Lobbying
Grahame Morris Excerpts(11 years ago)
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Mr Lansley
Let me explain a little more, then I will give way again.
There are two ways in which we can go about regulating conduct in political life. We can create a comprehensive rules-based system backed up by intrusive enforcement, to try to specify what everyone should and should not do pretty much all the time. That would be immensely bureaucratic and costly, and would involve a constant effort to keep up. It would create not a culture of openness but a “see what you can get away with” approach.
The other way forward is to be clear about the standards expected, based on the Nolan principles, and to ensure that all those who exercise responsibilities—and all those who seek to influence them—are subject to the necessary transparency in their actions and contacts, and held accountable for their actions, so that we can see who is doing what, and why. For those who seek to influence the political system without the necessary transparency, there will be clear sanctions available.
Mr Lansley
The hon. Gentleman will be aware that there are a number of models in a number of jurisdictions across the world, which we have of course looked at and considered carefully. What I am emphasising here is that we are going to proceed on the basis of a belief that the greatest possible clarity and transparency is the key to achieving the confidence we are looking for. In order for that to happen, what is particularly necessary is that the public can see who is lobbying whom.
Mr Lansley
I will give way later.
The question of the publication of shadow Ministers’ diaries in the same way as Ministers currently publish theirs is, of course, a matter for the Labour Front-Bench team.
Mr Lansley
I am sorry, but I did not hear the hon. Gentleman volunteer any comment in response to my question. To be fair, perhaps it is more the responsibility of the hon. Member for Hemsworth, so perhaps he would like to stand up and say that shadow Ministers believe that in order to secure the necessary transparency, they, as well as Ministers, should publish their diaries.
Mr Lansley
Perhaps the hon. Member for Easington (Grahame M. Morris) would like to speak on behalf of the Labour party and volunteer this confirmation on its behalf.
Grahame M. Morris
It is very kind of the Leader of the House to give way—I was starting to think that I had inadvertently offended him in a previous life. How does he think the public will react when they find out that, one in four Conservative peers and 58 Conservative MPs have recent or current financial links with private health care? Will the Bill address that?
Mr Lansley
I have no idea of the specifics of what the hon. Gentleman talks about or of what precisely he means by what he said, but what I would say is that transparency is important. If Members of this House have financial interests in companies, they should be very clear about them in the Register of Members’ Financial Interests and they should be very clear that they do not act in Parliament in a way from which they could personally benefit through their relationship with those external interests.
John Thurso
I have taken two interventions so I would like to get to the end of my speech.
I hope that the Bill will deal with third-party, non-party controlled expenditure and measures to regulate non-party actors who seek to influence elections. This touches on the whole question of the trade unions. The best way is simply for the trade unions to be treated in the same way as any other body according to the third-party, non-party controlled expenditure rules. If we had those rules, requirements made of trade unions would be made by way of alterations to the third-party controlled expenditure rules rather than to any trade union rules, which is absolutely the right way forward.
It is right that we look at lobbying and make sure that we have a register. It is too late for cross-party talks. We tried that with the House of Lords and look where it got us. I am scarred by that. We should just get on with it and make sure that it happens.
My inclination is towards pre-legislative scrutiny. I doubt that it is going to happen, but the Chair of the Political and Constitutional Reform Committee might take a leaf out of the book of the hon. Member for Chichester (Mr Tyrie). He went ahead with it himself on the Treasury Committee and I am sure that his Committee will just go ahead and do it. It will probably be an invaluable report. I look forward to supporting the Government in the Lobby and making sure that matters come to fruition and we see a Bill as soon as possible.
Dr Alan Whitehead (Southampton, Test) (Lab)
Like many hon. Members, I am lobbied every day, by my electorate and by people who have an interest in the things that I am interested in as an MP. It is a perfectly honourable process. Provided that it is carried out in an honourable, straightforward and transparent way, lobbying adds to the substance of Parliament and does not detract from it.
However, there is rather more to the issue than simply whether lobbying is carried out in a transparent way. It is a question not just of whether sunlight is the best disinfectant, but whether in addition to sunlight we need Sunlight soap in order to scrub the process clean. That is what the public remain concerned about. As hon. Members have said, it is not just about the transparency of lobbying, but about the way in which it is carried out, the secrecy of substantial elements of it and the influence that is brought to bear as a result of certain arrangements that lobbyists can make regarding resources, access and various other things. Those concerns relate not only to third-party lobbyists but are across the board.
Perhaps we ought to apply a comparative principle in devising what we want to achieve by having a register of lobbyists. If we think about it for a moment, we realise that what we—the parties set up in this House—do in seeking votes is lobby the electorate, and we must do so in a reasonable, bounded and temperate way. A number of sanctions have been laid down in law for a very long time to ensure that lobbying of the electorate is restrained and that we do not go beyond those bounds. They are known as the electoral offences.
There is the offence of bribery. As far as lobbying is concerned, if a Member of this House was asked, “Would you like to be a director of my company? I’ll give you £24,000”, that is a very straightforward approximation of the offence of bribery as it relates to this House. There is also the offence of treating, which means saying to the electorate, “I’ll buy you a slap-up dinner, and drinks at the bar are on us, provided you vote for us.” The parallel, as far as our affairs are concerned, would be offering a week’s holiday or substantial trips around the world in order to exercise some advantage.
