Hospital Parking Charges (Exemption for Carers) Bill

Jacob Rees-Mogg Excerpts

Friday 30th October 2015 Commons Chamber

[Philip Davies]

My hon. Friend makes a good point. The Bill applies only to car parking charges, and many carers cannot afford a car, let alone car parking charges. They travel faithfully on a probably more tortuous journey to hospital by public transport. If the Bill were to be passed, people who could afford a car would get their parking charges reimbursed but those who cannot afford a car and have to travel by public transport would not get their public transport costs reimbursed. Clearly, there is something not quite right about that. My hon. Friend makes a good point. While we are on that subject—I may come back to this as well—I should have thought that we were trying to deter people from using a car. Some people have to use a car, as he said, and nobody argues with that, but it would be perverse to give people an incentive to use a car rather than using public transport if they could. My hon. Friend has made a good point as to why the Bill would give people a perverse incentive to use a car rather than public transport.

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

I am rather surprised by my hon. Friend’s burst of socialism and that he should be discouraging the use of the motor car, which should be encouraged in a free society.

[Philip Davies]

I have been accused of many things in my time. A burst of socialism is a first, even for me. I may try and put that out to my left-wing constituents to show them that there is hope for me yet. If I did come out with a burst of socialism, I apologise profusely, not least to my hon. Friend, who always keeps me on the straight and narrow. I apologise for a burst of socialism; it was not intended to be such. I feel chastised.

We should consider why hospital car parks are not already free. There is an argument, I guess, that instead of picking out parking for carers, all hospital car parking should be free. In its 2009 report, “Fair for all, not free-for-all—Principles for sustainable hospital car parking”, the NHS Confederation stated:

“Charging for car parking is often necessary, but needs to be fair – and to be seen to be fair.”

It is important for Opposition Members to recognise that the country and the NHS do not have millions of pounds to spend on covering the cost of parking for a certain section of the population. The Labour Government left this country in a huge financial black hole which we are still struggling to recover from. Policies such as this could severely affect local NHS hospitals and services and their budgets.

There is an analogy that I always give in such situations, which I first heard Lord Tebbit use. I hope that goes some way to restoring my hon. Friend’s faith in me after my earlier lapse. The analogy in this context, which is not necessarily the context in which Lord Tebbit used it, is this: if somebody asked, “Do you think we should have free hospital car parking?”, the chances are that virtually everybody who was asked would say yes. If they were asked, “Should we have free hospital car parking? By the way, that will mean having to get rid of lots of doctors, nurses and essential staff”, people may give a different answer. In the analogy that Lord Tebbit used, the question was, “Would you like a free Rolls-Royce?”, and he suspected that the vast majority of people would say yes. If they were asked, “Would you like a free Rolls-Royce? You’ll have to live in a tent for the rest of your life to pay for it”, people may come up with a different answer.

Of course, in principle, people would love to have free hospital car parking, but we have to think what the consequences would be and whether people would want to face those consequences. When it comes to the crunch, I suspect the answer may be different. If the Government had an additional £180 million to spend, which would be the cost of free hospital car parking, I am sure there would be many other pressures to spend that £180 million on in some part of the NHS. For example, it may pay for another 2,500 doctors or 8,000 nurses for the NHS. If we had a vote on what is the most important thing that we should do with that money, I suspect that the additional doctors and nurses would carry quite a weight of support, not just in this House, but across the country as a whole. It is not just a free-for-all. The harsh reality is that there are consequences of doing these things.

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[Philip Davies]

My hon. Friend is right. There will, as an inevitable consequence of the Bill, be issues about preserving the integrity of the spaces.

I am not sure, but perhaps the hon. Member for Burnley intends to ask hospitals to provide designated spaces for carers to use, in the same way that there are designated spaces in car parks for people with disabilities or for parents with toddlers. If so, how many spaces should the hospital provide? There are rules and guidance on how many spaces there should be for disabled customers. From my memory of working at Asda, I think the rule is that 4% of all the spaces in a car park plus four should be set aside for disabled customers. That was certainly the situation when I was at Asda. Does she envisage a similar system—a number of designated spaces for carers, but when they are full they are full?

