Adult Social Care Funding

Christopher Chope Excerpts

Thursday 6th July 2017 Commons Chamber

[Steve Brine]

Of course I want to work—as will the current Care Minister, the Under-Secretary of State for Health, my hon. Friend the Member for Thurrock (Jackie Doyle-Price)—with the respected former Care Minister, and with any other Members who have any sensible suggestions. Taxation is of course a matter for the Chancellor at financial events, and there will obviously be a Budget later in the year.

On the areas where there are care challenges, we have picked up 12 local areas for review, as the Secretary of State said earlier this week. We have published the details that are suitable for the review, which we have developed from the dashboard criteria. We will give those involved every possible support, as we do with the inspection regime for hospitals, for instance. Such inspections are to get hospitals out of special measures and get them to a better place, and we will do the same for those areas. I will be very happy to meet the right hon. Gentleman. In fact, if he had not asked me, I would have offered to meet him.

[Mr Christopher Chope (Christchurch) (Con)]

If the Government’s plan is to reduce the pressures on adult social care, will my hon. Friend explain why the Dorset clinical commissioning group is proposing to close down the St Leonard’s community hospital, which provides really good services at the moment and is approved of by the community?

[Steve Brine]

No, I cannot go into the detail of why that is, as I suspect my right hon. Friend realises. There will be a one-NHS STP process in his area, and it will have to come up with proposals that meet the five criteria for any reconfiguration. As he will know, there were previously four criteria that had to be met, but there are now five; Simon Stevens, the chief executive of the NHS, has added a fifth on patient safety. My right hon. Friend mentioned St Leonard’s hospital, and any reconfiguration or change of service in relation to it will have to be considered in that context.

Cities and Local Government Devolution Bill [Lords]

Christopher Chope Excerpts

Monday 7th December 2015 Commons Chamber

[Mr Christopher Chope (Christchurch) (Con)]

I am concerned about amendment 56 and the Government’s acceptance of it, albeit subject to the proposal in amendment (a).

The reasons for my concern go back some time. Twenty years ago, before I was privileged to be a Member of Parliament, I served on the Local Government Commission, which looked at structures of local government in England, including at whether councils should switch from a two-tier structure to a unitary one. The method we adopted in those days was to invite local people and councils to submit evidence, and to hold public inquiries and hearings on the evidence. It was very much a bottom-up process. That was decided by consensus in the commission. In due course, it made recommendations to the Government, which were adopted by Parliament if changes were involved.

In Dorset, which I have the privilege of representing in Parliament, there was a lively debate about whether Poole and Bournemouth should become unitary authorities, with Dorset County Council remaining a county council and a two-tier system operating in the rest of the county. In the end, it was agreed that Poole would become a separate unitary authority, as would Bournemouth, but the remainder of the county council area would be two-tier, with Dorset County Council dealing with the main services such as education and social services, and the borough or district councils dealing with the services closest to the people.

Nothing that has happened in the 20 years since leads me to believe that people in Christchurch, East Dorset or Dorset are anything other than content with the current arrangements. When there was all this talk about the possibility of change being forced through by the Government, I was assured by my right hon. Friend the Secretary of State that nothing would happen to change things in Dorset unless it had the wholehearted consent of the councils concerned. On that basis, a half-baked proposal introduced by Poole, with support from Bournemouth, to try to set up a new unitary authority incorporating Christchurch and East Dorset, could not work. Dorset County Council understandably said that it would mean that part of its area, which enables it to provide good services and make economies of scale, would be taken away and no longer be included in Dorset county. The line, which the Secretary of State articulated to me very persuasively, was that there was no need to worry, because nothing would be imposed from the centre. It was something that would only come from the bottom up.

That is where we were until today and the inclusion of amendment 56 on the amendment paper. I assumed that the amendment did not have Government support, and I had not applied my mind to the question of opposing it. I assumed, on the basis of what I had been told, that it would be opposed by the Government. Much to my amazement, I found that a manuscript amendment had been tabled, suggesting that the Government were going to accept amendment 56, albeit on the basis that it would only be in operation until 31 March 2019, which coincides with the end of the current period for district councils. The terms of office for all the district councils that were elected last May expire at the end of March 2019.

That is the effect of the Government amendment, and they have not provided any detail about the criteria that they will use to exercise their significant power to intervene against the wishes of one or more local councils in, to take my county example, Dorset.

[Sir Edward Leigh]

I hope that the Minister is listening, because it is open to him to intervene on my hon. Friend, to make it clear that in areas such as Lincolnshire and Dorset we should only proceed towards a unitary authority by consent.

[Mr Chope]

Of course, it would be open to the Minister to do so. I understand—I have been told privately, not on the Floor of the House—that the Government are neutral on this. They do not have an agenda to try and create unitary authorities.

[James Wharton]

May I take the opportunity, as presented by my hon. Friend the Member for Gainsborough (Sir Edward Leigh), to confirm that it is indeed the Government’s intention to build that consensus? We are not going to impose change on areas that do not want it. However, we have been persuaded, that, as proposed in amendment (a), areas should not at the same time be prevented from being part of devolution deals. We are seeking to build consensus, not impose change on areas, but we should have the flexibility to ensure that we can deliver the deals that local people want.

[Mr Chope]

I am grateful for that, so far as it goes, but will the Minister explain how he will deal with the situation in, for example, Dorset? The county council wishes to retain control over the area that it currently governs. If one or more district councils in that county council area wish to enter into a unitary arrangement with, for example, Poole and Bournemouth, who will prevail? Is it going to be the will of the county council or is it going to be the will of, for example, Christchurch Borough Council? In my constituency, a number of councillors serve on the borough council and on the county council. To which group will the Government pay heed, or will they say, “Because there is no agreement, there can’t be any progress”, which I understood was the Government’s policy?

[James Wharton]

Of course we want to find consensus. Tempted as I am to go down the route of discussing individual proposals in too much detail, there is no intention to set out here or at any other time some sort of rule that would allow districts always to determine what happens, or counties always to determine what happens. We want to talk with local areas, take representations from those local authorities and local people, from local enterprise partnerships and, of course, from hon. Members representing those areas to build a consensus as to how best we should go forward with this process. The Secretary of State will apply a statutory test, which I will talk about later, but I hope I can at least give my hon. Friend that reassurance.

[Mr Chope]

I am grateful to my hon. Friend, so far as it goes, but basically he is saying that the Government will now decide. A few months ago the process was to be bottom-up, driven by the local councils: if they wanted change, they would be able to introduce change. Now we are told that nobody will be able to dictate, neither a borough council nor the county council, but ultimately the Government will decide. This is a significant change of Government policy, announced in the form of a manuscript amendment to amendment 56.

[Sir Edward Leigh]

This is an interesting triangular discussion and it is terribly important. What I think my hon. Friend is looking for, and what I am looking for—again, the Minister can intervene on my hon. Friend—is an assurance that if either Dorset County Council or one of the district councils does not want change, that would effectively be a veto, and the same would apply to Lincolnshire and other rural areas. In other words, change would proceed only by consensus. The Minister says he wants to proceed by consensus, as I understand it, and that is extremely important. Again, he can intervene on my hon. Friend.

[Mr Chope]

I am grateful to my hon. Friend for his intervention and for his suggestion that we might be able to find a modus operandi between the two of us, who are very concerned about this, and the Minister, who I know is doing his best to give us assurances which will enable us to support amendment 56, as amended by the Government, rather than dividing the House on it. I am happy to give way once more to the Minister if he is able to give the sort of undertaking that my hon. Friend the Member for Gainsborough was suggesting he might like to give.

[James Wharton]

I thank my hon. Friend for giving way. I will talk more about this issue when I speak to the new clause and amendment later. It is important to be clear that this is not about allowing areas to veto. We want to allow flexibility to build that consensus. The Government’s intention is to work with local areas to deliver economically sensible areas of devolution, with structures that sit beneath them that allow those things to be delivered and that potential to be realised. So it is not about giving one area or another a veto or taking a particular mandated approach; it is about having the flexibility to deliver what different areas need. That is what the amendment allows, which is why we are looking at it so closely and are keen to see it discussed further and delivered as part of the Bill.

[Mr Chope]

I am grateful to my hon. Friend for that intervention, but I am afraid that what he said goes against the position that we have already established, which was explained to me by the Secretary of State—namely, that the Government were not pushing any of this agenda, but that this agenda could be promoted by individual councils if they wished and if they had the agreement of their neighbouring councils. Now we are told that it no longer depends on their having the agreement of their neighbouring councils, but that the Government will intervene if they think the consent of a neighbouring council is, for example, being unreasonably withheld. That has not been spelled out yet in the legislation, but it is implicit in what the Minister says—a completely different proposition from what we had before.

This is a sensational change in the Bill, because up until now we had been told that the Government were neutral and that they were enabling councils to do what they want. If this measure goes through as the Government obviously want it to do, one of the consequences is that between now and 2019, in counties such as Dorset, instead of getting on and running local services for local people, the councillors and their officers will be preoccupied with arguing the toss about new structures—structures which, as I have already said, were established 20 years ago and have not been criticised at all. Small councils such as Christchurch Borough Council—the ancient borough—are threatened with losing their independence. Likewise, East Dorset District Council is threatened with losing its independence, ultimately at the whim of the Government.

This is all done, supposedly, in the name of devolution, but a district council is a highly devolved body because it is close to the local people. It decides those all-important planning applications in accordance with the wishes of the local people. I see my hon. Friend the Member for Bournemouth West (Conor Burns) in his place. He will know that one of the reasons that Bournemouth has great tower blocks on its clifftop is that for many years it has had a different planning policy from that of Christchurch, which has an equally delightful clifftop but has not wrecked it by allowing enormous tower blocks on it. That is why Highcliffe is still an attractive place in which to take a holiday, like Friars cliff and other places in Christchurch, which are gems on the south coast.

--- Later in debate ---

[Mr Chope]

It is interesting that the opposition leader on Poole unitary authority said he thought it was important that this issue should be dealt with by the people of Poole and that there should be a local referendum. That was pooh-poohed by the leaders of Poole and Bournemouth. My hon. Friend refers to leaders, but we must ensure that the leaders accurately reflect the wishes of local people. At present they have no plans properly to consult the people of Christchurch, East Dorset, Bournemouth or Poole. They are just rushing into some discussions. If those discussions are given the extra momentum that the Minister wants to give them by accepting amendment 56, they will create enormous anxiety among the people in my area.

