I speak as the chairman of the all-party group on Panjabis in Britain, which was founded more than a decade ago by my right hon. Friend the Member for Warley (Mr. Spellar) and several colleagues. Initially, it focused on human rights issues during that dangerous, unstable and uncertain period in the Punjab’s history. The group was reconstituted after 1997 with a much wider remit.

We describe the group as the Punjab community group, as it is a forum for discussion of the issues that confront the Punjabi community in Britain and concerns about their daily lives, but it also has a remit to examine issues in the Punjab itself that are of concern to the Punjabi community in Britain. In recent years, we have held a series of conferences and community consultations, and undertaken surveys of the Punjabi community in Britain that have set the agenda and the work programme for the all-party group.

Various sub-groups and initiatives have been introduced, including ones on health, human rights, the environment, culture and development. All the work is undertaken by a dedicated group of volunteers, and today I wish to recognise their contribution to the group’s work and to discussions that have taken place in the House over the years. In particular, I would like to recognise the contribution of Mr. Iqbal Singh, the group’s researcher; the co-ordinators of our environmental sub-group, Pardeep Rai and Dr. Pritam Singh, an academic adviser from Oxford university; and the co-ordinator of the health sub-group, Amritpal Sekhon. Harinder Singh Mann is the co-ordinator for the development sub-group, a new initiative that we launched only earlier this year. I would like to place on the record our thanks, on a cross-party basis, for the work that they undertake in supporting the parliamentary group.

There are dozens of other volunteers and numerous supporters of the group’s work. They have all participated in our enthusiastic discussions, debates and campaigns on a range of issues. Our work has been helpfully broadcast to the wider community by Desi radio, Punjab radio, Des Perdes and The Sikh Times. I thank them for their coverage of the group’s work and the support that they have given to our campaigns.

It is worth reminding Members of the origins of the Punjabi community in Britain. As Members will know, Punjab, the land of the five rivers, predates the partition of India and Pakistan in 1947, which split the Punjab between two countries. It comprises a population of Sikhs, Hindus, Muslims, Christians and those of no faith. The Punjabi community has included adventurous travellers who migrated to all parts of the world, and the worldwide diaspora is significant in many countries across Europe, America and Canada. Clearly, there is an historical colonial link between Britain and the Punjab, which has resulted in a large settled diaspora in Britain. Large numbers settled here in the 1950s, in particular. We now estimate the Punjabi community at about 700,000, with Punjabi established as the second language certainly in London and possibly within the United Kingdom.

Therefore, Parliament has a responsibility to consider the interests of this group of British citizens, as any others, on a regular basis, and to examine the policies that are needed to protect the interests of this sizeable population of British citizens and to enhance their quality of life.

I know the Punjabi community well, having grown up in Yorkshire and then moved to London. I have lived much of my life around that community. I congratulate the hon. Gentleman on securing this debate. He knows of the great contribution that the Punjabi community makes to this country in many ways, and its undeniable value in adding to our diversity and economy. He also knows that the community is extremely diverse, not least in terms of religion, as he just mentioned, and that there is little understanding of the Punjabi community among British people generally.

Will the hon. Gentleman set out ways in which the community’s leaders can spread a better understanding of their community across this country and explain how this debate, the Government and the media might help in that endeavour?

Order. I remind the House that if hon. Members want to make interventions, they should make interventions, and that if they want to make a speech, I shall be delighted to call them later.

Thank you for your protection, Mr. Amess, but I thought the intervention was apposite. It prefigured some of the issues that I shall raise later. It is the role of the all-party group as well to assist in the promulgation of information about the Punjabi community in Britain and to enhance its reputation.

To enable Parliament to examine issues that are of interest to the Punjabi community and, indeed, the issues that the hon. Gentleman raised, members of the all-party group have regularly sought a general Adjournment debate on the Punjabi community in Britain. The last one was convened by my hon. Friend the Member for Wolverhampton, South-West (Rob Marris) in March 2005, and I convened the first one four years ago. We seek to use such debates to measure progress on issues that were raised in past debates but, in addition to that, to ensure that there is a general overview and discussion of the issues that are of concern to members of the Punjabi community and that confront them in their everyday lives. We use the debates to analyse issues and to advocate the policies that are needed to address concerns. Each debate has proved useful in assessing progress, and the Government have responded extremely effectively to the issues that have been raised in them.

On the hon. Gentleman’s point, it is important to recognise the success of the Punjabi community in Britain and to celebrate its contribution to British society. Many members of the Punjabi community lead in the fields of business and commerce; law, where there are numerous barristers, QCs and judges; and politics and government at every level, from councillors to MPs and right through to a Government Minister. They lead in the arts and culture. Let me give a small plug for the filming of “Bend It Like Beckham” in my constituency. I congratulate the director of that film, Gurinder Chadha, on one of the most successful British films in recent years. The Punjabi community gave the world bhangra, the desi beat and the talents of Nitin Sawhney and Talvin Singh.

In sport, come back Monty Panesar, all is forgiven. I congratulate him on the service that he has rendered to his country so far. May I also give a plug for my local Yeading football club and Nev Saroya, a footballer who is one of the most comfortable defenders I have ever seen on a ball? His talents have not been sufficiently recognised in the higher leagues, but he is an excellent player.

Earlier this year, at about the time of the Punjabi traditional celebration of the spring festival of Vaisakhi, the all-party group launched its first annual awards ceremony to honour those who had contributed to the promotion of Punjabi culture. It proved to be an overwhelming success, and I invite all Members to next year’s celebrations and awards ceremony, to be held at Millbank on Tuesday, 20 March, at 6 pm. The awards ceremony is also an exceptional celebration of the cuisine of the Punjab. Food was supplied by the Punjab restaurant and Mr. Sital Singh Mann. I express my thanks for his assistance in hosting the event, and I also thank the Hounslow and other gurdwaras that assisted us throughout the year and supported our conferences and various campaigns.

The members of the Punjabi community are concerned about the issues that concern us all: health, education, housing, crime, community safety and the environment. However, some concerns are of special interest to that community. Let me identify some that have been raised via the all-party group’s consultations. They have informed our work throughout the past 18 months.

The first is the issue of recognition. Hon. Members will know that we have consistently lobbied on behalf of the Sikh community in Britain to ensure that it has recognition in the census. That issue has not fully been resolved to everybody’s satisfaction. It was dealt with in the last debate on the subject and there was some response from the Government about the measures that would be taken to address those concerns in the 2011 census. I would welcome further discussions on the issue at ministerial level and possibly a meeting between the all-party group and the relevant Ministers and civil servants to see whether or not we can resolve the matter in time for the next census.

Does my hon. Friend accept that that is a particularly acute issue because the planning for the 2011 census is imminent? It would be welcome if the Government gave an assurance over the next few months that they will accommodate that change.

I would welcome it if the Minister either responded accordingly today or, failing that, wrote to or met the group as a matter of urgency on that matter.

Does the hon. Gentleman agree that we need to look at the way in which the census has been tailored, as this goes beyond the Punjabi or Sikh communities in Britain? It still mirrors a statistical view of immigrant communities that dates back to the 1960s, and no longer reflects the diversity in our society. Understandably, people feel rather upset when they look down the various boxes and find that they fit into a definition of “Other”, which they then have to write in. If the whole thing were redrawn in a slightly more sensible fashion, it would be easier to complete and the Government would get some much more interesting statistical material.

That is a valid point, and a much wider debate needs to be had as a matter of urgency. However, on the matter of the recognition of Sikhs in the forthcoming census, I would welcome an urgent meeting so that we can address that concern.

Further to the point about the census and the preparation for the next one, does my hon. Friend agree that the Minister and the Government should take careful note of what is being tested in Scotland, where a separate Sikh category has been included?

That is a valid point to put to the Government and I would welcome their response. The Scottish example also helps on the matter of Punjabi language speaking. In the next census, we would welcome accurate information about the scale of Punjabi as a language in this country. As I said earlier, we believe that it is the second language and should therefore be catered for.

May I draw attention to another aspect of that, which is the read-across from the census categories to questionnaires that are put out by other Government bodies and local authorities? For example, in my area, in Sandwell, despite the fact that one in eight members of the population are Sikhs and many other groups are much smaller—in some cases, almost non-existent—Sikhs are not a separate category. We have corrected that now, but I think that such a change would be a clear signal to the administration in local and national government that they should be monitoring properly, particularly in areas with a high concentration from the Punjabi and Sikh communities.

My hon. Friend has made that point previously in debates and in representations to Ministers. It is critical. The importance of the census and other forms of identifying information about local populations is that they enable us to monitor the equality and distribution of services, the appointment of people to positions of employment and decision making within the local area. I would welcome the Government’s response and the all-party group would welcome an urgent meeting to discuss how we should go forward and to address the 2011 census.

One of the most important things for any community is the maintenance of its culture. Within a multicultural society, members of the Punjabi community have sought to integrate in an harmonious way in which they have respected the country in which they now live and in which many of them were born. There is a concern to preserve and develop Punjabi culture over generations. Language is a particular concern, and support for the teaching of Punjabi in our schools and by voluntary organisations is a matter that has been identified in the consultations that have been undertaken by the all-party group.

There are questions about how many schools in Britain have provision for the teaching of Punjabi, which is such a prominent second language in our country. An increasing concern emerged during our consultations that Punjabi language teaching is ignored in many elements of the UK education system. There is a belief in many areas that schools are progressively dropping Punjabi from their curriculums. There is an anxiety that the lack of funding for the voluntary sector organisations and community groups that provide Punjabi language teaching is resulting in inadequate access for those who want to learn the language and those who want their children to learn it.

There is also concern about the potential lowering of standards in the teaching of Punjabi as organisations struggle for funds. The all-party group would like to recommend to the Government that they undertake a short, sharp study of Punjabi language provision in educational establishments, schools, colleges, the voluntary sector and civil society organisations at large to identify how provision is meeting the needs and demands of the community. Based on that information, the Government are urged to produce a Punjabi language strategy that supports teacher training, sets quality standards and provides resources to give sufficient access to Punjabi language training in schools, colleges and community organisations. In that way, many believe that it will enhance the preservation of the culture and encourage a development of Punjabi in the education system that will stand us in good stead for generations to come.

Maintaining the culture is also about the means of communication. Language is critical, but it is also important that there is access to means of mass communication, particularly in modern times, if the culture is to survive. We can report a tremendous success story; the development of the Punjabi broadcast media in recent years has been a tremendous success. Desi radio is one example. Located in Southall, it gained one of the first community radio licences as part of the Government’s policy of widening access to community radio for the population overall. The all-party group assisted Desi in its approaches to the previous radio authority and its successor, Ofcom, to explain the significance of Punjabi language community radio in promoting and preserving a culture while serving the whole community. Originally a pilot broadcaster, Desi radio has now received a five-year licence under the Government’s planned expansion of radio licences for local community stations.

I pay tribute to Desi in particular for the role that it has undertaken bringing together communities from east and west Punjab, promoting community cohesion in a multicultural society and for broadcasting information programmes on education, health and social and cultural activities. Desi has created a huge volunteer base that is now supporting other community radio stations. It is involved in excellent training with the assistance of European funds—training in radio broadcasting, of course, but also bringing people into work through developing their confidence and overall skills. The word Desi translates as “people”, or “countrymen and women”. Desi radio has proved itself to be a real people’s radio and is an example to community radio and broadcasting throughout the country.

Freedom of speech is critical to the maintenance of a culture. Punjabis, and particularly Sikhs, pride themselves on their tolerance and adherence to the principles of free speech. They are a freedom-loving people, as has been demonstrated historically. I wish to express my and many others’ deep concern at the attack on the Punjabi radio broadcaster, my constituent, Mr. Jasvir Singh Rayat, who has been known for many years to be a peaceful, gentle and respectable person as a broadcaster on Panjab radio. He is a devout Sikh and a volunteer teacher of the Punjabi language and Sikh religion as well as a broadcaster. Earlier this year he was attacked by a group of Sikh religious extremists and physically assaulted; they broke his leg and left him in fear of his life. The motive appears to have been a reaction to a broadcast or interview that he undertook on Panjab radio. That small group of extremists must not be allowed to use illegal methods, including violence, to intimidate and harass fellow Punjabis or to disrupt academic discussion or community events.

I express my concern at the slow pace at which the police are investigating that attack and bringing the perpetrators to justice. I therefore recommend that the Home Secretary asks for an urgent report on the progress of the investigation. It was a dreadful crime that sent shockwaves throughout the Punjabi community.

I refer to another outstanding injustice that occurred more than 20 years ago; the murder of Mr. Tassem Singh Purewal, who was then the editor of Des Perdes, the most famous Punjabi newspaper in this country. That notorious case remains unresolved, and the killer has never been brought to justice. I understand from press reports that a suspect, Mr. Manjit Singh Rattu, is being held in Canada by the Royal Canadian Mounted Police. However, there is continuing consternation within the community and among Mr. Purewal’s family at the lack of progress in the Metropolitan police investigation into that case and their liaison with the Canadian police. I have therefore written to the Metropolitan Police Commissioner to check progress on the investigation, in particular whether the police have interviewed the suspect. Again, I urge the Home Secretary to call for a report on the case in order to ascertain progress and to give some reassurance to the Punjabi community, and particularly to the late Mr. Purewal’s family.

I turn next to the arts, an essential part of the cultural health of the Punjabi community. I congratulate the wide range of groups and bodies that have worked hard in recent years to preserve and promote the Punjabi arts and the cultural heritage. The Maharajah Duleep Singh centenary trust has pioneered a successful Anglo-Sikh heritage trail. Many Punjabi members of the community have enjoyed it, but it is enjoyed also by the wider community.

As on previous occasions, I congratulate Susan Stronge, a senior curator at the Victoria and Albert museum, on her hard work, through exhibitions, talks and demonstrations, on promoting the cultural heritage of the Sikh kingdoms. Many other community organisations are involved. This year, the all-party group honoured the Vaisakhi Da Mela committee in Glasgow, for its tremendous work in promoting Punjabi community activities in Scotland.

However, concern is expressed in the consultation that particular support and recognition is needed by Punjabi folk art. It seems that although the funding bodies—the Arts Council and others—recognise and fund some elements of what could be called the high arts they underestimate the importance to the Punjabi community of its folk art. Again, we recommend that a meeting of the arts funding bodies be convened by the Department for Culture, Media and Sport to discuss the support needed for that form of art.

The all-party group has recently lent its support to a new and exciting artistic venture in the Punjabi community. Earlier this month, the group hosted the launching in the House of Commons earlier this month of the Man Mela theatre group, which is developing a drama project to commemorate the 60th anniversary next year of the partition of the Punjab. I draw attention to the work of the director Dominic Rai and the writer of the play, Mr. Mahzin Tirmazi, who I believe is called Muz. When he came to the House, he gave us an exposition of the play and its development as a drama project; it was one of the most moving occurrences that I have attended in the House.

Partition was a traumatic episode in the history of the Indian subcontinent. It resulted in 1 million dead, and many millions more were made refugees in their own land. The Labour Government of the day did not consider the consequences of partition or take enough steps to prevent them. There should be a recognition of Britain’s role in that, with some expression of remorse about what occurred during that period.

The all-party group is urging support for that drama project to assist in its development in the coming year. The aim, if possible, is to promote it throughout the country, and then to perform it in English at the Edinburgh festival. I would welcome the Government’s giving whatever support they can.

To maintain and preserve their culture, people must be able to express their religion. There are continuing concerns—they were raised in previous debates—about the failure to create national guidelines or protocols on the ability of Sikhs to express their religion, in particular the wearing of the kirpan at Heathrow airport and when visiting other countries. We expressed concern about what happened in France, where it is illegal to wear turbans and other religious displays. This country has always had a more progressive attitude, but on a number of occasions we still have problems. Sikhs are still unable to gain entry to some buildings, and recently they were unable to gain access to the European Parliament because they were wearing the kirpan.

My hon. Friend is making a remarkably wide-ranging and fascinating speech. He touched on a subject that has been raised by my constituents, who visit me freely at the House carrying the kirpan and bearing other articles of their faith. Is it not the case that the approach taken by the House in dealing with people visiting Members of Parliament could be used as a model?

It is exactly that model that we should build upon and develop in order to create a protocol for the display of religious artefacts such as the kirpan. It is timely to revisit the matter. We secured a number of workable agreements at Heathrow to overcome such problems before, but the problems recur. The Government’s sanctioning the development of a protocol that can be adopted by public and private organisations across the country would help to establish a method of working for the future. That would ease the problems experienced in the past.

Is it not therefore extremely regrettable, as my hon. Friend says, that agreements reached at Heathrow that have satisfied both the safety and security authorities and the community are in danger of being overturned by directives from the European Union—often directives passed by countries with no experience or understanding of the situation?

The all-party group would like to see the Government take a lead on that matter, in discussion with our European partners. Given that members of the Punjabi community are travelling across Europe and the world, it is timely to have some form of agreement on the basic right of people to express their religion by way of symbols.

Would the hon. Gentleman put it on record that, as far as I am aware, there has been no incidence in this country of the kirpan being used aggressively, which shows how tolerant and peaceful the Sikhs are?

We have evidence, through our debates and parliamentary questions, that there has been no incidence of the kirpan causing any risk or being used in assault. I would not expect the Minister to respond in detail today, but it would be extremely helpful if we entered into discussion again on the progress and development of guidelines and protocols; they could be agreed nationally and used as good practice guides to all organisations and perhaps taken up with our European partners. That would resolve the matter once and for all.

May I tell the House of the experience of my constituent Harjinder Singh Gosal? He travels by air across the world. He does not object to having to check in the kirpan with the rest of his main luggage. However, he and some of his friends recently visited Belgium. At Brussels international airport on return to this country, they found that unlike everywhere else, where the turban is checked by a hand-held scanner, he and his friends were required by officials to remove their turbans—the officials refused to use the hand-held scanner. As my hon. Friend will know, that is highly offensive to Sikhs. Does he not agree that, on behalf of British citizens, the Government should take up the matter most urgently with the Belgian authorities?

I invite the Government to raise the matter directly; it is offensive and unacceptable behaviour. I would welcome the Government’s intervention on that matter, to ensure that it is not repeated.

My intervention may be for the benefit of the Minister and the Department. When talking about Heathrow, it could be thought that we are talking only about travellers. The crucial issue that we want to get across, particularly in an area with a high proportion of the Sikh community, is the right to work and to continue in employment while observing one’s faith.

For many of my constituents who are Sikhs working at Heathrow that is a critical issue of employment policy and practice.

On two issues my hon. Friend has referred to that come under the Department for Culture, Media and Sport would he, like me, welcome steps by the Government to clarify with professional sports bodies the issue of wearing the kirpan in places such as professional football grounds? A problem in my constituency was resolved through negotiation and we now have a very good policy, but I am hearing of difficulties with other sports venues in the country. Does my hon. Friend share my surprise that in professional association football there are few if any professional players who are Punjabi in origin and that that appears to be racist?

