Cervical Cancer Screening

Lindsay Hoyle Excerpts

Thursday 1st May 2014 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Jane Ellison)]

I congratulate the hon. Members for Wirral South (Alison McGovern) and for Liverpool, Walton (Steve Rotheram) on securing and leading this debate. We all wish that we were not debating this issue, important though it is, against such a tragic backdrop. I share the view of the hon. Member for Wirral South that it is a great innovation that, through e-petitions and the Backbench Business Committee—she knows that I used to serve on that Committee—we can now bring issues of such huge public concern swiftly to the House for debate.

This has been an excellent debate, and I thank all Members for their contributions. Depending on how tolerant Mr Deputy Speaker is feeling, I may not get the chance to address all the points that have been raised, but I hope Members know that I will, as I always commit to, respond to them after the debate.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The Deputy Speaker is always generous in the time that he gives but, recognising that there are constraints, I welcome those comments.

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[Sadiq Khan (Tooting) (Lab)]

On a point of order, Mr Deputy Speaker. You will be aware that we on the Labour Benches have on a number of occasions expressed concern about the Government’s policy on legal aid and its consequences. This morning His Honour Judge Leonard QC sitting at Southwark Crown Court stayed proceedings in the Crown v. Crawley and others, a £4.5 million fraud trial, after he heard representations from one of the country’s leading and most respected QCs that the case should not proceed, as a fair trial was not possible because of the consequences of the legal aid changes introduced by the Lord Chancellor.

This case alone has cost the taxpayer tens of thousand of pounds and justice has not been done, but it is extremely serious for the criminal justice system in this country, which has not just been brought into disrepute, but is now rendered ineffective by a Lord Chancellor who is out of his depth. [Interruption.] I understand that there are at least eight other complex criminal cases, including—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Mr Swire, I will make the decision. We do not need any help from the Front Bench.

[Sadiq Khan]

That demonstrates the respect that the Government have for the justice system.

I understand that there are at least eight other complex cases, including those relating to the LIBOR fixing scandal, where barristers of sufficient expertise have not been found. Mr Deputy Speaker, have you received any indication from the Lord Chancellor that he intends to make a statement today to the House about the consequences of the judgment for the criminal courts, and his proposals to remedy the crisis he has caused in the court system?

[Mr Deputy Speaker]

I can assure the right hon. Gentleman that I have had no indication that anybody from the Ministry of Justice team is coming to make a statement. It is not a matter for the Chair, but it is certainly on the record and people are now aware of it.

Care Bill [Lords]

Lindsay Hoyle Excerpts

Tuesday 11th March 2014 Commons Chamber

[Jeremy Lefroy (Stafford) (Con)]

I beg to move, That the clause be read a Second time.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

With this it will be convenient to discuss the following:

New clause 16—Powers of local commissioners in relation to TSA recommendations—

‘(1) In section 65DA(1) of the National Health Service Act 2006 (Chapter 5A of Part 2: Objective of trust special administration) omit “objective” and insert “objectives” and omit “is” and insert “are”.

(2) After subsection (1)(a) insert—

“(b) the continued provision of such of the services provided for the purposes of the NHS by any affected trust at such level, as the commissioners of those services determine.”.

(3) After subsection 1(b) omit “(b)” and insert “(c)”.

(4) In subsection (2) of that section after “The commissioners” insert “of the trust in special administration and any affected trust”.

(5) In subsection (4) of that section after “the commissioners” add “of the trust in special administration and any affected trust”.

(6) In subsection (9) of that section after ““commissioners” means the persons to which the trust provides services under this Act” add “and the commissioners of services at any affected trust”.

(7) In section 65F insert—

“(2E) Where the administrator is considering recommending taking action in relation to another NHS foundation trust or an NHS trust which may become an affected trust, the administrator shall engage with the commissioners of services at any such NHS foundation trust or NHS trust in order to enable those commissioners to make decisions pursuant to the matters set out in section 65DA.”.

(8) In section 651(1)—

(a) after “action which the administrator recommends that the Secretary of State” insert “or the commissioners of any affected trust“; and

(b) after “should take in relation to the trust” insert “or any affected trust”.

(9) In section 65K add—

“(3) Where the final report contains recommendations for changes to be made to services provided by an affected trust, the commissioners of services at that affected trust shall make a decision within 20 working days whether they wish to undertake public and patient involvement regarding all or any of the recommendations and, if they are so minded, shall comply with any arrangements for patient and public involvement agreed by those commissioners under this Act before making any final decision concerning the said recommendations.”.

(10) In section 65KA add—

“(7) Where the final report contains recommendations for changes to be made to services provided by an affected trust, the commissioners of those services shall make a decision within 20 working days whether they wish to undertake public and patient involvement regarding all or any of the recommendations and, if they are so minded, shall comply with any arrangements for patient and public involvement agreed by those commissioners under this Act before making any final decision concerning the said recommendations.”.

(11) In section 65KB(1)(d) after “that” insert “to the extent that the report recommends action in relation to the trust in administration”.

(12) In section 65KB(2)(a) after “decision” insert “in relation to any recommendations made the in relation to the trust in administration”.

(13) In section 65O add—

“(4) In this chapter “affected trust” means—

(a) where the trust in question is an NHS trust, another NHS trust, or an NHS foundation trust, which provides goods or services under this Act that would be affected by the action recommended in the draft report; and

(b) where the trust in question is an NHS foundation trust, another NHS foundation trust, or an NHS trust, which provides services under this Act that would be affected by the action recommended in the draft report.

(14) In section 13Q(4) at the end insert “save to the extent required by section 65K(3) or 65KA(7)”.

(15) In section 14Z2(7) at the end insert “save to the extent required by section 65K(3) or 65KA(7)”.

(16) In section 242(6)(b) at the end insert “save to the extent required by section 65K(3) or 65KA(7)”.’.

This Clause ensures that all commissioners of services affected by a trust special administrator’s report have the right to define local specified services; clarifies that, save for the trust in administration, local commissioners remain the decision makers for services they commission; and restores public engagement for changes other than for a trust in administration.

Amendment 30, page 102, line 31, leave out clause 119.

Government amendments 35, 36 and 11 to13.

[Jeremy Lefroy]

I wish to speak to new clause 6, which stands in my name and those of hon. and right hon. Members from across the House.

The new clause would give the Secretary of State some discretion to amend details of the final recommendations from Monitor regarding the outcome of the administration of an NHS foundation trust. As the law stands—so I am advised—the Secretary of State must either accept or reject Monitor’s recommendations in full. If they are rejected, there is another lengthy period of reconsideration. The result is that even if the Secretary of State broadly welcomes Monitor’s recommendations but has concerns about some matters of detail, it appears that he has to reject everything.

