I am pleased to have secured this debate, and I am delighted that the Secretary of State for International Development will respond. The fact that he is with us this morning shows the significance that he places on the subject.

The Democratic Republic of the Congo has had a turbulent recent history. Colleagues in the Chamber today will be au fait with events of the past 40 years, but during the past decade thousands of child soldiers have been thrown to the forefront of the conflict. The United Nations mission to Congo—MONUC—was deployed in the DRC in 2003, and it now constitutes the largest peacekeeping force in the world.

Living without shelter, access to health care and food has meant according to current estimates that, since the conflict began in 1996-97, 4 million people have died over and above what would normally be expected. That is a colossal increase in mortality. It is the most lethal conflict since the second world war, and most of the dead are women and children. The lives of the children, more than anyone else, continue to be devastated by the ongoing conflict in the east of the country.

War not only kills children but destroys the infrastructure that provides them with food, medicine, education and shelter—the very social fabric that would otherwise provide them with protection, care and hope. As a result, many children living with the consequences of war end up being conscripted into armed groups, are accused of being witches or are forced to undertake dangerous and exploitative work just to survive. Invariably they are pushed into a life on the streets.

There are more than 250,000 homeless children in the DRC. More than 40,000 children live and work on the streets of Kinshasa alone. These children are regularly beaten and sometimes even murdered. They are subject to frequent sexual abuse and, due to the lack of health care, die from illnesses that are both preventable and curable. In general, they have no access to education.

Our Government are the largest European Union provider of bilateral funds to the DRC. They have committed the support of the British public to the people of that nation. It is a long-term commitment that will help build a viable nation and establish the security and opportunities for people to lift themselves out of poverty. In June 2005, the all-party parliamentary group on street children received a report, “Your War is Not With Me”, from the British charity, War Child. As a result, the charity was invited to make a presentation on the street child crisis in the DRC to the all-party group. In turn, that led to the hon. Member for Gainsborough (Mr. Leigh) and I, the co-chairmen of the group, visiting Kinshasa last month. The visit engaged street children and established an informed basis on which our group can support the efforts of the Government and the international community in responding to this acute crisis.

Unemployment and a lack of income-generating opportunities have stretched the capacity of households to function as viable economic units. Divorce is increasingly common, and those children who are left with their mother are a burden that the extended family can rarely bear. Many children therefore end up working on the streets. Children who remain with their father are often marginalised by their stepmother in order to create the economic space to provide for her own children. Increasingly, HIV/AIDS results in the death of both parents, leaving children with the extended family, which is rarely able to care for them.

Within that framework, fetish priests turned pastors have established thousands of private revivalist churches in the major cities. Some of those fetish pastors regularly accuse children of witchcraft. For example, if a pastor is unable to cure a parent of illness through prayer, he will claim that a bewitched child in the family is the obstacle and request additional fees to perform an exorcism. Those children are often tortured in unimaginable ways by the fetish pastor as part of the exorcism process. That abuse is enabled by a widespread lack of education, which makes parents vulnerable to the exploitation of a deep-seated belief in witchcraft. Accusation of sorcery and witchcraft is the single largest factor resulting in children being pushed out of their families and on to the streets of the DRC.

The hon. Member for Gainsborough and I were fortunate enough to visit some of the centres that War Child is supporting which provide shelter and protection for some of the younger street children and help with family tracing, mediation and reintegration. War Child also arranged for us to meet some of the youths who are still living on the streets. I want to give hon. Members a couple of examples of children who found themselves on the street and describe some of the challenges that they faced—and still face.

Joseph was nine years old when his parents died of HIV/AIDS. He became a burden to the extended family as an extra mouth to feed. A local fetish pastor accused Joseph of bewitching his parents and causing their deaths. The extended family beat him, and he was finally pushed on to the streets. He slept at the local market, scavenging for food, occasionally stealing and earning pennies by carrying heavy bags and sacks of produce for people. The police would regularly seek him out, accusing him of witchcraft and telling him that he could not stay at the market. On one occasion he was kicked so hard by a police officer that two of his ribs were broken. Eventually, Joseph found his way to the Ameema abandoned children’s centre, which is supported by War Child. He is now safe, and trained War Child staff are trying to reintegrate him gradually with his family, but the process will take time, as strongly held attitudes have to be overcome.

Evelyn’s mother suffers from epilepsy, which makes it difficult for her to work and to generate income. Her father left them because of that, and Evelyn and her mother turned to the extended family for support. Epilepsy is not well understood, and Evelyn’s mother was accused of witchcraft and shunned by her family. She became separated from Evelyn, who was a baby at the time and was left to the care of her grandmother. Evelyn grew up believing that her grandmother was her real mother, but other children would tease her that her mother was a witch. Evelyn eventually tried to find her real mother and made contact with her, but she was accused of consorting with a witch and was pushed on to the streets, where she joined her mother. Evelyn was repeatedly raped during her time on the streets, and at the age of 12 she fell pregnant. Soon after that, Evelyn and her baby were identified and were helped by one of the abandoned children’s centres supported by War Child.

Accusations of sorcery and witchcraft are the primary reasons why children end up on the street in the DRC, but the phenomenon is compounded by an increasing divorce rate in the face of high unemployment and extremely low income.

When I went to the DRC some years ago, it was wonderful to see what War Child was doing. I visited a nun who was the embodiment of the Christian spirit. The biggest concern was finding employment for the younger people whom it got off the streets. There did not seem to be that much practical work for them, so effectively the charity cared for them until they were more mature. What opportunities does my hon. Friend think there are, because that will be the test?

From what I witnessed in my short time there, I know that my hon. Friend is correct. I share his concern and I will come on to that, as some good work is going on but it very much needs to be extended.

It is common for children to have to work on the streets and fend for themselves during the day, because their families are simply unable to care for them. Those street-working children are particularly vulnerable to becoming fully fledged children of the streets. As well as the 40,000 street children in Kinshasa, there are thousands more in other cities such as Mbuji-Mayi, Bukavu, Lubumbashi and Goma. The street child problem in the DRC is at crisis level. Street children survive through begging and stealing, which brings them into conflict with the law. Many undertake arduous work such as portering and regularly smoke marijuana to numb the effect of the reality in which they live.

Nevertheless, it is important to acknowledge that some progress is being made by the Government of the DRC in developing legislation and judicial codes as a platform for juvenile justice and as a basis for dealing with fetish pastors and abuses against children. That progress is limited to the commitment of individual civil servants who are rarely paid and is primarily confined to paper in a country where justice is rarely applied and more often corrupted.

Non-governmental organisations including international charities such as War Child are supporting locally run centres in the provision of family tracing, mediation and reintegration of street children. They are also providing income-generating support for street youths, but there is no coherent structure to bring those efforts together in a focused and co-ordinated way to maximise the limited resources available for addressing the crisis. Many of the civil servants and key service providers rarely receive salaries, so have to spend their time developing other forms of income.

Why is the street child crisis in the DRC anything to do with us? Why should our Government seek to allocate time, money and expertise to resolving the crisis, when we are already doing so much in the DRC? Street children in the DRC suffer unimaginable poverty. The marginalisation and suffering that extreme poverty brings is a frightening indicator of state destabilisation. Destabilised states such as the DRC become havens of unrest, violence and even regional and global insecurity. We need only to look to Afghanistan as a typical example of that. That is well recognised by the Department for International Development, which is investing upwards of £60 million per year, and more broadly by the UK Government, who have invested upwards of £30 million in the election process in the DRC. It is in the interests of national security to work with partners from the developed world in creating stable, viable states throughout the developing world and in so doing combat the cancer of poverty.

It is also important that we recognise the established and deep commitment of the British public to addressing poverty, especially among the most marginalised people such as street children. That was demonstrated by the mass participation in and commitment to the Make Poverty History campaign, and is reflected in the millennium development goals to which the UK Government have already signed up. As a signatory to the United Nations convention on the rights of the child, the Government are committed to securing the rights of children by

“Recognizing the importance of international co-operation for improving the living conditions of children in every country, in particular in the developing countries”.

The British economy is the fourth largest in the world, which establishes the UK as one of the most significant signatories to the convention on the rights of the child. The UK must therefore take a significant proportion of responsibility for ensuring that the rights of children, especially those who are marginalised, are realised in countries such as the DRC.

The all-party parliamentary group on street children is considering some draft proposals based on the fact that the UK Government have significant influence as well as responsibility in the DRC because of the scale of the commitment made on behalf of the British people. Consideration should be given to investment in education sector reform. Development is crucial both in formal and non-formal education, and the inclusion of women is especially important. The education of women will reduce their vulnerability and indirectly the vulnerability of their children. The education of children, especially marginalised children, will establish a key socialising process in its own right and a basis on which exclusion can be overcome. Crucially, education per se will address the deep-seated belief in witchcraft and the subsequent vulnerability of many children. That must be a priority for DFID and, through Foreign Office lobbying, for the European Union.

Investment is required in the strategic architecture to ensure focus, direction, best practice and coherence across all agencies working with marginalised children in the DRC, especially street children. At the broadest level, that should involve the allocation of resources and technical assistance to support the Government of the DRC in developing a plan for the implementation of the convention on the rights of the child to which the DRC is already a signatory. That plan must make specific reference to marginalised groups of children, especially street children and those formerly associated with fighting forces as child soldiers. The key elements of the plan and specific mention of street children must be reflected in DFID’s country-engagement plan and subsequently the country strategy that is being developed. Also, the key elements of the plan must be championed by Foreign Office policy and in its advocacy efforts with other significant bilateral and multilateral partners of the Government of the DRC, especially the EU.

Clear human rights indicators that refer to the status of marginalised children must be developed as part of the national plan to implement the convention on the rights of the child. Investment in the capacity of state actors to service and protect the rights of marginalised children and in civil society to monitor those indictors, with specific reference to street children and children formerly associated with fighting forces, will be required. On that basis, targets to improve the status of marginalised children must be agreed with the Government of the DRC and a resourcing strategy must be negotiated to meet those targets and ensure that they are achieved. As a result of the extreme levels of corruption and impunity, the achievements of those targets and verification of indictors must become a conditional element of the UK Government’s aid provision to the DRC.

War Child will be undertaking participatory research with street children in Kinshasa by the end of this year. The learning from work of NGOs such as War Child must be channelled into the UK Government’s strategic engagement with the Government of the DRC, not least through the Foreign Office and DFID’s developing country strategy for the DRC. In that way we will facilitate a crucial element of the convention on the rights of the child by ensuring that children are listened to.

Finally, the UK Government must work closely with civil society, especially local and international NGOs and Churches, the Government of the DRC and through local business networks. That work should be the basis for the development of a national strategy that will support the development of micro-enterprise nurseries, training and practical income-generating initiatives across acutely vulnerable communities.

I will conclude, because I know that colleagues want to take part in today’s debate. I look forward to the Secretary of State’s response and thank him for giving a commitment to meet a delegation from the all-party parliamentary group at the end of this month—I am delighted about that, as are my colleagues. I put on record my thanks to War Child for giving me and the hon. Member for Gainsborough the opportunity to visit the country to see the work that goes on. War Child is to be congratulated on its efforts. A major task lies before it and everyone else involved with the issue.

It is a delight to follow the hon. Member for Dumfries and Galloway (Mr. Brown). As he said, we visited the DRC recently. It has about the same population as the UK, although it is the size of western Europe. Throughout the major cities the national street population could be more than 60,000—that is an estimate as we cannot be completely accurate—which is 0.1 per cent. of the entire population. That does not include tens of thousands of children made homeless by displacement because of the continuing conflict in the east.

Some 50 per cent. of the republic’s population are children and 47 per cent. are under 14. As one walks around Kinshasa, as we did, it is extraordinary to see the sheer youth of the population—the impression is overwhelming. One hardly ever sees old people, and I was pretty well the oldest person that I came across during the entire week that we spent there, which is rather strange for someone from this country. I assume that the difficulty of living is such that all the old people are dead—not to put too fine a point on it. Some of the children on the streets were born there, and there is now a second generation of children living on the streets. On our visits, we regularly saw very young women—teenagers—with infants on the streets. This is therefore a crisis of staggering proportions in what is the poorest country in the world.

My colleague, the hon. Member for Dumfries and Galloway, explained why so many children end up on the streets, but the problem is made far worse by the system of organised kleptocracy initiated by Mr. Mobutu. We talked to several politicians, who, in my view, are a sorry lot of people. They were the only people who appeared to have carpets, computers or anything in their offices. The senior civil servants that we talked to—the equivalent of permanent secretaries in our system—had nothing. We talked to one who literally lived in a bare office, with no salary, no computer and with just a coat hanger on the wall. He was clearly doing a wonderful job with absolutely no resources. Of course, we were treated politely by politicians, as I would hope, given that this country is one of the DRC’s main bilateral funders.

When it came to it, most of the politicians that we met were honest enough to admit that, before the elections, they had been concerned that the fetish pastors had too much political power to be dealt with. When one goes around Kinshasa, it is staggering to see the sheer volume of new churches that are going up, and the politicians do not have the political will to deal with that growing number of churches. In theory, churches are supposed to be registered, and the constitution absolutely forbids people from dealing with children as though they were witches. As I said, however, the politicians ignore the street child problem.

I should say that there is absolutely no evidence that the mainstream Churches, both Catholic and Protestant, are involved in these practices, and many of the new evangelical Churches do a good job. However, there is a relatively small number of fetish pastors who make a living by denouncing children as witches. It is an extraordinary situation. People in extended families are under such economic pressure that they simply cannot cope with another child. That child’s parents might have died from AIDS or other causes, but the pastor is brought in and literally accuses the child there and then of being a witch. Sometimes the child is tortured and, more often than not, they are thrown out on to the streets. This is therefore a real problem, and I was staggered by it. People in this country joke a bit about witches and do not take the issue entirely seriously. We thought of writing to J.K. Rowling, who has made a lot of money talking about witchcraft. Perhaps she could donate a bit of money to deal with a situation in which witchcraft is a serious problem and in which tens of thousands of children suffer as a result of being accused of being witches.

It is common for governors to round up and incarcerate children regularly; indeed, the policy is popular with the general population because many street children are unpopular with them. During one round-up, the police beat a boy called Kondikor, from the Delveaux area of Kinshasa, on the head with an iron bar and then the butt of a gun, before leaving him to die in the street. We met the governor of Kinshasa. I have never seen a man with so many mobile phones in his office—apparently, he needs them to contact his various girlfriends. He was one of the few people we met who had any kind of affluence about his person, but he has now been removed by a military governor, thank God. He was a very warm personality and claimed that he was a personal friend of the street children. He said that he had found a number of jobs for them, including 700 jobs as street cleaners. We thought that that was an interesting initiative, so we went on to the streets to talk to some of those street cleaners. As it happened, some of those jobs had been created—with western aid, it must be said—but they had all gone to the families of existing street cleaners, not the street children. So much for the efforts of the governor of Kinshasa.

As the DRC takes its first faltering steps towards democracy, street children are becoming more vulnerable. Democracy à la DRC sees politicians mobilise large groups of street children for their political rallies. That leads the children back into confrontation with the law, resulting in beatings, incarceration and further abuse. The politicians then blame the children, thereby reinforcing negative popular opinion, and the whole thing goes around in a circle. In the meantime, many of these children are held in detention without trial. Incidentally, I should say that although we call them children all the time, and a lot of children are involved, there are also a lot of young men, and we met men in their early 20s who had never had a home.

Contrary to the advice of the Foreign Office, we went out in the evening and walked around the city. It is perfectly safe, and there was no fear that one was threatened in any way. We talked to a number of street children, and here are some of their testimonies. Philippe is 14 and was accused of sorcery, which is why he was forced out of his family and on to the streets three years ago. He collects leaves, which he sells on to people who use them for mulch and composting as part of their subsistence farming practices in Kinshasa. Incidentally, there is no public park in the city; if there were, it would immediately be reduced to allotments, such is the poverty. However, there is one park in the middle of Kinshasa—it is run by Lebanese as a private golf course. I have never seen a private golf course in the middle of a capital city. The monthly subscription is $400. Imagine that! That $400 would pay for a child’s education for a whole year.

Philippe augmented his income by helping to push carts around the city, transporting goods for local business people. We saw his home: he sleeps by the stadium in a large pipe near a pile of excreta on the muddy ground. The police come round two or three nights a week and extort what little money he earns, and he and his friends are regularly beaten. He told us of another boy, Joel, who was 10 years old. He was selling leaves to some policemen, but they refused to pay, so he complained. They beat him so badly that after they had pushed him into a drainage ditch, he did not have the strength to pull himself out and drowned.

We then talked to P.Y. from Delveaux. He hobbled into a filthy bar where we were meeting some young adults and older children. This young man had been attacked by police, who were trying to take his miserable, hard-earned pennies from him. As he fled, he tripped up. One of the policemen took a machete and chopped him in the knee. The wound had been dressed by a Catholic priest just before we met the boy, who was clearly in a lot of pain. None the less, he felt that he had been very lucky. Lucky? Being mugged by policemen and having one’s knee sliced with a machete is lucky? These children live in a world that we can barely comprehend.

However, there is hope, which is why we are here today. The United Kingdom is the DRC’s largest European Union bilateral funder, so we have some influence. As my colleague the hon. Member for Dumfries and Galloway said, we have the traction and leverage to influence the DRC Government. We can also influence individual politicians, although they are largely at fault in this, and senior civil servants—the ones we met were a hard-working and honest lot of people. We can encourage them to address impunity, corruption, exploitation and the abuse of the most marginalised people—particularly children.

As the DRC takes faltering steps towards democracy, it is important that the British Government use their influence to help those outside the democratic process. The children and young people that we are discussing are not involved in that process, except as spear carriers—often literally—at political rallies.

We must be ever mindful of value for money. We are talking about our taxpayers’ money and we must make sure that it has an effect. We met Ambassador Andy Sparkes, who I thought was very impressive. He gave us his time generously and I pay tribute to him. He is a man who cares about what is happening in the country and I want to quote what he told us:

“Accusations of sorcery are a convenient excuse for a particularly cruel way of dealing with poverty, and religion is used as its pretext. Cruelty like this should be punished, regardless of whether it is executed in the name of religion or not.

It is not natural for Congolese to behave in this way. It is a recent phenomenon. The consequences of war and the subsequent massive aggravation of poverty is being exploited by a small number of pastors from private, revivalist churches who use vulnerable children as a platform upon which to exploit families that are struggling to feed themselves. And they will charge them to do this!”

Indeed, it is not natural for Congolese people to engage in the practice of accusations of witchcraft. It is a relatively new phenomenon and if there were real political will—it is against the law—and if the western powers were to use their influence and, of course, take greater steps towards dealing with poverty, I am sure that, eventually, we could get a grip on it.

The hon. Member for Dumfries and Galloway has already dealt with some of the recommendations, and I want to emphasise them, as we have the Secretary of State with us today. I am delighted that he chose to come here himself, rather than sending a junior Minister. That shows the importance that he attaches to the problem and the all-party group is very pleased to see him here. We think that the main thing is to address the problem of impunity and corruption. With that in mind, we believe that the Foreign and Commonwealth Office’s bilateral fund should be used to invest in tactical, high-focus, high-impact but reasonably inexpensive projects.

I was very impressed by the work of War Child and some other charities in dealing with the problem on a micro level and creating small funds of perhaps a couple of hundred dollars, and not just giving them to a child or young person but training them. One of the children whom we heard about set up a new business with the help of that $200 and got himself off the streets by setting up a television set in his village, as a kind of local cinema. Television sets are still relatively rare, and he was making a living in that way.

The other vital thing—this is where the Foreign and Commonwealth Office can help—is to help with the training of, and payment of salaries to, a small number of magistrates dealing with juvenile justice matters. There is no law in the country. No one is paid. The police, the army, magistrates and judges are not paid, so they must be corrupt just to survive. Therefore there is no justice. If there is an accusation against a pastor concerning witchcraft and it comes before a magistrate it will be thrown out, because the pastor will simply bribe the magistrate. In a way the magistrate is not a wicked person; no one is wicked in that situation. We can imagine what would happen if none of us were paid—none of our police or soldiers, none of our civil servants or the Clerks of the House; we would all have to be corrupt to survive. The Department can help with this, and try to make things better.

I suggest the establishment of a legal aid fund to tackle targeted cases and the promotion of those cases across the media as high-profile wins. It was made clear to us that there have been virtually no prosecutions. I do not think that there have been any successful prosecutions—or perhaps there has been one in the entire country—of pastors who accuse children of being witches. If we had a few high-profile wins and could create a small corps of magistrates prepared to deal with the matter in a proper way, we might get the notion established in people’s mind that it is a criminal offence and that people will be punished for it. Then we could perhaps help with the training of specialised police units that could deal specifically with street children.