On the first issue regarding the wearing of the kirpan and access to football grounds and other sport stadiums, the development of a national protocol sanctioned by Government would overcome those issues. On the development of Punjabi activity in sports generally, across the board we have seen members of the Punjabi community coming forward and excelling. However, football seems to be a particular area in which there has not been that development. It behoves the Football Association and other bodies to examine that matter and at least arrive at a shared understanding of why that is occurring, together with policies to develop expertise and ensure that clubs adopt practices that do not discriminateor prevent people participating in sport, even unintentionally.

On the wearing of symbols, there was recently a particularly tragic attack on a young man in Edinburgh. A group of thugs tore off his turban and sought to cut his hair. That was a disgraceful attack and we send our sympathy to him, his family and the Punjabi and Sikh community in Scotland. However, it would be helpful if a report could be provided at some stage on the progress of the investigation into that case and if a review could be carried out into whether there is a particular problem in that area with attacks on Sikhs or members of the Punjabi community. At the moment, the information is not available statistically and a review would be useful certainly in the development of policing policy within that area.

I wish to move on to a number of the other issues that the all-party group has considered recently. Education has always been a key issue and the all-party group and hon. Members will recall the lobby that took place to ensure that there was fair treatment of Sikh schools in this country. The first Sikh school, the Guru Nanak school was established in my constituency. I congratulate the school on its success in the development of both the primary and the secondary school and thank the Government for the intensive investment in Guru Nanak schools and in other projects that have been developed in Slough and Southall.

On health, the all-party group conducted a survey of primary care trusts about the issues they had identified in the Punjabi community in their area and what policies and practices they were pursuing to address those issues. From the survey we identified the high incidence of diabetes and coronary problems in the Punjabi community. We also identified a wide range of good practice activities and strategies developed by primary care trusts. However, the survey confirmed that there is a lack of consistency across local health authorities and linked to that is a lack of representation of the Punjabi community on health bodies, primary care trusts and health trusts. We would welcome the Department of Health developing an overview of health provision, which is culturally specific to the Punjabi community. We would also welcome an examination of the process by which we are encouraging members of the Punjabi community to serve on health bodies across the country. Clearly, there is a lack of representation on a wide range of health bodies and the all-party group would like to work with the Government to encourage access to representation for the Punjabi community in those areas.

One of the hardy perennials of the all-party group and of other debates has been the issue of visas. We welcome the Government’s opening up of the Jalandhar visa office, but believe that it should be upgraded to provide a full service. That would overcome the problem of the long distances travelled to Delhi by many Punjabi families for interviews and visa application processing.

On visa applications for single people, there is concern that there may not be as thorough a consideration of the application as there would be if it was for a couple. We are concerned that there may well be a practice developing of automatic rejection of an application from a single person when, for example, they are applying to visit this country to see their families and attend important ceremonies such as weddings and funerals. It would ensure that the system is seen to be completely objective if there was a review monitoring applications from single people for visas from the Punjab.

Through the all-party group we established an environmental sub-group, which has been tremendously successful. It meets bimonthly and brings together experts who have looked at environmental issues in the Punjab. They have examined water depletion, soil degradation, desertification, and the large scale problems that are facing farmers in the Punjab. We now know that there has been a significant increase in suicide among farmers in the Punjab as a result of the poverty they face and the debt many have fallen into. The sub-group has liaised with a number of projects that are working hard on the ground in the Punjab and there have been discussions around the development role that the all-party group can play in assisting projects that are tackling environmental problems.

We have established a development group to look at the economic support that can be provided to the Punjab and issues around environment and farming practices. The group will also look at how we exchange technology between Britain and the Punjab to assist both countries in economic development. For example, there is a need for co-ordination between the public and private assistance provided by the Punjabi diaspora in Britain to the Punjab itself. We are examining the Canadian model whereby people from the Punjabi diaspora are coming together to co-ordinate the support they are providing back in their homeland.

We are also examining what technology transfer issues can be undertaken, particularly regarding links between universities and schools and colleges. The issue that has come up regularly in these discussions has been that of flights to the Punjab. Punjabis travel a great deal in order to return to their homeland and carry out visits on a short and long-term basis. They obviously visit Amritsar and Darbar Sahib. There are concerns about the pricing policy of direct flights to the Punjab and Amritsar and there are large differences between the costs of those flights and flights into Delhi. That may be a result of the frequency of flights or the need for further investment in developing the airport system in the Punjab. That is one of the issues we will examine in the development sub-group and we will also be liaising with the Government directly.

An issue raised regularly in debates is that of human rights. The all-party group was formed, as I have said, more than a decade ago as a human rights group. We still take up individual cases and I would like to raise yet again the case of Professor Devinderpal Singh Bhullar. Many hon. Members will know the background to this case so I will not delay the debate by going through the details except to say that Professor Bhullar is now awaiting a death sentence. He confessed to crimes under torture and we believe that he was deported from Germany illegally. Many consider him to be a prisoner of conscience. We welcome whatever assistance the Government can provide on liaison and representation to the Indian Government to ensure that the death sentence is lifted from Professor Bhullar. We have maintained our position as a group regarding our representations to the Indian Government about their refusal to admit UN rapporteurs on torture into the Punjab. We are liaising with organisations such as Liberation. My hon. Friend the Member for Islington, North (Jeremy Corbyn), the chair of Liberation, has raised that issue and other members of that group have raised it via the UN itself.

One other issue, which has arisen this year, involves members of the Punjabi community who served this country well in the second world war and became prisoners of war in Europe. That group has never received recognition, despite their arduous sufferings during that period. Many of them were captured in north Africa, taken to Europe and used by the Nazi regime and the Italian regime, almost as slave labour in some instances. Certainly many of them became prisoners of war in the most difficult circumstances. We believe that the Government need to review the situation of the people who served in the armed forces and became prisoners of war, and examine what compensation should be paid and what settlements should be made to compensate them for their sufferings and the service that they rendered to this country.

In addition, we are identifying cases of ex-servicemen, many of whom are of course now elderly, who originally were given some form of pension and award for their disabilities, but whose pension and disability award are now being reviewed and reduced. We would welcome a review by the Ministry of Defence of those concerns and are willing to work with the MOD to identify individual cases in which the problems can be overcome in, we hope, co-operation with the Indian Government.

Those are a range of the issues that we have been dealing with as an all-party group. As, I believe, a successful all-party group, we have been working with the community itself and working to an agenda set by that community. The group has established a forum for discussion in which we share experiences and then develop practical policies, to most of which the Government have responded effectively. We would welcome continuing dialogue with the Government. We want to raise issues about ensuring that there are adequate mechanisms whereby the Government can consult the Punjabi community to ensure that there is adequate representation from across that community and that that representation is genuinely representative of the overall community.

I place on record as well the support that has been given by a wide range of members of the group for the individual initiatives. The fact that that has happened on a cross-party basis is what has made the group so successful at representing the Punjabi community in Britain.

I was not necessarily expecting to speak as early as this, but the hon. Member for Hayes and Harlington (John McDonnell) took many pertinent interventions. I congratulate him on securing the debate. Clearly, he is a very articulate advocate for the Punjabi community. The debate has provided an opportunity to learn about a community and a religion with which, I confess, I am not as familiar as I should be. There is not a large Sikh community in Carshalton and Wallington, but I have enjoyed hearing about the work of the all-party group and it has been interesting to hear the group’s concerns on a wide range of issues, such as the teaching of Punjabi, community radio, football, culture and health.

While preparing for the debate, I was able to glean many useful facts and much useful information from previous debates, notably the debate secured by the hon. Member for Wolverhampton, South-West (Rob Marris) in February 2005. During that debate, he made the sensible point—no doubt this still applies now—that the Punjabi community’s concerns reflect those of the wider community in respect of education, health and law and order issues. A number of additional facts came out in that debate that were of interest to me, such as that the state capital was built by Le Corbusier in the 1950s—I was not aware of that—and that, as the hon. Member for Hayes and Harlington has stated today, Punjabi is now the second most commonly spoken language in the United Kingdom.

One fact that I have not been able to confirm and which was raised during the debate secured by the hon. Member for Wolverhampton, South-West is that Pakistan is an acronym, with the P standing for Punjab. I understand that Pakistan is translated as “the land of the pure”, but perhaps both those things apply. A fact that I have been able to confirm is that some of the issues that he raised in his debate 18 months ago have not been resolved. Perhaps progress has been made, but they have not been resolved. That has been confirmed by the briefing that hon. Members will have received over the weekend from the Sikh Federation and by the briefing that I received from my own party’s ethnic minority representatives.

During his debate, the hon. Member for Wolverhampton, South-West raised six principal points, some of which the hon. Member for Hayes and Harlington has referred to and some of which he has not. The first issue was pension credit. The second was the ethnic monitoring of Sikhs, which has been referred to. That is associated with the issue of Sikh appointments to various positions of responsibility in government. The third issue was language proficiency tests. The fourth was the kirpan, which has been referred to, and the fifth was the wearing of turbans. The sixth point related to human rights issues.

It is pertinent to this debate to consider the progress that has been made in those areas and to ask the Minister some specific questions on those points, given that during the debate 18 months ago, the Minister who responded, the hon. Member for Slough (Fiona Mactaggart), gave a number of undertakings. The first related to pension credit. People from the Punjabi community often return home for a period of longer than four weeks and are required to sign on again for pension credit when they return. During the debate 18 months ago, the Minister said that no decision had yet been taken on that issue,

“but officials are researching a range of options for potentially extending the period for which pension credit can continue”.—[Official Report, 2 February 2005; Vol. 430, c. 967.]

I have not been able to ascertain what the conclusion of that research was, whether it found in favour of making that change, or whether costings were conducted as to what the financial implication of the change would be. I hope that this Minister can respond on that point.

On ethnic monitoring of Sikhs and the census, the Minister said 18 months ago that the Office for National Statistics

“will consult widely with the intention of reviewing the classification system…and it should be able to accommodate some of the views expressed when adapting the current ethnic categories.”—[Official Report, 2 February 2005; Vol. 430, c. 968.]

I hope that this Minister will say today to what extent the ONS has taken on board those representations.

On language proficiency tests, reference was made to a “second stage of consultation”. That was due to begin 18 months ago and I assume that it has been completed by now. It would be interesting to know from the Minister what feedback and representations she has received about the changes to the rules in respect of language proficiency, whether that has introduced a constraint and, if so, to what extent that has been the case, and what representations have been received about further extending the scope for requesting language proficiency from people who are perhaps not actively involved in delivering religious sermons. I hope that the Minister will respond on that point.

The kirpan has been referred to in some detail, and the hon. Member for Hayes and Harlington was perhaps uncharacteristically generous to the Minister in offering her an opportunity to come back to him in writing at a later date. I hope that he is not going to develop a habit of being generous to Ministers. I believe that it would be appropriate for the Minister to respond now on the kirpan, given that she had notice 18 months ago from the hon. Member for Wolverhampton, South-West that that was an issue. At that point, there was discussion about consulting the community and finding out what the Government could do about the fact that they were in breach of the European regulation. I understand from the briefing from the Sikh Federation that immediately before the last general election the Government gave an undertaking that they would issue a code of practice on the subject, which has not yet been delivered. I hope that the Minister will clarify what progress has been made on that.

The key issue to which I should like the Minister to respond—I am trying to be as co-operative as possible to move the matter on promptly—is the need for a timetabled strategy for resolving the matter in civil society, the private sector and government in this country, and for moving it on to the European agenda and, if necessary, further. The issue is a timetabled strategy for monitoring the progress of Government policy and our interventions overall. I make those comments in a spirit of wanting us all to work together to resolve the matter.

I thank the hon. Gentleman for his sensible intervention, and I hope that the Minister will respond with the timetable and strategy that he seeks.

Something that was perhaps not covered in great detail in the debate 18 months ago was the representation and appointment of Sikhs. The hon. Member for Wolverhampton, South-West touched on it in passing, but it was not the main focus of his questioning then. I hope that the Minister will say what has been done with respect to consideration by the Government and the Appointments Commission of the appointment in future of appropriately qualified Sikhs in places such as the House of Lords. I accept that that is not just a Government responsibility; it is a responsibility of all the political parties, and I shall not absolve my own from it. We all have an important role to play.

I hope that the Minister will also set out what regular contact she has with representative organisations.

On appointments, we have in the past raised the question of appointments in the civil service, which is particularly pertinent at a time when the number of civil servants is being reduced. We have seen the Government targets to cut 104,000 civil service jobs. We have raised the question of adequate monitoring, so that no particular community feels the brunt of any reductions disproportionately.

I thank the hon. Gentleman for another very pertinent intervention and hope that the Minister will confirm that monitoring will be done to ensure that no one community will be affected by the changes more than another. I hope that she will also update us on the 2005 figures for ethnic minority representation in the civil service, so that we can see whether the trend is in the right direction. I hope that the Minister will tell us about her discussions with various representative organisations, such as the Sikh Federation and the Sikh Women’s Federation, about ideas for increasing the representation of Sikhs.

My final point is about human rights. I am the treasurer of the all-party group on human rights. There are significant abuses of Sikhs’ human rights, requiring investigation. The hon. Member for Hayes and Harlington has referred to the case of Professor Bhullar. There have been disappearances and massacres, as well as the attack in November 1984. There has been a request for the UK Government to call for a UN investigation into a series of human rights abuses over several decades, which the Sikh community feels have not been investigated sufficiently, or at all. Will the Government support the call for such an investigation?

It is clear that the Punjabi community plays a major role in many of our towns and cities, contributing significantly to business and to our cultural and faith diversity. Its aspirations are not unreasonable; its members simply want to be allowed the same opportunities as other communities. It is the duty of our Government and all political parties present today to see that those ambitions are realised.

rose—

Order. I did pause for a long while when the hon. Member for Hayes and Harlington (John McDonnell) sat down to allow Back Benchers the opportunity to contribute; it is a pity, but once we are on to the Opposition spokesmen it is out of my hands.

I am sorry to prevent an hon. Member with some some expertise in the matter from speaking, but if the hon. Member for Wolverhampton, South-West (Rob Marris) would like to intervene on anything that I say, he would be welcome to.

It is a great pleasure to serve under your resident chairmanship, Mr. Amess, and to follow the hon. Member for Hayes and Harlington (John McDonnell), who made an extremely comprehensive, knowledgeable and forthright speech. I think that we all benefited from his great knowledge of and familiarity with the issues that he talked about. I congratulate him on his work, and the right hon. Member for Warley (Mr. Spellar) on establishing the all-party group on Panjabis in Britain. I also pay tribute to the hon. Member for Wolverhampton, South-West and my hon. Friend the Member for Beaconsfield (Mr. Grieve), who together have formed the all-party group on UK Sikhs. Together those groups have both helped the House to understand some of the important issues that have been talked about today.

The hon. Gentleman kindly referred to my work both as the treasurer of the all-party group on Panjabis in Britain and as chairman of the all-party group on UK Sikhs. It is important sometimes to maintain the differentiation of Sikhs and Punjabis, because Sikhs form about 55 per cent. of the population of Punjab. On the matter of the census, does he agree that it would be helpful to have a specific Punjabi language box to tick, as well as a specific Sikh box to tick for ethnic, if not racial, monitoring, so that one could differentiate further and find out how many people of Punjabi origin are in the UK who are not Sikh? There are many in my constituency, for example.

I am grateful for that intervention, which anticipates the very point of complexity that I was going to make, particularly about the census.

We have all learned a lot from the debate. We know from the hon. Member for Hayes and Harlington that Punjab means land of the five rivers. I am no linguist but I understand that the Punjabi word “panj” means five, and is related to the ancient Greek “penta”, from which we get the word “pentagon”. It is a small reminder that Punjabi, English and, indeed, Greek are all part of the Indo-European family of languages. In languages common beginnings often diverge in all sorts of directions. I hope that in today’s Britain we are achieving the opposite of that, by building the united but not uniform kingdom of our diverse identities.

Identity, as has been pointed out, is a complex matter. That can be seen in the Punjabi community, which is drawn both from India and Pakistan. The Sikh community is of course predominantly Punjabi, but many Punjabis are Muslim or Hindu. Moreover, many Punjabis arrived in Britain from Africa, adding another layer of identity and complexity. The debate this morning is about the British Punjabi community, and so in addition to all those other overlapping features there is, of course, a strong British identity to the community that we are talking about today.

It is difficult for the categorisers of ethnic and religious identity to fit people into neat boxes, and their attempts to do so are unlikely to please everyone. However, it is important that all distinct and sizeable communities should be properly recognised in the appropriate way, whenever diversity is monitored by public institutions, and it seems to me that in trying to get it right a good place to start is to go to each community to ask the people who belong to it how they see themselves. My hon. Friend the Member for Beaconsfield and my right hon. Friend the Member for West Dorset (Mr. Letwin) have both put on record the view of my party that the census authorities should treat the question sympathetically and creatively. The hon. Member for Hayes and Harlington made the point that that is a matter of some urgency as the next census approaches. I ask the Minister when she replies to consider the urgency as well as the substance of the request.

As a Conservative, I am always aware that the apparatus of the state can take us only so far and, indeed, often gets in the way, so I am concerned about the down-to-earth realities of life as it is lived by the individuals and communities that make up this nation. In that respect, I think it is important to emphasise, as several hon. Members have done during the debate, the positive aspects of the Punjabi community in Britain. There are occasional setbacks and tensions, but the story of the Punjabi community in Britain is one of considerable success. On the one hand, a strong sense of cultural identity, tradition and belief has been retained; on the other, the community has successfully taken its place in the wider British community. That is surely the way things should be: the natural, organic co-existence of different groups, which the state does not need to plan and prod into place, but which emerges as ordinary people live together as Britons alongside one another.

That is not to say that the Government have no responsibilities, but we politicians should always aim to apply the lightest possible touch in such matters. We have seen more heavy-handed approaches in some countries, and I do not want this country to go down the same route. The hon. Member for Hayes and Harlington referred to some of the difficulties in other European Union countries, which we have successfully avoided. I hope that the Minister’s good offices can be used to influence the practice of some of our European neighbours.

Respect for the law and loyalty to our democratic system of government are one thing, but an increasingly convoluted regulatory system that tells people how different they are allowed to be is an entirely different matter. Such a system could serve only to undermine the purpose of communities and their members’ responsibilities towards each another. A state-driven approach to diversity forces the representatives of each community to turn away from those whom they represent and towards political hierarchies. I therefore hope that we will take a grass-roots view and not seek to impose a top-down version of community on the communities that we are discussing. Wherever we can, we should keep the politics to a minimum, and I think that that view is shared by the political parties.

Strong institutions, which draw their strengths from the grassroots, not from Whitehall, are the way to keep communities vibrant. Wearing my hat as shadow Minister with responsibility for charities, I believe that public funding streams need to be shaped in such a way as to uphold that principle, not undermine it. As we have heard, the Punjabi community provides many excellent examples of what civil society can achieve, and I hope that civil society, as expressed in all our communities, will increasingly be the means by which we aim to tackle the challenges of the future.

