John Healey (Wentworth and Dearne) (Lab)

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I wish to take the unusual step of telling the House and the Minister about the individual case of little Vinny Duggan to highlight a wider problem that the Government can solve by making legal changes so that other patients and other parents such as Andy and Andrea Duggan do not have to go through what this family has gone through in the past two and a half years. As Andrea has said to me, this is their fight, but it is also a fight for other people in their position.

I have been involved with the parents in the quest for information for only 10 months, whereas Mr and Mrs Duggan have been battling since Vinny was born nearly two and half years ago. At times, Vinny has fought for life. He is now a little lad who is full of life. I was with the family on Saturday, and he was smiling, laughing, climbing on the sofa and climbing on me, but he has a very serious congenital heart and lung condition. He has brain damage, likely to have been caused by a lack of oxygen, and he is unlikely ever to be able to speak. His parents have told me that they are very proud of Vinny and very grateful that they still have him here.

It has been touch and go at times. He was born on 20 August 2010 at Doncaster royal infirmary. He was full term and was a healthy 7 lb 9 oz. However, within the first day his mum, in particular, became concerned that he was very blue, that he was not feeding properly and that he was very sleepy. The following day, he was diagnosed with a heart murmur and the day after that he was discharged against the parents’ wishes, as they were concerned and wanted tests done before he was discharged. He was at home for two days and after that time, when he had not properly woken up or properly fed and had stopped wetting his nappies, they phoned the hospital and were advised to take him to the children’s observational unit, where they arrived at 7 o’clock that evening.

Within the first hour, they were assessed by a triage nurse as non-urgent—green, in other words—and had to wait almost another five hours before a doctor saw them. During that night, Vinny was put on a heart monitor and given the tests he needed. He had a very high heart rate and was transferred rapidly to the specialist unit at Leeds general infirmary. He was diagnosed as having a very serious life-threatening heart and lung condition. He was given open heart and major lung surgery and spent five months in Leeds hospital, six weeks of that in intensive care and 10 weeks in the high-dependency unit.

The internal investigation at Doncaster hospital afterwards concluded that there were “no real concerns” about the standard of care in Vinny’s case, despite the fact that there were many chances to notice that he was unwell, to do the tests that could have been required and to listen to Mr and Mrs Duggan’s concerns. There remain important discrepancies between the evidence of the parents and that of some of the staff and the hospital in the investigation. It took two years and a new chief executive before, six weeks ago, Mr and Mrs Duggan received a welcome letter from the new acting chief executive, Mike Pinkerton, who ended by saying:

“The care that Vinny received fell below the standard you have a right to expect from us and I do sincerely apologise.”

Like so many other parents, Mr and Mrs Duggan had principally wanted an explanation—not retribution or compensation. However, like many parents, they were driven down the route of trying to get answers through the courts, and that is what they are having to do. They also rightly turned to the professional body, the Nursing and Midwifery Council, which is responsible for regulating Britain’s 670,000 nurses and midwives. Mrs Duggan submitted a complaint in September 2011, which was turned down in January 2012. She challenged it, which caused the council to look again at the argument that there was no case to answer, and the internal review concluded that the case should be referred back to the investigating committee for reconsideration.

The Nursing and Midwifery Council, however, has limited powers to review its decisions and that has been reinforced and restricted further by a High Court judgment in May in the case of R(B) v. NMC 2012. In other words, the NMC does not have the legal powers it needs to review its own decisions. The chief executive, Jackie Smith, was good enough to meet me in the summer and to agree to commission independent legal advice on Vinny’s case and on the NMC’s restrictions. That independent legal advice came from Mark Shaw QC, who concluded:

“The Order and Rules makes it plain that the NMC has no statutory power to review, re-open or reverse a disciplinary decision (in particular, a decision of the Investigating Committee that a registrant has no case to answer) beyond the specific circumstances stipulated in rule 7, namely: receipt of a fresh allegation within three years of the dismissal of a previous allegation against the same registrant.”

He went on to point out:

“Typically, other professional regulators have wider review powers, granted explicitly by secondary legislation.”

Those other professional bodies include the General Medical Council, which is responsible for regulating Britain’s 250,000 registered doctors. The GMC’s powers were rightly extended in 2004, so it has the power to review and reopen a complaint, to take a view that its earlier decisions might be flawed, to take new evidence into account and to act. It is considering a review of the complaint lodged with it about a doctor involved in this case and we expect a decision imminently.

The General Optical Council and the General Pharmaceutical Council have similar powers; the General Dental Council does not. At a time when complaints from patients are rising and pressures on staff are increasing, if we are to maintain trust and confidence in our health professionals and the NHS, we must have a better and more open system of complaints and we must have regulators with the powers to do the job they are set up to do: safeguard professional standards and safeguard patients and the public, too.