Such projects could be combined with the provision of awareness training projects for fetish pastors. We went to a training project for fetish pastors with Save the Children, which does a wonderful job. We talked to a former fetish pastor who was now a mainstream evangelical pastor doing a perfectly good job and who freely admitted that what he had done in the past was wrong. He had undergone training with Save the Children and seen the error of his ways. We saw him sitting down with other pastors, trying to convince them that theirs was not the way forward.

As we have so much influence, as a large donor, can we not use it to agree sanctions with other EU heads of mission against local top politicians—especially governors? They are involved—and there is ample proof of this—in the arbitrary arrest, beating and death of street children. Those politicians are very sensitive to sanctions by the EU. By the way, they are also very angry with us and with the EU because they complain all the time that we give money direct to the people and not to the Government. I think that it is an extremely good thing, and I congratulate the Government on it.

It was a searing experience to walk around Kinshasa. The country has obviously been utterly ruined. It is now at the bottom of the world heap. I pay tribute to the personal commitment of the Secretary of State and I look forward to hearing what he will tell us today about attempts to improve the situation, even in a small way. Even if he saves only a few hundred street children from an appalling fate the whole House will, I think, be very grateful to him.

I was privileged to go as an international observer to the elections in the Democratic Republic of the Congo with a group of hon. Members from the all-party group on the great lakes region and genocide prevention. I want to express my gratitude to Christian Aid, which was my host and that of my hon. Friend the Member for Islington, North (Jeremy Corbyn), and which will fund me to go back for the second round of elections at the end of next week, for the presidential run-offs on 29 October. I also thank the other organisations, such as War Child, which fund our all-party parliamentary group. Without them, we would not be able to do the work that we do.

The elections were very impressive. They mostly went off peacefully, without a great deal of difficulty and with great enthusiasm from people for voting. They were mostly well run, with a few difficulties and hiccups. After the elections we saw how easy it is for violence to erupt, with the death of 23 people in Kinshasa. Given the continuing tension and the fact that the two remaining presidential candidates have their own armed forces and that other people have arms, the potential for further violence can be seen. At this point I want to note our condemnation of the beating up last week in London of President Kabila’s chef de cabinet, Leonard She Okitundu, who had been visiting members of the all-party group and the Foreign Office. I condemn violence from whatever quarter, whatever the reason for it.

Given the way in which, as the hon. Member for Gainsborough (Mr. Leigh) pointed out, street children have been used as part of the political process—rounded up and used on the streets—they may be particularly vulnerable if there is any potential for violence in the run-up to the next round of elections, and subsequently. We need to be aware of that. I think that it is important—I know that the Secretary of State has this in mind and has already taken action on it—that the UK Government should make every effort to emphasise to the two candidates and the other people involved in the political process, such as the parties and those who have been elected to the new National Assembly, that it is their responsibility to ensure a continuing peaceful round for the next elections and subsequently; to protect the most marginalised groups such as the street children; and to take on board the issues already raised so eloquently by my hon. Friend the Member for Dumfries and Galloway (Mr. Brown), whom I congratulate on opening the debate, and the hon. Member for Gainsborough.

We have a huge responsibility to keep with the process for a long time. This is just the start of the process. There are many things we need to do to put pressure on all political parties to take seriously the issues to do with street children. Those include trying to ensure that there is training on and, at least, awareness of the issues in the local law enforcement and security agencies, whose approach to street children at the moment is often more part of the problem than an attempt to deal with those issues.

I shall return to the matter of the elections and the situation thereafter, but I want to mention that while hon. Members were in the country for the first round of elections we had the opportunity to visit some projects involving street children. With some of my colleagues, I visited a project run by Save the Children, which has 15 projects. I remember seeing Ilunga, who was not accused of being a witch, as many children are, but whose parents had died in a diamond mining accident and who had then traipsed across the country to be taken in by his grandparents in Kinshasa. They threw him out because they did not have the money to look after him. Then he lost touch with his brother. He is living by himself on the streets of Kinshasa, going into that project during the day and making money by collecting rubbish from people’s houses and taking it to the dump. Given the state of the streets in Kinshasa and Congo generally, he is probably one of the few people who do go round collecting rubbish, but he looked so forlorn, so miserable. He had such a sad long face until we did the trick of taking photos and showing them to him, which always brings great smiles to the faces of the children, but he had looked so forlorn that our hearts went out to him and the other children there.

We also visited a War Child project, where a large number of children are living. Many of them had been accused of being witches. To me, they seemed like normal, bubbly, lively children who were living in desperate circumstances and had very few resources to do what they wanted to do. In fact, they were livelier than the children at the project in the middle of Kinshasa. When we talked to them about the elections, we got a better answer on how they were meant to be about getting people to make the country better and life better, than we did from most of the politicians on television. When we asked the children about the elections, they all started yelling, “Kabila, Bemba”. They were very well engaged. One boy we found who was one of the very few receiving an education was very bright and had just come top of the exams in his class, so the potential is there. Many of these children have been accused of being witches, yet to me they are just normal, bright, lively kids.

I gained a greater understanding of the beliefs behind witchcraft. That is not the only element, but it is a very large element in why the street children are out on the streets. There is also the issue of child soldiers and their re-engagement into society, which we have not touched on as much as we might have.

A very good Save the Children pamphlet called “The Invention of Child Witches in the Democratic Republic of Congo” explains the belief in the spiritual world that is very prevalent in Congo and how that ties in with the issue of dislocation. Interestingly, there is more of a problem in urban areas than in rural areas, which is not necessarily what one would expect when considering the concept of traditional beliefs. Those beliefs are deep-seated. Whether or not we change people’s beliefs on whether witches and sorcery exist, we must say that it is completely unacceptable for children to suffer cruelty and be abused on the basis of what is a false belief.

I was as bemused last year, when I went to America, by the fundamentalist Republicans who told me that people were invaded by Satan, as I am by the idea of there being witches, so I am not sure that we can always say that someone’s belief systems are all that peculiar. Of course, exorcisms still take place in some of our traditional Churches. The key point is that this is not about religion or people’s beliefs; it is about cruelty and child abuse, which must be tackled. That is why Save the Children had been working with a group of pastors to try to say to them that even if they still believed in witchcraft, the children they were seeing were not ones who had been infected by witchcraft and if they did come across any whom they believed were, they should deal with them in a way that was not cruel and did not involve physical violence, because that is clearly unacceptable.

In April, when we visited a Save the Children project in Mbuji-Mayi as part of the all-party group on the great lakes region and genocide prevention, Save the Children gave us a very good leaflet on precisely the issue that my hon. Friend is talking about—how children come to be accused of witchcraft. Such a child may have epilepsy, sleepwalk or be greedy. Their parents may have become unemployed. That could cover almost every child in Congo. Has my hon. Friend given any thought to or had any discussions with non-governmental organisations in the field about the possibility of using television to educate people? The leaflets are all well and good, but they are available only in the areas where the centres are operating, and given the disruptions of war, there are huge areas of the country where people are illiterate and cannot understand the excellent literature produced by the NGOs.

I agree with my hon. Friend and I know that War Child in particular is keen to engage in that type of awareness-raising campaign. The question is whether we tackle people’s beliefs head-on or take action in a different way. How do we get the message over to people so that we confront the issue of accusing children of sorcery, which is clearly, as the hon. Member for Gainsborough said, illegal? We need a campaign that tells people that accusing children of sorcery is not acceptable and that tackles those beliefs, but that will have to be done sensitively. As I have said, I know that War Child in particular is keen to tackle that, and my right hon. Friend the Secretary of State may have views on it. Those issues need to be taken on board very seriously and we have a responsibility to keep pressing the new Government and the politicians on the issues.

We also met the leaders of the Catholic and Protestant Churches, who have condemned the notion of accusations of witchcraft, but I would certainly urge them to be more strongly proactive, and on a continuing basis. It is important that they do that. We were not altogether convinced about the degree and continuity of that opposition, where those leaders clearly have a role to play.

I know that other hon. Members wish to speak, but I want to say briefly that we need to keep our eye on the outcome of the election because the street children will have a chance only if we have dealt with all the other issues, the key issues, and if we ensure that the newly elected politicians in the National Assembly and provincial government and the President and presidential team deal with those fundamental issues. I am thinking particularly of the security situation. They need to deal with the question of good governance, corruption and the use of resources because, without that, street children and their problems will never be dealt with. We will not be putting in the necessary resources. We will still be in a position in which the wealth of the country is plundered and it does not get down to taking those key issues on board and dealing with them.

I know that my hon. Friend has to be careful, and I congratulate her on going back to be an election monitor, but does she, like me, have concerns about the stratification of the election results in the first round, and the dangers that that presents in terms of the way in which children in particular will be brought into certain camps? One hopes that voting will be more balanced in the second round; otherwise, there will be difficulties and the risk of the country pulling apart. Does my hon. Friend agree?

I agree that that is a serious problem and I would be interested to hear the Secretary of State’s comments on what we can do. As we were told last week, a lot of work has been taking place on building alliances to try to overcome some of that stratification, but it is a serious danger. One issue is the terms in which the elections were fought, which involves the language that people spoke and so on. I have to say that the situation was similar to our local elections. If, in our council elections in Derbyshire, we put someone up for election in a village who does not come from that village, we get a bad reaction as well, but the stratification in the elections in Congo was extreme and that is a serious issue.

I ask the Secretary of State, in replying to the debate, to assure us—I am sure that he will—that this issue will not be put on the back burner after the elections, that it is a long-term continuing commitment and we will keep applying pressure and that, above all, we will look at dealing with the security situation. Can he say whether there will be a continuing commitment from the international community to co-ordination and international engagement on trying to reform the security system? I am talking about engaging states in saying that we need peace and security for any of the other issues to be dealt with. Will that continue to be a key priority? I also ask my right hon. Friend to press for the role of EUFOR, the European Union force, to be extended beyond the end of November, as is currently proposed, because peace and security are central to other issues that we have been discussing.

How the children are treated tells us everything about the health of a country and a society. We need to consider what we can do to make that society work and function so that those children, including the very bright kids we saw and met, who were absolutely delightful, have some chance of fulfilling their potential. I am talking about putting resources into their education and their future in terms of jobs and so on. That is a reflection of what possibility there is for hope and a future for all the people of Congo, and what possibility there is for having stability in a very important part of Africa that affects us all directly. I shall be interested to hear my right hon. Friend’s comments about what we can do to keep up the pressure on those key issues and to ensure that there is a system of peace, security and reform in the country. How can we keep up the pressure in order to deal with the awful things that happen to those children and the awful lives that they lead, and to give them some common humanity and a future?

rose—

It is my intention to start the winding-up speeches just after 10.30 am.

I shall be brief, because we need to hear those other speeches.

I welcome the debate and congratulate my hon. Friend the Member for Dumfries and Galloway (Mr. Brown) on securing it. I congratulate also the hon. Member for Gainsborough (Mr. Leigh) and my hon. Friend the Member for Amber Valley (Judy Mallaber) on their excellent contributions. I wish that we had a system that would allow us to show large photographs or film in debates such as this to accompany what we are saying, because it is hard to convey to a European audience the true horror of life for ordinary people in the Democratic Republic of the Congo—the sense of hopelessness and the complete sense of insecurity that surrounds their lives in every way.

I am pleased that the Secretary of State is here to reply to the debate, and I thank him for his huge personal commitment to give genuine and serious support to aid development in the poorest and most war-torn parts of Africa. That is appreciated and understood by many.

Like my hon. Friend the Member for Amber Valley, I was an election observer in the first round of the presidential and parliamentary elections in the DRC. Our visit was funded by Christian Aid. We met a number of non-governmental organisations on our visits to Kinshasa and where we were monitoring elections in Bas-Congo, which was an extremely interesting experience. I agree that the administration of the election on the day in the area that we saw was not too bad, although I have some misgivings about the quality of the counting at regional counting centres and the sheer chaos that surrounded much of that. However, there was clearly an understanding and a wish that the election process should be fair, open and properly run. The training levels and equipment provided were impressive given the situation and the circumstances.

There are nevertheless questions in my mind. On my visits to a number of villages in the Bas-Congo region, I saw that there was no water, poor roads, no schools, no police, no army and no health service, so I wonder what the election is all about. The people are electing representatives to go to some distant place, but will those representatives bring any real improvements to those communities or will they follow the grand tradition of corruption that has bedevilled Congo for the past 30 years and merely feather their own nests by fiddling contracts in Kinshasa, while the people of their areas do not benefit in any way?

Serious questions must be asked about what should happen after the election, because if there is to be any confidence in a democratic process, it has to bring about real improvements and changes for the people living in what is a very poor situation in an incredibly wealthy country. There is no question but that the wealth of Congo is astronomical compared with any other African country—indeed, almost any other country in the world. The population is small: as the hon. Member for Gainsborough pointed out, the country is the size of western Europe, it has a population the size of Britain’s, and it has resources that no European country has, so the potential is enormous. The money and wealth that has been taken from Congo, all around the world, is astronomical.

Those serious issues must be addressed, but the debate is about the more specific issue of children in Congo, particularly the victims of the war. When my hon. Friend the Member for Amber Valley and I went to a number of children’s centres, such as that in Kinshasa, I felt a sense of deep depression and hopelessness for those children. They are victims of war, AIDS, famine, being child soldiers, exploitation, prostitution and crime. Those who are lucky enough to get into some kind of centre at least have a modicum of security for part of the day, but the only way that they can survive is to go out and sell things on the streets of Kinshasa. I asked someone, “How does the economy of the DRC work for most people?” They replied, “Well, you buy things in small quantities and you sell them in even smaller quantities.” It goes on like that. There is very little manufacturing—it is all trading in bits and pieces of imported goods—so there has to be some serious economic development through which genuine jobs are provided in manufacturing and agriculture and all that comes with that.

In relation to the children, several issues must be raised. I welcome the support given by Save the Children, War Child and other charities and organisations which are doing a good job in supporting children in a difficult situation and in challenging the nonsense talked by a number of pastors, their exploitation of faith and religion, and the abominable way in which they treat children. Some of the illegal churches become quite good businesses: a person can set up a church, denounce someone as a witch and then exorcise Satan from their body, and they make quite a bit of money through the exorcisms. That is a vile and cruel business. The nearest example that I can think of is in the novel “Elmer Gantry” and the way in which people are treated in the United States.

What goes on is vile, but it is the product of the society. The hon. Member for Gainsborough explained quite well what goes on: if the police, army, teachers and civil servants are not paid, how on earth are people supposed to survive? The highest priority in Congo has to be the development of universal, free, secular primary education run by the state for the whole country. I do not know the figures—I do not think that anyone does—but I would be surprised if more than 30 per cent. of children go to school. Half the population are teenagers or younger. Logic tells me, and I am sure that everyone would agree, that illiteracy and the number of people with no education whatever is rising. If no education is offered, how are we to challenge the nonsense put forward by some of the pastors? I know that the support given by DFID and others concentrates on those areas, and I hope that the outcome of the election will be peaceful and will develop a Government who are serious about development and providing decent education and health opportunities for the people, particularly the children who have suffered so much.

It is hard for anyone outside Congo or who has never seen it to understand the sheer hopelessness of life for many of the children. They are growing up in a war-torn country and they have to migrate large distances. Often there are no family structures, but even where they exist, as Members have explained, children are commonly thrown out of them and have to survive on the streets of Kinshasa where the public health is appalling and the drainage, sewerage, refuse collection and health systems do not work. The only available health care is the sale of water tablets or bottled water in order to prevent them from contracting some horrible disease from polluted water or the fetid swamps alongside all the major roads in the city. There is a huge job to be done in that respect.

In a sense, the children are the absolute victims. I do not know the death rate or life expectancy figures—again, I do not think that anyone does—but I do know that large numbers of them die and large numbers of them live terrible lives. What kind of adults will children brought up in such an environment turn out to be? Those who have read “Lord of the Flies” by William Golding will have an idea of the horrible situation that those children have grown up in. Logic tells me that if the only life they have known is of begging, dealing, violence, drugs and prostitution, when they become adults they will become the abusers of the next generation of children. We create a cycle of depression and violence and the horror that goes with it.

I want to see enormous change in Congo. Everyone is agreed on the need for that. Some of it can be produced by overseas aid, but, above all, serious political structures that run public services and administration, and that are honest, open and accountable, must be developed. They have been sadly lacking in Congo for most of the past 40 years, and even those who are lucky enough to escape to another country and survive somewhere else suffer from the accompanying disruption.

I have also visited the neighbouring countries of Rwanda and Angola on different occasions. They have also gone through huge levels of disruption and, in many ways, are still dislocated societies. One thing that appeared to be developing quite well in Angola was a fostering system for the large numbers of orphans by way of a small amount of state support given to foster parents. I do not know whether that happens in Congo, but we could look at that area. If we do not, hundreds of thousands of children could grow up in an awful environment, which then creates the cycle of deprivation and violence from which they thought they were escaping in the first place.

I thank the House for having this debate, because the least we can do is support what the Government are trying to do by giving aid to the Democratic Republic of the Congo. Above all, we hope that the politicians in Congo who are lucky enough to be elected to local authorities, the presidency or some other body understand that they have a duty to start delivering the wealth of Congo to the people of Congo.

This is one of the most distressing debates in which I am likely ever to take part in this House. All the same, I congratulate the hon. Member for Dumfries and Galloway (Mr. Brown) on bringing it to the Floor of this Chamber, on taking us, in such a comprehensive way, through the issues and on setting the stage for the debate. It is the beginning of end child poverty month, so the timing could not be more apt, even if it could not be more upsetting.

As the hon. Member for Amber Valley (Judy Mallaber) said, this debate is also happening in the context of the second round of presidential elections between President Kabila and Jean-Pierre Bemba. There is a desperate hope among us all that the elections will be the basis for real progress, but I must say to the Secretary of State, who in a sense sits here for the international community, that the great challenge will be to persuade the loser to lose with grace and not to return the situation to civil war, because if they do that, we will be back where we started.

As Save the Children and others report, the primary victims of the years of civil war, instability and complete economic collapse have been the children of the Democratic Republic of the Congo. As the hon. Member for Islington, North (Jeremy Corbyn) said, basic services such as health, education, clean water and social services are beyond the reach of most Congolese children. That is crystallised for many of us in the statistic that one child in five dies before the age of five. He also mentioned that that is perverse in a country that is so rich in natural resources and minerals; it is the country’s curse when it could be its hope.

War and the mass population movements have separated thousands of children from their parents and families. Most appalling is that these impoverished, separated and sometimes abducted children are recruited into armed groups as child soldiers and, in effect, sex slaves. Save the Children has identified 30,000 such cases, but we all know that that must be an understatement. By the end of last year, some 17,000 children had been demobilised and, it was said, reintegrated into their communities. That leaves many more, particularly in the more remote forests where the Mai-Mai militias are, who are completely out of reach.

We are hearing about extensive re-recruitment of those children, their engagement in the demonstrations and violence that have been part and parcel of the presidential elections and their then being rejected, drifting to the cities and ending up as part of the street child population.

I was also concerned about informal estimates that 12,000 girls are part of the armed groups and that they are in sexual servitude. Many more have been raped. They are unable then to rejoin society because of the stigma. We hear nothing about the sexual abuse of boys. The reality must be that it is a widespread practice. Are we not at the point where that must be confronted head on? Mention of it seems to be absent in every piece of literature on which I can lay my hands, and I assume that that is for cultural reasons. We must confront and deal with the damage done to the boys, as well as the damage done to the girls.

Yesterday, I was talking to a woman from Sierra Leone—the hon. Member for Boston and Skegness (Mark Simmonds), who is the Front-Bench spokesman for the Conservatives, was present at the same meeting—about how poverty drives families to put their children into the sex trade as the only means of generating some income. Obviously, with that goes HIV/AIDS and its repercussions in the collapse of families and of economic and social structures.

As the hon. Member for Amber Valley said, the abandonment of children in urban areas has been the underlying and most fundamental cause of the street children phenomenon, which is the subject of today’s debate. The hon. Member for Dumfries and Galloway gave some numbers. Some 40,000 children are said to be living on the streets of Kinshasa, but other organisations put the numbers far higher. There have been accusations that witchcraft and fetish preachers play a key role in that process. We must take that seriously on a different level. I have dealt with such a case in my constituency. We must recognise that the power of some of these movements extends far beyond the borders of Congo, and that there is an interlinking set of issues. Something like this is inexplicable to me, but we have no choice but to take it head on. While one must recognise cultural norms, I cannot think of an acceptable one that allows children to be treated in that way.

Among the numbers I find no reference to disabled children. One of the issues that I have raised with the Secretary of State is disability, which is so often treated as a cross-cutting issue, but never finds itself on any priority list. I cannot believe that it is not wrapped into many of the problems and issues involving these children in Congo. Disabled children must be the most vulnerable group of these thrown-away kids.