Let me now respond to some of the points that have been raised, particularly by the hon. Member for Hayes and Harlington.

Before the hon. Gentleman moves on to the specifics, let me say that he has made a valid point about the role of Punjabi civil society—let us describe it in that way. One thing of which we have tried to make the Government aware—I think that we have been successful—is the role of particular institutions in the Punjabi community. One such institution is the gurdwara, which plays much more than a religious role in the community and has a whole social and cultural role. That was recognised as far back as the Greater London council days, when the first local government grants were given to gurdwaras in London in recognition of their more general role. I emphasise that because many gurdwaras provide the basis of Punjabi language tuition in the Punjabi community, and it is important that Members across the parties urge the Government to recognise the broader role of organisations in Punjabi civil society. In the case of some other communities and religions, such a role would not be recognised.

The hon. Gentleman makes a powerful point. I remember with great pleasure spending time in Gravesend during the election campaign. The gurdwaras there make an important and wide contribution to the community, which goes beyond the strictly religious. That is also true of other religions, and Christian churches play a valuable role in the social fabric of our communities, which is intimately connected with, but goes further than, their narrowly religious role. I always seek to encourage the engagement of faith groups in wider civil society and I am grateful for the opportunity to clarify that.

I echo the hon. Gentleman’s tribute to the Punjabi community’s strong cultural and, increasingly, sporting tradition. Our country would be diminished without the world-class contribution that the British Punjabi community has made to our national cultural life over the years.

We have discussed the census, and I look forward to the Minister’s response on the issue. The hon. Gentleman also mentioned community radio, and there could be no better example of grass roots institutions in which members of the local community come together to provide a service that is of interest not only to them, but to others. My hon. Friend the Member for Beaconsfield was telling me what a devotee he is of such wider cultural contributions, and I dare say that such community radio stations will attract his ear, too, if they are available online in Beaconsfield.

Of course, the community’s contributions go beyond the artistic, and I was interested to hear the hon. Member for Wolverhampton, South-West mention the Anglo-Sikh heritage trail. That is one family outing in west London that the Clark household might engage in before too long.

An important point was made about the kirpan, when it was confirmed for the record that there has been no recorded instance of it being used aggressively. The sensible, pragmatic arrangements that we have managed to establish contrast with some of the tales that we hear about practice on the continent. We talk about having influence in Europe, and this is an issue on which we should exercise that influence. We should make our experience available to our European partners to reassure them.

On the perceived under-representation of the Punjabi community, we know that Punjabis in Britain are prominent in the life of our communities and in our culture, and I would like that to be replicated in the organisations that represent our communities. There is a perception that members of the Punjabi community are under-represented, and I would be interested to hear whether that accords with the Minister’s view. What steps are the Government considering to address the problem, if, indeed, it is the problem that it has been suggested it is?

In conclusion, this has been a fascinating debate. We have had contributions—usually in the form of interventions—from both sides of the Chamber, and I think that all of us have deepened our understanding and appreciation of the Punjabi community’s contribution. It has been a great pleasure to participate in the debate.

I join others in congratulating my hon. Friend the Member for Hayes and Harlington (John McDonnell) on securing the debate and on setting what would be a wide-ranging agenda for any Minister to respond to. I share the race and faith portfolio with my hon. Friend the Minister for Local Government, who leads on the issue. Together, we work on a range of related issues, and I will do my best to answer those questions that I can. However, hon. Members have set me quite a daunting task, and I will forward any other questions to other Ministers or seek responses subsequently. We will see what I manage to cover in the time that we have.

It is encouraging to see an all-party group working in such depth, and the fact that its members have managed to secure debates on a number of occasions in previous years is a tribute to their work. That gives us a welcome opportunity to place on record the valuable contribution that the Punjabi community makes to our society, whether in public service, industry, culture or sport. There is no doubt that our country is the richer for the community’s presence.

We should also recognise the tremendous charitable contribution that the community makes, and my hon. Friend the Member for Hayes and Harlington talked about the important role played by gurdwaras. Indeed, other places of worship also play an important role in that respect in civic society.

Before I come to the specific points raised by hon. Members and to the Punjabi community, let me talk briefly about what the Government are doing to increase race equality and community cohesion generally. Our strategy paper entitled, “Improving Opportunity, Strengthening Society”, which we launched in 2005, was the first cross-Government strategy on increasing race equality and community cohesion, and its aim is to help to strengthen society. It will do that by seeking to create a society in which every individual, whatever their racial or ethnic origin, can fulfil their potential through the enjoyment of equal opportunities, rights and responsibilities. Hon. Members will also be aware that we are seeking to establish the commission for equality and human rights, which will also play a role in this important area.

We recently published our first progress report on the strategy, which showed that enormous progress has been made. We should be proud of the work already done to tackle race inequalities and to increase community cohesion. As hon. Members have mentioned, many issues still need to be addressed. We should not be complacent as there is much to do. Some communities still suffer disadvantages in comparison with the rest of society. This is a long-term strategy in which all of us have a role to play in creating an inclusive society where everyone in Britain has the life chances that they deserve.

In support of our strategy to increase race equality and community cohesion, we have also invested in our communities. We have introduced the faith communities capacity building fund. It has a number of aims, one of which is to help faith communities to promote understanding and dialogue. I am pleased that a number of Sikh and Punjabi organisations have benefited from it. I would particularly like to highlight the work of the United Kingdom Punjab Heritage Association, which seeks to highlight the shared cultural heritage between Britain and Punjab and to build a better understanding of shared histories in local communities. It is receiving £47,000 to build and to sustain its long-term development, which will enable it to develop high-quality, cross-faith projects on Punjabi heritage. That heritage is shared by members from the Muslim, Sikh and Hindu faiths.

I also pay tribute to the two Sikh schools in the maintained sector, both of which are in the constituency of my hon. Friend the Member for Hayes and Harlington. One is a primary school and the other is a secondary school, and they both continue to achieve outstanding results for their students.

A number of hon. Members raised the issue of the census. They will be aware that the 2001 census asked respondents, for the first time, to record their religion. That has provided us with a wealth of information on faith groups that had not previously been available. Sikhs are, of course, recognised as an ethnic group for the purposes of race relations legislation, and public authorities are encouraged to collect statistics in a way that will help them to provide services that are accessible and fair for all.

The Office for National Statistics will shortly be consulting data users on whether to include a question on language in the 2011 census, and, if so, on what languages they require information about. I am pleased that my Department has expressed its support for a language question. The proposed draft question would ask specifically about English and Welsh, but there would be space to write in one further language.

The question will cover four dimensions of language ability—understanding, speaking, reading and writing—and will therefore present an opportunity to identify the number and location of Punjabi speakers.

Could we, through this debate, pass the message to the ONS at the early stage of the consultations that a write-in block would be insufficient? Where there are blank spaces for individuals to write in, there is invariably a lower response rate. Because of the scale of Punjabi speaking in this country, it is expected that specific reference would be made to the Punjabi language. A tick-box approach would facilitate people in registering their adherence to that language.

I gave an indication of the proposed draft question. Hon. Members will have an opportunity to give feedback to the ONS on those issues and to raise them ahead of the 2011 census.

I understand that the draft census question makes reference to English, Welsh and British sign language, which I am pleased that our Government recognised as a language indigenous to these isles about four years ago. I would venture to say that there are a great many more users and speakers of Punjabi in the United Kingdom than there are British sign language users. Although it is important to have British sign language specified, I reiterate the point, which I hope the Minister will pass on to the ONS, that specifying the Punjabi language rather than having it as a write-in option would be far more preferable. Such an approach would also be more likely to reveal far more useful information.

As I say, I am happy to pass on hon. Members’ comments.

The issue of Punjabi language provision and the strategy was mentioned. Clearly, it is also an issue for the Department for Education and Skills and relates to a number of other community languages. The hon. Member for Tunbridge Wells (Greg Clark) said that he is not a linguist. I am, and I take the view that learning one language often enables people to be open to learning more languages. We need people in our country who can speak other languages for the benefit of our position in the world. I am sure that hon. Members will be disappointed that I learned Hindi and not Punjabi, although understanding some spoken Punjabi is within my reach.

In one of our community conference consultations, the point was made that under the Inner London education authority a group of Punjabi speakers came together to establish an association and in that way became advocates for the language. That group also set standards about how the language was taught in both schools and community organisations. In many ways, it is the community sector that requires the support. It would be helpful if we could pass on to the relevant Department the suggestion that such an initiative might be reinvigorated through cultural funds.

As I said, I am happy to pass the issue on to the DFES, which I am sure will give it appropriate consideration.

My hon. Friend also raised the important issue of the role of the media in promoting community cohesion, and I agree with the point that was made. There are clear benefits to be had from representation in the media and in the important areas of arts and culture, to which he referred. Inviting the relevant Minister from the Department for Culture, Media and Sport to a meeting of the all-party group might be an appropriate way to take those issues forward.

My hon. Friend also raised the important issue of cases where Sikhs have been attacked. One victim was a constituent of his. Like all other hon. Members, I deplore such crimes. The Government have introduced racially and religiously aggravated offences, which are designed to send a clear message that racist and faith-related crime will not be tolerated. The Crime and Disorder Act 1998 introduced nine new racially aggravated offences, which in England and Wales carry higher maximum penalties where there is evidence of a racist motive or racial hostility in connection with the offence. Clearly, my hon. Friend wishes to ask the Home Secretary to examine those issues, and I shall pass the substance of the debate on to the relevant Minister.

Hon. Members raised issues about religious dress. This Government believe that each of the UK’s faith and ethnic communities should be free to express its particular beliefs. Freedom of religious observance for all citizens is a fundamental principle of a free society. In a democratic and diverse society, people of faith must have the right and choice in respect of whether to wear religious dress or not. Such a decision should be made according to their own conscience and beliefs, and should not be subject to interference from Government.

Hon. Members asked how these issues are dealt with in certain circumstances. Adopting some form of protocol on the wearing of religious symbols is an interesting idea that we could discuss. I am interested to hear about situations where people feel that the matter is causing a problem. I listened to the points made by hon. Members about problems in other European Union countries, and I shall make the relevant ministerial colleagues aware of the issue so that they can raise it in appropriate situations.

I thank my hon. Friend for alluding to the issue that I raised, which was specifically the attitude of security staff at Brussels international airport. Brussels is home to the European Union Commission and Parliament, never mind that there may be other reasons why Punjabis, particularly Sikhs, might want to go there. Will she raise that issue with her colleagues?

Absolutely. The matter should be raised in the appropriate forum and I will ensure that the relevant ministerial colleagues are made aware of the issue.

The Minister referred to a code of practice or general procedure being an interesting idea. The idea was raised around 18 months ago, immediately prior to the general election, and a promise was made that a code of practice would be delivered. What has happened since then?

My understanding is that further work is being done and that the Commission on Integration and Cohesion, led by Darra Singh, will be asked to examine the issue, which goes wider than just the Sikh community.

Hon. Members will be aware, or at least not surprised to learn, that India has the UK's largest visa operation. Applications are expected to rise to more than 400,000 in this financial year. Our four visa issuing offices continue to offer an excellent standard of service with around 96 per cent. of straightforward applications being processed within 24 hours. That meets public service agreement targets. I can offer the assurance that the refusal rate is falling. It was 26.5 per cent. in 2005-06 and is 18.9 per cent. so far this year.

It would be remiss of us as hon. Members who deal with visa cases almost daily not to record the improvement and congratulate the staff involved in the various consulates and embassies. Those of us who deal with visa cases at our surgeries have often found them extremely distressing because people have missed funerals, weddings and other important occasions. Many of those cases have now been resolved, and I thank the staff for what they have done and the Government for their involvement.

I thank my hon. Friend and assure him that the issue is being monitored. I am sure that hon. Members will raise the matter with the relevant Minister if there are difficulties.

I want to reiterate the point that my hon. Friend the Member for Hayes and Harlington made about the opening of the British High Commission’s sub-office at Jalandhar. That is extremely welcome, not least because of the convenience of not having to travel to the High Commission’s office in Delhi. It is important to enhance the Jalandhar office because it will help to reduce the number of instances of Punjabis receiving bogus advice, which they pay for, about what they need to do to secure entry clearance. That bogus advice often costs them a visa, not just once but for many years thereafter.

I thank my hon. Friend for raising that issue and will communicate it to the relevant Minister.

My hon. Friend the Member for Hayes and Harlington raised the important issue of torture and the specific case of Professor Bhullar, which are matters of concern. We are aware of that case and, as hon. Members are aware, the UK opposes capital punishment in all circumstances. Only last month, we formally raised with India its use of the death penalty and expressed our concern about that.

India is a friend of this country. Have the UK Government recently raised with the Government of India the fact that Amnesty International has been excluded from Punjab for 30 years, as has the UN rapporteur on human rights? It seems extraordinary that the Republic of India allows that to continue in the state of Punjab. What representations have the UK Government made to the Indian Government about that?

I am afraid that I do not have the specific details. My hon. Friend will be aware that that matter does not come within my portfolio. However, I shall make inquiries.

My hon. Friend the Member for Hayes and Harlington raised the issue of compensation for prisoners of war and other issues with which the Ministry of Defence is concerned. No doubt he and the all-party group will seek to raise those directly.

May I put on record the work that Colonel Chanan Singh Dhillon has done in both India and this country? He highlighted the overall issue and has taken up individual cases. It would be invaluable if he could meet Ministry of Defence officials on his next visit to this country to discuss those cases.

I am pleased that my hon. Friend has had the opportunity to put that on the record.

The hon. Member for Carshalton and Wallington (Tom Brake), who speaks for the Liberal Democrats on local government, gave us an opportunity to review last year’s debate and raised a number of issues. On appointments, clearly the most important issue is to ensure that people apply and that they are aware of them. The Government encourage organisations to ensure that that happens. When we were seeking commissioners for the commission for equality and human Rights recently, we were most concerned, particularly given the nature of that new body, to ensure that as many people as possible with relevant experience from all communities had the opportunity to apply. A great deal of effort was made to ensure that that was taken forward. There is a recognised code of practice for the Commissioner for Public Appointments to ensure that the processes take place properly.

It is important to say that the Government have mechanisms for meeting representatives of all faith communities through the Faith Communities Consultative Council, which meets regularly and is usually attended by either my hon. Friend the Minister for Local Government or me. That body includes a representative from the British Sikh Consultative Forum and from the Network of Sikh Organisations. That is the mechanism that we use to raise issues with faith organisations and to take them forward.

We have had an extraordinarily wide-ranging debate and I have done my best, in the time available, to respond to as many as possible of the points that hon. Members raised with the information that is immediately available to me. This has been an important debate and an important way of having an in-depth discussion about one section of our community. The all-party group should congratulate itself on again having had what I hope it believes was a fruitful discussion. I look forward to continuing to work with all hon. Members who have concerns about these important issues.

It is a pleasure—in some ways—to be here, and a pleasure, too, to see so many Staffordshire Members of Parliament present. I bring apologies from my hon. Friend the Member for South Staffordshire (Sir Patrick Cormack), who had to be abroad on parliamentary business today.

We have all heard of a postcode lottery in the national health service. Until recently, we in Staffordshire have been the beneficiary of that lottery. We have the best ambulance service in Europe, and until now, a person was four-and-a-half times more likely to survive a severe heart attack in Staffordshire than in the west midlands. Why? Staffordshire ambulance service crews and community first responders arrive quickly to attend to victims, and until now, they have had the right drugs and equipment to apply treatment. But no longer. Life-saving equipment has been withdrawn from emergency ambulances, and drugs and equipment have been removed from community first responders. It is something that all Staffordshire MPs—Labour and Conservative—feared. We warned the Prime Minister and the Secretary of State for Health, and we are now witnessing a tragedy unfold before our eyes.

Will the hon. Gentleman give way?

I shall give way in a few moments, once I have developed my argument.

The tragedy will unnecessarily reduce standards of care in the NHS, and people have estimated that it will cost many lives each year in Staffordshire. If it is not halted, the clock will start ticking with the first death. Let me be clear: this debate is all about saving lives and praising the paramedics and community first responders who are so professional in their work in Staffordshire. However, they are being let down badly by the lack of leadership, the weakness and the unprofessionalism of some of their senior management.

Although Ministers provoked the problem through their merger plans with the West Midlands ambulance service, there have been unintended and avoidable consequences. I shall go further, and say to the Minister that the Department of Health has been professional and consistent in its advice to the management of Staffordshire ambulance service. They have chosen to ignore it, and to risk lives as a consequence. I hope that the Minister will pass on my praise to the health professionals in his Department, whose letters I shall quote from later.

Roger Thayne—the former chief executive of Staffordshire ambulance service, who built it up to become the great service that is now so under threat—and many others estimate that 20 lives or more will be lost unnecessarily in Staffordshire each year, because of confused and bewildered management. They have a lot to answer for.

I intend to expose to the Chamber the web of deception and lies that has engulfed the new management of the Staffordshire ambulance service ever since the Government announced their intention to merge it with the West Midlands ambulance service. Before that announcement, Staffordshire ambulance service had been demonstrating the kind of leadership in public care that was the envy of communities throughout the United Kingdom—and overseas.

When Staffordshire ambulance service recognised that most lives were saved in the first five minutes after an emergency, and that it would never be able to secure the resources to provide a rapid emergency ambulance service to rural areas, it set up progressive, community-focused initiatives. They included teaching first aid to children as young as five, and making defibrillators available in local areas. That common-sense approach resulted in the Staffordshire service achieving the UK’s quickest response times and some of the country’s highest survival rates. Cardiac arrest outcomes were about five times better than the national average, and four-and-a-half times better than in the area served by the West Midlands ambulance service.

In a national context, if all ambulance services were as successful as the Staffordshire service was—it is important that I have to use the past tense—the NHS would discharge each year between 4,000 and 5,000 more patients alive than dead. Staffordshire did all that while maintaining costs to the taxpayer which were 30 per cent. lower than the national average. A success story, indeed.

I shall discuss two issues. The first is the drugs that have been withdrawn from community first responders, or CFRs, and the second is the ResQPOD units that have been removed from CFRs, regular ambulance crews and paramedics. One of the most important and successful initiatives developed by the Staffordshire service is the community first responder service. Those local volunteers are highly trained, and they are supplied with the necessary drugs to treat heart attacks, asthma, epileptic fits, injuries due to falls, or serious trauma. They start the treatment that is continued by a community paramedic, who is also based locally, which is in turn continued by an emergency ambulance crew. All CFR work is supported and overseen by a doctor, who is available 24 hours a day and provides instruction over the phone. Often, CFRs reach an emergency first, in those life-saving minutes immediately after an incident.