Grahame M. Morris
That is a really important point, because there is a distinction between what happens in this place and what happens in local government, for example. If I was serving on a planning committee and owned a building firm, it would not be good enough for me simply to say, “I declare an interest”; I would not be able to take any part. All that happens here is that people declare an interest, but they are still taking money from private health care companies and then voting through the Health and Social Care Bill.
Dr Whitehead
My hon. Friend emphasises the power of Sunlight soap in other parts of the body politic, as opposed to our proceedings.
There are two other main electoral offences that relate to our lobbying of the electorate, and the Secretary of State has referred to one in relation to the content of his proposed Bill. He said that we want to know who is lobbying us and that the Government will legislate to fill that gap. That is the offence of personation. We need to know who is exercising the vote. If we were to try to defraud the electorate by having someone vote in place of the person who really had the vote, an electoral offence would be committed.
The final major electoral offence is that of undue influence. That is the parallel offence that is wholly absent from the proposed legislation as it relates to our proceedings. Undue influence is not about whether someone is paid or given a weekend away, or whether someone else stands in their place; it is about someone exercising various means of persuading another person to vote for them that are beyond the cause of reasonable lobbying. That seems to me to be the crux of the issue. The proposals do not provide for an overall register of all lobbyists, with sanctions and the ability to throw people off it, properly to take account of the question of undue influence in the lobbying process.
I am sorry that that appears to be the way the proposed legislation is proceeding, because it could easily be fixed by some fairly brief discussions between the parties. After all, this is a matter that affects not just one particular party or Government. The legislation needs to stand the test of different Governments of different parties. It is an issue that concerns all parties and this House. Therefore, it seems to me that above all the legislation must be proceeded with on the basis of what the parties think is the right way forward.
It is shocking that the Government have taken a year to respond to the all-party Select Committee inquiry on lobbying and what can be done about it. That is way out of line with what is normally expected of Government responses to Select Committee reports. That ought to be rectified immediately. Pre-legislative scrutiny of what is proposed would not derail the legislation unduly. For example, the Energy and Climate Change Committee was recently given six weeks to consider the entire draft Energy Bill before it came to the House. Pre-legislative scrutiny would give a vital opportunity to get something that works across the House.
I am a little disappointed that much of this afternoon’s debate has been something of a knockabout rather than about principle. I have tried to inject into the proceedings a little focus on what we are really about, which is principles for legislation. Between us, we must ensure that the legislation works for the future. If that takes a few weeks of discussions between parties to get it right, and if there is a little give and take with regard to how it will work, that will be a good thing for the House. If it ensures that undue influence is not exercised in the House by lobbyists, if it is clear about who should be included in the rules, and if the public are confident that the right people are included in those rules, that, too, would be a gain for us all.
I hope that the Government will not decide this afternoon that this is about bashing the Opposition’s motion and getting their amendment through; it is about trying to get something through that is good for us all. If that means both sides laying the motion on the Table in order to proceed, perhaps that would be a good thing for the House. I think that above all we need to get the legislation on lobbying right so that everyone benefits in future. It is not about one party scoring a few points from the other in the short term.
Grahame M. Morris (Easington) (Lab)
There have been some interesting and thoughtful contributions to this debate. We must acknowledge the Prime Minister’s perception when he predicted that lobbying would be
“the next big scandal waiting to happen”.
However, despite the bluster and sticking out of chests on the Government Benches, the coalition has had three years to bring in legislation, but a register of lobbyists was again noticeably absent from the recent Queen’s Speech. Let us be honest: it was only the most recent scandal exposed in the “Panorama” documentary that led the Government to consider introducing a Bill before the summer.
Let me read out a quote:
“It is vital that we act quickly and decisively to restore the reputation of politics. Too much unacceptable behaviour has gone unchecked for too long, from excessive expenses to sleazy lobbying practices. The people of Britain have looked on in horror as revelations have stripped away the dignity of Parliament, leaving millions of voters detached from the political process, devoid of trust in the political classes, and disillusioned with our system of government.”
That is a statement from the Conservative party manifesto; it is not very often that I agree with anything I read in there. That was the commitment that the Conservatives made in recognising the problem and that something needed to be done about it. So what has happened? We have had three years of Conservative-led coalition government and we have seen precious little action in relation to that commitment. We saw the former Foreign Secretary resign over the Werritty scandal and the cash-for-access case in which the Conservative party treasurer, Peter Cruddas, who was mentioned by my hon. Friend the Member for Leyton and Wanstead (John Cryer), offered “premier league” access to the Prime Minister for £250,000 a year. It is not a distinguished record. I am not shirking our responsibilities. The documentary that was broadcast quite recently was shocking. It related to one Member from this place and three from the other place, two of whom were members of my party. They should be thoroughly ashamed of themselves. Some sanction needs to be applied against such individuals. Clearly, there is the ultimate sanction for a Member of the House of Commons, but for those in the House of Lords there is no really effective sanction.
There are a number of things we have not done. Despite the warm words from Government Front Benchers, we have not curbed the improper influence of lobbyists, changed the ministerial code to bar Ministers and officials from meeting MPs on issues where the MP is paid to lobby, or required companies to report their annual spending on lobbying. I think that a Liberal Democrat Member referred to that; indeed, it was a promise that the Lib Dems made.
