(9 years, 6 months ago)
Commons ChamberI beg to move,
That this House notes New Economics Foundation research showing that local economies benefit twice as much from a pound spent in a pub rather than a supermarket; expresses concern that valued and viable pubs are being lost due to permitted development rights which allow pubs to be demolished or turned into supermarkets and other uses without planning permission, denying local people any say; notes that supermarket chains are deliberately targeting pubs and further notes CAMRA research that two pubs a week are converted into supermarkets; supports CAMRA’S Pub Matters campaign calling for an end to permitted development rights on pubs; notes that any change of use to a nightclub, laundrette or theatre requires planning permission, making it odd to refuse pubs the same status; notes plans to remove permitted development rights from pubs listed as Assets of Community Value (ACVs), and calls on the Government to announce how and when this will happen; notes, however, that pubs achieving ACV status is not as simple as Ministers have suggested, with the requirement for local communities to provide boundaries and plans and that every pub must be listed separately making it unrealistic for communities to protect all valued pubs; further notes that each ACV application costs local authorities over a thousand pounds, and listing all valued UK pubs as ACVs would cost millions of pounds and create significant bureaucracy; and therefore calls on the Government to make a simpler change and put pubs into the sui generis category so that communities can comment on a proposal to convert or demolish a pub.
I thank the Backbench Business Committee for granting the time for this important debate, which probably affects every constituency. I pay special tribute to the hon. Members for Leeds North West (Greg Mulholland) and for Easington (Grahame M. Morris). This is a cross-party motion on something that is incredibly common sense and popular throughout the country.
The Government have done a lot on pubs, but there is still a problem that needs solving, and every Member could give examples to show the Government the importance of the measure we are proposing. Every week, 31 pubs are closing and two are converted into supermarkets, with absolutely no chance for the community to have its say.
We had a vote on the issue two weeks ago when we attempted to amend the Infrastructure Bill. Sadly, we were defeated, but that does not change the fact that many of us remain completely convinced that we need to move pubs into a planning use class of their own—the sui generis planning class, for those of us who love our Latin—to protect them properly. That would not mean making an exception to any rule; it would not be an unusual thing to do. It would simply apply to pubs the kind of protections that exist for slightly counter-intuitive things in many ways, such as laundrettes, night clubs, petrol stations and scrap yards. It seems an extraordinary omission that pubs are not included in that planning category and that the Government put such energy into preventing them from being so.
The solution that I and other hon. Members have proposed has several advantages. It is simple, it would involve an easy change to the law and it would not require any more bureaucracy. That is in contrast to other measures that we have considered such as article 4s and assets of community value, which are bureaucratic, are difficult for the public to access and to find out about, and cost significantly more money.
The measure we are proposing is consistent. We protect other types of building in this way, which many would argue do not have the community significance of pubs, or at least do not have any more significance than pubs. Therefore, we would not be singling out pubs for special treatment; we would simply be applying to pubs the type of treatment we already permit for other valued community facilities.
The hon. Lady is making a strong argument. Does she agree that this is in accordance with the Government’s own localism principles? It is hardly revolutionary, and in terms of saving money the alternative proposed by the Government of listing pubs as assets of community value incurs a considerable cost while this is a simpler, more cost-effective way to ensure protection.
I completely agree. This is the kind of localism the Government have been pushing very strongly in other areas, empowering local authorities and empowering the planning system. Although I can see where they are coming from with the concept of the asset of community value, it is much more expensive and much more bureaucratic. I am also concerned that it is inequitable for the communities whose pubs it seeks to protect in that it will be easier for those communities that are more engaged in the political process and find it easier to be so—such as those where English is the first, rather than the second, language—to find out how to make the pub an asset of community value. Others may not find it so easy. I am therefore concerned that that mechanism may result in an inequitable protection of community assets that are equally loved and valued across different areas.
It is surprising that the Government do not seem to be taking the same view of localism on this one occasion as they are in other areas. Because I believe in the Government’s localism agenda, I urge them to rethink this and roll out their concept of localism that they have been pushing so effectively over the last four years to this item in planning.