Why have the new management of Staffordshire ambulance service, in the shape of chairman, Robert Lake, and acting chief executive, Geoff Catling, removed vital drugs from CFRs and life-saving equipment from paramedics and trained volunteers? We can only speculate. They blame the law, the Government and the Medicines Act 1968. However, that is a lie, as I shall demonstrate later.

One possible reason for the removal is that a West Midlands ambulance paramedic, not from Staffordshire, who is a paid UNISON official, first raised the issue of CFRs carrying life-saving emergency drugs and equipment through his concern that paid paramedics and ambulance crews would lose out on overtime and job opportunities. We do not have such problems with industrial relations in the Staffordshire ambulance service, thank God. In any event, Staffordshire CFRs are never used as an alternative to the ambulance service; for all 999 calls, a paramedic and/or ambulance is called out. CFRs simply arrive on the scene more quickly, as they are based in the area; I want to reassure UNISON, a good and constructive trade union, of that fact.

A quick response time is not enough, however. Without drugs and equipment, CFRs cannot do their job.

Is my hon. Friend aware of the Coppice Lane estate in my constituency? It is effectively cut off by a railway line, which creates enormous problems, because there are no facilities available with the proper equipment and medical care.

I used to represent Stone, before a boundary change, so I know the area. My hon. Friend is absolutely right. Indeed, there are many other areas like that in rural Staffordshire. At this point, I should like to heap praise on the hon. Member for Staffordshire, Moorlands (Charlotte Atkins) who has been only too aware of that very problem in her own rural constituency.

Why has the change taken place? The excuse given by Lake and Catling for withdrawing drugs and services is that their use is illegal under the Medicines Act. The Act prescribes which drugs can be administered by whom and under what circumstances, such as emergencies. It also outlines clinical governance for the storage and distribution of those drugs. That news first became public when on 17 October, NHS West Midlands head of special projects, Steve Coney, wrote to Members of Parliament and others informing them that all but three drugs previously available to save lives were to be withdrawn. Confusingly, the very next day, Staffordshire ambulance service issued a press release saying that, actually, six drugs remained available.

The press release was supported by correspondence from acting chief executive, Geoff Catling, who wrote to MPs and others. In his letter from the Staffordshire ambulance service, he said:

“Following an initial investigation, I have taken the decision that certain drugs used by our community first responder (CFR) schemes are to be withdrawn…whilst the training of the CFRs is extensive”—

I am glad that he admits that—

“and to a high standard, concern has been raised”—

by whom, we do not know—

“that under the Medicines Act, it would appear that a number of drugs are not eligible for use by lay people under the national legal framework for medicines. Now that the status under the Medicines Act for certain drugs is clear, the consequence is that the Trust can no longer provide indemnity to CFRs who may be operating outside the legal framework of the safe and secure handling of medicines.”

The indictment is clear. He blames the Medicines Act and the Government. He is right that the Medicines Act is clear, but it is not as he misleadingly claims. The use of the drugs is entirely legal—an opinion consistently supported by the Department of Health and the Medicines and Healthcare products Regulatory Agency. I have a letter from Victoria Milnes at the Department of Health’s customer service centre:

“The view of the Medicines and Healthcare products Regulatory Agency is that community first responders are in a similar position to Trust employees if they:

a) are engaged by a Trust to provide emergency response services as part of the Trust's business”,

which they are,

“b) are trained by and subject to the direction and control of the Trust”,

which they are,

“and

c) work on its behalf and are fully accountable to it”,

which they are. The letter goes on to say:

“This means that they can be supplied with appropriate drugs by the Trust without contravening the Medicines Act.”

I have a further letter from the MHRA, the executive agency of the Department of Health.

Will the hon. Gentleman give way?

I will just quote from it, and then I will give way to the hon. Lady. The letter says:

“The Agency has taken the view that if community first responders in Staffordshire were engaged by the Trust to provide emergency response services as part of the Trust’s business, are trained by and subject to the direction and control of the Trust, work on its behalf and are fully accountable to it, they are in a similar position to Trust employees: i.e., they can be supplied with appropriate drugs by the Trust without contravening the Medicines Act.”

The hon. Gentleman quoted from a Department of Health letter. After that quote, an additional paragraph mentions the importance of ensuring that

“clinical governance arrangements are sufficiently robust to ensure safe and effective practice.”

Is that not the problem that Geoff Catling and Robert Lake have picked up—the training of CFRs?

That is indeed what they are talking about, and I shall address it shortly, but it too is an excuse and a lie, as I shall point out later. CFRs in other ambulance services with fewer controls than the Staffordshire ambulance service use those drugs. It is an excuse, and the hon. Lady and other Members of Parliament should not be befuddled by excuses. The drugs are used by other ambulance services, and they have the approval of the Department of Health. I shall come to that in more detail shortly, but I am grateful to the hon. Lady, who has been a doughty defender of CFRs, for raising the issue.

Will my hon. Friend give way?

No, I will not. I want to move on, because I have quite a bit to talk about and other people want to speak. I shall give way to my hon. Friend later, because I know that he will have a chance to speak during the winding up.

Seven drugs have been withdrawn from CFRs: Atrovent, diazepam, Entonox—a gas—glyceryl trinitrate, midazolam, Pulmicort and Salbutamol. They are used to treat life-threatening asthma, prolonged and repeated fitting, severe pain, cardiac chest pain, childhood croup and severe pulmonary conditions. In each case, the Medicines and Healthcare products Regulatory Agency says that it is legal to provide the drugs, as they are administered orally, nasally or rectally and are therefore not covered by medicines legislation.

In fact, where the Medicines Act does restrict use of certain medicines—parenteral medicines, which are administered by injection—there is no bar to anyone using them in an emergency situation in order to save a life. Two such medicines, adrenaline and glucagon, are still being used by Staffordshire CFRs. There is no bar to CFRs using the drugs. Indeed, they are still being used by CFRs with less training in other ambulance services which have fewer protocols for keeping the drugs, including east midlands and Northumbria, where they are still being used to save lives, just as they could be used to save lives in Staffordshire. Who do the Staffordshire management think they are kidding?

In addition to the specific legal restrictions—this is the point raised by the hon. Member for Staffordshire, Moorlands—trusts need to ensure that their clinical governance arrangements are sufficiently robust to ensure safe and effective practice. That includes appropriate logistics as well as internal regulation and audit procedures. However, ever since the CFR programme began, Staffordshire ambulance service has had measures in place to address that—measures more complex and robust than in other ambulance services where the drugs have not been withdrawn. Whenever a CFR administered a drug to a patient, that drug was replaced from the back-up ambulance under the same procedure that paramedics use. It is a simple one-for-one arrangement that worked perfectly well. The details of the drug—its name, amount, batch number and expiry date—were recorded on the patient report form that accompanies the patient to hospital, and the ambulance service permanently retained a carbon copy.

I understand that a more strict and cumbersome arrangement is being devised in Staffordshire, but I know from the CFRs themselves, as I am sure the hon. Lady does, that even though the present arrangement is being used quite appropriately and legally in other ambulance services, CFRs in Staffordshire alone are happy to accept the added burden of paperwork if it means that they can continue saving lives. Let us not forget that they are volunteers who have undergone eight months of training and that many of them are doctors or have medical backgrounds—as I keep saying, they have a greater depth of training than CFRs in other regions, all of whom are allowed to use the drugs—and let us be clear that there has not been a single improper incident with the drugs and that many lives have been saved as a result.

The hon. Gentleman mentioned that some of the CFRs are doctors. Is it not the case that a doctor would be able to administer all 13 of the drugs?

Yes, but some of the CFRs are not doctors. They get to the scene first. Just as in other parts of the country, they were able to prescribe and give the drugs. They are not being allowed to do so now, and people will begin to die one by one in consequence. I repeat that there has not been a single improper incident involving the drugs during the past few years, and that many lives have been saved as a result.

I move to the question of equipment. As if taking such medicines from the first people on the scene was not bad enough, the new management of Staffordshire ambulance service have also withdrawn from all their emergency response teams, including regular ambulances, equipment proven to save lives in serious heart attack cases. When someone has a cardiac arrest, there are just a few minutes to save their life. Defibrillation does not always work, so cardiopulmonary resuscitation, which I have used, must be applied directly to the heart. I can tell you, Mr. Amess, that it is hard work. It can crack the sternum and break ribs, but compressing the heart manages to circulate some of the blood supply. That circulation is only 25 per cent. of normal circulation, which often is not enough.

ResQPOD is a device that artificially increases the amount of oxygen in the blood, thus getting more oxygen to the brain, heart muscle and other vital organs, and it increases the amount of oxygen that circulates under CPR by about 50 per cent. ResQPOD has been withdrawn, and again, our management friends, Mr. Lake and Mr. Catling, feature in this sad story. They cite safety reasons, but I have spoken personally to Dr. Keith Lurie, professor of internal and emergency medicine at the medical school at the university of Minnesota in the United States, and the reasons given for the decision taken in Staffordshire are spurious.

Let us be clear; we are talking about dead people, those whose hearts have stopped. ResQPOD is a life-saving device, and Lake and Catling—alone it would seem—are claiming that it is not. Yet it is used by other ambulance services in the United Kingdom—although, interestingly, not by the West Midlands ambulance service—and by ambulance services in the United States, whose legal system would soon see to it that it was quickly withdrawn from service if there were any doubts about its safety. It is also used in Canada, France, Germany and Scandinavia. I trust their judgment; I do not trust the medical judgment of Lake and Catling.

The future of the LUCAS unit is also in doubt. It is a mechanical device that provides chest compression during CPR and it effectively does the job of a paramedic by compressing the chest at a rate of 100 compressions per minute, which is very difficult to achieve or sustain. Anyone who has tried CPR will know how hard it is to sustain that rate for a minute or two, but the device does it automatically and indefinitely. It has not been withdrawn yet, and I hope that it will not be.

Each year, out of every 1 million people, about 1,000 suffer a cardiac arrest and will receive CPR. Fewer than 50 of those survive if manual techniques alone are used. If ResQPOD is used, the chances of a patient surviving a serious heart attack is doubled. If a LUCAS unit is used in combination with ResQPOD, and only if it is so used, the chances double again. Together the two devices keep blood flowing to and from the heart at 50 to 70 per cent. of the normal rate, which is much higher than the 20 per cent. figure achieved from the use of manual CPR alone. In Staffordshire, an average of 20 lives are saved; they will not be saved next year if the ban continues. That has all come about since plans for regional ambulance services were announced.

I have said from the outset that I want the best for the people of Staffordshire, the west midlands and the UK. I do not mind in principle if services become regional, or even national, as long as the service is, at the very least, as good as it is in Staffordshire. However, because Staffordshire has been consistently at the top of the performance tables for all measures of good service, such as response times and survival rates, it is the regional service that must improve—not the other way round. Lake and Catling say that response times are still tops, and for once I agree with them. That is great, but arriving swiftly at the scene is just part of the equation: without the vital drugs and equipment, paramedics, CFRs and ambulance crews can do nothing.

It is increasingly clear that the new management have an eye on the regional service, with the result that the people of Staffordshire are already beginning to suffer through the withdrawal of life-saving medicines and equipment. The morale of those who work so hard for the people of Staffordshire is already beginning to fall, through no fault of their own. I dread to think how many lives will be lost in Staffordshire when all the hard work they have put in to building a system that works simply evaporates because the regional service will not open its eyes to a common-sense approach. As I have said in this Chamber before, the Minister should be proud of what we have achieved in Staffordshire, and should want to repeat it elsewhere.

Before I close, I shall give the House some statistics and an example. Each day since 18 October, when Staffordshire ambulance service decided to restrict medicines, a CFR has been forced to wait helplessly with a patient, waiting for up to 45 minutes before a medicine that they could have administered on 17 October was administered. I shall read an extract from a message sent by “call sign 699”, who is a Brewood CFR group operator:

“job no:- 30/11/06/337 (Staffordshire Ambulance’s 337th incident last Monday), time 17:39, age 83, trauma (shaft femur), (broken thigh bone, near the top, the jagged ends will have been pulled by her thigh muscles so they overlapped, shortening the leg by about three inches—making diagnosis easy and the pain terrible) drug required:- entonox (gas and air–50 per cent. nitrous oxide, 50 per cent. oxygen—it would have dulled the pain enough to have allowed the ambulance crew to move her onto the ambulance as soon as they arrived; instead there was a further delay of about ten minutes while they set about dulling the pain”.

That drug could previously have been administered by CFRs and it has been unilaterally withdrawn by the Staffordshire ambulance service, even though it is in use by other CFRs in other parts of the country. The message continues:

“time for back up—14 mins (not bad: imagine an accident like this happening up in the Moorlands in a blizzard when the air ambulance can’t fly and the land ambulance is stuck on the Leek to Buxton road. How long would the poor old lady have had to wait for pain relief then?)”

That was sent by a community first responder called Ann.

It can easily take an ambulance 30 minutes to reach some areas—longer in winter—and we should note that the air ambulance does not fly at night or in bad weather. It is telling that no one from the West Midlands strategic health authority or the West Midlands ambulance service has visited a Staffordshire CFR group to see how it operates or to see the nature of the terrain. CFRs and community paramedics get into remote areas and deliver life-saving support—the Minister should note that it is a success story. However, although they are still the first on the scene of an emergency, they are no longer able to help. In the worst cases, they will be forced to watch someone go into cardiac arrest before they can attempt to help, knowing that before vital medicines and equipment were removed by the Staffordshire ambulance service’s management, they could have prevented it from happening.

The merger or “partnership”, as it is called, between the Staffordshire and the West Midlands ambulance services is developing into one of our worst fears. No sensible explanation has been given as to why, in the build up to the merger, drugs and equipment still in use in other ambulance services in England and elsewhere were suddenly considered to be illegal or dangerous for use in Staffordshire. The action by Staffordshire ambulance service to withdraw CFR drugs and ResQPOD is down to a major clash of cultures and, as it is neither practicable nor permissible for an ambulance service to operate different standards in a region, it is easier—and, I guess, cheaper—to restrict the medicine and equipment that Staffordshire’s emergency medical services carry than it is to train its colleagues in the west midlands.

It is disheartening to note that, perhaps uniquely, by merging the two services and ignoring best practice there is a real risk that clinical care will be reduced and operating costs and deaths will go up. The question that I put to the Minster is this: if community first responders and paramedics cannot treat emergency patients with appropriate medicines and equipment, why is the ambulance service still dispatching them? If that is being done to meet response time targets, it is surely a despicable misuse of volunteers that cheats patients because, without the vital drugs that have been withdrawn, the CFRs can do little when they arrive.

I started the debate with a figure. People in Staffordshire are nearly five times more likely to survive a heart attack than the national average. The people of Staffordshire in such circumstances are now five times more likely to die. I urge the Minister to use all the power of his office to sort this mess out because he will have a much more serious debate on his hands as soon as the first life is lost that could have been saved. The clock starts ticking with that first unnecessary death. I, for one, do not want that debate to be necessary.

rose—

Order. The winding-up speeches will begin at midday. Four hon. Members wish to speak and I want to call all of them, so I hope that they will share the time out between themselves.

I congratulate the hon. Member for Lichfield (Michael Fabricant) on securing this important and timely debate.

Passions have been running high in Staffordshire ambulance service over the past few weeks, especially since 17 October, when the bombshell was dropped that the 13 drugs that were previously available to community first responders had to be restricted to just six. As acting chief executive Geoff Catling admitted, withdrawing those drugs was like cutting off one of their arms. However, his view was that he had no choice but to make that decision, to protect both the community first responders, and the trust and its legal position. He said that the issue was a legal minefield. The problem concerns the interpretation of the Medicines Act 1968 and who can be responsible for the safe and secure handling of medicines.

On the other side of the argument are people such as John Jones, team leader of the Biddulph Moor community first responders, who says that there is no legal reason why he and his fellow community first responders cannot be allowed to administer all the 13 drugs that they have used for the past seven years without any problems at all. I fully understand their frustration. Community first responders are not just gifted amateurs; they are professionally trained to ambulance technician standards.

The community first responder schemes in Staffordshire operate under strict criteria for recruitment, personal specification, training, assessment and hands-on exercises. The schemes are maintained and managed by a qualified paramedic, and all community first responders, like trust employees, have 24-hour access to a trust doctor via the telemedicine desk in ambulance control. That allows online advice and a second opinion if appropriate, which ensures patient safety.

Let us be clear about the vital role of community first responders. They are local volunteers, operating mostly in the more remote rural areas, which is important in my constituency. There, the ambulance response may be a little slower, so community first responders are nearly always the first on the scene. They do not know what they will find when they arrive, but they have the professionalism, the bravery and the commitment to assess the situation and to take control until the ambulance gets there.

Staffordshire ambulance service emergency response times are the best in the country, and have remained so, but in remote rural areas such as mine, the weather, terrain and isolation can cause a delayed response. That means that those who volunteer to become community first responders are life savers. There is no doubt at all about that. Restricting the drugs that they can use has angered, demotivated and undermined the community first responders.

The view of the Medicines and Healthcare products Regulatory Agency is crucial. It has issued a statement—part of which the hon. Member for Lichfield read out—that says:

“The view of the Medicines and Healthcare products Regulatory Agency is that community first responders are in a similar position to Trust employees if they…are engaged by a Trust to provide emergency response services as part of the Trust’s business…are trained by and subject to the direction and control of the Trust; and…work on its behalf and are fully accountable to it.”

Community first responders clearly meet all three conditions. The MHRA continues:

“This means that they can be supplied with appropriate drugs by the Trust without contravening the Medicines Act.”

However, as I indicated earlier, there is another paragraph, which is where the problem arises:

“However, in addition to the specific legal restrictions, Trusts need to ensure that their clinical governance arrangements are sufficiently robust to ensure safe and effective practice. This would need to cover issues such as the training of community first responders, guidance on the use of medicines, storage and stock control”.

The hon. Lady is correct to read that out and I am grateful to her for doing so, but she will know that the previous chief executive sought advice on those very issues. He was assured that the standards of logistics, training, storage of drugs and so on met those requirements, which, moreover, are tighter than those that are in place in Northumbria and the east midlands, where the drugs are still being used. Why has it suddenly been decided that the protocol is illegal, when previously the protocol, which had been considered by the Department of Health, was judged to be legal?

I am coming to that issue. What the last paragraph of the MHRA’s statement indicates is that the Staffordshire ambulance service needs to ensure that the training of community first responders and the guidance on the use of medicines, storage and stock control are up to full scrutiny.

The training of community first responders in Staffordshire is certainly more extensive than in any other training regime for community first responders, with a minimum of 160 hours, proper assessment, five shifts with ambulance staff, and hands-on experience of up to 16 hours. The training regime is similar to that for ambulance technicians, but the problem seems to be that it is not approved or accredited by an outside medical body. I understand that it is provided by Northern college, which does not even award any qualification.