There can be no trust in politics when the public believe that politicians are for hire to the highest bidder. After the most recent scandal, all Members of Parliament holding directorships, advisory positions and consultancy roles are viewed with suspicion, whether that is justified or not. I want to put down a marker about second jobs and MPs spending in excess of 20 hours a week working outside Parliament. That raises questions about whose interests they are really serving. I do not have time to work 20 hours outside this place; I put all my efforts into representing my constituents. I do not know how Members can take up directorships and consultancies. That must put a question mark into the minds of their constituents; if not, it should.
All Governments have been tainted by the revolving door of former Ministers and special advisers who, in retirement, find themselves in lucrative jobs with companies they once dealt with as Ministers or advisers. That point was well made by my hon. Friend the Member for Newport West (Paul Flynn) in his Westminster Hall Adjournment debate on 2 November 2011. In my opinion, this is nothing short of corruption—the same kind of thing that we would condemn in other countries across the world.
The cosy relationship between some politicians and lobbyists was clear to see when the Prime Minister invited professional corporate and private health care lobbyist Nick Seddon into the heart of Government. Whose interests will Nick Seddon serve following his previous roles as a deputy director of Reform, which is listed as a free-market think-tank extensively funded by private health care and insurance companies, and as head of communications at private health care company Circle? Does that name ring any bells with anybody? At the heart of Government, corporate interests are over-represented to the detriment of the public. We do not want to be running a corporate plutocracy in the United Kingdom. I commend my hon. Friend the Member for Hemsworth (Jon Trickett) for his article in today’s Morning Star. It is an excellent piece that makes some terrific points about the excesses of corporate influence in the United States.
I recently witnessed this kind of corporate influence in action during the east coast main line debate. No matter how much public opposition exists against the privatisation of rail services, a Government who have surrounded themselves with advisers and lobbyists with corporate interests and connections remain fundamentally wedded to a policy of open competition in all public services, prioritising profits over people. Where is the voice of the public being represented?
I am sure that Members in all parts of the House will, like me, have received many hundreds of e-mails and representations from constituents regarding the Government’s proposals on plain cigarette packaging. I found it absolutely extraordinary that within weeks of the appointment of professional lobbyist Lynton Crosby, who had apparently lobbied against plain tobacco packaging in Australia, as the Conservatives’ election strategist, there was a change in policy. The links with private health care companies are wide and extensive in this House. As I said in an intervention, the Our NHS campaign reports that one in four Conservative Lords and at least 58 Conservative MPs have recent or current financial links to companies or individuals connected to private health care. Over 30 of the companies who are listed as corporate partners of Reform have recent or current financial links to Lords and MPs.
It is not the miners but corporate lobbyists at the heart of Government who are the enemy within. They undermine our democracy, which is increasingly becoming a plutocracy with access to Government and decision making going to the highest bidder and corporate interests at the expense of the public.
Damian Collins (Folkestone and Hythe) (Con)
I am following the hon. Gentleman’s argument carefully. I think that he needs to be careful, and the whole House needs to take care, in defining who lobbyists are and what their interests are. Several times he cited Reform, which is an independent think-tank with a cross-party board set up in the same way as many other think-tanks across politics, such as, in the past, the Institute for Public Policy Research and the Smith Institute, which have been aligned with the Labour party. That is very different from talking about someone who is a paid-for corporate lobbyist working for a professional lobbying company or an individual company. We must be careful about this.
Grahame M. Morris
I am grateful for that intervention. The point I am trying to make is that nothing is always as it first appears. Quite frequently, all-party groups are sponsored by pharmaceutical companies. Often, think-tanks with certain financial backers are coming up with certain policies, and when we look at who is funding them we can see why that is happening. Perhaps I could have selected a better example. If I was wrong, I acknowledge that.
The overwhelming majority of lobbyists understand and even welcome the need for a statutory register. They understand that in a democracy, the Government need to be open to influence from all parts of society. I have always considered myself to be the voice of the unheard. There is nobody else to speak up for the people I represent. It is right that we should speak for the smallest community group as well as listening to the point of view of the largest commercial operator. We should hear from everyone, from individual citizens to multinationals. We want an engaged, interactive citizens’ democracy. Without robust statutory regulation, the perception will continue that big business, the powerful and the few are able to gain private access to the decision makers at the expense of everyone else.
I hope that the motion will receive the support of the whole House, given its emphasis on cross-party negotiations, the implementation of a statutory register and a clear code of conduct that is backed by sanctions in the event of serious breaches of the code. I will leave it at that to give others a chance to speak.
Jacob Rees-Mogg (North East Somerset) (Con)
It is a great pleasure, as always, to follow the hon. Member for Easington (Grahame M. Morris). I learned that the Morning Star still exists. I confess that I was unaware of that. I thought that it had gone with the Berlin wall and all that.
As so often in this Chamber, we are not discussing a new problem. The issue of lobbying and undue influence goes back into the mists of time. Delving back not too far, who can forget Sir John Trevor, a former Speaker of the House who was expelled both from the speakership and from Parliament for accepting a 1,000 guinea bribe from the City of London to promote a Bill on orphanages? Interestingly, the Chairman of the Bill Committee, Mr Hungerford, received only 20 guineas for his service. He, too, was expelled from the House. I reflect that the Speaker was worth almost 40 times as much as the Chairman of a Committee. I wonder whether the relativities have changed in this more modern age.
Sir John Trevor and Mr Hungerford were expelled by this House for being unduly lobbied. Interestingly, they were unduly lobbied by another arm of the state: the corporation of London. It is worth bearing it in mind that, contrary to what the hon. Member for Easington said, it is not only wicked businesses that are involved in lobbying; it is something that happens across society. Everyone has an axe to grind regarding the issues that face this House. They therefore come to us to lobby. In and of itself, that is a perfectly legitimate activity.