I know the Law Commission is reviewing the common enabling legislative framework for all health regulators. That could take three years, so I want the Minister to confirm today that he knows that there is a problem and that in the meantime, in advance of the Law Commission’s report, he will act to change the operating rules and orders so that those professional bodies can do the job. Otherwise, many other patients and parents will face the same fight for the truth—

Jeremy Lefroy (Stafford) (Con)

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In September 2012 the Royal College of Physicians published a report, “Hospitals on the edge? The time for action”, which sets out starkly the challenges facing our acute hospitals. It begins:

“All hospital inpatients deserve to receive safe, high-quality, sustainable care centred around their needs and delivered in an appropriate setting by respectful, compassionate, expert health professionals. Yet it is increasingly clear that our hospitals are struggling to cope with the challenge of an ageing population and increasing hospital admissions.”

It highlights the consequences of failing to meet the challenges and refers to the history of my own trust. When the public inquiry reports next month, we will have the opportunity to consider its implications for the NHS. Today I wish to concentrate on the Monitor review of my trust in the light of the continuing rise in pressure on acute services that the Royal College of Physicians highlights.

There are three common themes that I hear in the NHS these days. The first is that we need to do much more in the community and at home and much less in acute hospitals, and that we must therefore close acute hospital beds and use the money in the community. Although I agree with the premise, I dispute the conclusion. Community care is essential, but it must work before it results in a reduction in admissions and lengths of stay. The fact that admissions are rising and, according to the RCP, the fall in length of stay has flatlined in the past three years, even rising for patients over 85, indicates to me that the shift to the community either is not happening fast enough or indeed will not happen as expected.

The conclusion also seems to ignore demography. In the area served by the Mid Staffordshire Trust, the population is expected to rise by some 10% in the coming 23 years. The number of people over 60 will rise by nearly half, and the number of those 75 and older—those most likely to need acute services—will double. I suspect that is the situation in many parts of the country.

Increasing admissions, rising and ageing population, flatlining length of stays—all of these indicate an increased demand for acute services in the coming 20 years, yet the talk is, and has been for many years, of further reductions in acute beds. It makes little sense to do that until community services and other medical advances mean that those beds are proved to be no longer necessary. In Stafford, there is a shortage of step-down beds, so rather than closing acute beds altogether why not keep them as community beds on the same site, leaving the door open for increasing acute services in the future, if and when the need arises?

The second theme is that we need to integrate primary and secondary care more closely. I agree, yet actions sometimes have the opposite effect. The previous Government took away the responsibility for providing 24/7 primary care cover from GPs. I regret that, as it detracts from integration. It may also be responsible for placing a greater burden on accident and emergency departments at night. If out-of-hours care is not to be the responsibility of GPs, let it be centred, where geographically possible, on acute and community hospitals. This makes better use of NHS premises and, by being adjacent to A and E or other emergency units, can help take the pressure off them while providing the hospital with extra income. That would certainly work at Stafford and Cannock.

Tariffs can produce strange results. The University Hospital of North Staffordshire has a block contract for A and E admissions. For any admission in excess of that, it receives only 30% of the tariff, so what is it supposed to do—reject emergency admissions on the basis that they will be loss-making? Of course not. I would propose that emergency departments are funded at what it costs to provide that service safely. In Stafford, the emergency department has a deficit of some £2 million per year based on throughput and tariff. The number of patients attending—more than 50,000—could not possibly be safely accommodated elsewhere. Surrounding hospitals are already at capacity, so it makes little sense to impose a national tariff, which inevitably results in a loss and which in turn puts pressure on the hospital to prove that it is sustainable.

The third theme is that medicine is becoming increasingly specialised, so most work will inevitably migrate to large specialist units. There is truth in this belief, but there is also danger. There are 61 approved medical specialties in the UK, compared with 30 in Norway. As the RCP says, this has

“rendered the provision of continuity of care increasingly difficult.”

For older people, who often have complex and multiple needs, this can result in poorly co-ordinated care. This has not been helped by the introduction of shift-based systems under the new deal and the European working time directive, to replace the teams that took responsibility for individual patients. Specialisation also means that there is a much smaller pool of staff from which to select for each post.

If we were to design from scratch a hospital where those who will need it most— the elderly, as the statistics show—will receive safe and caring care for their complex needs as close to home and loved ones as possible, integrated into primary and community care, we would end up with something pretty much like the district general hospitals and community hospitals up and down the country, such as Stafford and Cannock.

This is not an argument for no change. I believe there must be much closer working between the larger and smaller trusts, for instance, and much more sharing of common services than at present. But it is a warning that national tariffs are not impartial arbiters. They generally work, I believe, against acute care.

Keith Vaz

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I will not tease my hon. Friend, but I think that the word “McDonald’s” did enter the conversation somewhere. However, I accept that his response is now on the record.

I would support legislation aimed at ensuring that we are very careful about the amount of sugar, and salt, in our diet. Indeed, I have introduced a ten-minute rule Bill that says exactly that. Denmark started a “fat tax” but then decided that it was unworkable because the food industry lobbied so heavily against it, and so the tax was removed. I am not saying that the Government are going to legislate on this; I do not think they will. The food industry is one of the most powerful in this country. The sugary drinks industry, from Red Bull, a can of which contains more than eight teaspoons of sugar, right down to the people who make Coke and all these other drinks, will fight very hard on this. In the meantime, let us send out a message and work together to stop this epidemic consuming and subsuming our country.

