(9 years, 1 month ago)
Commons ChamberIf I had a pound for every time somebody brought forward a private Member’s Bill, or supported a private Member’s Bill, on the basis that it would send a signal, I would be a very wealthy person. Unfortunately, the problem is that we do not pass legislation to send signals. We pass legislation to bring something into the law of the land. The hon. Lady has sent a signal by making that point in this debate. If the whole purpose of this was to send a signal to show how important carers are to the country and how important it is that hospitals show some compassion for carers when they come to visit hospitals, the hon. Lady has achieved that by making that intervention. Perhaps therefore she may feel satisfied that we can leave the matter at that. We have all sent a signal about how important carers are, and I now want to move on to the Bill that is being proposed, which goes way beyond sending a signal.
We already have Government guidelines that set out a range of people who they think should be exempt, all things being equal. When hospital car parking charges were debated back in September 2014, the Minister stated that
“40% of hospitals that provide car parking do not charge and of those that do, 88% provide concessions to patients. However, I am aware that there are 40 hospital sites—which is 3.6% of hospitals in acute and mental health trusts—that have charges and do not allow concessions to patients who need to access services. As a Government, we want to see greater clarity and consistency for patients and their friends and relatives about which groups of patients and members of staff should receive concessions and get a fairer deal when it comes to car parking.”—[Official Report, 1 September 2014; Vol. 585, c. 89.]
Furthermore, in his latest position on the Bill, Lord Prior said that NHS organisations must have autonomy to make decisions that best suit their local circumstances and community interests, and that although the principles provide clear direction and leadership, a one-size-fits-all policy is not appropriate for car parking.
Although the Government have given strong guidance on where concessions should be made for hospital car parking they have, rightly in my opinion, left the final decision to be made by the hospital implementing the policy. Therefore, importantly, each hospital sets its own parking policies and is not required under law to make any exemptions. The Bill today will be the first time that Parliament has intervened to demand that hospitals give free car parking to a particular group of people.
The Government have set out guidelines about the people who, in their opinion, should be exempt from parking charges, or should receive concessions. They are people with disabilities, all frequent out-patient attenders, visitors with relatives who are gravely ill, staff working shifts who cannot use public transport and visitors to relatives who have an extended stay in hospital. Why does the hon. Member for Burnley not believe that those people should have the same benefit as regards hospital car parking charges as the people she includes in the Bill? Is she saying today that the people in the list I have just given are not as important as the people she wants the Bill to cover? Does she think that people with disabilities are not as important as carers? Is she saying that their needs are not as great? Is she saying that staff who cannot get there by public transport are not as important as the carers to whom she refers? Why are the carers so much more important? We all agree that they are important, but why are they so much more important than all the other vulnerable groups who she has spectacularly not included in her Bill while the Government are saying to hospitals that they should make some provision for those people? There is a great unfairness in her proposals.
If the hon. Gentleman believes in what he has just said—I agree that most of the people he has listed should be included—will he not propose an amendment or another Bill to say that all those people are important and that we should help everyone we can who has an issue with these horrendous charges?
I would have more sympathy with the principle of the Bill if it wanted to make the Government’s guidance mandatory, because there would be some logic to that. Clearly, a whole range of people struggle, but just to pick out one group at random seems iniquitous.
I was about to come on to that point, and my hon. Friend makes it very well. One of the essential reasons for hospitals charging is that, particularly near town centres, people use the free parking and then go and spend all day at work. That does not help any carer who is trying to find a parking space. That is why it is so important that hospitals have to be able to use charges in a way that suits their particular local circumstances to ensure that visitor and staff parking is always available when it is needed. Without their being able to make some restrictions on a local basis, there will be nothing to prevent people from using the site as a free car parking area.
I have no idea—perhaps the hon. Member for Burnley could tell me—whether parking would be free for carers only when they are coming to the hospital as a carer or free for them all the time because they are a carer. That is not clear in the Bill. I am looking for assistance from some of my more learned colleagues, but it appears that nobody knows the answer to that question, including the promoter of the Bill, so I will leave it there as something that does not seem to have been thought through.
This issue applies not only to hospitals close to town centres, as mentioned by my hon. Friend the Member for Solihull (Julian Knight), but to those that are close to railway stations, where there is also a large demand for parking. My hon. Friend the Member for Christchurch (Mr Chope) mentioned Scotland earlier. This issue has arisen at hospitals in Wales and Scotland since they scrapped car parking charges. The NHS Confederation said:
“The NHS Confederation represents 99 per cent of NHS trusts in England. On behalf of our members we support the right for NHS trusts to determine their own car parking and transport arrangements within current regulations and good practice”.
