Hospital Parking Charges (Exemption for Carers) Bill

Debate between Julian Knight and David Nuttall

Friday 30th October 2015 Commons Chamber

[Mr Nuttall]

There is always a danger with any scheme, as with the blue badge scheme, that some people will try to use it for their own ends. I hope it would be only a minority, but that danger exists. The assessors would need to be aware of that; they would need to be constantly on the lookout for people who were not genuine cases. That is what I think my hon. Friend is getting at—that some people might “try it on” to their own advantage.

Given that there are no explanatory notes and no impact assessment for the Bill, it is worth considering what has been done in the past. Fortunately, under the last Labour Government, an impact assessment was done—the NHS car parking impact assessment, which was published in December 2009. It estimated that there were 46 million in-patient visitors a day. We do not know how many of them are carers, but as we shall see, car parking charges vary significantly around the country. Regardless of the precise number, it is inevitable that one consequence of the Bill would be to divert part of the healthcare budget that could otherwise be used for front-line national health services—potentially life-saving services—to cover car parking maintenance and all the associated costs ranging from maintenance to administration and dispute management.

The Bill places Members here in the unenviable position of being asked to single out one particular group of people as being more deserving of financial assistance than any other. Without an exact number of those eligible for exemption, it is difficult to know how much money we are talking about in each area that the Bill would take out of the healthcare budget.

At the Bill’s heart is the principle of whether it is right to charge for parking at a hospital or other healthcare facility and, if so, which if any group should be exempt from those charges. I appreciate that some of the public—perhaps virtually all the public—take the view that charging to park a car at a hospital is simply an attempt to make a profit for greedy hospitals or, worse still, for nefarious parking companies. If that were the case, I suspect there would be universal condemnation of such a practice, but of course it is not the case.

Hospital car parking charges in our national health service are what are called “an income-generation scheme”. They are not just an extra-revenue scheme for hospital managers to provide comfier chairs or profit for private parking company executives to fund their jollies to the Seychelles. In 2006, the Department of Health issued guidance called “Income Generation: car parking charges —best practice for implementation”, which was subsequently revised in the same year. This guidance clearly states that to qualify as an income-generation scheme, the scheme

“must be profitable and provide a level of income that exceeds total costs. If the scheme ran at a loss it would mean that commercial activities were being subsidised from NHS funds, thereby diverting funds away from NHS patient care. However, each case will need to be assessed individually. For example, if a scheme is making a substantial loss then it should be stopped immediately.”

If a scheme such as car parking charges at an NHS hospital ran at a loss, it would not be acceptable. The Department of Health’s guidance goes on to state that

“the profit made from the scheme, which the NHS body would keep, must be used for improving the health services”.

The current guidance therefore prevents public money that should be used for patient care from being used to subsidise a loss-making scheme.

Clearly, if the Bill became law, it would inevitably affect the amount of income that a scheme would generate, meaning either that there would be knock-on effects for other users of the car park who are paying for it or that the health authority would be faced with the question of whether to start to subsidise it. It cannot do so because of the guidance, thus raising the question of whether the guidance would need to be revised in the regulations anticipated in the Bill. It is a principle that the Bill could reverse or it could open a door to making such a change.

[Julian Knight]

My hon. Friend is providing a forensic discussion of the Bill and all its parts. Does he agree that we could end up with hospital trusts seeing staff members taken off the front line in order to administer these schemes, or even with administration staff, who would be better deployed in the hospital, being brought in to ensure that the right people get the free hospital parking?

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[Mr Nuttall]

I want to move on to the devolution of healthcare. It was only very briefly touched on earlier, but it is of particular significance to my constituency, because, as Members will be aware, it is proposed to devolve healthcare to Greater Manchester. From April next year, it will be the first English region to get full control of its health spending. The situation in this regard is not at all clear. The Bill states that it will apply to the whole of England, but if healthcare is devolved, will Greater Manchester be exempt on the same basis that Scotland and Wales are exempt? Healthcare spending has been devolved to those countries and they are then excluded from this Bill.

