Hospital Parking Charges (Exemption for Carers) Bill

Lindsay Hoyle Excerpts

Friday 30th October 2015 Commons Chamber

[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.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I do not think we need to worry too much about going over the capacity of 100%. We need to concentrate on the Bill and worry about carers’ parking.

[Philip Davies]

I very much agree, Mr Deputy Speaker. I will move on. I will discuss how it might work with my hon. Friend in the Tea Room afterwards.

[Mr Chope]

If there is increased demand for car parking spaces at hospitals and it is desirable that those hospitals provide extra provision, that has to be paid for. How will it be paid for?

[Mr Deputy Speaker]

I do not think that is our worry for today.

[Philip Davies]

Whether it is or not, Mr Deputy Speaker, I will move on.

I asked my local hospital how many carers already use its car parking spaces, which very much is our concern today. It replied:

“The Foundation Trust is currently unable to determine how many carers use the designated hospital car parks. It would therefore be difficult to assess the potential impact on car parking revenue”.

That goes some way towards answering the question my hon. Friend the Member for Christchurch asked. The honest answer is that we do not know what the impact will be on any particular hospital. My local hospital certainly does not know.

[Julian Knight]

My hon. Friend is making the important point that his foundation trust does not know how many carers park at the hospital. I have asked similar questions and have not received any answers. That shows that we do not know how much the Bill would cost the country if it were put in statute.

[Mr Deputy Speaker]

In fairness, we have had an hour of explaining that we do not know the cost. I am sure that we do not want to rerun that.

[Philip Davies]

Absolutely, Mr Deputy Speaker.

Although there are no official statistics on this matter, in the NHS car parking impact assessment for 2009, the Department of Health provided an estimate of the revenue raised from hospital car parking charges as a whole, which was in the range of £140 million to £180 million. University Hospitals Birmingham NHS Foundation Trust raised £1.5 million from car parking in 2004-05. This measure would clearly leave a substantial hole in NHS hospital budgets.

As I have made clear, one consequence of the Bill would be increased car parking charges for people who do not apply for the free parking. One of my concerns is that we have already seen considerable increases in car parking charges at hospitals. Wye Valley NHS Trust has increased its average hourly rate from 33p in 2013-14 to £3.50 in 2014-15. I would be loth to put any additional cost on people who are using that car park. The Whittington health trust in London doubled its average hourly rate from £1.50 to £3, and Medway Maritime hospital in Gillingham increased its price for a five-hour stay from £5 to £8. Given that we are already seeing such huge increases in parking fees, I would not want to pass a Bill that would see people paying even more.

That point was highlighted by the British Parking Association in 2009, following the scrapping of hospital car parking charges in Scotland. It said:

“Car parks need to be physically maintained, somebody somewhere has to pay. Charges were not introduced to generate income but rather to ensure that key staff, bona fide patients and visitors are able to park at the hospital. Without income to support car park maintenance…funds which should be dedicated to healthcare have to be used instead.”

[Barbara Keeley]

On a point of order, Mr Deputy Speaker. The hon. Gentleman has been speaking for an hour and nine minutes, and we are now getting a lot of repetition. Many other people want to speak.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

In fairness, it is for me to decide whether there is repetition. I certainly do not need any advice. You should not be questioning the Chair’s ability to hold the speaker to account. I am sure that Mr Davies is well aware that many people wish to speak and that he wants to hear those other voices. He is in order, but I am worried that we will get into repetition. I certainly do not want to get bogged down in the maintenance of Scottish car parks. I am sure that he will move on quickly.

[Philip Davies]

I am grateful for that guidance, Mr Deputy Speaker. The hon. Lady has intervened on me more often than anybody else, which has held me up in making my remarks. My advice is that if she wants me to crack on, she should not keep intervening on me so that I have the opportunity to do so.

A big geographical inequality would result from the Bill because car parking charges vary wildly from one part of the country to another—from £4.26 in the north-east to £11.85—

[Mr Deputy Speaker]

Order. The hon. Gentleman has given a great number of examples. I do welcome examples, but there is a limit to how many we need. I think that people can get a flavour of the arguments from the examples he has used. Hopefully he will bring something new to the Chamber. If not, I am sure that he would like to hear somebody else. I am sure that some of his colleagues are desperate to speak.

[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.

[Philip Davies]

Thank you, Mr Deputy Speaker. Again, I will move on.

