Patient Transport Volunteer Drivers

Jamie Stone Excerpts

Monday 23rd April 2018 Commons Chamber

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I thank you, Mr Speaker, and all those Members who have remained at this late hour. In a way, my contribution tonight feels not unlike my maiden speech, because it is necessary to frame what I will say with a kind of tour d’horizon, because as Members will understand, the horizons in my constituency are massive. It is the second biggest in the UK—it is truly huge. The sheer distances involved in travelling in the highlands always come as a surprise to people who do not know the area.

As I have said in the Chamber before, a simple hospital appointment for my constituents living on the north coast can involve a return trip of well over 200 miles from the north coast to Raigmore Hospital in Inverness. In a part of the world where there is extremely limited rail travel, from Wick and Thurso going down the east coast to Inverness, and where buses are sporadic at best, my constituents have little choice other than to rely on the good old-fashioned motor car—either their own or private cars driven by volunteer drivers.

[Christine Jardine (Edinburgh West) (LD)]

My hon. Friend mentions the distances involved. Does he agree that in Caithness, Sutherland and Easter Ross, as in many other parts of Scotland, it is not simply the distance, but the fact that the roads make the journey even more difficult? Often we are talking not about dual carriageways, but about roads that are single track, and no more, and extremely difficult to travel on.

[Jamie Stone]

My hon. Friend makes an extremely good point. She holidays in Portmahomack and will know, as well as I do, that in winter weather, some of these roads can be absolutely impassable.

I want to read from an email that I was sent by a constituent of mine called Fiona who lives in Durness in north-west Sutherland. She wrote:

“I currently have an 83 year old neighbour who has had a stroke, has memory problems as well as other medical conditions and lives alone with no family in the area. He is having investigative work done at Raigmore”—

the hospital in Inverness—

“and 4 times I have tried (very hard) to arrange a hospital car for him. I have yet to be successful and end up taking him there myself. It is physically impossible for him to make the journey by public transport for his timed appointments even if he was physically fit!”

I think that sums up the nature of the problem in my constituency.

[Jim Shannon (Strangford) (DUP)]

Does the hon. Gentleman not agree that the current trend of closing down small hospitals and creating centres of excellence that are miles away from rural communities makes it difficult for those taking loved ones on long journeys for necessary treatment? People should not be penalised for living in rural areas, such as those in my constituency of Strangford in Northern Ireland.

--- Later in debate ---

[Jamie Stone]

That is absolutely correct. The hon. Gentleman and I have to be careful about straying into devolved areas, but the fact is that the NHS changes that are happening in our constituencies impact on people. We can say it is devolved, but nevertheless, the two of us represent our constituents and are bound to take up their issues, and, as best we can within the rules of devolution, air them in this Chamber.

I mentioned volunteer drivers a minute or two ago, and they are the people I wish to draw to the attention of the House tonight. That is the peg on which I hang my hat, because one has this balancing act between what is devolved and what is reserved to Westminster.

[Mr Alister Jack (Dumfries and Galloway) (Con)]

Does the hon. Gentleman agree that without proper reimbursement for volunteer patient transport drivers, we are at risk of having a deeply unfair postcode lottery in which people in rural and remote areas lack the access to the healthcare that they are entitled to?

[Jamie Stone]

The hon. Gentleman makes a sage point, which I will come to shortly. The issue is the taxation regime—it is a UK function, hence it being the peg on which I hang my hat—that applies to these drivers. I shall describe the problem. In 2011, the then Chancellor, George Osborne, set thresholds and payments for volunteer drivers that would not incur additional taxation over and above their PAYE. These rules, which still govern us today, were: a reimbursement of 45p per mile for the first 10,000 miles and of 25p per mile for any additional miles.

I shall work that into a typical example of a volunteer driver in my constituency. In my part of the world, it would be no surprise if a driver did as many as 50,000 miles a year—believe it or not—driving patients to and from their much-needed appointments. As I have said, he or she receives the higher rate of 45p for the first 10,000 miles and then the lower rate of 25p for the following 40,000 miles. As Members will understand, it does not take a financial genius to work out that the reimbursement for these higher mileages represents a net loss for the driver. It is for this reason that for far too long volunteer drivers have sadly been packing it in—giving it up. As I say, this is particularly worrying in constituencies such as mine where we have huge issues of distance, inclement weather and so on. Where a volunteer driver continues to drive and accept this taxation regime, just one 200-mile return trip a week will take them in a year up to the 10,000-mile point.