As ever, my hon. Friend makes a good point. I do not think that would be the case, and it is certainly not the case in respect of other facilities to which this applies. Another Government objection to this idea is that it would result in boarded-up pubs. That is certainly not the case. One of the major merits of this proposal is, simply, that it is fair. It gives communities the ability to have their say, but if a pub is genuinely unviable it would be allowed to fail and would have planning permission granted, because local authorities have every incentive not to see boarded-up properties. We do not see the high streets littered with boarded-up laundrettes.
I think we could all name pubs in our constituencies that are unviable and which the community does not need, and which perhaps historically have been run so badly for many years that it is hard to pick them up and change their reputation, and which are turned to other uses that are welcomed in the community. The Foresters pub in my constituency was turned into a supermarket. That is not something I would generally celebrate, but it has not been the end of the world. It has been a change that many people have welcomed, and our proposal would not in any way stop this kind of change taking place. It would simply allow people their say in the planning procedure before it takes place.
There are many local examples, and I am sure hon. Members could list ones in their own constituencies, where we have lost valued pubs of community value. The Bourne End in Brentry in my constituency was demolished very quickly and many in the community wanted the chance to have their say. There was nowhere near enough time to list it as an asset of community value. The developers simply came in and it was gone.
On the Government’s suggestion that local authorities should list pubs that are genuinely valued as an asset of community value, is the hon. Lady aware of the number of pubs that would be protected in that way out of the 48,000 in total? I am sure that she is, because she will have read the briefings from the Campaign for Real Ale and the Fair Deal For Your Local campaign.
The hon. Gentleman prompts me in a timely way. As I understand it—he will correct me if I am wrong—the number of pubs that currently have asset of community value status is around 600. That speaks for itself in regard to the efficacy, accessibility and ease of the Government’s measure. I will come back to that point.
(10 years, 8 months ago)
Commons ChamberI greatly welcome much of what is in the Bill. I am slightly disappointed by the tone of some—not all—Labour Members, who seem to suggest that the challenges our society faces with social care are in some way new. I looked after an old lady from 2003, during the economic boom times, and became very well acquainted with her care package, care needs and care challenges, and the challenges faced by her social workers. Back then, social workers were expected to get across London in 20 minutes, which was obviously impossible, so the care time that they had with my friend was severely cut down; in fact, sometimes it was 15 minutes, a figure that we have already heard. There was also a massive challenge in terms of raising the status of the profession of social work. Those challenges existed back then, during the boom times, and they still exist now. It is very brave and ambitious for the Government to be making such significant steps in unifying health and social care at a time when the economic situation is very difficult.
Other Members have dealt with the care and support aspect of the Bill more eloquently than I can, and I am sure that others will too. I want to focus my brief remarks on part 2, which is about the response to Francis and care standards.
I think that one lesson we have learned following the Mid Staffs scandal is that making rules does not necessarily mean making change. I remind the House of the 2002 “Code of Conduct for NHS Managers”, which states:
“As an NHS manager, I will observe the following principles: make the care and safety of patients my first concern and act to protect them from risk;…be honest and act with integrity; accept responsibility for my own work and the proper performance of the people I manage”.
Following the unravelling of scandals in Mid Staffs and elsewhere, it is very hard to understand how NHS managers were adhering to that code of conduct, which was written for them, and why none of them has faced the consequences of not doing so. That is a salutary lesson: we need to be wary that putting things in writing does not always mean that they will happen culturally. People have remained unaccountable for a serious breach of that managerial code of conduct, many of whom, I am afraid to say, continue to work in the NHS today.
As the Bill progresses, I want to see more detail on how the contractual obligation for a duty of candour, which is welcome, will be enforced. I understand the desire for a statutory duty on individuals, but I share fears that it may oversimplify the blame culture that this House has discussed at length. Having seen what happened with our hospitals’ complaints system and the cover-up of blame, I am very worried that a statutory duty on an individual clinician could be abused, such that blame could be parked at a clinician’s door by a management system that does not want its own failings to be highlighted. That could lead to unfortunate false allocations of blame by the system in which clinicians work.
