Hospital Parking Charges (Exemption for Carers) Bill Debate
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David Nuttall
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Hospital Parking Charges (Exemption for Carers) Bill
David Nuttall Excerpts(8 years, 5 months ago)
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Philip Davies
I agree that that part of the Bill is clear, but as the hon. Member for Worsley and Eccles South (Barbara Keeley) has just said that there are 6 million carers but only 1 million will gain any benefit from the Bill, some people may consider that there is an unfairness there.
Mr David Nuttall (Bury North) (Con)
These exchanges have completely overlooked clauses 4, 5 and 6. Those clauses refer to eligible carers, who are defined in clause 5. I shall not go into the definition now, but it could bring in millions more carers, rather than just the 1.1 million who we have just been told are covered in the Bill.
Philip Davies
My hon. Friend has made a very good point, and I hope that he will expand on it in his own speech. I do not want to steal his thunder.
Mr David Nuttall (Bury North) (Con)
It is a pleasure to follow the hon. Member for Birmingham, Perry Barr (Mr Mahmood), who gave us his take on the Bill, although I feel the matter is a little more complicated than he would have the House believe.
I congratulate the hon. Member for Burnley (Julie Cooper) on coming fourth in the ballot for the right to bring in a private Member’s Bill—as a new Member entering the ballot for the first time, she has done very well indeed—and on choosing such an important topic. I do not know if she does the national lottery, but if she does—
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. Obviously, congratulating the hon. Lady is a good way of taking up time, but actually I did the draw, so if the hon. Gentleman is going to congratulate anybody, I think it should be me. However, I do not want us to get bogged down in that, because I know he wants to get straight into the Bill, on which I would welcome his comments. I know he would rather talk about the Bill.
Mr Nuttall
Of course, you were there, too, Mr Deputy Speaker, doing the draw, and very well you did it as well. As you know, however, because it is done in reverse, coming first actually means coming 20th.
Mr Nuttall
I will move on.
This is the first Bill to come before the House for its Second Reading since the new Standing Orders were introduced last week on what generally is referred to as “English votes for English laws” but what I prefer to call, more accurately, “English vetoes for English laws”. The new Standing Orders make it clear that the new procedures do not apply to private Member’s Bills, but it is worth noting—
Mr Deputy Speaker
Order. They do not apply to private Members’ Bills, so we do not need to discuss them. Seriously, a lot of Members still wish to speak, and I do not want any filibustering. I know that people are interested in the Bill and want to concentrate on it.
Mr Nuttall
I am grateful for the work carers do in my own constituency, particularly at the carers centre I visited recently, which provides a wide range of activities and support for those who undertake the often unsung job of caring for a loved on. I also pay tribute to the work that Carers UK does, as the principal national charity for carers. Of course, it very much supports the Bill, in this its golden jubilee year.
The aim of the hon. Lady’s Park the Charge campaign, which has resulted in the Bill, is to improve the financial position of carers who have to use hospital car parks by exempting them from car parking charges. Without doubt, the Bill is well intentioned, and no one from across the House would disagree with the proposition that helping those who selflessly care for others is a worthy aim. The first difficulty, however, facing anyone determining the size and nature of a group is that of definition, and that applies to carers as much as to any other. Carers UK says there are 6.5 million carers in the UK, with 5.4 million of them living in England. As I tried to mention earlier, the Bill only applies to England so that is the relevant figure.
Carers UK goes on to state that these people are providing unpaid care for their loved ones, saving the economy an enormous £119 billion each year, yet its research found that 48% of carers were struggling to make ends meet, and 45% said that financial worries were affecting their own health. It is no surprise, therefore, that Carers UK and the Bill seek to alleviate one of the financial pressures on carers—hospital car parking charges. However, I have several concerns, ranging from the Bill’s drafting to its financial implications and potential impact on other groups.
It is not clear to me how we can objectively determine who should and should not be expected to pay for car parking, as we would be doing if we started centrally exempting one particular group as being more deserving than another group. It would seem preferable to allow individual NHS trusts to continue making such decisions locally. Otherwise, on the face of it, we seem to have here a fair and reasonable proposal. Indeed, my initial thought was that it sounded like a good thing to do, and I suspect that most people’s instinct would be to support the Bill simply because of the title.
I know that the hon. Lady has campaigned on this issue with the best intentions, but I want to deal precisely with the exemptions she seeks to introduce. The Bill would exempt two groups of carers. The first is defined in clauses 1 to 3. Clause 2 states that beneficiaries of an exemption would either be in receipt of carer’s allowance or have an underlying entitlement to it. Carer’s allowance is a taxable benefit currently set at £62.10 a week to help a carer look after someone with substantial caring needs, and it is paid to the carer, not the recipient of the care. To qualify, the applicant must be over 16, spend at least 35 hours a week caring for someone, have been in England, Scotland or Wales for at least two of the last three years and not be in full-time education or studying for 21 hours a week or more. The person in receipt of care must receive qualifying benefits, such as the daily living component of the personal independence payment, the middle or highest care rate of the disability living allowance, attendance allowance or the armed forces independence payment.
