Passenger Railway Services (Public Ownership) Bill

Debate between Helen Whately and Grahame Morris

Committee of the whole House
Tuesday 3rd September 2024 Commons Chamber

[Helen Whately]

No, I will make some progress.

For the reasons I have described, we have also tabled amendments to put some conditions on franchises moving into the public sector. Under the Secretary of State’s plan, the running of trains on our network will increasingly be tasked to a little-known Government company called DFT OLR Holdings Ltd, or DOHL, the current operator of last resort. It seems to me a huge risk to expect DOHL to successfully take over and run every franchise in the country. DOHL has had, shall we say, mixed results with the franchises it has taken over, and expecting it to run a further 10 on top of the four it is currently operating strikes me as a lot to ask. I recognise that the Bill makes reference to that risk by providing for franchise extensions where it would not be practical to bring the service in-house, but under the current plans, that would be decided by the Secretary of State. It is not that I do not trust the right hon. Lady, but she has shown herself to have a great deal of confidence in public operators, in the absence of any substantial grounds for that confidence.

I have been told that there is no plan to increase headcount, budget or resources of any kind for DOHL as it takes on that increase in workload from four to 14 franchises. I welcome the Government making an effort to achieve efficiencies at the centre, but I struggle to believe that more than tripling the number of franchises brought in-house will not involve some increase in resources. We therefore think it would be prudent for the Office of Rail and Road to form an independent judgment on whether DOHL has the capacity and expertise to take on each new franchise as it comes up, and to run it, at a minimum, as well as it is already being run. That could be done well in advance of most contracts ending, so it would not really be a hindrance to the Secretary of State’s plan, but it would provide a great deal of reassurance to passengers, and all of us as their representatives, about the capacity of the Government to successfully take over the functions of so many train operating companies.

[Grahame Morris (Easington) (Lab)]

On impact assessments and how we can have confidence that DOHL will improve performance, we can look at past performance. I remind the shadow Minister that the operator of last resort currently runs 14 franchises. Since the east coast main line, which serves my region, was taken over by LNER, revenues have grown substantially. Since TransPennine Express was brought back into public sector operations in May 2023, we have seen cancellations decrease from an average of around 20% to 5%. In the last quarter, TransPennine, which is run by the operator of last resort, DOHL, was the most improved operator in terms of cancellation scores compared with the same period last year.

[Helen Whately]

I accept some of the points that the hon. Gentleman made. That is why I said that the record of DOHL had been mixed. Sometimes there has been improvement in performance, but that is not the case for all the franchises it runs. That is my reason for not being confident that it is the right organisation to take on such a large increase in its workload, particularly without any further increase in its resources, including some operators that are performing better than the train companies that he mentioned.

We want every contract that is awarded to place a duty on DOHL to look at how to modernise our network and to ensure that passengers are at the forefront of all decision making—passengers not just in urban areas and around London but, crucially, in rural areas and places that have traditionally been under-served by the rail network. Time and again, the Secretary of State has said that her No. 1 priority is passengers—that she will protect their interests above all else, and that it is for them that she is seeking this change. This is a chance to put her money where her mouth is and create a legal duty that promotes the needs of passengers in all future agreements with public sector operators. That will build in a layer of accountability on things that we all agree are important.

On amendment 8, public bodies marking their own homework is not something that Opposition Members believe leads to good results. I know from my time in government that independent scrutiny makes life harder for Ministers, but it also improves accountability, and with that outcomes. That is why we seek to introduce proper financial reporting and oversight for public sector operators. Under the franchise system, whatever its shortcomings, train operators are incentivised to increase passenger numbers and control costs. That has been an undeniable success of privatisation. Passenger numbers have doubled and costs have been controlled, increasing at a far slower rate than revenue.

In future, passengers and taxpayers will have to foot the bill for any loss of control on costs, any inefficiencies or any failures to innovate. That is a serious implication, and something we should do our best to protect people from. Creating, or recreating, some incentives is a good place to start. We will need to know how well the public train companies are performing—what they are doing to increase passenger numbers and drive growth in rail services, how reliable their services are, how well they are keeping costs under control, and how satisfied passengers are with the service they provide.

Our proposals will allow us to identify both good and bad performance, hold the managers of those companies to account and reward them accordingly, such as by linking managerial pay to performance. Those companies will no longer have shareholders to answer to, or the financial incentives that go with a senior role in the private sector. The Government have told us that part of their rationale for these changes is to better align the incentives of train operators with the interests of passengers, but the Bill currently provides no mechanism for that. We are not seeking to frustrate a change that this Government were elected to deliver; we simply wish to bring proper transparency and accountability to the process. That includes reporting on the costs involved in bringing operating companies into public ownership.