If a contract’s duty of candour is not met, what will be the consequences? It is an issue that there have been no consequences for those who have breached things written down in guidelines and codes of conduct. It is important to understand in more detail what the consequences will be of a breach of contract.
I would particularly like to know whether managers, organisations such as NHS England, and Department of Health officials will have the same duty of candour. The reason why scandals such as Mid Staffs have been allowed to go on and on is that it was not just the hospital that was complicit in it; the entire system around the hospital should have been acting in patients’ interests, but it did not.
Some have faced consequences for their actions—their actions were good, but the consequences have been diabolical—namely whistleblowers. I know and understand that real reform of how we treat whistleblowers and enable whistleblowing will require changes to the Public Interest Disclosure Act 1998. If a whistleblower has been found to be correct in raising concerns in the NHS and those concerns are recognised, I would like to know why any future employer would choose not to employ them. If an employer is a good employer, they would welcome a whistleblower into their ranks as someone who would not go native and accept appalling care when others might do so and who would also have the moral fortitude to stand up and talk about failings when others might not. The test of a good employer is how well they employ people who have been proven to be whistleblowers.
People such as Eileen Chubb and David Drew have sacrificed their careers to highlight bad care, but they have not seen the systemic changes for which they made those sacrifices and they are still suffering the consequences. Surely that is a part of NHS and health culture that the Bill should seek to change.
I welcome the fact that the Care Quality Commission will be looking at the issue of whistleblowers and I welcome James Titcombe’s involvement in the CQC. As someone who thought that the CQC brand was so damaged that it should probably just be scrapped and we should start again, I have to say that I think David Prior has made remarkable progress, given what he started out with, in beginning to turn this monolith around.
Statutory independence of the CQC is very long overdue. I think that everyone in the House has been concerned about the fact that the CQC’s mission seemed to be reputation management for itself and the NHS, and not a brave and courageous stand on behalf of the patients it was supposed to be protecting. In order to ensure that the CQC remains independent from Government—independence in words is fine, but independence in culture is what really matters—it might be illustrative to look back to the era before the CQC and other regulatory bodies were in place, when royal colleges used to send their members into hospitals. They would do so not to inspect hospitals as such, but for reasons of medical training. However, by getting a granular view of the training on offer they could see whether or not it was sufficient. If not, the royal colleges could, under bodies such as the hospital recognition committee, withdraw training from a hospital, which gave the inspection teeth. It was the royal colleges that went in—often without any pay at all; just enough to cover expenses—and interviewed junior doctors and consultants individually, and problems naturally came to light because the interviews were often confidential.
A Wigan hospital fell foul of an inspection in 2001 and its chief executive did not take kindly to it. Funnily enough, just after the inspection took place, the chief executive, who was quite close to Alan Milburn and the then Prime Minister, went into the Department of Health and abolished the system whereby professional clinicians could get a granular view of what was going on in hospitals, replacing it with the postgraduate medical education training board and then the medical training application service, which was disastrous. The more we can put those who do not have an interest in bolstering the Government of the day—namely the professionals, clinicians and members of the royal colleges—on the ground and doing granular investigations, the more confident we can be that the CQC will be independent.
I am not sure that I share the hon. Lady’s enthusiasm about the transformation of the CQC; nevertheless, some progress has been made. Does she share my concern that clause 85 proposes to dilute the CQC’s powers with regard to investigating the commissioning of adult social services and social care by local authorities? Is that not a step backwards, particularly if the hon. Lady is concerned about the issue of 15-minute visits and the impact that has on quality?
I am afraid that the quality of care and social care could be the next boil of scandal to erupt as we gain a more granular view of what is going on. Organisations need not just more effective tick-box inspections, but more effective granular inspections. I do not agree with the hon. Gentleman: I think the CQC is taking great steps forward. I am very sceptical, but I am cautiously optimistic of progress and will continue to look at what the CQC does.