Does the hon. Lady expect someone to police the car park at all times to ensure that carers use the right spaces and that no one is charged unfairly? I do not know what system she wants. Perhaps she envisages a system of reimbursement, with carers paying for parking normally, just like everybody else, and then going into the hospital to demonstrate that they are a carer and have their costs reimbursed. That may require 24-hour-a-day, constantly manned reimbursement desks to be open at the hospital. Does she envisage that?

[Mr Rees-Mogg]

I am following my hon. Friend’s speech very closely. Is the heart of what he is saying that the scheme proposed in the Bill would prove so complex to administer that it would in effect be the end of all car parking charges, because to continue to have any charges would make the whole system collapse?

[Philip Davies]

Yes. That is absolutely my fear. Once we start down this route of having a centrally imposed system that has not been worked out locally, there will be all sorts of consequences. Ultimately, hospitals will be forced to turn a blind eye to this person or to that person, because their situation justifies having free parking just as much as a carer’s situation. It would be terrible for someone in the hospital car park to say, “Yes, you are a carer so you can have the free parking,” but, “You have a disability, so no, you can’t have free parking.” I do not see how we can allow hospitals to get into such a situation, because that would be grossly unfair.

From time to time, there will inevitably be disputes about whether somebody is a carer. If the system uses badges, somebody may forget to take their badge. As a carer, they would be entitled to free car parking, but if they had forgotten their badge, the hospital would not have to grant it. I am not entirely sure how such disputes would be policed. Would somebody be on site to adjudicate, or would the hospital do so? What training and qualifications would such people be given? Is this something for the Parliamentary and Health Service Ombudsman to adjudicate on? Is the hon. Member for Burnley suggesting that a new adjudicating body should be created to settle hospital car parking disputes? Those are all practical matters that need to be considered. This is not an easy yes/no question. There will be disputes from time to time, so who will sort them out, how will it be paid for and who will organise it and set it up? Will the hospital be judge and jury on its system of parking charges, or will that be monitored by an independent board?

[Mr Rees-Mogg]

To follow on from that, will the public or the private appeals system for parking offences be used? The two are completely different and have different statutory backings.

[Philip Davies]

My hon. Friend makes a good point. I do not know. The Bill covers not only NHS hospitals but private hospitals, which is another factor that needs to be considered. The hon. Member for Burnley did not say anything about how this would work in practice. In effect, we are being encouraged to vote for a pig in a poke.

The Bill will have unintended consequences. Hospitals may or may not be able to cope with the number of carers who use their car parks. The shadow Minister talked about the figures. According to the Department for Work and Pensions, just short of 721,000 people were claiming carer’s allowance in February, and a further 408,000 were estimated to be entitled to it. In England, 613,000 people actually claim it, and a further 331,000 are entitled to it. The number of people entitled to it varies quite widely from region to region.

I do not know whether this is why the hon. Member for Burnley has introduced the Bill, but she may be interested to know—this will certainly be of interest to my hon. Friend the Member for Bury North (Mr Nuttall) —that the north-west has a very high proportion of people entitled to carer’s allowance and a very high number who receive it compared with any other region in the country. I am not entirely sure of the reasons for that, but that is the fact of the matter, according to the figures from the Department for Work and Pensions. If, just under such a narrow definition, nearly 1 million people are suddenly automatically entitled to free parking in hospitals, how will hospitals cope with any potential increase in demand for car park places? Hospital car parks are bursting at the seams and unable to meet the current demand for car parking.

The principle of supply and demand is obvious in this regard. If the price of something is put up, the demand for it goes down, and vice versa. If we exempt people from car parking charges, an inevitable consequence will be a surge in demand. We all know that, much to the delight of my hon. Friend the Member for North East Somerset (Mr Rees-Mogg), car use is increasing in the UK. Presumably, the demand for hospital car parking places will get more acute as time goes on—something that he will no doubt welcome regally.

[Mr Rees-Mogg]

I do indeed. The more the motor car is used, the better. My hon. Friend is getting to the nub of the matter. One can ration either by price or by queue. There is no other way of determining how supply and demand meet.

[Philip Davies]

I am glad that we have got back to a situation where I am in agreement with my hon. Friend.

