Hospital Car Parking Charges

Robin Walker Excerpts

Monday 1st September 2014 Commons Chamber

[Mr Robin Walker (Worcester) (Con)]

I congratulate my hon. Friend the Member for Thurrock (Jackie Doyle-Price) on introducing the debate, and my hon. Friend the Member for Harlow (Robert Halfon) on his excellent speech and championing of this cause.

This is a huge issue in Worcester and has been for the eight years I have been banging on doors in the area. It came up regularly over the summer recess, so I apologise to the House if I am a little parochial in my arguments. As my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) pointed out, the private finance initiative is a big part of this. In Worcester it is a big part of the problem with capacity rather than just cost, and a lot of the land that was originally intended for parking was sold off because of the appallingly bad negotiations over PFI by the previous Labour Government.

Parking is not just a problem for patients, as the motion states, but for family visiting and—as my hon. Friend the Member for Hexham (Guy Opperman) pointed out—for staff. On top of that, it is a massive problem for people who live in the local area around the hospital when staff are effectively encouraged to park for free in residential streets. I have had complaints over the years from residents of Leopard rise, Aconbury close, Darwin avenue and Linksview crescent, which are all close to Worcestershire Royal hospital, about people not being able to park outside their homes.

Charges at Worcestershire Royal hospital are not quite as high as those mentioned in the motion, but as my hon. Friend the Member for Redditch (Karen Lumley) pointed out, they still start at £3 for two hours, which is more than people are charged for parking in Worcester city centre. For many people, costs can swiftly mount up. Someone visiting for one hour each day for a week could end up paying at least £21, and information about concessions, which is badly needed, does not always reach those who need it most. The hospital trust currently makes more than £400,000 profit on its parking overall, and by contrast with the new guidelines there is no difference in charges for the disabled and other users of parking spaces. There are some reserved bays, but 52 bays out of 1,543 does not seem enough to me or most of my constituents.

As I said, parking capacity is a massive problem for staff, and it is about to become much worse because the park and ride used by many staff was, until recently, subsidised by the county council. It has had to reduce that subsidy, and the hospital trust has agreed to take it over, but only temporarily. This is an urgent time for the Worcestershire Acute Hospitals NHS Trust to review its approach to charging staff and the public.

[Fiona Mactaggart (Slough) (Lab)]

May I reinforce the hon. Gentleman’s point about staff? Enabling nurses in particular to park near where they work means that hospitals can recruit nurses. In my constituency, if nurses live within 5 miles of the hospital, they are not able to get a parking space and have to pay high charges. In practice, most of them get on the train to St Mary’s in Paddington and work there rather than in Slough. That means that my constituents get a less good quality of care.

[Mr Walker]

The hon. Lady makes an excellent point, and I welcome the fact that the Government’s new guidelines suggest a concession for staff who may not be able to get to work by public transport. That is important, but it would be so much better if the charges were not there in the first place.

Concessions for patients at Worcestershire Acute Hospitals NHS Trust are largely good. There are £1 tickets for a day, including for terminally ill patients, people undergoing coronary care and those in an intensive therapy unit or in oncology and paediatrics, but not for those who may have suffered a premature birth, for example, or have complexities during maternity leave—my hon. Friend the Member for Harlow was right to raise those issues. The concessions are also for relatives attending the bereavement office but not for other relatives. An £8 weekly ticket is available for next of kin, which most people do not know about, and there are £1 weekly tickets for renal patients and people undergoing radiotherapy, but they still have to be applied for on the wards, and only after people have paid £3 for parking in the hospital in the first place. That is one of the absurdities of the current system of charging on entry, rather than on exit as the Government suggest.

I would like much better advertising of concessions, and I think a simpler system would be good as it would be easier for people to understand. As many colleagues have said, getting rid of parking charges altogether would put us in a better place. My only worry about that would be if it disincentivised hospitals to invest in capacity, because in hospitals such as mine there is a clear need for new capacity. Lack of parking capacity at Worcester has been made worse by temporary disruption from the construction of a new radiotherapy unit—something I strongly support. Other hospitals, however, such as that in the constituency of my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones), have delivered multi-storey car parks in time for such upgrades to their hospital, and I wish that Worcestershire Royal hospital had been able to do that. I welcome the fact that the planned breast unit at the hospital will come with its own parking, which I hope will contribute to addressing overall demand. I have raised the concerns of my constituents about hospital parking time and again, but it is right to show leadership in the House and for the Government to address the matter properly.

My final point is about accessibility and ease of payment. Asking people to pay in cash up front is unacceptable in this day and age. Worcester city centre has schemes where people can pay for parking by card or with their phone. People use those schemes; they are popular, and I urge Worcestershire Acute Hospitals NHS Trust to consider how it can implement such a scheme to make it easier for people who do not have ready cash to hand. If I take one thing from this debate it is that I hope my trust acts like that of the right hon. Member for Sutton and Cheam (Paul Burstow), and reviews its policies on these issues immediately, taking a lead from the guidance the Government have set and the arguments made in the House.

Special Measures Regime

Robin Walker Excerpts

Wednesday 16th July 2014 Commons Chamber

[Mr Hunt]

I do not accept that all profit-making organisations are going to deliver poor care. There are some excellent ones and some bad ones. Poor care is poor care wherever it exists. The hon. Lady is right to say that we need to value more the staff who work in residential care homes and domiciliary care services. They do a fantastic job that is often not well paid. The best thing we can do for them is to make sure that, where they are in an organisation that delivers poor care, we shout about it and talk about it, so that people find out about it and something gets done.