As my hon. Friend the Member for West Worcestershire (Harriett Baldwin) so rightly said, it is an historic right of every one of our constituents to come to Central Lobby, demand our presence and tell us their views on whatever subject is important to them. That is a wonderful historic right. It is a pity that people do not know about it and do not use it more. We ought to encourage our constituents to come and lobby us in that way. There is a nobility in lobbying that must not be lost in the midst of the discussion about what is, in effect, corruption. Let us try to use the terms differently and not allow lobbying to become a polite term for criminality, dishonesty and corruption.
Within British politics, there are essentially two types of lobbying. There is the lobbying of Members of Parliament, which is perhaps the triumph of hope over experience, whereby people come to see somebody such as myself, a junior Back-Bench MP, and say that they want me to do this, that and the next thing and to change legislation, thinking that the Prime Minister and the Leader of the House hang on my every word. Sadly, I have to tell such people that that is not quite how it works. MPs have the ability to debate and argue, but not necessarily to change the course of the world. Then there is the lobbying of Ministers, who have a much greater and more direct Executive power—a decision-making power, rather than merely an influencing power. The two types of lobbying need to be regulated differently and separately.
There is a difference between those on the Opposition Front Bench and the Government Front Bench. Opposition Front Benchers have the hope and possibly the expectation of power. Those on the Treasury Bench have the reality of power and lobbying them can have a direct influence on what is happening. They should therefore be subject to a higher standard of openness and transparency than Opposition Front Benchers, who ought to be entitled to their smoke-filled rooms, although as they are socialists, the rooms will have no smoke in them, because they do not approve of that sort of thing. You know what I mean, Mr Deputy Speaker.
Given the difference between Government and Parliament, we need to legislate only for Government. Parliament has all the powers that it needs to regulate its own affairs, if only we had the courage to use them. We have a Committee of Privileges and a Committee on Standards. We are entitled to expel Members who misbehave. We may do so not according to a detailed set of rules, but according to whether we believe, as a House, that they have undermined the reputation of the House and have not behaved like honourable Members. Such a decision is not justiciable in any court in the land because we are the High Court of Parliament. The regulation of our own affairs is not challengeable in the other House, as was established by the Bradlaugh case, when an atheist was refused the right to sit in Parliament.
We have the right as a Chamber to admit and expel Members. When Members abuse the rules, we ought to exercise that power and clear up politics directly ourselves. That does not require legislation to come through before the summer recess; it simply requires us to have the willpower and the backbone to do what we are able to do already.
Grahame M. Morris
I am sorry to interrupt the hon. Gentleman’s flow. I compliment him on his speech. Will he clarify what the consequence is in the other place when peers commit a similar offence?
Jacob Rees-Mogg
The House of Lords, when considering what it could do about the expenses scandal, discovered that it had the right to imprison a peer for a Session. It decided that it must therefore also have the power to suspend a peer for a Session. However, it may only do that Session by Session. It cannot expel a peer because a peerage comes from the sovereign, whereas our position in this House comes from the people to whom we can be sent back. To get rid of a peerage requires primary legislation. That was done in 1917 to remove a group of peers who were fighting for the Germans and the Austrians during the first world war. It is open to this House to do that with the other place. We may pass an Act of Parliament to remove a category of peers who have committed offences. The House of Lords itself can suspend peers Session by Session. It can repeat such a suspension if it believes that the offence is egregious enough.
This House also has the power to punish individuals outside the House. If people are in contempt of Parliament, we have the ultimate power to imprison them. I am not proposing that we should use that power extensively, but if lobbyists try to bribe or corrupt Members of Parliament, it is not unreasonable that Parliament herself should impose the punishment on those lobbyists. That would be a matter of us regulating ourselves, using the power given to us by the British people, rather than farming it out, through legislation, to the courts to decide whether parliamentary privilege has been breached.
Business of the House
Grahame Morris Excerpts(11 years, 5 months ago)
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Mr Lansley
My hon. Friend will understand that I cannot comment directly on individuals, other than to say that—I think this is a matter of public record—although Helen Moss is working in a consultancy role, she is not working directly in relation to the Mid Staffs trust. I completely understand the general point, however. The Francis inquiry is continuing, and the Government will respond in due course, but while its report has clearly set out many of the central issues for the system as a whole, it was not asked to draw conclusions about the behaviour of individuals, and it did not do so. That is principally a matter for the professional regulatory bodies, of course, but this issue does raise the question of the place of managers in particular in a professional regulatory structure of that kind.
Grahame M. Morris (Easington) (Lab)
May I draw the Leader of the House’s attention to early-day motion 773? It has attracted the signatures of over 95 Members from seven political parties, including the coalition parties.
[That this House notes that the most significant development that has followed from the Government's healthcare reforms has been the 7 billion worth of new contracts being made available to the private health sector; further notes that at least five former advisers to the Prime Minister and the Chancellor of the Exchequer are now working for lobbying firms with private healthcare clients; recalls the Prime Minister's own reported remarks prior to the general election when he described lobbying as ‘the next big scandal waiting to happen'; recognises the growing scandal of the procurement model that favours the private health sector over the NHS, by allowing private companies to hide behind commercial confidentiality and which compromises the best practice aspirations of the public sector; condemns the practice of revolving doors, whereby Government health advisers move to lucrative contracts in the private healthcare sector, especially at a time when the privatisation of the NHS is proceeding by stealth; is deeply concerned at the unfair advantages being handed to private healthcare companies; and demands that in future all private healthcare companies be subject to freedom of information requests under the terms of the Freedom of Information Act 2000 in the same way as existing NHS public sector organisations.]