As the hon. Member for Gainsborough (Mr. Leigh) said, this has been going on so long that there is a second generation on the streets and it is becoming institutionalised. There is little local sympathy. Descriptions such as “feral children” and “vermin” are used. Before we condemn that too heavily, I have heard the same comments in my community about children who are considered to be engaged in antisocial behaviour. We must be careful about our use of language. We can see how, in a sense, it could be extrapolated in situations and we can recognise how appalling the consequences are.

Even for parents who care about their children and want a future, education is beyond reach if they are poor, which is the overwhelming definition of people in Congo. The hon. Member for Islington, North said that he was not sure about the figures for public investment in education. I believe that in the 1980s more than 90 per cent. of children were in primary education, and now the figure is well below the 60 per cent. mark—I assume that it has dropped below half in the most recent years. The investment in education used to be a public subsidy of more than $500 per child, and now the figure is $18 per child. A poor family must find a way to make up that missing number. Some 3.5 million children in Congo are not in primary school and 6 million adolescents are not in education, so the problem is huge. We cannot separate any of those issues from the total collapse of the state, which we will have to address. That falls very much on the doorstep of the Department for International Development.

The hon. Member for Islington, North talked about the importance of focusing on economic development. Given the resources of Congo, if some measure of security can be established, there is surely the potential to find solutions to that issue. It is a credit to the British Government that they have been the largest bilateral donor. I am sure that the Secretary of State will take us through the numbers involved in the commitment, but it is one of which we can be proud.

I close simply by echoing some of the calls that have been made in this Chamber. There have been calls to engage the multilateral community, including the European Union, in ensuring that this remains a priority issue. We require programmes that listen to the needs of children and give them some degree of empowerment, programmes that examine reintegrating the kids and finding ways to get them into jobs, so that there is a change for their future, and programmes that reach girls and disabled children. We need to work with civil society, local non-governmental organisations and Churches. Above all, we must ensure, whether through pressure, the structure of aid programmes or the use of influence, that the Congolese Government have and use the resources and expertise, and that training is in place to provide genuine protection for street children and to ensure that people who commit crimes against them are pursued and pay the price.

I join other hon. Members in congratulating the hon. Member for Dumfries and Galloway (Mr. Brown) on securing this significant debate. He set out clearly the main issues that we should consider and debate today. There were many other significant contributions, particularly from my hon. Friend the Member for Gainsborough (Mr. Leigh), who powerfully articulated the extent and depth of the near collapse of the governmental infrastructure in Congo. We all hope that the fledgling democratic process that is taking place at the moment will be a new beginning for the country. I am sure that the Secretary of State agrees that the second round of elections at the end of this month will be not the end but the beginning of the international community’s support.

The hon. Member for Richmond Park (Susan Kramer) said correctly that there will be great dangers immediately after the election and we hope that the rule of law will be sustained and that the losing party will acknowledge that it has lost and will take a constructive role as a loyal Opposition. However, sadly, that is not the history of Congo.

I shall not speak for long because I want the Secretary of State to reply to the many good points that were made, but it is important to state that many factors contribute to the number of displaced children and street children in the capital and elsewhere in Congo. The situation is not a simple one of witchcraft, although that is a significant contributory factor. There have been two civil wars and many children were conscripted into various armed groups. If I have time, I shall return to that.

There has been a sharp deterioration in state services and the hon. Member for Richmond Park rightly highlighted the worrying fall in the number of children in primary education during the past decade and certainly during the past 30 or 35 years. There has been a significant increase in poverty and unemployment, which makes it impossible for parents to afford to look after, feed and clothe their children. Rapid urbanisation and a breakdown in the traditional African support culture have been exacerbated by the conflict, and a significant number of displaced people inevitably find their way to urban areas, which is making the situation more difficult.

There has been a significant increase in the prevalence of HIV/AIDS and it is estimated that 1 million Congolese children have been orphaned by that disease, while 30,000 children die from malaria each and every year. The Secretary of State will be well aware that a lot more could be done with the provision of bed nets, which are not expensive.

An increasingly high prevalence of divorce rates means that children from previous marriages and liaisons are not always welcome in a new marriage. We have heard a lot about the accusations of sorcery and witchcraft and the terrible abuse that takes place as part of that.

All that has led to an estimated 250,000 children being homeless in the DRC and 40,000 in the capital. Fifty per cent. of the population are children under the age of 14. The situation has reached crisis point and has been exacerbated by the presidential and parliamentary elections because the political structures have used street children to destroy their opponents’ campaigns and rallies. Therefore, there has been further unacceptable exploitation, often supported and encouraged by the police who, as my hon. Friend the Member for Gainsborough said, are not remunerated by the state.

One area that has not been covered sufficiently during this debate is the reintegration of child soldiers into the community. The Opposition welcome the investment in the multi-country demobilisation and reintegration programme. However, estimates suggest that at least one third of child soldiers—11,000—are not reintegrated with their families and communities. If the Secretary of State has time, will he explain what his Department is doing to try to improve the number of children who are reintegrated? Obviously, there is great suffering, abuse and trauma, much of which needs special mental and medical treatment.

It has been estimated that at the end of June 2006 CONADER, which is charged with the reintegration of child soldiers into the community, had not implemented a single community-based economic reintegration project for children, leaving non-governmental organisations to bear the brunt of the burden of the reintegration programme. I thank the NGOs that are operating in Congo for all their hard work. What steps is DFID taking to assist the reintegration, and to ensure that CONADER meets the criteria that were set down and uses its funding properly for the purposes for which it was intended? What is the time scale for that programme?

Corruption is another big issue that must be addressed—my hon. Friend the Member for Gainsborough made several points about corruption. The structures of the state must be rebuilt and reinvigorated, so that the Government can deliver and implement some of the new legislation that they have been trying to get through, particularly to reform the legislative and judicial system to protect street children.

I have a couple more questions for the Secretary of State. What progress is being made to develop the DRC poverty reduction strategy paper and will he encourage the DRC Government after the elections to make a commitment to street children in that poverty reduction strategy? My understanding is that there is no such commitment.

In May 2006, only 20 per cent. of the current humanitarian action plan for the DRC had been funded—$682 million was required to fund humanitarian needs and the shortfall could leave 10 million people without the life-saving funding that they require. It would be helpful if the Secretary of State could say what his Department is doing to try to put pressure on others to ensure that that commitment is fully met.

For the conflict to come to a complete end, there must be a significant reduction in the number of weapons in circulation in Congo. That requires schemes to collect existing weapons as well as the introduction of tighter controls to stop new weapons entering the country. We were all disappointed with the results of the small arms negotiations in New York earlier this year. What pressure and mechanisms is DFID putting in place to reduce the number of small weapons in circulation in the DRC.?

In conclusion, to my mind the key to the problem is improvement in education and putting structures in place to enable street children and others in Congo to be educated to take a fuller part in the development of their country and to enable it to move on from its terrible history, not just of the past 30 years but of the previous 150 years.

I congratulate my hon. Friend the Member for Dumfries and Galloway (Mr. Brown) on securing this debate and above all on the impressive way in which he set out the nature of this terrible problem. I thank members of the all-party groups on street children and on the great lakes region and genocide prevention, which, with organisations that have been referred to in the debate—Human Rights Watch, War Child, Save the Children and Amnesty International—have produced a series of thoughtful reports that help all of us to keep up the pressure on the Congolese authorities.

I am grateful for the contributions from the hon. Member for Gainsborough (Mr. Leigh), my hon. Friends the Members for Amber Valley (Judy Mallaber) and for Islington, North (Jeremy Corbyn), and the hon. Members for Richmond Park (Susan Kramer) and for Boston and Skegness (Mark Simmonds).

My hon. Friend the Member for Islington, North said that it is a pity we cannot have pictures to look at, but every speech that we have heard has painted a painful picture of what life is like for street children, who are at the forefront of our minds this morning. What we have heard tells us that the DRC at the moment is one of the worst places in which to be born and to grow up. One third of children under the age of five are underweight; less than half of children of primary school age are in school and the number has declined considerably in recent years. Only one in three have access to decent sanitation, and as we heard this morning, tens of thousands of children face appalling dangers and threats in their daily lives, having been abandoned to the streets by their own parents, subjected to extraordinary abuse by so-called churches, persecuted by the police, manipulated by political parties, subjected to sexual violence or enslaved by armed groups. Every single one of those children is vulnerable—all of them. Those children who are not in school and the street children are vulnerable. For a society to put its next generation through so much shows just how much the fabric of Congolese society has been destroyed by war, conflict and misrule. My hon. Friend the Member for Dumfries and Galloway made that point eloquently.

There is hope for all people in Congo through the political process. I wish my hon. Friend the Member for Amber Valley well in her further observation of the elections. She made the point that the world has witnessed in the DRC the first opportunity for a generation to use democracy to change people’s lives. Britain rightly played an important part in helping to fund those elections. In 11 days’ time, the second round of the presidential elections takes place. Several hon. Members made the point that there is a heavy responsibility on the two candidates to accept the results, whoever wins. The hon. Member for Richmond Park made that point forcefully this morning, and I made it to the candidates when I was in Kinshasa at the beginning of September. They must also reach out to others, as my hon. Friend the Member for Stroud (Mr. Drew) said, because if one candidate thinks that they can take all the power and exclude the rest of the people, there will be a risk of Congo returning to the war and violence that has destroyed the country.

There is a long way to go, and I agree with the hon. Member for Boston and Skegness that the elections are the start of the process. It will be slow, painful and difficult, but at the heart of the issues that we have discussed today is the need for governance. What we have heard described this morning is the result of a failure of governance. That is the fundamental problem in the DRC, and for that reason the international community must stay there for a long time. That is why we have a large and growing programme, which was worth £5.6 million in 2001 and will be worth £62 million this year. We did not have a bilateral programme in the DRC 15 years ago. It was not part of anglophone Africa, but we are there now because the country has its best chance of hope in a generation.

How are we contributing in order to improve the lives of street children? The British embassy is supporting a Congolese NGO to reunite street children with their families in Kinshasa and to educate parents against abandoning their children in the first place. Our HIV programme focuses on orphans and vulnerable children. In response to my hon. Friend the Member for Wakefield (Mary Creagh), we are already discussing with the World Bank a major education programme to reduce school fees in the DRC. With the World Bank, we will ensure that the programme addresses the needs of the most vulnerable, including street children, because removing school fees is probably the most important step that we can take to give children, and their parents if they have them, the chance to get into education. Street children will not get the education that they deserve unless there is a reduction in fees.

I welcome what the Secretary of State has said. Is there any chance that we could also provide resources for teacher training? The quality of teachers, particularly in private schools, leaves a lot to be desired, and teacher training is essential.

We will consider what we can do within the programme. I am about to describe what else we are trying to do, and other donors have responsibilities. It is important that we work together to ensure that all needs, including that which my hon. Friend raises, are covered.

We have given funding to train and equip the police to oversee the elections, and training includes the appropriate treatment of children. However, we have heard this morning that parts of the police force have no idea how to behave properly towards children, and changing their approach will be a long process.

We are also funding training for magistrates and police officers on children’s rights and the treatment of children in the justice system. The hon. Member for Gainsborough referred to that forcefully, and I shall ask my team to consider further whether we can do something in response to his specific suggestions. We have provided significant funding for the demobilisation and reintegration programme, and we have given £3 million to the Red Cross for its humanitarian appeal, which includes reintegration programmes for children.

We are working with NGOs in eastern DRC on a programme to reintegrate and protect refugees. However, the process is long, hard and far from complete. It is complicated, delicate and it is not working for everyone. The hon. Member for Boston and Skegness made that point. With the World Bank and NGOs, we are trying to ensure that international and national organisations with the expertise get the support that they need. We are working with the DRC Government to ensure that children are properly provided for in continuing demobilisation plans. I shall ask my team to consider the point about CONADER, and to respond to the hon. Gentleman.

I am delighted to hear about the Government’s investment, but I am sure the Secretary of State will agree that one of the most distressing parts of the report by my hon. Friend the Member for Dumfries and Galloway (Mr. Brown) and the hon. Member for Gainsborough (Mr. Leigh) was the description of children who had suffered severe physical abuse, including an account of boys who had had their penises cut off. Those children need specialised medical attention. Is there any way that we can provide such help, alongside training and equipment, for Congo?

The example that my hon. Friend provides is extremely distressing. She and I have discussed it before, and it is the most extreme and unbelievable form of child abuse. Other donors and NGOs that specialise in human rights and issues affecting children have a part to play. UNICEF, for example, is helping the DRC Government to implement the UN convention on the rights of the child. NGOs, several of which have been mentioned in the debate, undertake vital work to help children. The hon. Member for Richmond Park made an important point about the sexual exploitation of boys, which people do not talk about.

There has been debate in some quarters about whether we should make parts of our aid programme conditional on progress. It has been acknowledged, however, that we give very little aid through the DRC Government. We must ensure that we adopt the right approach, because if we were to remove aid because of DRC Government failings and a lack of governance, we would not help the people about whom we are concerned.

The real issue, which has come across forcefully in all the speeches, is that the primary responsibility for addressing the problem must rest with the DRC Government and people. It is about political structures that work and that are accountable—a point that my hon. Friend the Member for Islington, North made. We need a society in which the DRC Government start to take responsibility for the most vulnerable citizens. There is no want of legislation in the DRC.

The point has been made that much legislation is in place, and that includes the UN convention on the rights of the child, which was ratified in 1990—16 years ago. However, there is no action to do something about it and enforce it, which is in part a question of capacity. The graphic description from the hon. Member for Gainsborough of the permanent secretary’s office, with nothing in it apart from his own skill, makes the point. There is a lack of resources and of will, but there is corruption.

I assure hon. Members that we will keep up the political pressure on the Congolese Government in every way we can. We are in contact with President Kabila’s ambassador for children and the Ministry of Social Affairs, and I shall consider the point that the hon. Member for Boston and Skegness raised about the place of children in the poverty reduction strategy paper.

We have heard that children being abused in the name of exorcism is not a part of the Congolese tradition but a result of the dislocation of that society. As part of our presidency of the EU last year, we pushed for the Congolese authorities to do something about it, but no one has been prosecuted. The law and evidence exists, but the law must be enforced.

The Home Office, the Foreign and Commonwealth Office, and the Metropolitan police are also putting in place measures to prevent Congolese pastors who abuse children from coming to Britain from the DRC. That is one thing that we can do. I urge all hon. Members present and the organisations listening to the debate to provide us with the evidence. If they give us the evidence, including any evidence of politicians who have engaged in such activity, we can take action.

I am grateful to hon. Members and to my hon. Friend the Member for Dumfries and Galloway for raising the issue. We have heard just how important what happens in the DRC is, above all to the people who live there, and just how important good governance is to solving those problems. I assure the Chamber that we will continue to support the people of Congo—and the politicians, if they rise to their responsibility—to try to make a difference for them, and for the children in particular. They have suffered much too much for far too long.

I am most grateful to you, Mr. Cummings, for providing me with the opportunity to bring this matter to the attention of the House. In the next 11 weeks the European Union will experience yet another historic occasion as it expands to 27 members, further unifying a continent in which division, not unity, has historically been the dominant narrative. Many hon. Members deserve recognition for that remarkable achievement. No European leader has been as dedicated a supporter of the new EU members as our Prime Minister. The momentum behind the enlargement agenda was begun by the late Robin Cook when he was Foreign Secretary, sustained by the current Leader of the House when he was in that role, and now moves into a new era under the stewardship of the Secretary of State for Foreign and Commonwealth Affairs.

A great deal has been achieved in a short time, but enlargement is about more than just admitting new members; it is about respecting them and their citizens as equals. I shall use this debate to urge the Government to clarify their position on migrant workers from Romania and Bulgaria and make it clear that they will not be bullied into adopting restrictions merely because of the erroneous fears of supposedly populist, xenophobic commentators.

When I last spoke on the subject, in 2004, Europe was shortly to undergo its biggest ever expansion. It grew by 75 million citizens overnight and confirmed its place as the world’s largest single market, with the highest GDP of any single trading bloc. Then, as now, certain sections of the media and, I must say, some Conservative Members, forecast that the UK would be overwhelmed by desperate economic migrants. Then, as now, it was said that our welfare benefits system would prove vulnerable and irresistible to tens of thousands in eastern Europe. Of course, neither of those presumptions proved true.

Does my right hon. Friend accept that the Government predicted that approximately 15,000 would come to the UK from eastern Europe and that that figure has turned out to be nearer to 600,000? That was a gross underestimate—far more people have come here from eastern Europe than was anticipated.

My hon. Friend is right; more have come than was anticipated. I shall demonstrate why that has been good for the British economy and for Europe.

A well researched report produced by the Institute for Public Policy Research established that less than 1 per cent. of migrant workers have even applied for income-related benefits since 2004 and that most eastern European migrants are working in jobs that are hard to fill. Almost nine out of 10 visitors from the new EU member states have stayed in the United Kingdom for less than three months. Since May 2004, this country has benefited tremendously from an influx of skilled, trained workers while other countries in Europe, which have denied such migrants the right to work, have struggled to be competitive in a global market. Our Government’s decision to welcome the skills and talents of the new citizens of Europe has paid dividends.

I am sorry that I did not have the opportunity to advise the right hon. Gentleman of my intention to intervene. Does he agree that the empirical evidence of the past two years shows that disproportionate pressure has been placed on public services in a small number of areas as a result of the influx from the EU8 countries? That may well cause community cohesion problems in the future, particularly if workers from Bulgaria and Romania are allowed to enter the UK on the same basis as those from the previous eight countries.

I understand the point that the hon. Gentleman makes carefully, but I do not agree. The arrival of the eastern Europeans has not created the tensions that he describes—I do not know about Peterborough, but it certainly has not in Leicester, where many have come to settle. The evidence shows their contribution clearly. In April this year an Ernst and Young ITEM Club report showed calculations that migration contributed more than £300 million in revenue to Her Majesty’s Treasury in the first year after enlargement, keeping inflation under control and boosting overall economic output. The workers in question pay their taxes, and it is for the Government and local authorities to ensure that if any pressure is created, which I do not believe there is, that revenue is spent appropriately.

Will my right hon. Friend give way?

I shall make some progress, if I may.

With such clear benefits, I can only welcome the comments of Her Majesty the Queen yesterday. On a state visit to the Baltic states, she expressed her encouragement of the freedom of movement and labour between the UK and those states. I am sure that when she is able to visit Romania and Bulgaria she will congratulate them on the progress that they have made in rejoining the European family.

Our Prime Minister made the crucial interventions during the enlargement discussions on Romania and Bulgaria in 1999. In the first ever speech by a British Prime Minister to the Romanian Parliament, he announced Britain’s determination that Romania join the EU as soon as possible. Our Government then ensured that the accession of Romania and Bulgaria was at the top of the European agenda during the 1999 Helsinki conference. We could not have been clearer: we wanted full and proper membership for those members of the European family.

In the past year it has been disappointing to see the remarkable good will that we have worked so hard to establish with Bucharest and Sofia draining away as the Home Office has equivocated and tabloid scare stories have proliferated. Despite being conclusively wrong about the effects of the previous enlargement, tabloid journalists and right-wing commentators are saying that the stability of our society, the security of our welfare system and the success of our economy will be in grave danger unless we block the access of Romanians and Bulgarians to our labour market. There is simply no evidence to support that. The enlargement will have much less impact than the 2004 experience. Romania and Bulgaria have a much smaller combined population than the previous accession countries and have no well established links with the UK. Those who do wish to travel look instead to Mediterranean countries such as Italy or Spain as their first choice.

Will my right hon. Friend give way?

I give way to my hon. Friend for the last time.

I regret that my right hon. Friend has indicated that this is the last time that he will give way, because the issues are important. Does he accept that while in the first terms of the Labour Government unemployment in my constituency went down by more than 50 per cent., in the past year it has gone up by approximately 9 per cent.? Anecdotal evidence and my own local experience indicate that many of the jobs that would have been filled by people from my area, many of whom we are trying to move off income support and other benefits under the welfare to work scheme, have been taken by migrants from eastern Europe. Employers should not be blamed, because if they are given a choice between a keen, enthusiastic, highly trained 25-year-old from eastern Europe and someone from my constituency who may have been unemployed and has a drink problem, the latter will lose out.

Order. Interventions should be brief.

I have great affection for my hon. Friend; we speak about many matters, especially on Europe. He should not be upset that I will not give way to him again; that is simply because this is an Adjournment debate, I have limited time and I have given way three times. I do not accept what he says; he is talking about anecdotal evidence and chats that he has in the pub in Glasgow. I am interested in the real facts, which are clear. If my hon. Friend shows me a report containing facts, I shall debate them with him. At the moment we have only gossip, innuendo and so on.

The Institute for Public Policy Research, a well- respected organisation, has confirmed in its new report that the new inflow of migrants is likely to be relatively small, and that any impact on the British labour market will be positive. To those who say that wages have fallen owing to the number of new workers, my response is simply to refer them Department for Work and Pensions working paper No. 29, which concludes that

“there appears to be little evidence of a fall in nominal wage growth in the whole economy…since accession”

of the new member states.