I have tabled this new clause as a direct result of my experience representing a constituency that has undergone the very first trust special administration of a foundation trust. I hope it will also be the last—at least in its current format. It has been a hugely time-consuming and costly process, and I would not wish it on any other community, constituency or Member of this House. The new clause would slightly improve the process, but what I would much rather see is a total rethink of the way in which the basic tasks of a trust special administration are carried out, both for NHS trusts and for NHS foundations trusts.

In my view, the relevant legislation—introduced by the previous Government and continued under this one—is not fit for purpose, but that is a debate for another day. In the meantime, I simply urge Monitor and the NHS Trust Development Authority not to put any other trusts—whether they be NHS trusts or foundation trusts—into the current form of administration. I urge everybody to work together on developing a system that enables trusts that are too small, such as the Mid Staffordshire trust, to be dissolved without having to go into a rapid, short-term and wholesale redesign of services. It can be done and I am certainly willing to work with anyone who wishes to design a better system.

I will not go into the full details of the administration of the Mid Staffs NHS Foundation Trust—that is a subject for a full debate on another day—but I will simply point out that it was made a foundation trust in 2008 on the recommendation of Monitor after a lengthy process, and that it is now being dissolved in 2014 on the recommendation of Monitor after a lengthy process. In paragraph 4.269 of his inquiry report, Robert Francis says:

“There can be no doubt that the Trust should never have been authorised as an FT”,

which happened in 2008. There must be a better way of doing things.

My new clause 6 would give the Secretary of State the power to accept the broad thrust of Monitor’s recommendations in the unhappy event of any future administration, giving her or him discretion to alter their detail without having to reject them in their entirety. The new clause therefore offers the Secretary of State flexibility and discretion in what is too rigid a process. I think that any Secretary of State would welcome that. A constant theme of the Ministers whom I have heard in my short time in Parliament has been that such and such an amendment would introduce too much inflexibility into the law. I am therefore doing exactly what Ministers long for, which is to offer them such flexibility.

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[Joan Walley (Stoke-on-Trent North) (Lab)]

The hon. Gentleman is making well-informed comments about the whole issue we face. He says that the arrangements need to be looked at on another day, but surely our experience in Staffordshire and the complete confusion over a set of recommendations that have been accepted but cannot be implemented means that we ought to find some way to resolve the whole issue in this evening’s debate, not give the Secretary of State powers to close down general hospitals at random all over the country.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Ms Walley, in fairness, interventions must be very short.

[Jeremy Lefroy]

I am grateful to the hon. Member for Stoke-on-Trent North (Joan Walley) for playing an extremely important and constructive role in this whole matter. She has been very supportive, and she makes some extremely important points. We need to look at the whole issue of administration, to which I will come in a few moments.

The Secretary of State’s decision to introduce the addition has given me considerable comfort about new clause 6, which I tabled before his decision, not being necessary. He does not seem to consider himself entirely constrained by the law into only accepting or rejecting Monitor’s recommendations in full; there is clearly room for proposing changes to details while still accepting the main thrust about the dissolution of a trust.

We shall of course need to see the results of the NHS review of consultant-led maternity services. If, as I hope, they are retained as a vital part of the regional health service—together with the level 1 special care baby unit, which serves a much wider area—it is important that finances are put in place to ensure that they are sustainable. I would therefore welcome clarification from the Minister about how the Department of Health now interprets the law.

If the Secretary of State’s decision on Mid Staffordshire demonstrates that the law allows for positive changes to the details of recommendations without Monitor having to go through another lengthy and legalistic process at a time when, as in the case of Stafford, a hospital is in a very fragile state, I welcome that fact, and new clause 6 will be unnecessary. However, if the Minister wants confirmation of the flexibility set out in the new clause, I would be happy for the Government to accept it or something similar.

Finally, to return to the question of trust special administrations, I believe that they are the right way to dissolve the legal entity of a foundation trust, but they are most certainly not the right way to redesign clinical services. That is not to criticise Monitor generally or the trust special administrators in the case of Mid Staffordshire—I believe that they acted within the remit given to them by this House—but we as a House did not get it right either in 2006 or in 2012. I urge a complete rethink, starting today.

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[Mr Jim Cunningham (Coventry South) (Lab)]

My hon. Friend is right when she says that the Secretary of State wants the power to privatise—I will be brutal about it—NHS services. We must recall—this is why we cannot believe the Minister or the Secretary of State—that before and during the general election, the Prime Minister said that there would be no top-down reorganisation of the national health service—[Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. With the hon. Gentleman facing that way I could not hear a word he had to say. I am sure it was a very short intervention that I would love to hear. Will he repeat the question?

[Mr Cunningham]

I am sure my hon. Friend will agree that the changes the Government want to make are in order to privatise the national health service through the back door. That is why the Secretary of State wants that power. Equally, we cannot believe the Secretary of State because, during the general election, the Prime Minister said that there would be no major changes to the national health service, and no top-down reorganisation. Why should we believe this lot now?

--- Later in debate ---

[David T. C. Davies]

I listened with great interest to my hon. Friend the Member for Enfield North (Nick de Bois) but I will be supporting the Government 100% tonight because I have great confidence in what the Government have achieved with the NHS. I say that because I have seen the alternative; I have seen what has happened to the NHS when it is run by Labour, because that is the problem that I and many of my constituents face at the moment in Wales.

My right hon. Friend the Member for Sutton and Cheam (Paul Burstow) came forward earlier with a petition from the left-wing pressure group 38 Degrees. Health campaigners have been talking today about the amount of salt that we take but one has to take dangerously large pinches of salt with anything that comes out of that organisation. These people purport to be happy-go-lucky students. They are always on first name terms; Ben and Fred and Rebecca and Sarah and the rest of it. The reality is that it is a hard-nosed left-wing Labour-supporting organisation with links to some very wealthy upper middle-class socialists, despite the pretence that it likes to give out.

It is 38 Degrees who were coming out with all sorts of hysterical scare stories a few years ago about how the Government were going to privatise the NHS. It took out adverts in newspapers, scaring people witless that that was going to happen. Of course the organisation has forgotten all about it now because there was never any intention to do that. We will never privatise the NHS because we believe in public services in this party. A couple of months ago, 38 Degrees came out with more scare stories about how it was going to be gagged because of another piece of legislation that the Government were putting through to bring about fairness in elections. It said that we would never hear from it again, and yet here we are a few months later with yet another host of terrible stories, scaring members of the public quite unnecessarily. I do not think that we have to take any lessons from 38 Degrees, nor hear any more about their petition.