Christchurch and East Dorset have recently had a local plan inquiry. They now have a new local plan, under which they are able to preserve most of the green belt in their area. My constituents are very jealous of the green belt. Why is it that Poole and Bournemouth want to get their hands on the land in East Dorset and in Christchurch? It is so that they can impose their planning policies on the green belt and expand outwards into our area. That is the perception of my constituents and that is why they are so concerned about it. Up until today, I have been able to say, “Don’t worry. That is never going to make any progress,” because I know for a fact that Dorset county council regards as anathema the idea that it should have two boroughs within its two-tier system taken away from it, because that would make Dorset county council less viable. I had assumed up until now that that would give Dorset county council a veto and therefore that none of these half-baked ideas would make any progress.

[Mr Skinner]

The situation is very difficult, and it is pretty clear that the Government are making decisions on the hoof. It is almost a fag packet job. I live in and represent an area that is involved in two of these structures. One of them is dominated by Sheffield and the four adjoining council areas of Barnsley, Rotherham and so on. That is now attracting the attention of at least three, maybe four, councils in north Derbyshire—Bolsover, Chesterfield, North East Derbyshire and possibly Derbyshire Dales. On top of that, there is the D2N2 power structure which covers Nottinghamshire and Derbyshire. It is time that the Minister got to his feet and explained precisely what will happen if Sheffield demands the powers that currently reside with Derbyshire County Council around transport and takes them away from the county. We have got two power structures both vying for the same thing. Although Dorset is complicated, this is even worse.

[Mr Chope]

I instinctively think that the hon. Gentleman is right. I say that not only because I have on my wall at home a picture of his constituency that was presented to me by his council when I was a junior local government Minister—a picture that I chose—but because I think that his experience means that he understands the complexity of these issues and their potential impact on ordinary people.

The Government can sometimes give the impression that they get rather intolerant of those us who want to raise issues such as this.

[Graham Stuart]

I have tried to follow this closely but I may not have understood amendment 56, which I am trying to square with the assurances from the Minister. If his assurances are right, why would the Government support amendment 56, which will allow the imposition of this if only one affected local authority says so?

[Mr Chope]

My hon. Friend makes a good point, and perhaps the Minister will reply to it. If we are talking about genuine consensus—in other words, agreement between local authorities—then we do not need amendment 56, which is designed to enable the Government to intervene when some local authorities do not do as the Government think they should be doing. That is essentially what this is about. We might as well face up to the reality that this is a very centralising part of the Bill because it brings power back to the Government to enable them to change the structures of local government boundaries in areas such as Dorset.

[Sir Greg Knight (East Yorkshire) (Con)]

Further to the point made by my hon. Friend the Member for Beverley and Holderness (Graham Stuart), if amendment 56 is accepted, could it not, despite the promises from the Minister, be used as a lever against a recalcitrant council to say, “You’d better fall into line or amendment 56 will be brought into play”?

[Mr Chope]

My right hon. Friend knows all about levers, having been a deputy Chief Whip. That is exactly how I envisage this power being used. I am sure that that is why there was an attempt to smuggle it through at the last minute. Now we are, I hope, exposing it for what it is, which is a power grabbed by the Government to try to ensure that they can have the final word and beat their stick against a council that is not doing as they wish it to do.

[Bob Stewart (Beckenham) (Con)]

I am making the assumption that my hon. Friend would support the amendment proposed by my hon. Friend the Member for North East Somerset (Mr Rees-Mogg) to have a referendum.

[Mr Chope]

Absolutely. I am very supportive of that amendment, but I have not yet had a chance to talk about it because I am so concerned about amendment 56 and amendment (a). I am not going to restate the case about the referendum, but I think it is a necessary safeguard.

If we look at the history books we see the unintended consequences that can flow from local government reorganisation. It was only because Wandsworth council started a campaign to abolish the Inner London Education Authority that education was given back to the inner-London boroughs, which were then able to gain economic growth as a result of having good-quality education within their boundaries. The same thing happened with the Greater London Council. The Greater London Council was interfering in the lives of the boroughs in inner London and outer London, so those in charge of the boroughs at the time persuaded the Conservative Government to abolish it. As a result, parks such as Battersea park are run by the local authority—Wandsworth council—rather than by a remote authority for Greater London.

If we are not going to put proposals like this to the electorate, we must have the necessary safeguards. None of this stuff was in our manifesto. There was no suggestion that a Conservative Government were going to restructure local authorities so as to try to squeeze out small councils that are closest to the people. If we are not going to test this in a general election and amendment 56 is going to be on the statute book until the end of March 2019, it is all the more important that we should be able to have the safeguard of a referendum—the very safeguard that the Poole People party and the Liberal Democrats have sought, in vain, from the leaders of Poole, Bournemouth, East Dorset and Christchurch Borough Councils.

We are on the threshold of a big spat at local government level between different councils at different tiers and different councillors with different personalities and political parties. This threatens completely to preoccupy local government for the next three or four years. We will look back and say that this all started with the Government wanting to interfere in areas where they should not be interfering at all. They should be trusting local councillors and local people to decide what is best for them. They should not be taking away from Dorset County Council or East Dorset District Council, for example, the power to veto any proposals to change the boundaries in which they operate.

I very much hope that the House will not accept amendment 56 as proposed to be amended by the Government but will push them back to their previous position, which was that this is genuinely for local councils and local people to decide, and the Government are not going to interfere.

[Graham Stuart]

I will try to keep my comments brief, because contrasts are always a pleasant thing. It is a pleasure to follow my hon. Friend the Member for Christchurch (Mr Chope), who spoke powerfully about this issue.

--- Later in debate ---

[Graham Stuart]

It leaves me in a position of having profound doubts about amendment 56. I really appreciated the Minister’s interventions setting out what the Government want to do. The police reorganisation under the previous Labour Government was top down and people did not like it. It is not that we are neutral—my hon. Friend the Member for Christchurch was wrong to say that the Government have always said they would be neutral. The Government have a position and a vision, but I think it is much smarter to offer reassurances and tell people that, whatever we think, we are not going to push it on them, because we have seen that that does not work. People have to consent to it. There will be difficult council leaders who we will think are being a pain because of their own individual interests, but we should bind our hands and restrain ourselves from just pushing them aside. We need to listen and say to everybody, “Unless you can bang heads together yourselves and get a consensus, we’re not going to come piling in, because we’ve seen where that ends up.”

It might be a Labour Government’s instinct to think that they know better than the people, but it should be a Conservative Government’s instinct to recognise that they do not know better and that even if, in their opinion, the people are wrong—and history might show that they were wrong—it is the people who get to decide, and if they feel strongly about something that should be respected.

[Mr Chope]

Will my hon. Friend give way?

[Graham Stuart]

My hon. Friend has had a fair crack and I am going to sit down.

--- Later in debate ---

[James Wharton]

I hear what my hon. Friend says, but it remains the case that a council or group of councils can now, regardless of the Bill, ask the Secretary of State to implement a proposal for structural change through the traditional processes of the Local Government and Public Involvement in Health Act 2007, even where not all councils agree or where there are competing proposals for different councils. He has those powers, but only as part of a convoluted and lengthy process. This is not about forcing unwanted change on areas just because we have the power to do so; it is about enabling the flexibility to deliver the right devolution deals for areas and in a timely and flexible way. I know that hon. Members have raised concerns, but there are none the less statutory tests that have to be satisfied in doing that. This place would need to approve any change, but the fast-track process, with its significant safeguards, is a welcome one.

The new process would still require the Secretary of State to lay before Parliament a report on the fast-track process, including on matters he has taken into account when deciding to use it, and I reiterate that it could not be used without Parliament’s approval. Having carefully considered and weighed the arguments; having listened to the comments of my hon. Friend the Member for Carlisle and others; and having considered the need to ensure flexibility if we are to make devolution last, we have decided to support the amendment. We have tabled a manuscript amendment so that it is for a trial period and not something that would necessarily last in perpetuity; none the less we welcome the flexibility in the amendment.

[Mr Chope]

Will my hon. Friend confirm that the Secretary of State would not, under any circumstances, force change on a local authority against its will, and is really only interested in encouraging local authorities to talk to each other? He said, at the beginning of his remarks, that the starting point remains that change will not be forced on any one but suggested that ultimately the Government wished to have the power to force it.

[James Wharton]

I remind my hon. Friend of my earlier comments: those powers already exist. The Government’s intention is to find consensus, to build on the local desire for devolution and to deliver lasting devolution to areas that will benefit from it. Those powers are already there. This is about ensuring we can deliver, in a timely way, the devolution that local areas want, but I can absolutely reconfirm the Government’s commitment to seeking and building on consensus. That is how devolution will stand the test of time.

Amendments 16, 30 and 55 ensure that criminal liabilities of a public authority can be transferred to either a local government or combined authority on the same basis as other liabilities when public authority functions are conferred. Amendments 17 and 31 amend clauses 7 and 16 respectively and allow references in a transfer order or regulations to be made to a formal document, such as guidance, which can be amended from time to time.

Amendment 36 is a technical amendment substituting the original word “jointly” with the new word “concurrently”. The change is necessary to ensure that certain transport functions being carried out by strategic transport bodies and local authorities can be undertaken concurrently rather than jointly. Amendment 3 would change how mayors for combined authorities should be elected. We have debated this matter at length. We believe that, where we are electing an individual to exercise significant executive power, the voting system for which we have made provision is the right one, and that therefore the amendment should be rejected. Finally, amendments 10, 37 to 43, 45 and 44 are necessary to bring the Bill into line with the arrangement in London. They provide clarity and consistency in respect of mayoral deputies with police and crime commissioner functions.

I hope that hon. Members will accept the Government amendments and reject Opposition amendments and that the House will continue broadly to support the delivery of devolution, on which there is so much consensus and support.

