Hospital Parking Charges (Exemption for Carers) Bill Debate
Full Debate: Read Full DebateChristopher Chope
Main Page: Christopher Chope (Conservative - Christchurch)Department Debates - View all Christopher Chope's debates with the Department of Health and Social Care
(9 years ago)
Commons ChamberI beg to move, That the Bill be now read a Second time.
I am pleased to have the opportunity to introduce the Bill and facilitate this debate in the House. I thank Members who have given up their valuable Friday constituency time to take part.
This is an important subject and it is essential at the outset to outline the context. The Bill raises, not for the first time in this place, the controversial subject of hospital car parking charges. Other hon. Members have made the case for free hospital car parking. In 2012, the hon. Member for Kingswood (Chris Skidmore) ran a prominent campaign against hospital car parking charges. In 2014, the right hon. Member for Harlow (Robert Halfon) ran a high-profile campaign on free hospital car parking, arguing that charges represent a “postcode lottery stealth tax”. The hon. Member for Wellingborough (Mr Bone) then chose the abolition of hospital car parking charges as the subject of his private Member’s Bill. I am grateful to them all for their work, which has provided a valuable foundation for my Park the Charges campaign.
No one likes to pay to park, full stop. To pay to park at a hospital, when sickness is involved, seems to add insult to injury. The majority of people in Scotland and Wales enjoy free parking when visiting hospitals and other medical facilities. During the course of my research for the Bill, many people contacted me to express the view that all hospital users in England should enjoy the same privileges as their Scottish and Welsh counterparts and be able to park for free when attending hospitals. That may well be desirable, but it goes beyond the scope of the Bill, which focuses on providing support for carers.
The Bill makes provision for carers who are entitled to carer’s allowance to park free of charge in hospital car parks in England. The duties in the Bill would also apply to walk-in centres, GP practices and private hospitals. The Bill, if passed, will require health authorities to put in place a strategy to exempt a broader range of carers from paying parking charges within one year of the Act coming into force.
I chose this subject for my Bill because about 18 months ago, I had a taste of what it is like to be a carer. My mother was seriously ill in hospital. So serious was her condition that we were not sure what the outcome would be. It was a distressing time. I was, by and large, the only visitor and I visited every day for nine weeks, often staying for long periods to provide comfort and support. I spent a lot of time sitting in hospital corridors, waiting to speak to medical staff; I had read every notice on the walls. Each night when I left, tired and distressed, I queued up to pay for my parking. It was costing me £40 a week, and on one of those days, driving out of the car park, it occurred to me that I was lucky, because I could afford to pay that charge. I reflected on the matter and wondered about those people who could not afford to pay—not those who would rather not pay to park, but those who could not afford to. I was distressed and worried about my mum, but I thought how much more distressing it must be for those in financial hardship that is made worse by hospital car parking charges.
There are currently 5.5 million carers in England providing unpaid care for people who have specific support needs. More than 700,000 of them receive carer’s allowance at a rate of £62.10 a week. A further 400,000 are entitled to the benefit. Those are the carers who will benefit if the Bill is successful.
The hon. Lady makes a compelling case, but do hospitals not have discretion to respond in the way that she wants them to, without the need for the Bill?
I am grateful to the hon. Gentleman for raising that point, and I will come to it later in my comments, if he will bear with me.
That is the point I was making. If I did not make it, I apologise for not being clear. For the avoidance of doubt, those decisions are made locally and I support that fact. Labour Members clearly do not believe that they should be made locally. They believe that the rules should be set nationally. In a nutshell, that is where we have a difference of opinion. I believe the decisions should be made locally; the hon. Member for Burnley clearly believes they should be made centrally. That is a perfectly respectable position to hold, but it happens to be one that I do not agree with. That is the nub of the point on localism.
My hon. Friend is absolutely right. I will say more about Scotland and Wales in due course, because we have seen the impact of this policy in those countries. There is not a never-ending supply of money, and if more is spent on free car parking in the NHS, less will inevitably be spent in other areas. Labour Members seem to think that money grows on trees and that there is a never-ending supply of it, but back in the real world, we have a certain amount of money and we choose how to spend it. If we choose to spend it on one thing, we inevitably have to take it away from somewhere else. The hon. Member for Burnley did not mention the need to make that choice, but it is important that we face that fact.