Government Members will no doubt point to the money that will be saved by removing management fees, but this equation is not one-sided. While the Secretary of State might be saving £150 million each year on fees, industry experts have predicted that the Bill could cost passengers and taxpayers up to £1 billion a year in lost productivity and growth—and that is before accounting for the Government’s taking on all the long-term liabilities of the companies. Pension obligations, rolling stock and long-term leases will all be transferred on to the Government balance sheet, and we have had alarmingly little information on what that figure will be.

NHS Workforce Expansion

Debate between Helen Whately and Grahame Morris

Tuesday 28th February 2023 Commons Chamber

[Grahame Morris]

It is not correct that Labour’s spending plans are unfunded, and I hope that the Minister will put the record right. On the cancer plan, there is information out there that the incidence of cancer is increasing. To get value for money, would it not be sensible for the Government to invest in precision radiotherapy, as a treatment that improves patient outcomes in a cost-effective manner? That would get the best value for money for the taxpayer.

[Helen Whately]

I know that the hon. Gentleman feels very strongly about the issue; we have talked about radiotherapy. He will know that we have invested more than £160 million in improving radiotherapy equipment. This year, we are investing an extra £50 million in the cancer and diagnosis workforce. We are continuing to work hard with the NHS on reducing the backlogs that we have seen since the pandemic, when people did not come forward for cancer treatment as they would have in normal times.

Cancer Services

Debate between Helen Whately and Grahame Morris

Thursday 8th December 2022 Commons Chamber

[The Minister of State, Department of Health and Social Care (Helen Whately)]

I very much thank my hon. Friend the Member for Winchester (Steve Brine) for raising the Select Committee’s report on cancer today. I know that he is passionate about this issue both as a former cancer Minister and for the personal reasons that he mentioned, as do I. The Committee’s 12th report makes valuable recommendations, and I am grateful to it for all its hard work. I assure him and hon. Members that we are working night and day, together with our colleagues in the NHS, on three priorities for cancer in particular. They are: to recover from the backlog caused by the pandemic; to get better at early diagnosis and treatment, using the tools and technologies that we have; and to invest in research and innovation, because we know that advances in such things as genomics and artificial intelligence have the potential to transform our experience of cancer as a society.

This is my first opportunity to congratulate my hon. Friend on his election as Chair of the Health and Social Care Select Committee, where I know he will do an excellent job, bringing his expertise as well as his passion on the subject to bear. I also welcome the focus that he will bring to the Committee on cancer and prevention, as he mentioned in his remarks. I am truly sorry that he has lost members of his family to cancer, including, as he said, his father. He rightly said that cancer affects pretty much everyone in our country in one way or another.

My hon. Friend talked about some of the challenges that we and our NHS face in the diagnosis and treatment of cancer. In his time as cancer Minister, he was absolutely right to focus on early diagnosis, because we know that that makes such a difference. As he said, he set the 75% ambition for early diagnosis to be achieved by 2028, and the NHS is indeed working towards that at the moment. He talked about wanting to see the plan for achieving that ambition—I say “ambition” because, as he will know, it was intentionally set as a stretching target—and about the importance of us having the capacity to treat cancer. I think that is currently higher than it was before the pandemic, but I certainly see the need to expand it further.

My hon. Friend talked about the importance of surgical hubs. We have 89 of them, but more are planned, with £1.5 billion of capital funding recently approved for their expansion and future new hubs. He rightly talked about the importance of cancer research and the alignment of that with cancer treatment and cancer services. He also talked about the significance of health disparities and the prevalence of risk factors such as higher smoking and obesity rates in more deprived communities. I will address some of those points during my speech.

The hon. Member for Easington (Grahame Morris) spoke in particular about radiotherapy as well as giving a broader perspective. As he said, we met the other day together with Professor Pryce, and he raised his concerns with me about the use of radiotherapy, the impact of tariffs, the potential for better use of radiotherapy machines, staff, and several other points in the plan. It is too soon to give him the quality of answers that I would like on those points, but I am looking into exactly what he raised and will get back to him and those others we met as well.

My hon. Friend the Member for Erewash (Maggie Throup)—I have huge respect for her, including the work that she did as a Health Minister and the expertise she brings to the debate—is absolutely right about the importance of community diagnostic centres. We are rolling them out around the country, with 19 more just announced, increasing our capacity to diagnose cancers promptly. She also spoke about workforce pressures. I am sure she will know that the 2017 cancer workforce plan was delivered and, in fact, exceeded by over 200 additional staff. Since then, Health Education England has received additional funding of £50 million for the cancer workforce in the last financial year and this one.

I agree with my hon. Friend that we should continue to focus on ensuring that we are training, supporting and retaining the cancer workforce that we need. That is so important to achieving our ambitions in cancer as well as the wider NHS workforce. Indeed, many of those who work in the NHS will be looking after patients with cancer, not just those who might have a specific cancer workforce label. I am sure she will know that we are well on our way to achieving our ambition of 50,000 more nurses in the NHS, with over 29,000 more at the moment.