[Julian Knight]

It is very interesting that my hon. Friend mentions devolution in this context. Should there be devolution from next April in the Greater Manchester area and if this legislation were introduced soon afterwards, could the numbers that devolution has been predicated on no longer be correct? Could we have to go back to the drawing-board in terms of Manchester devolution and how the finances are worked out in respect of hospital parking charges?

[Mr Nuttall]

I will not go down that road, Mr Deputy Speaker, although my hon. Friend has made a good point. His area could well be affected by any future devolution.

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[Julian Knight]

Thank you, Madam Deputy Speaker. I will now address only the Chair using that particular word.

I congratulate the hon. Member for Burnley, but unfortunately I cannot support the Bill. However, like my hon. Friend the Member for Shipley (Philip Davies) and many other Members who have spoken, I support the fairer hospital parking that she is trying to achieve. I want to share my experience in Solihull as a campaigner for fairer hospital parking, as it has direct relevance to how we approach the issue as a country and to the Bill.

Many hon. Members have mentioned their hospitals and the experience they had when parking charges were introduced. For my constituents in Solihull, parking charges were introduced not only to bring extra revenue into the NHS and front-line services but to ensure that hospital car parks were free for the use for which they are intended. We have had many difficulties in Solihull because the hospital is located near the town centre and, as that is a popular area, people have used the car park all day while they have been shopping. Many people who needed to use the facility at the hospital were therefore unable to do so and might have parked illegally, receiving fines at a later date. Hospital parking charges, although very unpleasant, are in many cases necessary, particularly at sites close to town centres. As we live in a very densely populated country, there are not many hospitals that are so far from town centres that it would be an easy win not to have any charges whatsoever. The car parks might still be misused in the way that I have explained.

Over time, hospital parking charges have grown exponentially. At the moment, in the three hospitals that make up the Heart of England NHS Foundation Trust—Solihull, Good Hope and the Heartlands—charges can be up to £5.75, but for just one hour they can be £2.75. Again, people have to guess how long they will stay, which is unfortunate. I have looked at the contracts that our local hospitals have signed and in my view there is an excessive charge on the provider from the private companies involved. I am not happy with many aspects of these contracts.

[Mr Nuttall]

My hon. Friend says that he has looked at these contracts. Has he noticed how long they were for? I am rather concerned that if the Bill is introduced, it would affect the viability of those contracts.

[Julian Knight]

My hon. Friend makes a good point. There are often penalty charges which would mean unintended consequences if the Bill came into law and a real hit to the bottom line for our hospitals.

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[Mr Nuttall]

Does my hon. Friend not fear that the Bill might make things worse for members of the group?

[Julian Knight]

My hon. Friend makes a good point. The wording of the Bill and the fact that it covers just one narrow group could mean that charges go up for other groups that are not covered by it. That is an unfortunate and unintended consequence.

I have helped to lead the way with the campaign in Solihull, but it has been about individual engagement with the hospital trust rather than introducing national legislation and a one-size-fits-all policy. As we have explored in our discussions, hospitals have a great deal of discretion in the charges they can put in place. The August 2014 NHS patient, visitor and staff parking principles are much broader than the Bill in allowing people from different groups to have free or reduced hospital parking. As I see it, individual engagement is the way to go.

In Solihull, we have had many achievements through discussion and through highlighting particular issues. For example, earlier in the debate we discussed advertising and websites and it was pointed out that many people did not know what monthly or weekly concessions there are. I have urged my local hospital trust to improve the provision of that information and they have put the concessions up front and centre on their website, so it is now easy to see that information.

[Mr Nuttall]

The hon. Member for Heywood and Middleton (Liz McInnes) made the point that not everybody has access to the internet, particularly many elderly people. Does my hon. Friend agree that we should perhaps consider ensuring that information about car parking charges is included in every letter sent out offering an appointment at a hospital?

[Julian Knight]

My hon. Friend makes a good point and I have urged my hospital trust to make the information available not only online, which always seems to be the catch-all approach of any organisation, but in the hospital, so that patients and visitors do not have to come into the hospital and take up the time of staff and administration staff to clarify something that could easily be set out in a leaflet, a letter or a small poster by a desk.