--- Later in debate ---

[Greg Clark]

I thank all hon. Members from both sides of the House who have contributed to the development of the Bill, particularly those who participated in the extensive scrutiny on the Floor of the House both in Committee and on Report. The House will observe that we have followed the principle of listening to the views of Members, both in Committee and on Report. We made several improvements to the Bill after having heard serious representations from those across the House. I want to put on the record my thanks to my officials and to the Clerks, who have guided us adroitly through every clause.

I also want to thank councillors of every party and business leaders from across the country who have helped to give this Bill the momentum it deserves by embracing the localism agenda that began in the last Parliament. Important though the Bill is, it is worth noting that it is not the only means by which devolution is being advanced. For example, the Chancellor’s announcement that 100% of business rates would be retained by local government, rather than sent to the Treasury, is a significant step forward for the greater independence of local government.

I want the Bill to commence several things. I want it to allow the often latent potential for economic growth across all parts of the country to be better unleashed. The Bill and the process that we have introduced have brought businesses right across the country into close collaboration with their local authority leaders. The degree of enthusiasm for this has been gratifying.

The Bill allows reform where civic leaders and councillors desire it. It is a Bill that proceeds from the bottom up, rather than the top down. That makes it a novel Bill in the history of legislation concerning local government that this House has considered. It is a Bill that does something that previous Governments have baulked at, which is to transfer deliberately powers that Ministers and Governments have held and exercised in Westminster and Whitehall to authorities across the land. The insight of the Bill is that those objectives can be achieved together if local people are given their voice and allowed to set their arrangements in their own way.

The breakthrough is the recognition that not all places need to be the same. One of the glories of this House is that we know that each of our constituencies is very different from the others. No two places are the same. A world in which policy is identical in every part of the country is a world in which policy is not well set for particular parts of the country. Each place has a different history, different strengths and different capacities.

In the past, proceeding at the speed of the slowest has hampered efforts to devolve. Therefore, the approach that we have taken has been to invite every part of the country to make its proposals to the Government from the bottom up and to encourage those with the most ambitious proposals to advance them, while encouraging other places to find their feet and take the powers that they want for themselves and their people.

[Mr Chope]

Will my right hon. Friend give the House an assurance that amendment 56 will not be used by the Government to force change on any local authority?

[Greg Clark]

I will indeed. My hon. Friend raises an important point. The whole process by which we have operated and negotiated with places has recognised that the best ideas come from local places themselves. Previous local government Bills have attempted, with unhappy consequences, to impose a Government view of how local government should be organised on reluctant local authorities. This Bill does not do that and the amendment that he mentions will not be used for that purpose either. Rather, it will bring local communities and local authorities into a discussion about what is best for their area.

--- Later in debate ---

[Mr Chope]

I thank my right hon. Friend the Secretary of State for the thoughtful way in which he responded to the concerns that were expressed about amendment 56. I think that what he said will be very helpful in ensuring that the Bill is not just about devolution but evolution, and that changes happen gradually and work with the grain of what the people want locally, rather than being imposed top-down and from the centre.

What concerns people about local government—apart from the level of local taxes—is their wish to have some control over the way in which their own communities develop, and to control planning in particular rather than its being controlled by much more remote communities. For a short time I was a member of the Inner London Education Authority, which purported to make decisions on education matters throughout the inner-London boroughs. Most of its members had never ventured outside their own local authority areas, let alone visited all the other parts of London that were covered by ILEA. The danger with very large authorities is that they can lose touch with the sensitive issues that cause the greatest concern to our constituents and to local residents. I hope that as we evolve different administrative and representational models for local government we will bear in mind the need to retain the very powerful local involvement in planning. I speak on behalf of the people of Christchurch, an ancient borough with a priory church that goes back over 900 years where people enjoy the opportunity to elect their own local mayor. One of the downsides of some of the proposals is that they could result in people losing the power to be able to elect their own local mayor for their council—the person who could speak on behalf of the town. Councillor Spreadbury, who, sadly, died about a year ago, had the privilege of being the mayor of Christchurch in five successive decades, having welcomed Her Majesty in 1966 and then had four successive terms. He was typical of a local person brought up in the area and truly representing what the community felt.

Why not retain the distinctions between the different parts of our country? Why try and merge and homogenise the New Forest with Christchurch or Christchurch with East Dorset? A lot of change could be achieved by allowing back office services to be worked out together and by having single chief executives instead of multiple chief executives, but we must not lose sight of the fact that ultimately local government is for most people the body to which they look to take decisions in the best interests of the local citizens.

Question put and agreed to.

Bill accordingly read the Third time and passed, with amendments.

Junior Doctors Contract

Christopher Chope Excerpts

Friday 20th November 2015 Commons Chamber

[Alistair Burt]

Let me see what Sir Bruce Keogh said. [Interruption.] I did not write the letter, so I will have to look through it. He said:

“I would reiterate to both sides that I believe the best way to ensure patient safety is for the planned action not to take place. I would strongly urge you, even at this late stage, to come back to the negotiating table.”

As far as conciliation is concerned, I have made it entirely clear that the Secretary of State has not ruled it out. I cannot see ACAS mentioned in the particular letter that I am looking at. Sir Bruce Keogh said that there must be direct negotiations between those who know most about the matter. The Secretary of State has said that if that does not work, he is open to conciliation.

The Secretary of State has reviewed the contract, published the terms and dealt with the BMA, which said first that it was a pay issue, then that it was a safety issue and then that it was an issue about imposition. At each stage, it has moved the goalposts, whereas the Secretary of State has been open about what he wishes to see. It is now up to the negotiations. We all want negotiations to happen because nobody wants to see the withdrawal of junior doctors’ work and, I suspect, neither do they.

[Mr Christopher Chope (Christchurch) (Con)]

Is not the root problem that the NHS is a monopoly employer of junior doctors? If the veterinary profession can provide 24/7 care for sick animals, why cannot junior doctors provide the same for sick people?

[Alistair Burt]

As the House is well aware, the Commonwealth Fund said recently that the NHS was the best in the world. NHS staff, by implication, are the best in the world. They do an extraordinary job and junior hospital doctors do a fantastic job. Patient satisfaction is extremely high. We want that to continue. There is no reason to believe that NHS Employers, which is also calling for negotiations to continue and for the strike action not to take place, is not in full view of what staffing it needs to create an even safer health service. Its judgment is that the contract set out by the Secretary of State to be negotiated on provides the best basis for the employment of doctors in the health service.

Male Suicide and International Men’s Day

Christopher Chope Excerpts

Thursday 19th November 2015 Westminster Hall

[Philip Davies]

I am grateful to my right hon. Friend for coming to the debate and making that point. I would have preferred the debate to be in the main Chamber, especially given that the International Women’s Day debate is held there, but I am grateful that we have the opportunity to raise these issues, which we have never done before, so it would be churlish of me to be too critical.

I want today to be the day when we in this House start to deal with some of the forgotten men’s issues and realise why the political correctness that underpins issues relating to the differing treatment of the sexes can be damaging to men. It might sound odd for someone leading the debate on International Men’s Day to say this, but in many respects, I would rather we did not have to be here having this debate, because when we think about it, in so many ways, considering men and women separately as if they live their lives in complete isolation from one another is ridiculous. Neither group is isolated. Both sexes have mothers and fathers, sisters and brothers, uncles and aunts, grandmothers and grandfathers, sons and daughters, husbands and wives, boyfriends and girlfriends. Every woman has related male parties and therefore a vested interest in men’s issues.

The problem is that virtually everything we do and debate in the House seems to start from the premise that everything is biased against women and that something must be done about it. There is never an appreciation that men’s issues can be just as important and that men can be just as badly treated as women in certain areas.

The hon. Member for Belfast East (Gavin Robinson) supported my request for a debate, and I know he is sorry that he unfortunately cannot be here today. Had he been here, he no doubt would have shared the fact that last year, Belfast City Council hosted its first event to mark International Men’s Day. I understand that the event was held in Belfast castle and opened by the First Minister and the Lord Mayor of Belfast at the time, Nichola Mallon, following a proposal by Alderman Ruth Patterson. It seems our Ulster friends appreciate that there are some specifically male issues that should be addressed, with both sexes involved.

I want to be very clear: I do not believe there is actually an issue between men and women. Often, problems are stirred up by those who might be described as militant feminists and the politically correct males who sometimes pander to them. Members do not just need to take my word for it. Before the Equal Opportunities Commission was merged into the Equality and Human Rights Commission, it conducted research that found women had very clear views on these matters. Its findings included the following conclusion:

“There was little support for the idea that women, as a group, are unequal in society today.”

Presumably, that went down like a lead balloon in an organisation dedicated to fighting for women’s interests and rights, so it was pretty much swept under the carpet.

One of the most depressing things to happen recently was the introduction of the Select Committee on Women and Equalities. After everything else, in 2015 we have a separate Committee to deal with women’s issues, on top of the Women’s Minister, Women’s Question Time and the many strategies in this country that only deal with women.

For the record, I could not care less if every MP in this House were female or if every member of my staff were female, as long as they were there on merit. To assume that men cannot adequately represent women is a nonsense, just as it is to say that only women can represent other women. As a man, I can say quite clearly that Margaret Thatcher represented my views very nicely indeed, but I am not sure she would be a pin-up for many of the politically correct, left-leaning women who are obsessed with having more women in Parliament today.

It seems to me that we have an “equality, but only when it suits” agenda in Parliament that often applies just to women. The drive for women to have so-called equality on all things that suit the politically correct agenda but not on the things that do not is a great concern. For example, we hear plenty about increasing the number of women on company boards and increasing female representation in Parliament, but there is a deafening silence when it comes to increasing the number of men who have custody of their children or who have careers as midwives. In fact, there generally seems to be a deafening silence on all the benefits women have compared with men.

[Mr Christopher Chope (Christchurch) (Con)]

Would my hon. Friend add to that list the deafening silence about the shortage of male teachers in primary schools, who are important male role models?

[Philip Davies]

My hon. Friend is absolutely right; we hear very little about that. If there were a shortage of female primary school teachers, I suspect we would hear a great deal more about it.