As the Torbay scheme is the nearest to the one that the hon. Member for Burnley proposes, I asked some questions through freedom of information requests about the impact and take-up of the scheme. I asked how many people had used the scheme since it was introduced, and the reply from Torbay was:

“We are unable to provide you with the information requested as it is not held electronically or in a central location. We do not record the details of carers, only a verification that they are on the register.”

We do not even know how many people take up the scheme that has been introduced.

--- Later in debate ---

[Philip Davies]

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

[Mr Deputy Speaker]

Order. May I just say that we have covered Torbay? The hon. Gentleman has moved on, but unfortunately the hon. Member for North East Somerset (Mr Rees-Mogg) keeps wanting to drag him back to what he has already covered. I know that he does not want to go back to that.

[Philip Davies]

I am pleased that you have acknowledged that I am being led astray, Mr Deputy Speaker.

[Mr Deputy Speaker]

But a little bit too easily.

[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.

--- Later in debate ---

[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.

[Philip Davies]

My hon. Friend makes an interesting suggestion. I contend that the Bill is so flawed that it cannot be rescued in Committee, or that rescuing it would involve filleting it to such an extent that it would come out barely recognisable, which would be a pointless exercise. I appreciate that such issues could be considered in Committee—as ever, Mr Deputy Speaker, you are perfectly right.

Clause 7 says that the Act must come into force

“12 months after the day on which this Act receives Royal Assent.”

There are two pertinent points about that. If it is so unjust for carers to pay hospital car parking charges, how can the hon. Lady justify requiring them to pay charges for another year? Why not introduce the change much sooner? I think I know the answer to that question, and it reinforces my argument. I think the hon. Lady realises that the provisions in the Bill would be a logistical nightmare to implement, for some of the reasons that I have already mentioned—I am sure there are also many others. She probably realises that to make anything of the Bill it would require at least a year to come up with anything that makes any sense. It is interesting that such a measure is part of the Bill, and it justifies my concerns. The hon. Lady said that she would like the measures in her Bill to be extended in future to cover other people. She made the point that this is a good start—

--- Later in debate ---

[Mr Deputy Speaker]

Order. That is speculation for another day. We are dealing with the Bill before the House, not what might be before us in future. I know that the hon. Gentleman is desperate to hear the views of other hon. Members, and I am sure his colleagues are desperate to speak.

[Philip Davies]

I agree. This is hard work, Mr Deputy Speaker, and you are right—I am anxious to press on.

[Mr Chope]

Before my hon. Friend concludes, will he address clause 7(2) which states that the Act extends to England only? Does he think that, as with free school meals, there will be Barnett consequentials?

[Mr Deputy Speaker]

I reassure the hon. Gentleman that we are not going to open that can of worms today. Philip Davies, I know that you want to get beyond clause 7 and to your conclusion.

[Philip Davies]

I knew it was a mistake giving way to my hon. Friend, and that he would try to lead me astray once again. I will leave him to consider Barnett consequentials in his remarks—I am desperately trying to reach a conclusion.

I appreciate that the hon. Lady genuinely wants to help carers, and if the principle behind her Bill is to support carers, I will happily support that principle. However, of all the worthwhile issues and campaigns championed by different carers organisations and charities, it seems that she has picked the one dud. I would have been happy to support many other campaigns for carers had she raised them. For example, parent carers could be offered an assessment rather than having to request one for their children, and we could introduce measures such as:

“Clear recognition in law that parent carer assessments and services must have the promotion of their well-being at the heart of what they do.

Consolidation of legislation on parent carers from three different Acts”.

I would have been prepared to support such worthwhile campaigns to help carers, but I fear that the hon. Lady has picked the wrong campaign. For future reference I urge her to consider some of the other campaigns that carers organisations would like to be raised. I think she would get a lot of support from across the House and—I hope—from the Government.

In conclusion, the Bill is ill-thought through and many areas are far too vague. It will be a logistical nightmare to enforce and implement, and it would cost NHS trusts up and down the country millions of pounds, forcing higher charges on other visitors, or risking patient services. It would exempt a lot of people who are just as worthy recipients of parking concessions—I think that the Government’s guidance on hospital car parking is far more sensible than the provisions in the Bill, and they encompass more people who deserve to be considered. Hospitals already have power to implement the policy suggested by the hon. Lady if they wish, and perhaps on reflection she should go away and come back at some point in future with a different Bill. I have not mentioned the money resolution consequences of this Bill, but I hope that others will consider that issue. I have not seen any money resolution proposals.