Beyond national self-interest, there is a case to be made on the European level. As the Chancellor of the Exchequer said in a speech to the Confederation of British Industry,

“enlargement has provided and is providing a stimulus for economic reform across the continent.”

It is perhaps a consequence of how successful the European Union has been that we have not properly recognised the progress that has been achieved. I do not want to get the hon. Member for Peterborough (Mr. Jackson) too excited at the mention of his name, but as President Barroso said at Chatham House on Monday, Britain has been too modest in its achievements in Europe, and too weak in publicising the benefits of EU membership to the British public. In a world of uncertainty and challenges, the European Union has formed an association of states that come together to form more than the sum of their component parts.

I wonder whether my right hon. Friend is aware, when he quotes such studies, that a comprehensive survey has been undertaken in Bulgaria of where migrant workers are likely to travel after accession. All the indications are that the favoured countries are Germany and Spain, not the United Kingdom.

I am aware of that survey and I am grateful to my hon. Friend, who is very experienced and a former Member of the European Parliament, for bringing it to the Chamber’s attention. He is absolutely right.

The European Union is a union built upon four fundamental freedoms: the freedom of goods, services, capital and, of course, people. Although implementation of those principles has often been imperfect, since 1997 our Government have led the way in championing them. It is of course understandable that people have doubts. In a new, globalised world, competition and open markets pose new and unfamiliar challenges, but as our Prime Minister made clear in Manchester in September, we must face up to those challenges and not try to draw away from them. In this case, our Government must lead the debate in explaining why welcoming hard-working individuals from Pitesi and Varna does not pose a threat to either our prosperity or our national way of life. The Prime Minister also said in Manchester that we must ensure that British citizens are confident global citizens. The Government must first ensure that they can be confident European citizens.

With 75 days left before Romania and Bulgaria join, the Government have unfortunately still not made their position clear on what the new proposals will be or what the restrictions will be and when they will apply. Last week the Leader of the House informed me that we can expect a full statement from the Home Office nearer to the end of this month. However, I must reiterate that there is not much time left. As soon as a statement can be made, it should be made. I hope that that clarification will be provided by my hon. Friend the Minister, who is very hard-working.

If the Home Office decides to push ahead with a separate scheme for the two new member countries, it will need the good will and close co-operation of Romania and Bulgaria to implement it. I have been informed by some officials that the Home Office has refused to give any indication of the proposals that may be announced later this month. That is not the basis for partnership. If the Home Office has to implement joint mechanisms for migration control, I would ask that the Minister hold discussions with representatives from Romania and Bulgaria as soon as they can be arranged and to tell them the facts.

Furthermore, I have been informed in other discussions with officials from those countries that British recruitment agencies have now become established in Romania. The private sector has staked its position on the worth to the economy of those workers, even as the Home Office refuses to make its position clear. The situation will lead to confusion for British industry and disappointment for the workers of the new EU member states. In contrast, other member states, such as Finland, have announced that they will fully open their labour markets. Other countries, such as Hungary, have been clear for several months about the types of restrictions that they will impose.

In the United Kingdom there is the worker registration scheme, which we established in May 2004. I was sceptical about the scheme, but it is on track and has been going well. I hope very much that the principles of the scheme will be followed. It would allow many talented students at British universities to stay in the UK, with their fresh skills and ambition.

I have been informed of a representation made to the Prime Minister and passed to the Home Office by senior figures of the Romanian community in the UK. The letter outlines their concerns that media hysteria is damaging the image of Romania, with the potential to damage bilateral relations. I hope that the Minister can assure me that such a representation will receive full consideration. I hope that she will also assure me that if a scheme is introduced, there will be an appropriate right of appeal and a review of the decision once it is taken. I am sure that I do not have to tell her that immigration control is difficult to administer, but it is important that we should be fair with the people with whom we are dealing.

In conclusion, I would ask that the Government make clear their position regarding the new workers as soon as possible. In doing so, they must consider the impact on our economy, our reputation in Europe as a champion of enlargement and open markets, and our image with our close friends and allies in Romania and Bulgaria. Most importantly, the Government must consider the interests of the United Kingdom and its citizens, which are best served by welcoming the skills and talents of other European nations into our work force, and announcing that no restrictions will be introduced from the start of 2007.

I congratulate my right hon. Friend the Member for Leicester, East (Keith Vaz) on securing this debate. I pay tribute to him for his long-standing interest in European Union enlargement and for his valuable contributions to previous debates on the subject, notably during the passage of the European Union (Accessions) Act 2006, which related to Bulgaria and Romania. I thank him and other hon. Members and hon. Friends for their thoughtful contributions to this debate, which touched on the important subjects of European Union enlargement and managed migration.

This debate indeed comes at a timely moment. I assure my right hon. Friend at the outset that the Government are not to be bullied and that xenophobic commentators carry no weight with us.

Hear, hear!

Last month Bulgaria and Romania reached an important milestone, with the recommendation in the European Commission’s final monitoring report on their preparedness for EU membership that both countries will be in a position to take on the rights and obligations of EU membership on 1 January 2007. So, subject to the formalities of final ratification of the accession treaty by those countries yet to complete that process, the EU will shortly welcome Bulgaria and Romania as its newest members.

We welcome the Commission’s assessment of progress towards accession criteria in Romania and Bulgaria. We welcome its proposal to establish a mechanism based upon robust benchmarks to monitor progress in the field of justice and home affairs, particularly as regards the reform of the judiciary and the fight against corruption and organised crime. Both countries have made progress over the past 18 months under the constant pressure of EU scrutiny, but continuing the monitoring process will maintain a high degree of pressure for reform. The UK stands ready to assist the two countries in meeting the benchmarks set.

I have met my Romanian and Bulgarian counterparts on a number of occasions and made clear the UK’s view on the continuing reforms needed in those countries, on our support for a monitoring mechanism and on our consideration of restrictions to the labour market. I assure my right hon. Friend that those conversations and meetings have been friendly, open and candid.

The monitoring mechanism is an unprecedented approach and the Commission is clear that it will take safeguard action if either country fails to make adequate progress. That could include the temporary suspension of instruments of mutual recognition, including the European arrest warrant, in the criminal or civil fields. The threat of such a sanction over a member state is very powerful.

On law and order and crime, will the Minister explain why the Government specifically absented themselves from the scheme to share criminal records data? The scheme was to ensure that the wrong people—that is, active criminals—did not enter the country. Seven EU member states belong to the scheme, which commenced in May this year. Why did the Government decide not to join it?

Sticking to the subject under review, I assure the hon. Gentleman that I have discussed the warnings index, and information on individuals from Bulgaria and Romania on it, in my meetings with my Bulgarian and Romanian counterparts. I hope that the hon. Gentleman is reassured that there are discussions about such issues between the UK, Bulgaria and Romania.

I turn to labour market access, the issue that my right hon. Friend the Member for Leicester, East put on the table. In 2004, only the UK, Ireland and Sweden provided the A8 full access to their labour markets. Two and a half years on, we believe that A8 migration has brought economic benefit to the UK. Based on their economic circumstances, other member states may have decided differently from us in 2004, but several have followed the UK example. Spain, Portugal, Greece and Finland did so in May this year, and in July, Italy announced the lifting of restrictions on A8 workers. Even member states that announced restrictions have issued many work permits to A8 nationals. Germany, for example, issued 500,000 work permits to A8 nationals in the 16 months after accession.

Workers from the new member states have played a significant role in boosting the available pool of labour and helping ease shortages in the UK. The Department for Work and Pensions has published two reports on the impact of A8 enlargement of the EU on our labour market, and it has found that the broad outcome of enlargement has been to increase output and jobs.

On that point, I should say that that is not only the Government’s view, but that of the CBI as well.

Indeed; I am indebted to my hon. Friend. I am aware of his considerable involvement and expertise in these issues.

My hon. Friend the Member for Glasgow, South-West (Mr. Davidson) raised concerns about employment in his constituency. I know that the figure of 13,000 is often cited as a Government underestimate of the numbers of A8 nationals who would come to the UK after accession, but that was never an official Government estimate. It is important that we bear in mind the economic boost that we have witnessed since the accession of the A8.

Hear, hear!

Data from the worker registration scheme show that most accession state workers take employment in sectors to which employers find it difficult to recruit from the resident work force. Accession state workers also contribute to the delivery of vital services. For example, 12,700 A8 nationals in the UK are registered as care workers.

On one of the remarks made by the hon. Member for Peterborough (Mr. Jackson), I should say that although the overall picture of accession is positive, we are aware of some local authorities’ concerns about localised pressures. We take those seriously and are looking into them carefully.

Will the Minister accept that the concern of people such as me is not that there should not be any influx of labour? I am happy to welcome migration, but it has to be managed. Does she concede that, particularly at the low-income end of the spectrum, there is a substantial degree of displacement? Eastern Europeans who are better skilled and trained are taking jobs that otherwise would have been taken by people coming off unemployment. Will the Minister accept that although it is true that the vast majority of eastern Europeans are not claiming income-related benefits, they are claiming work-related benefits?

Order. Interventions really should be brief.

I have directed my hon. Friend to a number of studies that will give him factual information on the issue. Based on that information, which is not anecdotal, we are firmly of the opinion that our decisions in respect of the accession of the A8 were right for our economy; I shall come to decisions that we might take on the A2 in a moment. The evidence is that we made the right decisions at that time, although that is not to say that we do not recognise that there may be some localised pressures. Planned migration is very much the policy of this Government.

Time is short. We are eager to find out when we will know whether there will be restrictions, and if so, what they will be.

I thank my right hon. Friend for refocusing us on the issue that we are discussing. I shall make a little progress and then come to his exact point.

The Government’s decision on labour market access for the 2004 enlargement was right for the UK. A bigger EU has been good for Britain and British business. A8 workers fill valuable roles in sectors of the UK labour market. Now that the accession date for Bulgaria and Romania has been confirmed, the question for us is about what access there will be this time around to UK jobs for migrants from the new member states.

Of course, our experience with the A8 has a bearing on our planning for A2 accession, but that does not mean that our approach has to be exactly the same. The Government have carefully considered their approach to the derogation that could be exercised for Bulgarian and Romanian nationals’ access to our labour market. We are considering how we will apply restrictions consistent with our support for the principle of managed migration.

We have decided on a gradual approach. In following a policy of managed migration, we have sought, while tackling abuses of the system, to attract the migrants who will most benefit the UK. Our migration system should be responsive to economic needs and produce economic benefits. The Treasury estimates that migration has increased output by at least £4 billion and attributes 10 to 15 per cent. of economic trend growth to migration. Migration has eased skill shortages in key industries and public services, including health and education. We want to build on that success.

We have announced our plans to introduce a points-based system for economic migration. That will improve our ability to identify and attract migrants with the skills that the UK economy needs, while improving compliance and dealing with abuse. We have also announced that we will consult on introducing a migration advisory committee, which will produce independent expert advice to the Government on where migration can fill skills gaps in the economy. We shall do so shortly.

We have been doing a lot of work on how to control access to the labour market. By the end of this month, we will announce to Parliament exactly how we see the system for Bulgaria and Romania working in practice. The controls that we put in place will be spelled out in draft legislation that will be laid before Parliament so that it has the chance to examine and discuss them fully. Any controls will, of course, be fully consistent with the obligations of the accession treaty and we will take the necessary powers to ensure enforcement of the relevant legislation and to deal with anyone who might be tempted to work here irregularly or to exploit irregular workers.

It is too early fully to assess the long-term impact of A8 accession on migration to the UK, as we know that, although some will, many who come here do not intend to stay for the long term. We have some useful figures from the labour force survey and from the worker registration scheme.

I know that various estimates have been made of the number of Bulgarians and Romanians who will migrate to the UK and other member states after accession. Estimates have produced a wide range of figures, which goes to show the difficulty of making predictions. Some of the estimates have been based on—

Order.

I am extremely grateful to have obtained this debate on the national health service in Buckinghamshire. Right at the start, I want to present the apologies of my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan), who is convalescing after an emergency hip operation and is thus unable to be here today. When I spoke to her on the phone two days ago, she specifically asked me to point out that, to the best of her knowledge, she is the only member of the Conservative parliamentary party to have personally tested the skills of NHS surgeons during this our party’s NHS action week. I shall do my best to voice some of her concerns later. My hon. Friends and, indeed, the whole House will join me in wishing her a speedy recovery.

It is also right to pause for a moment before plunging into the debate to thank on behalf of my constituents and myself—I was once through the doors of accident and emergency at Wycombe hospital—the doctors, nurses, midwives and other medical staff who work in the NHS in Buckinghamshire. They work under great pressure and intense scrutiny, and not all of them have always been led as well as they might have been. They are not always thanked as they should be, so we should thank them today.

I want to begin the debate proper with the recent “Shaping Health Services” exercise in Buckinghamshire. “Shaping Health Services” proposed that children’s and maternity services be moved from Wycombe in my constituency to Stoke Mandeville in the constituency of my hon. Friend the Member for Aylesbury (Mr. Lidington), and that elective operations be moved from Stoke Mandeville to Wycombe. It was also proposed that trauma patients who arrive at Wycombe A and E be transferred to Stoke Mandeville if possible.

The changes were opposed in the southern and middle part of the county by hospital consultants, the local medical committee, local midwives, the Buckinghamshire patients forum, Wycombe Race Equality Council, Wycombe district council, all the main political parties, including the Minister’s, and more than 40,000 local petitioners. In summary, the all-but-unanimous view in my constituency was that the proposals came without a proper transport plan, clinical risk assessment or full financial plan. I shall return later to those three issues: transport, safety, money.

In short, my constituents and others believe that they are paying record amounts of tax and are receiving in return some improved services—that is true—but also the removal of key services from their area. In other words, they believe that the NHS in Buckinghamshire is at risk from the dismal drip, drip, drip of cuts and closures.

An all-party committee, Save Hospital Services, was formed under the chairmanship of Steve Cohen, the editor of Bucks Free Press, to fight the proposals. I acknowledge the work of all those who served on the committee, as I did. It is invidious to name names, but I want to single out Dave Parsons for the exceptional amount of time and trouble that he dedicated to the committee’s work.

Our concerns were graphically illustrated by a letter that arrived in my post last October. It states:

“People think that there is still a fully functioning accident and emergency department here”—

that is, in Wycombe. The letter continues:

“Clearly, this is untrue…Major trauma and sick medical/surgical patients are receiving sub-optimal care and lives are being put at risk. This is a major clinical governance issue. There needs to be a serious revision of the current management of emergency patient care.”

The authors of the letter were the entire anaesthesia department at Wycombe hospital. The Minister is aware that it is extremely unusual for a whole department to sign a letter that uses such stark and graphic language.

On the same day, the minutes of the 12 September meeting of the medical advisory committee of the Buckinghamshire Hospitals NHS Trust also arrived on my desk. Andrew Kirk, the then medical director of the trust, is quoted as saying:

“The system is fragile and there is a need to redress the position…There is also the future service change for women and children, which it is considered can make the situation worse.”

I asked the trust to appoint an independent outsider to examine those claims immediately. It finally consented to do so in February. During the summer, its chairman and chief executive resigned, shortly before the report into the outbreak of clostridium difficile at Stoke Mandeville, which cost more than 41 lives and which I am sure my hon. Friend the Member for Aylesbury will mention later.

Last week, I received a letter from Alan Bedford, the interim chief executive of the trust, which states:

“We still believe that the SHS model is the right model for now. However, it is complex, there are some risks involved”—

I believe that this is the first time the trust has been so candid about risk—

“and as you know the health community is substantially in difficulty financially.”

The letter also confirmed that middle-grade doctors are now providing support 24/7 as a result of the independent review of A and E at Wycombe. I quote:

“We have agreed to do this to ensure that both our A&Es come up to the required standard.”

This confirms that the anaesthetists’ concerns were reasonable, despite the assurances that we received at the time about A and E.

In respect of “Shaping Health Services”, we are, in effect, in no man’s land. We do not know whether children’s and maternity services will be moved to Stoke Mandeville. We do not know the future of what remains of A and E at Wycombe. We do not know who the permanent management team of the trust will be. Indeed, my hon. Friends and I do not know the full future of our local hospitals at Amersham, Stoke Mandeville and Wycombe, or of community hospitals such as Marlow cottage hospital in my constituency.

We do know that the deficit problem that was previously the responsibility of the hospital trust is now the responsibility of the primary care trust. The latest estimate of the PCT’s deficit is £15.2 million, compared with a control deficit of £7.1 million, and the PCT is seeking immediate cuts of £3.5 million. It is worth noting that £15.2 million is only an estimate, as far as I can see, and that a definitive figure will be known only when the figures for the final period of the former smaller PCTs in Buckinghamshire are known.

The £3.5 million cuts are only the start. The new PCT’s total savings target is more than £31 million. Consequently, it has developed a three-stage financial turnaround programme to achieve it. Details are vague at present, but it is clear that the trust is looking for savings in, inter alia, hospital referrals, prescribing, services for older people and mental health provision. I shall return to the matter later, but I pause to note that a falling deficit in one part of the local health economy tends to worsen a rising deficit in another part of it. For example, what would the scale of the effect on the hospital trust’s finances be if fewer patients were referred to Wycombe and Stoke Mandeville by the new PCT?

I shall now probe what I believe are the five main themes woven through this tale of deficits and, alas, closures. First, there is transport. Buckinghamshire is a narrowly drawn county with few major north-south connections and a considerable rural hinterland, particularly in the north. At the time of “Shaping Health Services”, we were told that a blue-light ambulance journey from Wycombe to Stoke Mandeville could be done in roughly half an hour and that the ambulance service could take the strain, but anyone who has travelled on the A4010, which is not a modernised road, and who is familiar with local traffic, particularly during school-run hours, knows that the half-an-hour estimate simply is—let me put it this way—unreliable. Anyone who has noted that, during the last year, the number of emergency calls to local ambulances has risen sharply by more than one fifth, on average—in the Wycombe area, by 21 per cent.—knows that the service may not be able to take the strain, and certainly would not be able to do so in the event of, say, a flu epidemic or major terror incident.

It is not only ambulances that will have to make journeys on unmodernised roads but cars containing families and, of course, patients. To travel to Stoke Mandeville from Marlow in my constituency, for example, a driver would have to negotiate High Wycombe in order to get on to the A4010 at all. Such a driver might, of course, go to Wexham Park, just north of Slough. That raises further questions about the degree of planning that has taken place not only between the two hospital trusts concerned but at strategic health authority level.

In the wake of the parts of “Shaping Health Services” that have already been implemented, will the Minister liaise with his colleagues in the Department for Transport and find out what plans it has, if any, to update the A4010 and other transport links to the north and south of the county and to what timetable? Will he guarantee that before any further structural changes are made a full reassessment of blue-light times and transport times will be made by the hospital trust and published? Will he find out, too, whether the new bus service from Wycombe to Stoke Mandeville, which is essential for patients without cars of their own, is running fully during afternoons and when the service will run at weekends?

If the Department intends Bucks county council to help to fund future transport health requirements, how is the council expected to do that when last year it found itself £15 million short of the funds that it needed to preserve the previous service levels? Finally—at least in this section—what guarantee do we have that the new strategic health authority will help to ensure that the transport plans of NHS trusts in Bucks accord with those of NHS trusts elsewhere?

Second after transport comes safety. The tale of the anaesthetists’ letter confirms that anxieties about safety and the quality of patient care are well founded. I said earlier that the trust is looking for savings in hospital referrals, prescribing, services for older people and mental health provision. I accept that some treatments that are carried out in hospitals can be done elsewhere, and that some treatments have higher priorities than others. None the less, the consequences of the PCT’s plan seem to be that some patients who might have had operations or treatments will not obtain them, that some patients who might have been prescribed drugs will not get them, that some people who might have had follow-up appointments will not have them and that some mental health patients—mental health is, of course, often the poor relation of health care—will be treated in circumstances that are not yet clear. Will the Minister guarantee that a full risk assessment—not, please, the risk description that we had in “Shaping Health Services”—will be made on the proposals that the PCT will put forward for consultation in the spring, and that local doctors and other health professionals will be full partners in the consultation?

Furthermore, can the Minister tell us what impact any cuts will have on improvements that have already been promised, such as the new sexual assault referral centre that will probably, I learned this week, be based in Aylesbury? My hon. Friend the Member for Chesham and Amersham has asked me specifically to mention the Chesham health zone, which was apparently pledged when Chesham hospital was closed. I appreciate that the Minister will say that those are local decisions, and there is some truth in that, but the NHS is a national—I scarcely need to underline that word—health service, for which Ministers have responsibility.