I will make progress, because I do not want to prevent other Members from contributing to the debate. Essentially, the Bill can only put down regulation. One of my favourite things is to warn against systems so perfect that nobody needs to be good, yet this House really only has levers to change systems. We cannot always enable people to be good, but we can devise systems that enable them to be good. This House is attempting to turn around a massive cultural tanker and it is unrealistic to think that we can do so through the scope of a single Bill. I think, however, that the Bill takes very important steps forward in a very difficult context. I am disappointed that it is not supported throughout the House, although I think that constructive amendments and changes to it will be welcomed in the interests of the patients we are all here to serve. I heartily recommend the Bill to the House.
(11 years, 1 month ago)
Commons ChamberI absolutely agree, although there is a distinction to draw between managerial staff, who I think have been leant on heavily to make their hospital look good, and the ground-level staff, many of whom have been battling over the last decade to be able to put clinical priorities ahead of management and political priorities.
I am going to make progress, if I may.
I am surprised when many on the Opposition Front Bench talk about the welfare of staff, because one of the things Labour did that was so disastrous was take the medical royal colleges out of inspections. That happened after one hospital in particular was found to be lacking. Alan Milburn at the time—in the early 2000s—removed the medical royal colleges from the inspection regime, and did so perhaps, we have to ask, because they might come up with some very unpleasant truths. I am delighted that the Secretary of State is looking to reverse that decision in respect of those who know and will give Governments of all colours a good kicking if things go wrong.
There has also been, unfortunately, a culture of cover-up—I would love to be proved wrong on this; there is still time, there is information that I am still seeking, and anyone can come to me with it—about the three reports that were commissioned on the 60th anniversary of the NHS. The right hon. Member for Leigh shakes his head but I would very much like to meet him to see whether he can show me the minutes of the meetings which he must have attended, at which these reports were discussed. [Interruption.] I will make progress while he talks at me from the Opposition Benches.
It is ironic that on the 65th anniversary we have cupcakes. On the 60th anniversary there were three reports which warned, I remind Members, of a culture of fear and compliance—that sounds familiar; hitting the target and missing the point, which also sounds familiar; and inadequate regulation and inspection. Goodness me, doesn’t that sound familiar? The reports were exhumed only after freedom of information requests. I have put freedom of information requests to the Department of Health which, oddly, have been obstructed. I seek the help of the Secretary of State and of the shadow Secretary of State, if he would like to set the record straight, in seeking information. Who was present at those meetings where those reports, which cost the taxpayer £500,000, were discussed? They were by international experts, including Don Berwick, whom we are now putting at the centre of our NHS on the zero-harm strategy.
I am terribly sorry. I will make progress.
I would also like to set the record straight on who knew what about hospital trusts. The right hon. Member for Leigh says that he took astute action. He knows, because I have the e-mails, as he does, that he was written to by Professor Sir Brian Jarman about 25 trusts about which he had concerns. He said he was concerned that the CQC was not doing its job. Seven of those were investigated by Sir Bruce Keogh. Fifteen of those trusts were in marginal seats and one, as he will know, was in the constituency of the right hon. Member for Leigh.
(12 years, 6 months ago)
Commons ChamberA number of Members on the Government Benches have referred, in Health questions and at other times, to the huge support among clinicians and GPs in their area, but Clare Gerada, the chair of the Royal College of General Practitioners, has said that just because GPs are compelled to man the lifeboats does not mean they agree with the sinking of the ship. That sums things up.
Hon. Members on the Government Benches should be particularly concerned by some recent polling figures. According to a poll by ICM, the over-65s—the category of people who are most likely to use the NHS and most likely to vote—want to drop the Bill by a margin of 56% to 29%, or two to one, which is the largest such margin. Sadly, not one Conservative Member, as far as I am aware, has had the courage to sign the early-day motion or to call publicly on the Health Secretary to publish the risk assessment. I know that, privately at least, some of the more thoughtful Conservative Members have been advising the Secretary of State to publish, but he seems to be flatly ignoring them. The risk register contains an objective list of the Department’s view of the risks, an estimation of the likelihood of each specific risk occurring and an estimation of its severity if it did occur. To be clear, what the Health Secretary is determined to conceal are the severe and likely risks of his own reckless attack on the NHS.