The hon. Lady has clearly had difficulty in finding evidence to support her Bill, so I thought I would help her out a bit. She has clearly spoken to lots of carers groups, and she has set up the Park the Charges campaign with Carers UK, for which I commend her. For the sake of balance, however, we should not just listen to the views of carers, important though they are. We should also seek the position of the hospitals on this matter, because they would ultimately be the most affected by the proposed changes.
I am not sure what discussions the hon. Lady had with the hospitals, given that her Bill would force them to change their car parking policies. I contacted the East Lancashire Hospitals NHS Trust, which I believe is the hospital trust that covers her constituency. I asked the trust what consultations she had had with it on this policy. I put in a freedom of information request to ask what communication Burnley general hospital had received from the hon. Lady on the issue of carers and hospital car parking charges. I received a response on 25 September, which stated:
“I can now confirm that we have not had an enquiry of this nature from Ms Cooper”.
I have been accused of many things in my time. A burst of socialism is a first, even for me. I may try and put that out to my left-wing constituents to show them that there is hope for me yet. If I did come out with a burst of socialism, I apologise profusely, not least to my hon. Friend, who always keeps me on the straight and narrow. I apologise for a burst of socialism; it was not intended to be such. I feel chastised.
We should consider why hospital car parks are not already free. There is an argument, I guess, that instead of picking out parking for carers, all hospital car parking should be free. In its 2009 report, “Fair for all, not free-for-all—Principles for sustainable hospital car parking”, the NHS Confederation stated:
“Charging for car parking is often necessary, but needs to be fair – and to be seen to be fair.”
It is important for Opposition Members to recognise that the country and the NHS do not have millions of pounds to spend on covering the cost of parking for a certain section of the population. The Labour Government left this country in a huge financial black hole which we are still struggling to recover from. Policies such as this could severely affect local NHS hospitals and services and their budgets.
There is an analogy that I always give in such situations, which I first heard Lord Tebbit use. I hope that goes some way to restoring my hon. Friend’s faith in me after my earlier lapse. The analogy in this context, which is not necessarily the context in which Lord Tebbit used it, is this: if somebody asked, “Do you think we should have free hospital car parking?”, the chances are that virtually everybody who was asked would say yes. If they were asked, “Should we have free hospital car parking? By the way, that will mean having to get rid of lots of doctors, nurses and essential staff”, people may give a different answer. In the analogy that Lord Tebbit used, the question was, “Would you like a free Rolls-Royce?”, and he suspected that the vast majority of people would say yes. If they were asked, “Would you like a free Rolls-Royce? You’ll have to live in a tent for the rest of your life to pay for it”, people may come up with a different answer.
Of course, in principle, people would love to have free hospital car parking, but we have to think what the consequences would be and whether people would want to face those consequences. When it comes to the crunch, I suspect the answer may be different. If the Government had an additional £180 million to spend, which would be the cost of free hospital car parking, I am sure there would be many other pressures to spend that £180 million on in some part of the NHS. For example, it may pay for another 2,500 doctors or 8,000 nurses for the NHS. If we had a vote on what is the most important thing that we should do with that money, I suspect that the additional doctors and nurses would carry quite a weight of support, not just in this House, but across the country as a whole. It is not just a free-for-all. The harsh reality is that there are consequences of doing these things.
My hon. Friend makes a very good point. The hon. Member for Worsley and Eccles South made the point that people find it very stressful to have to pay after they have been to visit a relative in hospital, but as my hon. Friend rightly points out, it is probably even more stressful if they cannot find a car parking space at all. We need to bear that in mind.
I very much agree, Mr Deputy Speaker. I will move on. I will discuss how it might work with my hon. Friend in the Tea Room afterwards.
Thank you, Mr Deputy Speaker. Again, I will move on.
As the Torbay scheme is the nearest to the one that the hon. Member for Burnley proposes, I asked some questions through freedom of information requests about the impact and take-up of the scheme. I asked how many people had used the scheme since it was introduced, and the reply from Torbay was:
“We are unable to provide you with the information requested as it is not held electronically or in a central location. We do not record the details of carers, only a verification that they are on the register.”