Given that £7 billion of NHS contracts is currently being tendered for, or has been awarded to, private sector health companies, may we have a debate on whether freedom of information requests should apply to private health companies bidding for NHS contracts that currently hide behind a cloak of commercial confidentiality?
Mr Lansley
Health questions will take place on the next sitting Tuesday. On public procurement and the need to audit public money, the Freedom of Information Act cannot at present reach wherever public money goes, but the transparency requirements set out in contracts enable there to be absolute clarity about the propriety and purposes of public funds used in procurement.
HEALTH
Grahame Morris Excerpts(11 years, 7 months ago)
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Jeremy Lefroy
I thank the hon. Gentleman for his intervention. I am not convinced that that is the case at all. I believe Ministers are listening and are considering matters very carefully, but there is a danger, of course, that a template will be inflicted. The hon. Gentleman and I both earnestly trust that that will not be the case.
As I said, I believe that national tariffs are not impartial arbiters. They generally work against acute care, and there is a risk that the constant pressure which they are placing on acute care, particularly in district general hospitals, will make much of the sector unsustainable, yet without it, we do not have an NHS.
Finally, I wish to raise a specific point about Monitor’s review of Mid Staffordshire. Clearly, the population served by the trust is a very important consideration. The trust’s 2011-12 report said that it was around 276,000, yet I have heard reports that the Monitor team considers it to be as low as 220,000 and therefore potentially too small to sustain certain services. The facts that I have clearly support the trust’s figure, not the one that I have heard rumoured.
I have spoken much today about figures, because they are an important part of the Monitor review, but more important is the quality of services, for which Monitor also has a legal responsibility. Early next year, the Secretary of State will bring to the House the report of Robert Francis QC from his public inquiry into Mid Staffordshire. Julie Bailey and the Cure the NHS group, who from their own experiences brought to light the harm that was done, have set out radical and clear ideas for turning the NHS the right way up, with the patient at the top, not the bottom—right first time with zero harm to each and every patient. That is something which caring, hard-working staff in our NHS in Stafford and Cannock—where waiting times and mortality rates are improving, although there is much to be done—and right across the country went into the NHS to provide.
The NHS, as the right hon. Member for Wentworth and Dearne (John Healey) said, and the nursing and medical professions must make it clear that there is no place for anyone for whom quality patient care does not come above all else. The regulations must show that.
The Monitor review is an opportunity for Stafford and Cannock hospitals to become a model of how to provide sustainable high quality emergency, acute and community care to a mid-sized population. If Monitor succeeds in achieving this there and elsewhere, as the hon. Member for Lewisham West and Penge (Jim Dowd) mentioned, it will have done the nation a great service, and I am sure the Minister will be remembered as someone who played a major part in improving our NHS. I urge Monitor to rise to the challenge.
Grahame M. Morris (Easington) (Lab)
I thank the Backbench Business Committee for making this debate possible before the Christmas recess. I shall raise an important issue, access to advanced therapeutic radiotherapy. I have raised this previously and I make no apology for doing so again. I intend to keep raising it until my constituents and those all across the country have proper access to advanced and innovative therapeutic radiotherapy systems.
I remind the House that prior to the Conservative party conference the Prime Minister pledged that from April next year cancer patients who need innovative radiotherapy will get it. That pledge was confirmed to the House by the Secretary of State for Health on 23 October and by the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), who has responsibility for cancer services, in written replies on 30 October.
The Department of Health’s press release on 8 October expanded on the Prime Minister’s statement, indicating that a new £15 million cancer radiotherapy innovation fund was being created, drawn from the underspend of the cancer drugs fund. I bring to the House’s attention the fact that the £200 million cancer drugs fund has been under-spent by an average of £150 million each year since it was established. That was reported to the House on 16 April 2012—column 134W in Hansard.
The Health Minister confirmed on 30 October that the pledge meant three specific things: patients would have access to appropriate radiotherapy wherever they lived; the new national Commissioning Board would be responsible for funding; and intensity-modulated radiation therapy, known as IMRT, stereotactic ablative radiotherapy, know as SABR, and stereotactic radiosurgery would be included.
Since the Prime Minister’s pledge, the Department of Health has contacted all cancer centres to inform them that the cancer radiotherapy innovation fund is a revenue fund only and that its use is to be focused on getting as many centres up to the standard of delivering 24% access to IMRT by April next year. In a letter to all cancer centre chief executives on 17 October, the cancer tsar, Sir Mike Richards, stated that only four of the 50 centres were reaching the 24% requirement set by the national radiotherapy implementation group.
In a letter to all radiotherapy service managers on 25 October, the national cancer action team stated that the cancer radiotherapy innovation fund was to be used effectively so that the Prime Minister’s pledge could be honoured and that if they are not delivering IMRT at the required 24% they were to submit an action plan by the end of November indicating how they would achieve that.
The letter also stated that the radiotherapy service managers could access initial funding of up to £150,000 to help them reach the target. However, the Health Minister, when questioned about funding for the pledge on 30 October, told the House that there would be no extra or ongoing funding similar to the cancer drug fund for commissioners to draw on and that any capital funding requirements would have to be met from the current £300 million bulk purchase fund announced earlier this year. In other words, there was no extra money. It seems to me that the pledge cannot be met, in terms of both revenue and capital.