[Mr Robin Walker (Worcester) (Con)]

More nursing staff and a rigorous focus on care for the person, as well as an improved inspections regime, are very welcome, but does the Secretary of State agree that we also need to focus on sharing best practice and innovative approaches to care, such as those being pioneered at the Association for Dementia Studies at the university of Worcester?

[Mr Hunt]

We absolutely do need to do that. Dementia care is an area where there needs to be lots more work and innovation. There is huge variation and even some very caring places could try new ideas. There are some very interesting ideas about dementia care in Holland, too. I absolutely welcome that work.

Oral Answers to Questions

Robin Walker Excerpts

Tuesday 10th June 2014 Commons Chamber

The Secretary of State was asked—

[Mr Robin Walker (Worcester) (Con)]

1. What recent assessment he has made of the role of the Prime Minister’s challenge fund in improving access to GP services.

[The Secretary of State for Health (Mr Jeremy Hunt)]

Mr Speaker, it is a pleasure to see you again so soon.

The Prime Minister’s challenge fund will be rolled out over 1,100 of the 8,300 GP surgeries in the country. It will improve access out of hours, at weekends and electronically, and it will benefit up to 7.5 million people.

[Mr Walker]

I am glad that this Government, unlike the previous one, whose disastrous contract negotiations led to a decline in GP access, is making sure that out-of-hours care is as widely available as possible. Will the Secretary of State assure me that he will do whatever he can to ensure that places, such as Worcester, that have not yet been reached by the challenge fund will also see the benefits of this approach?

Hospices (Children and Young People)

Robin Walker Excerpts

Wednesday 18th December 2013 Westminster Hall

[Stuart Andrew]

That is absolutely right. A lot of lessons can be learned from the hospice movement on providing care, because what matters at the end of the day is the children and the families—they should be able to access services as easily as possible.

I was talking about the youngsters living longer, but the hospice environment was generally geared towards young children. It started to become less appropriate or even desirable for young adults to go into the same building. The trustees at Martin House took the brave decision to build a new, separate teenage unit in the grounds. Through generous public donations, Whitby Lodge opened its doors in 2002, the first hospice of its kind in the United Kingdom. It has been a huge success, and is being replicated around the country, because young adults get to behave just like that: as young adults. The conversation is more appropriate to their age, and they can share and talk openly about their own needs, fears and hopes. As a result, the care team can learn more about the young people and help them where they can with their particular ambitions. While I was based at Martin House, a number of young people went to university, encouraged by the care team. The team also tried to help those young people when they were going through the transition from child care to adult social care.

[Mr Robin Walker (Worcester) (Con)]

I congratulate my hon. Friend on the important and passionate case that he is making for children’s hospices. As he has pointed out, people are now living much longer with complex conditions, so transition is a key area. Does he welcome the work that Acorns children’s hospice is doing with the Help the Hospices movement to design better pathways for transition?

[Stuart Andrew]

Absolutely. I will talk in a little more detail about transition later. The Care Bill had its Second Reading on Monday, and I raised specific points about transition during that debate, because it is a big issue for many of those young people.

The conversations those young people had were very moving. I will never forget one particular young man. We were recording a promotional video to show to health professionals and as a fundraising tool, and we asked the young people at the hospice to say what it meant to them. The head of care was interviewing them, so that they were with somebody they knew and felt as comfortable as possible; she asked that young man, “What is the most difficult thing about your condition?” He considered the question for a moment, and what he said had a profound effect on me. He said: “Falling in love.” At that moment, it hit me that despite their physical limitations or their conditions these are still young people, with all the same feelings and hopes that we all experience. He wondered if anybody would ever love somebody who was, as he put it, “Like him.”

That local experience at Martin House is but one piece in a huge jigsaw. Support and palliative care do not come only through hospices such as Martin House, Hope House or the others that have been mentioned. I want to cover three areas: NHS funding for children’s palliative care; short breaks; and support with mobility for children under three.

Cancer Patient Experience

Robin Walker Excerpts

Wednesday 30th October 2013 Westminster Hall

[Mr Clappison]

The hon. Gentleman makes an excellent point, and some of the matters I will turn to in due course underline its strength. May I apologise to hon. Members? I mentioned NHS England, because that is what the survey covers, but I will turn to the situation in Northern Ireland, Wales and Scotland in due course. I am delighted that so many Members from Northern Ireland are here this morning.

The next issue is financial support. Cancer patients and their families obviously need financial support, just as everybody else does. Although significant progress has been made since the first cancer patient survey in 2010, almost half of patients who would have liked information about how to get financial help or benefits still do not receive it.

[Mr Robin Walker (Worcester) (Con)]

I congratulate my hon. Friend on securing this hugely important debate. He mentioned the importance of financial advice and support, but does he agree that service design is also important? I came across a case of one constituent, David Wilson, who, while undergoing chemotherapy, received 270 different pieces of paper from our city council in just one month—August this year. It is vital that we design services so that Her Majesty’s Revenue and Customs, local councils and the Department for Work and Pensions work together to make life for patients easier and simpler and to ensure that they understand the financial entitlements.

[Mr Clappison]

My hon. Friend makes an excellent point that I am sure the Minister will want to address. The last thing that somebody coping with the treatments and everything else wants is to be bombarded with different pieces of information and requests from central or local government bodies, which could do something much more coherent and easy to understand if they streamlined their services.