The Cumberland infirmary in Carlisle has outlined its concern over its four car parks on its website:

“We are currently experiencing unprecedented levels of cars requiring parking spaces at the Cumberland Infirmary.”

It is already having that problem. How on earth is it expected to find the additional car parking spaces for carers to park free of charge?

In the north-west alone, 102,000 people are receiving carer’s allowance and a further 60,000 people are entitled to it. That is 162,000 people just in the north-west who would be entitled to free car parking under this regime. Where on earth will they all go?

In the 2015 edition of the Department of Health’s health technical memorandum entitled “NHS car-parking management: environment and sustainability”—they always have catchy titles at the Department of Health—Leeds Teaching Hospitals NHS Trust was quoted as saying:

“The car-park occupancy levels often reach and surpass 100%.”

It is not as though there are lots of car parking spaces available to allocate to worthy groups of people who might need to use them.

[Mr Rees-Mogg]

I am momentarily puzzled about how the usage of a car park can exceed 100%. Are the cars crashing into each other or parked on top of each other? Can my hon. Friend explain?

[Philip Davies]

I suspect it means that people are parking in places where they should not be parking within the car park because there are not enough spaces, so they park somewhere where there is not a space.

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[Philip Davies]

I am very grateful, Mr Deputy Speaker.

I will turn to the example that the hon. Member for Burnley used in her remarks, which she encouraged me to reflect on. As she said, at the end of last year, Torbay and South Devon NHS Foundation Trust announced that it would offer free parking to registered carers at Torbay hospital. I should point out that that scheme, unlike the Bill, is offered specifically to unpaid carers, rather than people who receive carer’s allowance. That is not what the Bill proposes, despite the impression the hon. Lady wanted to give. The interim chief executive of Torbay hospital, Dr John Lowes, said in December 2014:

“Family members and friends who provide unpaid care to our patients at home are invaluable, so we wanted to do something to make their hospital visits a little less stressful, and to demonstrate that we really do value what they do.”

He explained that the system was being implemented with the involvement of the established local care providers and that

“if someone is registered with either Devon or Torbay Carers Services, they just need to display their Carers Card on the car dashboard whilst they are parked in the public pay and display areas, and they will not be charged for parking.”

There are two points to make about that. First, the hon. Lady argued that what happens in Torbay shows why we can happily roll out the scheme across the country, but my view is that it is a perfect illustration of why we do not need legislation. Torbay has managed to do it without any legislation in a way that suits its local requirements, which is what I want to see.

Secondly, I know from my own experience that there is a problem with having a card displayed on a dashboard in a pay and display area, which is effectively what happens with blue badges. Anybody who has been involved in that area knows that people hand their badge to someone else to use—a member of their family, or whoever. It is not right—it is a terrible thing—but it happens, and we cannot ignore the fact that it would happen under the system proposed in the Bill.

[Mr Rees-Mogg]

I just want to say that I am sure things like that do not happen in Somerset.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. And I am sure that it is not part of the debate for today.

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[Philip Davies]

I very much agree, which is why I think the Bill is unnecessary. This can be done much better locally than by central Government diktat.

Gloucestershire Hospitals NHS Foundation Trust has also set up a scheme for carers, aiming to support their needs when they visit hospitals. It asks that carers make hospital staff aware of their caring responsibilities, and it also mentions that they may be entitled to a carer’s badge that they can use during a hospital stay. That entitles the carer to exemption from parking fees, but also to reduced meal costs in the hospital restaurants, free drinks on the ward and the use of toilet and washing facilities in the ward area. When we allow local hospitals the freedom to do their own thing, they can give carers an enhanced service that is much better than what the hon. Member for Burnley proposes. I fear that if there were a central Government diktat that was bureaucratic and difficult to implement, areas such as Gloucestershire would scale back the other benefits that they gave carers and instead just meet the requirements of the law.

It is perfectly clear that the Torbay and Gloucestershire schemes have completely different ways of working and of identifying eligible carers. If it works at local level, all is well and good, but that would not be possible under the Bill.

[Mr Rees-Mogg]

Is my hon. Friend saying that carers who currently receive the benefit of free parking would have to be removed from the Torbay scheme if the Bill were brought into law, because they would not qualify and Torbay would have to change the scheme?