That is the first group to which we can start to put a number. According to Department for Work and Pensions figures, as of February, 721,000 people were receiving carer’s allowance, so these people would be the first group that would clearly qualify under the criteria. However, the Bill would go further, by also including within the first group all those who have what is referred to as an underlying entitlement to carer’s allowance. The term “underlying entitlement” refers to the fact that a claimant cannot usually receive two income-replacement benefits together—for example, carer’s allowance and the state pension. This is called the overlapping benefit rule. If a person is not entitled to be paid carer’s allowance because of this rule, they are said to have an underlying entitlement to carer’s allowance instead. This might mean they could get the carer’s premium in jobseeker’s allowance and income support, the extra amount for carers in pension credit or the carer’s allowance element of universal credit. The importance of including those people is that the Bill would otherwise exclude carers in receipt of other benefits, such as the state pension, bereavement allowance, contribution-based employment and support allowance, contribution-based jobseeker’s allowance, incapacity benefit, industrial death benefit, maternity allowance, severe disablement allowance, universal credit, war widow’s or widower’s pension or widow’s pension.
Not surprisingly, the inclusion of these people significantly increases the number of those eligible under the Bill. DWP figures, as of February, estimate this group to number 409,000. Taken together, therefore, clauses 1 to 3 could exempt approximately 1.13 million people. These people are either receiving carer’s allowance or have an underlying entitlement to it. As the hon. Lady will be aware, in the north-west, where both our constituencies are located, there are 163,000 such people. To give some idea of the massive increase in the number of carers in recent years, I should add that the figure of 1.13 million is up from 451,000 in February 2000.
If, however, the definition of entitlement is applied in strict accordance with clause 2, the Bill would exclude, a university student caring for a disabled parent, for example. I suspect that the second group of potential beneficiaries was defined for people in such a position. The Bill therefore draws a distinction between a “qualifying carer”—someone caught by clause 2—and an “eligible carer”, as defined in clauses 4 to 6. My hon. Friend the Member for Shipley (Philip Davies) touched on this, and I pointed out in an intervention that the figure of 1.13 million—the figure quoted by Opposition Members as being the total number involved—seemed to ignore completely those included under clauses 4 to 6.
Clause 5(1)(a) defines the eligible carer as someone who
“has been assessed for free hospital parking”
by virtue of an amendment to the Care Act 2014, which this Bill would insert. The Bill proposes to amend section 10 of the 2014 Act, which deals with carer’s assessments. A carer’s assessment is made by a trained person either from the council or another organisation that the council works with. The Bill will make it a mandatory requirement for the assessor to assess
“whether the carer should be eligible for free hospital…parking”.
This is in addition to assessing, as outlined in the rest of section 10—
“(a) whether the carer is able, and is likely to continue to be able, to provide care for the adult needing care,
(b) whether the carer is willing, and is likely to continue to be willing, to do so,
(c) the impact of the carer’s needs for support on the matters specified in section 1(2),
(d) the outcomes that the carer wishes to achieve in day-to-day life, and
(e) whether, and if so to what extent, the provision of support could contribute to the achievement of those outcomes.”
It is not clear at all on what basis the assessor is expected to make this decision. If only eligibility or underlying eligibility to carer’s allowance is going to be checked, this provision is superfluous, as such people would be covered in the first group. If some other criteria are to be applied, there is nothing in the Bill or in any guidance notes—no such notes have been issued—to suggest what that might be.
Returning to my example of the student who is caring for a parent but cannot get carer’s allowance because of their studies, clause 5(1)(b) perhaps comes to the rescue. It says an “eligible carer” is a person who
“provides or intends to provide substantial care on a regular basis, other than by virtue of a contract or as voluntary work and has been certified as such by an appropriate clinician.”
I believe that the meaning is ambiguous. What does “intend to provide” mean? How far into the future is it expected that the care will be delivered—within the next week, the next month, the next year, or what? The Bill does not say. Or is a fixed timescale not required; is consideration of caring enough? What constitutes “substantial care” in this provision? Is it the 35 hours a week required to be eligible for the carer’s allowance, or is it fewer than 35 hours a week? We need to know, because the Bill is asking an assessor to be the ultimate arbiter of whether someone is entitled to free hospital parking charges.
Suddenly, the number of people who might benefit from free hospital parking becomes a lot less certain. The first group gave us 1.13 million people. How many more of the 5.4 million carers estimated by Carers UK to be living in England would be included in the second group? We simply do not know.
Mr Rees-Mogg
Does my hon. Friend agree with the further point that clause 5(1)(b) might provide an incentive to increase the total number of carers because people would have a strong need to say that they were carers or had the intention to be carers—even if the reality were completely different, which would mean falsely inflating the figures?
Mr Nuttall
There is always a danger with any scheme, as with the blue badge scheme, that some people will try to use it for their own ends. I hope it would be only a minority, but that danger exists. The assessors would need to be aware of that; they would need to be constantly on the lookout for people who were not genuine cases. That is what I think my hon. Friend is getting at—that some people might “try it on” to their own advantage.
Given that there are no explanatory notes and no impact assessment for the Bill, it is worth considering what has been done in the past. Fortunately, under the last Labour Government, an impact assessment was done—the NHS car parking impact assessment, which was published in December 2009. It estimated that there were 46 million in-patient visitors a day. We do not know how many of them are carers, but as we shall see, car parking charges vary significantly around the country. Regardless of the precise number, it is inevitable that one consequence of the Bill would be to divert part of the healthcare budget that could otherwise be used for front-line national health services—potentially life-saving services—to cover car parking maintenance and all the associated costs ranging from maintenance to administration and dispute management.
The Bill places Members here in the unenviable position of being asked to single out one particular group of people as being more deserving of financial assistance than any other. Without an exact number of those eligible for exemption, it is difficult to know how much money we are talking about in each area that the Bill would take out of the healthcare budget.