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

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I have very much enjoyed sitting through this debate on health. I remember that when we had the equivalent debate last year, many speakers did not have the time they wanted to make their speeches. The fact that we have had longer today has enabled many right hon. and hon. Members to make valuable contributions on a number of subjects, focusing not only on health care issues in their constituencies and on important individual cases that highlight the need for changes in the system, but on the big challenges that face the NHS in tackling long-term medical conditions.

In the time available to me, I will do my best to answer the questions and points put across by Members on both sides of the House. My hon. Friend the Member for Stafford (Jeremy Lefroy) and I have met on a number of occasions, along with my hon. Friend the Member for Stone (Mr Cash), to talk through the challenges facing Mid Staffordshire trust. My hon. Friend the Member for Stafford has been a great advocate for, and a great support to, the patients and staff at that trust. I would like to put on record my thanks to him for all that he has done for all his constituents. His advocacy during his time in this House has been tremendous.

My hon. Friend the Member for Stafford raised some important issues. We know that it is desirable, not only because it makes good health care economics but, more importantly, because it is good patient care, to keep people well and looked after in their own communities and in their own homes. My hon. Friend threw up a legitimate challenge when he said that if we are to deliver good care in the community and in people’s homes, we need to find a way of moving from the current situation. At the moment we have a crisis management response by default, where people are rushed into A and E, and he is right to highlight the fact that some parts of the country do not have an adequate GP out-of-hours system to look after people around the clock. We need to ask how we go from a system set up around crisis management to one that is better placed to meet the future needs of preventive care and looking after people with long-term conditions such as diabetes, dementia and heart disease in their own homes and communities. The Government are taking steps to address this issue by making sure that GPs and local health care commissioners, through clinical commissioning groups at a local level, will hold a lot of the health care budget. That will ensure that the focus is on primary preventive care and on better looking after people with long-term conditions.

My hon. Friend is right to say that we need sufficient numbers of hospital beds, but as time passes there might less need for beds in some hospitals if local CCGs effectively meet the challenge of ensuring that that they invest in community and preventive care. In the interim, we need to support good commissioning of beds locally. We must have intermediate care beds available at community hospitals and in other care settings in the community for step-up care, step-down care and respite care.

On the other side of the River Thames, the clinical director of St Thomas’ hospital, Ian Abbs, is looking into year-of-care tariffs, which look after patients with long-term conditions such as diabetes and heart disease in a holistic way that enables them to be supported when they need a hospital bed and need to be looked after in the community. That has to be the right way forward. We in the Department’s ministerial team will work with clinicians, medical directors, trusts and commissioning boards to make sure that Eurocare tariffs are in place, so that we can shift the focus away from the community, but in a managed way that means that hospital beds will still be available as people require them.

The hon. Member for Easington (Grahame M. Morris) has been a strong advocate—he has raised his concerns many times—for constituents and others throughout his part of the country who are patients who need access to cancer care, cancer services, the cancer drugs fund and, indeed, high-quality radiotherapy. It is worth setting out some of the background—he outlined it himself in his speech—to the Government’s commitment to improving care for patients with cancer.

In 2011 the Government made a commitment to expand radiotherapy capacity by investing more than £150 million more over four years from 2011. As the hon. Gentleman knows, that was to increase the utilisation of existing equipment, support additional services and ensure that all high-priority patients with a need for proton beam therapy get access to it. In April 2012, the then Secretary of State announced that the Department had set aside up to £250 million of public capital, to be invested by the NHS in building proton beam therapy facilities at the Christie hospital in Manchester and the University college London hospital, to treat up to 1,500 patients each year. In October we announced a £15 million radiotherapy innovation fund for 2012-13, which brings this Government’s additional investment in radiotherapy over the spending review period to more than £165 million. The fund is designed to ensure that, from April 2013, radiotherapy centres will be ready to deliver intensity-modulated radiotherapy to all patients who need it.

The hon. Gentleman was right to say that, in spite of that increased investment, there are ongoing concerns about the variability of access to radiotherapy services in the NHS. I hope that it will reassure him that, in response to the requests of radiotherapy centres to the fund, we will go beyond the original commitment and will this week notify the centres of allocations totalling almost £23 million. We have taken on board the hon. Gentleman’s concerns and are making sure that we continue to invest in high-quality radiation in the years ahead. I know that he will hold the Government to that task in the coming years.

The right hon. Member for Wentworth and Dearne (John Healey) has rightly raised issues of principle arising from the Vinny Duggan case. I want to put on record my best wishes to the family concerned. I will deal with two issues: first, the issue that arose from the way in which the trust handled the complaints procedure, and secondly, the wider point about the Nursing and Midwifery Council.