I am backing the Government tonight because I know that the Secretary of State has done an enormous amount to drive up standards in the NHS even as they fall in Wales. It is this Secretary of State who has presided over falls in waiting lists to 18 weeks in England. People are lucky in Wales if they can get to the target of 36 weeks. There has been an increase in funding when it has been cut in Wales and there is much better access to cancer drugs in England than we have in Wales.

New clause 16 refers to the need to confer with members of neighbouring boards. We have health boards, not trusts, in Wales. I hope the Secretary of State will confer with the boards in Wales about these changes. The only criticism that I have of the Government is that they have been so successful in improving the NHS in England that large numbers of people now contact me every single day, in Wales and in my constituency, asking for the right to be treated by the NHS run by the coalition Government and not by the NHS run by the socialists in Wales.

I ask the Minister and Opposition members to look at an article in the Western Mail today by a woman called Marianna Robinson who has spoken about the difficulty she has had in trying to get treatment and how desperately she wants to be treated in Bristol. There is a place for her in Bristol but she is not allowed to have it. I ask Ministers, and perhaps Opposition Members, to think about what we are doing here. I would like to see patients in Wales who wish to be treated in England being allowed to go to England and get treatment, with the money then being taken off the block grant to the Welsh Assembly. If Opposition Members—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I think I need to help the hon. Gentleman. As he knows, we are dealing with the new clause. I do not want the history of the Welsh health service, which is certainly not what Members are here to listen to. I know he wants to get back to the new clause, which is where we will carry on. He should also look to the Chair now when he speaks.

[David T. C. Davies]

I shall simply say this, Mr Deputy Speaker. I will vote in the Lobbies with the Government tonight. Many people in Wales would like the opportunity to vote with their feet and be treated by the national health service which is run by this coalition Government, and I hope that we shall get around to addressing that at a later stage.

Care Bill [Lords]

Lindsay Hoyle Excerpts

Monday 10th March 2014 Commons Chamber

[Paul Burstow]

I beg to move, That the clause be read a Second time.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

With this it will be convenient to discuss the following:

New clause 10—Exercise of functions—

‘When exercising functions under section 31 (Urgent procedure for suspension, variation etc.) of the Health and Social Care Act 2008, the Care Quality Commission may not take account of its functions under section 83 (Trust special administration: appointment of administrator) of this Act.’.

New clause 12—CQC duty to support integration of social and health care—

‘In exercising the functions and duties set out in section 90 (Performance ratings), the Commission must act always to require, enable and encourage the provision of health services in ways that support and facilitate the functions and duties of—

(a) local authorities set out in section 3 (Promoting integration of care and support with health services etc.) of this Act,

(b) the NHS Commissioning Board set out in section 23(1) 13N (The NHS Commissioning Board: further provision) of the Health and Social Care Act 2012, and

(c) clinical commissioning groups set out in section 26 (14Z1) (Clinical commissioning groups: general duties etc.) of the Health and Social Care Act 2012

where it considers that this—

(i) improve the quality of those services (including the outcomes that are achieved from their provision),

(ii) reduce inequalities between persons with respect to their ability to access those services, or

(iii) reduce inequalities between persons with respect to the outcomes achieved for them by the provision of those services.’.

New clause 27—Corporate responsibility for neglect—

‘(1) This section applies where a person registered under Chapter 2 of Part 1 of the Health and Social Care Act 2008 (a “registered care provider”) in respect of the carrying on of a regulated activity (within the meaning of that Part) has reasonable cause to suspect that an adult in their care is experiencing, or at risk of, abuse and neglect.

(2) The registered care provider must make (or cause to be made) whatever enquiries it thinks necessary to enable it to decide whether any action should be taken in the adult’s case and, if so, what and by whom.

(3) Where abuse or neglect is suspected, the registered care provider is responsible for informing the Safeguarding Adults Board in its area and commits an offence if (without reasonable cause) it fails to do so.

(4) A registered care provider is guilty of an offence if the way in which its activities are managed or organised by its board or senior management neglects, or is a substantial element in, the existence and or possibility of abuse or neglect occurring.

(5) A person guilty of an offence under this section is liable on conviction to imprisonment for a term not exceeding two years, or to a fine, the range of which will be specified by regulations, or to both.’.

New clause 28—Review of protections for persons in the health and social care sector making disclosures in the public interest—

‘(1) Within six months of this Act receiving Royal Assent, the Secretary of State must make arrangements for an independent review of—

(a) the adequacy and effectiveness of provisions for the protection of persons employed within the health and social care sector who make disclosures in the public interest (whistleblowers) about matters of concern to their employer, a prescribed person or body or another person or body;

(b) the treatment and experience of past whistleblowers; and

(c) the need and opportunities to improve existing protections.

(2) The review shall take account of—

(a) the efficacy of existing legal provisions, policies, procedures and practices for the protection of whistleblowing and whistleblowers and access to redress for whistleblowers who suffer adversely consequent upon their disclosures;

(b) the available evidence on—

(i) the impact of whistleblowing on changes in health and social care standards; and

(ii) the treatment of whistleblowers over the last 20 years; and

(c) other matters as required by the Secretary of State.

(3) The Secretary of State shall arrange for a report with recommendations (or an interim report as may be required) from this review to be prepared and laid before each House of Parliament within 12 months of the review commencing.’.

New clause 29—Duty to minimise harm—

‘In section 20 of the Health and Social Care Act 2008 (regulation of regulated activities), after subsection (2)(b) insert—

(c) ensuring that the likelihood of harm befalling persons in respect of whom a regulated activity is taking place is reduced as far as possible.”.’.

New clause 30—Mandatory incident reporting and patient safety management systems—

‘In section 20 of the Health and Social Care Act 2008 (regulation of regulated activities), after subsection (3)(k) insert—

(l) impose requirements as to the reporting by all providers of regulated activities to the affected persons or their representative and family of incidents occurring in the carrying out of such activities which lead to the—

(i) death;

(ii) unexpected deterioration of condition; and

(iii) introduction of a new adverse condition in respect of the person, regardless of the severity of the new condition and the short and long term impact on the person;

(m) impose a requirement for the preparation and publication by all providers of regulated services of a safety management system plan.”.’.

New clause 33—Candour Commissioner—

‘(1) The Secretary of State shall establish an Office of the Care Commissioner for Candour and Disclosures in the Public Interest (the “Candour Commissioner’s Office”).

(2) The Candour Commissioner shall have duties to—

(a) protect and promote a culture of candour and disclosure in the public interest in the health and care services sector,

(b) provide or arrange confidential advice and support for persons working in the health and social care sector considering making a disclosure in the public interest,

(c) provide or arrange advice and support for persons in the sector who have made such a disclosure, and

(d) monitor the treatment, employment and re-employment of persons mentioned in paragraph (c) within the sector.

