In Amenas Hostages

Debate between Rosie Cooper and Mark Simmonds

Wednesday 12th June 2013 Westminster Hall

[Mark Simmonds]

Of course I am aware of the detail of the Foreign Affairs Committee investigation. The hon. Gentleman is partially right, in that the perpetrators of that terrorist atrocity were not all from inside Algeria, but he will also be aware that the borders in that part of Africa are extremely porous. It is a significant challenge that countries in the region must resolve, with the co-operation and assistance of the international community at both multilateral and bilateral levels, if we are to ensure that that sort of situation does not occur again.

To pick up on one of the key elements of the contribution made by the hon. Member for West Lancashire about the safety of the British nationals involved, the repatriation of those killed and the evacuation of the wounded and freed hostages was the top priority of the Foreign and Commonwealth Office, and of the international community as it related to people of other nationalities. Staff in London and Algiers worked around the clock to support the Algerians in resolving the crisis, and our embassy in Algeria was strengthened by 18 consular experts, six experts from the Red Cross and specialists from the Metropolitan police. We gave direct assistance to the British nationals involved in Algeria, and our ambassador was the first to reach In Amenas. Our response involved playing a leading role among the countries affected, including sharing information with them and supporting the identification of victims. We have continued to take a lead since then, for instance by co-ordinating work on the return of possessions.

As hon. Members will remember, In Amenas is two days’ drive from Algiers; it is in the middle of the Sahara desert and is one of the most remote places in the world. Information was therefore difficult to come by, not least since we were not informed in advance of Algerian operations. None the less, I understand and regret that the unpredictable nature of events and a lack of detail caused distress for those waiting for news.

The attack was on a significant scale. From the outset, the Prime Minister led the United Kingdom response, chairing Cobra on a number of occasions. He continued to do so in the month after the attack, making a ground-breaking visit to Algeria, closely followed by the Under-Secretary of State for Foreign and Commonwealth Affairs, my hon. Friend the Member for North East Bedfordshire (Alistair Burt). We believe that early, proactive and personal engagement with families and relevant MPs is essential. I am grateful to the hon. Member for West Lancashire for her commendation of my hon. Friend, who did a sterling job in difficult circumstances.

My right hon. Friend the Prime Minister immediately offered ministerial contact, via police liaison officers, to all affected families and MPs, a number of whom took up the offer, including the family of Mr Barlow. I know that my right hon. Friend has recently spoken with them again and regrets sincerely that he cannot be here in person today.

I accept that we may not always get contact right in crises where information is limited. The Foreign and Commonwealth Office always seeks to learn from such incidents, and my hon. Friend the Member for North East Bedfordshire will be doing so. He has discussed the police liaison process with the assistant commissioner of the Metropolitan police to see whether it can be improved in future.

The hon. Member for West Lancashire specifically made the point that what happened was unclear. It is still unclear. Some of the details are still not known. I know how hard that must be for the families, but it would not be appropriate for me to comment on behalf of the Algerian authorities or BP. Instead, we very much hope that the investigation, on which the Algerian authorities are leading, and the coroner’s inquest in the UK, will answer some of the hon. Lady’s questions, and those of her constituents and others.

We continue to discuss the detail of the In Amenas attack with the Algerian authorities at every available opportunity, including at ministerial level, as we did when the Prime Minister and the Minister for the middle east visited in the weeks following the attack. We will support their investigations in any way that we can. We continue to seek assurances from the Algerian authorities that they will share details and access to the site in the aftermath of the attack. None the less, it must be said that Algeria is a sovereign country and, just as we would expect to do here, the Algerians must be allowed to conduct their investigations in accordance with their own laws.

The coroner’s investigation will take place early in 2014. The Government are supporting that process. A small team of Metropolitan Police Service officers travelled to Algeria on 18 January to lead on the identification and repatriation of those who died, and they continue to gather information. They last travelled to Algeria in May. Her Majesty’s coroner for West Sussex will hold a preliminary hearing on 1 July, which will set out the scope of her investigation.