In Solihull, a reduction in the price of monthly tickets and concessions was the direct response to the lobbying done by me and local councillors. We have also seen a doubling of the free parking time at Solihull hospital from 15 minutes to 30 minutes. At the hospital it can often take up to 15 minutes just to find a space, so I urged the trust to increase this time, and the Heart of England NHS Foundation Trust kindly saw fit to double the time. These are small wins, but they are an example of what can be achieved through individual engagement, by putting our case and understanding that there is not an endless supply of money and that we have to be sensitive to the bottom line—the finances of the NHS—because if we are not careful, we may end up depriving the NHS of vital cash.

My own Heart of England NHS Foundation Trust has a deficit—this is in the public domain—of £29 million for the first five months of the financial year. So seriously is this viewed that the management of the University Hospitals Birmingham has been brought in to help close the black hole in the finances. I welcome that move, but it shows that this is no time to destabilise NHS finances or those of individual hospital trusts in our areas.

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[Julian Knight]

I agree that we must value carers. However, the Bill is very narrow in its focus, whereas a much greater number of people could be covered by the guidelines and the NHS patient, visitor and staff car parking principles. There are opportunities to engage in our localities with our local hospitals and local hospital trusts in order to encourage them to expand existing provision. There is the possibility of working on a case-by-case basis, rather than by means of a rather blunt instrument. I take the hon. Lady’s point, but we should look at hospital car parking charges in the round, not just as they affect carers. [Interruption.] The Bill is about carers. The subject matter, though, is a much greater variety of people who use hospital car parks, including many vulnerable people, as we know.

I suggest that other hon. Members follow what has been done by my right hon. Friend the Member for Harlow (Robert Halfon), the Minister without Portfolio, and my hon. Friend the Member for Wellingborough (Mr Bone) and engage with the local hospital trust, put pressure on the trust and get it to reduce the complexity of charges and to ensure that when it puts charges in place, they reflect the local area. For example, I made a case to my hospital trust that we have three hours’ free parking at council car parks in Solihull, so why do people have to pay £2.75 for just one hour at the local hospital? Why is that not in tune with the local economy and the local environment?

More widely, on the people who are not covered by the Bill, I have mentioned those who may be covered by the NHS patient, visitor and staff car parking principles, but what about people who do not have a car? What about carers who travel by public transport? I was involved in a campaign in Solihull to help save the No. 73 bus service, which was a lifeline to Heartlands hospital. If it had been cancelled, people in Shirley in the west of my constituency would have had to travel by three buses in order to attend hospital appointments. If there is any extra money, surely it would be better for it to be directed at them as they are more likely to be on a lower income and potentially in a more vulnerable position than those driving and using the car park.

In conclusion, I welcome the sentiments of the Bill and I applaud the hon. Member for Burnley for introducing it. We have had a vigorous debate. There is a patchwork of provision and it is up to us as individual Members of Parliament, as well as local councils and bodies such as chambers of commerce, to come together in order to try to get the best possible deal for our area. That, in some instances, may include many more people than are the subject of the Bill.

[Mr Nuttall]

My hon. Friend touches on a key point, which I mentioned briefly—that is, there are competing pressures in different parts of the country, depending on whether a Member represents a rural area or an inner-city area.

[Julian Knight]

My hon. Friend makes a valuable point. In his speech he also touched on devolution. In my area we have the West Midlands combined authority coming to the fore. Although it does not currently have responsibility for NHS provision, that may come down the track towards us, as in the case of Manchester, which takes charge of its NHS in April 2016. The concern is that although these devolution packages are very tightly costed, if we suddenly add an extra expense in the form of NHS provision and take away a valuable income stream, that may damage the devolution project and other services may end up being cut.

I support the intention of the Bill and the heartfelt efforts of the hon. Member for Burnley, but it does not take account of an approach that I prefer—local engagement and following the guidelines, which are much more wide ranging than those in the Bill.