That seems an awful waste, because many people spend more than eight months, and sometimes nearly a year, training to become community first responders. They put in all that time and effort, entirely voluntarily, yet at the end of the training they do not receive any recognised qualification. They are regarded by the trust as lay people, when they clearly have a lot of expertise and are, in effect, ambulance technicians. The acting chief executive, Geoff Catling, is going to look at the training syllabus, but I do not understand why that has not been done before. Although there might be an issue concerning the amount of hours that community first responders can spend with a qualified paramedic or technician, the training is virtually identical to that of an ambulance technician.

It is nearly six weeks since the drugs were withdrawn, and I am concerned that there is evidence that some community first responders are voting with their feet. Some are not responding to certain calls. The problems centre on the withdrawal of Salbutamol, GTN and Entonox, because the community first responders now cannot offer relief for an asthma attack, treat chest pains or offer pain relief for trauma. They cannot use those drugs and therefore have to sit back while they wait for the ambulance. They can use treatments such as adrenaline in certain circumstances, but often they have to sit back unnecessarily while the patient is suffering, even though they know full well how to relieve that pain.

The Staffordshire ambulance working group is meeting tonight to try to find a way around that problem, but for us all, particularly the community first responders, things are taking far too long. The withdrawal of the drugs is clearly a temporary measure, but many community first responders are becoming disillusioned. Perhaps it is not surprising that conspiracy theories abound, many of which we heard from the hon. Member for Lichfield. According to those theories, the decision is supposedly about dumbing down the Staffordshire ambulance service and reducing its effectiveness, so that a merger with the West Midlands ambulance service can come about. That is because a merger will not take place until the performance of the West Midlands ambulance service matches that of the Staffordshire ambulance service. However, all the talk of dumbing down does great discredit to the hard work that is done in the ambulance trust every day of the year.

The same sort of claims have been made about the withdrawal of the ResQPOD. However, that decision was prompted by none other than Dr. Anton van Dellen, the former deputy chief executive and Roger Thayne’s right-hand man. Anton was concerned about the theoretical risk of fluid accumulating on the lungs when the ResQPOD was used with the LUCAS device, normally known as the “thumper”, during the treatment of cardiac arrest. The opinions of three external experts have now been sought, and their recommendations are now with the director of clinical performance, Dr. Matthew Wise, for his consideration.

I am familiar with the ResQPOD device. It is interesting. On the issue of blood arising in the pleura, one has to remember that the patients are dead. The experiment was done two and a half years ago and there is some doubt about it. As I said, if there were any doubt about whether the ResQPOD is safe, would it be as widely used as it continues to be in other ambulance services in the United Kingdom, the United States, Canada, France, Germany and Scandinavia? That experiment is irrelevant. Once again, only in Staffordshire do we suddenly discover that such things are an issue.

I bow to the hon. Gentleman’s greater medical knowledge, but Anton van Dellen is and has always been well respected in the trust. I do not believe that he would decide—and it was his decision to make—to withdraw the ResQPOD unless he was worried about it. He originates from South Africa and has huge experience. He is well respected by paramedics, management and community first responders. The decision had to be his.

In conclusion, I should say that there is real concern in the Staffordshire ambulance service about the withdrawal of the drugs and the ResQPOD. A very long time has passed, certainly since the ResQPOD was withdrawn from service. I urge the Minister to involve his officials to try to speed up the process.

We are coming up to the Christmas period, when community first responders will clearly be in great demand. I urge the Minister to try to ensure that there is a decision before Christmas on both the drugs and the ResQPOD, so that the performance of Staffordshire ambulance service can continue to be as great as always. As yet, there has been no evidence that those withdrawals have led to lower performance on the part of the ambulance trust.

I have no problem with the partnership between Staffordshire and West Midlands ambulance services. That has nothing to do with the withdrawal of the ResQPOD or the drugs. However, it is important that we overcome the problem, because the future of our community first responders is very much at stake.

First, I congratulate my hon. Friend the Member for Lichfield (Michael Fabricant) on an excellent speech that contained a huge amount of apparently unanswerable technical information. I also congratulate Mrs. Jean Tabernor and Mrs. Ann Edgeller, who are here today, and all those who have contributed to the magnificent movement—that is what it is—in my constituency and elsewhere in Staffordshire to save our vital service and ensure that that is done properly. That was the burden of my hon. Friend’s argument, which remains on the table. I shall be fascinated to hear what the Minister says. I have a meeting with another Minister of State at 12.15 pm; I hope that this Minister will understand that I have to go. However, I shall read what he said afterwards.

One of the most compelling arguments is about the relationship between the consequences for people caught in the impossible circumstances in which a person has a five-times better chance of being saved in Staffordshire, and the consequences for those elsewhere in the country. The constituency of the hon. Member for Staffordshire, Moorlands (Charlotte Atkins) includes an area adjacent to mine. All her remarks about the hill farm areas are extremely important, particularly given the extreme weather conditions that can prevail up there.

I was particularly intrigued by what I thought she was saying—that the merger would not take place until the regional arrangements were up to the same standards as Staffordshire’s. I do not know where she got that from; that has not been put forward by anybody else, at least to my knowledge. I shall be happy for her to intervene and correct me on that.

It has been made clear that the partnership board will propose a merger when the West Midlands performance is up to the standard of Staffordshire’s. It is made clear in the partnership documents that the Staffordshire ambulance trust will have to make a decision on the merger only when that would not jeopardise patients.

No doubt the Minister can make that clear, but it is certainly not commonly understood. Whether the West Midlands service manages to maintain such standards is crucial to how the operation would be conducted and how the merger would take place. I continue to oppose the merger, and it is not just a question of medical equipment and CFRs. There are profound reasons, to do with regional arrangements that preclude a proper service for Staffordshire people. I do not believe that it will be possible, in realistic terms, for the five-times proportional difference to be made up by an improvement in the West Midlands service as a whole. I would require an enormous amount of proof to be convinced of that. There is no evidence for it; it is just an assertion. I leave it at that for the time being.

My hon. Friend raised extremely serious legal issues. To say the least, I have been extremely annoyed at the Government’s responses. I am sure that my constituents have been as well, given that I have presented two petitions in this field of endeavour with something like 5,000 signatures from my constituency alone. For example, the Government’s response to my 8 February petition to Parliament was that no observations would be issued on the petition. I find that intolerable; the Government know perfectly well what is at stake.

I repeat what I have said before, although Labour Members will take exception to it; they have in the past. During the 7 February House of Commons debate, all nine Staffordshire Labour MPs failed to support the motion opposing the merger as expressed in the terms of reference. That is on record. I should also say that on 26 February, the Conservative-controlled Staffordshire borough council passed a motion opposing the proposed merger. All the Conservatives supported the motion; none of the Labour councillors present did so. That is the record. I find the behaviour of members of the Labour party somewhat disingenuous, although I understand the reasons for it. I do not want to deprecate the reasons for it in themselves, because I am sure that Labour Members have a proper sense of duty to their constituents. However, difficult dilemmas arise, and to my mind it is clear that when the test has come, members of the Labour party—in Parliament or the local council—have, in general, supported the Government’s position. That remains a matter of record.

On the question of legality and the important matters raised by my hon. Friend the Member for Lichfield and the hon. Member for Staffordshire, Moorlands in respect of the Medicines Act 1968, there may be a solution in the hands of Government. My hon. Friend mentioned correspondence from Mr. Catling, and the hon. Lady also mentioned correspondence that is on the record. I believe that there is a procedure that could be used in a serious dispute about whether the Medicines Act and other medical legislation is applicable, but it is open to the Government to determine whether to use it; that is, to go for a declaration in the High Court, as there is clearly risk of death—my hon. Friend made that clear—and the matter of five times proportionality is very serious. I do not believe that there is the slightest chance that the West Midlands arrangements will ever come up to the standard that has been set. These are questions of great importance; of life and death.

The hon. Member for Staffordshire, Moorlands said that people were no longer prepared to take the action that they took until quite recently. Apparently, some people are not taking up the voluntary activities that they did in the past. I suspect—I do not know for sure—that the authorities in question have acquainted them with questions about insurance and negligence, and exposure even to legal action if they were to continue to provide services. So we have not only the differential in respect of potential for death as a result of the failure to make proper arrangements—that is in the hands of the Government and the trust—but the question whether the people who could provide the service have been warned off.

There are doubly good reasons why such matters should be taken up by the Government. Merely providing an opinion may or may not be sufficient. First, because the situation is serious, the Government should take leading counsel’s opinion, and that may need to be tested in the courts if we do not get the right answer.

I remain opposed to the merger. It will not work. I congratulate my hon. Friend on his expert analysis of the situation, and I concur with his conclusions. In this matter, the Labour party as a whole has failed the people of Staffordshire over an extended period. I await what the Minister has to say, but there is absolutely no evidence in anything that I have heard so far that the merger will be called off and/or that the situation for the people of Staffordshire will be materially improved in respect of the matters raised by my hon. Friend.

I shall try to be brief, Mr. Amess. I, too, congratulate the hon. Member for Lichfield (Michael Fabricant) on obtaining this debate on an important subject in Staffordshire at an important time. However, his blame of the trust management is ill-judged. As Staffordshire Members of Parliament, our united voices should be directed at the Minister, who should be spending time daily to sort out the problem until it is resolved.

Let us remember that Staffordshire ambulance service is the best in the country. The Government’s target is for three quarters of class A emergency calls to be responded to within eight minutes. Even in the past 12 months, Staffordshire exceeded that target every month. It usually performed at between 86 and 87 per cent. That is why it is the best performing ambulance trust in the country.

It is also why, apart from London, which was not involved in the merger configurations, Staffordshire was the only ambulance trust that was not forced into a merger with a bigger organisation. That was a recognition by even the Department of Health that it is the best performing ambulance trust in the country. Because there is now a West Midlands ambulance trust, the Government directed that the two trusts must work together to raise standards throughout the west midlands so that eventually there can be one West Midlands ambulance service. That is why a partnership direction was given, and why there is a partnership board. It is no surprise to me that issues have arisen as the practices of both trusts are examined and questions are asked about the legality of this and the clinical effectiveness of that. A responsible board such as that of the Staffordshire ambulance service trust must take seriously allegations of clinical ineffectiveness or illegality when it decides how to respond to an outside allegation, and that is what has happened.

Several setbacks have occurred during the past six months. The service lost several patient transport contracts—that was not because of the board’s leadership or the Department but because of withdrawal of the ResQPOD. The decision was taken on clinical grounds, as my hon. Friend the Member for Staffordshire, Moorlands (Charlotte Atkins) said.

Probably the biggest single reason why Staffordshire has the best ambulance trust in the country is the excellent leadership of its former chief executive, Roger Thayne. He is a man who takes innovation to a new level, especially in the national health service. Some of the issues that he left to the ambulance trust are now occupying the time of the partnership trust. Roger himself contributed to one of the difficulties of the past six months when he questioned the legality of some of the directions given by the Department in the partnership direction, and the ambulance trust had to obtain legal advice on the issue. There was also the suggestion by a whistleblower that the trust was not collecting figures on response times properly. That has been dealt with and put to bed.

The hon. Member for Lichfield raised the latest difficulty, which affects the community first responders. The question originally was whether the seven drugs that were withdrawn in October were being held and administered illegally by volunteers, in contravention of the Medicines Act 1968. I believe that the issue has now been resolved to everybody’s satisfaction. The regulatory authority, the Department, and the regional and strategic health authorities all accept that the Act does not provide a valid objection to community first responders holding and administering those drugs. The debate has moved on to whether applicable pharmacy rules would restrict their use. That is the remaining issue, and the Minister must resolve it as soon as possible. I echo what others have said about it.

In the meantime, the ability of an absolutely brilliant arrangement in Staffordshire—it was another of Roger Thayne’s innovations to use community first responders, especially in isolated rural locations—to augment the excellence of the ambulance service is being restricted. That is causing anger, demoralisation and despondency among people who know that they can help yet have both their hands tied behind their back until the issue is resolved. That is the urgent matter in today’s debate, and that is what I want the Minister to respond to.

I shall try to be brief, Mr. Amess. I congratulate the hon. Member for Lichfield (Michael Fabricant) on securing this debate.

Those of us who are not community first responders can only imagine how dispiriting it must be to attend an emergency and not be able to give the pain relief or other treatment that was available until the middle of October. My constituent David Holt, who is the secretary of the Staffordshire community first responders, is keeping a record of all incidents in the county in which patients suffer unnecessarily. In a briefing to Alex Fox, the chairman of the South Staffordshire primary care trust, he stated that, on average, once every day since 18 October a CFR has sat helplessly with a patient for up to 45 minutes waiting for a paramedic to administer Salbutamol, GTN or Entonox. What is even more frustrating for David Holt and the first responders of Mayfield in my constituency is that over the border in Derbyshire, East Midlands ambulance service recently trained its CFRs in the use of Salbutamol and GTN spray and issued those drugs to them. Mayfield and Ellastone CFRs used the drugs for four and a half years before 18 October without any adverse incidents.

I understand from David Holt that no one from the strategic health authority or the West Midlands ambulance service has visited Staffordshire CFR groups to see how they operate. I would urge them to do so. Having said all that, I can well understand the actions that the Staffordshire ambulance service, faced with the advice that it received from the strategic health authority in October, took to ensure that the community first responders were acting legally. It now seems clear that the advice, which according to the press release issued by Staffordshire ambulance service concluded that some drugs

“were not eligible for use by lay people under the national legal framework for medicines”

and that

“management policy falls outside the Medicines Act”,

was wrong.

In fact, even as long ago as July, the Medicines and Healthcare products Regulatory Agency stated in its e-mail to Staffordshire ambulance service that

“medicines legislation does not address the administration of non-parenteral medicines so there is nothing to prevent CFRs administering the remaining drug products in your letter”.

That e-mail was in response to a letter from the Staffordshire ambulance service that, I believe, listed a total of eight drugs, four of which are banned. All four of those drugs—Entonox, Salbutamol, GTN and diazepam—are non-parenteral and therefore are not covered by medicines legislation. Another two of the banned drugs that were not listed in the letter—Atrovent and Pulmicort—are also non-parenteral.

In a recent reply that I received from the MHRA, Professor Kent Woods confirms that the MHRA was not involved in the trust’s decision to withdraw the medicine. The letter clearly states:

“The Agency has taken the view that if community first responders in Staffordshire were engaged by the Trust to provide emergency response services as part of the Trust’s business, are trained by and subject to the direction and control of the Trust, work on its behalf and are fully accountable to it, they are in a similar position to trust employees; i.e. they can be supplied with…drugs by the Trust without contravening the Medicines Act.”

Professor Woods went on to say:

“The Trust’s clinical governance arrangements relating to use of medicines, documentation etc. do need to be sufficiently robust.”

We have now gone from a question of legality to a question of the clinical governance that needs to operate. I know that the CFRs are willing to have tighter protocols if that means that they can relieve the pain or suffering of those they attend before a paramedic or ambulance crew arrives. I have urged Staffordshire ambulance service to reach a speedy conclusion to this unfortunate situation.

We are grateful to Ministers for listening to our concerns earlier this year. I now urge my hon. Friend to press the strategic health authority for an urgent decision on the advice that they can give to Staffordshire ambulance service. It would also be helpful if he could give a clear reassurance that it is not about a dumbing-down of the service offered to Staffordshire people and if he could put an end to the conspiracy theories that seem to be circulating.

I join other hon. Members in congratulating the hon. Member for Lichfield (Michael Fabricant) on raising the issue. As we have heard from all the Staffordshire Members who have spoken so far, it is clearly an urgent issue that needs to be resolved forthwith. As the first non-Staffordshire Member to speak in the debate, I have been convinced not only today but in previous months of the quality of the service provided by the Staffordshire ambulance service. Hon. Members from the other two parties have repeatedly pressed the fact of the quality of the service in expressing their concerns about the proposed merger and I want to put on record my appreciation of all the work that is done by the paid staff of the service and the volunteers about whom we have heard today.

I find it strange, coming completely from the outside, that some fairly serious allegations are being made by the hon. Member for Lichfield, who has accused professional ambulance management of being liars and unprofessional. He clearly feels passionately about the matter. We have had some more measured contributions to the debate, too, but the key issue remains. In relation to the withdrawal of the drugs, has one ambulance service spotted something that no one else has? In a sense, that is sometimes the benefit of regional and local services; they can do things differently and if they have done so for a good reason, perhaps others should follow. I do not get any sense that, where Staffordshire ambulance service has led in terms of the withdrawal of drugs, any other ambulance trust has followed, although I am happy for the Minister to correct me on that. It seems that, although ambulance services are at liberty to consider the issue, it must not be allowed to go on.

I was interested that no one has so far referred to the letter from the chairman of Staffordshire ambulance service to the Staffordshire media, which is dated 16 November. He said:

“In regard to the actions taken to reduce the number of drugs that can be administered by CFRs in Staffordshire, the decision was taken…on the grounds of patient safety.”

He went on to say:

“We have always said that this action is a temporary measure”.

I find that quite interesting. I did not pick up from the speech made by the hon. Gentleman that the ambulance trust was saying that the measure was temporary. Clearly, that is what the chairman was saying in writing two or three weeks ago.

The chairman went on to say that

“we will re-introduce these drugs if, and when, it is legal and safe to do so.”

That is where the role of the Department of Health comes in. To some extent, the trusts are regional, devolved bodies that are charged with getting on with the job. If there is an inconsistency between what trusts are doing, if they are interpreting the law in different ways and if, potentially, patients in one part of the country are losing out, the Minister has a role to consider what is going on, the different practices and why different trusts might be getting different legal advice, and to try to provide some consistent advice to the trusts so that they can provide the same quality of care across the area.

With regard to the withdrawal of the ResQPOD, there seemed to be some discussion as to whether that was a clinical judgment, as the hon. Member for Staffordshire, Moorlands (Charlotte Atkins) suggested. One person has judged that there might be clinical issues, and I understand from the debate that the ambulance trust has sought expert clinical advice from other people and is now considering it. That seems to me to be an entirely proper procedure. It would be wrong if any of those changes, as was intimated by the hon. Member for Lichfield, had been motivated not by clinical care but by organisational fiat or some political agenda. I was trying to work out quite what he was alleging. There were lots of hints, nudges and suggestions. I think that he was saying that the decisions are not being made because they are the right things to do or because there is some uncertainty, either about the legal position or the clinical implications, but because of forced harmonisation with the larger trusts.

I was not saying anything like that. I was saying that I do not know why it is being done. Why are there these questions when it is apparently perfectly legal to use such things in other ambulance services? Why are ResQPODs suddenly regarded as dangerous when they are used by other ambulance services throughout the world? We do not know the reason—we can only speculate, as I said in my speech.

What worries me is calling people liars and unprofessional, but only speculating on their motives. Clearly, my plea in this debate would be for transparency on the part of the trust. That is essential. The letter from which I quoted said that the decision to withdraw the drugs was

“on the grounds of patient safety.”