First, as the right hon. Gentleman has highlighted, the trust clearly failed to acknowledge to any adequate degree that mistakes happened and that the quality of care was not of the standard that it should have been. That much was clear in this regrettable episode in the trust’s history. Two years is an unacceptable amount of time to wait for an apology or for an adequate explanation for what went wrong. The right hon. Gentleman is absolutely right to say that what patients want when things go wrong is a sincere apology and an explanation as to why things happened. We all know, no matter how good the care is in the NHS, that bad things will sometimes happen, but we need to know that that mistake has been recognised, that there has been an apology and that lessons have been learned for the future. We cannot rewrite history or always unpick mistakes, but we can learn lessons for the future and make sure that such bad things do not happen again. That is what good medicine is about. Clearly, in this case there were problems with the way in which the complaints were addressed.

Secondly, on the wider point raised by the right hon. Gentleman about the NMC and the disparity between how different professional regulators approach the complaints process, he is right that the NMC can review or reopen a case only when new evidence is available. If old evidence is reconsidered or if it changes, as in this case, it is very difficult to review it. There are differences between the medical and other professional regulators with regard to how such cases are handled, and the Law Commission has rightly highlighted those inconsistencies. There needs to be more consistency throughout all parts of the medical, nursing and allied health professional groups, in order to make sure that patients know that, when complaints are made and concerns are aired, they will be looked into and, where necessary, complaints can be reopened and reinvestigated.

The Law Commission proposals are expected to be introduced to the House in 2014. The right hon. Gentleman asked whether we could do anything sooner than that, but, as he will know, if we brought in a section 60 order, it would take about two years for it to get through the full parliamentary process. Given that the Law Commission proposals are holistic and apply to not just the NMC, but all health professions, we believe that the right approach is to consider those proposals in 2014. We hope that that will bring a lot more consistency, which I think we all feel is desirable, to future cases involving the professional conduct of all medical, nursing and other health care professionals.

I thank my constituency neighbour, my hon. Friend the Member for Suffolk Coastal (Dr Coffey), for her kind comments about the work that I, other Suffolk MPs and, indeed, the Minister of State, Department of Health, my hon. Friend the Member for North Norfolk (Norman Lamb), have done in relation to problems with the East of England ambulance service. People in more rural counties, particularly North Norfolk and parts of Suffolk, appear to be getting a service that is not of the standard that we would expect. We need more transparency with regard to response times, not just on a regional level, but on a county-wide level. My hon. Friend the Member for Suffolk Coastal asked whether there could be a breakdown by postcode. That is a little more challenging, because it is possible that, in any given month or response period, not enough people in a particular postcode will need an ambulance. There is a desire, however, for more transparency with regard to sub-geographical regions.

My hon. Friend the Member for Waveney (Peter Aldous) has also taken a keen interest in the issue and has recently been out with the ambulance service on a number of evenings.

Jim Dowd

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Nobody disputes the Minister’s last point. That is why there is a reconfiguration process especially for that purpose. That is what should be used, rather than this back-door method.

Dr Poulter

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I will do so, Mr Deputy Speaker.

I am sure that my right hon. Friend the Secretary of State will take those considerations into account when he receives the report and comes to his conclusions in due course. I know that the hon. Member for Lewisham West and Penge will continue to make his views clear.

Finally and importantly, I turn to the good remarks made by the right hon. Member for Leicester East (Keith Vaz). He is right to point out that one of the big challenges facing this country in health care terms is to better look after people with long-term conditions. Diabetes is a key challenge. Patients with diabetes have a higher risk of coronary heart disease, stroke, amputation, vascular disease and a number of other medical problems. One key way to deal with that is to focus more on prevention, rather than cure. That means investing in more GP-led care and primary prevention, rather than picking up the pieces in hospital. We should focus on helping people with type 1 diabetes to have a normal life by educating them to understand their condition, through the use of insulin pumps and by helping younger people to manage their condition.

The Government are committed to preventing diabetes and bad lifestyle habits from developing in the first place by focusing on better education in childhood. When local authorities have control of public health budgets, that will be a key priority for them. We must set good lifestyle habits from the early years to ensure that people do not develop diabetes later on.

Thank you, Mr Deputy Speaker.

Transport

Chris Williamson (Derby North) (Lab)

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I will start by telling the Minister that there is great concern in my Derby constituency about the possibility of a pre-Christmas betrayal of the Bombardier work force in the city. In March 2011, the Prime Minister brought the Cabinet to Derby because he felt it was an excellent backdrop that would give credibility to his assertion that he wanted to rebalance the economy. Derby provided a perfect illustration of the sort of economy that the Government—who at the time were relatively new—wanted to create. Within a few weeks, however, that rhetoric sounded hollow. It was followed up in the Budget statement when the Chancellor spoke about the march of the makers:

“We are only going to raise the living standards of families if we have an economy that can compete in the modern age. So this is our plan for growth. We want the words: ‘Made in Britain’, ‘Created in Britain’, ‘Designed in Britain’ and ‘Invented in Britain’ to drive our nation forward—a Britain carried aloft by the march of the makers. That is how we will create jobs and support families.”—[Official Report, 23 March 2011; Vol. 525, c. 966.]

However, just a few months later, when the Government could have done something positive to show that they meant those words, they awarded preferred bidder status for the Thameslink contract to Siemens rather than to Bombardier in Derby.