I would like to address relational care, which the hon. Member for Upper Bann (David Simpson) raised in his intervention. It covers matters such as communication, trust in nurses and being treated with respect, all of which are important for cancer patients. There is still room for improvement, according to the findings of the most recent survey. For example, 42% of respondents said that not all doctors and nurses asked what name patients preferred to be called by, which can be important to older people. It is a question of finding the right amount of kindness. Our clinicians—nurses and doctors—are marvellous, but that did emerge from the patient survey. Kindness can make a great difference to people in that situation.

Macmillan Cancer Support’s report showed that patient experience across the NHS is still not regarded as having equal importance as clinical effectiveness and patient safety. The Government’s decision to make patient experience one of the five domains against which the health service will be held to account should be warmly welcomed. It is clear, however, that a lot of effort needs to be put into the institutional framework to reinforce that priority.

The NHS mandate and outcomes framework needs a stronger focus on improving relational care. Hospital boards need to take a lead on prioritising patient care; a recent survey showed that its importance to different hospital boards varies considerably, which is clearly wrong, because all hospital boards should take it seriously. Commissioners of cancer services have a vital role to play, as does the chief inspector of hospitals. All such bodies need to reinforce the need for relational care and kindness in dealing with cancer patients.

--- Later in debate ---

[Mark Durkan (Foyle) (SDLP)]

It is a pleasure, Mr Owen, to meet under your chairmanship this morning. I congratulate the hon. Member for Hertsmere (Mr Clappison) on introducing this important debate. I want to raise a few points on the cancer experience that arise from my constituency.

As other Members have said, it is important that, in providing and modelling our services, we should directly draw on the experience, both in qualitative and quantitative terms, of patients and focus on outcomes. We also need to harness fully the insights that patients can give us into how services can be improved, better managed, better modelled and, more importantly, better accessed and understood.

In my constituency, there has been a major campaign for a localised radiotherapy unit. It was meant to happen as part of the overall improved cancer strategy in Northern Ireland, but for various reasons it got held up. The campaign was led by the Pink Ladies, a group who have gone through the cancer journey. They have all experienced breast cancer, but they are in no way exclusive about their cancer as opposed to other types of cancer experience.

On Monday morning, I attended a Pink Ladies event, which focused on the new partnerships in which the group was involved. It has spread its involvement to include not just Macmillan Cancer Support and Action Cancer but local community partnerships. It discussed providing new services at a neighbourhood level, including counselling services, listening-ear services and complementary therapy services. All are supported by professionals in the Western Health and Social Care Trust.

The issue is about making the services more accessible, comfortable and compatible with local users, who will rely very much on those who have been through, and are going through, the cancer experience, because such people are best placed to give support to others who are new to the journey.

On the point made by the hon. Member for East Londonderry (Mr Campbell) about male sufferers, an offshoot of the Pink Ladies has been formed comprising males who have been through, or are on, the cancer journey. They, purely in derivative terms, call themselves the Pink Panthers, but they are addressing exactly the issues that the hon. Gentleman mentioned. Part of the role of the groups is to help to provide advice to other patients, and their families and carers, about some of the issues that might arise and to anticipate some of the questions that might be going through patients’ heads—questions that they are just not able to articulate or are not yet ready to vocalise.

[Mr Robin Walker]

I am grateful to the hon. Gentleman for giving way. I apologise for having to leave the debate before the summing up.

I want to pick up on the hon. Gentleman’s point about how cancer patients can contribute to the campaigns. I have had a radiotherapy campaign in my own constituency in which Paul Crawford, a former head and neck cancer patient, has played an important role. Does the hon. Gentleman agree that cancer patients can play an important role by getting on the boards of local health trusts and health bodies and providing knowledge and experience, as indeed my constituent has?

[Mark Durkan]

I fully accept the hon. Gentleman’s point. The point that I was about to make myself exactly “rhymes” with his observation. It is that these people are in a position to offer advice to others diagnosed with cancer; to offer advocacy to politicians, service providers and managers as to how things can be improved; and to offer real insight in administrative terms, by helping to future-manage such services and review them against the sort of yardsticks that other hon. Members have said they must be measured against.

I said that the radiotherapy unit now to be based at Altnagelvin, which will be funded on a cross-border basis in Ireland, is really a roll-out of part of the wider cancer strategy in Northern Ireland. A number of years ago, I served as Minister of Finance in Northern Ireland in the first Executive following the Good Friday agreement, and then as Deputy First Minister. One of the most important things I did was when we negotiated what was called a reinvestment and reform package, with new borrowing powers coming from Westminster but also a funding package that was to complement the infrastructure fund that we as the Executive had developed.

The first item that I was able to insist on with Tony Blair and then with the right hon. Member for Kirkcaldy and Cowdenbeath (Mr Brown)—the two former Prime Ministers—was that funding should go to the regional cancer centre. It was meant to be a key part of the cancer strategy in Northern Ireland that was being led and advocated by Professor Paddy Johnston. We were able to fund that scheme, which was not coming forward and which did not seem to be breaking through in the Department of Health’s plans or budget submissions to me or to anybody else. We had been on the point of losing Paddy Johnston, who was going to go back to the United States, where he was going to be funded to do all sorts of things and use his skills.

However, as I say, we were able to create that cancer centre without going to a private finance initiative or anything else. Great work is being done there, not only for the patients it serves in Northern Ireland but because of the calibre of people it can attract and the clinical trials it can run, which are all part of improving the picture of cancer services throughout the United Kingdom.