What triggered it? Who raised the issue of patient safety and what was the case? We need to know that, and whatever else has happened the trust should have been more transparent. We have some more understanding of why the ResQPOD was withdrawn. I hope that the clinical advice will be published—there is no reason why it should not be—and that the decision will be made quickly.

Transparency is important in such matters. In terms of NHS reform, the public sometimes legitimately worry that changes are being made not on a clinical basis but because of cost or some other agenda. When trusts are making decisions that they believe are to do with legal advice or clinical judgment, they can be open and up front about it. I do not see any reason for that not to happen.

During the debate, we heard that the hon. Member for Stone (Mr. Cash), who is no longer in his place, submitted a petition on the issue. It is disappointing when hon. Members of any party submit a petition with a large number of constituents expressing a concern and the Government decline to offer a comment. The Minister might feel that they had said all that there was to say, but it undermines our efforts as constituency MPs if we gather the views of thousands of our constituents and they are simply disregarded by the Department. I hope that the Department will consider its policy on responding to petitions and will think again about that.

We heard the hon. Member for Stafford (Mr. Kidney) praise the previous chief executive, who certainly seems to have done an outstanding job. His views have been placed on the record. The hon. Member for Staffordshire, Moorlands rightly raised the question of what has changed now, if the drugs have been used for seven years. We are talking about an Act that has been in force for 35 or more years, and that clearly has not changed, so why has the legal advice changed? What was the trigger? It comes back to my point about transparency; that is what we want. I take her point, which was also made by others, that many of the community first responders are well trained, highly skilled people who have been doing the job for a long time. I understand the frustration pointed out by the hon. Member for Burton (Mrs. Dean)—when people are on the scene, they want to do what they have been doing quite safely and they ought to be allowed to continue to do it.

In conclusion, I enter a plea for transparency from the trust. It should place on record much more fully the sequence of events that led to the two decisions. What advice did it receive, and where is it going? Will the Minister recognise the urgency that has been expressed in many of the speeches and try to resolve the inconsistencies where different legal or clinical advice has been given to ensure that the people of Staffordshire, as elsewhere, get the first-class ambulance service to which they have become accustomed?

I add my sincere congratulations to my hon. Friend the Member for Lichfield (Michael Fabricant). No Member more assiduously or ardently defends the interests of his constituents, or those of the Staffordshire ambulance service. On behalf of his constituents and of all the people of Staffordshire, he made a clear, robust and brave speech.

The reorganisation of the Staffordshire ambulance service—one of nine such reorganisations in nine years under this Labour Government—took place on the back of a spurious interpretation of Peter Bradley’s review and a sham consultation. The NHS Appointments Commission sent out letters two months before the end of the consultation asking for nominations for the chairmen and chairwomen of the new NHS ambulance trusts, at the request of the Department of Health. That was no doubt the process under which Messrs. Lake and Catling were appointed, as at the announcement of the merger proposal, Roger Thayne departed—to the great consternation and anxiety of the people of Staffordshire after such a wondrous spell as top guy.

One of the greatest travesties of the reorganisation was the treatment of the Staffordshire ambulance service. As I said in my response to the initial ministerial statement on the Floor of the House, the service has been put in the departure lounge. That debate was notable for the Minister’s dogged avoidance of a promise to protect the high standard of Staffordshire ambulance service.

I asked, as did my hon. Friends the Members for Lichfield, for Stone (Mr. Cash), and for South Staffordshire (Sir Patrick Cormack) and the hon. Member for Cannock Chase (Dr. Wright), for an assurance that no merger would take place until the West Midlands ambulance service trust had reached the standards of the Staffordshire ambulance service. No such assurance was given. It is increasingly plain to see why. It cannot or will not get there.

We warned and warned again. My hon. Friend the Member for Lichfield was too generous to the Government and the Department. They were warned, so the tragic consequences for the people of Staffordshire about which we have heard today cannot, by definition, be unintended. To ram something through, as the Department of Health has done with its mergers, despite being warned of the consequences that would inevitably flow from the change, means that Ministers intended the damaging consequences that have resulted. Unless they can account for themselves, they have no escape other than to be damned by their actions.

On the other hand, MPs across the House were reassured by the Minister’s promise to the hon. Member for Staffordshire, Moorlands (Charlotte Atkins) when she asked him to confirm that

“Staffordshire ambulance service will remain operationally independent and that it will have its own trust board and its own chief officer, so that it can continue to run its system, which is completely different from those used by other ambulance services in the country?”—[Official Report, 16 May 2006; Vol. 446, c. 864.]

However, his answer turned out to be just warm words. Barely three months later, my hon. Friend the Member for Lichfield came across a leaked e-mail that made it clear that operational independence was being eroded by the very ministerial team that gave the guarantee. The e-mail, signed by a senior civil servant on behalf of the Secretary of State for Health, stated that the chief executive of the West Midlands ambulance service must now be invited to board meetings of the Staffordshire ambulance service and that his “advice” must be taken in all important decisions. In addition, there would be joint control of personnel, finance and IT functions. By reneging on his promise to protect Staffordshire’s operational independence, the Minister has reneged on his promise that the Government

“would not want Staffordshire ambulance service’s standards to be eroded in any way.”—[Official Report, 16 May 2006; Vol. 446, c. 860.]

The Staffordshire ambulance service is slowly being undermined, and the decisions spoken of in today’s debate carry the inevitable suspicion that it is being levelled down to the overall standard of the rest of the area under the West Midlands ambulance trust, bearing in mind Staffordshire’s consistent pre-eminent position at the top of all score sheets before the merger proposals were made.

At the time of the announcement, I and others demanded that if the West Midlands ambulance service had not reached the standard of Staffordshire within the arbitrary two years set out by the Minister, no merger should go ahead. The Home Secretary had guts enough to scrap the totally misconceived police mergers, but the Secretary of State for Health has been found wanting in every respect when faced with exactly the same choice.

Although the Minister would not accede outright to the merger not going ahead, he intimated to the hon. Member for Burton (Mrs. Dean) that the two-year time frame was not set in concrete should more time be needed for the West Midlands ambulance service to come up to scratch. However, it is clear that the current chief executive of Staffordshire ambulance service wants to speed up the process, and he appears to be under pressure from the Department. He said in the summer:

“The directions handed down show the merger with Staffordshire should take place by 31 December 2007, but that could happen sooner, maybe by the end of this year”.

Will the hon. Gentleman give way?

I do not have the time, and the hon. Lady has already made her point in trying to defend the current management. Without taking the necessary steps to improve West Midlands ambulance service, the only way to speed up the process is actively to dumb down Staffordshire.

As we have heard, the ResQPOD was withdrawn, apparently on safety grounds. Every ambulance and paramedic car in Staffordshire carried one, but the West Midlands ambulance service does not use them. In addition, there have been fears that the LUCAS, often called the thumper, will similarly be banned—another device not used by West Midlands ambulance service. According to the NHS, people are four and a half times more likely to survive a severe heart attack in Staffordshire than in the rest of the west midlands because of the speed of response of the Staffordshire ambulance service and the community first responders and because of the training and equipment available to Staffordshire ambulance paramedic crews. Attempts to portray that decision as clinical fly in the face of the evidence—and, frankly, of reason. To say that it was done for reasons of safety is plainly a smokescreen for the politics of merger.

The latest development was the withdrawal on 18 October of seven of the 13 drugs administered by the community first responders. The trust invoked the Medicines Act 1968 to support that decision, but again a leaked e-mail from the Department of Health to the trust—I believe that it was sent on 26 July—saw no problem with all 13 medicines being administered by CFRs. My hon. Friend the Member for Stone mentioned an action for declaration if there was any question of doubt; the Minister has that within his gift and could order it today.

My hon. Friends in Staffordshire, the volunteer staff of Staffordshire ambulance service and the people of Staffordshire are having to fight tooth and nail to protect their ambulance service and community first responders. Patient choice was ignored with a sham consultation, and it continues to be ignored by bureaucrats bent on delivering a political and financial agenda rather than a clinical one. The Minister’s civil servants and the new chief executive of Staffordshire ambulance service need to account for the fact that they have not been able to keep the Minister’s promise to protect the people of Staffordshire by keeping their ambulance service at the level that they have enjoyed in the past, without suffering compromise in order to merge with the West Midlands ambulance service. It is right to ask the Minister: what has changed?

I, too, congratulate the hon. Member for Lichfield (Michael Fabricant) on securing this debate. I do not doubt his sincerity and strength of feeling on the matter. I also congratulate my hon. Friends the Members for Staffordshire, Moorlands (Charlotte Atkins), for Stafford (Mr. Kidney) and for Burton (Mrs. Dean) on their contributions to the debate. If every organisation in the NHS inspired such civic pride and as much interest and energy as the Staffordshire ambulance service, we would be in a good place.

The concerns expressed this morning are understandable, because the ambulance service provides the first point of access to health care for a wide variety of patient conditions, ranging from life-threatening emergencies to chronic illness and social care. The 12 NHS ambulance service trusts in England are the first and often the most important contact for the 6 million 999 callers each year. Of course, it is vital that patient care is not only safe but of a high quality. There has been a rising demand for the ambulance service. The latest figures for 2005-06 show 6 per cent. more calls than in the previous year and a 5 per cent. increase in the number of incidents attended. Despite that, improvements in response time continue.

I, too, take the opportunity to pay tribute to the hard work and dedication of staff at the ambulance service, including community first responders. Not long ago, I was a patient of the Staffordshire ambulance service, as I mentioned to my hon. Friend the Member for Burton. I had an accident on the M6, somewhere in the constituency of my hon. Friend the Member for Stafford. I was involved in a collision between a Government car and a foreign lorry. Even though the service knew I was a Government Minister, I was looked after very well indeed, which shows the professionalism and skill of the service.

On a more serious note, it seems that there is a high level of loyalty, commitment and passion for the job that the staff of the service do. That is to be commended. As part of that success story, the Government acknowledge the valuable support that community first responders offer as they are trained in life support and first aid, and are equipped with defibrillators. I gather there are 313 trained community first responders living in the boundaries of the Staffordshire service and a further 116 in training at present.

My hon. Friends mentioned individuals to whom they had spoken and I pass on my thanks and appreciation via them to their constituents for the work they do in supporting the NHS and, more generally, in helping people in the community who need support. At the same time, it is right for me to say as a health Minister that if we have people helping in our NHS it is vital that they operate within a proper framework of clinical governance and accountability. That, too, is an important consideration to bear in mind.

I have listened closely to the comments of the hon. Member for Lichfield and other hon. Members about the Staffordshire ambulance service. I also heard the plea for transparency that was made in a useful contribution by the hon. Member for Northavon (Steve Webb) and I agree entirely with him. Where changes are made, there should never be suspicion of an agenda that is anything other than patient safety. All of us as Members of Parliament should have that as priority number one, two and three regarding any changes that are considered in the national health service. Nothing should be done that knowingly compromises patient safety and I urge that clear statement to be the backdrop for what we are discussing.

The piece of equipment referred to as the ResQPOD, or impedance threshold device as it is also referred to, has been temporarily withdrawn from use by the Staffordshire Ambulance Service NHS trust. I understand that it was withdrawn because of concern regarding the theoretical risk of pulmonary oedema, which is fluid accumulating on the lungs, when ResQPOD was used together with another device—the LUCAS device—in the treatment of cardiac arrest. The trust felt that on the basis of the advice it received about the theoretical risk, it should suspend the use of the device and undertake a review, which it has been seeking external expert advice to assist with. I understand that the review has now been completed and that the recommendations are being considered so that a decision can be made by the trust as to whether or not to reintroduce the ResQPOD.

As my hon. Friend the Member for Staffordshire, Moorlands said, the advice came from the then medical director under the former chief executive that it was right and proper to withdraw based on evidence brought forward about the use of ResQPOD in connection with another piece of kit. In response to the hon. Member for Lichfield, I accept that there are international examples; I am not contradicting that. It is also important to say that no other ambulance trust in the UK is using the ResQPOD. External advice is being sought and the collective view of ambulance trusts is that a formal controlled trial of this piece of equipment is required before clear guidance can be given. I resent the comment made by the hon. Member for Eddisbury (Mr. O’Brien) to the effect that bureaucrats are bent on delivering a financial and political agenda. The suggestion that this is not to do with patients or patient safety does not further the quality of this debate one iota and was a mistaken comment to have made.

Clinical practice and governance of any group of individuals who are administering patient care is a matter that must be managed very carefully. The restriction of the number of drugs that community first responders in Staffordshire can administer as well as the equipment they use, is a matter for Staffordshire Ambulance Service NHS Trust. Staffordshire ambulance service has an obligation to ensure that it is providing a high-quality service and that it is acting in accordance with the law. When concerns were raised locally that the range of drugs administered by community first responders might be in excess of those permitted by the law, it is entirely understandable that Staffordshire ambulance service felt the need to take precautionary action while a review of its practice was undertaken.

I will now turn to the legal requirements that apply to the administration and supply of medicines. Under medicines legislation, the administration of injectable medicines is restricted. Unless self-administered, they may only be administered by an appropriate practitioner or anyone acting in accordance with the directions of such as practitioner. There is an exemption from those restrictions that allows anyone to administer a specified list of such products for the purpose of saving life in an emergency. Adrenaline and glucagon are examples of items on the list, which, as hon. Members know, are administered by community first responders in Staffordshire.

Apart from controlled drugs, there are no legal restrictions on the administration of non-parenteral medicines including those classed as prescription only medicines. However, the ability to obtain supplies of drugs is restricted. Controlled drugs are subject to additional legislation, which is set out in the Misuse of Drugs Act 1971 and the Misuse of Drugs Regulations 2001. There are different rules depending on the type of drug, but generally they cannot be administered by anyone other than an appropriate practitioner or a person acting on the directions of such a practitioner. Examples of controlled drugs are diazepam and midazolam. Drugs such as those may not be supplied to community first responders.

The list of some of the drugs that have been in use was given and the hon. Member for Lichfield will know, as he referred to them, that diazepam and midazolam are among the drugs being used by community first responders. I have a list of drugs used by community first responders in ambulance services around the country, which indicates that diazepam and midazolam are not being used. However, there is variation and in other places a more restricted list of drugs is in use and advice has been taken about what constitutes appropriate practice.

When the Medicines and Healthcare products Regulatory Agency was asked for its views on the administration of drugs by the community responders scheme that advice drew the distinction between drugs for oral administration and those intended for injection. The agency’s advice was that, under medicines legislation, drugs for oral administration could be administered by community first responders in their capacity as “agents” of the ambulance trust and within the trust’s guidelines for the community first responder scheme. After the trust took the decision to withdraw the drugs, the agency drew the trust’s attention to the fact that two products were also subject to the additional requirements set out in the misuse of drugs legislation, as I have said. I hope that the hon. Gentleman will accept that this raises important questions of clinical governance and patient safety and it is right that time is taken to ensure that the legal basis on which any such products are used is clear so that everybody knows where they stand.

I would briefly like to pick up on some of the hon. Gentleman’s other points. He said that community first responders have to wait for 30 to 45 minutes for an ambulance in some parts of Staffordshire. I wish to make it clear that community first responders are not a substitute for an ambulance. For category A calls an ambulance should arrive within 19 minutes of the 999 call 95 per cent. of the time and in addition to the initial community first responder. He also said that patients will die because community first responders cannot do anything when they get there. Again, it is important to be clear that community first responders are not a substitute for an ambulance; they should be deployed to patients whom they have the training to deal with. Where they are deployed, an ambulance should also be dispatched to the scene and be there in 19 minutes or less. Those are important points of clarification.

Some of these issues have raised questions relating to the governance of the ambulance service. The Healthcare Commission has recently been in touch with the ambulance service and has highlighted a number of areas of concern that it has asked the ambulance service to address. For the purposes of this debate, it is important that there is urgent clarification. I accept that and the point made by my hon. Friend the Member for Stafford. We need urgent clarification and to give people working in the field—the community first responders—absolute certainty about the ground on which they are operating so that we can continue to use their good will. However, I would say that the Government, in allowing the time that they did for these issues to be resolved in terms of the discussions about the merger of the two services, have been proved right by this debate.

I am grateful to have been granted this Adjournment debate and I am pleased to see my hon. Friend the Minister in his place, particularly given his special responsibility for dignity in care, which is the main theme of the debate. He will know from the exchange of correspondence with the Department, and from my informal conversations with him, of my concerns about standards of care at my local hospital. Those standards of care recently led our local coroner, Mr. John Pollard, to describe the treatment of some patients there as “despicable” and “chaotic”.

I am grateful that the Minister has already agreed to meet me privately to discuss the issue in more detail than the time available today will allow. However, today’s debate provides an opportunity for me to place some of my concerns on the public record. I genuinely regret that that has become necessary, but the issues that I shall speak about are extremely serious and have had a devastating impact on the lives of too many of my constituents. Those issues have also damaged public confidence in our local hospital. My main purpose today is to start to rebuild that confidence, and I believe that that will be possible only if there is an external and independent inquiry into what has gone wrong.

Tameside and Glossop general is situated in Ashton-under-Lyne and also serves as the local hospital for the constituents of my hon. Friend the Minister for Pensions Reform, who represents Stalybridge and Hyde, and my hon. Friends the Members for Denton and Reddish (Andrew Gwynne) and for High Peak (Tom Levitt). It is one of the smallest acute trusts. In many ways, it is a competently led and managed hospital. Financial management has been good; this is not a hospital in financial crisis. The hospital managers have frequently assured me that their staffing levels are adequate and appropriate. Just a couple of years ago, the hospital secured three-star status, and under the new assessment regime it is classed overall as “good”. What is more, Tameside hospital has met the criteria for, and been given approval to go forward with, foundation status. Most significantly, it has recently been given the go-ahead for a much-needed £100 million new hospital construction project, which will see the largely Victorian workhouse buildings swept away to be replaced by 21st-century facilities.

All that is tremendously good news for my constituents, but sadly there is another side to the coin, and too often the bad news has outweighed the good. A number of factors have contributed to that. First, the hospital’s standardised mortality rate is far too high. It is under investigation by the local authority health scrutiny committee. Next is the persistent and apparently insoluble infection problem, which has placed Tameside in the national top 10 worst hospitals for the incidence of MRSA. Then there are the long-running anecdotal stories in the local community about lack of care and dignity in treatment, particularly of elderly patients.

More recently, those fears have been given a new legitimacy—initially last year by one of the hospital’s own consultants, who made harsh criticisms of care standards, which he blamed on inadequate staffing levels. This September, the local coroner, Mr. Pollard, made his comments in court about “despicable” and “chaotic” treatment, which, not surprisingly, were picked up by the press and subsequently widely reported in the local and national media.

In the few weeks since the coroner spoke out in court, we have seen the emergence of the Tameside hospital action group, with more than 100 members, all of whom recounted stories of poor standards of care at Tameside hospital similar to those highlighted by the coroner and many of which could equally well be described as despicable or chaotic. Again, many of those stories have been picked up and widely reported in the press.