Ministers seem to have ignored the provisions within the invitation to tender documentation. The ITT states that the successful bidder must demonstrate that it can exploit advances in technology and have a world-class proven solution in one package, but Siemens did not have that. It had not developed a lightweight bogie; indeed, plans were still on the draughtsman’s board and had not even been tested or put into any form of production. In spite of that, however, Ministers decided to appoint Siemens as the preferred bidder.

That decision has already led to 1,400 job losses in Derby at Bombardier, and considerably more jobs have been lost in the supply chain. The Department for Transport seems not to be acting in the national interest and to be completely out of control. We saw the fiasco of the franchise for the west coast main line and, as we know, that process was suspended. The same civil servants who gave rise to concern over that franchise also worked on the Thameslink contract, yet Ministers seem to draw a veil over that.

Ministers have also tried to blame EU regulations for the decision to award preferred bidder status to Siemens. However, that simply will not wash because, when convenient, Ministers have ignored EU regulations on the issue. EU regulations are enshrined in English law. Regulation 4 is apposite and states:

“A contracting authority shall (in accordance with Article 2 of the Public Sector Directive)…treat economic operators equally and in a non-discriminatory way.”

That did not happen. At the fourth stage of the evaluation process, the DFT adopted a complex methodology involving the use of discount rates as shown in the Treasury Green Book, which is complicated for a layperson like myself. When the Transport Committee took expert evidence, Professor Karel Williams from the Manchester business school stated that there was a

“bias in favour of Siemens because they had a superior credit rating and that gave them an advantage of maybe several hundred million pounds”.

It therefore seems clear that the Government are in breach of their obligations under regulation 4.

The Business Secretary reportedly said that the end result of the evaluation process was inevitable. The ITT makes it clear that the Secretary of State will let the contract. In my view, that makes the Thameslink contract a Government contract. Regulation 23(b) of the public contract regulations makes it clear that, where a bidder has been found guilty of corruption, it should be excluded from the process. We know that Siemens falls into that category, yet the Government have proceeded regardless.

When the matter has been raised with Ministers, they have claimed that Siemens should not be excluded from the bidding process, and to some extent I agree. Siemens plc is not part of the special purpose company—Cross London Trains—which has been created to take forward the Thameslink contract. Siemens Project Ventures GmbH, which is a division of Siemens AG, is part of that special purpose company. Siemens AG has been convicted of corruption which, in my view, makes it ineligible for the contract unless there is an overriding requirement “in the general interest” to include it—that is what the regulations state.

As I have said, Ministers say there are no grounds to eliminate Siemens but they are applying the wrong test. They should have been looking at whether it was right to include the special purpose company that includes Siemens AG as part of the consortium. I therefore hope that when he sums up the Minister will give a commitment to look at the issue again. I believe that the Government are in breach of regulations 4 and 23. We will not get value for money, although Ministers claim we will—they are adopting a very expensive model to procure the trains and there are less expensive ways of pursuing that.

The industry is in great shape and the market is expanding, and we have huge potential and a massive opportunity, so I urge the Minister to ensure that he does not allow the industry in this country to slip through his fingers. He has the power to stop the contract—the invitation to tender makes that extremely clear—to do the right thing and to look at it again. Hopefully, he will give Bombardier in Derby the opportunity to continue to deliver a train manufacturing industry—

Jeremy Corbyn (Islington North) (Lab)

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It is a pleasure to follow my Friend the Member for Derby North (Chris Williamson). I pay tribute to him for the incredible campaign he has run in support of the workers in his constituency and the skills that have been brought to the country by the decades—over a century—of train manufacturing in Derby. It would be a crime if we lost that. The danger is that, unless the Bombardier contract is issued, there will be further job losses and further loss of train-making skills in this country.

We do not understand or value enough the heritage of the rail industry in this country, the skills involved in train manufacture and railway development, or the future of the industry. Following the closures, we have around 10,000 miles of track. We have a programme of railway network expansion, and more people travel by train than at any time since the second world war. The majority of the public who have access to railways prefer to use them—there is no question about that.

If we involve ourselves in a procurement process that specifically encourages sustainable, local-ish or UK-based employment, we will develop our industrial base and provide great opportunities for railway expansion in this country and other places. However, sadly, the model of privatisation adopted by the Conservative Government in the 1990s not only broke up our railway system but handed all the rolling stock to rather dubious leasing companies. Huge profits were made as a result, but 10 years into privatisation the Department for Transport’s procurement policies have moved much more into a totally market-based international comparator system rather than the system used for Transport for London, which has deliberately sought to develop UK-based employment, and fair wages and employment practices and so on.

Mr Burns

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On the hon. Gentleman’s second point about the final part of that process, we expect a conclusion early in the new year, though I cannot provide a precise date at this point. On Crossrail, as I said to him earlier, the procurement contract is going ahead and normal processes will be abided by and gone through. It is premature at this stage to start speculating on the detail of future processes, because there is an element of commercial confidentiality and the deals, checks and balances that one would expect from a normal major procurement of this nature.