Over the past two years adequate revenue funding has never been available to local commissioners to fund all the radiotherapy patients who have needed it. I know that full well from cases in my constituency. There is no indication that the new national Commissioning Board is to receive any additional funding. Without extra money, how will it fund care for the new 8,000 to 10,000 cancer patients the Prime Minister claims his pledge will help?
I would like to consider capital for a moment. I received an e-mail last night from the charity Breast Cancer Campaign, which indicated that, given the current age profile of the linear accelerators in England, an additional 147 new LINACs will be needed by 2016, at an average cost of £1.5 million. I want to ask the Minister how those will be funded. There are simply not enough advanced radiotherapy systems in the NHS to deliver the pledge. The Department of Health has admitted that only four of the 50 cancer centres are able to deliver IMRT to the required standard. At full capacity they could treat between 1,200 and 1,500 patients a year.
There are only four systems in the NHS delivering SABR up to the required standard, as the Minister has confirmed in written answers, and I have been to see one of the machines in St Bartholomew’s. At full capacity they could treat 1,000 patients a year. There is only one Gamma Knife in the NHS delivering stereotactic radiosurgery—in Sheffield—and at full capacity it could treat around 300 patients a year. With no extra capital available to fund new machines, it will be impossible for patients in most of England, including my region, to be treated by the NHS. There are some machines in the private sector, but the treatment is very expensive.
I am asking not for more money for cancer care, but for a more equal distribution of resources. The Department of Health is telling commissioners that radiotherapy, in conjunction with surgery, is very effective, curing 70% of all cancers. I have come here neither to lambast the Minister, nor to condemn him with faint praise; I have come bearing gifts, as it is Christmas, in the form of a potential solution. If the total underspend from the cancer drugs fund was transferred to radiotherapy in each of England’s regions, the systems could be upgraded with the most advanced radiotherapy equipment by 2015, which would enable constituents in my region and across the country to access life-saving therapies and allow the Prime Minister to fulfil his pledge.
Keith Vaz (Leicester East) (Lab)
It is a pleasure to follow my hon. Friend the Member for Easington (Grahame M. Morris). I share the concerns of all right hon. and hon. Members who have spoken so far about the importance of our national health service and our concerns about its current state. I think that the Minister—I have said this to him privately—is one of the most effective of the junior Ministers who have appeared at the Dispatch Box since the reshuffle. Because he is a doctor, I hope that he will take the concerns that I raise today on diabetes extremely seriously.
I suffer from type 2 diabetes—I declare my interest—having discovered it only five years ago after a routine test. I thought I had it under control, because I was taking my medication and doing a little exercise every day, walking from Norman Shaw North to the Palace of Westminster, until I read the national diabetes audit report published on 10 December. It states that people with diabetes are 48% more likely to suffer a heart attack, 65% more likely to have heart failure, 144% more likely to need kidney dialysis, 210% more likely to have leg amputations, 331% more likely to have part of a foot removed and 25% more likely to suffer a stroke. Overall, those with diabetes are, on average, 40% more likely to die each year than those without it. Members will understand my concern, as we approach Christmas, after reading statistics of that kind.
I know that other hon. Members have subsequently discovered that they, too, have diabetes. My hon. Friend the Member for Sedgefield (Phil Wilson), who is in the Chamber, discovered he had it only after being tested here in Parliament by the Silver Star charity. He went to see his GP and then knew that he had been diagnosed.
We are facing a diabetes epidemic, and I ask the Government to take more note of what is happening as far as diabetes is concerned. Generally, people with diabetes look fairly normal—I do not know whether you think I look normal, Mr Deputy Speaker—and do not make a virtue of telling people we have diabetes, except in debates of this kind. That normality lulls us into a false sense of security. We need a national campaign on diabetes in the same way as for other illnesses. Because people are getting treatment and are able to go and get their Metformin or other medication on a regular basis, they feel that everything is going to be all right.
This issue will not only not go away but will get worse. At the moment, 3.7 million people have diabetes, and that figure will rise by another 700,000 in a few years. Some 80% of amputations are preventable with proper care and management. I say to Ministers that this is something we can help the population with now. If we do so, we can save the 10% of the budget that is currently spent on diabetes care and the £1 million an hour that is spent on medication and care in our hospitals. These issues are very much in our hands.
I welcome the new Minister with responsibility for diabetes, the Under-Secretary of State for Health, the hon. Member for Broxtowe (Anna Soubry), who has made an excellent start. The first thing she did was to hold a summit for those with an interest in diabetes. It included Diabetes UK, which does some fantastic work on the subject, Silver Star, a charity of which I am privileged to be the patron, and others, including clinicians. She said what very few Ministers have said in my career in this House—“I want you to tell me what I should do about this subject”—and she was given a lot of good advice and ideas about how to take these matters further.
One thing that we could do immediately is to send out the message to GPs, even in the current climate of ongoing changes within the NHS, that it takes only a minute to offer each patient who comes to see them a diabetes test. I know that we are having screening for those of a certain age and disposition, but people go to see GPs for all kinds of reasons. Campaigning organisations such as Silver Star and Diabetes UK are able to go out to communities and conduct these tests. Indeed, anyone can conduct them. I have my kit with me, and although I am obviously not medically qualified, I can still conduct the test on people and am happy to do so. It is very easy to do. We should say to GPs, “Don’t wait for the screening process—begin now by testing anyone who comes to your surgery.”