At the Bill’s heart is the principle of whether it is right to charge for parking at a hospital or other healthcare facility and, if so, which if any group should be exempt from those charges. I appreciate that some of the public—perhaps virtually all the public—take the view that charging to park a car at a hospital is simply an attempt to make a profit for greedy hospitals or, worse still, for nefarious parking companies. If that were the case, I suspect there would be universal condemnation of such a practice, but of course it is not the case.
Hospital car parking charges in our national health service are what are called “an income-generation scheme”. They are not just an extra-revenue scheme for hospital managers to provide comfier chairs or profit for private parking company executives to fund their jollies to the Seychelles. In 2006, the Department of Health issued guidance called “Income Generation: car parking charges —best practice for implementation”, which was subsequently revised in the same year. This guidance clearly states that to qualify as an income-generation scheme, the scheme
“must be profitable and provide a level of income that exceeds total costs. If the scheme ran at a loss it would mean that commercial activities were being subsidised from NHS funds, thereby diverting funds away from NHS patient care. However, each case will need to be assessed individually. For example, if a scheme is making a substantial loss then it should be stopped immediately.”
If a scheme such as car parking charges at an NHS hospital ran at a loss, it would not be acceptable. The Department of Health’s guidance goes on to state that
“the profit made from the scheme, which the NHS body would keep, must be used for improving the health services”.
The current guidance therefore prevents public money that should be used for patient care from being used to subsidise a loss-making scheme.
Clearly, if the Bill became law, it would inevitably affect the amount of income that a scheme would generate, meaning either that there would be knock-on effects for other users of the car park who are paying for it or that the health authority would be faced with the question of whether to start to subsidise it. It cannot do so because of the guidance, thus raising the question of whether the guidance would need to be revised in the regulations anticipated in the Bill. It is a principle that the Bill could reverse or it could open a door to making such a change.
Julian Knight
My hon. Friend is providing a forensic discussion of the Bill and all its parts. Does he agree that we could end up with hospital trusts seeing staff members taken off the front line in order to administer these schemes, or even with administration staff, who would be better deployed in the hospital, being brought in to ensure that the right people get the free hospital parking?
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. I think we have heard this question before. Mr Davies was asked whether staff would be taken from the front line. We are going over ground that has already been covered. This is about a Bill, about car parking, and about the benefit of carers. What I do not want to do is become involved in speculation. We are not here to speculate about the future.
Mr Nuttall
I was about to say exactly the same thing, Mr Deputy Speaker, but I do not think that my hon. Friend the Member for Solihull (Julian Knight) was in the Chamber when someone made what I agree was a very similar point. I will merely say that, undoubtedly—I think that Members in all parts of the House will agree with this—the scheme will have to be administered somehow. It is not going to run itself. Someone, somewhere, will be required to run it, either someone new who has been brought in or someone who is currently doing another job in the hospital.
I do not know whether, as part of her preparation for the Bill, the hon. Member for Burnley ascertained how many national health service trusts in England might have to alter their price structures—that is, increase their parking charges to avoid falling foul of the income- generation principle—if the number of exempted carers were to be as significant as it appears. I do not know whether she proposes to scrap the principle of not running a scheme at a loss, as required by the 2006 guidance from the Department of Health. The NHS Confederation, which is the membership body for some 500 organisations that plan, commission and provide NHS services, says:
“NHS principles and Government policy are clear that healthcare is funded through taxation, not through patient charges. Surpluses from parking charges should only be a by-product of covering costs and managing space fairly.”
Most trusts make it clear that the income they receive from car parking charges goes towards covering the maintenance of the car park: for instance, the security, facilities and staff. To be specific, we are talking about the ongoing costs of anything from lighting to CCTV, footpath and cycle path maintenance, car park surfacing, and the employment of enforcement and security staff. If there is any money left over—and some trusts have no surplus from their car parking—it must, in accordance with the guidance, be used to improve local health services.
The Government have already been active in ensuring that information about parking is made very clear to members of the public, and I think it perfectly fair and reasonable to require trusts to ensure that that information is clearly visible on websites and in patient information in, for instance, letters. Patients are entitled to the reassurance of knowing that the purpose of the car park charge is not to provide the NHS with an additional, excessive income stream, but to provide for the car park in the first place. Charges, therefore, are used primarily to cover the running costs of the car park, and if there is a surplus, it cannot be used for other pet projects.
I referred earlier to the 2009 NHS car parking impact assessment. The then Labour Government commissioned the detailed, 61-page assessment of the costs of introducing free car parking. It concluded:
“On the available evidence there is scope for this policy to have both a positive and negative impact, both for older people and the disabled.”
Despite that rather mixed finding, Labour’s 2010 manifesto pledged to scrap hospital car parking charges. Five years later, however, at the time of this year’s May general election, Labour appeared to reverse its view, and to decide that the policy was unworkable. I look forward to hearing from the shadow Minister later whether that is still the position of the official Opposition. In fact, the Bill runs contrary to the principle that individual trusts feel that it is right to set parking charges according to their own financial situations. Only yesterday it was reported that the Oxford Health NHS Foundation Trust was consulting on the introduction of parking charges at its community hospitals.
What are hospital car parking charges actually paying for? That is a perfectly legitimate question for people to ask. It is reasonable to say that visitors and patients do not generally have a great deal of choice when it comes to parking at a hospital. There is usually just one car park operator, and patients, staff and visitors are therefore a captive audience. In some town centres, one might be fortunate enough to have the choice of a cheaper place in which to park, but for hospitals there is no market incentive to keep costs under control.