That is what is under threat today. A response from the House of Commons Library states:
“There is nothing specifically stopping hospitals from giving concessions or free parking to carers or other groups—although all public bodies need to operate within the framework of the Equalities Act—i.e. avoid discrimination against protected groups. Decisions on hospital car parking charges are a matter for the NHS body running the car park.”
Hospitals clearly have the flexibility to offer a free parking policy for carers—as the hon. Member for Burnley said, some have already done so—but it is not right that we as a House should force them to do so. Hospitals that do not already have a free car parking policy for carers have clearly assessed the situation and chosen not to, for whatever reasons. There may well be good reasons that we are better not second guessing. If she feels so strongly about this issue, perhaps her time would be better spent lobbying her own hospital trust in Burnley to persuade it of the argument for giving carers free parking, as opposed to coming along here and trying to impose it everywhere else when she has not even persuaded her own hospital in Burnley to do it.
Hospital parking charges are a key part of income generation. Hospitals may choose not to give free parking because car parking on healthcare sites is an income- generation scheme under the income-generation powers that enable NHS bodies to raise additional income for their health services. NHS bodies are allowed to charge for car parking, and to raise revenue from it as an income-generating activity, as long as certain rules are followed. Income-generation activities must not interfere to a significant degree with the provision of NHS core services. It is also crucial to note that these income- generation schemes must be profitable, because it would be unacceptable for moneys provided for the benefit of NHS patients to be used to support other commercial activities. It has to be the other way round; the commercial activity has to support the core NHS services. The profit made by income-generation schemes has to be used to improve health services. That is absolutely crucial. The money has to go towards that particular purpose.
The Department of Health’s “National Health Service Income Generation—Best Practice: Revised Guidance on Income Generation in the NHS”, which was published in February 2006, clearly sets out that income generation must be profitable. Paragraph 30.10 states:
“For a scheme to be classed as an Income Generation scheme, the following conditions need to be met: the scheme must be profitable and provide a level of income that exceeds total costs.”
It then goes on at great length, but that is the key part, so I will not bore everybody by reading the whole paragraph. The document goes on to say that
“the profit made from the scheme, which the NHS body would keep, must be used for improving the health services”,
and
“the goods or services must be marketed outside the NHS. Those being provided for statutory or public policy reasons are not income generation.”
Therefore, if exemptions are made for other people, that must be taken into consideration when calculating the estimated annual revenue and whether it will make a profit or a loss.
I fear that if the hon. Lady’s Bill is successful, the consequence will be not just exemptions for carers—worthy sentiment though that may be—but, I suspect, higher car parking charges for everybody else who visits the hospital so that it can protect its revenue stream. The hon. Lady did not mention that and she has not been open about it, but the chances are that that will be the consequence of the Bill. Everyone else will have to pay more in order to meet the NHS’s criteria for income generation. That means that all of the people the Government think should get a concession from car parking charges, including people with disabilities and those who visit hospital regularly, will not be exempt, but will have to pay more as a consequence of this Bill. Does the hon. Lady really want to tell all disabled patients who go to hospital that, in order to pay for her Bill, they are going to have to pay more to park at their local hospital? If that is the message she wants to send, I think she is rather brave. I would not want to tell my disabled constituents that they are going to have to pay more. It seems to me that that would be an inevitable consequence of the Bill. That is why we cannot pass legislation based on a worthy sentiment; we have to think through the consequences. [Interruption.] If the hon. Member for Birmingham, Perry Barr (Mr Mahmood) wants to intervene, I would be very happy to give way to him.
The hon. Gentleman was chuntering—I misinterpreted him. I thought he had something worth while to say, but clearly not.
Given the guidelines, I would be interested to know what information the hon. Member for Burnley has obtained to determine an impact assessment for the scheme in question to be rolled out nationally. Indeed, during my research on the Bill, the House of Commons Library—which, as ever, I praise for its fantastic work—confirmed to me that
“no central data is collected on NHS hospital car parking charges or concessions”.
It therefore seems to me that the hon. Lady could not possibly have done an impact assessment, because no assessment has been made of the current impact.
Where is the money made from car parking charges spent? Obviously, the provision of car parking incurs overheads, including for the running of it and for maintenance costs. If no charges were imposed, the maintenance costs would have to be sourced from elsewhere, at the risk of diverting funds from patient services. There is also the cost of monitoring the car park, to make sure it is being used for its intended purpose. That money has to be recouped, and it is recouped through car parking charges.