The Crossrail procurement is the responsibility of Crossrail Ltd. It is currently assessing the bids received at the end of October. I expect that all bidders will have submitted strong, competitive bids that meet the exacting requirements of Crossrail, while providing best value for money for the UK taxpayer and future fare payers. Crossrail and Thameslink will have a transformational impact on travel in London and the south-east. They will significantly boost jobs and growth more widely in the economy. Their benefits are vital and urgently needed, and the Government remain firmly committed to their delivery.

The hon. Member for Islington North mentioned a number of other issues. I will write to him about them, except to say—this will come as no surprise to him—that I do not share his enthusiasm for what would in effect be a renationalisation of the railways.

I should like to ensure that the House is fully aware of what is being done to help Bombardier and Derby. The hon. Member for Derby North will be aware that Bombardier recently secured a £188 million bid to build 130 new railway carriages following a procurement competition run by Southern Railways. Last week, Southern Railways announced that it was exercising an option to invest in 40 new Electrostar carriages from Bombardier. Bombardier is among the suppliers who have bid for the new Crossrail rolling stock, which I referred to earlier, but as the procurement process is live it would be inappropriate to go into details. The Department for Transport is working to develop proposals for a further procurement of 116 rolling stock vehicles, which Southern, if it goes ahead, will be able to bid for. Through its talent and expertise, Bombardier has secured a considerable amount of work. There are a number of significant opportunities for it to seek to make more procurement bids successfully, which would lead to a bright future for the company. If it secures all the potential bids, it will help it to strengthen its capabilities and work force, and allow it to develop its potential.

In conclusion, the Government do not just talk the talk, they walk the walk. In the past two and a half years, we have invested record amounts of money—billions of pounds—to play catch-up from the failure of successive previous Governments to invest in our railway infrastructure, so that we have a first-class, fit-for-purpose railway network that can compete with our European competitors and ensure that we get a higher standard of journey for passengers and more freight on to the railways. In recent years, since privatisation, we have seen freight on our networks increase by 60%, with all the benefits that follow on from taking the freight off our road networks. [Interruption.] On the prompting of one of my hon. Friends, I would like to wish you and the staff, Mr Deputy Speaker, a very happy Christmas, secure in the knowledge that we are investing significantly to improve our railways. If you are returning to your constituency for Christmas on the west coast main line with a Virgin train, I wish you a prompt, enjoyable and speedy journey.

General Matters

Mr David Amess (Southend West) (Con)

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Before the House adjourns for the Christmas recess, there are a number of points I wish to raise. Members are familiar with the Freedom of Information Act 2000. A number of constituents have raised with me the fact that they think it perverse that they cannot have the name and address of the person who raises the FOI inquiry. I agree with them; I think the law should be changed.

In October, I met Paul Atkinson, from Prysmian Group, who is very troubled by the state of electrical cables. He fears that safety regulation of imports is not currently strong enough, and that this is causing fires, as well as the loss of British jobs. Having recently met fire officers in my constituency, I think this is a real problem.

Earlier this year, I secured a debate on the lack of burial space. There were excellent contributions from the hon. Members for Strangford (Jim Shannon) and for Ealing North (Stephen Pound), and a very good reply from the Under-Secretary of State for Justice, my hon. Friend the Member for Maidstone and The Weald (Mrs Grant). I hope that further work will be done on this issue because, as the hon. Member for Strangford said, the only things we can be certain of in life are death and taxes.

I have long campaigned in this House on the role of the Iranian resistance movement. There have been gross violations of human rights in Iran and the sharp rise in public executions continues. Her Majesty’s Government need further to support democracy and change in Iran, and the National Council of Resistance of Iran must be recognised as a legitimate opposition movement.

A few weeks ago, there was a power cut in my house and that of my next-door neighbour. I complained to E.ON, with whom I settle the bill, as did my neighbour. It was passed on to UK Power Networks, who passed me on to the energy ombudsman, which was an absolute waste of time. No one seems to be responsible for these matters, and my neighbour and I want compensation.

One of my constituents is particularly worried about postal vote fraud. To prove a point, he put five fictional names down at his address to register them as voters, and received postal votes for all of them. The census was obviously not checked to verify the residents in the property. He was arrested for electoral fraud, but the police brought no charges. We are both anxious about what appears to be a very lax system.

Last month, I visited Broadway Opticians in my constituency to see at first hand the different enhanced eye care services that optometrists and opticians can deliver. Community optometrists offer patient-centred, cost-effective quality eye care services in convenient, accessible locations. A key benefit of implementing those enhanced services is a reduction in referral rates to GPs and A and E units. These services are very patchy in our area. I ask what plans my right hon. Friend the Secretary of State for Health has to make sure that these enhanced services are available across the country.

No doubt the whole House would like to see driving become safer—according to my wife, if anyone drove with me they would see why. I was contacted by the Association of British Insurers, which is seeking to change the law on learning to drive. It wants a minimum one-year period for learning to drive and a ban on intensive driving courses. At the same time, it would like to allow teenagers to start learning to drive at 16 and a half, although as a politician I am not so sure about that.