We do not even know how many people take up the scheme that has been introduced.
I agree. This is hard work, Mr Deputy Speaker, and you are right—I am anxious to press on.
I reassure the hon. Gentleman that we are not going to open that can of worms today. Philip Davies, I know that you want to get beyond clause 7 and to your conclusion.
Madam Deputy Speaker, I think we have a solution. It does not say that on my copy. I must have a first edition, and it might be more valuable! It is priced at £3, but now we have discovered that it is a rare first edition, it might be worth a lot more. I am willing to raffle it and donate the proceeds to Carers UK. I am glad that the matter has been corrected, Madam Deputy Speaker, and I am sorry if I inadvertently addressed my comments to you personally. I was not trying to suggest that you had had any involvement in the preparation of the Bill.
I understand entirely where my hon. Friend is coming from and in an ideal world I would agree. I would like to see free hospital parking. However, I recognise that there are pressures on our car parks, and that car parking charges at a hospital have to reflect the car parking charges in the local area; otherwise we will have the problem that we encountered in Solihull prior to the introduction of charges, when people were parking at the hospital and then shopping. It is a fine balancing act and it should be dealt with by individual areas on a case-by-case basis.
My hon. Friend makes a good point. During my election campaign in the course of canvassing and door-knocking, we mentioned the hospital parking campaign and the response was mainly positive. Obviously, as soon as people are asked whether they want free hospital parking, they say, “Yes, absolutely”, but the other question was what this means for nurses and doctors and for the bottom line of our local hospital’s finances.
It is a great pleasure to serve under your chairmanship, Madam Deputy Speaker.
It is a pleasure to follow the hon. Member for Ealing Central and Acton (Dr Huq). Like many speakers, she made some good points, but I am not sure that the conclusions she drew from her analysis were the correct ones. We are all full of admiration for the people who do the caring—the carers—across our country, some 6 million of them. If we want to help them more than we already do, we should do it in a general way rather than by supplying free benefits in kind in specific areas, because that inevitably creates a distortion in the marketplace. The hon. Lady says that some carers in her constituency are being put off going to hospital by these charges, and her solution is to provide them with free parking, but what about the carers who do not have cars and go to hospital using other forms of transport? What are we going to do to help them? As soon as one introduces some sort of exemption, it creates a distortion in the marketplace.
In this debate, we have heard, if nothing else, how complex this issue is. One of the great benefits of Friday debates is that we are able to get down to the nitty-gritty of proposals like this, which, on the face of it, seem ever so attractive. I would not wish to criticise The Sun in any way, but sometimes it does not get down into enough of the detail and just goes for the broad-brush approach without looking at, in particular, the unintended consequences flowing from this sort of legislation.
The hon. Lady said that there is stress in parking in difficult situations, and so there is, but there is even greater stress if one cannot find anywhere to park at all. Many of my constituents have for years complained of a lack of parking facilities at Royal Bournemouth hospital. The hospital has been trying to increase its parking facilities but has encountered difficulties from the local council, which takes the view that creating more car parking spaces generates more traffic and therefore more congestion on the roads. The trust itself has invested a lot in improved car parking, and if the proposals to consolidate healthcare provision on the Royal Bournemouth site in Dorset go ahead, it will need a heck of a lot more car parking provision. It is by no means clear how that would be affordable unless the hospital itself is able to put in place funding arrangements so that the capital provision can be paid off through the income generated from charges. The hon. Lady’s speech raised some real issues that underline the Bill’s weakness.
I want to pick up on some of the points that have not been addressed. Clause 1 would provide a duty to exempt qualifying carers from hospital car parking charges, and clause 2(2) sets out the qualifying activities, including
“transporting, visiting or otherwise accompanying or facilitating a person to whom the care…is provided and who has been admitted to, or is attending, a health care facility for diagnosis, testing, treatment or other appointment relating to their health.”
It is very difficult to police such things. If somebody who was entitled to an exemption parked in the Royal Bournemouth car park and then, for part of their stay, went over to the Crown court, which is within easy walking distance and has a similar parking problem, how would that be policed? It would be policed only by having more personnel, who cost money, and that, as often happens, could result in confrontational situations. It is incumbent on the Bill’s promoter, the hon. Member for Burnley (Julie Cooper), to explain how that will be dealt with.