The Prime Minister must also be held to account for his broken promises on the NHS, for allowing his Health Secretary to put the NHS at risk and for standing by him while he tries to cover up the mess that is the Health and Social Care Bill. I remind the House that the coalition agreement that was signed by the Government parties stated:
“The Government believes that we need to throw open the doors of public bodies, to enable the public to hold politicians and public bodies to account.”
How does that statement square with this decision? Where is the accountability now? No one in the country voted for these health reforms, the Health and Social Care Bill has no mandate and we in the House will be asked to vote on reforms in the knowledge that the Department of Health and the Health Secretary are complicit in hiding the associated risks.
I am only going to give way twice, so I shall give way to the hon. Lady.
That is very kind; I thank the hon. Gentleman. Does he agree that if we want to debate the health reforms, this is not the place to do it because we are talking about the risk register? Also, does he agree that all this is slightly disingenuous because Governments do not publish risk registers for good reasons, in that it would be far more risky for patients, whom we should all be considering, if Government Departments could not have frank and open discussions? The risks we should really be looking at are those to patients.
I thank the hon. Lady for her intervention, but if she had been present for the whole debate, she would know that we have covered much of that in discussing the nature of a fundamental change—the biggest ever shake-up—in the national health service since it was established. We are not calling for the nationalisation of the railways or the abolition of the House of Lords. We are simply calling for the risk register to be published, in the interests of openness and transparency, to identify the risks associated with the changes proposed by the Government.
The changes are a matter of the most serious consequence. If the Health Secretary is suppressing a report that shows that the reforms could put patients at risk and worsen the functioning of the NHS—if that is in the report, which I do not know, as I have not seen the strategic risk register, at least the national one—he would be guilty of the biggest political cover-up in a generation.
As my right hon. Friend the Member for Leigh (Andy Burnham) mentioned, in his ruling back in November the Information Commissioner, Christopher Graham, said of the Secretary of State’s reasoning:
“Disclosure would significantly aid public understanding of risks related to the proposed reforms and it would also inform participation in the debate about the reforms.”
But almost three months on, we as parliamentarians are still being kept in the dark. We were told that releasing the risk register would jeopardise the success of the policy, but the Information Commissioner refuted that and said it would only enhance the quality of the debate and allow for greater scrutiny of the policy.
We were then told by Ministers that they had published the relevant risks associated with the reforms in the impact assessment. If that was the case, why would the Information Commissioner rule that they should be published to inform debate and why would the Health Secretary fight tooth and nail to prevent that?
Finally, we were told that publication would risk the frankness of future risk registers, another point that the Information Commissioner specifically ruled out. Before the general election, the Conservatives promised to “unleash an information revolution” in the NHS, yet in government they are giving us the biggest cover-up in the history of the NHS. The Prime Minister once described his priorities in three letters: NHS. So we should not be shocked by the professional and public outcry of “OMG!” since he has broken his promise of
“no more top-down reorganisation”
and deployed WMD—weapons of mass deception—to conceal the true nature of his reforms.
Opposition Members know the dangers for the future of the NHS with up to 49% of work carried out in NHS hospitals being done by the private sector, and every service provided by the NHS, whether it be radiotherapy or speech therapy, put out for competitive tender, making it vulnerable to private sector takeover. It is no wonder we are debating the threat to the NHS when so many pre-election promises have been broken.
I conclude by offering some advice to the Health Secretary. I leave him with this thought: history is littered with examples of people who have fallen from grace, not for their crimes, but for the cover-up. He should end his terrible attack on the NHS and have the courage to be open about his plans to fragment and privatise our beloved national health service.