As other hon. Members have said, staff at that centre and others are helping to work miracles every day with people who are suffering from cancer, but they are very conscious and very clear that their task is still to keep narrowing the gap between what the services ought to be and what they actually are, which is why we constantly need to drive on performance and outcomes in these areas.

Regarding the cancer experience, I am also very conscious of a constituent of mine who wrote a book a number of years ago, based on her experience, which basically says, “I have cancer but it doesn’t have me.” She is a lady called Kate Dooher and her book sets out very clearly her experience of a cancer journey and the implications for her family, colleagues and friends. Again, policy makers can get real insight from that about what the issues mean in real and practical terms.

I am a member of a number of the all-party groups on cancer, including all-party groups on different cancers, here in Parliament. Those groups can provide a platform for those with real insights, those who are providing care, those who are leading a lot of the professional fight against cancer and those who are driving the research platform. We should not underestimate the importance of either research or the linkage between good care networks and research. That is why Cancer Research UK is one of the most prominent advocates for more radiotherapy provision, because it believes that such provision not only makes services more accessible but that it is important in qualitative terms and in the research benefits that can come from improving services and treatment models in the future.

Going back to what the hon. Member for Hertsmere said, that is why, when we are talking about the patient experience, we very much have to listen to the patients themselves and base things not on what we think is the “nice fit, reasonable fit, just about cost-effective patient experience” but think in real and wholehearted terms about the patient experience.

Patients know how they have been able to improve their own experience for themselves, and they know how services whose staff might think they work do not really work for them, and how those services can be improved and modified. We need to gain their insight and emancipate their understanding as part of lighting the way forward for ourselves.

Brain Tumours in Children

Robin Walker Excerpts

Tuesday 3rd September 2013 Westminster Hall

[Mr Raab]

I thank my hon. Friend for her intervention. I am open to that idea, but the point is that councils have an internal mail system for delivering items to schools and nurseries. They are used to distributing in bulk, which is what we are talking about, to all schools. If we distributed the cards via MPs, I am not sure that it would happen in every case, although it certainly would for many. We need a comprehensive, co-ordinated approach, and, of course, our local councils have responsibility in this area.

[Mr Robin Walker (Worcester) (Con)]

rose—

[Mark Pawsey]

rose—

Health and Social Care

Robin Walker Excerpts

Monday 13th May 2013 Commons Chamber

[Mr Charles Walker (Broxbourne) (Con)]

I pay warm tribute to the right hon. Member for Cynon Valley (Ann Clwyd). That was an incredibly moving speech—we could have heard a pin drop in the House of Commons throughout those eight minutes—and a fantastic contribution to the debate.

I had intended to make a statesman-like speech, but sitting next to me is possibly one of the greatest statesmen, my right hon. Friend the Member for Mid Sussex (Nicholas Soames). I do not want to go out and bat on a losing sticky wicket; I would rather have a general thrash around the field of play. I admit to the right hon. Member for Leigh (Andy Burnham) that I am a Eurosceptic. When I came to the House of Commons, I fell into bad company, including my hon. Friend the Member for Aldershot (Sir Gerald Howarth). Indeed, when I arrived here, I was nursed at the bosom of my hon. Friend the Member for Stone (Mr Cash), so I am a Eurosceptic—[Interruption.] Anyway, I want to crack on.

In 2011, I attended a public meeting in my constituency. We were discussing the future of an urgent care centre. Five hundred of my constituents were there for a lively debate, which ended at about 8.30 pm. I had arranged at 9 pm to travel northwards in my constituency to Hoddesdon to meet 12 or 14 Polish people. As I left the room of what I would regard as fairly natural Conservatives and got in my car to drive up the A10, I thought, “Why on earth am I heading up the A10 to meet 12 or 14 Polish people?”

I was pleased I did. They waited in a circle to see me. We were in a recession at the time, but their eyes were gleaming and glittering. They said, “Mr Walker, this is the land of opportunity. It is fantastic. You don’t just get one job here; you can have two jobs. If you do those jobs really well and do what you are asked to do, you get promoted. This is a fantastic country.” It was so refreshing to see such enthusiasm in the room.

We should have had transitional measures in place when the Poles came over to this country. It was not good enough to say, “There might be 15,000 or 30,000,” when 500,000 ended up coming here. That was a grave error. However, to say that the Poles are somehow responsible for the country’s problems is a gross simplification and a fairly disgraceful statement to make. As I have said, I wish fewer had come here, because we should have had transitional arrangements. The infrastructure was not ready to welcome 500,000 people to this country, but I cannot fault them for a second for wanting to come here.

People say that people from eastern Europe want to come to this country to sponge off the NHS and our welfare system. The minority will, but the majority want to work hard and do the best for their families. There are rotten apples from European nations in this country, but there are quite a few rotten apples from this nation in foreign countries—hon. Members might have managed to see that a British fugitive was arrested by Spanish police yesterday on the Costa del Sol.

Immigration is not a uniformly good thing. It tends to work for the middle classes and the upper middle classes, whatever they are now. Basically, it works for people with money. Immigrants work very hard in our restaurants and cleaning our offices. However, immigration does not work so well if people are competing for scarce resources such as health, transport and education. I understand the concerns of people who now face additional pressures on scarce resources. We did not plan well. I do not want to sound overly partisan, but—dare I say—the previous Government did not plan well for the upsurge in immigration, which has created difficulties in our constituencies and a great deal of concern.

In my remaining three and a half minutes, I want to say a few more things about immigration. I am not a soft touch on that matter. I am extremely concerned about the continued underperformance of the UK Border Agency. About six years ago, I made the decision not to deal with immigration cases in my surgeries; I have enough problems from my own electorate to deal with, without having to take up UKBA’s case load as an unpaid officer.