It is important to understand that this is a complex inquiry into deaths that occurred at a site staffed by multinational personnel. Nationals from nine other countries lost their lives, and individuals from a total of 29 countries were involved, so much of the information that might assist the coroner is not automatically available in the UK. The police are therefore liaising with the Foreign and Commonwealth Office, the Algerian authorities and other international authorities and partners to progress enquiries and get that information on the coroner’s behalf. Regrettably, that will take time, but I am sure that the hon. Member for West Lancashire will agree that it is absolutely essential that the investigation is thorough and benefits from the maximum availability of the appropriate amount of information.

[Rosie Cooper]

I am happy to agree that the investigation should be thorough and proper, but can the Minister comment on the fact that SO15 officers were not allowed access to begin that investigation when members of the media were? Surely that is the starting point for a thorough investigation, is it not?

[Mark Simmonds]

I understand the hon. Lady’s point. She was right to emphasise in her initial remarks the assurances that the United Kingdom Prime Minister received, but I am sure she also understands that the Algerians are leading the judicial investigation. They have allowed some access to the site for the repatriation of personal property and possessions, which the UK took a lead on. I assure her that we will continue to press for the appropriate level of access for the UK investigative team in support of the Algerian and coroner’s inquests. I assure all hon. Members that the Government will continue to do all they can to support the families in their search for answers to their very appropriate questions.

Health and Social Care (Re-committed) Bill

Debate between Rosie Cooper and Mark Simmonds

Tuesday 6th September 2011 Commons Chamber

[Mark Simmonds]

I will not get into the nuances and the legal battles that other hon. Members have raised. Professor Steve Field and his team did an excellent job thoroughly and comprehensively in a relatively short time. To be fair to the Secretary of State and his team, they looked carefully at the suggested changes and have incorporated some of them in the clauses before us. I agree with many of them, and I highlighted some of these points on Second Reading—a greater emphasis on integration, wider engagement with a broader range of clinical commissioning teams, and greater protection for services which, in financial or quality terms, may not be providing the service that patients expect. All those have been changed in the Bill.

Almost all the Members on the Government Benches would not support the Bill if it was about privatisation of the national health service. It is not. It tries to ensure that the national health service has a future, and that the organisation that is in the best position to provide a particular service in a particular geographical locality has the ability to do so. That is not just the private sector; it is the voluntary sector, the charitable sector, the not-for-profit sector and the social enterprise sector. The mantra coming from the Opposition seems to dictate that those organisations should not be allowed to provide health care—that unless health care is provided by the state, it should not be allowed. That clearly is wrong. What is important is not the delivery mechanism, but patient outcomes and the quality of service provided.

I shall deal specifically with new clause 2 and amendments 100 to 104, 106 and the subsequent related amendments. They ensure that equity of access continues, irrespective of whether the provider is in a good financial state or not. My right hon. Friend the Member for Charnwood (Mr Dorrell) put his finger on exactly the right point, as he so often does. What matters is continuity of service, but not necessarily from the same provider.

The national health service has always changed in that way. It has always reconfigured services to make sure that the patient receives care of the best possible quality. New clause 2 puts in place an essential mechanism to ensure continued access for patients to NHS services. It is right that the Government are putting in place safeguards to protect patients and taxpayers, but the clause does more than that. It also enables commissioners to replace services with higher quality and better value options. Among the major failures of the last decade in which Labour was in charge of the national health service was not only the decline in productivity, but the fact that there was insufficient decommissioning of poor services and insufficient replacement and improvement of poor-quality service provision. Nowhere is that more marked than in Tunbridge Wells and Stafford.