This was for a long time a big issue for me during my time as a Member of the Scottish Parliament, and every time I raised it in Holyrood with the Scottish Government, they would say—with truth on their side—“We’re sorry but this is a matter for Westminster”. I am here now—some might say by a dreadful accident of the electorate, but there we are—and it is precisely because it is a matter for Westminster that I raised it with the Leader of the House not very long ago. It is also the reason I applied for this debate—and now I have been lucky enough to be chosen to place the issue before Members tonight.

It would be easy for me to say to the Minister, “Will Her Majesty’s Government please go away and think about it?”, but I know from previous ministerial responses that he might well respond, “If the volunteer driver thinks he is losing money on this deal, he can always present his books to Her Majesty’s Revenue and Customs and say, ‘You’re being unfair to me’”. But let’s face it: how many volunteer drivers have such a detailed grasp of accountancy or the time to do that? It would take up too much of their time or be beyond their capabilities. They just want to get on with helping their friends and neighbours get the medical treatment they need.

I have instead a suggestion for the Treasury—if it chooses to take it apart, so be it, but I will argue my corner. It seems extraordinary that the 10,000-mile threshold and the rate of reimbursement have not been looked at since 2011, when George Osborne put in place the current arrangements; it was seven years ago. If nothing else, surely the time is now right for the matter to be revisited. One way forward would be to raise the threshold to, say, 15,000 miles—or another figure that Her Majesty’s Government might suggest. The beauty of this is that, while it could be argued that other drivers—for instance, employees using their own cars for business, which is governed by the same taxation law—might be tempted, in a bad world, to incur extra mileage to ramp up their income, a simple change in taxation rules to recognise the specific and special role of NHS volunteer drivers would be a safeguard and could easily be written into law.

Sticking to volunteer drivers, some have expressed the fear that increasing the threshold might encourage NHS drivers in urban areas, or perhaps in the home counties of England, to up their mileage to cash in, but there are only so many working hours in a day and one can only drive for so long in a day. As a highlander who has come down to these strangely populated parts of England, I have discovered it can take an awfully long time to travel from A to B, even when the mileage is comparatively short, owing to urban hold-ups and so on.

[Nic Dakin (Scunthorpe) (Lab)]

There are lessons to be learnt from northern Lincolnshire, where Thames Ambulance Service Ltd took over the contract and changed the arrangements for rewarding volunteer drivers, as a result of which the whole contract became very difficult to run. I congratulate the new chief executive on changing the arrangements again, as a result of which volunteer drivers are now coming back. As the hon. Gentleman has said, they make a big contribution to the health service, and they need to be properly remunerated.

[Jamie Stone]

I thank the hon. Gentleman for his intervention, which was thoughtful and to the point. Ultimately, however, whether the matter is devolved or reserved, I am left with the problem of trying to help people whom I know and love to reach hospitals and medical centres so that they can be given the treatment that they need.

[Douglas Ross (Moray) (Con)]

I am grateful to the hon. Gentleman for securing a debate on such an important issue. I was concerned to hear about the volunteer drivers who have given up driving for the reasons that he has explained. Does he agree that it is not just their driving that we lose, but the extra service that they provide? The drivers who work for the Speyside community car sharing scheme in Moray do not just drop people off at the doctor’s surgery or the hospital and then pick them up again; they wait for them, and take them back to their homes to ensure that they are safe after what can sometimes be a traumatic experience.

[Jamie Stone]

That point is incredibly well made. The hypothetical Mrs Mackay who goes to Moray or Caithness, Sutherland and Easter Ross will know the local people. She will know, when she picks up Mrs Mackenzie, that she may have forgotten to take her heart tablets with her. That is crucial. Local knowledge will also inform her if Mrs Mackenzie has been bereaved, or if there is some difficulty in her family. That makes life so much better.

At the end of the day—and at the end of this day, too—patient transport in my vast and beautiful constituency is exceedingly challenging. I acknowledge that. However, no challenge should be ducked, and I think that sensitive law making can take on some of the nuances. I am bound to say that, in my 11 months in this place, I have been grateful to Her Majesty’s Government for their recognition that I represent a very remote and rural part of Scotland and of the United Kingdom, with a fragile economy. I look forward to the Minister’s reply, and I stake my claim for the future by saying that I should be more than happy to meet him, talk about this problem, and work towards a constructive solution as the days, months and years go by—although I hope that it will not be years.