Does my hon. Friend agree that it would have been helpful if we had been given an explanation of the costs of administering the proposed scheme? We could then have based this debate on some actual figures.
The costs may vary from one hospital to another, but it is clear from the debate that the hon. Member for Burnley does not have the first clue about what the costs would be. We have established that they would be significant, but we have not established who would pay them. Would they be borne by the taxpayer through subventions to hospitals? The Scottish health boards were given £1.4 million to implement a similar policy.
If the money does not come from the taxpayer, would it come from increasing the charges of those who will continue to pay them? My hon. Friend the Member for Shipley (Philip Davies) made some really good points about that. According to the Government’s guidance, they believe that concessions should be disbursed more widely than just to carers. The perverse and unintended consequence of the Bill—this would be inevitable, in my view—would be that higher charges would be borne by people who are worse-off. To take a topical example, a working family on tax credits may be a lot worse-off financially than a carer affected by this Bill, but they would have to pay higher charges to use the hospital car park. That is an example of the perversity of the Bill.
If I ever get the chance to make my speech I will come to this, but it is not just families who are on tax credits. A lot of working carers on the carer’s allowance will be hit by tax credit cuts, too.
I hear what the hon. Lady says. I will not go down that route, Madam Deputy Speaker, because we have had enough debate about tax credits and I do not think you want time taken up on them. My point is that many people less well-off than the carers exempted under the Bill will actually pay for the cost of such exemptions. Interestingly, the hon. Lady did not disagree with that point in her intervention, but that is one of the Bill’s perverse consequences.
There is another problem. Clause 1(1) states:
“providing bodies shall make arrangements to exempt…carers engaged in…the qualifying activities…from charges for parking their cars in spaces provided for service users at hospitals”.
It does not state by whom the spaces are provided.
I apologise that I did not cover that point in more detail earlier. My hon. Friend is absolutely right. The implication of the clause is surely that other car park providers may be affected, not just NHS hospitals that provide car parks.
Exactly. Public bodies increasingly decide to delegate non-specialist responsibilities to other specialists; for example, they delegate to car parking companies the supply and building of car parking facilities close to a hospital. It is unclear from the clause to what extent the people providing the spaces—the spaces may not be provided directly by the hospital, but are designed to be used by those visiting it—will be caught by the provision. Their investment and their business plan may therefore be compromised by the Bill. The hon. Member for Burnley did not make that clear.
Perhaps that matter could be dealt with by amendments in Committee. Many other amendments have been suggested in this debate, particularly during the hon. Lady’s speech. She said that such matters could be dealt with by amendments, but a lot of them would not actually be within the scope of the Bill. That problem arises because the Bill is very narrow in scope. It proposes to exempt carers from hospital car parking charges and is for connected purposes, which seem to be centred around facilities similar to hospital car parks. It is very worrying that, even during this debate, the sponsor of the Bill has suggested that it is far from perfect and said that she would like to amend it. In fact, some of the amendments she has in mind would go beyond the Bill’s scope.
Clause 1(2) extends much further than national health service hospitals. There has not been much discussion of the other facilities mentioned in paragraph (a), such as a
“walk-in centre, GP practice or other health care facility to which patients are admitted, or which they attend, for diagnosis, testing, treatment or other appointment”.
Without exception, GP practices in my constituency provide free car parking for everybody. The last thing a GP practice wants is not to have the flexibility to respond to an increase in demand by introducing charges or restrictions. It is inherent in the clause that a qualifying carer who parks beyond the limit would be exempt. However, at a motorway service area, for example, if people stay for longer than two hours, they can no longer park for free and are subject to a charge. If GP surgeries, walk-in centres or other facilities are subjected to a lot of illegal parking—people taking advantage of their car parks but not using the facilities or using them for only a short time—they might choose to impose charges on people who are there for more than two hours. To what extent would people be exempt from those charges under the Bill? How difficult or easy would it be to enforce against them?
My hon. Friend is touching on an important point that has not been covered this morning. We have blithely said that about 40% of hospitals do not charge at all. Given what he has just said, does he agree that the Bill would be likely to result in some of those hospitals being required to introduce charging or some other restriction?