I want now to turn to my third theme, for which there can be no doubt whatsoever that Ministers are responsible. That theme is targets. Conservative Members tend to claim that there are too many targets, that they change too often and that they are too prescriptive, stifling local initiative and accountability. Ministers tend to reply that targets are essential to raise the quality of the service, so I want today to cite a source that is neither Opposition claim or ministerial response, namely Professor Sir Ian Kennedy’s report into the clostridium difficile tragedy at Stoke Mandeville. The report was extremely critical of the precious senior management team at Buckinghamshire Hospitals NHS Trust. Those criticisms naturally tended to grab the headlines when the report was published.

The full report is worth reading closely. On page 89, Sir Ian wrote:

“At Stoke…the increased throughput of patients needed to meet performance targets resulted in patients being moved, difficulties in isolating patients with infection and high occupancy”

rates. There is no suggestion that the trust was unique in that respect. On page 88, Sir Ian wrote:

“There is much in this report to suggest that there may be continuing tensions between the control of infection…and other national priorities”.

That sounds to my ears like a masterpiece of understatement, and suggests that the targets regime was a contributor to the disaster at Stoke. I would be grateful if the Minister told us whether the Department saw a draft of the report before it was published, whether any changes were requested and whether any were made.

Nor can the fourth theme that emerges from circumstances in Bucks over the past few years be shunted away from the Department and from Ministers. We read a lot these days about families with chaotic lifestyles and, indeed, I presume that in the pursuit of health promotion and illness prevention the Department has an interest in reducing such lifestyles. It seems that on closer examination, however, the whole Department is in the grip of a chaotic lifestyle.

When I was first elected in 2001, Wycombe hospital had just been merged with Stoke Mandeville. Since then, the mental health trust has been formed and effectively merged with that in Oxfordshire, primary care groups have become primary care trusts, the three primary care trusts have become one and the strategic health authority has been widened so that its scope includes places as far away from High Wycombe as, say, Ventnor in the Isle of Wight. Not a single combination of chief executive and chairman is the same.

The chief executive at Wycombe hospital when I first arrived, Roy Darby, had been in place for more than 10 years. Wycombe will soon be on its third chief executive in five years—and Stoke, for that matter. Such management chaos and confusion undermines responsibility, weakens accountability, strengthens the temptation to pass the buck and makes sensible medium-term planning in our local NHS all but impossible. There must be—indeed, there is—a link between the unstable and erratic change and the fluctuations in the finances of our local NHS. In 2003-04, Wycombe PCT underspent by £536,000 and the SHA underspent by £4.2 million. In the future, can we please have only change that is built to last?

Finally, and inevitably, comes money. According to the Association of Councils of the Thames Valley Region,

“in 2007-08 PCTs in Thames Valley will in aggregate receive the lowest level of funding per crude head of population of anywhere in England. It will effectively deduct 20 per cent. of the population.”

My colleagues and I were told last week that each Bucks resident receives approximately 18 per cent. less per head of NHS spending than the average resident in England and Wales. I realise that the Minister’s response will be that Bucks is a relatively prosperous area, but that raises some important points.

In even the most prosperous areas there are, of course, pockets of poverty and deprivation. One super output area, as they are now described, in Oakridge and Castlefield in my constituency is ranked among the most deprived 25 per cent. in the country. When it comes to housing, 12 SOAs in my constituency are among the most deprived 20 per cent. in the country and five are in the most deprived 5 per cent. In short, one way of looking at all that is that my poorer constituents are being penalised, in terms of health care funding, for living alongside richer people rather than those who happen to be as poor and deprived as themselves.

There is a wider point. NHS spending is weighted, as we have heard, towards more deprived areas, but it is claimed in some quarters that disease and illness in Britain are relatively evenly distributed. Has the Department considered rebalancing its funding so as to give greater weight to the distribution of illness and disease? What confidence can we have in present financial arrangements when we learn in Monday’s edition of The Times that

“seven times as many community hospitals have closed or are under threat in constituencies held by opposition MPs. There are 62 closed or at-risk hospitals in Conservative constituencies and…11 in Labour areas”

The Times continued:

“The revelation comes a month after The Times disclosed that Ministers and Labour party officials held meetings to work out ways of closing hospitals without jeopardising key marginal seats.”

Many of our constituents will, I am afraid, conclude that they are effectively being punished for not voting Labour.

I accept that NHS budgets are always limited, that not all change is for the worse, and that there have been some improvements. I accept that change is always difficult. However, as our constituents look at their local NHS, they see cuts in their local hospitals, then cuts in the provision of primary care, and then the likelihood, if not the probability, of more cuts in local hospitals—in short, a descending spiral of cuts and closures that leave in their wake transport problems that have yet to be resolved and burning questions about patient safety and the quality of care. Yet all the while existing health bodies are being wiped off the map and senior managers are trooping in and out of revolving doors.

My hon. Friends and my constituents tell me that when the Conservative party was in government life was not perfect, but there seemed at least to be a measure of continuity, stability and predictability. When we were in government, new services were coming to our hospitals, not going out. The blue light now seems to be flashing above at least parts of our local NHS. We hope that the Minister will be able to provide us with some answers.

I congratulate my hon. Friend the Member for Wycombe (Mr. Goodman) on his success in obtaining this afternoon’s debate and on the measured and comprehensive way in which he introduced the subject, which is of massive concern to the constituents of all hon. Members who represent Buckinghamshire constituencies.

I shall touch briefly on three subjects—finance, the implications of housing growth on the health service, and staff morale—but I start by making an acknowledgment on two fronts to the Minister. First, there always has been and always will be change in the national health service. We have to accept that and work with it, but I and my constituents are worried because change in Buckinghamshire seems to be driven by short-term financial crises rather than by a considered assessment of the developing needs of patients and the possibilities of medical science.

Secondly, I happily acknowledge that not everything that has happened under the stewardship of this Government has been wrong. I am sure that the Minister will have in his brief a list of projects that the NHS has completed in Buckinghamshire over the past nine years that he will be able reel off. I remember similar lists being available under the previous Conservative Government.

Not on the health service.

Yes, very much on the health service. Although the Government have increased considerably the amount of money spent in Bucks and elsewhere, we are entitled to ask why our primary care trust is struggling with a deficit of £18 million—a deficit that it will find difficult to reduce by a mere £3 million during the current financial year. That comes at a time when the county faces a further reconfiguration of hospital services next year and when our constituents are experiencing cuts in the quality and scope of the health care available to them locally day by day.

I turn to the funding formula. I accept that the NHS budget is finite, and that the principle of having some form of distribution formula based on need is correct. However, like my hon. Friend the Member for Wycombe, I rely not on a Conservative party handout for my comments on the impact of the distribution formula but on a more independent source. I shall make considerable reference to board paper 33/06, published by the Thames Valley strategic health authority in May under the signature of Nicholas Relph, the then chief executive.

The paper found that by 2007-08, the average primary care trust in England would get £1,388 per head to spend on health care, while the average PCT in Thames Valley, covering the counties of Buckinghamshire, Berkshire and Oxfordshire, would receive £1,125 per head. As my hon. Friend pointed out, that is the lowest per capita rate anywhere in England. If Thames Valley were funded at the national average, it would receive an extra £575 million per year extra; if it were funded at the level of the highest paid—I do not argue for that today—it would have an extra £1.1 billion for local health spending. Mr. Relph’s conclusion was that the distribution impact of the formula is so significant that it must be asked whether it is too great, and that it leaves some parts of the country with such a low level of funding that the range of care provided will have to be constrained. The board paper went on to say:

“What might be considered core services elsewhere will have to be critically examined to see if they are affordable.”

That is the considered view of a senior professional health service executive who was responsible for NHS resources in our area.

The charge is sometimes levelled that such deficits are down to inefficient management, so let us consider the figures provided by the strategic health authority. The official NHS analysis shows that in the most recent year for which figures were available, 2003-04, Thames Valley had the fourth most efficient services in England, that admissions were well under the English average, that prescription costs were likewise below the average, and that the number of available bed-days in hospital were considerably less than the average. It is not inefficiency that is at the heart of the problem. The truth, in Mr. Relph’s words, is that

“in order to balance the books commissioning PCTs should be purchasing 21 per cent. less acute community, mental health and other services than the English average PCT. It follows that in Thames Valley we should have one fifth lower hospital, mental health and community provision than the English average.”

What does that mean for my constituents? Children who are diagnosed as needing speech and language therapy are being refused treatment and funding. At one school in my constituency, physiotherapy for physically disabled children at a special unit has been halved in frequency. I was told last week that child protection work is done by a community nurse who is so overstretched that she is unable ever to meet other members of her child protection team. The entire overnight community nursing service is now under threat and may be axed.

The Ian Rennie hospice at home has written to Members of Parliament and others to say that it is struggling to meet the demands placed on it and points out that only 14 per cent. of its costs—less than half the national average for PCT funding of hospices—are being met by the Buckinghamshire primary care trust. I ask the Minister seriously to consider—not in his speech, because he will have prepared a brief, but perhaps after the debate—whether the current distribution formula is not putting at risk some basic core health services in constituencies such as mine.

The hon. Gentleman makes a powerful case on behalf of his constituents, but I want to apply the logic of his argument as it applies to other constituencies. Is he saying that NHS money should be taken away from parts of the country where people die younger than in his constituency?

I am looking not only at the straightforward matter of distribution but at the structure of the allocation system, and separating those parts of the NHS budget for which the costs are more or less the same throughout the country from those matters that are variable. I hope that my hon. Friend the Member for Westbury (Dr. Murrison) will be able to take up that issue if he catches your eye later, Mr. Cummings.

The growth of Aylesbury is of huge importance not only to me, but to my hon. Friends the Members for Buckingham (John Bercow) and for North-East Milton Keynes (Mr. Lancaster). As the Minister knows, the Government have decided to impose significant new housing growth on Buckinghamshire, and particularly on the Aylesbury vale area and Milton Keynes. Our area is one of the four zones in the south-east that have been designated by the Minister’s colleagues in the Government for major growth over the next 15 years. That clearly has serious implications for health provision.

Last year, senior health service managers in the Milton Keynes and south midlands area jointly commissioned an independent report from the Hedra consortium—

I am advised that it is in order to proceed without the Minister being here. I am sure that he will attend as soon as possible.

I am sure that in the Minister’s absence invisible hands will be making notes on further contributions to this debate to make sure that he is adequately briefed when he returns.

I was referring to the impact on health services of the Government’s plans for significant residential growth in the Aylesbury vale and Milton Keynes areas. I want to make two points—about the capacity of health provision that will be needed and the pace at which funding responds to population growth.

First, last year the chief executives of trusts in the Milton Keynes and south midlands growth area commissioned an independent report from the Hedra consortium about the impact on local health facilities of the Government’s plans for growth. The conclusion of that report was that the Milton Keynes and Aylesbury vale areas alone will, if the Government’s plans come to fruition, need 178 additional hospital beds by 2021 and 430 by 2031. Those are just acute hospital beds. The report added that within the same time frame an extra 958 community beds and 639 community day places will be needed.

Throughout that independent report ran a consistent theme: it would be a strain on the NHS to accommodate the demands of a significant rise in population and that it could be accomplished only on the assumption that the NHS would be able to reduce the average length of stay in acute hospitals and the provision of community and domiciliary services could be improved. Yet, in Aylesbury and elsewhere in Buckinghamshire today we are seeing measures to cut back on community and domiciliary care services. On the assessment of the primary care trust, there is the consequent impact of additional admissions to acute hospitals and longer stays, with additional numbers of delayed discharges.

Secondly, I was talking on Friday to local GPs about the pace at which funding responds to population growth. They said that, although it is true that, in time, additional per capita funding follows a growth in population, what the Department quaintly terms “the normalisation procedure” means a gap of as much as 18 months between new people arriving and health funding being delivered to local trusts and GP practices. That gap is too great, particularly if there is an increase in population of some thousands each year for a decade and more. There needs to be a much smaller gap between the establishment of the need, the increasing demand for health treatment and the delivery of resources to meet that demand.

I also want to deal with the effect of the crisis in the Buckinghamshire national health service on NHS staff. I endorse everything that my hon. Friend the Member for Wycombe said in praise of those staff. They have been subjected to constant reorganisations, myriad targets and other changes. I shall give the Minister a couple of illustrations drawn from a meeting that I had last week with doctors from the Mandeville and Elmhurst surgery in my constituency. That practice serves an area that is as far removed from the caricature of leafy Buckinghamshire as can be imagined; it serves two of the poorest council estates in my constituency.

The doctors first told me about independent treatment centres. I have no problem with the principle of independent treatment centres and involving the independent sector in providing NHS care on contract. However, the doctors told me that the practice has £65,000 deducted from its budget each year as a notional contribution to the cost of independent treatment centres, but that the nearest ITCs are not in Aylesbury. They are in Banbury, Reading and Milton Keynes, which are a minimum of an hour away by car and for which public transport is at best inconvenient and at worst non-existent. When the doctors’ patients ask, “Why on earth do we have to go to those places? Can’t we go to Stoke Mandeville hospital just around the corner?” The doctors usually say, “Yes, you’re right”, because in Southcourt ward, which is served by the practice, 35 per cent. of households have no car. Common sense tells us that those without a car are most likely to be pensioner households, and pensioners are the biggest consumers of health care and most likely to be in need of elective operations. Therefore, the location of those ITCs is doing little good for the patients of that Aylesbury practice. Money is being taken away in return for slots at ITCs that cannot be of service to the patients in the Southcourt, Walton court and Elmhurst estates. The Government need to look at that again. I support bringing independent advisers into the NHS, but they should be brought into the same framework of money following treatment—payment by results—as existing provider institutions.

The second anecdote is about the enhanced services budget, which in this case went to provide a minor injuries service at the Mandeville and Elmhurst practice. The tariff for treating a minor injury was £50. The practice could actually do it for £15, but the crisis of funding at the PCT meant that the service was cut. The result was fairly predictable: patients were instead referred to the local accident and emergency department where the treatment for a minor injury costs £100 a case. No money was saved for the local health economy; the bill has actually gone up and the PCT is now trying to work out how to reinvent the service that it had got rid of in order to try to save money. It is little wonder that staff are frustrated and in many cases very angry.

I am prepared to believe that Health Ministers from any political party discharge their responsibilities with the best of intentions towards the health service and those who work in it, but in the past year senior executives and non-executive directors have telephoned me on their private mobiles from their homes and told me that they are doing so because they dare not tell the truth about the local NHS from their offices as the Department of Health can and will interrogate them on whom they have been telephoning and to whom they have been sending e-mails.

I have had in my constituency surgery health managers and health visitors who are at the sharp end of the service wanting to tell me about their disquiet about what is going on, but begging me not, under any circumstances, to reveal their names because they fear for their jobs. In the past month, I have had nurses saying to me that they are afraid to speak out about the changes proposed for reductions in primary care services in Buckinghamshire and that they have been reminded by management of their duty of confidentiality and that they should attend classes on how to prepare and present their CVs in preparation for when they will need to reapply for posts under the new structure. I am genuinely sorry to say that there is, in my experience, a culture of fear among a great number of national health service staff at the moment. Any Government of any political party ought to hang their head in shame over that.

Between them, my hon. Friends the Members for Wycombe (Mr. Goodman) and for Aylesbury (Mr. Lidington) have offered the House an erudite and clinical exposé of the NHS crisis in Buckinghamshire and of the Government’s culpability for it. In the short time available to me, I should like to focus narrowly on two issues within the NHS of particular concern to me and to the substantial number of constituents who have approached me about them.

First, I should like to focus the attention of the Chamber and the Minister on speech and language therapy. In the vale of Aylesbury, five and a half whole-time equivalent speech and language therapists cater to the needs of the entire area. It is posited that in due course that number will rise with the amalgamation of the local primary care trusts, but there is no guarantee of that happening. We are talking about five and a half such qualified personnel for the whole of the vale of Aylesbury. There is a recruitment freeze now, which seems set to continue for an indefinite period, so an increase in staff is simply not on the agenda. As we speak, the human consequence of that freeze and of the manifestly inadequate resource available is clear for all to see. Two hundred children in the vale are waiting. They have serious problems and need help, but they have not been diagnosed or assessed and, in the vast majority of cases to which I am referring, they have not been seen at all.

From the panoply of cases that have come to my attention, I should like to focus simply on one, that of two-and-a-half-year-old Peter Metcalfe; he will be three on 13 December this year. His mother, Brenda, is understandably upset and furious about the situation in which she and her young son find themselves. They were seen by a health visitor in November 2005. It was clear that there was a problem, although at that stage the extent of it was uncertain. They were told that an appointment could be made for three to six months’ time, at which progress could be reviewed. Specifically at that point—I underline the significance of this—Brenda Metcalfe was told that, in the event that she wanted at that stage to have an assessment, an immediate assessment could be provided at a drop-in centre.

June 2006 is reached, the health visitor comes and the extent of the problem is clearer. The extent to which the young boy is behind where he should be is apparent to the health visitor and to the mother, and she of course then wants an assessment. She goes to the PCT and asks for an assessment, but is told, “No, you can’t have an assessment. There’s no prospect of that at the moment. There is a recruitment freeze. We have a cash crisis. The service isn’t available. Nothing can be done to assist your child.” In the circumstances, it is absolutely understandable that Mrs. Metcalfe is disorientated and disgusted by the lack of help available from the PCT for her young child. There is nothing on offer.

Subsequently, to add insult to injury, two suggestions were made to Mrs. Metcalfe, and I think that my right hon. and hon. Friends will testify that this is symptomatic of a wider picture. First, Mrs. Metcalfe was offered a meeting. She had a meeting, but it was utterly pointless, as it transpired, for it turned out to involve simply an explanation of the financial difficulties besetting the NHS in the vale of Aylesbury and of the steps that the local PCT was taking to seek to address those problems. There was no offer made, no hope held out, and no assistance on the table.

The first offer, of a meeting, raised expectations and was taken up, only for those expectations to be dampened. The second proposition was, “Go private.” First, very large numbers of people cannot for one moment contemplate going private because they simply cannot afford to do so. Ministers need to understand that point and to lodge it firmly in their heads. Secondly, even for people who can contemplate the possibility of going private, why on earth should we in what is supposed to be a national health service freely available to people on the basis of clinical need and not on the strength of capacity to pay?

The reality is that Peter Metcalfe, approaching his third birthday with a very severe problem of speech and language difficulties that requires immediate attention, is not getting that attention. The point that I want to emphasise in this context is the manifest disparity between what Ministers say and what is medically understood to be important on the one hand, and what is happening at the coal face on the other. In the special educational needs codes of practice, as this Minister will be well aware, it is underlined almost in triplicate that it is important to identify special educational needs as early as possible. To that observation is added the significant observation that once those needs have been identified, early action is vital to address them. That is said there, but it is also said elsewhere, in the Department for Education and Skills 2005 advice to parents. In that context, it is on the record what Ministers think on the strength of the professional advice that they have received. The document states:

“Language is the core to all social interaction. Without it, a child is isolated.”

As the father of a child who has significant speech and language difficulties, I can readily testify to the reality of that state of affairs.

In “Every Child Matters”, the Government have once again pinpointed the significance of early intervention. It is not only that early intervention is valuable; there are significant downsides in its absence. If there is not early intervention to tackle speech and language problems—the problem being suffered by so many children in the vale of Aylesbury—real problems result. There are likely to be emotional and psychological difficulties. Educational attainment will be lower. There will be a persistent communication handicap and there will be damaged employment prospects to boot. In very practical terms, grave and possibly irreparable damage can result.

I hope that the Minister will understand when I say to him that it is reasonable for hon. Members to expect consistency between the words that Ministers utter and the deeds that they do—between the promise and the performance—and that is lacking at the moment. I am grievously concerned about large numbers of children in my constituency who are suffering and will continue to suffer unless they get the help that they need. They will not be able to access the national curriculum. They will have damaged prospects in school and their chances of acquiring the training, education and qualifications that they need will be significantly undermined.

A second problem, to which I want briefly to allude, is the threat to the district nursing service. A cut of 50 in the number of district nurses is on the table for Buckinghamshire; that is the proposal. I have met countless constituents who have said what an enormously valuable service it is. I think of Arthur Christian, who wrote to me recently. He is a cancer patient who has been a direct beneficiary of the district nursing service. We are talking about qualified specialist high-achieving nurses, capable of performing a wide and disparate range of specialist tasks for the benefit of patients. If the district nursing service is slashed, people such as Arthur Christian will lose out in consequence. Again, I point to the disparity between promises made and performance achieved to date. It is not merely that my hon. Friends and I are wont to invoke the merits of the district nursing service; the Government themselves have consistently been doing precisely that.

The Secretary of State for Work and Pensions, when he was Minister of State in the Department of Health, acknowledged and highlighted in a written answer on 8 September 2003 the importance of the work of the district nursing service. He said that he wanted that work to be extended and that a greater prominence should be given to the role of the district nurse. In pursuit of that worthy and noble ambition, he announced that he had issued a document entitled, “Liberating the Talents: Helping Primary Care Trusts and nurses to deliver The NHS Plan”, so he thought that it mattered. The Government reckon that it is important but now propose a scenario of substantial reductions in the numbers of district nurses, and their replacement by less well qualified and, inevitably, less dextrous health care assistants. That is not to knock them, but they are not as well qualified.