I would like to expand a little on some of those events. Last year, the hospital became the subject of media attention when one consultant went public with a whistleblowing claim that care standards were being adversely affected by inadequate staffing levels. The hospital management’s response was to invoke their disciplinary procedures against the consultant. Local press reports claimed that the consultant had been “gagged” and that the staff had been warned not to speak to the press. However, the hospital management did not deny the existence of problems. At that time, 18 months ago, the hospital’s medical director said:

“An action plan has been developed and approved by the Board to address a whole range of issues”,

which he said were “being fully addressed”. I would like to return to that later.

Also last year, the hospital was ranked seventh worst in the country for its standardised mortality rate. That was according to the respected Dr. Foster organisation. The number of deaths at the hospital was far greater than would be expected from a similar-sized hospital serving a comparable population. The local authority health scrutiny committee is investigating the mortality rate, particularly among elderly patients. As might be expected, that issue, too, has been widely reported in the media, to the apparent discomfort of the hospital management, who complained about the presence of the media at a recent scrutiny committee meeting. Such meetings are, by law, held in public. Among the reasons proffered by the hospital for the high standardised mortality rate is the supposed Shipman effect, whereby general practitioners and nursing home managers are reluctant to take responsibility for patients as they approach the closing days of their lives, and instead refer them for admission to the hospital.

In August this year, the hospital gained another unwelcome top-10 placing. We heard that the long-running persistent failure to eradicate hospital-acquired infection placed Tameside in the 10 worst hospitals in the UK for control of MRSA. Again, that was widely reported in the local media, and again the reason proffered by the hospital was that it was someone else’s fault. This time, we were told, the blame lay with the patients, some of whom were alleged to have brought the infection from home or from their nursing home into the hospital.

All that negative, but none the less accurate, media reporting has contributed to a loss of confidence in the hospital in a community that, as I readily acknowledge, has an understandable scepticism about the medical profession based on the still fresh memories of the depredations of Harold Shipman in Tameside.

The final ingredient in the brew came in September, when the south Manchester coroner, Mr. Pollard, held five inquests on the same day into the deaths of patients at Tameside hospital. In four of those cases, he found that standards of care had been unacceptable. He described the care of one elderly patient as “absolutely despicable” and the care of another as “chaotic”. He made his comments in court after being confronted with evidence of poor standards of care.

The hospital’s response was to issue a press release, which described the coroner’s comments as “unfair”. The press release also tried to shift responsibility for the distress of bereaved relatives, or for increased anxiety for patients, from the hospital on to the coroner.

Sadly, the reality is that what the coroner found in those four cases could hardly be regarded as isolated incidents. Too many such cases have been reported in the past, and subsequently the coroner has heard even more cases involving allegations of poor care standards at the hospital. The coroner has provided me with brief anonymised details of 20 such cases that have been come before his court in the past 10 months alone. I shall not read out details of all 20, as the Minister will be grateful to hear, but I will give one or two selected quotes from two-line summaries that the coroner has put together.

There was an inquest in April into the death of a man called Kenneth, whose son complained about his father lying in a wet bed in a disgusting state, with huge pressure sores, and said that the staff had been very rude to him. In May, the coroner heard from the son of a woman who had been told that she had “a bit of an infection”, which turned out to be MRSA and pneumonia. She had fallen out of bed on the ward, and that had not been recorded when the family asked about it.

In June, another man’s son said that his father had had two falls while in hospital. In September, there was an inquest into the death of an elderly lady who had had two hip replacements and then developed MRSA and septicaemia. She was left in her own excrement for three hours and ignored by staff. That was during the last days of her life. Concerns were voiced about cleanliness and hygiene. In another case, a son complained about the lack of care for his father and the lack of communication with staff. He, too, was lying in his own excrement, which had dried on his skin.

The last example that I shall give involves a woman whose case was heard in September this year. Her son complained that she had deteriorated rapidly in hospital. She had lost a lot of weight through not eating; no attempt had been made to feed her. She had been sitting in her own urine and faeces. She had pressure sores and was in a lot of pain. Those are just examples from 20 cases that have been before the coroner, in which allegations of that nature were made as part of the evidence to the court. It is therefore hardly surprising that the coroner chose to speak out about his concerns in September.

As a consequence of the storm of media interest that followed the coroner’s comments, the sheer scale of the problem started to become clear. The four cases that he mentioned appeared to be the tip of an iceberg. In the few short weeks since the Tameside hospital action group was formed, more than 100 people have joined. I have received dozens of letters and e-mails, and many other people have contacted my office by phone. Not all the complaints of which I have been made aware relate to elderly people, but most do. Many have similarities to the cases that the coroner commented on in court. The majority of cases involve a bereavement—typically the loss of a frail, elderly family member. Relatively few correspondents report dissatisfaction with the quality of medical or surgical treatment, but almost all report very poor aftercare, including a lack of dignity.

A number of the letters talk about disappointment with the outcome when cases have been raised through the hospital’s complaints procedures. Many others express regret that the writers did not initiate a formal complaint in the difficult time following the death of a loved one. I know that the coroner has also received a number of unsolicited letters detailing similar experiences. I think that it would be helpful if I read out today a few more selected quotes from the letters that I have seen.

The correspondence has a consistent theme of neglect and a disregard for elderly patients’ need for dignity. Many letters refer to incontinent patients being left for long periods before being changed and made comfortable. A lady wrote about her 86-year-old dad, who went into Tameside hospital in July this year with breathing difficulties. There he contracted MRSA and E. coli. On one occasion when she went to see him his medication was still on his tray from that morning—a total of eight tablets. She says:

“My dad was originally in a side room…then was moved to a 4 bay…even though he had MRSA”.

A man wrote to say that his mother had been

“forced to endure the discomfort and indignity of waiting over an hour and half festering in her own faeces before staff could spare the time to clean and change her.”

He went on:

“I saw for myself open rubbish bins that were full to overflowing, spillages not mopped up, and, on one occasion, an attached catheter bag left trailing on the floor leaving an elderly patient open to urinary tract infection or even worse”.

Another lady wrote about her mum:

“In November 2005 my mother was admitted to Tameside hospital. After extensive tests and excellent care over 5 days in the medical assessment unit she was treated for a heart condition and transferred to the geriatric ward. Whilst there she contracted a severe stomach upset. Despite poor mobility due to rheumatoid arthritis she struggled to go to the bathroom unaided during the night. She leant on a locker, which moved, causing her to fall. The staff did not respond to her cries for help and another patient had to get help for her…It then took 13 hours for my Mum to receive orthopaedic assessment, during which time she was in abject pain. It was then confirmed that she had fractured her femur.”

She adds:

“The nursing care was inferior to say the least, especially as during this time she was still battling a severe stomach infection.”

She was told that her mother was suffering a massive infection that was causing her vital organs to cease working; her mother died within the hour. Her request for an inquest was refused.

Another member of the action group wrote:

“Our family have had a few really bad experiences at Tameside. The first was my father, who had a stroke. I was actually sat at the bedside when he asked the nurse to help him, as he needed to go to the toilet. The nurse replied, “Just do it in the bed. I am too busy. We’ll sort it out later.” I will never forget the look of humiliation on my father’s face.”

The same correspondent says:

“Whilst sitting with mum before she died we witnessed elderly people being given food at the end of the bed where they couldn’t reach and then 20 minutes later it would be taken away; we saw a nurse clean an old lady after the toilet, then give someone a drink without washing her hands.”

She mentions her brother who developed an infection after an artery graft and ended up having his leg amputated.

There are two more letters that I should like to quote, which I think are significant for the debate. A man told us about his father, who died three weeks after being admitted to hospital. He was admitted to the ward, but had a fall. It was suspected that he had broken his hip. However, it took five days for the hospital to confirm that, and during that time he was doubly incontinent, and in severe pain. On numerous occasions the family would arrive on the ward to find that his food and drink had been left out of his reach.

Finally, a lady wrote:

“My husband was admitted to hospital on 21st June 2006. He was never given a bed bath and I regularly had to wash him myself. He was deteriorating all the time he was in hospital. One day I asked for a commode and I was told by the nurse that he had used the toilet the day before so he could not have a commode…One day I went to visit him and during the night he had experienced a nosebleed. He had blood on his hands and face. It was obvious that nobody had tried to clean him up. His meals had been placed out of his reach and then removed when the staff cleared up after mealtimes. Nobody ever questioned why he had not eaten.

My husband passed away on the 9th July and it breaks my heart to think of the undignified and negligent way he was treated at Tameside hospital.”

It is true, of course, that some of those patients would have died anyway of the illness that led them to be in hospital in the first place. The concern that has been repeated to me over and over again is that, even if death was inevitable, basic standards of care, cleanliness and dignity should still have been provided, and in too many cases they were not. Ensuring that very basic standard of care is the responsibility of the hospital’s management. Quite a few of the people who have contacted me about this matter have urged me to press for resignations from the senior management and the chair of the trust. If senior management continues to resist the external inquiry that the public are demanding, I fear that there may be an increase in such requests in future.

I was disappointed when my request for an independent external inquiry into the problems was turned down. I felt, and still feel, that the hospital cannot be regarded as a learning organisation. There is a theme in the events that I have described. It seems that when things go wrong at Tameside hospital the reaction is to look elsewhere to attribute blame—MRSA is not hospital-acquired, but home-acquired; the high mortality rate is somehow the fault of Shipman; and the loss of public confidence in the hospital is the fault of the coroner. What is more, the team that has been set up by the hospital to look into the issues arising from the coroner’s comments is dominated by the very people who carried ultimate responsibility for the problems that were identified. That means that in effect they will be investigating themselves. I do not believe that, given the previous tendency to look for a scapegoat, we can expect an internal hospital inquiry to come up with recommendations to tackle the deep-rooted, systemic and cultural problems that mark out Tameside hospital, and which are the responsibility of the hospital management.

Significantly, the Tameside hospital action group shares that view, and is steadfast in its determination to press for the independent inquiry that is its core demand. From what I have been told, we can expect an imminent announcement from the hospital about its plans to address the issues arising from the coroner’s comments and from the many cases that have been brought to the fore by the action group. I hear that the hospital board has approved a 17, 19 or even 21-point plan, which, like the long forgotten plan of 18 months ago, will address a range of issues. I am sceptical. The action group will be sceptical. I agree with it that nothing other than an independent external inquiry will do, and nothing that the hospital management has thus far proposed persuades me to waver from that view. I hope that what I have said today will be sufficient to persuade my hon. Friend to think again and order an independent look at Tameside hospital. I look forward to my promised meeting with the Minister or one of his colleagues, and I hope that I shall be able to persuade him also to meet a small deputation from the Tameside hospital action group.

I congratulate my hon. Friend not only on securing the Adjournment debate but on bringing to our attention the horrendous experiences of some of his constituents. I recently launched, nationally, a dignity in care campaign, because we believe that too many older people are not treated with the dignity and respect to which they are entitled, in a variety of care settings—on hospital wards, in nursing and residential homes, and even in services provided through domiciliary and day care. We are not only launching that campaign but seeking to stimulate a debate in every community, neighbourhood and care setting about the care that older people should be entitled to expect in a civilised society. Indeed, we are not only stimulating a debate but seeking to stimulate action from those who are charged with fulfilling the relevant responsibilities, whether they are in management and leadership positions or professionals working on the front line.

I think that my hon. Friend would want me to say that many people in the hospital, in his constituency and elsewhere in the NHS do a fantastic job in difficult circumstances, and we would not want to question their sensitivity, compassion and skill in any circumstances. As my hon. Friend said, there is much that is good about the hospital and the trust, which have been objectively inspected and given a three-star rating. Beyond that, we know that much of what they do is good. However, that cannot be an excuse for the treatment to which the older people covered by the coroner’s comments were subjected.

We should test our reaction to this issue by asking ourselves how we would feel if our own family members were treated in this way. Would we regard that as acceptable and be prepared to tolerate it? The answer, I suspect, is that no Member of the House would expect somebody they loved to be treated in that way in any circumstances, but particularly when, as in the case of many of the older people we are discussing, they were coming to the end of their lives. In that respect, my hon. Friend makes an important point. There is no suggestion that lives could have been saved in many of these cases. There is, however, a serious suggestion that the very least that one can expect when families are under the most stress and experiencing the most insecurity and anxiety, and when the older person concerned is sometimes in a lot of pain, is the greatest sensitivity, compassion and care. The evidence before us suggests that that has sometimes not been the case.

I understand that the report that the trust has conducted is due to be published tomorrow, and my hon. Friend will receive a copy, as will the relatives of the older people referred to by the coroner and the local authority’s overview and scrutiny committee. The report will obviously identify the internal inquiry’s findings, as well, I hope, as a programme of action. The overview and scrutiny committee is undertaking a review of older people’s deaths at the hospital and will no doubt consider the inquiry’s outcome and the recommended course of action.

I am very conscious of the development of the Tameside hospital action group, of which my hon. Friend has been a great supporter and champion. Essentially, it is a group of relatives who have come together and who feel that they have common experiences of the hospital’s not treating their relatives with the respect and dignity due to them. The message that I would want to come very strongly from the debate is that the trust management and the hospital authorities have a duty and a responsibility to engage directly with the action group and with relatives who have had such experiences. I say that for two reasons. First, many of those relatives are, frankly, owed an unequivocal apology. Public services, and those who lead and manage them, should be prepared to say sorry when that is appropriate. Secondly, however, they should do more than just say sorry, because many of the relatives want assurances that other families and older people in my hon. Friend’s community will not experience what they have experienced.

I am pleased to hear my hon. Friend say that, and the strong message from the members of the action group is precisely what he says it is: they are looking not only for an apology but, beyond that, for an assurance that patients at the hospital will not be treated in the way in which they saw members of their families treated. For the vast majority, that would give full satisfaction.

As I understand it, the hospital has indicated a willingness to engage some of the relatives in staff training and in a dialogue with staff who work on the front line in the hospital, and that is desirable and important. Equally, however, it is important to engage with relatives and to recognise that much of what they have experienced is unacceptable, rather than to hedge one’s bets by using language that simply recognises and acknowledges that things should have been done differently. People have a right to expect higher standards of care. It is also important to persuade people in my hon. Friend’s constituency through action, not words, that older people will be guaranteed the highest levels of care. Frequently, as my hon. Friend said, people have serious concerns not about clinical practice or the quality of the medical intervention but about the aftercare.

My hon. Friend specifically mentioned an independent inquiry. It would be premature to give a decision on that one way or the other at this stage, because we have to analyse the content of, and the recommendations from, the trust’s investigation, which I understand will be in the public domain tomorrow. At that stage, my hon. Friend will meet the Minister of State, Department of Health, my hon. Friend the Member for Don Valley (Caroline Flint), and I hope that he will have the opportunity to talk to her with representatives of the action group; indeed, I am sure that she will accede to a request from him to bring members of the action group with him. There will be an opportunity to discuss the content of the report, the experiences of relatives and the wish for a more independent inquiry, if that is still the wish after the report has been published. My hon. Friend and the action group will have an opportunity to make representations on those issues to my ministerial colleague.

It is important that I mention one or two things that the trust has been doing to improve the situation. In July 2005, it introduced matron’s rounds, which are used to assess the quality of nursing care in all wards and clinical areas. They place particular emphasis on basic and essential care, nutrition and hydration, and communication and documentation. With the exception of the emergency and critical care areas, the trust has eradicated mixed-gender wards. It has also implemented the red-tray initiative, which is a system commended by Age Concern. Under the initiative, nursing staff are discreetly alerted when a patient requires assistance with feeding, without making it evident to other patients or visitors. The initiative was introduced in conjunction with new nutritional screening guidelines and protected meal times for patients.

On MRSA, which is a significant issue at the hospital, an action plan has been developed and is being fully implemented. A team under the chairmanship of the trust’s chief executive meets every fortnight, and progress against the action plan has been reported to the Department of Health’s MRSA improvement team every week since its visit. In addition, the trust is working with the team to develop a bespoke antibiotic prescribing policy, which should have a dramatic impact on reducing infection rates.

It is therefore important to acknowledge that the trust has been taking practical steps directly to address the real concerns that people have articulated. Although good intentions, action plans, strategies and a renewed focus are important, the difficulty, as hon. Members will be aware, is that it is the everyday experiences of patients and their families in the wards at the hospital that will determine whether the local community is reassured that lessons have genuinely been learned from the poor practice that has undermined dignity and respect for older people on too many occasions. That is where the judgments will be made. As my hon. Friend said, the community has been scarred by the damage done by Harold Shipman, particularly in relation to the treatment of older people, and we must remember that in any debate on these issues.

However, the proof of the pudding will be when older people and their families see that things are improving at the hospital and that their dignity and respect for them have been put at the heart of the care that they are offered. We expect no less. I again commend my hon. Friend for bringing this issue to the attention of the House and for championing those who are often voiceless in such situations—vulnerable older people and their family members. I promise that we will work closely with my hon. Friend to address these issues.

I thank Mr. Speaker for granting us permission to have this debate and the Minister with responsibility for post offices for attending. I welcome my hon. Friend the Member for Wellingborough (Mr. Bone), who I know would like to make a valuable contribution.

The main purpose of this debate and my main mission is to ensure that the Minister does not leave it without being made fully aware of the strength of local feeling in the Kettering constituency and in the rest of Northamptonshire about the future of the county’s sub-post offices. That feeling is shared not only in the county’s many villages, but in its large and small towns. Local opinion is strong on the issue. People value local sub-post offices and are distressed that many have been closed. Residents are anxious about the fact that more sub-post offices are likely to close in the future.

It is not an exaggeration to say that as a direct result of the Government’s policy on post offices every sub-post office in Northamptonshire faces the threat of closure within the next five years. That is the case because of two Government policies. The first is concerned with the doubts about the ongoing provision of a subsidy for rural post offices. The subsidy is scheduled to run out in 2008 and there is no provision for it to be extended beyond that date. The second policy is the Government’s decision to abolish the Post Office card account in 2010. There is, as yet, no firm proposal either to reverse that decision or to come up with an adequate replacement for POCA. Those two aspects of Government policy could spell extremely bad news for every sub-post office in Northamptonshire and every customer who uses one.

Residents in the Kettering constituency and in the rest of Northamptonshire hold their post offices dear. It would be remiss of me if I were not to pay tribute to the local sub-postmasters and sub-postmistresses who work extremely hard on behalf of local residents. I should like to mention one or two people who are particularly inspirational in that regard.

The first such person is Mr. Toby Clegg at the Barton Seagrave sub-post office, who has been extremely innovative in providing services for local customers. As other sub-post offices have been forced to close, he has gone out of his way to ensure that displaced customers are offered the best service possible. Mr. Quentin Bland at the Grafton Underwood sub-post office is likewise a pillar of the local community, and offers services to local residents that are way beyond those expected of him in his role as sub-postmaster.