On an issue of great concern to senior citizens, constituents of mine have been informed that their pensions will no longer be paid into the Post Office, but instead will be paid into a bank account. The letters informing them of the change came from Her Majesty’s Treasury, not the Post Office. This change is very difficult for many senior citizens to manage, and I urge Her Majesty’s Treasury as well as the Post Office to think through this change very carefully.

Another constituent of mine has raised with me his issues with Wonga, the pay-day loans company. He is particularly concerned about its television advertising, which does not mention the annual percentage rate of 4,214 applied to loans. It is worrying how easily one can obtain money from such companies. Its website guarantees quick decisions and money delivered swiftly. Any company making such quick decisions on loans can hardly be spending much time considering how the loans might affect the person’s life or how it could be paid back.

Dredging is damaging the environment in my constituency. It is affecting the cockle and the fishing industries, and is fundamentally changing the Southend coastline and affecting Southend pier, the longest in the world. I have seen the evidence with my own eyes. There has been a huge reduction in the amount of mud on the foreshore in Southend and Leigh. The pace of change is very dangerous. I have mentioned it in the House before, and I will continue my ongoing campaign to look after the Southend coastline.

Yet another constituent met me recently to discuss the creation of the supermarket watchdog, which is part of the Groceries Code Adjudicator Bill, introduced in September. Supermarkets can treat suppliers badly without fear of any consequences. Although supermarkets are clearly beneficial to society, we must be careful to protect their customers and suppliers. I congratulate ActionAid on its long campaign and look forward to seeing the watchdog ensure fairness for producers, supermarkets and customers.

A constituent of mine, James Price, who belongs to the Plymouth Brethren, has been in contact with me on a number of occasions regarding the Charity Commission’s plan to remove charity status from the Brethren’s gospel halls. Not only should this group be able to keep its current status, but I am worried about the implications if it cannot do so. I was pleased with yesterday’s ten-minute rule motion on this subject. What is to say that other religious organisations, such as the Church of England or my own Catholic Church, will remain safe if the gospel halls are not?

The final subject that I wish to raise is art. Art is wonderful and should be cherished. Southend West is a centre of cultural excellence. I enjoyed hearing the inaugural concert of Southend youth orchestra and was particularly delighted to hear from David Stanley’s group, the Music Man Project, which offers a unique service for people with learning disabilities. It is absolutely wonderful. David and the orchestra deserve a national audience, and it was my joy to go to No. 10 Downing street yesterday and present the Prime Minister with the DVD. Furthermore, I will be organising an event called “Southend’s Got Talent” on 15 February further to promote the arts in my constituency, and I hope that hon. Members will join me on 4 March in the Jubilee Room, where we will be celebrating all that is wonderful in Southend.

This year, my mother turned 100, and we enjoyed the diamond jubilee and the Olympic games. I do not know what can top it next year, but some of us will be celebrating 30 years in Parliament. I wish you, Mr Deputy Speaker, and all the staff a very happy Christmas, and everyone else good health, peace, prosperity and a wonderful new year.

Mr Allen

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It is important for those who served in Bomber Command and survived—it had the highest attrition rate of any theatre of combat in the second world war—get the full recognition they deserve. Finally the Arctic convoy veterans have got it. They have been honoured effusively in the former Soviet Union—what is now Russia—and indeed continue to be, in a way that we had to struggle for in our own country.

Having said that these are valuable moments for Back Benchers, let me raise a number of constituency and Back-Bench issues that are sadly all too familiar in my constituency. The first concerns the treatment of disabled people in my constituency. Many who are applying for incapacity benefit have to go through work capacity assessments with the Department for Work and Pensions through its stand-in, the French firm Atos, which colleagues in all parts of the House will have had experience of.

The waiting time for a disabled person in my constituency to be refused what they regard as their rightful entitlement because of their incapacity is 57 weeks, in some cases. It is unacceptable in a civilised society that they should have to wait that long for a decision on appeal. That is not the way we should treat our disabled people. It would not be good if it happened to just one person, or even if it happened to 10% of the people who appeal and who get what they deserve at the end of the day, but in fact, one in three cases are overturned on appeal. Those people need their incapacity benefit to live their lives effectively. The situation is unacceptable, and I have recently written to the Justice Secretary to express my concern. I was assured, in a letter from him dated 5 December, that extra resources were being brought in to press the numbers down and to enable the cases to be dealt with more expeditiously. I am very grateful for that but, sadly, two days later I received a letter from the Tribunals Service saying that the waiting times had gone up, and that it was now taking an average of 57 weeks for these cases to be dealt with.

I have a constituent named Susan Goldsmith who had her assessment in August 2011. She heard in October that she had failed. She felt aggrieved and immediately appealed. She lodged her appeal with the Tribunals Service in November and, following interventions by me, her appeal was finally heard this month. The judge took only a few minutes to decide to allow her appeal and to dismiss the opinion of Atos. My constituent, who needs her incapacity benefit, had experienced a delay of 54 weeks. I have had many similar cases, as have colleagues throughout the House. The system is a shambles, and I hope that colleagues will continue to write in about it until we get this right and start to treat our disabled people with the respect they deserve and to deal with their cases in a timely manner.