Although our immigration system is improving, it still has a long way to go. It is simply not right that some people in this country should have to wait seven, eight or nine years for a decision on whether they can stay here. That is inhumane—it does not serve them or the taxpayer well. Unfortunately, those people are egged on by fairly ruthless and unpleasant lawyers, who keep lodging appeals and dragging out the process. However, it is we as politicians, of course, who provide the scope and room for those people to pursue those endless appeals processes. We must truncate the appeals process.

[Mr Robin Walker (Worcester) (Con)]

I congratulate my hon. Friend on his excellent speech. Does he agree that a system that does not work and leaves people in limbo is neither efficient nor compassionate?

[Mr Charles Walker]

I completely agree. Such a system is not efficient or compassionate and does not carry the confidence of the British people. More needs to be done to ensure that our immigration system carries the confidence of the British people, is fair and rewards immigrants who play by the rules. There has to be a premium for playing by the rules. We have to do something about the immigration system; we have to truncate the appeals process and to deal with people more quickly, including removing them more quickly once a decision has been reached.

I conclude with a few thoughts. I am a great fan of culture; I have travelled the world and immensely enjoyed other people’s cultures. However, I am also a great fan of our culture, which I think is pretty special—indeed, its promotion and protection are probably why most of us have chosen a vocation in politics. Our culture is often caricatured as being about the royal family and maypoles. Those are important—well, the royal family are; I am not so sure about maypoles—but what is our culture? Our culture, which we should promote ruthlessly, is freedom of speech, freedom of association, freedom of thought and expression, and the rights, protection and promotion of women and minorities. That is what being British is all about and what makes this country so attractive to so many people around the world.

I want to say something that I hope will not be misinterpreted. If people want to come here and make a positive contribution, that is fantastic. But people coming to this country should please value and respect everything that it offers them. It really is a great place. We can celebrate other people’s cultures, but we cannot have separate communities and societies in this country—that is not healthy for us or for those wanting to live here who eventually, I would like to think, integrate and become part of what is still a great place to live.

I am afraid I am running out of time, which probably comes as a great relief to most Members. I would just say that I am a world-expert moaner; if the Prime Minister even thinks about me, it is, “Oh my Lord! There goes Charles Walker moaning away again—the moaner-in-chief.” Actually, however, we are not in a bad place in the United Kingdom. Look at what is going on in Italy, Spain, Greece and Ireland. Things are pretty good here. I am sorry to say this to my Liberal Democrat hon. Friend, the Minister of State, Department of Health, but I am the first to whinge about the coalition. However, we are not actually in a bad place and in the final analysis, we should be grateful for what we have.

--- Later in debate ---

[Mr Robin Walker (Worcester) (Con)]

It is a pleasure to speak in the debate on the Humble Address that was proposed so elegantly by my neighbour and hon. Friend the Member for Mid Worcestershire (Peter Luff), in whose speech I was named and suitably embarrassed. I was grateful for the kind tributes that were paid to my late father by my hon. Friend and the right hon. Member for Doncaster North (Edward Miliband), the Leader of the Opposition. I was keen to speak in today’s debate because what the Leader of the Opposition referred to as “that voice of moderation” and what my hon. Friend rightly identified as the middle way, the spirit of one nation conservatism, is not, as the right hon. Gentleman tried to suggest, unfashionable, but is at the heart of this Government’s programme and embedded in the Queen’s Speech.

“Efficiency with compassion” were the watchwords of my late father. He believed that a balance of the two was essential to meet the challenges of the hour and the needs of our country. I believe that the same is true today. Compassion has been shown by the coalition Government in introducing the Care Bill and by being the first to introduce legislation to cap social care costs. I spoke in the debate on last year’s Gracious Speech to express my disappointment that there was no such legislation and to support Opposition Members who were calling for it. It would be churlish of those who spoke out then not to recognise the enormous significance of the move in this Gracious Speech.

By setting a cap, albeit a higher one than many of us would have liked, the Bill will start the process of ensuring that nobody has to lose their home to pay for care. Setting a cap at any level should help the insurance industry to create products that protect thousands more people from that risk. The threshold, as the right hon. Member for Sutton and Cheam (Paul Burstow) pointed out, is key and will ensure that thousands more people are helped by the Government than would have been the case without the legislation.

This is not a theoretical far-off issue that we can put off tackling, but a real and painful issue that has affected our constituents for too many years. Hard-working people who have laboured and saved for years to afford the roof over their heads should not find that when they need care, their families are deprived of that asset. We all have constituents to whom that has happened. This is not, as some would like to pretend, a problem only for the rich. It affects everyone who owns a home and stands to lose it if the costs of their care are too great. Many of them are people who can afford to own a home only in retirement and many of them live in former council houses.

It was right of the Government to commission the Dilnot review and it is right to strike the balance that Dilnot acknowledged was needed between the cost of the policy to the public purse and the desperate need for a cap. Too many homes have been sold to pay for care. It is a tragedy that Governments of all colours have failed to act sooner to address the problem. It is greatly to the credit of the coalition that it is proposing the first part of a solution. I also draw the Minister’s attention to Macmillan’s ongoing campaign for further progress on free social care at the end of life, which was mentioned by my hon. Friend the Member for Truro and Falmouth (Sarah Newton).