The primary purpose is to enable Monitor to support commissioners to access services and place conditions on a licence holder. Some of those conditions are set out in the Bill. All hon. Members know that there is considerable variation in performance of organisations within the national health service. Providers who are providing excellent services should be allowed to thrive, innovate and drive the quality of clinical care. Those that are under-performing will require challenging, and support where necessary. Ultimately, if they cannot respond to that support and that challenge, they should be replaced by an alternative provider. That should apply both to the independent sector and to state sector provision. It is not acceptable that, purely because a service is provided by the state, it should be allowed to continue as a substandard service.

Some of the key changes in the new clauses and amendments allow that to happen. They make sure that funding is much more transparent. The existing framework has allowed hidden bail-outs to take place, which all too often have hidden poor management, poor service provision, and the need for clinically appropriate and evidence-driven reorganisation. All too often that has not happened, to the detriment of patient care.

I was pleased to see that the Secretary of State had allowed a safety valve in this part of the Bill, which would enable tariffs to be topped up, particularly for the provision of services in rural areas, such as my constituency in Lincolnshire. This must not be seen as an opportunity for the Department of Health to support and subsidise inefficient management and service provision. All too often there are inefficient cost bases and money could be transferred instead to front-line patient care.

I would be grateful if the Minister, when winding up, confirmed some specific points relating to new clause 2 and the subsequent amendments. Will he confirm that the new system will ensure that innovation is not inhibited—that providers and clinicians will have to configure services not only to satisfy patients, but to improve the quality and productivity of services, which, as we all know, have been very poor in the past decade or so? Will he confirm that the structure set out in the new clauses will enable Monitor to intervene early to ensure that the service provided is safe and provides good-quality, patient-centric services?

Will the Minister also confirm that the proposals build on the system set out in the Health Act 2009, which is in line with the Secretary of State’s consistent assertion that the Bill is about evolution, not revolution? Ministers must not allow the importance of integrated services, vital though they are, to be an excuse to maintain poor-quality providers. In the interests of patients, underperforming incumbents must be challenged and continued innovation must be facilitated and incentivised.

If the Minister has time when winding up, I would like him to address the point that I made to my right hon. Friend the Member for Charnwood, which is that the new clauses seem to ensure that Monitor will maintain minimum-based standards, particularly as they relate to acute foundation hospital trusts. We need commissioners, the Care Quality Commission and Monitor to work together to ensure that there is continuing improvement in patient care and continuing determination and drive to make sure that services are better the next year than they were the previous year. It is unclear from the amendments who will be responsible for co-ordinating that effort to drive up standards continually.

I have two final questions. What will happen if Monitor has to step in to provide advice, shore up a service or provide an alternative service provider, but the commissioners cannot agree on who should be the subsequent service provider? Who will resolve disputes between two commissioning consortia? Will it be the NHS commissioning board, Monitor or the Department of Health? Where a provider delivers a service to more than one commissioner, and one of the commissioning groups has access to an alternative provider already in existence but not another, who decides who will provide the service that has failed?

I will draw my remarks to a close. I am, as I believe are most Government Members, an avid supporter of the national health service. I defer to no other group more than I do to those who work tirelessly in the NHS to provide the excellent care that, more often than not, is delivered, and not only in the state service but across the range of NHS providers. However, if we are to continue the NHS, free at the point of delivery and based on need, not ability to pay, it must reform and change. We cannot allow it to stand still. I believe that these clauses and amendments provide an essential framework to ensure continuity of access to service, value for money for taxpayers and better quality patient care.

[Rosie Cooper]

Members of the public listening to Government Members this afternoon might wonder whether we were having this debate in a parallel universe, because they have heard the Prime Minister promise that there would be no top-down reorganisation of the NHS, and what did we get? We got the biggest reorganisation in the history of the NHS. The Prime Minister said only recently that everyone was on board and behind the Bill, and yet we find that clinicians, professionals and the public are far from being on board. The Government talk about the protection of services, but the public will have read only yesterday that the Government are meeting McKinsey about the possible transfer, albeit a slow transfer, of up to 20 hospitals.