(3) The Commissioner shall report to the Secretary of State, with recommendations—

(a) on any issue within the Commissioner’s remit as she/he sees fit,

(b) making an assessment of the extent to which persons and bodies within the sector are protecting and promoting a culture of candour, with particular reference to the treatment, employment and re-employment within the sector of persons who have previously made a disclosure in the public interest.

(4) The Secretary of State shall lay a copy of the Commissioner’s annual report before each House of Parliament accompanied by an explanatory statement setting out the steps that the Government plan to take to remediate any shortcomings identified by the Commissioner.’.

Amendment 19, in clause 90, page 81, line 27, at end insert—

‘(2A) The Commission must, in respect of such English local authorities as may be prescribed—

(a) conduct reviews of the provision of such adult social services provided or commissioned by the authorities as may be prescribed;

(b) assess the performance of the authorities following each such review; and

(c) publish a report of its assessment.

(2B) Regulations under subsection (2A) may prescribe—

(a) all adult social services of a particular description; and

(b) all local authorities or particular local authorities.’.

[Paul Burstow]

This part of the Bill and this group of new clauses and amendments are all about ensuring that the system delivers the best possible quality of care and that, when things go wrong, it is clear how the situation is to be corrected and what penalties will be faced by those who have let people down and, in some cases, treated them in an appalling way. There is much in this part of the Bill that is to be applauded, although the nature of the Report stage of a Bill means that we often do not applaud a Bill much, because we are focusing on the things that we want to amend further.

New clause 8 deals with a subject that was also a feature of our discussions in Committee—namely, the concern that the commissioning role of too many local authorities, and the discharge of their responsibilities for planning for the care and support needs in their communities, had degenerated into little more than crude procurements and, worse still, in some cases just spot purchasing of care services. In some local authorities, there was no sense of strategy or of engagement with the local population, and there were no pragmatic conversations with provider organisations ahead of a procurement process. There was no real sense of how to shape the market to deliver the best possible outcome from the point of view of the wider public interest.

Those concerns were expressed a number of times in Committee, and they have been echoed throughout all the stages of the Bill. They were certainly strongly expressed by a number of the representative bodies of provider organisations when they gave evidence to the Joint Committee scrutinising the Bill. Of all the evidence sessions in that Joint Committee, the one that sticks with me is the one at which the provider organisations gave evidence. There was a palpable sense of the deterioration, and even the collapse, of relationships between local authorities and providers as a consequence of the commissioning not being done well in some organisations.

My new clause is designed to address a concern expressed by a number of organisations about a change that the Government made to the Bill in the other place. In that change, they removed from the legislation that established the Care Quality Commission the provision for periodic reviews of the performance of local authorities in regard to their statutory duties on care and support. I am prepared to accept the arguments that the Minister made before removing that provision, but only if we can have much greater certainty that the Care Quality Commission will undertake regular thematic reviews of care and support services.

New clause 8 sets out a number of the things that I think such a thematic review should include. For example, we have established a regime for sector-led improvement whereby local authorities can seek peer review of their delivery of quality commissioning of care and support services. It is working well in some places, but there is certainly evidence that it is not in others. There is a concern that arrangements will be made that allow an inadequate level of peer review and, frankly, people to get away with not doing the right thing. That is why a back-stop provision allowing thematic reviews is absolutely essential, and why ideally I would like the CQC to be independent in its judgment on that, rather than beholden to Ministers to authorise it. That is not the situation we are in, but the new clause would have us look at those issues.

I was told by a provider that I met at an event which the United Kingdom Homecare Association organised with me that CQC inspectors positively discourage comments about local authority commissioning. If a provider has a concern about how they are being constricted, arguably inappropriately, by a commissioner’s decision or practice and tries to raise that with an inspector, they are told, “That is not a matter for us.” It is absolutely a matter for the CQC. I hope the Minister can say something about what he will say to the CQC on that issue. It seems to me that understanding the intervention of commissioners is a really important part of gathering intelligence about the robustness of a local care economy, and the best way to gather that intelligence, at least in part, is by inspectors being open to being told about that.

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[Andrew George]

My right hon. Friend is making an excellent case. There is another reason why it is essential that inspection in that area becomes paramount, and that is because of the drivers in the system itself that discourage avoidable hospital and community hospital admissions and seek the earliest possible discharge into the community. What we have is a scenario in which people are being cared for in their homes, in an “out of sight, out of mind” environment, so inspections become all the more important because of the need to ensure that they are safe—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Paul Burstow.

[Paul Burstow]

My hon. Friend makes an important point—

[Mr Deputy Speaker]

I think he made a speech.

[Paul Burstow]

I defer to you on that point, Mr Deputy Speaker.

New clause 8 would ensure first, that there is an examination of how sector-led improvement is working; secondly, that the concern about rates for care, which we touched on when we debated new clause 15, is looked at, particularly time and task commissioning and procurement; and thirdly, that the way in which resource allocation formula are drafted and how they operate—an issue that came up in my Committee’s inquiry into the Bill—and the fact that they are often very opaque to the public, with regard to what is and is not in them when it comes to determining the level of a personal budget, are absolutely crucial to the quality of the care someone might be able to receive.

Francis Report

Lindsay Hoyle Excerpts

Wednesday 5th March 2014 Commons Chamber

[Grahame M. Morris]

Well, that’s very kind of the hon. Gentleman.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. The hon. Member for Beckenham has only just come in. He perhaps ought to hear a little bit more of the debate to get the flavour of it before he intervenes. That would help his good self.

[Grahame M. Morris]

We should remember that most hospitals provide very high standards of care, and have dedicated and compassionate staff. I am not just talking about doctors and nurses, but ancillary workers, cleaners and support staff. I worked in a pathology department as a medical scientific officer for a number of years. We should remember that the NHS is an integrated service that relies on all of its elements to perform at a high level and deliver a high-quality service.

Clearly, what happened in Mid Staffs was alarming. There were unacceptable practices, including, as other Members have said, professional failings. The hon. Member for Stafford (Jeremy Lefroy), in a terrific speech that was considered, thoughtful and non-partisan, alluded to those professional failings. My right hon. Friend the Member for Rother Valley (Kevin Barron), a former Chair of the Health Committee, made the point strongly that many Labour Members feel there should be a duty of candour on individuals. That is one of the recommendations of the Francis report that was rejected by the Government but could well make a difference. There were clear signs that changes needed to be made and we need to ensure that failures are never repeated elsewhere.

