads, and 26 on urban roads. It is between five and 10 times more dangerous to cycle per mile on a rural A road than it is in the city. I would particularly like to remember the 11 people from my constituency who were killed or seriously injured cycling between 2005 and 2010. In pressing for change, may I also urge the Minister to consider a change to the language and stop calling them accidents? I suggest that driving and overtaking at 60 mph on a rural lane and hitting a cyclist is not an accident—that is a crash. It minimises, and makes it worse for the victims’ families if we call them accidents. Let us abandon the language of denial and neglect.

I am grateful to my many constituents who have written to me today to give me their ideas, one of which was on speed limits. I know that other hon. Members have referred to this, but the Netherlands is rolling out changing to 60 kph on rural networks. That is the equivalent of 40 mph, as the hon. Member for Llanelli (Nia Griffith) said. Will the Minister consider that change? It is disappointing to hear that perhaps that is not something the Department will press forward with. On behalf of all hon. Members, I press him to reconsider. I would also like to reconsider, as many hon. Members have, the issue of a safe passing distance of at least one metre. That should made very clear, be part of the driving test and in The Highway Code.

Cycle training is improving. This weekend, I will visit a Steiner school with a wonderful organisation called Always Be Cycling. Not only does it give excellent training to both children and adults, but it teaches people how to repair their bikes. Most people own a bike, but not everybody uses it. Part of the reason for that may be that they lack the confidence to repair it. I urge the Minister to continue to give more support to such excellent cycling training schemes. I would like to see safer manhole covers—non-slip manhole covers would be an excellent development—and more training for lorry drivers. Finally, I want the Minister to focus on how we separate vehicles from cyclists in rural areas.

I pay tribute to the parents at the Steiner school in my constituency who got together and formed the sustainable transport action group, and actively considered how many children were cycling to school—a miserable 2.8%. By working closely in co-operation with local landowners, the parents have increased that figure to 9.1% in just two years by introducing a safe off-road route. This demonstrates that we really do see effective change.

In contrast, in another part of my constituency, at Littlehempston, with regard to which the Minister has already been helpful, it is a scandal that at the home of the transition movement—Transition Town Totnes—we have possibly the only bridge in the country that keeps communities apart. The final link in National Cycling Network 2, the route running all the way from Kent to Cornwall, could be joined up if there were a safe route through Totnes to Littlehempston. At the moment, if I were a parent in Littlehempston I would not want my children to cycle to school. The road between Totnes and Paignton is hideously dangerous. I have cycled it myself many times.

If only the bridge were open and there was co-operation with landowners and, crucially, the co-operation of a sustainable steam railway—the South Devon Railway—which had the bridge built. The real scandal is that £87,000 of public money went towards the £173,000 cost of building that bridge.

We have all heard the bogus arguments about cycling, including the dangers of vandalism and all that stuff—the resistance that is sometimes seen from communities and landowners who do not understand the real benefits that cycling can bring their communities.

[Mr Bradshaw]

I should like to highlight another example, which is the failure so far to complete the cycle route from Exeter to Dawlish, a wonderful route along the Exe estuary, because of the failure of the landowner—the Earl of Devon—to agree to a new bridge over the railway. That bridge would be publicly funded, but he just does not like the look of it.

[Dr Wollaston]

I thank the right hon. Gentleman for that.

Let us sweep away some of these bogus arguments and have real involvement and drive. I should like Devon county council, for example, not to be put off from issuing compulsory purchase orders where there are short gaps, so that the local community can really benefit. In this Olympic year, I should like to think that a child living in Littlehempston might be able to start their future Olympic cycling career by cycling from Littlehempston to Totnes.