Compassion is also being shown in the determination to improve the pensions of those who have spent years bringing up children, in the focus on preventing sexual violence across the world, and through tackling the impact of climate change, which will affect millions of the poorest people in the world. Compassion continues to be served by other ongoing policies of the coalition Government, such as the pupil premium, which directs funding to the most deprived pupils and helps schools to raise their attainment; the greater increase in the basic pension; and the increased investment in our NHS.

We have heard much from Labour Members about the pressures on our NHS and Ministers are right to have acknowledged the challenges faced in A and E and urgent care, but it is absurd for the Labour party to rail against pressures that have been building for years, including under its rule, and then to implement cash cuts in NHS spending in Wales, where that party runs the Government. The South Worcestershire clinical commissioning group will receive a £7 million increase in funding this year as a result of the coalition’s policy of increasing NHS spending. By coincidence, that is the amount by which the funding of Welsh health boards is being cut this year by the Labour Administration. On a recent visit to my local hospital, I saw some of the pressures on A and E, but I also saw how the coalition’s investment had enabled the retention of more nurses and how it will soon deliver a new clinical decisions unit that will help to alleviate some of the pressures.

We have heard much from the Labour party about the supposed privatisation of the NHS. I recently asked my local clinical commissioning group what amount of its budget goes to the private sector. Knowing that it has for some years, including under Labour, contracted certain operations, such as hip replacements, to private sector providers, I had presumed that the amount would be quite significant. I was surprised to find that the spending of the South Worcestershire clinical commissioning group in the private sector amounted to just 1.8% of its budget. That is less than its increase in spending this year. This Government are committed to efficiency and compassion in the NHS.

Compassion and efficiency are served by the emphasis on education in the Queen’s Speech. I would like to expand on that in more detail, but fear that I do not have time. We have heard excellent speeches from my hon. Friends the Members for Lancaster and Fleetwood (Eric Ollerenshaw) and for South West Devon (Mr Streeter) about the funding formula in health. I merely point out to the Government that addressing the funding formula in education is equally urgent.

[Jeremy Lefroy (Stafford) (Con)]

Will my hon. Friend acknowledge that that is an issue across many parts of England, including in my county of Staffordshire?

[Mr Walker]

I wholly agree with my hon. Friend. I will be in Staffordshire to meet the F40 group and its executive, who are campaigning for fairer funding and a more efficient system.

That brings me to the efficiency side of the equation. As a member of the Business, Innovation and Skills Committee, I would have liked to speak on the day of the debate that was themed on that portfolio. I regret that the Opposition chose to assign that theme to a Friday when I, like most other MPs, have many commitments in my constituency, including speaking to local businesses and schools.

There is a great deal in the Queen’s Speech to support business and increase efficiency in Government. The employment allowance is something that I have campaigned for and it will be extremely welcome to smaller businesses and entrepreneurs as it will reduce the cost of taking people on. I would like to have seen a Bill to reform business rates and will continue to push for further such reforms. The Bill to reduce regulation on business has been called for by almost every business organisation that I have met and will be universally welcomed, as long as it works.

The investments in infrastructure are sensible and necessary to support growth in our economy and to get Britain moving. Reducing the deficit is essential. For all the noises off that we have heard from the Opposition in this debate, they still have not got the point that the answer to a debt crisis cannot be to borrow more. When one invests, it is essential to invest well. The story of Worcester’s colleges is just one example. The previous Labour Government promised huge rebuilds costing tens of millions of pounds, but delivered nothing. This Government have delivered measured investments that have made a difference.

It would be remiss of me, having spoken in the Back-Bench debate on an EU referendum some years ago, not to mention the amendment that has been tabled by many Back-Bench Members, which I hope will be selected for debate by the Chair. I was proud to support a motion that called for a European referendum two years ago. I welcome the fact that our Prime Minister has set out clearly that he will fight for a referendum at the next election and that he is pressing for a renegotiation of our relationship with the EU in the meantime. He was right to wield his veto, he was right to press for a reduction in the European budget, which many thought was impossible, and he is right to say that the people of this country need to be given a real choice. Like my right hon. Friend the Member for Mid Sussex (Nicholas Soames), I have every confidence that he will continue to succeed on this issue.

I regret that some in the media have sought to build the amendment up as a criticism of the Prime Minister. It is for that reason that I did not sign it. However, I do regret that we could not include an EU referendum Bill in the Queen’s Speech, not because I believe it could have succeeded against the arithmetic of this House and its current composition, but because the debate would have shown how out of touch the main Opposition party is on this issue. I shall therefore support the amendment if the chance arises, and I welcome the fact that in my party at least, it will be a matter of conscience and a free vote. Although the current media frenzy is trying to paint a picture of division, I am pleased that my party is united in its determination to change our relationship with Europe for the better.

In conclusion, it is a challenge for all Governments to balance efficiency with compassion, but for all the strains of coalition—and there are many—the coalition Government continue to govern in the national interest. Perhaps that is why, despite being mid term and despite visits in the weeks before the recent local elections from the leaders of UKIP and the Green party and the Leader of the Opposition, the party that won the greatest share of the popular vote across Worcester was none of those but the true one-nation party—the Conservative party.

I particularly welcome the historic and long overdue decision announced in the Gracious Speech to place a cap on the cost of social care. I am honoured to have spoken in this debate and I look forward to supporting the Government as they continue to press for a fairer and more prosperous Britain.

Immigrants (NHS Treatment)

Robin Walker Excerpts

Monday 25th March 2013 Commons Chamber

[Mr Hunt]

If we do not know the figure, is not the right thing to do to find it out and sort out the problem, unlike what the hon. Gentleman’s party did during 13 years in office?