When care failures are uncovered, the priority above all else is to make a candid assessment of what went wrong and what needs to be done to fix it. Francis was clear on the need for cultural change. That is exactly what happened in the wake of the Mid Staffs scandal. Despite attempts by some Government Members to undermine Labour’s commitment to the NHS, for the record we should be aware that it was the then Secretary of State, my right hon. Friend the Member for Leigh (Andy Burnham), who is now in his place, who called in Robert Francis to lead the initial review into what had happened so that we could find out what went wrong and learn lessons for the future.

I accept the point made by the hon. Member for Stafford that we should not hark back to previous Administrations, but my recollection, as a relatively new Member from 2010, is that that was not something we engaged in. It was a huge issue for Labour, and for me personally, that people were dying due not to lack of care in a hospital setting, but to the length of waiting lists—people were dying on waiting lists. After 1997, the NHS was transformed. Spending had tripled to £104 billion when Labour left office. Under Labour, 100 new hospitals were constructed, and the Labour Government employed 89,000 more nurses and 44,000 more doctors than had been employed in 1997. The transformation of the NHS under the last Government was reflected in public satisfaction with the service, which rose from record lows before 1997 to record highs.

There was a bit of contention during Prime Minister’s Question Time, and subsequently during the opening speeches in the debate. The Secretary of State suggested that the number of nurses had risen, but my information from the Royal College of Nursing and FactCheck indicates that that is not the case. I hope that the record can be corrected, because staff numbers are a key issue. A number of Members have referred to it today, and Robert Francis cited staffing as a causative factor.

It would, I think, be irresponsible to assume that a combination of implementing the Francis recommendations—even all of them—and talking down the last Government will be sufficient to ensure the provision of high-quality care throughout the NHS. The truth is that the combination of cuts in alternative services—I am not just talking about the replacement of NHS Direct with the 111 service, the reduction in the number of walk-in treatment centres, the difficulties in gaining access to GP services and, indeed, the cost and disruption caused by the top-down reorganisation—is more likely to contribute to failures in care. It will certainly increase the pressure on accident and emergency departments.

The Francis report made it clear that the “overwhelmingly prevalent factors” in the failures at Mid Staffordshire

“were a lack of staff, both in terms of absolute numbers and appropriate skills”.

It was made clear that ensuring that our hospitals are adequately staffed is key to ensuring that standards of care are high. That point was made by the hon. Member for St Ives (Andrew George), who I know has been campaigning on the issue for some time. A year on from the Francis report, a survey found that 39% of nurses believed that the staffing position had become worse rather than better, and 57% said that their wards remained dangerously understaffed. I hope that the Minister has noted that, because it must be cause for concern.

The hon. Member for Stafford told us that when he was first elected the NHS trust was running a deficit of £10 million, and the focus of the hospital management was on reducing the deficit in order to secure foundation trust status. What went through my mind then were figures given to the Select Committee, according to which nearly a third of NHS trusts are predicting deficits towards the end of the current financial year, and the possibility that similar pressures will be applied as a result. We are now seeing the spectre of clause 119 of the Care Bill, which we are to debate next week on Report and Third Reading. If it paves the way for rapid hospital closures—Labour Members fear that predatory private health care interests may seize the opportunity—that will be very dangerous. We must examine that issue very seriously.

According to evidence from the survey conducted, I think, by the RCN, not only are hospital wards increasingly understaffed, but nurses are being burdened with work that is preventing them from doing their jobs. I am sorry to fire statistics at the House, but, according to that evidence, 86% agreed that the amount of non-essential paperwork had increased in the last two years. There has thus been an historic recent increase in administrative duties. That has been keeping nurses in their offices or at their nurse stations, standing in front of computers or photocopying machines, instead of being available on the wards providing the TLC—that direct health care—that patients require.

Just this week the president of the Royal College of Psychiatrists warned the Government that the mental health sector is heading towards its own Mid Staffs-type scandal. I am very concerned about that. The figures for that field were given earlier, but the fact that the budget for mental health services is reducing in real terms should be a cause for concern. This Government gave a commitment to parity of esteem as between physical and mental health. That was promised and loudly trumpeted as a significant step forward, but in truth it has failed to materialise. There is a clear funding imbalance between acute providers and non-acute trusts, which will disproportionately impact on mental health services in the wake of the Francis report.

I also want to touch on the tariff reduction. In 2014-15 there will be an overall reduction in the tariff price—essentially, the price that hospitals are paid for procedures and operations they perform—of 1.5% for acute providers and 1.8% for non-acute trusts. A third of NHS trusts are predicting they will be in deficit at the end of the financial year, and this tariff reduction will only compound that problem. This means the efficiency target for mental health and community trusts is in practice a fifth higher than for acute trusts, so perhaps it is no wonder that we have a chronic bed shortage, highlighted by various newspapers and the BBC, with children and adolescents travelling long distances to access appropriate care and sometimes temporarily being put in police cells. This is not acceptable, and there are real concerns that programmes introduced by the last Labour Government to make talking therapies available to people with mental health conditions are not getting the priority they deserve. Last year half of all patients referred for counselling did not see a specialist, with a third giving up entirely because the waits were so long.

As I mentioned in an earlier intervention, 1,700 mental health beds have been lost over the last two years, and services are under such pressure that people with mental illnesses are ending up either in police cells or presenting at accident and emergency departments, as the right hon. Member for Sutton and Cheam (Paul Burstow) said. Those are completely inappropriate locations.

I want to mention the cuts to social care since 2009 and the impact they are having on the ability of the service to deliver quality care in the light of our review of the Francis recommendations. We should not forget that since 2009-10 some £1.8 billion has been cut from local authority budgets for adult social care. The cumulative spending power of my own local authority, Durham county council, is being reduced by 17.3% under this Government.

Areas such as mine with a legacy of coal mining or industry have higher care needs. These are the areas that are being hardest hit by cuts to local government. It is simply not possible to make cuts of this significance to local government without it having an impact on standards of care. Some 76% of community nurses agree that social care cuts have resulted in increased work pressures, with just 15% thinking that patients are receiving adequate support from social care services. Cuts mean that an increasing number of those with care needs are going without any support—the figure I have seen is about 800,000—and those receiving support are not even having basic needs met. We know about the 15-minute visits, and councils are now having to introduce or increase charges for services that may well have been free before or might be free in other parts of the country.

Care in the home and in the community is declining, and people are turning to their local hospitals—this is the point I am trying to make—as the default option. That means that those who should be taken care of at home are staying unnecessarily in hospital beds. Accident and emergency is the coal face—the pressure point—and any failures in the system show up there, putting even more pressure on an already burdened system. In “The Francis Report: one year on”, Robert Francis said that there needs to be

“a frank discussion about what needs to be provided within the available resources…It is unacceptable to pretend that all can be provided to an acceptable standard when that is not true.”