We need to send out through the Department of Health a message about what we eat. You have changed physically, Mr Deputy Speaker, in all the years I have known you. I know of your great interest in rugby. You used to be a very beefy character when you were first elected to this House, but you have slimmed down, perhaps since you have been an occupant of the Chair. If people look after their lifestyles better by taking exercise and being careful about what they eat, that could help them. Every time anyone drinks a glass of Coke, eight teaspoons of sugar go straight into their system. When I went over to Atlanta and met the chief executive of Coca-Cola, I asked him what he was doing about it, and he said that Coke Zero is the answer, but it is only part of the answer. The kids in our schools are offered drinks in vending machines which have a huge amount of sugar, and then they get addicted to it for the rest of their lives. This is about things that we can do ourselves and things that parents can do to bring down the bill for the NHS.
When I finish this speech, and after I have listened to the Minister, I will be going to the Tea Room. When we get to the very helpful people there, we find that we have chocolates and mince pies on offer to us. If we turn to the left, we see a lot of food that is totally unfit for diabetics. Of course, I continue to eat this food because we do not have a choice, but it would be possible, through labelling of the drinks and food that we consume, as for people with a nut allergy, to add the words “Suitable for diabetics” or “Unsuitable for diabetics”.
Business of the House
Grahame Morris Excerpts(11 years, 8 months ago)
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Mr Lansley
I am grateful to the shadow Leader of the House for her response, and to the shadow Secretary of State for Health for how the Opposition responded to my right hon. Friend’s statement.
On the practicalities of the matter, hon. Members will of course be concerned to know that tomorrow’s business of the House motion, which I will table later, ensures that they can raise issues by tabling amendments, including before Second Reading. I hope that the motion will permit that to take place, to allow the full debate that Members will wish to have in Committee.
My colleagues, including the Secretary of State for Health, and I of course looked carefully at the requirement for the proceedings on the Bill to be conducted on such a time scale. As the hon. Lady will recall from my right hon. Friend’s responses to questions following his statement, a 72-hour period is allowed to put in place the assessment necessary to make a section under the Mental Health Acts. By extension, once it is clear that there is any procedural irregularity, there is a risk of legal proceedings being raised by the patients concerned. The legal advice makes it clear that it is desirable to achieve clarity as quickly as possible, otherwise there is a risk of large numbers of assessments having to be entered into. I know that our collective judgment will have been explained to the shadow Secretary of State.
I hope that along with the Department of Health, we will be able to take every step that we can. The Department has published the Bill and explanatory notes, which the hon. Lady will have seen. She will know that the Bill contains one substantive clause plus those on commencement, extent and short title, and I hope that today’s statement and the explanatory notes make it clear that it is focused specifically on the point in question.
As far as stakeholders are concerned, the issue that has arisen is about the approval of medical professionals. We were therefore particularly focused on the Royal College of Psychiatrists. As my right hon. Friend the Secretary of State made clear, patients’ rights and interests have not been prejudiced, and I hope that they will take reassurance from that. I have no doubt that immediately following his informing the House of the situation, my colleagues at the Department of Health will have ensured that all those in a position to represent patients’ interests have been given the necessary details and that they will have the opportunity to contact the Department and Members over the next 24 hours.
Grahame M. Morris (Easington) (Lab)
Can the Leader of the House clarify what will happen to the Second Reading of the Growth and Infrastructure Bill, which was planned for tomorrow? Have I misunderstood, or will it be rescheduled?
Business of the House
Grahame Morris Excerpts(11 years, 9 months ago)
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Mr Lansley
Yes; I reiterate my hon. Friend’s extremely good point and commend it to the shadow Leader of the House when she considers the business on—I believe— 7 November, when the Opposition will no doubt take the opportunity to debate the latest positive figures on growth, employment and the reduction of inflation, and the simple fact that since the Government came to office, we have cut the deficit we inherited by a quarter.
Grahame M. Morris (Easington) (Lab)
I understand the Leader of the House used to have an interest in health. In that case, will he use his influence with the current Health Secretary to persuade him either to have a debate, or at least to make an oral statement, on access to radiotherapy? There was an announcement at the Tory party conference, which the Health Secretary mentioned in question time, but it would be a courtesy to the House if we were allowed to understand the detail. The issue is about not just capital, but revenue.
Mr Lansley
The hon. Gentleman might like to know that the Leader of the House still has an interest in health, and I was at Health questions this week. He is right that the Health Secretary made it clear that he has made an announcement relating to a new radiotherapy innovation fund, which will support hospitals to ensure that patients have intensity-modulated radiotherapy if it is appropriate for them and that there is more access to stereotactic ablative therapy, both of which the hon. Gentleman has asked for and both of which this Government are now supporting.
Business of the House
Grahame Morris Excerpts(12 years ago)
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Sir George Young
I understand my hon. Friend’s concern. The Government have put forward some proposals that deal with antisocial behaviour, and the behaviour she outlines certainly strikes me as antisocial. When appropriate legislation is brought forward to deal with this, there might an opportunity to close any loopholes that exist.
Grahame M. Morris (Easington) (Lab)
We heard a statement yesterday from the Health Secretary in which he talked about steady progress in the NHS, but I draw the attention of the Leader of the House to the funding guidelines for public health, which mean that my region will lose £53 million and my local authority, Durham county council, will lose £20 million. I know that that is in line with the Government’s policy of moving resources from poor areas to rich ones, but may we have an urgent statement or debate on the gerrymandering of public health funding?