There are more than 500 young children in Nottinghamshire who are deaf or have a degree of deafness, and the National Deaf Children’s Society has asked me to raise a specific issue that is pertinent to them. I am going to write to the Secretary of State for Work and Pensions and ask him to look again at the personal independence payment that will replace the disability living allowance on 26 April next year. I am afraid that the change could result in a step backwards for many of those deaf young people. Following the abolition of the bottom rate of DLA, all those affected will have to apply for the bottom rate of the personal independence payment but, inexplicably, that will not be available to deaf young people unless they use sign language. In other words, those who use lip-reading or some other means of communication will fail to qualify for those payments, despite having previously been entitled to DLA. Only 10% of deaf young people use sign language, which means that 90% of them will not be entitled to apply for the PIP. I hope that that is simply an unintended consequence, and that my writing to the Secretary of State will result in his looking at the regulations and putting this right, so that all those deaf young people will not be hit disproportionately by this measure.

Another group that I would like to talk about came to visit us some time ago—

Simon Hughes (Bermondsey and Old Southwark) (LD)

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Thank you very much, Mr Deputy Speaker, for presiding over our last debate before Christmas. I have one specific subject that I want to raise, and a couple of very little things that I shall mention at the end.

A lot of my constituency casework—about 40%—relates to the Home Office and to the UK Border Agency, and many of the cases involve people who are here legitimately and who want to renew their visas. The process is simply not working, and we need to sort that out. All sorts of people are affected, including people who are working here and need to renew their visa in order to carry on doing their job, and people who came here as spouses and need to renew their status to be able to continue to live with their wife, husband or partner.

People can choose how to apply to renew their visas. They can apply by post, or in person after booking an appointment online. The applications are not free. The minimum cost is about £300 and the maximum is about £2,000, so people are making a significant contribution. Both application systems have problems, and they are causing my constituents, and those of many other colleagues, severe inconvenience. It is possible to use the premium same-day service, and it costs between £300 and £400 more to apply in person than to apply by post.

My constituents tell me that the system often releases new appointments at midnight, which is inconvenient, and because everyone logs on to the website at midnight, the system regularly crashes. The website also has basic technical errors. One constituent, a friend of mine named Selcuk Akinci, found that it was offering appointments only for 2020, which was not particularly useful. There are rarely any appointments available within two months, although that fact is not advertised anywhere. Most people, quite reasonably, think about applying to extend their stay only one or two months before their current visa is due to expire. Many therefore find that they cannot get an appointment before their leave expires. They then have to apply by post, which often means a six-month wait without being able to travel. People will not have expected that, and it can cause real problems for them, especially if they need to visit family regularly or if their work involves frequent travel. This problem can often prevent people from doing their job, if they need to travel for work.

Appointments can be made at any of the seven public inquiry offices in the UK. The system tells people where the next available appointment is, and they might find that they have to go from south London to Glasgow or Birmingham. Many people have to travel a long way for their appointment. When they arrive, even if they have booked the premium same-day service, there is no guarantee that the application will be processed on the same day. If the UKBA decides that further checks are necessary, the application is taken out of the premium service queue and put into the postal applications queue, which means that it could take up to six months to process. There is no refund of the premium fee in those circumstances.

People have no way of knowing whether their case will require further checks, which can be triggered by many different factors. There can be genuinely good reasons for carrying out such checks. For example, the person’s name might generate a hit on the police national computer, they might have used a different identity in the past, or they might have no leave to remain at the time of their application. However, further checks are sometimes triggered for bad reasons. Whatever the reason, the person concerned is not allowed to talk to anyone. They are taken out of the premium application process and told that their case has gone into the postal system and that they have to go home and wait, perhaps for more than three months. The case is placed in a kind of “cannot process it today” queue and sent away to a casework centre.

Cases are sometimes referred for further checks for illegitimate reasons. My senior caseworker, James Harper, deals with such cases every day in our Bermondsey office, and I deal with them often. For example, a person’s records might not have been properly updated on the UKBA database. In a recent case, a Ghanaian couple travelled all the way to Birmingham so that the husband could apply to extend his marriage visa in the normal way. However, Mr Kusi’s records had not been properly updated on the Home Office system to show his existing leave to remain. It therefore appeared to the officers at the inquiry office that he had no right to apply, even though he did, and the couple were turned away and left with only three days to apply by post before his existing visa expired. The couple pleaded with the officers to ring the visa office that had dealt with the original application, but were told that that was not possible and that they would have to leave. This is really unacceptable.

In a further case, an Iranian woman in my constituency was applying to extend her stay as the wife of a British citizen. Her case was referred for further checks because it was believed that she did not have high enough English language test scores: level 4.0 on the IELTS—International English Language Testing System—scale in reading and writing. In fact, this was a misinterpretation of the rules, as level 4.0 is required only in speaking and listening. My constituent qualified and her case was sent on, but it was subject to a long delay; only after we intervened did the UKBA admit that an error had been made and then refund the additional premium fee.