I agree with him. It is no good telling people that care standards will be improved or maintained while removing the support that is required to provide high standards of care, particularly social care. In conclusion, I agree with the Health Committee that legislation and regulatory bodies can only do so much to ensure that care standards are met if the necessary staff and resources are not available.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I now have to announce the result of Divisions deferred from a previous day.

On the motion relating to the draft Marriage (Same Sex Couples) (Jurisdiction and Recognition of Judgments) Regulations 2014, the Ayes were 360 and the Noes were 104, so the Question was agreed to.

On the motion relating to the draft Marriage of Same Sex Couples (Registration of Shared Buildings) Regulations 2014, the Ayes were 363 and the Noes were 100, so the Question was agreed to.

On the motion relating to the draft Marriage of Same Sex Couples (Use of Armed Forces’ Chapels) Regulations 2014, the Ayes were 366 and the Noes were 103, so the Question was agreed to.

On the motion relating to the draft Consular Marriages and Marriages under Foreign Law Order 2014, the Ayes were 367 and the Noes were 100, so the Question was agreed to.

On the motion relating to the draft Marriage (Same Sex Couples) Act 2013 (Consequential and Contrary Provisions and Scotland) Order 2014, the Ayes were 365 and the Noes were 103, so the Question was agreed to.

On the motion relating to the draft Overseas Marriage (Armed Forces) Order 2014, the Ayes were 368 and the Noes were 98, so the Question was agreed to.

I now call Alex Cunningham.

Children and Families Bill

Lindsay Hoyle Excerpts

Monday 10th February 2014 Commons Chamber

[Ian Paisley]

I appreciate the Minister helping us to get to the bottom of this. I understand that under rule 148 of The Highway Code a driver is prohibited from smoking, eating, drinking, doing a crossword or listening to a loud radio at the wheel, for very obvious reasons. If that is the case—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I think we have got the message. The hon. Gentleman has had two interventions. We are going very well, so let us not challenge the Minister too much so early on.

[Jane Ellison]

Thank you very much, Mr Deputy Speaker. Clearly there will be a lively debate about this provision, and I wish to draw my remarks to a conclusion soon—

--- Later in debate ---

[Luciana Berger]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. We are up against time and a lot of Members want to speak, so I would be grateful if we could move on as quickly as possible.

[Luciana Berger]

I thank my hon. Friend for his intervention. He raises a point that I am seeking to make in my contribution: we have an opportunity to do something, so I hope that Members will support the Lords amendment in the Lobby tonight.

Bronchitis, asthma, meningitis, glue ear, the common cold and reduced lung function are just some of the many respiratory illnesses that can be suffered by children as a result of passive smoking.

--- Later in debate ---

[Several hon. Members]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. May we have less chatter during speeches. It is getting difficult to hear.

[Paul Burstow (Sutton and Cheam) (LD)]

I rise to support the Government amendments to put the two regulation-making powers in the Bill, and to support the initiatives taken by Cross Benchers in the other House and by a cross-party group in this House. I speak as chair of the all-party group on smoking and health.

We have been asked to be clear about the evidence. One area in which the evidence is absolutely clear is that smoking is a childhood addiction, not an adult choice: 40% of smokers are addicted by the age of 16 and two thirds by the age of 18, while 200,000 children take up smoking every year. That is why I strongly support, and urge hon. Members on both sides of the House to support, the Lords amendment to provide for the power to regulate and standardise packaging. I do so not least because of the evidence from the tobacco industry’s campaign against it, and from documents released through court cases that have demonstrated that it knows that packaging is a way of driving market share, as well as of driving people to smoke in the first place.

On passive smoking in cars, both the NHS and the World Health Organisation are very clear about the dangers of second-hand smoke for children. Other hon. Members have already listed that evidence. I do not know where the hon. Member for North Antrim (Ian Paisley) was in relation to the data. Every week, 430,000 children aged 11 to 15 are exposed to second-hand smoke in their family cars. That is not their choice. The hon. Member for South West Bedfordshire (Andrew Selous) is absolutely right. This issue is not about a child’s choice, because they have no choice. They have to get into the car if their parents want them to do so.

The concentration of toxins in a car makes it a significantly different environment from a smoky pub or home. The evidence demonstrates the impact that that environment has on a child’s health. That is where the Millsian test applies. The harm to the child should trigger us to act in the way that I hope the House will act tonight. That is why I support the free vote.

Tobacco Packaging

Lindsay Hoyle Excerpts

Thursday 7th November 2013 Commons Chamber

[Bob Blackman]

I will not give way, because Mr Deputy Speaker wants us to make progress.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Everyone wants to get in, but we are running out of time. I need to remind the House that the opening speech was to be 15 minutes, but we are well over that already.

[Bob Blackman]

Now that we have the evidence, I ask the Government to listen to the debate. We will hear a response from the Minister, and I trust that by the end of this debate, the view of the House will be overwhelming and the Government will seek to introduce regulation on standardised packaging as fast as possible. We will not seek to divide the House today—this is a general debate—but if the Government do not come forward with regulations before Christmas, we will seek another debate on a motion that allows the House to divide and express its clear will.

--- Later in debate ---

[Mr Deputy Speaker]

Order. I shall now reduce the speaking time limit to eight minutes—[Interruption.] If the hon. Member for Stockton North (Alex Cunningham) wants me to reduce it further, I shall be more than happy to do so, but I am sure that he would rather speak for eight minutes than five. The danger is that speeches will run on, and many Members wish to speak in the second debate.

Managing Risk in the NHS

Lindsay Hoyle Excerpts

Wednesday 17th July 2013 Commons Chamber

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I advise the House that Mr Speaker has selected the amendment in the name of the Prime Minister.

--- Later in debate ---

[Andy Burnham]

I will give way to the hon. Gentleman, but I hope that his intervention will not be about Wales. [Interruption.]

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. I want to hear Mr Cairns.

[Alun Cairns]

Mr Deputy Speaker, I can assure you that my intervention will be about Wales, because it is about my constituents who are suffering. Will the right hon. Gentleman pay tribute to the transparency that the right hon. Member for Cynon Valley (Ann Clwyd) is seeking to enforce by exposing the different data that apply to Wales and England? Does he share my dismay that only 83% of patients who are admitted to A and E are admitted, treated and discharged in hospitals in Wales, compared with the 91% who are admitted, treated and discharged in hospitals in England? Why do my constituents have to wait 89 days, compared with the 51-day waiting time in England—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. Mr Cairns, do not take advantage of the situation; it is not fair to other Members who also want to intervene. We want this debate to be heard in the best possible way.