My hon. Friends have touched on a plethora of serious concerns that affect our constituents. I underline in particular my anxiety about the prospects for an expanded Aylesbury vale if the Government do not get their act together and focus in an intellectually muscular fashion on the task before them. I am expected to absorb another 1,000 houses a year in Aylesbury vale, and my hon. Friend the Member for North-East Milton Keynes (Mr. Lancaster) has to contemplate the prospect of a substantial increase in the population of his community. We are already underfunded and there are major service problems. Significant parts of the national health service in our communities will become inoperable unless the Government recognise that an increased population will inevitably bring an increase in the number of children, in the demand on services and in the requirement for appropriate funding, which is not there.

I like the Minister very much and have a high regard for him. I have liaised with him about the Nuffield speech and language unit and he has been courtesy and responsiveness itself. I appeal to him—whose career, as long as this Government are in office, I wish well—to go better than the average. He should not content himself simply with reading out the prepared brief. He is a bright man and I look to him to respond to the serious points that my hon. Friends and I have sought to put on the table, not in the spirit of political partisanship, but in the interests of our long-suffering constituents. Too many of them have suffered too much for too long with too little being done about it, and that must change.

rose—

I remind hon. Members that the debate will conclude at 4.30 pm. I have one more speaker on my list, and of course there are three winding-up speeches.

It is a pleasure to speak with you in the Chair, Mr. Cummings. I congratulate my hon. Friend the Member for Wycombe (Mr. Goodman) on securing this valuable and timely debate. I shall be brief so that other Members can contribute.

I start by thanking the staff at Milton Keynes primary care trust and the hospital for their sterling work in difficult circumstances. If there is one question that I want the Minister to answer, it is this: why at a time when the Government are forcing Milton Keynes to expand are they forcing our health service to shrink? That is simply unacceptable. My hon. Friend the Member for Aylesbury (Mr. Lidington) touched on the normalisation procedure—the time delay between the increase in population and the funding that follows, which can be up to 18 months. Currently, 13 people a day are moving to Milton Keynes. That is 7,000 people in an 18-month period, which means a potential lag in funding of 7,000 people. That is why a local general practitioners’ practice in Milton Keynes village has had to close its books; it is full. Due to financial constraints, the PCT is delaying issuing a new contract. Those are the sorts of problems that we have.

Our funding allocation in Milton Keynes is not quite as bad as it is for other hon. Members elsewhere in Buckinghamshire. We receive 95 per cent. of the national average, but that is still 5 per cent. below the national average. Earlier this year, I outlined the impact that the £5.5 million levy that the strategic health authority forced the PCT to cut from its funding has had on our services. In a moment, I shall touch on the effect that it has had on adult mental health services in Milton Keynes.

Last week was a bad week for health care in Milton Keynes, because, following another 6.2 per cent. cut, Milton Keynes hospital had to withdraw its application for foundation status. That is a major blow for the people of Milton Keynes.

The Government cuts are having an impact on adult mental health services in Milton Keynes. There have been many reports, both nationally and in Milton Keynes, offering visions of how the needs of people who experience mental health difficulties should be met. Two recent Government reports are particularly relevant. The first, “Our health, our care, our say: Making it happen”, has visions of creating health and social care services that generally focus on prevention and promoting health. Another report, “Improving Services, Improving Lives”—these are great titles—proposes to give local people a more direct influence over the services that they receive.

At a local level, a July 2005 report by the Sainsbury Centre for Mental Health proposed a restructuring of the mental health service to give a single point of contact for new referrals; a 24/7 service, including an out-of-hours phone number; a greater focus on recovery in its broadest sense; and a move away from the domination of a medical model of mental illness to a more holistic service. Those are great aims, and were broadly supported by service users in Milton Keynes, but, at a time when it has been agreed that our mental health services need additional funding, the cuts mean that the proposals that were recently consulted on will not be fully delivered. The cuts will affect community-based day services, a memory screening clinic and a community drug and alcohol service. That is a major blow for people in Milton Keynes.

Back in July, I presented a petition with the names of local service users to which the Government response was, unfortunately, “No comment.” They simply do not seem to care about what is happening in Milton Keynes and Buckinghamshire, or about the impact of the cuts. Exactly the same thing happened with the closure of the Fraser day hospital in Newport Pagnell. My hon. Friend the Member for Aylesbury outlined a report that shows how many more places we need, yet we are closing day hospitals. I simply do not understand.

I am conscious of the time, so I shall finish where I started—with staff. What does the Minister suggest that I should say to my constituent, Paula Gawronska, who came to my surgery on Friday to explain that, having just finished her nursing degree in Liverpool, she is pulling pints in Milton Keynes to pay off her £12,000 student loan debt because there are simply no jobs for nurses in Milton Keynes or, it would appear, anywhere else in the national health service?

I do not want to repeat the comments of my hon. Friends. My constituency is the southernmost constituency in Buckinghamshire, so there is an issue about people using services outside the county, which is an essential part of living in a border area.

I could not fail to notice that, when my hon. Friend the Member for Aylesbury (Mr. Lidington) suggested that there was once better predictability in the NHS, a wry smile seemed to pass across the Minister’s face. Given the amount of money that the Government have sunk into the NHS in the past nine years—I am the first to acknowledge that—which constitutes a substantial increase in real terms, the problem that I face as an MP in Buckinghamshire is in understanding how that money has been spent locally and why we face a constant cutting of services, which is currently on an accelerating pattern from an already low base. I hope that the Minister will enlighten us on that. The point has been well made about our overall underfunding in national terms, but if the Government strategy were working, I would expect that somewhere along the line, some little crumbs from the cornucopia of money being spent would be falling off the table towards us. However, that is far removed from the reality of local health services. That is the key issue that the Minister must address in his reply.

It is easy for us to cite examples. In a sense, that is all we can do as MPs, because we have to marry up what the Government tell us in theory with what the evidence and anecdote tell us in practice. First, criticisms are sometimes made of those who run our hospital health trusts and PCTs. In nine years, I have, on the whole, been impressed with the people who run our NHS trusts and PCTs. We have had differences, but I do not think that the place has been run by incompetents. Therefore, the overall impression I derive is that people are labouring under impossible conditions. The report by Professor Sir Ian Kennedy on clostridium difficile at Stoke Mandeville hospital amply illustrates that point: targets are incapable of being met without disrupting clinical practice.

Another example comes from Wexham Park hospital, just across the border, on which a great many of my constituents depend—this is the border issue that I raise with the Minister. Evidence has been presented to me by nurses about management interference in clinical judgments on who should be seen in the accident and emergency department. Decisions might depend on the amount of time that people have spent there. At Wexham Park, as the four-hour point approaches, managers come down from their offices to redirect the nursing and medical staff towards their own priorities and not those of the nursing and medical staff. I am sure that that is occurring.

Secondly, anecdotally, I am told that the Haleacre unit for mental health at Amersham is unfit for purpose. That is clear, and anyone who goes to have a look at it can see that for themselves. When my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) and I visited it, we were appalled at the demoralisation of the staff and the general conditions. To learn that it needs replacement and then to find, to our amazement, that somebody has decided that it can manage on refurbishment is another illustration of the extent of the crisis that we are facing.

The points have been made about specialist services, speech therapy, which is raised with me frequently, and the understaffing of the child and adolescent psychiatric unit at Amersham, which means that children are waiting far too long to be seen. There is a constant sense of disruption. We are also facing a 50 per cent. cut in district nurses. No sooner has something become a centre of excellence, for example, a physiotherapy service offered by a particular practice, than it is chopped, because a decision is taken that it is absorbing too much money in one location and the money must be redistributed more generally. All those things are pictures of a service in crisis.

I shall give the Minister one final example. It concerns a constituent, who, following a failed operation for a hernia at Wexham Park hospital, developed a fistula. She was sent to St. Mark’s hospital in west London, at Northwick Park. At that stage, it was thought that she would die very quickly, but the Northwick Park and St. Mark’s hospitals thought that they could do something for her. She received excellent specialist care, but it became clear that they had done as much for her as was possible, and that her condition could be managed but not cured. Her returning to Buckinghamshire totally fazed the ability of the PCT and the health trust to manage it, until we finally got to strategic health authority level. It was managed; she died eventually, but she got the services and support she needed.

That did not illustrate to me that these people were uncaring. It illustrated that the moment we put something slightly unusual into the system, it had no flexibility to respond to it. The district nurses pointed out that her case was so difficult to manage that management at home was being proposed, partly for financial reasons although I am sure, it was impossible. The local hospital did not have the resources to do it, and the thing had to be put together as a special package. That does not surprise me, but it troubles me that it needed so much external interference from Members of Parliament and others to sort out a straightforward management problem of a seriously ill patient that ought to be capable of being resolved routinely. That is the extent to which our services are overstretched and cannot cope.

A new raft of cuts are coming up, which we have heard about. I should be interested to hear the Minister’s comments about how he thinks the savings in the PCTs will be achieved without closing community hospitals. I think it almost inevitable that such closures will happen, yet we are told that community hospitals are now rather an important priority for Government. How does the Minister reconcile those two concepts?

The truth is that Buckinghamshire remains seriously underfunded. The hon. Member for Northavon (Steve Webb) raised a point: where there is underfunding, is there a proposal that we should take money from elsewhere, where the need appears to be greater? I am not in a position to answer that question. I am able to say that the redistribution of wealth from wealthy to poorer areas is the precondition of the running of a unitary state, so I accept it. However, I worry not that what is being done is an equalisation to provide a uniformity of service, but that the end result is that those who are disadvantaged in my constituency—despite its being wealthy, there are many disadvantaged people; one ward is listed in the indices of disadvantage—are getting some of the poorest services in the land. They would be far better off moving to north Liverpool. Although there might be other drawbacks of doing so, their health care per head of population and the expenditure would be much greater.

I do not want the Minister to give us a list of what is being done through spending money or capital projects. Some of those may be worthy, but if the revenue expenditure does not accompany it, they will never function properly. I am eager to hear him explain how a Government that are apparently spending so much taxpayers’ money and raising so much more for the national health service than in 1997 should have an area such as Buckinghamshire where the history of service provision is one of continuous cutback.

I am sure that all hon. Members wish to give the Minister plenty of time to respond, so I shall curtail my planned remarks. I am sure that my Conservative counterpart will do the same. I congratulate the hon. Member for Wycombe (Mr. Goodman) on securing this debate. I believe that it is not the first debate that he has secured in the House on health services in Buckinghamshire. I share the good wishes he gave to the hon. Member for Chesham and Amersham (Mrs. Gillan), who I think took part in the last such debate.

The contributors to this debate have all spoken powerfully on behalf of their constituents in Buckinghamshire, and rightly so. One of the interesting features of participating in these debates as a Front-Bench spokesman is that I get to see certain trends occurring across the counties. Some of the examples from Buckinghamshire that we have heard are all too often mirrored in other areas, and I should like to give one example of that.

Clearly, there is always a legitimate argument to say that hospital services should not be set in stone, that they can be looked at and that reconfiguration can be considered. The two preconditions for any consideration of reconfiguration are that it should be clinically driven and locally accountable. The example given by the hon. Member for Wycombe, where the clinicians, local politicians of all parties and local people appear to be pretty much uniformly against the proposals, is a classic case of where the system is failing.

Nobody is arguing that there should not be change in the NHS as we learn new ways of doing things. Perhaps we can do things better. We know that population shifts and that transport networks change, so there is no argument that there should not be review and reform. However, as the hon. Member for Aylesbury (Mr. Lidington) said, it should be driven not by short-term financial crisis management, but by long-term strategic planning. It should also be democratically accountable, with not merely the consent but the active support of the clinicians, to whom one would hope the Government were listening. I agree that when that does not happen it is simply unacceptable.

We lack democratic accountability in the NHS, because where local people are not happy with the reform, as has happened in Buckinghamshire, the best that they can ultimately do is appeal to the mercies of the Secretary of State, who may or may not refer it to an independent reconfiguration panel, in itself a quango. If the Secretary of State declines to refer it, that is it. Clearly, one can campaign in all sorts of other ways, but the only democratic back-stop to reform in Buckinghamshire, as elsewhere, is the Secretary of State, who may simply decide not to refer or reconsider, and then the deal goes through.

We have also heard from the hon. Member for Wycombe about the knock-on effects when money is tight in primary care trusts. Some eloquent contributions have been made about what gets cut. We have heard about cuts in mental health services. All too often, it is the apparently peripheral services—the unfashionable services, where perhaps the client groups are least able to shout the loudest—who suffer. The hon. Member for Buckingham (John Bercow) spoke effectively and made a powerful contribution about the impact of the cuts in speech and language therapy. No doubt the Minister will read out lists of millions and billions of pounds. Nothing can be done without millions and billions of pounds, but the financial straits in which the hon. Member’s constituents find themselves have a human impact. I hope that the Minister will respond to the hon. Gentleman’s plea and explain whether the Government have any views on how the problems with speech and language therapy in Buckinghamshire will be addressed. I hope that he will not simply say that that is a local problem for the hon. Gentleman, which is what I presume he will say.

The hon. Member for North-East Milton Keynes (Mr. Lancaster) highlighted a problem that is peculiar to Milton Keynes and applies more broadly in Buckinghamshire—population growth. My friend and colleague, Jane Carr—I am sure that the hon. Gentleman knows her—gave me a briefing about the situation in Milton Keynes which tallies with what he said. She said that the population growth in Milton Keynes is such that the area requires a class of children a week. Clearly, the figures must reflect that, but they must reflect it more quickly because capital costs are involved in adjusting to a rapidly rising population. Marginal increments are not sufficient. New facilities are required and there is clearly a time lag before they can be put in place. If the money does not come through for 18 months or more, that makes things difficult for people on the ground.

First, I accept that the calculation of the entitlement of a particular area should be based on accurate figures. In the case of Milton Keynes, it is widely accepted that it was not based on accurate figures. Secondly, it should adjust promptly to the situation on the ground. Thirdly, if there is a formula, leaving aside what it is, and 100 per cent. of the funding under that formula is available, areas should receive 100 per cent., not 95 or 97 per cent. I agree with the contributions that we have heard on that point.

I raised an important point during an intervention. If I were a Member of Parliament for Buckinghamshire, I would have done precisely what the hon. Members who have spoken have done—plead for more money for their constituents. There is no reason why they should not do that because the financial pressures in Buckinghamshire are clearly leading to some practical problems. However, Conservative Front Benchers cannot say that they want more money in Buckinghamshire, Bedfordshire and Hertfordshire—I have taken part in all those debates—without simultaneously saying that they want less money in north Liverpool, Manchester and so on, which was implied. It is reasonable for a political party to say at an election that it will give more money to the south of England if people vote for it and less money to the north of England. If that is the prospectus for the next election, the electorate can make a fair choice.

Will the hon. Gentleman give way?

I shall let the hon. Gentleman speak in a moment.

It is legitimate to raise a debate about the formula and whether the weightings are correct, but I hope that the debate will be consistent because I do not want hon. Members to say one thing in one part of the country and something else in another part.

On the substance of the debate, clearly, there are pressures in Buckinghamshire because of data being out of date, information not being updated, and not being paid at 100 per cent. as should be the case, whatever the formula. Those points have rightly been raised and I hope that the Minister will make a constructive response.

The hon. Member for Northavon (Steve Webb) did not give way to me, as is his right, but had he done so I would have pointed out that he is defending a system that results in his constituents in south Gloucestershire receiving £227 per capita in 2006-07, less than the English average, and £245 in the coming financial year. The correspondent for the Western Daily Press was sitting in the Gallery earlier but has now departed and I am sure that he will be interested to hear the hon. Gentleman’s justification for defending a system that so clearly sees off his constituents, as it sees off mine and those of my hon. Friends who have spoken so eloquently today.

I congratulate my hon. Friend the Member for Wycombe (Mr. Goodman) on securing this debate and on introducing it in his usual robust way. I am pleased to hear that my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan), even from her sick bed, has contributed to this debate by proxy.

Where Buckinghamshire fits into the Secretary of State’s heat map is uncertain. Our freedom of information request on this subject comes to light in a few days—we hope that the response will be free and frank, otherwise we shall apply to the Information Commissioner. My suspicion is that it will show Buckinghamshire as being pretty cold. The reason for that is deficits, which lie at the heart of the difficulties that my hon. Friends have expressed and that I have experienced in my constituency. It beggars belief that the Secretary of State can claim that it is all down to bad managers, which is her thesis. Bad managers choose their appointments for many reasons, but I fear that they do not choose them based on whether there is a Conservative Member of Parliament representing their area. Perhaps it would be a good thing if they did so, but they most certainly do not. We must nail that first and foremost.

We are talking about a matter to do with the funding formula. The hon. Member for Northavon raised it and I shall talk about it in some depth because it relates directly to what my hon. Friends said. Indeed, it lies at the heart of that.

I hope that the Minister has read the work produced by Professor Asthana and Dr. Alex Gibson. He should have done because it was recently submitted in evidence to the Select Committee on Health. They work from the university of Plymouth and have done extensive work on the funding formula. If the Minister has not read it, I seriously recommend that he does so without delay. It points out clearly that deficits are strongly associated with per capita allocation of funding and levels of deprivation. However, it is old age that drives cost in the national health service and the Minister should know that. Old age overwhelmingly causes costs to be generated within the national health service and as diseases of old age—chronic diseases and long-term conditions—become more and more prevalent, it will need more and more focus in a funding formula that since 2003 has given equal weight to measures of social deprivation as it does to old age.

The gradient in the prevalence of chronic disease is much steeper across age bands than across social class bands. I appreciate that the Secretary of State has a particular political axe to grind, and my hon. Friend the Member for Beaconsfield (Mr. Grieve) touched on redistribution. We all accept that redistribution is what Parliament does. It is part of the deal. However, I suggest that redistribution through the funding formula for the national health service is inappropriate and takes us away from what we should be doing: funding disease burden and health care need. What drives those above all else is age. We must all appreciate that because we are all getting older and will increasingly become prey to such conditions, which I fear will be insufficiently funded because of the funding formula that has operated since 2003, when parity was achieved between indices of social deprivation and old age in terms of how funding is apportioned.

The market forces factor also weighs on Buckinghamshire. It is meant to equalise costs in metropolitan and non-metropolitan areas with particular reference to incomes, but the national health service has national pay scales, so market forces do not apply to the NHS to the extent that they do elsewhere. However, they are still a factor. Many of us believe that that should operate in reverse in many of our rural constituencies, such as Buckinghamshire, because we all know that more senior and elderly people tend to work in non-metropolitan areas. We have seen that in primary schools, where there is a particular problem in village schools, which face staff costs far in excess of those in more urban centres. It certainly applies in the NHS.

We see no reflection of rurality—

Order. We need time for the Minister to respond.

By my reckoning, Mr. Cummings, I have seven minutes and I have spoken for five, unless you wish to correct me.

Order. Perhaps the hon. Gentleman will draw his comments to a close.

Thank you, Mr. Cummings.

There has been no reflection of rurality in the funding formula, except in the ambulance service, and we need that. The solution is to have some flexibility on brokerage, which the Secretary of State has removed. That lies at the heart of what Buckinghamshire is experiencing. The brokerage that levelled up the unequal funding formula that I have described has been removed. In the long term, deficits should not recur, and we must consider service items in the national health service using a formula that is based more on the age demographic of the population, and less on social factors.

In response to the hon. Member for Northavon, it is equally important that we fund public health properly. We must separate it from service funding in the national health service, because health inequalities have got worse under this Government. We will not address those problems unless we isolate public health funding and deal directly and transparently with such difficulties as obesity, hypertension and hypercholesterolemia, which are arguably more prevalent in some of the communities to which the hon. Gentleman referred.

It has been a good debate, and I pay tribute to the hon. Member for Wycombe (Mr. Goodman) for securing it. I also pass on my good wishes to the hon. Member for Chesham and Amersham (Mrs. Gillan). I inherited her office when I took over at the Department for Education and Skills, and the curtains were very interesting, indeed. I pay tribute also to the hon. Members for Aylesbury (Mr. Lidington), for Buckingham (John Bercow), for North-East Milton Keynes (Mr. Lancaster) and for Beaconsfield (Mr. Grieve) for their contributions.

I begin by praising all national health service staff who make a difference in those hon. Members’ constituencies and throughout the country. We are united in the belief that staff on the front line make a tremendous difference to the quality of people’s lives. On many occasions, national health service staff go further than that by saving people’s lives.