Sir George Young
I resist any accusations of gerrymandering. As the hon. Gentleman knows, the Government have transferred responsibility for public health from the NHS to local authorities, which I think is a perfectly progressive move, and one that has been welcomed by local authorities. The money has been redistributed in what I regard as a fair way. I will certainly raise with my right hon. Friend the Secretary of State for Health the hon. Gentleman’s concern that his region has somehow been short-changed, but I hope that the hon. Gentleman will endorse the principle of transferring responsibility and linking it with social care, housing and other responsibilities discharged by local authorities.
Business of the House
Grahame Morris Excerpts(12 years, 2 months ago)
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Sir George Young
My hon. Friend is right: credit unions and community finance organisations have a key role to play in helping those on low incomes to balance their books, particularly when they do not have access to bank accounts. I believe that a week ago a written ministerial statement announced a feasibility study setting out the way forward for credit unions. We are listening to representations made on the basis of that, and will announce our decisions shortly thereafter.
Grahame M. Morris (Easington) (Lab)
May we have a statement on gun law? It is some time since the Home Affairs Committee, chaired by my right hon. Friend the Member for Leicester East (Keith Vaz), issued a report on firearms control. There were some terrible events in my constituency on new year’s day, and I think it is time that we had an opportunity to question the Home Secretary on the Government’s intentions and on how we can best protect public safety.
Sir George Young
The Government would normally respond to a Select Committee report within a given number of weeks—I think that it is eight weeks—and I hope that we responded in time to that report. However, I will raise the hon. Gentleman’s concern about gun law with the Home Secretary, and will ask her to write to him setting out our proposals in that important area.
Business of the House
Grahame Morris Excerpts(12 years, 6 months ago)
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Sir George Young
I am grateful to my hon. Friend, who raises the important issue of truancy in schools. We have reduced the threshold at which a pupil is defined as persistently absent from 20% of time missed to 15%, ensuring that schools act earlier to deal with absence; and we are looking at the range of sanctions that can be placed on parents of truanting children, with a view to introducing higher fines and a more consistent application of sanctions. I hope that goes in the direction that my hon. Friend has indicated.
Grahame M. Morris (Easington) (Lab)
I have always thought that the Leader of the House is the most reasonable of the brothers on the Government Front Bench. Does he agree with me, my right hon. Friend the Member for Leicester East (Keith Vaz), the Chairman of the Home Affairs Committee, the Association of Chief Police Officers, the British Association for Shooting and Conservation and several Members on both sides of the House that existing firearms legislation, which is scattered among 34 Acts of Parliament, needs codifying, and that, in view of the terrible events in my constituency on new year’s day, it would be timely to have a debate on the merits of such a course of action?
Sir George Young
I am grateful to the hon. Gentleman and understand his constituency concern. The Home Affairs Committee recently produced a report on the issue, but it did not recommend a reduction in the age at which people can hold a shotgun licence. There were other recommendations in the report, however, and I will ensure that the Government not only respond to it, if they have not already done so, but deal with the specific issue the hon. Gentleman raises about codifying existing legislation on shotguns and trying to achieve a more rational approach.
Business of the House
Grahame Morris Excerpts(12 years, 8 months ago)
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Sir George Young
I understand that there is an e-petition on the slightly broader issue of immigration and if that got through the 100,000 threshold, there would indeed be a debate in which it would be relevant for my hon. Friend to raise this issue. [Interruption.] There might be a debate—indeed. In addition to the 470 colleges that my hon. Friend has touched on, 302 have had their licence revoked and a further 172 have been allowed to continue to teach current students but may not sponsor any new ones from the EU. I hope that he is assured that Ministers at the Home Office have this matter under serious consideration.
Grahame M. Morris (Easington) (Lab)
The Leader of the House has previously told us that he is not keen on having any debate that involves the expenditure of additional resources. However, I wonder whether we might prevail upon him to persuade the Health Secretary to have a debate on NHS procurement, not least because we desperately need a credible plan for jobs and growth, and NHS procurement could provide a way of securing such a commitment.
Sir George Young
I am grateful to the hon. Gentleman. I think I am right in saying that the Select Committee on Health, or possibly the Public Accounts Committee, has recently produced a report on NHS procurement—I think it was the PAC—in which case the Government will want to respond to that in due course. If there are lessons to be learned in order to procure more efficiently, get better value for money and, indeed, create jobs by so doing, of course the Government would like to pursue that.
Business of the House
Grahame Morris Excerpts(12 years, 9 months ago)
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Sir George Young
If anything illegal has taken place, I hope the appropriate authorities will be notified. I shall share my hon. Friend’s concern with my right hon. Friend the Secretary of State for Work and Pensions and see whether anything irregular has taken place.
Grahame M. Morris (Easington) (Lab)
There are reports that up to 60 NHS hospitals face serious financial difficulties due to the new burdens being imposed by NHS reforms. As there are risks that such trusts could be taken over by private sector health interests, may we have an urgent debate or an urgent statement, so that we can take some action before the situation becomes terminal?
Sir George Young
No trust can be taken over by a private sector concern, but I simply say to the hon. Gentleman that any financial problems confronting his trust or other trusts would be even worse without the extra resources committed by this Government, which his party opposed.