My hon. Friend also spoke about cancer equipment. For instance, since 2016, £160 million of capital investment has been invested in radiotherapy equipment. I will take away her call for an equipment audit. She also importantly talked about obesity and alcohol as risk factors, although I appreciated that she said we should focus on alcohol reduction after the festive season. I thank her for allowing us to enjoy a drink over Christmas.

[Grahame Morris]

I am amazed that figures are not to hand on how many radiotherapy machines are more than 10 years old. Is it unreasonable to expect that NHS England would have an ongoing audit to identify which machines need replacing on a planned basis? Will that be addressed?

[Helen Whately]

There will be huge numbers of figures on things that NHS England will be monitoring. I said to my hon. Friend the Member for Erewash that I am very happy to look at her specific suggestion, on the extent to which the data already exists or whether we should be collecting it. That is part of what I will be looking into when I follow up on that.

We heard from the hon. Member for Coventry North West (Taiwo Owatemi), who brings really valuable experience to this topic. She said that she is a former oncology pharmacist and, if I heard her right, that she also volunteers as a pharmacist in her local hospital. That is hugely welcome experience to bring to the debate. I am very happy to speak to her more about some of the challenges she raised. I will follow up after the debate to see if we can get that in our diaries.

The hon. Lady pointed out that we are not achieving our targets on treatment rates, which is absolutely true, but she also spoke about cancer referrals. On that point, I want to share some good news. More people than ever before are being referred to hospitals by their GPs to see if they have cancer. The latest data for October this year, published only this morning, shows that almost 250,000 urgent cancer referrals were made by GPs in England, which is up about 109% on the levels in October 2019. It is 10,000 more than in October last year and over 35,000 more than in October 2020. That is thanks to the hard work of GPs, to the 91 community diagnostic centres which have carried out more than 2 million additional scans, tests and checks already, and to all the people who have come forward and got themselves checked. We know it is not always easy if you are worried that you might have something that could be cancer. We are working hard to encourage people to come forward if they are worried, so that we can improve early diagnosis. That is why we are working to raise awareness with campaigns such as “Help us, Help you” alongside targeting case-finding efforts such as targeted lung health checks. Such initiatives are successfully countering the pandemic’s negative impact on cancer referrals.

In further important news, NHS England announced it is expanding direct access to diagnostic scans across all GP practices. That will cut waiting times and speed up diagnosis or the all-clear for patients. Since November, every GP team has been able to directly order CT scans, ultrasounds or brain MRIs for patients with concerning symptoms, but who fall outside the NICE guidance threshold. Non-specific symptom pathways are transforming the way that people with symptoms not specific to one cancer, such as weight loss or fatigue, are either diagnosed or have cancer ruled out. That gives GPs a much-needed referral route, while speeding up and streamlining the process so that, where needed, people can start treatment earlier. Thankfully, with the increased level of referrals, the majority of people referred will be given the all-clear. However, it is crucial to start treatment promptly for those who are diagnosed, while giving peace of mind to those who do not have cancer.

On treatment, my Department has committed an additional £8 billion for the next two years, on top of the £2 billion elective recovery fund, to increase elective activity including for cancer services, because speed of treatment following early diagnosis is of course very important.

I am looking at the time and I know that I need to try to wrap up promptly. I will skip as fast as I can to a conclusion, while answering a couple of points that were raised as we go.

Many hon. Members commented on the pandemic. I recognise that the pandemic severely disrupted health services. The recovery of performance is a multi-year effort. The NHS is working very hard with a delivery plan specifically to tackle the covid elective care backlog. Under the plan, reducing the number of patients waiting over 62 days for treatment is a top priority.

Many hon. Members are interested in the progress of the 10-year cancer plan. We are reviewing the responses we have received on the call for evidence to that plan. In parallel, I am closely scrutinising holding the NHS to account on its elective recovery plan, a major part of which is cancer care, as well as looking to the future and making sure we drive forward research and innovation, including, for example, with our recently announced life sciences cancer mission which will invest over £22 million in a vaccine taskforce approach to cancer research.

I would like once again to thank my hon. Friend the Member for Winchester for securing this debate today. I look forward to working with him and other hon. Members on improving cancer outcomes.

Oral Answers to Questions

Debate between Helen Whately and Grahame Morris

Tuesday 1st November 2022 Commons Chamber

[Grahame Morris (Easington) (Lab)]

As we get older, many of us—individually or our close family and their immediate family—will be touched by cancer. Can the Minister confirm when the 10-year cancer plan will be published in full, and will the Minister agree to meet me and a small delegation from the all-party parliamentary group on radiotherapy to hear more from the experts on the frontline about how we can use this technology to improve cancer outcomes?

[Helen Whately]

Sadly, cancer takes far too many people before their time, and the Government are determined to improve cancer outcomes in the short term and the long term. I am very happy to meet the hon. Gentleman to discuss this further.