In December 2010, the British Parking Association, which is the largest professional association in Europe representing parking and traffic management organisations, released a charter of best practice for parking in hospital car parks. Understandably, given the large number of disabled users, it set high standards. The Charter for Hospital Parking stated that hospital parking operators should provide
“good lighting, high standards of maintenance for structures and surfaces, payment systems and equipment that are easy to use and understand, signs that are clear and easy to understand”
and
“clearly marked parking bays.”
Patients and visitors will understandably want a safe and secure environment in which to park when they go to their local hospital, or, potentially, a hospital that is out of their immediate area if they are receiving specialist treatment. As Carers UK points out, attending hospital can be a stressful experience for patients and visitors. The last thing they want is to have their car broken into, or to spend 20 minutes driving round in circles because entrances and exits are not marked properly, or to be stuck facing a ticket machine that does not work with the threat of an unfair penalty charge looming. Patients, and their carers, visitors and staff, will quite reasonably expect a properly maintained car park with proper lighting and adequate security, along the lines of what is set out in the charter, whether the purpose is to guide a daytime visitor with proper and effective signage or to protect the doctor or nurse who gets into the car at 3 am in the dark after a long shift.
The charter also states:
“Parking charges can help to pay for maintenance and management services, and prevent these from becoming a drain on healthcare budgets. Therefore, we encourage NHS Trusts and car park operators who manage hospital car parks to sign up to this charter and to abide by its letter and spirit.”
So far, 24 hospital trusts have signed up to the charter.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. This is very worthy, and it is great to acquire this extra knowledge, but it is not really anything to do with carers. The hon. Gentleman has got on to nurses and lighting, and I understand all that, but, worthy as it is, it is not in the spirit of what we are meant to be discussing.
Mr Nuttall
Parking places are finite, Mr Deputy Speaker. If the Bill encouraged more carers to visit hospitals, which is what I think would happen, it would make it easier for them to gain access to car parks, and one consequence of that might be a knock-on effect on the income that would—
Mr Deputy Speaker
Order. I understand the point that the hon. Gentleman is trying to make, but it has already been well thumbed. As the hon. Gentleman knows, it was covered very thoroughly by Mr Davies, and I do not want him to repeat everything that Mr Davies covered. I think that, in his hour and a half, Mr Davies did not leave a lot of scope, but this is one point that he made sure we were well aware of.
Mr Nuttall
The problem with selecting a group to exempt from parking charges is the necessity of considering other groups, and deciding which groups it is fair to charge and which groups should be exempt. Is it fair to exempt a particular visitor, albeit a carer, but to charge a clinical support worker who parks at the hospital every day? It could be someone with children or other dependants, working and acting as a carer but not in receipt of carer’s allowance.
Fairfield general hospital in my constituency comes under the Pennine Acute Hospitals NHS Trust. According to figures from the northern commissioning region for the latest available year, I understand it is one of the trusts that charges on average 11p per hour for staff to park. I have to say that the trust sets out very clearly what its charges are for hospital car parking, and it provides a range of concessions. I take note of your stricture, Mr Deputy Speaker, so I will not read them out, but it is fair to say that it has obviously looked at this question and considered the various groups that should be entitled to a concession. For example, it has picked out blue badge holders, patients and visitors who need to attend on a frequent or regular basis and those who need to visit because they have suffered the bereavement of a loved one.
Such a scheme would be put in danger, and the trust would have to revisit it, which would undoubtedly have an effect on the viability of that scheme. Is it fair to charge a spouse or partner of a cancer patient who is still working and does not get carer’s allowance if they are too busy to get certified as eligible for hospital parking charge exemption, as required under clause 5 of this Bill? The Bill would require them to be approved in advance, and there will be many other deserving cases not covered by the Bill. The Bill does not seek to exempt people because of their low incomes, which is one a weakness. Some of the carers may well be in straitened circumstances, but there may be others who would be able to pay the charge, whereas some members of other groups would not be in that position.
The conclusion may well be that the fairest answer is not to exempt any groups but to make car parking free for everyone, as has happened in Scotland and Wales. Aligning us with those countries would be a popular idea with many people, but we must not forget that it would mean taking hundreds of millions of pounds out of the healthcare budget. The 2009 impact assessment suggested that the cost then would be between £140 million and £180 million. In six years’ time, it is reasonable to assume that cost would have increased enough to pay for 13,000 band 1 clinical support workers or 9,000 band 5 nurses. We have to ask what we think it is right to spend the healthcare budget on: patient care or free or reduced car parking.
Mr Rees-Mogg
Perhaps my hon. Friend intends to mention it, but he is ignoring the reduction in the availability of spaces that would come about without charges—people would be able to park all day, and there would be much less control. It is not going to make it easier for carers to park if all the spaces are taken and they are blocked.
Mr Nuttall
My hon. Friend is right. The fact is that in September 2014 the then Health Minister, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter), noted in a debate that 40% of hospitals now do not charge for hospital car parking. They are likely to be in rural areas where there is less demand for parking—where it is easier to provide parking and there is less pressure on it. I suspect the reality is that a hospital with a car park in a central location in a busy town or a major city centre has no choice but to have a car parking charge. That is the reality of life. If it were be free, there would just be chaos; essentially, it would mean that those who really needed to get close to the hospital would not be able to do so. There has to be some system in place to protect the spaces that are close to the hospital for those who need them. Whatever system we have, there is no simple answer to that.
What we do know is that the present system of having local decision making is working. Fairfield hospital allows 30 minutes of free parking for everyone; then it costs just £1 for up to one hour. In the constituency of the hon. Member for Burnley, by contrast, people would pay £1.90 for up to three hours’ parking. There is a huge disparity across the country. We heard earlier—in an intervention from the hon. Member for Streatham (Mr Umunna), I think—about the costs in central London, which are understandably very much higher than in the provinces.