[Philip Davies]

That is my reading of the situation. Because the definition of carers in the Bill is different from that used by Torbay—

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[Philip Davies]

In which case we must look at the Bill itself, Mr Deputy Speaker, if that is what you are urging me to do.

The Bill is called the Hospital Parking Charges (Exemptions for Carers) Bill, but it would actually apply to all health service providers, both public and private, and not just hospitals. I do not think many people appreciate its true scope. Clause 1 states that bodies that provide healthcare must

“make arrangements to exempt qualifying carers”

from car parking charges. That applies to

“any National Health Service hospital, 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 relating to their health”,

so we are not just talking about hospital car parking charges. It also extends to private hospitals, so not only are we dictating what should happen in the NHS, but we are telling private hospitals what they should do. Many people might argue that those who can afford private healthcare treatment can also pay for car parking. Whether that is a legitimate use of resources is a different matter.

[Mr Rees-Mogg]

I wonder whether the Bill’s proponents have considered the human rights implications of taking a revenue source away from a private company without compensation. The Bill makes no provision for compensation.

[Philip Davies]

That is a very good question, and I do not know about that. My understanding is that Bills have to be certified to say that they fulfil obligations under the Human Rights Act and all of that stuff, but I do not know whether that applies to private Members’ Bills. My hon. Friend raises an interesting point, and I am not sure what the answer is.

Clause 2 is an attempt to define who would qualify. It states:

“A qualifying carer under section 1(1) is a person who…receives the Carer’s Allowance, or…has an underlying entitlement to the Carer’s Allowance.”

I have no idea where to begin with that. To claim carer’s allowance, a person must provide at least 35 hours a week of care for a severely disabled person receiving one of the following benefits: the middle or highest rate of disability living allowance; attendance allowance; the daily living component of personal independence payment; constant attendance allowance at or above the normal maximum rate with an industrial injuries disablement benefit, or at the basic rate with a war disablement pension; or armed forces independence payment. The person applying must be at least 16 years old, meet residence and presence conditions, not be subject to immigration control and not be in full-time education or gainfully employed. Anyone entitled to carer’s allowance would automatically receive free parking at hospitals under the Bill, whether they frequently visited hospital or not.

The hon. Member for Burnley has specifically identified that the members of the caring community who should be entitled to free parking are not only those who receive carer’s allowance but those who have an underlying entitlement to that allowance. I do not understand how on earth a hospital is supposed to know whether somebody has an underlying entitlement. The benefits system in this country is incredibly complex, and I would prefer our NHS hospitals to concentrate on the complicated process of providing the appropriate treatment to the right patients rather than have to be bogged down in Department for Work and Pensions rules on who is eligible for a particular benefit. That is what the hon. Lady is asking them to do in clause 2—to understand who is eligible for the benefit, not just who receives it.

As the hon. Member for Worsley and Eccles South made clear in an intervention, many people in this country care for people but are neither recipients of carer’s allowance nor eligible for it, because of the restrictive entitlement definitions. Why would we want to exempt some carers from parking charges but not others? That seems very unfair. I tried to get some information about what defines a carer, and it is not necessarily the same as what qualifies somebody for carer’s allowance. We need some flexibility on that.

I want to move on, because other Members want to speak. Clause 3 sets out provision for the Secretary of State to issue guidance and regulations through statutory instruments about the implementation of the duty to exempt carers from car parking charges. It is an important part of the Bill. It is something that we often see in private Members’ Bills: whether the Bill has merit or not—I am trying to flag up some serious concerns about that—the Member in charge includes a provision that would allow Ministers to extend the Bill’s requirements with the stroke of a pen and with barely a breath being taken. Clause 3 is a dangerous part of the Bill, because a Secretary of State or Minister could come along and say, “Actually, I’ve decided that we’re going to extend this left, right and centre”, and the hospitals will just have to implement it. That is very worrying.

Clause 4 would introduce a

“Duty to establish a scheme for exempting eligible carers from hospital car park charges.”