I shall try to address sensibly and reasonably the comments of most hon. Members. First, however, I shall deal with the contribution from the hon. Member for Westbury (Dr. Murrison). It goes beyond the pale when a Front-Bench spokesman on behalf of Her Majesty’s loyal Opposition seemingly suffers memory loss. When the hon. Gentleman’s party left office in 1997, the national health service was by any standards and measure a complete shambles and in a complete mess. Subsequently, the Conservatives have repeatedly voted in the House of Commons against our proposals, particularly against our most significant proposal to increase national insurance to enable us to put far more money into the NHS.

At the last general election, the Leader of the Opposition wrote a manifesto that suggested the best way of reorganising the NHS was to incentivise people to leave the health service and spend money in the private health care sector. When the hon. Member for Westbury starts lecturing me on public health, I say to him that the Conservatives were the party that banned the use of “poverty” when it came to the development of any element of public policy. Let us please have a balanced debate about what is happening in hon. Members’ constituencies. He should not be impudent when he describes the health service and the improvements that have been made.

Hon. Members cannot argue for independence and the devolution of power to the front line in the health service, and then attend debates such as this day after day, demanding ministerial intervention in individual cases, reconfiguration and the prioritisation of resources in their local health economies. The two positions are intellectually incoherent.

On the question of the fair distribution of resources, we agree that public resources are always finite. The Government will always be required to make decisions about the distribution of resources, and we make no apologies for saying that those areas with higher levels of social exclusion, deprivation and health inequalities needed a larger share of the cake than they had received historically. That is why we reordered the formula. Some constituencies that have benefited are represented by Opposition Members, and I wonder how they would feel if we started to redirect resources. The issue is about fairness, and I do not apologise for focusing resources where health inequality is at its most acute.

I say also to the hon. Member for Westbury that we are right to say to the health service, “You have a budget, and finally, you have a duty and a responsibility to balance that budget just like any other organisation in the public or private sectors.” We cannot move forward organisationally until we control our finances. It is a basic fact for any organisation responding to perpetual change. If its finances are not under control, it is difficult to make the necessary changes.

I shall respond to the specific points that hon. Members have made about their constituencies, but if I do not reach their questions, I shall write to them in detail wherever I can. Buckinghamshire primary care trusts received £524.8 million for the financial year 2006-07, and they will receive £573.5 million in 2007-08. That represents a 19 per cent increase over two years, and by any standards, a significant year-on-year increase.

The hon. Member for Beaconsfield asked what the funding has bought. I shall tell him. It has been instrumental in the fact that no patient in Buckinghamshire waits longer than 26 weeks for in-patient treatment and no patient waits longer than 13 weeks for out-patient treatment. No cancer patient waits more than two weeks from referral to being seen by a specialist, and more than 96 per cent. of people on being diagnosed with cancer wait fewer than two months after referral to be seen by a specialist. Without targets, many objectives would not be achieved. We should debate the right and smart targets, and the unintended consequences of targets, but it is nonsense to suggest, as the Opposition do, that we ought not to have targets for public service outcomes and delivery.

The increased funding has paid for 5,612 more nurses, 794 more consultants, 481 more GPs and 635 more dentists in the NHS south central area since 1997. It has allowed the provision of single specialist medical units for cardiology, respiratory and haematology, and a new stroke unit at Wycombe hospital. First-year data analysis from the strategic health authority shows reductions in length of stay, and improvements in outcomes such as mortality rates.

Hon. Members may be interested to know that the percentage of patients seen as soon as they felt it necessary by a GP in hon. Members’ constituencies rose from 56 per cent. last year to 81 per cent. this year. That is an important representation of how patients in hon. Members’ constituencies feel about improvements in primary care.

In 2003-04, the most under-target primary care trust was 22 per cent. under its fair share of available resources. By the end of 2007-08, Buckinghamshire primary care trusts will be only 0.3 per cent. under target. That represents significant momentum and improvement.

“Shaping Health Services” is the name for the reconfiguration of services. Surely hon. Members accept that it is impossible for a Minister in an office in Westminster or Whitehall to make a judgment about the most appropriate configuration in hon. Members’ localities. They must engage with managers, clinicians and the local community to achieve a sensible way forward. It is not right for Ministers to intervene in decisions about service reconfiguration.

Difficulties in accident and emergency departments and the shortage of anaesthetists have been recognised, and that is why health management has intervened and problems are being put right. The problems should not have occurred, but importantly, management are doing something about that.

It is not for me to write to Transport Ministers about issues in individual Members’ constituencies. However, if they can demonstrate a direct correlation, and they want me to pass on to Transport Ministers communications that relate directly to an impact on health, I am willing to consider it.

The hon. Member for Wycombe referred to the difficulties at Stoke Mandeville hospital. The Secretary of State commissioned an inquiry into Stoke Mandeville hospital, and we all agree that it spotted dreadful and unacceptable failures that led to tragedy.

The hon. Member for Buckingham spoke about speech and language therapy. He cares passionately about it and he is objective about it. He was right to raise concerns about the practical impact on young children such as Peter Metcalfe. I have said that it is inconsistent to ask for ministerial interference while demanding independence, but because the hon. Gentleman is genuine about that issue, I am willing to ask for information from the local health authority about the speech and language therapy situation, and specifically, about the action that it proposes to improve it.

If I have been unable to cover any other issues, I shall write to hon. Members.

It is my pleasure to raise again a matter that I raised a few years ago. In the spirit of agreeing that prevention is better than cure, rather than request an Adjournment debate in outrage when someone unsuitable is placed in open conditions and walks out, I felt it better to raise my concerns about those who are being sent to open prisons before things go wrong.

As the Minister knows, Leyhill open prison is in my constituency. I have visited it on a number of occasions, including recently. I do not want the views that I express to be taken as representing those of anybody else, although they have been informed by the people at Leyhill to whom I have spoken. Many of the comments that I make will be equally applicable to other open prisons.

I begin with a sincere word of praise for what goes on at Leyhill. It is clear that some people within the prison system, typically serving long sentences for serious offences, approach the end of their sentence without being ready to be sent out into the community. If we were to take them straight from closed conditions into the community, they might not cope or they might reoffend—who knows what might happen? I therefore support the principle of open prisons. Leyhill prison employs many people in my constituency, and people in my local community accept the principle of the work done there. I often meet people who are at Leyhill and are working in the community, getting back the ideas of discipline, personal responsibility and routine to equip themselves for life on the outside. That work is to be praised.

I also wish to praise the dramatic turnaround in the problem of absconding from open conditions. The shadow Home Secretary, the right hon. Member for Haltemprice and Howden (David Davis), received a written answer on 25 July showing the number of absconders from various open prisons. The number of people absconding from Leyhill, the prison in which I am particularly interested, went from 19 in 2001-02 to 33 to a peak of 114 in 2003-04—more than two a week. It then fell to 102 the following year and 66 in the financial year that has just ended. In fact I am told—the Minister will probably have more up-to-date figures—that in the first eight months of this calendar year, only eight prisoners absconded. That is obviously eight too many, and we all accept that we do not want anybody to abscond. Clearly, some of the people who do so have committed serious offences. However, there has been a dramatic improvement on the situation that existed in the not too distant past. I salute the intelligence-led work at Leyhill that has got that situation under control.

My key theme is that I am concerned that the good work and progress on both rehabilitation and cutting the number of absconders is about to be undermined and jeopardised if open prisons are used as a kind of overflow car park or dumping ground for prisoners for whom we cannot find anywhere else. The public’s attention was drawn to the matter recently, after my recent visit to Leyhill, by a memo from the governor of Her Majesty’s Prison Ford, who said that by the autumn of last year open prisons were operating close to 95 per cent. capacity. She said that

“the instructions coming down…state that local prisons must review prisoners serving short sentences for non-sexual or violent offences who are relatively low risk and likely to be suitable for transfer to open conditions…we are likely to get more very short termers, some who should really be in Cat C conditions… this will mean almost inevitably that the abscond rate will go up in Cat D prisons. Ministers have apparently been briefed to this effect and are taking this risk.”

There is no point in being hysterical; that is all pretty much a statement of fact.

I appreciate the spirit in which the hon. Gentleman is putting his case. It is not the Government’s policy to comment on leaks, but I can say that the leak to which he refers was completely wrong.

I look forward to hearing the Minister clarify the way in which it was wrong. Perhaps the Home Secretary was also wrong; he appears to have reinforced the impression given in the leak when he spoke in the House of

“providing maximum flexibility within the prison estate to allow transfers to the open estate under severe restrictions in addition to those transferred as a matter of course.”—[Official Report, 9 October 2006; Vol. 450, c. 33.]

In other words, we have a system of transfers to open prisons, for which people are risk-assessed. The Home Secretary used the words “in addition”; in addition to what? He means that in addition to the people who would ordinarily be assessed as suitable for open conditions, more people are being placed in them because of the pressure elsewhere in the system, albeit, as he said, “under severe restrictions”. It seems uncontentious to say that that is what is happening. I have also learned that there is something called an overcrowding draft. I do not know whether that is a colloquialism, but it is understood within the Prison Service. It means that when a closed prison simply cannot cope on a particular day or night, it contacts Leyhill or another open prison, often at short notice, to say, “Can you take five lads? We can’t fit them in our prison tonight.” I find that worrying.

I tabled a named day question on the matter, but the Minister was regrettably unable to answer it in time for this debate. I hope that he has brought the requested information with him. The question asked how much of this is going on. In other words, how often are overcrowding drafts issued? Where are prisoners sent from and to, and how long do they stay there? Who are they and how many of them are? There are several questions and I do not expect the Minister to answer them all, but I have no sense of the scale of the overcrowding drafts. I have not asked the governor of Leyhill these questions, but is that prison regularly getting people because of overcrowding elsewhere? Is it exceptional? When it does get them, how long do they stay? Are they there for the rest of their sentence, or are they sent back? We need that information.

Is the hon. Gentleman aware of the term “churning”? It means prisoners being moved from prison to prison without ever getting on to a training or rehabilitation course. They are “churned” because there is insufficient room in the prison estate as a direct consequence of the Government’s failure to plan.

I am indeed familiar with that term. The hon. and learned Gentleman touches on a point that I shall come to later: the impact on inmates of churning—the shunting of prisoners around the system.

I understand that prisoner numbers at Leyhill have risen by almost 100 in six weeks. That is a dramatic increase on an initial population of a little more than 300. The latest official figures on the Home Office website are for August, so I do not know whether the number that I have given is up to date or whether it has risen more rapidly. An extra 100 is a substantial number of people to accommodate, and there are three principal problems with that.

First, if prison officers and staff have to devote their time to taking in dozens of extra inmates, often at short notice and in high volumes, they cannot do the day job properly. They cannot spend the time and effort required on the rehabilitation work that they need to be doing. Prison officers’ time and managerial energy is being devoted to containing short-term inmates and overflow prisoners rather than to the long-term rehabilitation work that open prisons are uniquely well placed to perform. It is preventing them from doing what they are there for, which is very damaging.

Secondly, the problem is terribly bad for the morale of officers. They go into those situations, often working with difficult offenders who have committed serious offences, because they believe in the possibility of rehabilitation, yet they cannot do it to the quality that they would want because of the short-term pressures.

As the hon. and learned Member for Harborough (Mr. Garnier) pointed out, the practice is no good for the short-term prisoners who are being shunted from one part of the system to another. For example, how can an inmate with basic literacy problems be taught to read better if they are not in any one place long enough to do a course? How can offending behaviour be tackled if they are being shunted around all the time? If open prisons are simply being treated as a series of successive high or low-security bed-and-breakfast establishments, rehabilitation goes out of the window and reoffending rates soar.

That is one of the nubs of the argument. The concern is not simply about the welfare of the inmates, but about the welfare of members of the wider population, who we do not want to become the next victims of crime. If we fail to rehabilitate inmates in closed or open conditions, we will have more reoffending, more victims of crime and more calls for locking more people up, and we will end up in a downward spiral.

I mentioned my debate from a couple of years ago on a specific case, and it is striking that we have been in this situation before. I have with me the annual report of the chief inspector of prisons for 2002-03. Based on a review of all the inspections of open prisons in that year, he—I think it was he at the time, but I might be wrong—said:

“Open prisons play an important role…but they too are now receiving different kinds of prisoners for shorter periods. Population pressure has meant that open prisons are receiving prisoners who would not formerly have been sent to open conditions at that point in sentence. Some arrive without…sentence plans, let alone work to address offending behaviour. Some also arrive barely detoxified.”

One starts to see why the prison staff at prisons such as Leyhill have a heck of a job on their hands doing anything meaningful with the people coming in. I should be grateful if the Minister would clarify how long such prisoners stay for. When they arrive because of overcrowding, do they simply get a bed for the night before they are off, or are they there for the duration? Is anything meaningful or long term done with them, or they just shunted round the system?

To give another example, which I think is true of Leyhill too, the report says:

“At North Sea Camp, some prisoners were arriving with only a week of their sentence to serve.”

They have to go somewhere, but we simply cannot expect anything worth while to happen if they are moved at that point. If such prisoners are in for a fairly short period, what is going to come of moving them?

I have great praise for what has been achieved. Just eight absconders in the whole year so far is a fantastic improvement on more than 100. To wrap up, however, what should we be doing? My constituents need to know that the security threshold is not being lowered by the sending of prisoners to open conditions. We need to know that, regardless of the pressures elsewhere in the system, we are not becoming an easy touch. Open conditions are just not suitable for lots of prisoners. Open prisons require a degree of trust, maturity and responsibility, but many prisoners will simply walk out—I fear that the figures will start to bear out my prediction on that. So, there should be no lowering of the security threshold.

What else do we need to do? As ever, we need to tackle the causes of offending behaviour. I am the Liberal Democrat health spokesman and I see what is happening in mental health. Mental health problems, including psychosis, are extraordinarily prevalent in the prison population, yet we are seeing a squeeze on mental health services. We must consider spending money up front on preventing crime, not simply on tackling the consequences.

There are people in prison now whom we could get released to free up spaces, namely foreign nationals, many of whom have completed their sentence but cannot be got rid of because the Home Office does not have the paperwork sorted. I am currently chasing two constituency cases of prisoners who have been saying daily, “Deport me! Deport me!” I believe that one of the gentlemen concerned was finally deported this week, after the end of his sentence. He wanted to get out and be deported months ago, yet he took up a space in the prison system, which meant more pressure to send people to open conditions. If the Home Office could sort its paperwork out, I suspect that hundreds of prisoners who are in closed conditions could be sent home.

The final thing is that, in my judgment, we are locking up too many of certain types of offenders, particularly non-violent first offenders. It is not just soft liberals who say that sort of thing. The right hon. Member for Sheffield, Brightside (Mr. Blunkett), the previous Home Secretary but several, said in March 2002:

“If anyone…seriously believes that a further exponential rise in the prison population for short-term prisoners and first-time offenders is the way to ensure our safety then they are sorely deluded.”

How right he was, at least on that occasion. Ultimately, we must tackle the source of the problem, such as the mental health and behavioural problems that are an important part of—although clearly not all of—offending behaviour. We must also look at sentencing and punishment. Serious community sentencing that means what it is called and actually achieves something for the community must be a better bet in many cases and will mean less pressure on open prisons, which have an important job to do and need to be allowed to get on with it.

I hope that the Minister can give some information to my constituents about who is being sent to open prisons such as Leyhill, how many are being sent, how often they are sent and what the pressures are, and give me some guarantees that the security threshold will not be relaxed one jot. Without those assurances, my constituents will be rightly concerned. The last thing that I want to say in six to 12 months’ time is “I told you so”.

rose—

Order. Does the hon. and learned Gentleman have the permission of the hon. Member for Northavon (Steve Webb)?

I gave consent to the hon. and learned Gentleman to intervene during my speech, which he asked me for, but I did not give consent for a speech in the debate.

I congratulate the hon. Member for Northavon (Steve Webb) on securing this debate and on the work that he does with the prison at Leyhill and the other establishments in his constituency, which I read up on during his last Adjournment debate on the matter. If the hon. and learned Member for Harborough (Mr. Garnier) wants to intervene on me, I am sure that he will do so at an appropriate time.

The hon. Member for Northavon has given me the opportunity to set the record straight on some of the issues that affect the prison estate. Although this debate is about open prisons, there are concerns about what is going on within the Prison Service and about issues that affect the whole estate. He was right to start by acknowledging the excellent work that is done in the 16 open prisons in England and Wales, but particularly at Leyhill in his constituency. He paid tribute to the staff and the offenders for what they have done there. I should like to pay tribute to the 15 prisoners a day at Leyhill working for Mead Construction, which is giving them qualifications, so that they can come out into the wider community at the end of their sentences.

That is the nub of the question, in relation to the open estate. How do we use it? The hon. Member for Northavon was generous enough to say that the process is right. There are two parts to a sentence: there is the penal, custodial part of the sentence—the punishment part—and then there is the rehabilitation part, which is what the open estate should be used for. Hon. Members would not want us to release people without any attempt to rehabilitate them, because they would reoffend. I was happy that the hon. Gentleman mentioned reoffending. I am sure that we will return to the issue in discussing how the Government want to try to upgrade the contribution of all involved towards reducing reoffending. I look forward to that debate at a later date.

The hon. Member for Northavon asked me a number of questions about Leyhill. I shall try to respond to those and then return to prison capacity, the reassurances that he requires on public protection and what we want to do to build public confidence. The hon. and learned Member for Harborough raised what he perceived to be incompetence on the part of the Government, to which I will respond in due course.

I am grateful to the Minister for allowing me to intervene. Before he comes to the detail of Leyhill, which is a constituency issue, albeit one that reads across into the wider issue of what we are doing with our prisons, could he please deal with the HMP Ford memo? Can he fit that into his Department’s wider policy—if there is such a thing—on open prisons? There is a suspicion, which is not simply based on ideas plucked out of the sky but increasingly on solid fact, that the Government are using the open prisons, as the hon. Member for Northavon said, as a dumping ground to deal with the overcrowded secure prison estate. The public need a huge amount of reassurance—

Order. Interventions should be brief.

This is a reasonably brief one, but I think that the Minister has got the point.

I am grateful for the hon. and learned Gentleman’s intervention, and I shall try to answer the point as we move along.

Let us meet the issue head-on. There is the idea that there was no planning for the eventualities. Let us look at where we were. There was pressure on the prison population when the Government took over in 1997; there has always been such pressure. Since 1997, there has been an increase in prison place capacity of 19,000 and the new ministerial team has been considering the issue since it took over in May. A further 8,000 places were identified, and there are another 2,000 to meet some of the pressures.

In his announcements about our short-term contingency plans, the Home Secretary clearly said that we would use Operation Safeguard if necessary. We acknowledged the fact that the prison population was the highest it had ever been. I agree with the hon. Member for Northavon that we need to consider the issues of the prison population, community sentencing and the other alternatives that need to be in place. We ought to have that debate outside the frenzy of how the media ratchet up the issue by looking at it as purely political—or, dare I say it, party political—and trying to expose perceived weaknesses.

If we had not maximised the use of the open estate, we would have been blamed for not trying to resolve capacity issues. The key point about the transfer from closed to open conditions is the risk assessment, which has to be carried out to a set standard by the governor. I reassure the public and hon. Members across the House that there has been no change to that risk assessment or to how people are assessed for risk. The Home Secretary and I have impressed on the Prison Service that public protection and confidence in what we are trying to achieve are fundamental to maximising the use of the estate. There have been no changes of categorisation.

rose—

I fear that we are running out of time. I do not want to miss the opportunity to answer the point raised by the hon. Member for Northavon about Leyhill.

In recent months, Leyhill has operated considerably below its full capacity, but it is now moving nearer to full capacity. Clearly, prisons are resourced to operate at full capacity. The general operating capacity of the open estate is 95 per cent. at the moment. Only prisoners who have passed the rigorous and robust risk assessment can be allocated to open prisons. As I said, there is pressure for the Prison Service to maximise the use of the estate, but the appropriate allocation to open conditions continues to be paramount. The public can be reassured that we are not moving people into open conditions outside the normal risk procedures.

The hon. Member for Northavon mentioned prison education and how maximising the estate affects our ability to develop people so that they do not reoffend. I am conscious of that; it is important that we ensure that the relevant projects are in place. Leyhill is making maximum effort to ensure that people are given the opportunity to be rehabilitated back into society. However, there are pressures when the prison population rises and we shall look at those issues and the outcomes. It would have been wrong of us not to try to maximise the estate, given the pressures that we are under. However, for us the public are paramount; we shall protect them as we said we would.

The hon. Member for Northavon raised the issue of absconders. He made a good point. He praised Leyhill’s record on absconding during the past five years, and rightly said that there had been dramatic reductions in the number of absconders. He asked me for the figure for this year; I think that currently it is 25, but I shall confirm that. Leyhill is clearly showing the signs of improvement that he asked to see; as the hon. Gentleman rightly said, the rate of absconding has come down over the years.