While the Bill does explain the generality of what is required, it does not explain how the system would work in practice. In the opening remarks of the hon. Member for Burnley, she mentioned that the system would work by way of having a badge in the car window. I am happy to be corrected if I misheard. That is the first time I had heard that. It would perhaps have helped all of us if that had been in an explanatory note saying this was how the scheme would work. She also mentioned that in some hospitals people have to pay on entry—I think the hon. Lady is nodding. That is all very well, but I am not quite sure how simply having a voucher in the car window would help in that scenario. It must be more complex than that, and some sort of token would be needed in order to get through the barrier.
Mr Deputy Speaker (Mr Lindsay Hoyle)
Order. The question is not how people get into a car park; it is whether there is free concessionary parking for carers. We are dealing with that, not the detail of how we get there. Obviously if the Bill were to go into Committee, these would be the areas that Members would want to cover there. I want to concentrate on where we are now and how we keep to where we want to be within the Bill.
Mr Nuttall
I will move on from that detail. I accept it is a detail, but it is an important detail.
Mr Deputy Speaker
Order. I agree, but we have heard about all the different scenarios previously and in detail. That is what worries me. We can get bogged down in repeating details, and I know the hon. Gentleman does not want to do that.
Mr Nuttall
I want to move on to the devolution of healthcare. It was only very briefly touched on earlier, but it is of particular significance to my constituency, because, as Members will be aware, it is proposed to devolve healthcare to Greater Manchester. From April next year, it will be the first English region to get full control of its health spending. The situation in this regard is not at all clear. The Bill states that it will apply to the whole of England, but if healthcare is devolved, will Greater Manchester be exempt on the same basis that Scotland and Wales are exempt? Healthcare spending has been devolved to those countries and they are then excluded from this Bill.
Julian Knight
It is very interesting that my hon. Friend mentions devolution in this context. Should there be devolution from next April in the Greater Manchester area and if this legislation were introduced soon afterwards, could the numbers that devolution has been predicated on no longer be correct? Could we have to go back to the drawing-board in terms of Manchester devolution and how the finances are worked out in respect of hospital parking charges?
Mr Nuttall
I will not go down that road, Mr Deputy Speaker, although my hon. Friend has made a good point. His area could well be affected by any future devolution.
Philip Davies
I did not get a chance to talk about this earlier. Does my hon. Friend know whether, under the Bill, the Government would reimburse the hospitals for the lost revenue, or whether the hospitals’ balance sheets would have to take a hit?
Mr Nuttall
The Bill is silent on that point. It might well be that, in the mind of the hon. Member for Burnley, some mechanism would be put in place to reimburse the trusts, depending on the number of carers registered with them. Or perhaps she would simply say to them, “Sorry, if you’ve got a lot of carers in your area, you’ll just have to suffer the consequences.” It is not clear what would happen.
I want to turn to a drafting matter that has not been touched on. Clause 1 is entitled “Duty to exempt qualifying carers from hospital car parking charges”, and subsection (1)
states:
“Health Care providing bodies shall make arrangements to exempt qualifying carers engaged in any of the qualifying activities listed in section 2(2) from charges for parking their cars”.
The question that arises is how wide the scope of healthcare facilities actually is. Clause 1(2)(b) states that the duty in that previous subsection is the responsibility of “any private hospital”. I personally believe it would be a step too far if we were to legislate on what private companies were allowed to charge for and to whom they should give exemptions.
Clause 1 provides for “arrangements” to be made for “qualifying carers”, while clause 4 provides for a “scheme” for “eligible carers”. Why does there have to be a difference? Why does one set of carers get arrangements while another get a scheme? It appears that schemes are more complicated than arrangements. Clause 1(4) requires the arrangements for qualifying carers to be in place within 12 months, whereas in the case of eligible carers, 12 months are allowed for a scheme to be submitted to the Secretary of State, and it does not have to be implemented until a year and a half after the Bill becomes law. If the matter is so urgent, why will it take a year and a half for carers to become entitled to the exemption?
It is a pleasure to welcome you to the Chair, Madam Deputy Speaker. I think there has been an error in the printed version of the Bill. In the printed copy that I have, clause 4(1) states:
“Health Care providing bodies shall establish schemes to exempt eligible carers engaged in any of the qualifying activities listed in section 2(1)(b) from hospital car park charges and submit such schemes to the Secretary of State within 12 months of this Act coming into force.”
However, clause 2(1)(b) states:
“A qualifying carer under section 1(1) is a person who…has an underlying entitlement to the Carer’s Allowance.”
The provision in clause 4(1) has been amended online to refer to section 2(2), which is the correct subsection. Section 2(2) is indeed the subsection that sets out what a qualifying activity is. It states:
“A qualifying activity under section 1(1) is transporting, visiting or otherwise accompanying or facilitating”—
Madam Deputy Speaker (Mrs Eleanor Laing)
Order. As the hon. Gentleman has drawn my attention to a matter concerning the activities of the House—namely, the printing of the Bill—I will for the sake of clarity make it clear that the Bill that I have, and that I assume other people have, clearly refers to section 2(2) and not section 2(1). I am happy to clarify that point as the hon. Gentleman made his point directly to me.
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.
Madam Deputy Speaker
For clarification, the hon. Gentleman has done nothing wrong. The printing of material such as this is a matter for the House and a matter for the Chair.