The fight for equality on all things that suit women has ended up in a situation where we are quick to point out that women need special protections and treatment in certain areas but need greater equality in others. Let me give the example of prison uniforms. Men in prison have to wear a prison uniform; women in prison do not. How, I have asked on many occasions, can that possibly be fair? Where is the equality in that? I will come on to the treatment of men and women in our justice system later, but that is clearly an issue. What is the explanation? I am told that it is because women are different. As I have said, it is a question of equality, but only when it suits.

Off-patent Drugs Bill

Christopher Chope Excerpts

Friday 6th November 2015 Commons Chamber

[Marcus Fysh]

My hon. Friend makes a good point. The General Medical Council says that, traditionally, doctors have been reluctant to do that, partly because they may be wary of prescribing drugs for new uses owing to the increased level of personal liability that they may encounter.

Providing a way to overcome this reluctance, where efficacy has been demonstrated through licensing, deals with the argument made by the Under-Secretary of State for Life Sciences, my hon. Friend the Member for Mid Norfolk (George Freeman), in the debate on the previous Bill that the current law best meets the individual clinical needs of patients. The flexibility clinicians currently have to prescribe medicines, which my hon. Friend described, is fine, and it is each doctor’s solemn prerogative, but it should not be used as a structural excuse not to pursue new treatments where they have been shown to be effective for non-clinical reasons. In practice, that can encourage a lack of consistency and assurance for the patient because of the lack of NICE approval in the form of a technology appraisal. NICE is, in fact, in a very good position to conduct studies that test efficacy on particular subsets of patients, with their consent.

A partnership in my constituency between Yeovil District Hospital NHS Foundation Trust, Somerset clinical commissioning group, South Somerset GP federation and Somerset County Council was selected this March by a rigorous NHS England process to be one of 29 partnerships spearheading new ways of working—a vanguard project in finding new models of care. This partnership, called Symphony, is looking in particular at the integration of health and social care, bringing together GPs, hospitals, community hospitals, mental health and social services, and is focused on joint commissioning based on outcomes for patients. The intention is for the lessons learned in implementing this new model to be taken on board in replicating the integration process across Somerset and beyond. We need to learn the lessons and move forward together—fast.

I believe that this vanguard, which is led by very committed and talented people in each partner organisation—I congratulate and encourage them today—could act as a leader not only in developing this new care model, but in working with NICE in its role under the Bill to conduct technology appraisals for new uses of off-patent drugs.

This has particular application to one of the most difficult issues of our time—the fact that our population is ageing rapidly. There are areas of Somerset, as elsewhere in the country, where a majority of people are of retirement age—and that is likely to increase dramatically over coming years. The management of conditions that are becoming more prevalent as our population ages must be taken forward with every tool available to us.

A report written by the governors at Yeovil district hospital in October last year shows that there has been an increase in the number of local patients with suspected cancer. Indeed, Somerset has one of the highest proportions of cancer prevalence in England. This may come as no surprise, as it is a very attractive place to live and work, and it has attracted many people moving from other parts of Britain, with many choosing to retire in the area.

I strongly support the new cancer drug fund that this Government have implemented, which has given more cutting edge treatment options to those with cancer, but we can go further by increasing access to new treatments through off-patent drugs, which can be much cheaper.

[Mr Christopher Chope (Christchurch) (Con)]

My hon. Friend, like me, strongly supports the Bill. Time is of the essence, so I think the best thing we can do as supporters of the Bill is to reserve what we wish to say until Committee, so that the Government can respond to this very important measure. [Laughter.]

[Marcus Fysh]

I thank my hon. Friend, who makes a good point—I am almost finished!

Given the seriousness of our healthcare challenges, I believe the Government should seek licences for off-patent drugs in new indications, thus increasing equality of access to proven treatments at an affordable price for more individuals and their families across our nation. I commend the Bill to the House.

--- Later in debate ---

[Alistair Burt]

When I get a chance to make a little progress, I can explain to my hon. Friend why that is the case.

[Mr Chope]

rose—

[Alistair Burt]

I will take one last intervention.

[Mr Chope]

I am grateful to my right hon. Friend, and I feel his pain. He says that he is concerned that he will not have sufficient time today to explain the Government’s position. In that case, why does he not allow this Bill to go into Committee, where he would have oodles and oodles of time in which to explain fully the Government’s position?

Hospital Parking Charges (Exemption for Carers) Bill

Christopher Chope Excerpts

Friday 30th October 2015 Commons Chamber

[Julie Cooper (Burnley) (Lab)]

I 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.

[Mr Christopher Chope (Christchurch) (Con)]

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?

[Julie Cooper]

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.

--- Later in debate ---

[Philip Davies]

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.

[Mr Chope]

In Scotland within the past week there has been enormous criticism of the quality of healthcare being delivered by the Scottish Government. Is not that an example of a place that has free hospital car parking but does not necessarily have a better quality of health service?

[Philip Davies]

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”.

--- Later in debate ---

[Philip Davies]

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.

[Mr Chope]

We are talking not just about free car parking, but about car parking? Too many hospitals do not have adequate car parking. That is one of the great complaints that so many patients have—that they cannot find anywhere to park when they go to hospital.

[Philip Davies]

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.

--- Later in debate ---

[Philip Davies]

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.

[Mr Chope]

If there is increased demand for car parking spaces at hospitals and it is desirable that those hospitals provide extra provision, that has to be paid for. How will it be paid for?

[Mr Deputy Speaker]

I do not think that is our worry for today.

--- Later in debate ---

[Philip Davies]

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.

[Mr Chope]

Surely that is a good thing, because it shows that there is a light-touch approach without too much bureaucracy and administration.

--- Later in debate ---

[Philip Davies]

I agree. This is hard work, Mr Deputy Speaker, and you are right—I am anxious to press on.

[Mr Chope]

Before my hon. Friend concludes, will he address clause 7(2) which states that the Act extends to England only? Does he think that, as with free school meals, there will be Barnett consequentials?

[Mr Deputy Speaker]

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.

--- Later in debate ---

[Mr Nuttall]

rose—

[Mr Chope]

Will my hon. Friend give way?

[Mr Nuttall]

Certainly.

[Mr Chope]

Further to what you have just said, Madam Deputy Speaker. At the top of the Bill of which you and I have a copy, it states:

“This is a corrected copy and is being issued free of charge to all known recipients of the original publication.”

[Mr Nuttall]

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.

--- Later in debate ---

[Julian Knight]

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.

[Mr Chope]

Does my hon. Friend not think it reasonable that the costs of hospital car parks should be met by the users of those car parks, rather than by eating into money that would otherwise be available for clinical care?

[Julian Knight]

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.

--- Later in debate ---

[Mr Christopher Chope (Christchurch) (Con)]

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.

[Mr Nuttall]

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.

[Mr Chope]

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.

[Barbara Keeley]

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.

[Mr Chope]

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.

[Mr Nuttall]

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.

[Mr Chope]

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?

[Mr Nuttall]

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?

[Mr Chope]

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.

[Julie Cooper]

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.

[Mr Chope]

So the hon. Lady is saying that this provision would apply to private hospitals when they were treating NHS patients and that it would only affect the carers of NHS patients, rather than the carers of private patients.

[Julie Cooper]

indicated assent.

[Mr Chope]

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.

[Mr Nuttall]

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.

[Mr Chope]

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.

[Mr Nuttall]

Does my hon. Friend think the Bill requires a money resolution?

[Mr Chope]

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.

Access to Medical Treatments (Innovation) Bill

Christopher Chope Excerpts

Friday 16th October 2015 Commons Chamber

[Dr Sarah Wollaston (Totnes) (Con)]

As with any book, we should not judge a Bill by its cover. All Members want to improve access to innovative medical treatments, but I sincerely believe that the Bill is not the right way forward. My hon. Friend the Member for Daventry (Chris Heaton-Harris) referred to a number of organisations, implying that they are in favour of the Bill, but he knows that the overwhelming majority of research and charitable organisations are ranged against it. It is opposed by the Association of Medical Research Charities, whose membership reads like an “A to Z” of expertise, including bodies such as Cancer Research UK, the Wellcome Trust—the list is very long, so I will not detain the House by reading it out. The Academy of Medical Sciences opposes the Bill, as does the Academy of Medical Royal Colleges, including all those he quoted in his speech.

The General Medical Council, the British Medical Association and the Patients Association oppose the Bill, and I direct my hon. Friend to their article in The Guardian. Action against Medical Accidents, and even the Association of the British Pharmaceutical Industry, oppose the Bill because of its unintended consequences. Legal experts, including Sir Robert Francis, firmly oppose the Bill. All those organisations oppose the Bill because it is unnecessary, it is unworkable, it would unravel important patient protections and, most importantly, it would have unintended and dangerous consequences for research.

I pay tribute to all the Bill’s sponsors and absolutely understand that they are motivated by very good intentions. I would love to sit down and work with them on how we genuinely improve access to innovative treatments. I hope they understand that I oppose the Bill because I sincerely believe that it is the wrong way forward.

The Secretary of State already has the power, as the hon. Member for Lewisham East (Heidi Alexander) pointed out, to set up a register of innovative treatments, so we simply do not need that provision. We also do not need the heavy hand of legislation. We do need a register, but it needs to be set up by the research bodies themselves and to be adequately funded. We absolutely need transparency. There is a danger that we will misunderstand the science.

[Mr Christopher Chope (Christchurch) (Con)]

My hon. Friend refers to the power of the Secretary of State to set up a system. When does she expect that to happen, and what is causing the delay?

[Dr Wollaston]

My hon. Friend makes a good point. Principally, there are issues with funding and complexity. The Bill fails to recognise the science and the issues that a vast, sprawling database might cause. My hon. Friend the Member for Daventry referred to the desirability of the public being able to access a database and gave the example of male pattern baldness. There would be vast profits to be made by the quackery industry from male pattern baldness products. I envisage a vast, sprawling database of anecdotal treatments, and I am afraid it would act as free advertising for the quacks of this world. It is an invitation to quackery.

I started in medicine in the late ’80s and worked for a while in paediatrics. The prognosis for children with leukaemia was grim, but today most of the children diagnosed with the same conditions will survive and thrive, not because of access to a vast, sprawling database of unconnected, anecdotal treatments but because of the meticulous progress of medical research, whereby with thousands of people we compare existing treatments with innovative treatments and find out which are genuinely the best. Any single anecdotal treatment might be effective in one single patient, but that does not tell us whether, when applied to a population, it is better or not.