We are trying to establish alternatives to open prison. The hon. Gentleman will be aware of home detention curfews and how we are trying to find ways of rehabilitating people. The Public Accounts Committee recently published a report into the effectiveness of that scheme. Clearly, there are issues to be addressed, such as making sure that prison governors know all the outcomes in respect of people going on home detention. Clearly, information about the availability and eligibility of people going on to home detention curfews needs to be shared between prisons. It is important that we look at the prison population and try to find alternatives in which the public have confidence.

May I get the Minister to focus in the few remaining minutes on the issue of overcrowding drafts? How often are people being sent to places such as Leyhill because other places are overcrowded, and what happens when they get there? Do they get sent somewhere else or are they there for the duration?

As I said, there is still capacity in the estate. For example, some prisoners in the south-east are moved to the north, where there is more space. Such movements are known as “out of area transfers”, not “overcrowding drafts”. Once prisoners are moved to an open prison, they stay there and do not keep churning around. We have a one-move policy, to maximise the position relating to the capacity problems.

How often?

As I said, the figure for Leyhill absconds from 1 April to 16 October is 25.

The whole issue of sentencing and capacity is key to what the Government want to achieve. The Home Secretary has said that Operation Safeguard is not ideal, but it puts something in place that stops us having to let out of prison people who are not to be given the opportunity to get back into society. The home detention curfew scheme is an ideal alternative, but as more people become eligible for it there will be no need to put them into open conditions because an alternative will have been found. That makes the population in relation to open conditions different. The key factor is that the risk assessment has not changed.

The hon. Member for Northavon (Steve Webb) asked the Minister a direct question, which the Minister said that he would get back to. It was about the memo. Does the memo not exist? Did it exist, but the governor of HMP Ford not understand it? Will the Minister give us a proper understanding of the position? The issue touches directly on the points raised by the hon. Gentleman, and he asked the question directly.

I thought that I had answered the point by saying that the memo was wrong. Normally the Government do not talk about leaks, for understandable reasons that I am sure hon. Members would accept. I said that the memo was wrong because it was a wrong interpretation of what the Government had said. I am trying to reassure the hon. Member for Northavon that the position on risk assessments has not changed.

Yes, the Government have asked for the capacity of the estate to be maximised, but against that risk assessment so that people who should not be there are not put there. I cannot be clearer on our position on public protection. We want to protect the public and to maximise the estate, given the high numbers in prison at the moment. We then want to look at the prison population to evaluate what can be done to ensure that the most dangerous and prolific offenders, who should be in prison, are there. We then want to consider the rest of the prison population.

One of the statistics that I find amazing is that of the 79,000 people in prison, fewer than 5,000 are women. We could argue that that is too high, given some of the mental health issues raised by the hon. Member for Northavon. What does that say about the prison population? How do we deal with people—usually young men—who themselves may have been victims, and reintegrate them into society?

Many issues affect the prison population and are faced by the staff. I put on the record, as did the hon. Gentleman, my congratulations on what the staff have done to ensure that the public are protected, that people are rehabilitated and that individual prisoners are supported in various ways.

We in this country need to have a serious discussion about why our prison population is so high, and why per head of population we imprison more people than any other country in Europe. We need to have that debate soon, not just because of prison capacity issues but because of how society is going. We must try to address some of the problems.

We must be careful about people becoming risk averse. I say that cautiously because, as I said, we have not changed any of the criteria. I want to be in a position where judges—

Order. We must move on to the next debate.

If any constituency in the UK needs further education, it is Nottingham, North. It takes in eight outer-city former council estates in the north of the city. Sadly, as the Minister knows from his interest in taking on the problems and tackling them, it is the least educationally attaining constituency in the UK. We send the fewest youngsters to university of any constituency, youngsters cannot stay on beyond 16 at any of the seven local secondary schools, and all the Nottingham, North wards are in the bottom 5 per cent. for educational attainment. Of those who go on to secondary school, 11 per cent. cannot read the first lesson at their school.

However, all the above are symptoms and not the cause of our perpetual educational underachievement. The cause is the anti-education culture of all too many parents on the estates. It is that which needs to be tackled, above all by developing effective parenting skills in the parents of children aged nought to five. Every Ofsted report on local primaries shows that children do not arrive at primary school school-ready; hence they do not have a fighting chance to develop the social and emotional intelligence that they need to learn and to attain. Putting those building blocks in place at nought to five is not a scheme or a nice-to-have—it is a prerequisite for sustainable improvement in attainment in a place like Nottingham, where 58 per cent. of children are born out of wedlock, and which has one of the highest teenage pregnancy rates in the UK. Both of those factors contribute to poor inter-generational parenting skills.

I would ask the Minister to ensure that the Department for Education and Skills is at least as demanding in measuring local performance in improving parenting skills as it is in targeting five A to Cs in areas such as mine. One size does not fit all. Middle-England targeting does not fit the UK’s most under-attaining constituencies. DFES and local education policies must be much more sensitive to local situations and solutions. For example, we have not been helped by dilution of the local focus on education—on its own the toughest job in Nottingham—by piling children’s services, youth offending, social exclusion, teenage pregnancy and half a dozen other subjects on to one local education department. One difficult child abuse case could divert the single-minded drive on parenting and school readiness that we so desperately need to focus on in Nottingham. Those and other structural problems need to be confronted, but it is important that decisions are not made that make things worse, and that is where the Basford Hall college further education campus comes in.

We began to hear rumours that New College, Nottingham was planning to close its Basford Hall campus, the last further education base in Nottingham, North, and sell it for housing. In educational terms, that beggars belief, as the site is sandwiched between the Aspley ward, where two out of three people have no qualifications whatever, and the Basford ward, which has the highest number of people not in employment, education or training of all 20 wards in the city of Nottingham. Those two wards are flanked by the outer-city estates of Broxtowe, Bulwell, Bilborough and Bestwood, whose educational records are just as chronic. They are shockingly illustrated by this map, which shows the distribution of people who have qualifications below level 2. The darker the blue, the fewer the qualifications. We can see the appalling concentration of darkest blue on the map, and right in the middle of those areas—perfectly located—is Basford Hall college. Which educationist in their right mind would close a college that is located in exactly the right spot for a base to fight back against the local problems, which is what we are doing?

A local campaign led by tenants’ and residents’ associations, churches, councillors, communities and many others sprang up almost immediately. It has been absolutely magnificent. I hope that New College, Nottingham, having finally listened to our representations, will agree not only to keep Basford Hall open but to use it as a base to reach out seriously to the local communities whose youngsters need it so much. In fact, its board is meeting in Nottingham at this very moment. We do not want Basford Hall campus pickled in aspic. We want it to be used for something that has not been done effectively for many years: reaching out to local communities and drawing in the people who so badly need its services.

It is not always clear what has been agreed with New College, Nottingham, but, having met with the principal and the chair of governors of the college on Saturday, I hope that it will now publicly commit to the Basford Hall campus tackling not just educational underachievement but much more, and that it will become, as further education everywhere should, a motor for wider regeneration of the area and for the personal development of the young people and adult learners of Nottingham, North and elsewhere. Our objective as a campaigning group, if I am allowed the privilege of speaking on behalf of the Basford Hall action group—

I want, too, to thank the Minister’s officials for the way in which they have ensured that this has been a constructive debate.

The objectives of the campaign are clear. First, to remain on the existing site and rebuild the construction block there. Secondly, to acquire the now defunct Red Lion pub on the site and to use it, either as a base or to create better road access. Thirdly, to create a community learning base—a brain factory—that might well accommodate our community learning champions. They are people who, having learned skills in further education, return to the estates from which they came to encourage other people into further education. They have been there and done it, and can say, “It doesn’t hurt. It actually helps you; give it a try.” Fourthly, to agree a land swap with the city council to create a further education shop front on that prime roadside site on the main route from the M1 to Nottingham city centre. Thousands of vehicles pass by every day. Those points make it more evident what is going on on the site.

The community is bursting with bright ideas, including negotiating changes in bus routes to help the youngsters to get off the estates and access the site. Our action group has agreed to a brainstorming session with New College, Nottingham in the near future if it agrees to keep the Basford Hall campus open. We would also welcome other FE providers, both from the private sector and from other FE colleges, to work together for the good of the community and of Nottingham on that site.

I can see the question going through the Minister’s head of why the matter could not have been worked out locally rather needing to be brought before him and Parliament by an MP. That is one question that I shall have to leave him to think further about. I cannot answer it at the moment.

Thankfully the debate is being answered by a Minister who is not only committed to the mission of further education but has taken the time to visit Nottingham, North. We appreciate that. The Minister has seen our problems and has been supportive of our activity. We do not have the fatalistic view that we are bottom of the league and there is nothing we can do about it. We have worked hard in a number of areas so that we can get two academies and “Building Schools for the Future” money, and so that Ministers, including the Minister who is present today, will come along to see what we can do. The Secretary of State came just a few months ago. We are buzzing with ideas and creativity and we need to get on and do that sort of stuff.

I hope that the Minister will dispose of the following questions and of one or two of the red herrings that have been thrown up. We all need New College, Nottingham to put together a clear proposal in an accommodation strategy, after consulting local people and others, and to get that proposal in front of the local learning and skills council without further delay.

The first point that the Minister can help us with is the 14-19 strategy, which must continue to be honed to improve vocational education. I understand that if the local learning and skills council makes it clear that it supports a project—in this case, the educational redevelopment of Basford Hall—the national Learning and Skills Council’s capital committee is not bound by rigid formulas but can act flexibly. Can the Minister confirm that that means meeting on average 35 per cent. of the costs and that new guidance is being considered by the Department for Education and Skills that could take that up to 100 per cent. were that considered to be appropriate?

The second point is about using the small but significant amount of DFES capital funds that is available via the LSC to build community learning centres in areas of great need. Will the Minister tell me the name of that fund, say something about its scope and confirm that it can be accessed by further education colleges such as Castle college and New College, Nottingham, not least to help build a community learning centre that is welcoming to those who live on the local estates? It should help to outreach from the base to the estates to draw people in.

The third point is increased participation at 16-plus. The increased flexibility programme gives 14 to 16-year-olds the chance to sample vocational education. It motivates them when they are at the greatest risk of being turned off by education. I present the certificates annually for that programme at the Basford hall campus, and it is great to see the delight of the winners and their parents when they receive their prizes for education—often their first. I know that changes are planned, and the strong feeling on the ground is that it must be done with great care. Will the Minister explain the changes to that programme and confirm that it will not simply result in dispersing the IFS money to the schools from next year?

The fourth point concerns training for adults. We need to continue the drive to ensure that training is better linked to the job market, and I welcome the Government’s emphasis on that, but we must not forget that some of the routes into vocational training for adults are via softer courses. If I can continue to present to adults from the Hope centre on the Broxtowe estate their first ever certificates of achievement, then I don't give a damn if it is for nail-painting, door keeping or basket weaving. It is the vital breakthrough for people who have never before attained anything, and it could be the first step to their receiving training in other more productive and vocationally based areas. It is getting them that taster—that education does not hurt and that it can be enjoyable and interesting—that may help them to progress and get a better job.

We all agree with the new priorities—focusing on the skills that employers need, and seeking fee income from those who can afford to pay. However, in areas like Nottingham, North, which is not middle England, we have to get adults back on the learning track—and I do not care whether it is by hook or by crook. Can the Minister confirm that funding will continue to be available to support adults back into learning and so help them progress into employment and other learning opportunities?

I now throw in something that I did not have the chance to warn the Minister about. He will know that I am the chair of the local strategic partnership, One Nottingham, and our proposal for a city strategy on welfare to work has been approved by the Government. Perhaps the Minister would be kind enough to write to me. I do not expect a reply today, but I am concerned that the assistance for adult skilling includes employability skills for those cities with city strategy pathfinders. I would be most appreciative if the Minister or his officials could write to me.

The fifth and final point is strengthening the learning and skills council. The LSC has been supportive of efforts to tackle Nottingham, North’s further education problems, and has itself undertaken a study into the constituency. There is a need for a clearer focus on the foundation curriculum for young people, and the LSC area director tells me that he will make it a particular focus of his planning for next year. Local providers would all be grateful for more clarity on where they might each fit into that local strategy. Will the Minister consider strengthening the planning powers and control of the LSC over education providers, and give it formal responsibility for ensuring that the adult learning and the 14-to-19 strategies are delivered?

Nottingham has a pilot scheme for linking up funding for 14 to 19-year-olds. It is between the LSC and the LEA. It should be a mainstream approach. Only in that way will it be rolled out effectively. There should be a mainstream joint budget between the LSC and the LEA to pay for curriculum development, courses, transport between sites and capital development. Currently, the budgets are not focused enough and are in separate pots. The funding pilot is helping, but it needs to be extended and made a permanent feature, even if it means considering top-slicing current allocations. My final question to the Minister is whether he will consider strengthening the role of the LSC and mainstreaming the LSC-LEA 14 to 19-year-old pilot.

Some of the ideas emerging from the Basford Hall action group and New College, Nottingham are exciting; they include a learning park, a base for learning champions, employability skills, and a centre of excellence for voluntary and third sector providers working with the college. We must enable such social entrepreneurship to thrive by ensuring flexibility and responsiveness in our funding systems. Central and local educational bureaucracies need to develop imaginative and hand-made solutions to tackle the deep-seated problems that are holding back areas such as mine and preventing them from benefiting from the prosperity that higher qualifications can bring—qualifications which are taken for granted in so many parts of the country.

If the DFES, the local education department, the LSC, New College, Nottingham and the local community can work together, not only will we make Basford Hall campus a great success, but we will make a serious contribution to developing talented and achieving youngsters. They will be the parents of tomorrow’s generation and, in turn, they will be the ambassadors within the family, passing on the value of education and learning to their children. That, and only that, will destroy once and for all the inter-generational, anti-education culture that disfigures the life chances of so many of my constituents.

I congratulate the my hon. Friend the Member for Nottingham, North (Mr. Allen). I know from personal experience that he takes such issues exceedingly seriously—he has rightly lobbied me heavily—and when I visited his constituency, I saw the real need there.

My hon. Friend has raised a series of points to which I shall try to respond in the short time available to me. He spoke about children’s services and early years. In “Reaching out: an action plan on social exclusion”, we recently announced that we were setting up 10 demonstration projects in 10 local authority primary care trust areas. We have no preconceived preferences for where those projects should be located, and partners in Nottingham, North may wish to consider making a bid once they have seen the criteria.

I agree with my hon. Friend about the importance of parenting skills. In Nottingham and throughout the country, we need a strong further education sector. Everyone who wants it should have the chance to benefit from further education, regardless of their background or circumstances. Access to good FE helps create opportunities for students in areas of under-attainment particularly—as in my hon. Friend’s constituency—if there is no tradition of continuation in education and training beyond the age of 16. That is especially important in areas such as Nottingham, North, which includes the most deprived ward in Nottinghamshire. Indeed, we are doing some work in my hon. Friend’s constituency, which has one of the three lowest participation rates in higher education.

My hon. Friend mentioned his specific concerns about the long-term future of the FE campus on the Basford campus.

We are expecting a Division in the House at half-past 5, and I ask that we return afterwards. I apologise for delaying everyone, but it is an important issue and I am sure that those extra nine minutes will be well spent.

I am happy to do that.

My hon. Friend is aware that New College, Nottingham is considering how it will deliver FE provision in the future, and it has been considering the provision of accommodation on all its sites. It is important that FE colleges regularly assess their plans and consider the available options. However, they must ensure that opportunities for high-quality learning are maintained and that the needs of all students, but particularly those in areas of under-attainment, can continue to be addressed. For example, we know that ease of access and transport will be key issues for many students, and colleges will need to consider them carefully before any decision about the future location of provision is made.

Many young people and adults recognise the potential benefits of studying at the local college. For some it is a second chance, an opportunity previously thought lost, to get back into education and training and to improve their life chances. Whatever their reasons, it is vital socially and economically that all who can benefit from further education have the chance to do so.

Let me say a word about consultation with partners. Given the requirements that I have set out, we would expect any college considering the future of its sites to consult and work with students, local employers, community groups and other local partners when making decisions. The role of MPs in that process is paramount.

Any decision on the future location of college sites also has to meet the needs of learners in the local area and take into account the requirements of those with the potential to become disengaged from education or training. In that regard, only in very exceptional circumstances would we expect to see the removal of a significant FE site from an area of educational under-attainment and low achievement, particularly given the links and reputation that will have been established between the FE provider and local community over many years.

I understand that New College, Nottingham is participating in numerous discussions at a local level and it may be helpful for all parties if a clear timetable is now set out to clarify when and how decisions about the future of the campus will be made.

The learning and skills council has a key responsibility for planning and funding and it is critical to ensure that appropriate high-quality provision continues to be available in areas such as Nottingham, North. In that particular case, the LSC is fully aware of the issues that the area faces and has a strategy focused on helping to deal with them. I am assured that the LSC is open to considering any proposals from New College, Nottingham that set out its plans for future delivery arrangements and that it will want to ensure that meeting the needs of learners is at the heart of any proposed changes.

My hon. Friend has raised a number of specific questions that I will try to respond to. First, on capital funding, he asked about the funding to support the development of vocational education. He is correct that, on average, projects receive 35 per cent. grant support contribution from the LSC. The LSC will be prepared to pay up to 100 per cent. to ensure that we have the right provision, mix and delivery of programmes if the circumstances dictate it. Next month the capital prospectus will be published, which will give more detail, and that will generally be welcomed in the FE sector.

Secondly, my hon. Friend asked about funding for building new learning centres. The LSC administers the neighbourhood learning and deprived communities capital fund, which is available to help local voluntary and community sector organisations to deliver learning opportunities for people living in disadvantaged neighbourhoods. The priority recipients of this fund are voluntary and community sector organisations engaged in direct delivery of learning or working in partnership with a range of providers that are offering learning.

However, I assure my hon. Friend that the fund is not designed exclusively for them. FE colleges are also eligible to apply for funding, but if such provision is required in an area and a suitable plan is presented by a college, that would be supported out of mainstream FE funding.

Thirdly, my hon. Friend asked about the increased flexibility programme. I am pleased that he has seen the benefits of that at first hand. Let me reassure him that funds for that programme are not being cut or phased out; rather, funding will not be ring-fenced in future. However, we have made it clear that we do not expect to see any reduction in the overall volume of provision next year. The LSC will still be able to allocate funding to 14-16 college provision; indeed, that funding can be enhanced if it is aligned with local authorities’ own vocational provision. That could lead to an increase.

The fourth issue is the first steps provision: the stepping-stone provision up to level 2. My hon. Friend raised key concerns. Certainly, we are maintaining our commitment to learning for personal and community development and we have safeguarded through the LSC budget £210 million in both this financial year and the coming financial year for that type of learning.

We are also conscious that while our approach is rightly targeted at level 2, which is the minimum educational attainment level necessary to maintain someone in a sustainable manner with employment, we nevertheless need to ensure that we have proper stepping-stone provision up to level 2. That is why we are creating the foundation learning tier, to identify what genuinely leads to progression and what does not in terms of course provision. Over time, as resources allow, we have made it clear that we look to make that foundation learning tier an entitlement.

Fifthly, my hon. Friend talked about the strengthening of the role of the LSC and mainstreaming an LSC and local education authority 14-19 pilot. He asked about strengthening the LSC. In the recent White Paper we set out our intention for the LSC to become a strategic commissioner, strengthening both its ability to plan at a regional level and its ability to work on the ground at a local level. That is part of the way forward.

My hon. Friend also asked about mainstreaming a pilot being run in the area for 14-19 year olds. The pilot in Nottingham is one of a number that encourage 14-19 partnerships to develop effective area organisation and funding models led by the LSC and local authorities. It includes pragmatic local arrangements for pooling and aligning funds from a range of sources into a virtual budget to support 14-19 delivery and development. We will want to draw on best practice from those pilots in rolling out the specialised diplomas from 2008.

My hon. Friend also talks about the role of One Nottingham, which I know he chairs, and its engagement with the city strategy on welfare to work. The Department for Work and Pensions is working on that programme. He raised an important question and I will respond to him.

We appreciate the need for the long-term planning and funding of 14-19 reforms and the delivery of specialised diploma entitlements, in particular to be underpinned by mainstream funding in line with the principles for 14-19 funding announced in the White Paper.

My hon. Friend rightly raised genuine concerns that exist on the ground in his constituency. I know from all that I have seen and having visited his constituency that it is an area of genuine deprivation where we need to work across agencies and Departments to help to raise aspirations, attainment and engagement with the education service. I fully understand the views and concerns that my hon. Friend expressed this afternoon. I hope that an effective solution can be found for the problems of Nottingham, North that meets the needs of its students, partners and the local community quickly. I reiterate that I fully understand his concerns and I trust that those will be addressed by the college and the LSC. I again thank him for the real interest that he takes in these issues and the assiduous way in which he put forward the concerns of his constituents.

Question put and agreed to.

Adjourned accordingly at twenty-three minutes to Six o’clock.