Mr Nuttall
I shall bring my comments to a conclusion. Given the real likelihood that the effect of the Bill will be to reduce the income from car parking, it must be a possibility that the legislation would increase the cost of the NHS to the public purse. In the first year of the abolition of parking charges in Scotland, the sum of £1.4 million was given to Scottish health boards by the Scottish Government, so I wonder whether the Bill might require a money resolution in due course, as my hon. Friend the Member for Shipley has suggested.
It is a worthy aim to try to help carers with their hospital car parking charges. In reality, however, there are a number of problems. Fundamentally, we are faced with this question: what should £200 million be spent on—healthcare or free parking? The answer might be to say that we will exempt only one group, but if we exempt carers, should we not exempt staff, for example, or armed forces personnel? The list soon expands. However well-intentioned the Bill is, we have to look at the problem in the round. No one likes paying parking charges, but the fact is that, alongside general taxation, income from car parking ultimately supports front-line services.
I commend the hon. Member for Burnley for her work on the Bill but, for the reasons I have outlined, I cannot support it today.
Liz McInnes (Heywood and Middleton) (Lab)
I should like to declare my support for the Bill, and I congratulate my hon. Friend the Member for Burnley (Julie Cooper) on bringing it to the House today. We have had an interesting debate. It has been enlightening for me; I am not often here on Fridays, and I have been intrigued by the way in which the discussions have gone on.
My hon. Friend made a good point about the amount of money that carers save the NHS as a result of the unpaid voluntary work they do, attending hospitals, caring for friends, relatives and loved ones and relieving the pressure and stress that our support workers, nurses and doctors are under. When we talk about money resolutions and finance, we need to remember that not everything has a financial cost. We cannot put a price on everything, and the amount that carers save our NHS is priceless. It is not something we can quantify. However, I certainly agree with my hon. Friend that the amount of money that carers save our NHS is far over and above what they might bring in in car parking fees.
I am speaking from the point of view of a former NHS worker. I used to work at North Manchester general hospital, which is now part of Pennine Acute Hospitals Trust to which the hon. Member for Bury North (Mr Nuttall) referred. He spoke about the trust as something of an exemplar in the way that it advertised car parking to patients and visitors. Having worked there for a long time, my experience is that its policies caused a lot of confusion. Frequently, when I turned up to work, visitors asked me whether they should pay, whether I had any change for the parking machines, and whether I could help them with where they were going. Not wanting to be too critical of my ex-employer, I have to say that I do not think that Pennine Acute is a shining light when it comes to dealing with car parking for patients and visitors.
Mr Nuttall
I do not know when the hon. Lady left the employ of that particular trust, but it seems from its website that it has tried to simplify things by having different coloured signs for different groups—green signs for patients, blue signs for blue badge holders and pink signs for staff. It seems that it is making an effort. I am sure that the hon. Lady knows more than me whether its system is working in practice.
Liz McInnes
What the hon. Gentleman said was very telling. He said that he had looked at the website. Not every patient or visitor has access to the website, however. I agree that the system is clear on the website, but it is not clear in reality. When someone turns up with a sick relative or a distressed patient, they do not have time to go through the colour coding. Pennine Acute could improve its signage, but that is not why we are here, or why we are talking about this Bill.
The hon. Gentleman asked how long I had worked at the hospital. I started at North Manchester general in 1987, and I was there when hospital car parking charges were first introduced. I remember the disquiet that was caused to staff, who have always had to pay those charges. Many people do not realise that staff have to pay car parking charges at hospitals.
Liz McInnes
I appreciate that, but it always comes as a surprise to the wider public to hear that staff have to pay to park at their own place of work. I am sure that there would be an uproar if such charges were introduced for our exclusive car park facilities in this place. I know that the staff’s objections to having to pay to park at their place of work have been ignored. We have been protesting about it for many, many years. However, I am not here to talk about staff; I just wanted to make people aware that that practice still goes on. I have always seen it as a tax on coming to work.
We are here to talk about carers. I want to use Pennine Acute as an example. Most recently, it has engaged a private parking company, the income of which comes solely from administering fines to people who have parked incorrectly or who have not paid the right amount of money. The business of this private parking company depends on people contravening parking regulations; it actually wants people to contravene parking regulations, because that is the only way that it gets any income.
When I worked at the hospital, I was a workplace rep for Unite the union. I dealt with a lot of staff who were very, very distressed about the letters they had received from this company, demanding a fine that had to be paid by a certain day, and if they did not pay it by that day, the fine would go up. They were given the opportunity to appeal. If the appeal was not successful, some people found that they had to pay an inflated fine because they had had the temerity to appeal.
With regard to my hon. Friend’s private Member’s Bill, my main concern is about carers. What would happen to them if they were to get one of those bills? At least members of staff, if they are in a trade union, can go to a rep and get some help to deal with the situation. I worry about private parking contractors, because they exist solely to make money out of people. Exempting carers from car parking charges would bring much needed clarity to the matter. It would stop these exploitative companies from making money out of them.
Julian Knight
Thank you, Madam Deputy Speaker. I will now address only the Chair using that particular word.
I congratulate the hon. Member for Burnley, but unfortunately I cannot support the Bill. However, like my hon. Friend the Member for Shipley (Philip Davies) and many other Members who have spoken, I support the fairer hospital parking that she is trying to achieve. I want to share my experience in Solihull as a campaigner for fairer hospital parking, as it has direct relevance to how we approach the issue as a country and to the Bill.