[Mr Robin Walker (Worcester) (Con)]

I congratulate the right hon. Member for Birkenhead (Mr Field), who in raising this issue is, as always, streets ahead of those on his own Front Bench.

May I thank my right hon. Friend the Health Secretary for the extra £20 million funding that the NHS in Worcestershire will receive this year, and urge him to take that agenda forward and ensure that as much funding as possible goes to the residents of Worcestershire and to addressing the kinds of pressures that we saw over the last week in A and E?

[Mr Hunt]

Obviously, I want to ensure that as much money as possible goes to residents throughout the country by tackling abuse, and I would not want to minimise what the issue might be in Worcestershire. I stress, however, that the biggest problem we face is in big urban centres where there are large numbers of illegal immigrants, and we must get a grip of that problem for the sake of the elderly population in those cities.

Alexandra Hospital, Redditch

Robin Walker Excerpts

Tuesday 12th February 2013 Westminster Hall

[Dr Poulter]

With regard to “bread and butter” day-to-day medical services, my hon. Friend is absolutely right to say that. My point was that for some services—for example, trauma or stroke—having specialist centres brings better results for patients, and there is good clinical evidence to back that up. However, day-to-day, higher-quality “bread and butter” services for patients—such as heart care or children’s services—are often best provided locally, and he is absolutely right to make that point.

[Mr Robin Walker (Worcester) (Con)]

I congratulate my hon. Friend the Member for Redditch (Karen Lumley) on securing this very important debate.

The Minister mentioned the issue of recruitment of clinical staff. One thing that the NHS in Worcestershire has worked very hard on is a cancer strategy to keep cancer care within the county and to make the Worcestershire Royal hospital a centre of excellence for cancer care. We are looking to secure a radiotherapy unit in the near future. I urge the Minister, in taking whatever decisions are necessary to ensure that the county has the strongest, most sustainable NHS, to pay attention to that work and to the importance of having a cancer service for the county.

[Dr Poulter]

My hon. Friend is absolutely right to praise the high-quality work done in Worcester to look after cancer patients. It is exactly the point that I was making in response to the intervention from my hon. Friend the Member for Mid Worcestershire (Peter Luff): the high-quality day-to-day services that patients need must be delivered locally, but more specialist operations—such as for head and neck cancer—might be carried out at a specialist site that is geared up for such operations. Day-to-day oncology care, however, is often best carried out locally, particularly when people are unwell with cancer and receiving sometimes very intensive treatment. In those situations, they need to be looked after locally.

It does not benefit patients, for medical and many other reasons, to have very long distances to travel. However, when surgical outcomes might benefit from operations being carried out at specialist centres, we must differentiate day-to-day treatment from the more specialist care that may be required as a one-off surgical intervention. We should do that when the evidence stacks up that specialist centres for such surgical interventions often deliver better results and better care for patients. Nevertheless, my hon. Friend is absolutely right to pay tribute to his local trust for the work that it does on cancer care in Worcester, which I know is very important to him personally.

I will now respond specifically to some of the points that have been made in the debate, and consider how we go forward from where we are now. Hon. Members, particularly my hon. Friend the Member for Redditch, have made us well aware, through their articulate contributions, of the challenges that are faced by the local health care economy. Such ongoing uncertainty about the future of local health care services is wrong and completely undesirable. When local commissioners bring forward proposals for the two options that are likely to be considered later in the month, I urge them to move forward as promptly as possible to bring certainty to the situation. That will allow consideration of important issues, such as the need to have high-quality professionals working in hospitals. When there is uncertainty about the future of a trust or a particular site within a trust, it can be difficult, as my hon. Friend rightly outlined, to recruit high-quality staff to work in that trust. That is not in patients’ best interests, so the sooner we can have certainty, the better. I know my hon. Friend will join me in urging local commissioners to bring things forward as expediently and quickly as possible.

As we know, the trust is committed to providing the best-quality care for patients. That is essentially about finding the best solution for the people of Worcestershire so that they receive the best care in the future. As my hon. Friend outlined, Worcestershire Acute Hospitals NHS Trust and the West Mercia cluster have jointly commissioned a strategic review of services in the area. The review is essential to secure the clinical and financial sustainability of high-quality services for local people. That is about looking not just at getting through the next couple of years, but at what will be right for the local health economy in five or 10 years’ time.

I understand my hon. Friend’s concern that there have been delays with the review, and I once again urge local commissioners to take things forward as expediently and quickly as possible. The Worcestershire joint services review started in January 2012, and it was expected to be completed by November 2012. I hope my hon. Friend is somewhat reassured that we will move forward more quickly, notwithstanding a patchy history on resolving local health care issues. There is a need for certainty locally, and we must make sure that the time line is met and that we have a firm conclusion.

Importantly, the review involves clinicians and commissioners across the area and the NHS. It engaged with local people last summer to inform the development of proposals. As we know, developing proposals for the future of local services is about clinical leadership and about clinicians saying what is important and in patients’ best interests, but it is also about local involvement and engagement. When I met my hon. Friend before Christmas, we discussed that. The local newspaper has played a tremendous role in promoting local patients’ needs. My hon. Friend and the local population should be proud of the cross-party consensus on the importance of Redditch’s future.

Through the review, local people will have made, and will continue to make, their voices and views clear. That is important for the Government and for our four tests for reconfiguration. It is also important that local health care providers, the local trust and the trust’s board listen to local people and local health commissioners to make sure that their views are informed by what local patients want and need and by what local clinicians say is in patients’ best interests.