[Andy Burnham]

This is debate is about the NHS in England, and if the hon. Gentleman has concerns about the NHS in Wales, why does he not have a word with his right hon. Friend the Chancellor of the Exchequer and get a better deal for the Welsh Assembly so that a bit more money could be put back into the Welsh national health service?

As I was saying, the Government have put staff morale at rock bottom, and where are the promised benefits of this reorganisation? Clinical commissioning groups are not, as we were promised, the powerhouse of the new NHS; they are embryonic at best and anonymous at worst. Members of all parties, I am sure, write letters to CCGs that get passed to NHS England, which then either does not provide a proper answer or passes them on again. [Interruption.] I hear the public health Minister saying it is dreadful that Members do not get proper answers. When my hon. Friend the Member for Easington (Grahame M. Morris) wrote to her about cancer services in his constituency, she also brushed it off to NHS England. Is this proper accountability? No.

--- Later in debate ---

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. If the right hon. Member wants to give way, he will give way. We do not need people standing up, shouting and bawling. I want to hear what the shadow Secretary of State has to say, just as I want to hear what the Secretary of State has to say. Let us have a little more courtesy from everyone.

[Andy Burnham]

Thank you, Mr Deputy Speaker.

Alarming patients, demoralising staff and casually trading figures about deaths in the pursuit of political advantage is no way to run the NHS, and those are not the actions of a responsible Government. Today people are asking what kind of Government this is, if they are willing to cause further damage to fragile hospitals for their own self-serving political ends. Yesterday the Secretary of State told the BBC that he had no idea who had put the 13,000 figure in the public domain. Does he seriously expect us to believe that?

Health and Care Services

Lindsay Hoyle Excerpts

Wednesday 3rd July 2013 Commons Chamber

[Dr Lee]

My hon. Friend is right: in a rural location the distances become further. I do not know the particular situation in his region, but I would suggest that there are probably location issues with regard to existing hospitals.

Moving neatly on, that is why—yes, you heard it here first: a Conservative calling for a Soviet-style central plan—I have called for a national plan for acute and emergency care. By definition, we cannot have a market interfering in that; we need to look at it in the round and say, “Where would we put these hospitals? Where are the motorways? What is the population density? Where is the rural location? Where is the urban location?” The problem is that if we reconfigure in isolation—I have seen this locally—it has a knock-on effect on other hospital services which then say, “Where are we getting our patients from?”

We should have a national plan that everyone from both parties has bought into. We should have—dare I say it?—a cross-party party committee looking into this. We should take it out of the political exchanges that we all engage in. We know what is going to happen in certain quarters in 2015—it will become a political football. I know that my hon. Friend the Minister is very aware of this. That is dreadful when we are talking about saving lives. Let us try to take this out of party politics. We can have robust exchanges, on principle, about payment, about how services are commissioned or not commissioned, and about whether there should be top-down reorganisation, but the fundamental question of where hospitals—acute and community hospitals—are located should be decided nationally; otherwise we could have perverse decisions whereby some services wither on the vine and we end up with gaps in emergency and acute care across the country. I make a plea for some cross-party activity on this.

Let us put the national health service’s budget into context. This country has debts and liabilities in excess of five times the size of our economy, and the situation is getting worse. Almost 40% of spending is on health and welfare, and it is growing. We know that that will happen; we have heard it this afternoon. Let us be realistic: there is only so much we can afford. I genuinely want a service that is based on clinical need. I genuinely want somebody to arrive at the appropriate location and get the very best care available. I fear that if we continue along this path of denial as regards how the service is paid for and, more important, structured, we will end up with more and more scandals. There are more in the pipeline. The chief executive of Tameside hospital has just resigned.

The public out there want more from us. They want us to make some difficult decisions, for sure, but using evidence, not party politics. I make that plea to everybody. If we can do that, we can structure a service that becomes the envy of the world; it is not that at the moment. However long I end up staying in this House, if that is achieved in the time I have been here, I will retire a happy man.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Before I call the Front Benchers, may I remind Members that if they are going to bring mobile phones into the Chamber they must be on silent and that they should not wait for them to ring? This is not the first time I have said that, but I certainly want it to be the last. Has the hon. Member for Strangford (Jim Shannon) taken that on board? Excellent.

--- Later in debate ---

[Mr Dorrell]

rose—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Did you want to come back, Mr Dorrell? We are up against time with the next debate.

[Mr Dorrell]

I am not pressing; I was led to believe that it is the convention to respond. I believe I have two minutes.

[Mr Deputy Speaker]

One minute, I am sure you have.

Carers

Lindsay Hoyle Excerpts

Thursday 20th June 2013 Commons Chamber

[Norman Lamb]

I am not sure whether the hon. Gentleman was present when I said that we need to be much smarter about how we use the money available. One of the things we need to do—I think there is a degree of agreement here—is integrate health and care. It is a crazy silo situation that we face. We are not using the money effectively. We could achieve much better support if we combined the disparate parts of the system to provide support shaped around the needs of the individual and their family.

The last spending round provided local government with a challenging settlement. That is why we decided to provide extra funding to help local authorities maintain access to services. However, local authorities ultimately have discretion over how they use their resources. Improving care and support is not simply a case of more money. Local authorities must look at how they can transform care through innovation and new ways of working. As I said earlier, collaboration with the voluntary sector is critical to this. Many local authorities are successfully integrating health and care services to improve quality, and we are developing the concept of “pioneers” to act as exemplars to support the rapid dissemination and uptake of lessons learned across the country.

Some hon. Members talked about the role of doctors and other health care workers. I agree that much more needs to be done. We can look at incentives such as the GP survey mentioned in the exchange that I had with the shadow Minister, the hon. Member for Leicester West, and we have provided funding for the Royal College of General Practitioners and others to encourage GPs to think about the role of carers, but what we see from examples around the country, such as Changing Lives in Cornwall, is that once GPs start to collaborate and work as a partnership—as a team—with carers and the family, they begin to see that their burden is relieved because others can help them in the role that they have to perform. That is the essential change that it is so important to achieve.

My right hon. Friend the Member for Sutton and Cheam referred to the £400 million funding over four years for carers’ breaks. It is deeply frustrating that that has not been used as intended in all parts of the country. There are some areas, including Surrey and many others, which have done good, innovative things as a result of that. The Department asked the policy research unit in economic evaluation in health and care intervention to conduct a survey of a number of PCTs to gain their views on the benefits of NHS support for carers’ breaks. The findings will be published shortly and will help inform our understanding of what has happened. The early indications are that there may be more good things happening than we sometimes recognise, but clearly there have been significant gaps and much more needs to be done.