Many hon. Members have mentioned their hospitals and the experience they had when parking charges were introduced. For my constituents in Solihull, parking charges were introduced not only to bring extra revenue into the NHS and front-line services but to ensure that hospital car parks were free for the use for which they are intended. We have had many difficulties in Solihull because the hospital is located near the town centre and, as that is a popular area, people have used the car park all day while they have been shopping. Many people who needed to use the facility at the hospital were therefore unable to do so and might have parked illegally, receiving fines at a later date. Hospital parking charges, although very unpleasant, are in many cases necessary, particularly at sites close to town centres. As we live in a very densely populated country, there are not many hospitals that are so far from town centres that it would be an easy win not to have any charges whatsoever. The car parks might still be misused in the way that I have explained.
Over time, hospital parking charges have grown exponentially. At the moment, in the three hospitals that make up the Heart of England NHS Foundation Trust—Solihull, Good Hope and the Heartlands—charges can be up to £5.75, but for just one hour they can be £2.75. Again, people have to guess how long they will stay, which is unfortunate. I have looked at the contracts that our local hospitals have signed and in my view there is an excessive charge on the provider from the private companies involved. I am not happy with many aspects of these contracts.
Mr Nuttall
My hon. Friend says that he has looked at these contracts. Has he noticed how long they were for? I am rather concerned that if the Bill is introduced, it would affect the viability of those contracts.
Julian Knight
My hon. Friend makes a good point. There are often penalty charges which would mean unintended consequences if the Bill came into law and a real hit to the bottom line for our hospitals.
Mr Nuttall
Does my hon. Friend not fear that the Bill might make things worse for members of the group?
Julian Knight
My hon. Friend makes a good point. The wording of the Bill and the fact that it covers just one narrow group could mean that charges go up for other groups that are not covered by it. That is an unfortunate and unintended consequence.
I have helped to lead the way with the campaign in Solihull, but it has been about individual engagement with the hospital trust rather than introducing national legislation and a one-size-fits-all policy. As we have explored in our discussions, hospitals have a great deal of discretion in the charges they can put in place. The August 2014 NHS patient, visitor and staff parking principles are much broader than the Bill in allowing people from different groups to have free or reduced hospital parking. As I see it, individual engagement is the way to go.
In Solihull, we have had many achievements through discussion and through highlighting particular issues. For example, earlier in the debate we discussed advertising and websites and it was pointed out that many people did not know what monthly or weekly concessions there are. I have urged my local hospital trust to improve the provision of that information and they have put the concessions up front and centre on their website, so it is now easy to see that information.
Mr Nuttall
The hon. Member for Heywood and Middleton (Liz McInnes) made the point that not everybody has access to the internet, particularly many elderly people. Does my hon. Friend agree that we should perhaps consider ensuring that information about car parking charges is included in every letter sent out offering an appointment at a hospital?
Julian Knight
My hon. Friend makes a good point and I have urged my hospital trust to make the information available not only online, which always seems to be the catch-all approach of any organisation, but in the hospital, so that patients and visitors do not have to come into the hospital and take up the time of staff and administration staff to clarify something that could easily be set out in a leaflet, a letter or a small poster by a desk.
In Solihull, a reduction in the price of monthly tickets and concessions was the direct response to the lobbying done by me and local councillors. We have also seen a doubling of the free parking time at Solihull hospital from 15 minutes to 30 minutes. At the hospital it can often take up to 15 minutes just to find a space, so I urged the trust to increase this time, and the Heart of England NHS Foundation Trust kindly saw fit to double the time. These are small wins, but they are an example of what can be achieved through individual engagement, by putting our case and understanding that there is not an endless supply of money and that we have to be sensitive to the bottom line—the finances of the NHS—because if we are not careful, we may end up depriving the NHS of vital cash.
My own Heart of England NHS Foundation Trust has a deficit—this is in the public domain—of £29 million for the first five months of the financial year. So seriously is this viewed that the management of the University Hospitals Birmingham has been brought in to help close the black hole in the finances. I welcome that move, but it shows that this is no time to destabilise NHS finances or those of individual hospital trusts in our areas.
Julian Knight
I agree that we must value carers. However, the Bill is very narrow in its focus, whereas a much greater number of people could be covered by the guidelines and the NHS patient, visitor and staff car parking principles. There are opportunities to engage in our localities with our local hospitals and local hospital trusts in order to encourage them to expand existing provision. There is the possibility of working on a case-by-case basis, rather than by means of a rather blunt instrument. I take the hon. Lady’s point, but we should look at hospital car parking charges in the round, not just as they affect carers. [Interruption.] The Bill is about carers. The subject matter, though, is a much greater variety of people who use hospital car parks, including many vulnerable people, as we know.
I suggest that other hon. Members follow what has been done by my right hon. Friend the Member for Harlow (Robert Halfon), the Minister without Portfolio, and my hon. Friend the Member for Wellingborough (Mr Bone) and engage with the local hospital trust, put pressure on the trust and get it to reduce the complexity of charges and to ensure that when it puts charges in place, they reflect the local area. For example, I made a case to my hospital trust that we have three hours’ free parking at council car parks in Solihull, so why do people have to pay £2.75 for just one hour at the local hospital? Why is that not in tune with the local economy and the local environment?
More widely, on the people who are not covered by the Bill, I have mentioned those who may be covered by the NHS patient, visitor and staff car parking principles, but what about people who do not have a car? What about carers who travel by public transport? I was involved in a campaign in Solihull to help save the No. 73 bus service, which was a lifeline to Heartlands hospital. If it had been cancelled, people in Shirley in the west of my constituency would have had to travel by three buses in order to attend hospital appointments. If there is any extra money, surely it would be better for it to be directed at them as they are more likely to be on a lower income and potentially in a more vulnerable position than those driving and using the car park.