Another problem with the Bill is the danger that it would undermine medical research. In effect, it would give private clinics the opportunity to offer anecdotal treatments as a way of bypassing clinical trials. When individuals, and particularly parents, are desperate because they have a dreadful diagnosis, they are at their most vulnerable to the claims of individuals who say, for example, “Look at the database and see how it worked for Mr Smith.” They might be lured into thinking that was the best way forward. Someone in a very vulnerable place might be lured into not taking part in a clinical trial by the siren call of an anecdotal treatment recorded on a publicly accessible database. I am afraid that the Bill would undermine research, and that is why the vast majority of bodies are very unhappy about it.

My hon. Friend should reflect on all the concerns that have been expressed about the Bill, and think about how science moves us forward. We progress not by a series of anecdotal treatments but through a solid research community.

We need greater access to clinical trials. The searchable database set up by the National Institute for Health Research is a welcome step forward, but it is rather clunky. Patients need to be able to see very clearly what trials are available and be able to take part in them. There is progress, people are surviving today with treatments based on clinical trials that may have taken place 10 years ago and many go on themselves to take part in clinical trials that will benefit future generations. It is absolutely vital that we continue to support this approach.

--- Later in debate ---

[Philip Davies]

I merely read out, word for word, Cancer Research UK’s response to the consultation; I can do no more than quote its words. I will take my hon. Friend’s point in that regard.

[Mr Chope]

If there is such widespread opposition to this Bill, why was it that the Saatchi Bill made such good progress in the other place during the last Parliament, when I understand it had the benign support of the Government?

[Philip Davies]

My hon. Friend often asks me questions that I cannot answer. He has now asked another that I am not in a position to answer. I often think it is a mistake to give way to him; he is far too clever for my liking. Again, he has stumbled across something that I cannot answer. He raises a very good point, so perhaps we shall leave it hanging there for others to have a crack at later in the debate.

The Academy of Medical Royal Colleges said that it applauds the intentions of the promoters of the Medical Innovation Bill:

“The stated purpose of the Bill is to encourage responsible innovation in medical treatment, and accordingly to deter innovation which is not responsible. Those are aims which medical Royal Colleges would wholeheartedly support and welcome.”

That is an important point.

--- Later in debate ---

[Philip Davies]

My hon. Friend is very kind, although it would have been rather better if he had not had to be prompted to say that. Nevertheless, I will take those comments in the spirit in which I know my good friend intended.

[Mr Chope]

My hon. Friend has not responded to the intervention of my hon. Friend the Member for Beckenham (Bob Stewart). Surely the point is that if we want to discuss this in more detail in Parliament, the ideal opportunity for that is in Committee when it can have detailed scrutiny.

[Philip Davies]

My hon. Friend makes a good point. I have not heard anything so far today to suggest that the Bill should not at least go into Committee for further scrutiny, and perhaps even for some improvement, if I may be so bold as to suggest that may be possible. I do not think I have heard anything today that suggests the Bill should be stopped in principle on Second Reading. I hope that my hon. Friend the Member for Totnes will appreciate, however, that I am also trying to be balanced in setting out some of the concerns that have been expressed, perhaps so they can be considered if we do get into Committee, which would be a useful exercise.

Another concern raised by some of my constituents is that the database may compromise patients’ anonymity. Innovative medical treatments will be applied on a case-by-case basis with a specifically honed technique for one particular individual. The fear is that a degree of detail will be needed in the register, which would end up compromising a patient’s anonymity. That is a valid concern, and protections would need to be put in place to ensure all information is stored securely within the database to protect anonymity. However, that may be at the cost of using innovative treatments. There may well be a tension between those two factors.

While the information stored in the database should only be accessible by doctors, it will need to remain confidential aside from access for medical purposes and, ultimately, it should be the patient’s choice whether to use an innovative treatment that will be recorded for medical purposes. Furthermore, in an age when we want more doctors to spend more time with patients and not at their desks, we need to be careful to ensure that the register does not become overwhelming to the point where doctors are put off from using innovative techniques for the sake of the amount of paperwork and red tape that would accompany it. The Academy of Medical Royal Colleges said

“current experience in the NHS show that establishing an effective register for far more standard procedures is a complex task. Establishing and maintaining a register of innovations would be a costly and potentially burdensome and bureaucratic task.”

My hon. Friend the Member for Totnes made that point. That is another factor that needs to be considered when the database is created. Of course the database and the information gathered should be rigorously checked and regulated. However, that is not always easy when doctors are already busy.

Overall, I believe this clause, originating from an amendment to Lord Saatchi’s Bill, is one of the key clauses. For rare diseases such as some cancers there is a lack of published evidence on which to rely when determining treatments to try. It is also widely regarded that some methods used to treat some types of cancers have remained similar for many years, with only slight modifications to the techniques. With this in mind, a database that allows knowledge to be stored and accessed at a doctor’s level will be not only desirable but probably essential for allowing doctors to innovate responsibly. It will encourage a culture of knowledge sharing, which, importantly, will include both successes and failures. This is a vital part of the Bill, and indeed I do not see how the power to innovate can move forward without the inclusion of a database recording the results of these treatments. I therefore commend my hon. Friend the Member for Daventry on including this clause.

We need to look at what we consider to be a responsible innovative treatment. Clause 2(2) states that a treatment is regarded as

“‘innovative’ if it involves a departure from the existing range of accepted medical treatments”

for a condition. We can therefore assume a wide scope to cover the cases that should be recorded in the new database.

However, concerns have been raised regarding the distinction between innovation and research. While clause 5(2) specifically states that this Bill does not apply to medical research, some medical organisations have raised concerns as to how this would work in reality. The Academy of Medical Royal Colleges states:

“We do not understand the distinction between ‘individual patient innovation’ and ‘research’. The distinction seems false and potentially dangerous. As a college president stated ‘Innovation without research isn’t innovation, it’s more often just advertising’.”

Although the Bill uses the two in harmony, it is important to raise these points and for them to be considered in Committee.

One of the main differences that separates the two is that this legislation allows doctors more freedom to modify and specifically cater treatments towards the individual they are treating. That is very important and worthwhile. Although they will not be finding a brand new cure for cancer, it allows doctors to cater treatment plans more specifically to the patient’s needs and wishes. Many patients will benefit from that, and often would prefer it.

We have discussed the Bolam test. By working from the current common law Bolam test, the Bill identifies the steps a doctor can take to show that they have acted responsibly before innovating. The common law Bolam test is defined as the test

“used to determine the standard of care owed by professionals to those whom they serve, e.g. the standards of care provided to patients by doctors.”

Established from the case Bolam v. Friern hospital management committee in 1957, it shows that if a doctor acts in accordance with a responsible body of medical opinion, he or she will not be negligent. Subsequently this standard of care test was amended—the Bolitho amendment—to include the requirement that the doctor should have behaved in a way that “withstands logical analysis” regardless of the body of medical opinion.

This determination of whether a professional’s actions or omissions withstand logical analysis is the responsibility of the court. The Bill, through clause 3, aims to reflect as closely as possible the steps under the current common law which a responsible doctor could be expected to satisfy when innovating. However, clause 3 has caused specific concern for many of my constituents and I would like to raise some of their concerns today.

Most groups and individuals from the medical profession seem to be satisfied with the current Bolam test as a standard for regarding medical innovation, with the Royal College of Surgeons regarding it as “adequate”, so there are concerns that, instead of clarifying the legal position, clause 3 will confuse the current mechanism for judging responsible innovation.

Subsection (2)(a) requires a doctor to

“obtain the views of one or more appropriately qualified doctors in relation to the proposed medical treatment, with a view to ascertaining whether the treatment would have the support of a responsible body of medical opinion”.

This implies that the innovating doctor need only rely on an interpretation of a responsible body, and need not gain the support from a responsible body itself. In practice this might not be a problem, however, as the Bill specifically states that those supporting views must be obtained from “appropriately qualified doctors”—that is, those with appropriate expertise and experience in dealing with patients with the condition in question. It may therefore be taken that the doctor is qualified in the relevant field, which would provide reassurance. It is this clause that many of my constituents are concerned about, however.

This brings me to another point that was raised by my hon. Friend the Member for Totnes. Some of my constituents fear that the database could be used as a tool by quacks, crooks and charlatans, giving them the flexibility to use devious experimental treatments. Indeed, that concern has been echoed by the Royal College of Surgeons, which claims, in reference to clause 3(2)(a):

“This sub-clause could also provide post-hoc justification for an unethical treatment from a doctor asserting s/he sought the view of one other doctor.”

We must be sure, therefore, that appropriate safeguards are in place to protect patients from such doctors. I do not think that many of them exist, but I do not know. My hon. Friend the Member for Totnes and I might have some disagreement about that. The important point is that there needs to be a safeguard, because it is inevitable that some such doctors will exist.

NHS Reform

Christopher Chope Excerpts

Thursday 16th July 2015 Commons Chamber

[Mr Hunt]

No, that is not the case, and the hon. Lady should avoid scaremongering.

[Mr Christopher Chope (Christchurch) (Con)]

Given the political priority which my right hon. Friend attaches to 24/7 consultant cover for accident and emergency hospitals, why was his Department unable to answer the question I put about which hospitals in England currently provide such cover? Will he collect that data and make sure that it is published?

Oral Answers to Questions

Christopher Chope Excerpts

Tuesday 7th July 2015 Commons Chamber

[Ben Gummer]

It is telling that the hon. Lady wishes to talk about wards rather than outcomes. Over the last five years, we have seen a significant increase in the number of patients treated in emergency wards, and we will continue to see an increase, and the difference is that they will operate seven days a week, rather than just five days a week, as is currently the case for many services across the NHS.

[Mr Christopher Chope (Christchurch) (Con)]

11. Whether his Department has discussed with the Dorset clinical commissioning group the provision of accident and emergency services in Dorset; and if he will make a statement.

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I understand that Dorset CCG is reviewing the provision of healthcare across the county under its clinical services review, and that includes emergency services. Obviously, any changes to services must be clinically led, in the best interests of patients and, certainly for acute services, in line with the principles of the Keogh review.