My hon. Friend is absolutely right. That brings home the point that this Bill has not really been thought through. To what extent has it been discussed with GP practices? I doubt whether it has been discussed with them at all.
If one wanted to bring forward a Bill under the private Members’ Bill procedure and give it a good chance of success, I would have thought that one would ensure that it was very narrowly focused, specific and precise. If the hon. Member for Burnley had discussed her Bill with me before she presented it, I would have given her the same advice that I have given to many other hon. Members from both sides of the House who have aspired to make progress with their Bills: it is better to have a small, modest measure that is carefully thought through than something that is general and easily open to different interpretations, which makes it unlikely to make progress.
On that theme, the inclusion in clause 1(2)(b) of private hospitals is completely absurd. Why do we want to drag private hospitals into the issue of whether to impose car parking charges on carers? I am happy to give way to the promoter of the Bill so that she can explain why she wanted to bring private hospitals into the Bill. Most of the discussion has been about NHS provision. Why does she want to interfere in the private sector? In my experience, most private hospitals do not have any charges for parking.
To clarify that point, NHS patients have the opportunity to use private hospital services. The carers who transport them there may well still need access to free car parking.
Of course, it does not say that in the Bill. That is a point of detail that I am sure was just overlooked in the drafting. I am grateful to the hon. Lady for making that clearer.
The provision applies to
“car parking spaces provided directly or indirectly, including under contract, by or on behalf of a health care provider…for patients and other users to whom car parking charges would otherwise apply.”
Again, my submission is that that goes far too wide because it drags in contractual provisions in the private sector and could impose directly on hospitals that have contracted out by agreement to private providers. They might have said, “Please build this car park and provide spaces for our patients, and in return we will allow you to charge patients,” and a business plan will have been drawn up accordingly. Clause 1(3) would effectively drive a coach and horses through that contractual arrangement. It could result in a compensation bill being payable by the hospital concerned to the private provider because of a breach of contract. That is another example of why clause 1 is far too wide.
On clause 2, which is about qualification for the parking charge exemption, I am indebted to my hon. Friend the Member for Bury North (Mr Nuttall) for explaining the number of people who have an underlying entitlement to carer’s allowance. In my constituency, where there are a large number of pensioners, a significant number would be subject to the overlapping benefit rule and would therefore be included as carers under the Bill by reason of having an underlying entitlement.
The bigger problem is that the Bill would not help unpaid carers. The vast majority of the 6 million carers in this country do it voluntarily and do not get any help from the state or the taxpayer, yet the Bill would not help them at all. Indeed, it could perversely make them worse off.
One point that we have not covered is that for some reason, under clause 5(1)(b), people who are caring as part of their voluntary work are specifically excluded.
That is a very good observation by my hon. Friend, who always looks assiduously at the details. Perhaps the hon. Member for Burnley would like to intervene again to explain why those engaged in voluntary work are specifically excluded under clause 5(1). That problem shows that the hon. Lady needs to reconsider the Bill.
As you know, Madam Deputy Speaker, the first stab at getting a private Member’s Bill on the statute book often fails, but there is then an iterative process whereby somebody else is successful in the ballot and brings forward a revised Bill for the House to consider. I believe that Lord Steel’s Abortion Bill, which got the House’s approval, was the sixth iteration of that Bill. I wish the hon. Lady luck in improving her Bill, having considered the points that have been made, and perhaps bringing forward one in the next Session that meets the concerns that have been expressed today.
I have always been concerned about new bureaucratic burdens being placed on organisations, so I am particularly concerned about the job that local authorities would have to do under clause 5(1) and (2), which provide that there would have to be an assessment of
“whether a carer should be eligible for free hospital car parking.”
No criteria are set out for the basis on which such a decision would be made, and there is nothing about how long that process might take. People often need quick decisions, but there is nothing about that. Would there be an appeals system if an applicant believed that the wrong decision had been taken? That would add to the bureaucracy and administration, and the time taken to deal with cases. It would cut across the discretion that hospitals and other organisations have to decide on their own parking charges.
Let me refer briefly to what happens at a few hospitals in my locality, because it shows that current discretionary arrangements are full of common sense and enable individual hospitals and hospital trusts to meet the needs of their communities by using available local expertise and experience.