I appreciate that time is almost up. I entirely agree with my right hon. Friend and many others about the importance of work. I make the point again that providing help and assistance to enable people to remain in work is in employers own self-interest, as they maintain the skills in the work force while enabling that person to continue their caring responsibilities.

This has been a good debate. There has been some informed discussion and I am very grateful to hon. Members for their contributions.

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

I call Paul Burstow. We have about 40 seconds.

Budock Hospital Site

Lindsay Hoyle Excerpts

Tuesday 11th June 2013 Commons Chamber

[The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)]

I congratulate my hon. Friend the Member for Truro and Falmouth (Sarah Newton) on securing this debate and on her ongoing tremendous advocacy on behalf of her constituents. She talked eloquently of her own knowledge of the school—“care farm” is the expression I would use in my constituency—and the relationship between the school and the old hospital. She highlighted the importance when looking for value in NHS land of doing as much as possible to maximise the land receipt and put that money back into the NHS, but of course NHS land is community land, and it is important that, wherever possible, we work with surrounding communities to support them in local activities that benefit the population.

My hon. Friend also outlined eloquently the challenges faced by more rural parts of the country, and Cornwall in particular. We know that community resources and facilities are much scarcer in rural areas, as she highlighted in her speech. When we look at the affordability of local homes and the provision of community facilities, rurality is an important consideration and one that we always bear in mind in the NHS.

I appreciate my hon. Friend’s interest in the Budock hospital site and support her concern that best use be made of public sector land not only in releasing its monetary value, but regarding the availability of affordable homes for local people to live in. I understand that NHS Property Services has intervened to begin the process of facilitating a mutually beneficial resolution of the issues previously hindering the sale of this land to the local school. Those issues predate the transfer of ownership to NHS Property Services, and were between the former Cornwall and Isles of Scilly primary care trust and Falmouth school. Thanks to swift action since NHS Property Services took over control of the NHS estate, the issues are well on their way to being unlocked. NHS Property Services inherited a portfolio of 4,000 other properties from 161 disparate previous NHS organisations on 1 April, and a win-win resolution is now in sight.

I am sure we will have other debates on similar matters, so it is worth outlining to the House the role of NHS Property Services and some early successes that have occurred. On 1 April, NHS Property Services inherited about 4,000 NHS assets, including health centres, office accommodation, care homes and hospital buildings. It houses about 12,000 tenants and is valued at more than £3 billion. It also inherited more than 3,000 members of staff from former PCTs and strategic health authorities throughout England. This brand new organisation is already doing tremendous work in the face of this huge challenge to create efficient, fit-for-purpose facilities and services for the benefit of patients and the public. All too often in the past, there was an unacceptable variability in estates management—not just in this case, but throughout the NHS—by PCTs and SHAs. The advantage of having estate management under one central roof has already paid dividends throughout the NHS. The creation of NHS Property Services has generated an opportunity to explore options to bring together a fragmented system—

[Mr Deputy Speaker (Mr Lindsay Hoyle)]

Order. May I just gently remind the Minister that this is a very tight debate? We are talking about one site; we should be dealing with Falmouth and nowhere else. There may be a good story to tell but we can save that for another day.

[Dr Poulter]

Indeed. Thank you, Mr Deputy Speaker, for bringing me back to the task in hand. There are many good stories to tell from other constituencies but you are quite right; we should focus on how successes in Ludlow and South Suffolk can be translated into success at the Budock hospital site.

The focus of NHS Property Services is about resolving some local planning concerns where PCTs have had difficulties in the past, which is what we are going to concentrate on. I understand that Falmouth school’s plans to purchase the Budock site pre-date the transfer of land to NHS Property Services on 1 April 2013. The school and the former Cornwall and Isles of Scilly primary care trust had previously agreed to enter into a land swap to release the school’s playing fields—which were difficult to access—for the hospital site. The NHS was then to dispose of the playing fields for housing land.

I understand that differences in the size and estimated value of the sites, and planning permission issues, had prevented both parties from reaching agreement to progress this proposal, which commenced some time ago in 2011.

The Government’s priority for easing the shortage of land for housing development is to see development take place in sustainable locations; the predominantly brownfield sites of some of the old NHS estate no longer used for clinical purposes can help bring forward land for affordable homes to be built for local families. The Budock site is brownfield land and is located in a settlement that is forecast to experience significant growth over the coming years, as my hon. Friend outlined.

The site was assessed under the Cornwall strategic housing land availability assessment and found to be suitable for approximately 100 dwellings. My hon. Friend will also be aware that Treasury guidelines on managing public money state that public sector organisations may transfer assets among themselves without placing the property on the open market, provided they do so at market prices. They also state that the organisations should work collaboratively on the transfer to agree a price, and that it is good practice to commission a single independent valuation to settle the price to be paid. My hon. Friend said that is the plan in this case.

I am pleased to report that NHS Property Services and the school have agreed that the original proposal can be revisited, with a planned joint instruction to the district valuer from both parties. NHS Property Services has agreed with Falmouth school that it will take the Budock hospital site off the market while reviewing the original land swap option. To enable both the school and NHS Property Services to deliver these proposals, support will be required from the local planning authority to ensure that a clear planning brief is available for both sites. I am sure my hon. Friend will be helpful in facilitating that accord. This will ensure that both organisations and the district valuer can understand and agree an estimated value for both sites.

This value can be demonstrated in land value and in wider community benefits such as housing, health and well-being, and education and leisure use. My hon. Friend eloquently outlined the many local sports and leisure groups that are hugely supportive of this project, and rightly so. The project will be for the sake of the local community and would be beneficial as well to the NHS through the profits from the land, which could be distributed elsewhere to support local NHS projects.

The potential outcome from this approach is a win-win situation for the local community, the school and the NHS. NHS Property Services will be able to maximise receipts from the sale of the current school playing fields for reinvestment in front-line NHS services. Falmouth school and the wider community will benefit from improved access to leisure facilities on the former hospital site, and much needed housing development in the Falmouth area will be brought one step closer. I understand that an initial report setting out the context and options for the proposed transaction can be delivered within six weeks. That will require the co-operation of the school, NHS Property Services and, importantly, the local planning authority. The report should set out a programme to include a target of three to six months for initial agreement, in the form of a contract to be reached for the transaction. This could take a number of forms, subject to the advice that both parties receive from the district valuer—contract for sale and option agreement.

This evening my hon. Friend has eloquently outlined the case for why the project should go ahead. I will of course be monitoring progress on the ground. The door is always open for her to come and see me if there are further problems or concerns. I am sure that her tremendous advocacy on behalf of her constituents will continue to unlock the potential of these proposals and make them a reality.

Question put and agreed to.