[Mr Chope]

In that case, will my hon. Friend assure me that the Government do not support the CCG’s bizarre proposal to close 450 beds at the Royal Bournemouth hospital and force 40,000 in-patients each year to go to Poole general hospital?

[Jane Ellison]

I understand that the process is not even halfway through—the CCG’s plans are about to enter the consultation phase—and I would expect my hon. Friend, along with other Dorset MPs, to be engaged with that. I would be disappointed if they felt that they had not been so engaged. However, the House might be interested to know about just one of the proposed improvements. There is currently no 24/7 consultant cover anywhere in Dorset, and the proposed improvement plan aims to correct that.

--- Later in debate ---

[Mr Jeremy Hunt]

I think that those were woeful and inadequate questions. What I said after the election was exactly the same as what I said before the election, which was that a number—[Interruption.] Yes, we will have about 5,000 more GPs by the end of the Parliament, which is just what I said before the election. I said that a total of 10,000 more people would be working in primary care. I also said before the election that the woeful problems in general practice would be dealt with only if we unpicked the terrible mistakes made by Labour in the GP contract. That is why this year we are bringing back named GPs for every single NHS patient.

[Mr Christopher Chope (Christchurch) (Con)]

T4. Does the Secretary of State accept the verdict of the Competition Commission, which decided recently that it would be against the interests of patients for Royal Bournemouth General Hospital and Poole Hospital to merge? The clinical commissioning group has responded by saying that one of the hospitals will have to give up all its services.

[Mr Hunt]

I think that we must respect the independent view of the Competition and Markets Authority, but I also think that there are lessons to be learned by the NHS more generally from the way in which that process was conducted. There will have to be changes on the ground if we are to give patients the care that they need in the very constrained financial circumstances in which we operate.

Health Service Commissioner for England (Complaint Handling) Bill

Christopher Chope Excerpts

Friday 27th February 2015 Commons Chamber

[Mr Nuttall]

That is right, and it prompts a question about whether some advantage is to be gained by the commissioner providing more help at the initial stages to try to signpost people. Indeed, the annual report states that the ombudsman receives about 40,000 contacts a year, including queries about where and how to complain about public and non-public services. Of those 40,000 contacts, 27,566 were inquiries for the commissioner, which demonstrates that many members of the public will quite innocently contact the commissioner about matters that do not fall within her responsibilities.

[Mr Christopher Chope (Christchurch) (Con)]

Does that show that new clause 1 is ill conceived? It states that before people make a complaint they must get an estimate of how long it is likely to take to resolve it. However, the bigger issue for people before they make a complaint is what the chances are of it being accepted for investigation.

[Mr Nuttall]

My hon. Friend makes a good point. People may assume that they have simply to make a complaint for it to be followed up, but as statistics from the commissioner’s report show, that is not the case. Many complainants would presumably like someone to deal with their complaint, but are disappointed at the outset before they have even got going, and are told, “I’m sorry; you’ve come to the wrong person.” It may be that there is nobody to deal with that complaint, and the complainant is sent off to look elsewhere.

I have one further point on the detail of new clause 1. If the commissioner was expected to make a more accurate assessment of the time within which the complaint is likely to be completed, she would have to find out much more detail about the nature of the complaint. That would obviously entail more work for her and her staff. It is the law of unintended consequences: we may find that imposing more obligations and burdens on the staff of the ombudsman’s office, in an attempt to be helpful, extends the length of time it takes for a complaint to be resolved, because staff will be engaged in assessing how long it would take to deal with a new complaint, rather than getting on with dealing with complaints. That is a problem.

I accept that all these matters could be dealt with by providing extra resources. We have not really addressed that point so far this morning; it is the elephant in the room. I do not think this is outside the scope of the new clause. If we impose, or even just set out, an expectation on the commissioner to follow this provision, there will be implications for the deployment of resources. The commissioner could rightly say, “Well, it is all very well expecting me to give an estimate to every member of the public who approaches my office of how long their case will take, but where are the extra resources?” That would be a legitimate question to ask. Otherwise, the commissioner is likely to say that complaints might take about a year, which would probably not be very helpful to most prospective complainants.

New clause 2 relates to complainants who, perhaps having looked at the website, have decided that regardless of the length of time it will take, they will make a complaint. The new clause states:

“The Health Service Commissioner shall make available to the complainant, at the outset of an investigation, an estimate of the period within which the investigation is likely to be completed.”

That implies that initial details have already been taken. I would expect this to be rather more specific advice than that provided to a member of the public. This is someone who has lodged a specific complaint, which the commissioner has accepted. It is a small point, and I have not bothered tabling an amendment to new clause 2, but I would prefer it to read, “The health service commissioner shall give the complainant, within 14 days of the outset of an investigation, an estimate of the period in which the investigation is likely to be completed.” I would have tried to tighten it up a little bit, but I nevertheless accept that that is the wording put forward by my right hon. Friend.

I raised a point about providing updates. My right hon. Friend’s response was that there was no need to legislate on that, because he felt that the commissioner was providing updates anyway. If she is, I could use the same argument about new clauses 1 and 2. If we have no evidence—no one has been able to provide any—that this is a problem, either for members of the public, in respect of new clause 1, or for specific complainants, in respect of new clause 2, I have to question whether these new clauses are required at all. On balance—I accept that it is a fine balance—I do not think that they are required, and should he press either new clause to a Division, I would vote against it, but only because, as he has said himself about legislation to provide updates, there is no need for legislation to require the commissioner to provide this information to the public or a specific complainant.

--- Later in debate ---

[Mr Davis]

Yes, there are laws of nature and there are laws of man, and in Eric Forth’s case, there are forces of nature which sometimes are the forces of man. It is a wonderful paradox, but given that it was my right hon. Friend who provoked me to conjure the five laws, I blame him, not myself.

My right hon. Friend made a very thoughtful speech, and perhaps met Eric Forth’s sixth law, which is that all this has to be tested—that is the point of this House, and it was Eric Forth, more than anybody, who insisted that we did not just shovel through, sausage-like, a set of laws because the Administration or some pressure group wanted them, but that we tested them, and my hon. Friend the Member for Bury North has been doing that this morning.

This reform is likely to be the first of a number picked up by the Executive, not by us. The Public Administration Committee is looking at this, the Department of Health is looking at it, the ombudsman’s office itself is looking at it, and the Cabinet Office is also looking at the issues raised by my right hon. Friend and my hon. Friend. The Executive will be aiming to minimise the number of times complaints are turned down out of hand; to minimise the number of times people are told, “You’ve got the wrong department. Complain to somebody else”; and to minimise the constraints on the ombudsman’s office that might not permit it to intervene; and they will also be aiming to deal with the resource issue. It seems to me that we do not need to solve those problems. It is for the Executive to do so properly in Executive time, with debate going on across the Front-Bench teams. It is for them to deal with that; we are dealing with a simple problem here.

[Mr Chope]

When my right hon. Friend discussed the Bill in Committee, he contemplated the prospect of introducing amendments at this stage to reflect the outcome of the deliberations taking place in government and elsewhere. In the light of the Government’s failure to deliver a timely response, how much confidence does he have that they have the will to do this?

[Mr Davis]

A lot of confidence. I do not wish to pre-empt the Government’s forthcoming announcements, but neither do I want to push them into doing anything ill thought through. If the law of unintended consequences applies to anything, it applies to Government legislation—more than anything else. I am confident that this will happen, and in a way that will command support across the House. As my hon. Friend knows, it may be dangerous to make a prediction, but I think there will be agreement. Whatever happens in the general election, I believe these reforms are coming.

--- Later in debate ---

[Mr Arbuthnot]

After hearing valuable comments from both sides of the House, I have come to the conclusion that my new clauses would not be helpful and I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.



New Clause 3

Statutory duty of the Health Service Ombudsman

‘It shall be a statutory duty of the Health Service Ombudsman to resolve any complaints within twelve months of the date when the complaint was received.’—(Mr Chope.)

Brought up, and read the First time.

[Mr Chope]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dame Dawn Primarolo)]

With this it will be convenient to discuss the following:

Amendment 3, in clause 1, page 1, line 7, after ‘Commissioner’ insert—

‘before the end of that period’.

Amendment 4, page 1, line 8, at end insert—

‘together with an estimate of the target date for completion of the investigation.’

Amendment 1, page 1, line 8, at end insert—

‘(b) The Commissioner shall subsequently keep the complainant informed, as far as reasonably practicable, as to the progress of the investigation.’

Amendment 5, page 1, line 8, at end insert—

‘( ) If the reason for the delay specified in Section 2HA is lack of financial resources it shall be the duty of the Commissioner to set out the action which is being taken to remedy that lack of financial resource’.

Amendment 2, page 1, line 15, leave out ‘, and’ and insert—

‘(ba) the reasons for each of those delays, and’.

--- Later in debate ---

[Mr Chope]

The new clause would simplify the Bill enormously. It would require the health service ombudsman to resolve any complaint within 12 months of the date on which it was received. As we are paying tribute to my late friend Eric Forth, may I say that the new clause would have commended itself enormously to dear Eric, because it puts on the tin what people say we want to put on the tin. With the greatest of respect to my right hon. Friend the Member for Haltemprice and Howden (Mr Davis), I think he has been timid in his Bill. We know that 99% of these cases are dealt with within one year. The new clause would require that 100% of them be dealt with within one year, and there would also be a sanction, because a breach of a statutory duty can be justiciable. That would concentrate minds. If it looked as though a complaint was being dealt with slowly, the health service ombudsman would be able to say, “You’ve got to get a move on because we’ve got a statutory duty to resolve this within one year.”

--- Later in debate ---

[Stephen Pound (Ealing North) (Lab)]

I am not sure whether the hon. Gentleman heard the comments by the Minister on the previous group of amendments but I think she addressed that point precisely. There is a complexity within the system that cannot be anticipated, and it would artificially fetter the discretion of the commissioner if an arbitrary time limit were put in place. Does he not agree that there are occasions when the complexity is such that we simply cannot fix the rigid metallic corset of a time limit on it without diminishing the value of the investigation?