The joint services review steering group met on 12 September 2012 and, unfortunately, decided to delay the process again until it could explore all options to allow it to maximise service provision at the Alexandra hospital, including investigating the potential to work with other NHS providers—Birmingham being a case in point.

My hon. Friend will be aware that the Redditch and Bromsgrove clinical commissioning group has started initial discussions with three NHS providers in Birmingham to explore the feasibility of providing services from the Alexandra hospital: the University Hospitals of Birmingham NHS Foundation Trust, Birmingham Women’s NHS Foundation Trust and Birmingham Children’s Hospital NHS Foundation Trust. Those discussions are still in their early stages. However, my hon. Friend is right that when proposals are brought forward—hopefully, by the end of this month—we should move things forward quickly for the benefit of local patients.

No decisions have been made, and the discussions are only about the Alexandra hospital—that needs to be clearly set on the record. The Worcestershire Acute Hospitals NHS Trust would continue to provide all other services. Given the concerns my hon. Friends have raised, it is important to note that, although the services the trust provides need to be seen holistically, the ongoing discussions are about the specific future of Alex’s site in Redditch. That is an important distinction, and I hope it gives my hon. Friends some reassurance that any proposals are unlikely to disrupt local services to the patients they care about.

Ultimately, the decision is for local determination, and it would not be appropriate for me to comment on the discussions in further detail until we have firm proposals. We will continue to meet regularly. I am visiting Redditch in the near future, and will take a keen interest to make sure I can do all I can to support the right result for local patients.

Dementia

Robin Walker Excerpts

Thursday 10th January 2013 Commons Chamber

[Oliver Colvile]

I agree with my hon. Friend. This is also about the families, who have to deal with dementia on a daily basis.

Given the appalling events at Stafford hospital, appropriate checks and balances must be put in place to ensure that people with dementia are given the proper quality of care in all hospitals. Further, it should become standard practice that the demands of someone with dementia should be listened to. It is incredibly important that we get better at listening to what they, and their families, are saying. Dementia is a complex illness, and it is often difficult to assess its onset. Whenever possible, however, conversations should be held with the individual and their loved ones about what is happening and the process that is involved. Such conversations would be useful in helping the family through the process.

Dementia is now one of the top five causes of death in the United Kingdom, and it is disappointing that the health and wellbeing boards are being a little slow to consider people’s needs. About 800,000 people in the UK have dementia, and that number is going to go up. It is said that more pressure is being put on the national health service. I do not think that is right. I think that we are making enormous strides in order to deliver better health care for our elderly. It is because we want to do more that our national health service is facing increasing levels of challenge.

For those with dementia, the changes to long-term care are crucial. I am delighted that the Government are looking at trying to take forward the Dilnot report, to which I made my own submission—I have a copy here or I could e-mail it to the Minister. That report must be viewed as a blueprint for how to go forward.

There has been increasing debate with the Treasury since the 1940s. Let me remind everyone of what happened in 1947 when the national health service, of which we are all very supportive and proud, was first set up. The other half of the equation was long-term social care. Over the last 10 or 15 years since I was a candidate for Plymouth, Sutton as it then was—it is now Plymouth, Sutton and Devonport—I have spoken about the divorce of social care from the national health service. If I have a heart attack or have cancer, I will have to deal with it one way, but if I have Alzheimer’s, Parkinson’s or dementia, it will be considered to some extent as being a separate challenge. I believe that we need to bring the two much closer together.

I have some concerns about using insurance. Every time I have had to make claims—on my car insurance, for example—I have always had some difficulty with my provider. We need to look at that, but we need to ensure that people do not see all their savings just disappearing into a black hole. That is something that we need to deal with as a country. There is a danger that the amount of money individuals are asked to pay for their care will remain far too high. We cannot hide from that in our ageing society.

At the beginning of my time in the House, I wrote a paper on the strategic defence and security review, in which I said that there were two important matters of which we needed to take notice. The first was that more money needed to be put into defence—I continue to say that—but the second was that we should devote more money to long-term care for the elderly. That was my No. 2 priority; it has to be incredibly important.

I welcome the Government’s decision to take on the global health challenge—a priority after years of neglecting this growing problem. I welcome the Prime Minister’s commitment and the leadership and extra support he has provided for people with dementia in carrying out their everyday tasks. That shows a shift in the wish to combat the stigma that surrounds dementia and to achieve greater awareness of the illness. We need to learn, too, from the ethnic minority communities that tend to work much more closely together with their families in providing care.

[Mr Robin Walker (Worcester) (Con)]

My hon. Friend is making an excellent speech. I want to support his point about the Prime Minister and the issue of stigma with a quote from Professor Dawn Brooker, who helped found the Association for Dementia Studies at the university of Worcester. She said:

“Stigma and fear are the biggest enemies of achieving”

progress on dementia. She continued:

“What makes the PM Challenge so important is that it says very clearly that he is not ashamed or fearful of standing up and talking about dementia. If he can do this then it makes it safe for every politician and leader to do the same.”

I believe Members of all parties have shown the same courage in taking this issue forward today.

[Oliver Colvile]

My hon. Friend is absolutely right, and the same issue applies to mental health, about which I have also spoken at some length in this place. We need to break down these taboos and move on.

I very much hope I have not taken all the thunder of the hon. Member for Plymouth, Moor View. There must be joint responsibility between Government health boards and staff in the health service to ensure that the diagnosis of dementia and the quality of care improve significantly. In way, we can show that we are on track for the future.