In Royal Bournemouth hospital, all blue badge holders pay to park, and the only exemption is for disabled blue badge holders with tax-exempt vehicles. That is in line with neighbouring hospitals and other local authorities, and reflects the fact that the Christchurch and Bournemouth area has a large number of blue badge holders. If they were all able to avoid paying to park, relatively few people would have to pay, but they would have to pay a lot more. Sensibly, the Royal Bournemouth hospital offers exemptions for certain visitors and patients, and can arrange exemption certificates for specific patients and their visitors. Surely that is sensible.
Poole hospital has a similar arrangement, and a seven-day parking permit costs £16—a reasonable charge considering that parking normally costs £9 a day. Hospital governors recognise that if those with a long-term need to use hospital car parks have to pay £40 or £50 a week—those are the sorts of figures we have heard—that is not reasonable. Poole hospital chooses to exercise the discretion available to it, which is sensible.
Southampton General hospital is further away, but it is used by my constituents who have severe heart conditions and need surgery that often involves a long spell in hospital. It has a system of free parking or transport for patients who receive certain benefits, and concessionary parking for patients who are receiving certain treatments. A patient can be eligible for free parking or transport if they receive income support, hold an NHS tax credit exemption card, or an HC2 or HC3 certificate, which is a low-income support scheme that covers prescription, dental and healthcare travel costs.
Such sensible arrangements rely on the principle of localism and the idea that the best people to decide on such matters are the local community. Much hospital provision in this country, and too much of the NHS, is far too centralised, and the Bill would further centralise and remove discretion from individual hospitals and healthcare providers. I know that the Bill sounds good and is superficially attractive, but when one looks below the surface one finds that it does not stand up to detailed scrutiny.
I hope that when he responds the Minister will clarify whether—this is on a par with the issue of free school meals—the Bill, if enacted, would have Barnett consequentials. Barnett consequentials are a cost to the taxpayer. There is already free provision in Scotland, and my constituents are already subsidising the Scots to the extent of £1,600 a head, but if my reading of the Barnett consequentials is correct, another hidden cost would be that Scotland would have to be paid more money from the national Exchequer to compensate for the fact that the Bill does not apply to Scotland. That is another example of why proposed legislation can often turn out to be a lot more complex than it might appear on the surface. I hope my right hon. Friend the Minister will be able to help on that point when he responds to the debate.
That is obviously a matter for the House authorities, but the Bill is bound to cost taxpayers money and would therefore need a money resolution to proceed. It is possible to bring forward legislation which, although prima facie makes exemptions that impose costs on the taxpayer, contains compensating provisions to ensure that those costs are borne not by the taxpayer but by somebody else. It may be that the promoter of the Bill thinks we do not need to seek a money resolution because the costs arising from it will actually be borne by a lot of other people who do not yet know they will have to pay that cost.
I am not sure, however, who would meet the costs of the Barnett consequentials. I do not think there is any provision yet in statute to enable Barnett consequentials to be passed on in the form of higher car parking charges for users of hospital car parks. I am sure that that can be addressed in due course. I am sorry there is nobody here from Scotland today. I am a member of the Scottish Affairs Committee, which enables me to be briefed on issues relating to Barnett consequentials. I know hon. Members from Scotland are always keen for us to pass legislation in this House that would give them more money through the Barnett consequentials. I imagine that if they were here today and voting on this private Member’s Bill—although it extends only to England—they would be rather enthusiastic about it, because it might deliver some more money for them through the Barnett consequentials.
We all think that carers do a great job, but I am not sure that it is only the paid carers we need to think about. We need to think about the unpaid carers, and the Bill does nothing at all for them. It extends a lot of bureaucracy and interference to our already over-regulated hospitals and healthcare sector. It would inevitably impose additional costs on those who are not exempted under its provisions and add additional bureaucracy and administrative burdens.
In summation, the Bill contains elements that may well make progress in this House, but I would not be keen for it to make progress today. There is so much work that needs to be done on the Bill in its present form that the Committee stage would be far too prolonged. I congratulate the hon. Member for Burnley on introducing the Bill. She is a new Member and I am sure that in the coming years she will be able to perfect the Bill, so we can get something on the statute book that meets some of the concerns she has expressed in this debate.