[Mr Chope]

With the greatest of respect to the hon. Gentleman, I do not accept that, which is why I tabled the new clause. As he says, the Minister was addressing new clauses 1 and 2, and I would not at this stage anticipate her response to the debate we are now having on new clause 3. If a statutory duty is in place, minds will be concentrated. That means that the ombudsman would, for example, be able to explain to a complainant who it was who was not providing the information that was necessary in a timely fashion and say, “If we don’t get a move on, your complaint will be time-barred because we will dismiss it on the basis that we have a lack of evidence.”

[Jacob Rees-Mogg (North East Somerset) (Con)]

Following on from the point made by the hon. Member for Ealing North (Stephen Pound), may I say that I am not entirely sure that corsets are normally metallic—I believe they are generally made of whalebone? Leaving that aside, I wonder whether my right hon. Friend the Member for Haltemprice and Howden (Mr Davis) ought to be introducing a shorter time limit, because we all know that work expands to fill the time available. [Interruption.] Parkinson’s law, indeed. As soon as a 12-month time limit is introduced, that is the time that will be taken. If 95% of complaints are being dealt with within six months, six months would seem to be quite a good limit.

[Mr Chope]

I agree with my hon. Friend. It is a pity that he did not put down an amendment to my new clause to replace the limit of 12 months with one of six months. We know that the Bills that we debate on Fridays involve an iterative process. If the new clause were accepted today by my right hon. Friend, we would start off with a 12-month limit, which might in due course move to six months. That deadline, which will have the effect of concentrating minds, makes the measure legally meaningful, whereas, at the moment, everything in the Bill is legally meaningless. The Bill is, as someone has said in relation to the draft clauses of the Scotland Bill, “legally vacuous”.

[Mr Arbuthnot]

How does my hon. Friend deal with the problem that there might be some issues that are outside the control of the ombudsman? For example, the ombudsman might be hoping for a response from a health provider that he is simply not getting. How would the ombudsman then obey the statutory duty that we would be applying?

[Mr Chope]

Unlike quite a lot of organisations, the ombudsman is accountable to this House. If the ombudsman were experiencing the difficulty to which my right hon. Friend refers, I would expect the ombudsman, the chief executive or chairman to contact my hon. Friend the Member for Harwich and North Essex (Mr Jenkin) and say that they wished the Public Administration Committee to look into the matter and put pressure on the recalcitrant Department. In a sense, my right hon. Friend is saying that, because we may have customers—if that is the right expression—who are minded to delay things, we should facilitate enabling them to delay things beyond a year. We need to focus on who the real customer is. The customer is the person who has made a complaint, and whose complaint has been accepted for investigation by the ombudsman. In my view, they are entitled to have a decision on that complaint within 12 months, which is why I put in this statutory duty.

[Jacob Rees-Mogg]

It occurs to me that, for once, my right hon. Friend the Member for North East Hampshire (Mr Arbuthnot) is wrong. If a public body failed to respond to the ombudsman, it should be found against and that would be quite a penalty and an incentive not to procrastinate.

[Mr Chope]

Again, my hon. Friend makes a first-class point. I hope that, when the Minister responds to this short debate, she will support the line that is being taken. We need to ensure that there is no scope for statutory bodies to avoid their responsibilities to deliver and that we facilitate the ombudsman to reach a result within 12 months of a complaint being made.

At the moment, the ombudsman is dealing with about 4,000 complaints a year, some 3,000 of which are related to health. The cost of those complaints to the taxpayer is about £4,000 a time. As the taxpayer is investing that amount of money, a reasonable return on that would be to say that those complaints should be dealt with in a maximum period of one year. If we pass new clause 3 and include it in the Bill, we will have a useful piece of legislation, instead of an empty vessel—although even an empty vessel with the name of my right hon. Friend the Member for Haltemprice and Howden on it will be cherished by many people, especially his constituents.

Amendment 3 is more specific. It will require the commissioner, in fulfilling the obligations set out in clause 1, to explain the delay before the end of the 12-month period, rather than after it. At the moment, there is a lacuna here—perhaps it is a deliberate one—to ensure that the minimum pressure is applied, which will show that we are just engaged in gesture politics. I hope that that is not correct. As it stands, clause 1(2) says:

“Where the Commissioner has not concluded an investigation before the end of the 12-month period…the Commissioner must send a statement explaining the reason for the delay to the person who made the complaint.”

But it does not say when the commissioner should send that statement. Unless there is a requirement on the timing of that statement, the measure is completely meaningless. It may be that that statement will be sent at the same time as the ultimate decision is made. In an effort to make the Bill do what my right hon. Friend wants it to do, which is to put pressure on the health service commissioner to deal with complaints in a timely fashion, I am suggesting a modest amendment.

Amendment 4 is on the same theme. When that statement is sent, it would not just explain the reason for the delay, but contain an estimate of the target date for completion of the investigation. I accept that, in itself, that would not be much use, because if there is another target date—it could be in another year—there may still be no remedy for the complainant. At least, though, it would force the ombudsman service to apply its mind to how much longer it thought it was reasonable for the investigation of the complaint to take.

Amendment 5 brings us into a slightly different territory. I suspect that a main reason for the delay in dealing with these complaints is a lack of resource. The amendment would add to clause 1 the words:

“If the reason for the delay specified in Section 2HA is lack of financial resources it shall be the duty of the Commissioner to set out the action which is being taken to remedy that lack of financial resource.”

Again, if the delay is due to financial reasons, it is surely important that the world outside, and particularly the complainant, should know about that so that they can make the necessary complaints. It is also important that the ombudsman is able to say, “Well, because of a lack of financial resources, I am not able to deal with these cases as quickly as I would have wished. Therefore, I am asking Parliament for more money to help us meet our case load.”

There is a £15 million budget for this exercise. Each case currently costs some £4,000 on average. The average compensation payment that was paid out in 628 cases amounts to less than £1,000. I am not sure that anyone coming from another planet and looking at this system would say that it is financially well focused. The average cost of dealing with a complaint is over £4,000. The average amount paid to a successful complainant is just less than £1,000. That shows that there is a potential problem in relation to the funding of the ombudsman service. That may be exacerbated by the ombudsman’s decision to take on more complaints for investigation by “lowering the threshold” for investigating such complaints. As the annual report makes clear, the consequence of that is an increase in the number of complaints being investigated, only a reduced proportion of which is being concluded in favour of the complainant. Expectations among the complainants are being raised, but they are not being delivered on by the ombudsman because a lot more cases are being taken on which probably should not have been taken on in the first place. The report states that because the ombudsman is

“taking on many more investigations than before, the proportion of investigations…upheld or partly upheld has inevitably declined”.

I think that the expression “inevitably declined” is a bit of an underestimate, because it has declined from 86% to 42%, which is a dramatic reduction in one year.

[Mr Arbuthnot]

Might one not read that in a positive way by saying that if the complaints are found not to have been justified, that suggests that the national health service is doing a pretty good job?

[Mr Chope]

I do not go along with that, I am afraid. It is rather like saying that we should encourage the maximum number of complaints against something, engaging bureaucracy and taxpayer expenditure to deal with the complaints, to give some perverse satisfaction to the people who want to say that the Government service, in this case the health service, is doing a good job. If we want to measure consumer satisfaction with public services, there is a much more direct way of doing it than looking at how many complaints against their services have been made and rejected.

By way of an aside, one difficulty with the ombudsman service is that it cannot take on complaints from public sector organisations. In my constituency, for example, a head teacher of a school that was unfairly done down by Ofsted was told—or it was implied—that he could complain to the ombudsman service, but the ombudsman service deemed his complaint to be outside its scope. Although he is an individual, as he is the head of a school, Ferndown upper school, the complaint is regarded as coming from a public organisation and therefore does not come within the scope of the ombudsman’s rules. I would prefer to see the scope of the ombudsman to investigate issues widened, while keeping a focus on complaints that are prima facie likely to be well founded, to going down the road of saying that we should have many more complaints and that when we reject those complaints it means that the public services are doing very well. That is where I would disagree with the ombudsman service’s strategy, which is to try to maximise the number of complaints.

When people make complaints, it often involves quite an effort on their part and they normally make them on the basis that they expect a positive result. They do not make them hoping that their complaint will be rejected, thereby endorsing the national health service, local government organisation or other body for performing in a way that did not result in the complaint against them being justified. The best organisations are organisations that have no complaints against them and I should have thought that that was what we should be aiming for—a health service in which there were no complaints, or in which all the complaints were dealt with long before they came before the ombudsman.

Those are my amendments. I shall leave my right hon. Friend the Member for North East Hampshire (Mr Arbuthnot) to address his amendments 1 and 2. If some of these amendments were accepted, I think the Bill might have some worth and value.

[Mr Arbuthnot]

My hon. Friend the Member for Christchurch (Mr Chope) suggests that I might like to address amendments 1 and 2. During the last debate, my hon. Friend the Member for Bury North (Mr Nuttall) pointed out that I was not suggesting that the health service ombudsman should keep the complainants properly informed and I said that I was persuaded that it was not actually necessary to do so. What I should have said was that I had proposed an amendment to do so in the next group of amendments, but during the course of that debate I persuaded myself out of the value of amendments 1 and 2 so I think it would be best for me simply to sit down and not move them. What my hon. Friend the Minister and my right hon. Friend the Member for Haltemprice and Howden (Mr Davis) said in answer to that debate satisfied me that more detailed legislation for the ombudsman, apart from the extent to which my right hon. Friend wishes to change the law, is probably not helpful.

In answer to my hon. Friend the Member for Christchurch, I do not agree with the rather rigid approach that his new clause 3 might introduce. Inevitably, there will be some complaints that are so complicated and in which so many people are involved in answering the issues that it would be a bad idea to place on to the ombudsman a duty that, with the best will in the world, they might simply not be able to fulfil. During the course of the morning I have been looking for a quotation from Idi Amin, referring to someone who had displeased him. He said, “When we catch him, he will be executed. He will have a trial, of course, but by trial I do not mean one of those things that goes on all day.” I think that that is the approach favoured by my hon. Friend in the new clause. I hope that he will forgive me if I do not support his new clause and fail to move my amendments.

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[Mr Nuttall]

My hon. Friend has achieved his wish.