Finally—very finally—I have people visiting Parliament today, so I apologise in advance if I cannot be here for the entire debate. I will try to stay for as much as possible because it is an interesting discussion.

[Mr Deputy Speaker]

Don’t let us disturb you. I think your guests are waiting for you.

[Philip Davies]

Perhaps they are, perhaps they are not—I do not know. I genuinely wish the hon. Lady well in her time in the House, and I do not doubt the worthy sentiment in this Bill. We all support what carers do in this country, but I think the Bill is misguided.

--- Later in debate ---

[Mr David Nuttall (Bury North) (Con)]

It is a pleasure to follow the hon. Member for Birmingham, Perry Barr (Mr Mahmood), who gave us his take on the Bill, although I feel the matter is a little more complicated than he would have the House believe.

I congratulate the hon. Member for Burnley (Julie Cooper) on coming fourth in the ballot for the right to bring in a private Member’s Bill—as a new Member entering the ballot for the first time, she has done very well indeed—and on choosing such an important topic. I do not know if she does the national lottery, but if she does—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Obviously, congratulating the hon. Lady is a good way of taking up time, but actually I did the draw, so if the hon. Gentleman is going to congratulate anybody, I think it should be me. However, I do not want us to get bogged down in that, because I know he wants to get straight into the Bill, on which I would welcome his comments. I know he would rather talk about the Bill.

[Mr Nuttall]

Of course, you were there, too, Mr Deputy Speaker, doing the draw, and very well you did it as well. As you know, however, because it is done in reverse, coming first actually means coming 20th.

[Mr Deputy Speaker]

Order. Let us leave it there for today.

[Mr Nuttall]

I will move on.

This is the first Bill to come before the House for its Second Reading since the new Standing Orders were introduced last week on what generally is referred to as “English votes for English laws” but what I prefer to call, more accurately, “English vetoes for English laws”. The new Standing Orders make it clear that the new procedures do not apply to private Member’s Bills, but it is worth noting—

[Mr Deputy Speaker]

Order. They do not apply to private Members’ Bills, so we do not need to discuss them. Seriously, a lot of Members still wish to speak, and I do not want any filibustering. I know that people are interested in the Bill and want to concentrate on it.

[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.

--- Later in debate ---

[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?

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I think we have heard this question before. Mr Davies was asked whether staff would be taken from the front line. We are going over ground that has already been covered. This is about a Bill, about car parking, and about the benefit of carers. What I do not want to do is become involved in speculation. We are not here to speculate about the future.

[Mr Nuttall]

I was about to say exactly the same thing, Mr Deputy Speaker, but I do not think that my hon. Friend the Member for Solihull (Julian Knight) was in the Chamber when someone made what I agree was a very similar point. I will merely say that, undoubtedly—I think that Members in all parts of the House will agree with this—the scheme will have to be administered somehow. It is not going to run itself. Someone, somewhere, will be required to run it, either someone new who has been brought in or someone who is currently doing another job in the hospital.

I do not know whether, as part of her preparation for the Bill, the hon. Member for Burnley ascertained how many national health service trusts in England might have to alter their price structures—that is, increase their parking charges to avoid falling foul of the income- generation principle—if the number of exempted carers were to be as significant as it appears. I do not know whether she proposes to scrap the principle of not running a scheme at a loss, as required by the 2006 guidance from the Department of Health. The NHS Confederation, which is the membership body for some 500 organisations that plan, commission and provide NHS services, says:

“NHS principles and Government policy are clear that healthcare is funded through taxation, not through patient charges. Surpluses from parking charges should only be a by-product of covering costs and managing space fairly.”

Most trusts make it clear that the income they receive from car parking charges goes towards covering the maintenance of the car park: for instance, the security, facilities and staff. To be specific, we are talking about the ongoing costs of anything from lighting to CCTV, footpath and cycle path maintenance, car park surfacing, and the employment of enforcement and security staff. If there is any money left over—and some trusts have no surplus from their car parking—it must, in accordance with the guidance, be used to improve local health services.

The Government have already been active in ensuring that information about parking is made very clear to members of the public, and I think it perfectly fair and reasonable to require trusts to ensure that that information is clearly visible on websites and in patient information in, for instance, letters. Patients are entitled to the reassurance of knowing that the purpose of the car park charge is not to provide the NHS with an additional, excessive income stream, but to provide for the car park in the first place. Charges, therefore, are used primarily to cover the running costs of the car park, and if there is a surplus, it cannot be used for other pet projects.