I think I have sufficiently covered who that would apply to and why it is a dangerous path to go down. Clause 5 states that a person would be eligible for free hospital car parking if they are assessed by a local authority under section 10(5) of the Care Act 2014, and it would change the provisions of that Act. It therefore seems to me—perhaps the hon. Lady will correct me—that under clause 5 eligibility could be granted on an intention to provide care, rather than someone actually being a carer. I am not sure how well that has been thought through.

[Mr Rees-Mogg]

Can my hon. Friend explain whether under clauses 2 and 5 somebody can quality for this allowance but not be eligible, or be eligible but not qualify?

[Mr Deputy Speaker]

If the Bill goes to Committee, such points can be teased out and straightened out there, rather than on the Floor of the House today.

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[Mr Mahmood]

I wholly agree with my hon. Friend. The services that carers provide are really beyond the call of duty and any compensation they might receive would not account for that. They provide huge support to nursing staff pressed by the shortages that currently exist in our hospitals. The huge amount of support and love they provide comes at great financial cost, and that is why I support the Bill. They are making a huge contribution to society, as well as to the people they support.

The hon. Member for Shipley went around the issue of parking about 25 times and back again, but the questions he asked were not substantive. As Mr Deputy Speaker helpfully pointed out, if he and his colleagues are really interested in this subject, they can sit down in Committee and raise the issues there rather than breaking down the issues in the Bill at this stage, which is their intent. Carers in their constituencies should take note of that and hold them to account.

Parking charges are excessive. This is not the first time I have raised this issue. I have raised it a number of times in Birmingham, because it affects the people who are least able to pay. The biggest issue is how to have some sort of discount. Offers are available, but they are hardly ever advertised and people are not aware of them. Many hospitals employ private contractors and it has been claimed that it is very easy to negotiate with them, but it can be very difficult to go through the bureaucracy to get that discount. The hon. Member for North East Somerset (Mr Rees-Mogg), who is no longer in his place, talked about human rights. It is interesting to hear a Conservative Member talk about human rights, but what did he do? He talked about the human rights of the car parking contractors. These are the people who drive around in Porsches with special number plates. That is what Conservatives believe in. The real issue is support for carers. They are the ones who need support.

Comments have been made about the technicalities of sorting out carers’ parking. That is not the problem. Who comes in and who goes out can be verified, and that currently happens. The hon. Member for Solihull (Julian Knight), who is also not in his place, mentioned problems associated with city centre hospitals. There are procedures that deal with that quite easily. The Bill would not make parking free for everybody. Tickets would be validated only within the hospital. People could not park and then go off to the city centre to go shopping. A huge number of red herrings have been raised by those on the Government Benches. The intention of the Bill is clearly to give very vulnerable people more of the support they need. Carers in the north-west are not paid a huge amount. They do the job because they want to support the people they are caring for. That is the main issue. That is the problem.

Contractors make a huge profits. There has been a national campaign in the newspapers and we should back it. I see the hon. Member for North East Somerset is back in his place. He wants the human rights of parking contractors to be considered over the human rights and liberties of carers.

[Mr Rees-Mogg]

Will the hon. Gentleman give way?

[Mr Mahmood]

I am not going to give way to anybody on the Government Benches. They have wasted enough time, so I will not indulge them.

We have to support this important Bill, because it would provide support to the people who pay in a huge amount to society. I was glad to hear Conservative Members talking about using public transport. The problem with public transport is that services do not run as well as they should. They do not run late, so somebody receiving dialysis in the evening may not be able to manage and carers may not be able to get a bus at that time. If no buses are running they will have to pay for a taxi, which is a lot more expensive. People use their own cars because of the equipment they might sometimes need to carry or if they have to drive their children. Some carers bring their children into the unit—the children can sit and do some work while the dialysis take place—because there is no one else to provide childcare.

These are all very significant and important issues and concerns. The Bill is a small measure. People say the NHS will go bankrupt, but the money generated does not go back to the NHS; it is paid to private contractors who hold the car park licences and make a huge amount of money, as has been pointed out in the newspapers and by the national campaign. That is the real issue and we need to deal with it. We need a lot more action, rather than the huge amount of jaw that has, and will, be expended by other Members. We should have a vote and show our support for carers. They care for the most vulnerable and they are sometimes the most vulnerable themselves.

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[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.

--- Later in debate ---

[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.