I think that what is set out in amendment 5 would fall into a set pattern, with the commissioner saying every year, “Well, if you gave us a bit more money, we’d have a few more staff and things would get better.”

[Mr Chope]

With the greatest respect, I think that my hon. Friend misunderstands the amendment. The idea is to increase transparency so that rather than the commissioner being able to complain sotto voce that this is all because they do not have enough money, that would have to be brought into the open, and then the very points that he and my hon. Friend the Member for North East Somerset (Jacob Rees-Mogg) have been making about the ability of many public sector organisations to get a lot more bang for their buck could be exposed to public debate.

[Mr Nuttall]

I am grateful to my hon. Friend for that clarification. He suggests that the amendment is purely about transparency, which means it has more merit than I had accorded it.

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[Mr Davis]

I started off being flattered by the suggestion from my hon. Friend the Member for Christchurch (Mr Chope) that I had been in some way seduced into mitigating the Bill, but I think that I am far beyond the point at which seduction, either metaphorical or real, is an option. Perhaps that is why, when it comes to new clause 3, which I think is the most substantive amendment in the group, I am not as much of an expert as the hon. Member for Ealing North (Stephen Pound) and my hon. Friend the Member for North East Somerset (Jacob Rees-Mogg) appear to be on the subject of corsets. As I understand it, corsets constrict things at one point and let them out at another. The risk in new clause 3 is that it would put such constraints on the ombudsman that problems would be created elsewhere.

There have been two problems with the operation of the ombudsman over the past few years: not meeting timetables and making mistakes. On a number of occasions the ombudsman has got things wrong, which has made things even more acutely painful for the people seeking help and support, because the ombudsman has had to go back and correct mistakes. Indeed, that happened on a number of occasions in the very case that is at the centre of this piece of legislation. Were we to go down this route, we might create a series of problems arising from the ombudsman making erroneous recommendations and proposals, which would of course lead to the issues being multiplied down the generations, rather than dealt with straightaway.

We must also remember that some of the issues that the ombudsman deals with not only require information from other Departments and other parts of Government, but sometimes involve contested arguments and may have legal liability associated with them, so we should not forget that there is a natural justice aspect to this. Finally, these issues are very often on the edge of science. The sepsis problem was one such issue, for which the medical profession is still seeking new solutions. We should be wary of going so far on this that we cause another set of problems. That is why I think the Bill as printed strikes the right balance.

[Mr Chope]

My right hon. Friend refers to potential legal liabilities, but my understanding is that anybody who comes before the ombudsman with a complaint has to give a guarantee that they are not intent on taking legal redress.

[Mr Davis]

I am not sure that the legal liability relates simply to the person bringing the complaint. It could relate to other people too, such as those contracting services. It also relates very much to reputation. Someone may, in effect, be asked to make a confession according to a timetable, which is not a good idea in a statute.

I agree with my hon. Friend the Member for Bury North (Mr Nuttall) in his critique of amendment 5. On amendment 4, I would leave that to practice guidelines, rather than putting it into law. It is dangerous, as I said earlier, to create lots of onerous responsibilities in law. The aim of the Bill is to exert pressure and give a degree of public guarantee, not to try to tell the ombudsman how to cross every t and dot every i.

The one amendment with which I felt some sympathy but am still uncertain about is amendment 3. I presumed from the Bill that the ombudsman’s department would respond close to the 12-month point when it knew that it might go past it. Earlier, it is likely to have to adjust the timetable; later is not tolerable. I am uncertain whether it may lead to perverse or unintended consequences if we do exactly what my hon. Friend the Member for Christchurch has proposed. I will have to think about that. The Bill has to go through a Lords stage. I ask my hon. Friend not to press the amendment today, but I give him an undertaking that I will look at the matter closely and see if I can come up with a form of words that I can suggest as a change in the Lords; I will let him know if I am not able to do that.

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Finally, other Members have made very good points about amendment 5, which centres on investigations that take more than 12 months to conclude. My understanding is that lack of resources has played no part in any single investigation by the health service commissioner that has taken more than 12 months. My hon. Friend the Member for Bury North (Mr Nuttall) made an interesting point about the possible unintended consequence of the insertion of a resource clause. The amendment does not pick up on an issue that we have reason to believe is a major problem, so it would not be right to legislate on it. The strength of the Bill is that it picks up on a specific identified issue of poor complaint handling by the health service ombudsman. For that reason, I hope that the amendment will not be pressed and that the Bill will proceed unamended.

[Mr Chope]

May I thank everybody who has participated in this debate and my right hon. Friend the Member for Haltemprice and Howden (Mr Davis), the Bill’s promoter, for his generous offer to at least consider amendment 3? I do not mean to be churlish, but it is a problem that we are debating the Bill on the penultimate private Members’ Friday. If my right hon. Friend were to choose, on reflection, to incorporate amendment 3 in an amendment in the other place, he would, in effect, jeopardise his Bill, because we would then have to consider it again after it had been amended. The Minister has indicated her potential support, so perhaps she would like to intervene on me to guarantee that, should that eventuality arise, the Government would give the Bill the necessary time to ensure that it was not frustrated by that process but reached the statute book. I must say that I am tempted to press amendment 3 to a vote, because it might be easier to include it in the Bill now rather than have a promise that something will be done later.

One could sum up this debate by saying, “Excuses, excuses, excuses.” It is so easy for public sector organisations to make excuses about why they cannot meet particular time limits.

[Mr Arbuthnot]

My hon. Friend has made a valid point about the remaining number of private Members’ Fridays. I hope that the ombudsman will at least read this debate and recognise that it would be best practice to put into her report the relevant time—in other words, as amendment 3 says,

“before the end of that period”.

[Mr Chope]

I am grateful to my right hon. Friend for putting that suggestion, which could help, on the record.

On the issue of excuses, I fear that we are entering the territory of double standards. When my constituents who are company directors are required to submit their company accounts by a particular day and fail so to do, or when other constituents are required to submit their tax return by 31 January and fail to do so, that failure incurs a penalty of £100 and there is no room for excuses such as family bereavements, delays by accountants or third parties and all the rest of it. In relation to the excuses made by Departments, or the ombudsman in this case, on which we want to place similar obligations, we are not consistent.

[Mr David Davis]

My hon. Friend has made a minor slip. The ombudsman is not a Department; it oversees Departments, responding to and being overseen by a parliamentary Committee.

At the end of the day, my hon. Friend may have a very good point about the timing of amendment 3. If he is right, the alternative would be for me to make it very plain to the ombudsman that that is what Parliament expects. It is certainly what I expect and what I intended in drafting the Bill. Rather than jeopardise the Bill, we should make sure, as is very easy to do, that the ombudsman understands that point, as does the parliamentary Committee overseeing it, which is our final recourse.

[Mr Chope]

My right hon. Friend is right to say that we are talking not about a Department but about a parliamentary sponsored organisation that tries to hold the Government to account. Yesterday, the House discussed the whole saga of Equitable Life, and what a long drawn-out saga it was. We know that the ombudsman tried desperately to get timely responses from the Treasury and other Departments, and was frustrated at every turn. Looking back at that, we can see that being able to say that she had a statutory obligation to deliver the result of an inquiry within a particular period would have helped rather than hindered her in the work she had to do.

[Jane Ellison]

I completely understand my hon. Friend’s point. I tried to draw out the fact that the interests of complainants may not be served by the proposal. As we all know, serious and complex complaints sometimes involve a death or serious injury, which means dealing with a bereaved family. The course of events over the 12-month period may not run smoothly for the very people making the complaint and wanting it to be resolved sensitively, sensibly and properly. This is not about Departments or the NHS making excuses, but about acknowledging that the sensitivities of the complainants and their loved ones mean that the ombudsman needs a little more time in some instances.

[Mr Chope]

I hear what my hon. Friend says. In essence, the more usual scenario in cases of bereavement is that people want what they describe as closure sooner rather than later. The Bill has been introduced to emphasise that it is the will of the House that such matters should normally be dealt with within 12 months.

[Mr Davis]

My hon. Friend is wrong about one thing: the ombudsman’s power rests on trust in the accuracy of the case that he or she makes. Equitable Life’s problems did not arise from that, but from the complexities of moral hazard and other such issues. A better example was the case of the state earnings-related pension scheme, in which the ombudsman, the Public Administration Committee and the Public Accounts Committee, under my chairmanship, was able to get the Government to pay out what turned out to be billions of pounds because of errors identified from accurate—though not, as it turned out, fast—investigation. The things we must not jeopardise are the accuracy and effectiveness of the ombudsman’s investigations.

[Mr Chope]

My right hon. Friend gives an example of which he had direct experience. All I can say is that it is a pity that people who present their tax return late are not allowed the same indulgence—saying that their affairs are very complex, or that their accountant let them down—to avoid a penalty. There is an issue with ensuring consistency in the rules.

We have had a good run round the circuit on this matter. As in the previous debate, this again emphasises that, as Eric Forth said, Bills should never go through on the nod without proper discussion. Although people may have looked at the Bill and thought it a pretty minor piece of legislation, even such a Bill—I have not seen many that are more minor—is worthy of discussion to work through its implications. Having said that and thanked hon. Members for their contributions to this short debate, I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.



Third Reading

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[Mr Chope]

I hope that I have not been too harsh on my right hon. Friend the Member for Haltemprice and Howden (Mr Davis) in the course of this debate.

In preparing for Third Reading, I looked at the explanatory notes to the Bill. The summary states:

“The Health Service Commissioner for England (Complaint Handling) Bill seeks to increase the effectiveness of the Commissioner (known as the Health Service Ombudsman), who is the final tier of the NHS complaints system. It does so primarily by requiring the Health Service Ombudsman to take action with a view to concluding investigations of complaints within 12 months”.

The Bill does not actually do that. That is my concern. I fear that the Bill is in danger of raising expectations, because it does not require the health service ombudsman to do anything to bring forward a resolution of complaints within 12 months. All it does is to say that if she does not, she has to include references in the annual report and communicate with the complainant.

Even on the basis of the summary in the explanatory notes, I fear that the Bill falls short of the expectations of its promoter. Obviously, if we are in the business of littering the statute book with more pieces of legislation, there is no reason why this one should not be added to the others.