I referred earlier to the 2009 NHS car parking impact assessment. The then Labour Government commissioned the detailed, 61-page assessment of the costs of introducing free car parking. It concluded:

“On the available evidence there is scope for this policy to have both a positive and negative impact, both for older people and the disabled.”

Despite that rather mixed finding, Labour’s 2010 manifesto pledged to scrap hospital car parking charges. Five years later, however, at the time of this year’s May general election, Labour appeared to reverse its view, and to decide that the policy was unworkable. I look forward to hearing from the shadow Minister later whether that is still the position of the official Opposition. In fact, the Bill runs contrary to the principle that individual trusts feel that it is right to set parking charges according to their own financial situations. Only yesterday it was reported that the Oxford Health NHS Foundation Trust was consulting on the introduction of parking charges at its community hospitals.

What are hospital car parking charges actually paying for? That is a perfectly legitimate question for people to ask. It is reasonable to say that visitors and patients do not generally have a great deal of choice when it comes to parking at a hospital. There is usually just one car park operator, and patients, staff and visitors are therefore a captive audience. In some town centres, one might be fortunate enough to have the choice of a cheaper place in which to park, but for hospitals there is no market incentive to keep costs under control.

In December 2010, the British Parking Association, which is the largest professional association in Europe representing parking and traffic management organisations, released a charter of best practice for parking in hospital car parks. Understandably, given the large number of disabled users, it set high standards. The Charter for Hospital Parking stated that hospital parking operators should provide

“good lighting, high standards of maintenance for structures and surfaces, payment systems and equipment that are easy to use and understand, signs that are clear and easy to understand”

and

“clearly marked parking bays.”

Patients and visitors will understandably want a safe and secure environment in which to park when they go to their local hospital, or, potentially, a hospital that is out of their immediate area if they are receiving specialist treatment. As Carers UK points out, attending hospital can be a stressful experience for patients and visitors. The last thing they want is to have their car broken into, or to spend 20 minutes driving round in circles because entrances and exits are not marked properly, or to be stuck facing a ticket machine that does not work with the threat of an unfair penalty charge looming. Patients, and their carers, visitors and staff, will quite reasonably expect a properly maintained car park with proper lighting and adequate security, along the lines of what is set out in the charter, whether the purpose is to guide a daytime visitor with proper and effective signage or to protect the doctor or nurse who gets into the car at 3 am in the dark after a long shift.

The charter also states:

“Parking charges can help to pay for maintenance and management services, and prevent these from becoming a drain on healthcare budgets. Therefore, we encourage NHS Trusts and car park operators who manage hospital car parks to sign up to this charter and to abide by its letter and spirit.”

So far, 24 hospital trusts have signed up to the charter.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. This is very worthy, and it is great to acquire this extra knowledge, but it is not really anything to do with carers. The hon. Gentleman has got on to nurses and lighting, and I understand all that, but, worthy as it is, it is not in the spirit of what we are meant to be discussing.

[Mr Nuttall]

Parking places are finite, Mr Deputy Speaker. If the Bill encouraged more carers to visit hospitals, which is what I think would happen, it would make it easier for them to gain access to car parks, and one consequence of that might be a knock-on effect on the income that would—

[Mr Deputy Speaker]

Order. I understand the point that the hon. Gentleman is trying to make, but it has already been well thumbed. As the hon. Gentleman knows, it was covered very thoroughly by Mr Davies, and I do not want him to repeat everything that Mr Davies covered. I think that, in his hour and a half, Mr Davies did not leave a lot of scope, but this is one point that he made sure we were well aware of.

[Philip Davies]

It is worth repeating.

[Mr Deputy Speaker]

Only in your opinion.

[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 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.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The question is not how people get into a car park; it is whether there is free concessionary parking for carers. We are dealing with that, not the detail of how we get there. Obviously if the Bill were to go into Committee, these would be the areas that Members would want to cover there. I want to concentrate on where we are now and how we keep to where we want to be within the Bill.

[Mr Nuttall]

I will move on from that detail. I accept it is a detail, but it is an important detail.

[Mr Deputy Speaker]

Order. I agree, but we have heard about all the different scenarios previously and in detail. That is what worries me. We can get bogged down in repeating details, and I know the hon. Gentleman does not want to do that.

[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.