In conclusion, I welcome the sentiments of the Bill and I applaud the hon. Member for Burnley for introducing it. We have had a vigorous debate. There is a patchwork of provision and it is up to us as individual Members of Parliament, as well as local councils and bodies such as chambers of commerce, to come together in order to try to get the best possible deal for our area. That, in some instances, may include many more people than are the subject of the Bill.
Mr Nuttall
My hon. Friend touches on a key point, which I mentioned briefly—that is, there are competing pressures in different parts of the country, depending on whether a Member represents a rural area or an inner-city area.
Julian Knight
My hon. Friend makes a valuable point. In his speech he also touched on devolution. In my area we have the West Midlands combined authority coming to the fore. Although it does not currently have responsibility for NHS provision, that may come down the track towards us, as in the case of Manchester, which takes charge of its NHS in April 2016. The concern is that although these devolution packages are very tightly costed, if we suddenly add an extra expense in the form of NHS provision and take away a valuable income stream, that may damage the devolution project and other services may end up being cut.
I support the intention of the Bill and the heartfelt efforts of the hon. Member for Burnley, but it does not take account of an approach that I prefer—local engagement and following the guidelines, which are much more wide ranging than those in the Bill.
Dr Rupa Huq (Ealing Central and Acton) (Lab)
I congratulate my hon. Friend the Member for Burnley (Julie Cooper) on her important private Member’s Bill from which, thanks to Conservative Members’ contributions, a somewhat epic debate has ensued. I am pleased to speak in favour of the Bill. I have broken my usual rule of Fridays in Ealing Action and Bedford Park to be here since 9.30 am. The Bill is an important piece of legislation, which we need. I shall be brief.
It is important to point out that we are talking about carers who are in receipt of carer’s allowance of £62.10 a week. To receive this, they have to do at least 35 hours of caring for an older or disabled person, and they are not allowed any extra income above £110 a week. The state is paying these people in recognition of their caring duties, which take a burden off the health service. If all that is going on car parking fees, then it is a false economy. Waiving their car parking fees alone would pay dividends for the future.
I have elderly parents; in fact, I lost my father a year ago.
Dr Huq
I need to do a TV interview that I am late for, so I wish to make progress; I will not be giving way.
My parents have had all sorts of ailments. We lost my dad a year ago last September so I have been in and out of Ealing hospital as a visitor, and I have grumbled that it seems to cost no less than £4 for an in-and-out visit. People on carer’s allowance can be there for days on end, or hours on end, and the cost for them can rack up into the hundreds. This is even more punitive given that they are on £62.10 a week and bear a heavy burden as it is.
For these carers, the stress of parking is at best, the last thing they need, as my hon. Friend the Member for Burnley said, and at worst, on a more generous interpretation, bordering on a slap in the face. They are people who negotiate difficult situations. My own mother has dementia, and people with such conditions can fly off the handle and be quite erratic. If someone is negotiating that, or, say, dealing with someone’s incontinence pads, they do not want to be fumbling about for the correct change, as my hon. Friend so graphically described. This is the least we can do, as a decent society, in recognition of the enormous contribution that carers make. They are almost the social glue of the NHS; it would fall apart without them.
Yesterday in this Chamber we discussed benefit changes and how the safety net is tightening. It is important to consider these parking charges, which are sky-high in any case. In 2008, my hon. Friend the Member for Ealing, Southall (Mr Sharma) said to the local press that they are a stealth tax on the poor. They are already steep, but disproportionately so for carers. We heard research quoted earlier. Leeds University and Carers UK have estimated that £119 billion a year is saved on the adult social care bill through having these unpaid carers who just receive an allowance.
Conservative Members have said that it is fine to exercise discretion. At Ealing hospital, that amounts to a handful of spaces, and there are quite strict criteria. Often, a situation that would result in an unpaid carer taking the person they care for into hospital would arise from sudden things that cannot be predicted, and the four spaces, or whatever, that some London North West Healthcare NHS Trust hospitals reserve as part of their discretionary allocation may be gone.
Members on both sides of the House are lobbied all the time from powerful groups with identical emails that clog up our in-boxes, but this is about people who are the unsung heroes of our system. It should not be those who shout the loudest—the powerful lobby groups—who get their way. According to the figure I got from the House of Commons Library last night, there are 944,000 of these unsung heroes, but I have heard different figures here today. Anyway, on the basis of a cost-benefit analysis, a substantial number of people are saving the NHS money in this way. It is a matter of respect that as a country we should be saying thank you to these carers and we should appreciate their vital contribution. We have the power to change all this today and to deal with the fact that they are being penalised.
We would not want carers to be put off going to hospital because of these charges. That is the logical extension of the 81% rise in NHS West London CCG’s car parking charges. When I lobbied it and said that this is a constant issue in my postbag and my in-box, I was told, “It’s the commercial car parking providers you should take this up with.” Does the House want to be seen to be siding with commercial car parking providers or with carers in our society?
Campaign groups such as Contact a Family, the Alzheimer’s Society and the Multiple Sclerosis Society are all supporting this Bill. Even The Sun, which is not usually a newspaper that supports Labour, is backing the Park the Charges campaign.
Dr Huq
Not in recent times. It has not supported the Labour party in any recent general election. Historically, Rupert Murdoch’s politics are not aligned with ours.
I urge Members in all parts of this House to do the decent thing and support this Bill in the strongest possible terms. I congratulate my hon. Friend the Member for Burnley on leading this extraordinary debate. I suppose I should also congratulate some Conservative Members on the show of stamina to which they have subjected us.
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.
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.
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 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.