Sylvia Winter and her husband David run the award-winning Creaton sub-post office, providing a range of community services. Its closure would be devastating for local residents, who are currently collecting signatures on a petition that I hope to be able to present on the Floor of the House in the not-too-distant future. It would be devastating news for the larger towns in the Kettering constituency, such as Desborough, Rothwell, Burton Latimer, Brixworth and Moulton, and for the small rural communities if sub-post offices were closed.

The sub-postmasters mentioned by my hon. Friend have worked for years and years to build their business. One of the things that seems to have been overlooked in the debate is that they were relying on good will in respect of that business for their retirement pension and because of the change in Government policy, that has been swept away overnight.

As ever, my hon. Friend makes an extremely pertinent and telling point. It is worrying for local customers that their post office may close, but, in many respects, it is even more worrying for the postmasters and postmistresses involved. There have been bitter experiences locally over post office closures. There used to be eight sub-post offices in Kettering, the largest town in my constituency, but under the ludicrously titled, “Post office urban reinvention programme” their number has been cut to five. The Windmill avenue, King street and Neale avenue post offices were all closed.

The closure of the Neale avenue post office means that there is no sub-post office in the northern part of Kettering. People used to be able to walk to the Neale avenue post office or park conveniently outside it, but now customers have to go to the main post office in Kettering, where the queues are often extremely long and where it is often difficult to park. The situation is thoroughly inconvenient for all concerned. The counter staff do their best in the main post office, but they are simply unable to provide the level of service that the former, smaller sub-post office at Neale avenue was able to provide.

The Windmill avenue post office was in the Pipers Hill ward, in the middle of Kettering. The area has a lot of elderly residents, and they used that post office to collect their pension. It was closed under the reinvention programme, despite the fact that the shopkeeper next door made a formal offer to the Post Office to keep that post office open. His application was rejected. In the absence of any other community facilities, the heart of the local community was lost when that post office closed.

Local residents are worried that similar reinvention proposals could befall the remaining sub-post offices in the constituency. Given the strength of local feeling on the issue, I extend a warm invitation to the Minister to visit lovely Northamptonshire. He could meet Sylvia Winter at the Creaton post office, or he could come to Rothwell’s post office. He could talk to sub-postmasters, sub-postmistresses and local customers in order to listen to their concerns at first hand. I know that he is sincere in what he does and that he takes these issues seriously, but so do local residents. They would welcome the opportunity to put their concerns about the future of the post office network directly to him. I hope that he will sincerely consider that offer.

Local sub-post offices provide not only post office services, but the eyes and ears of a local community. We all know, as constituency Members of Parliament, that many people in our constituencies have contact with other local residents only when they bump into them at the local post office. The local post office can keep an eye out for local residents who are experiencing medical difficulties, who might become confused or who have other issues that can be spotted. The post office acts as an unofficial social service. That needs to be recognised by Her Majesty’s Government when they make up their mind about the future of the subsidy for the rural post office network. The same is true in respect of the remaining sub-post offices in urban centres.

In conclusion, I want to get across to the Minister the strength of local feeling about this issue. Thousands of local residents in Northamptonshire want the Government to understand their anxieties, and to come up with clear policy statements about the continuation of the subsidy for the post office network, and about either keeping POCA or coming up with a suitable replacement. Our local communities depend on small post offices, and far too many of our most vulnerable people are involved for the Government not to listen to local concerns on the issue.

I thank you, Mr. Atkinson, and Mr. Speaker for the opportunity to put residents’ concerns direct to the Minister.

I congratulate my hon. Friend the Member for Kettering (Mr. Hollobone) on securing this debate and on batting yet again on behalf of the people of Kettering.

I welcome the Minister. It seems that, whenever the Government get themselves into a mess or are on a sticky wicket, they ask the Minister to come and bat. I am afraid that we will see a batting collapse in Government policy that is faster than that of the English in Australia this morning.

I want to talk about a letter that I received from the Office of the Deputy Prime Minister. I had asked a question about how far away post offices are from people, to which the Deputy Prime Minister replied that

“99 per cent. of people live within one mile”.—[Official Report, 1 November 2006; Vol. 451, c. 281.]

It would be wonderful if that were true, but I doubted it at the time. Promptly afterwards, I received a letter dated 7 November which stated:

“Dear Peter,

When replying to the question you asked on 1st November about the Post Office network, I said that about 99 per cent. of people live within one mile of a Post Office…I apologise that I should have made clear that 99 per cent. of the urban population live within one mile of a Post Office. I understand that 93 per cent. of the population as a whole live within one mile of a Post Office.”

That was followed by a squiggle and then John Prescott’s name.

I commend the Deputy Prime Minister for quickly correcting what was obviously an inadvertent slip in the House, but it raises an interesting issue. I know that that statement was wrong and he knows that it was wrong, but no one else knows that, because Hansard recorded the answer as the Deputy Prime Minister said it. If he was given wrong information, has the Minister also been given wrong information and have the Government’s conclusions about the necessity of rural post offices been based on the wrong statistics?

The Deputy Prime Minister’s answer in his letter of 7 November states that

“93 per cent. of the population as a whole live within one mile of a Post Office.”

He also said that

“99 per cent. of the urban population live within one mile of a Post Office.”

By my calculation, that could mean that only 70 or 80 per cent. of those in rural areas live within one mile of a post office, and I have some specific questions that I would like the Minister to deal with in his response if he can. Does he know the distance that people in rural areas must travel to their post office? If 70 or 80 per cent. of the rural population live within one mile, perhaps the information on which the Government based their policy is based on misinformation. If the Minister has that information, on what date was it based? It may be that 90 per cent. of the urban population live within one mile of a post office. On what date is the information based? Many urban post offices have closed recently.

I am worried that Government policy is being determined on statistics that may not be correct. When the Deputy Prime Minister stood up in the House and gave a statistic in reply to an oral question, he must have got that statistic from his officials, so I am worried that misinformation has been given to Ministers and is leading to incorrect conclusions.

I want briefly to mention how people are affected. For me, it is inconvenient that a post office has closed in my area. In fact, post offices in London road, Bedford road, Avenue road and Newton road have closed, but all I do is to hop in a car and go to Little Irchester. However, what about people in my area who are elderly, vulnerable, such as single mums, or disabled? They cannot do that and their only alternative is to go to the one remaining post office in Rushton, which means that they must queue up, often outside the post office, for service.

The Government may have adopted this policy on the basis of wrong information and they certainly did not realise the consequences. I do not believe for one moment that the Minister came into politics to make the lives of the vulnerable, the disabled and the elderly more difficult. I am sure that that is not the case but, unfortunately, that is what has happened. The whole country is praying and hoping that in the case of rural post offices, Jim really can fix it.

It is a pleasure to see you in the Chair, Mr. Atkinson.

I congratulate the hon. Member for Kettering (Mr. Hollobone) on securing this debate and the hon. Member for Wellingborough (Mr. Bone) on his able assistance. Both hon. Gentlemen have regularly lobbied the Government effectively on this important issue. We acknowledged in previous exchanges the importance of the post office network and gave some reassurance that we would continue to subsidise the rural network and its sustainability, and that there would be a successor to the Post Office card account. Until the House hears the details, there will be a degree of scepticism. That is the nature of politics, but I hope that we shall be able to dispel that scepticism in due course.

Much has been said and written about post offices recently, underlining the need for balanced and constructive debate of the matter. Many scare stories are doing the rounds and it is important for the peace of mind of sub-postmasters and customers—our constituents—in all communities that we distinguish between myth and reality.

I will address in writing the specific questions raised by the hon. Member for Kettering. When the Secretary of State has made his statement, there will be a period of consultation, which may be the appropriate time to analyse the evidence upon which we are basing our conclusions. I shall be very happy to have a meeting with the hon. Gentleman and the hon. Member for Wellingborough to discuss the specifics of my response, which I will send in due course.

The myth is that the Government are in some way engaged in systematically removing services from post offices. The reality is that we have invested more than £2 billion since 1999 in the post office network because we know that post offices are an important part of British life, particularly in rural and deprived urban areas. As the Secretary of State said, he will make an announcement before the Christmas recess which will include our proposals to ensure a long-term, stable footing for a continued national post office network.

The rural network is currently supported by the Government's social network payment of £750 million over the five years from 2003 to 2008. There are still more than 14,000 post offices, which is more than eight times the number of Tesco outlets. There are more post offices than bank and building society branches combined. Maintaining a network of that size is hugely expensive and the cost is rising, with Post Office Ltd expecting to lose £4 million every week during the current financial year. The latest figures show that on average fewer than 16 people a week use the 800 smallest rural post offices. Every trip they make effectively gets a subsidy of £17 from the public purse. More than one third of business in the rural network is done in the largest 10 per cent. of branches. There are around 6,500 rural social branches, which lose around £150 million a year. Those rural branches represent 45 per cent. of the network total, but they account for less than 7 per cent. of overall income.

The key challenge in moving forward is how best to address the needs of post offices in rural and deprived urban areas where they can play a key social role. If the network is to survive, it must meet the present and future needs of its customers on a sustainable basis. Both the Government and Post Office Ltd are looking closely at service provision in the context of utilisation levels. Over the past year, Post Office Ltd has been testing new service delivery channels with particular focus on the loss-making rural segment of the network. Those trials are based on a hub-and-spoke or core-and-outreach principle and aim to deliver value-for-money rural post office services that can be tailored to different situations.

In those trials, a core post office is providing services to a number of outreach sites using one or more of the four outreach options being tested. In all pilots, the service hours have been set at a level much more commensurate to the level of business generated in that community, so that the wastefulness of long opening hours with little or no custom is eliminated. Although opening hours have been reduced, in many cases the range of available services has been extended. Many of our constituents in very rural areas have local access to motor vehicle licensing and passport check-and-send services for the first time. Encouragingly, once people get used to the new means of service delivery, levels of satisfaction with the pilots run very high—at about 93 per cent.

We recognise, however, that not all initiatives undertaken, whether by the Government or by the Post Office, have been as successful as we would have wished. Whether we like it or not, post offices are not being used as they once were, and the trend is accelerating. It is important to recognise that declining business at post offices is not a new phenomenon: the size of the network peaked in the mid-1960s, with about 25,000 outlets, but by as early as 1970, the numbers started to decline. The business is going through a sustained period of change, and it needs to adapt to customers’ changing lifestyles and habits.

As a result of dramatic advances in technology in recent years, we have seen unprecedented changes in the communications and banking industries. People increasingly choose to access services in different ways, using direct debits to pay their bills, hole-in-the-wall machines to get cash, and the telephone and internet for banking or information on Government services.

Much is said during these debates about the social role that many post offices are seen to play. However, it is too often forgotten that the Post Office operates in a commercial marketplace, not in a vacuum. Sub-post offices account for 97 per cent. of the network, and they are private businesses, bought and sold commercially, which usually run alongside an associated retail business. The hon. Member for Kettering made effectively the point about their significance in communities where they provide a range of services.

I hope that the Minister will take up the invitation to visit Northamptonshire. If he comes to the county, there are two post offices that he could visit: one at Creaton, which I have mentioned, and the other at Guilsborough, where Lieutenant-Colonel and Mrs. Evans have reopened their shop, Seatons, and revived Guilsborough post office. They are rising to the commercial challenge of running a small shop in a rural community. There are sub-postmasters and sub-postmistresses who want to make a real success of their post offices, and the Government must offer them encouragement.

I acknowledge the hon. Gentleman’s point, and I shall return to his kind invitation towards the end of my contribution.

The services that the network provides, including lottery tickets, foreign currency, telephony, bill payments and financial services, are in direct competition with other retailers and providers, and we have helped to equip the Post Office to tackle the changing needs of its customers. Our £2 billion investment in the network included £500 million for the horizon project to bring modern computer systems into every post office in the country, enabling the Post Office to tap into new markets and to open its counters to potentially 20 million bank customers.

We are supporting the Post Office with efforts to improve the company’s profitability and to introduce new products and services. The Post Office is now the UK’s number one provider of foreign exchange services, with 12 million transactions last year, and it is also the largest independent provider of travel insurance. The Post Office continues to broaden its range of financial services and other services that the hon. Gentleman described. In March, it launched its instant saver account, a competitive savings account that should prove popular with customers who want to use the post office.

The future of the post office network is a significant cross-cutting issue for the Government, with a number of different Departments delivering services through it. We continue to look for ways in which we can use the network, but it is the duty of a responsible Government to provide services where the public can choose the means of access, and services that offer value for money. For example, the Driver and Vehicle Licensing Agency’s online vehicle licensing service was launched only last year, but already it has been used by some 4 million people, and many transactions are carried out outside normal post office opening hours. Choice for and convenience to the customer has been increased, but those issues pose a real challenge to the Post Office.

The Post Office card account is one of about 25 different accounts that can be used to access benefit and pension money over the post office counter. Some 70 per cent. of the 4 million Post Office card account customers also have a bank or building society account; and 8.5 million of the UK’s 10.8 million pensioners have their state pensions paid into a bank account. Ninety-eight per cent. of customers making new state pension claims choose direct payment into an account, whether that is a bank account or a Post Office card account.

Discussions between the Government and the Post Office about the Post Office card account continue, and the Secretary of State will make a statement before Christmas on our proposals to ensure that we maintain a national network. Our aim is to ensure that customers are given a range of options for accessing their money at post offices. There has been substantial activity behind the scenes to obtain and assess data on the network and how that feeds into the options for its future shape and size—the point made by the hon. Member for Wellingborough about the accuracy of the evidence. I am sure that we will return to the issue in due course.

Hon. Members will know of the range of research and reports published over recent months by Postcomm, Postwatch, the Commission for Rural Communities, the National Federation of Sub-postmasters, the Select Committee on Trade and Industry and others. The findings, conclusions and recommendations from that extensive range of work are being taken into account alongside our own analysis and assessment so that we can inform our thinking on a forward strategy. We do not yet have the answers, but people can rest assured that we are listening and we shall take account of their concerns when reaching our conclusions. We also recognise that we need to take some tough decisions, but because they will be tough, we have been working intensively to ensure that they are right.

I acknowledge the kind invitation to visit lovely Northamptonshire. However, it is unlikely that I shall be able to accept. Having met the executive of the National Association of Sub-postmasters, addressed its rally at Westminster in October, been with its members when they presented the Prime Minister with a 4 million-signature petition, and received voluminous correspondence from individuals, parish councillors and others, on top of the Adjournment debates, Trade and Industry questions and meetings with individual MPs and regional groups, I can assure the hon. Gentleman that I am in no doubt whatever about the seriousness of the issues that we are addressing.

I quite understand the Minister, but if he visited Kettering, he could come through my constituency, stop with the wonderful sub-postmaster at Little Irchester, and get one of the very good cups of tea and bacon buns that he prepares. The Minister might not be able to visit, but I was disappointed that the Post Office would not send any representatives to listen to the complaints from my constituents. That was unfortunate.

As a vegetarian, the bacon butty would not be for me. I was disappointed, as the hon. Gentleman was, to hear the news from Australia; but I was even more disappointed that he brought it into the debate.

In closing I want to make it absolutely clear to the hon. Gentlemen present that we know we must provide for the most vulnerable, whether they are in rural communities, suburbs or deprived urban areas. It will be a key consideration of the Secretary of State’s statement. We recognise how post offices that can never be commercially viable, but which play an important social and economic role, will need continued public funding to ensure service provision. We shall also look to ensure that those services are delivered as efficiently as possible, and where appropriate, that they are more cost-effective.

We are listening to and understand the concerns of sub-postmasters and others, and I commend the hon. Gentlemen for the way in which they have presented their case today.

I am delighted to have secured the opportunity to lay before the Minister the case for Portsmouth naval base to remain the home port for the majority of the British service fleet, and a major centre for warship maintenance, repairs and refits.

The decision by the Ministry of Defence to undertake a major review of Britain’s naval bases, bringing with it the threat of closure for one of them, understandably sent shockwaves through the Portsmouth community. I and the hon. Member for Portsmouth, South (Mr. Hancock) immediately pledged to do all we could to ensure the survival of Britain’s premier naval port, and I am heartened by the spirit in which the local council, local industry, trade unions and other MPs in the region, from whatever party, have been working together on behalf of Portsmouth. The issue is much bigger than party politics; it is about our city. Our local paper, The News, immediately launched a campaign that has received massive support from people not just in Portsmouth and the UK but around the world. Such is the affection and esteem in which Portsmouth naval base is held.

Much as I would like him to, I understand that my hon. Friend the Under-Secretary cannot give firm assurances about the future of Portsmouth naval base while the review is ongoing. However, I should like some assurance that the points that I outline today will be taken on board fully before any decision is made. I should make it clear from the outset that I do not intend to make the case for Portsmouth at the expense of the other two naval bases. I was disappointed by the DML Group’s decision to go down that route, and I do not believe that it has done the group any favours. Portsmouth does not need to do that. Our case stands up by itself.

There is an historical case to be made for Portsmouth. It has been a centre for naval shipbuilding since 1194, and since then, Portsmouth’s skilled craftsmen and women have been supporting our naval fleet through times of peace and war. My grandfather was one of them. However, I am realistic enough to know that grateful though we are to those men and women of history, that case is not sufficient on its own to stand up to an up-to-date, rigorous value-for-money inquiry, and quite rightly. In these troubled times, we need maximum resources on the front line and we must ensure that our naval bases are giving cost and battle-effective support to that front line. Therefore, I intend to focus on just two aspects of Portsmouth’s case: the financial and the military-strategic.

Portsmouth is the home port of 60 per cent. of the surface fleet—its ships and its sailors. All major naval operations are mounted by the naval base commander, Portsmouth. The Portsmouth area has the majority of naval training establishments as well as fleet headquarters, a considerable naval manufacturing base including VT Shipbuilding and, in the Defence Science and Technology Laboratory and QinetiQ, world-class defence research and development.

Most people think of a naval base as a place where ships are repaired. Portsmouth is not. In fact, only one third of the naval base’s non-Royal Navy salary costs relate directly to ship maintenance. The naval base alone looks after some 13,000 sailors and more than half of all naval families. It includes accommodation, medical centres, dental centres and training. It stores 80 per cent. of naval equipment. All Ministry of Defence ration packs and sea survival equipment are prepared and maintained there. It is, in effect, a small industrial town. However, it is a modern, forward-looking industrial town with a unique and successful partnership with the MOD and private industry. Much of the naval base is operated by Fleet Support Ltd, which is seen by many as a benchmark industry partner and which has developed an innovative joint working relationship that has delivered over £50 million in savings to the MOD.

Portsmouth’s delivery record for major ship repair is among the best in the country, and now it does not just repair ships but builds them too. In 2002, VT Shipbuilding built the UK’s most modern and productive shipbuilding facility at Portsmouth naval base. VT is the UK’s largest exporter of warships. It is building large elements of the Type 45 destroyer and is a builder and owner of offshore patrol vessels. Portsmouth naval base is a unique one-stop shop for designing, building, launching, upgrading, repairing and eventually disposing of ships, all at one small, cost-effective site. The synergies between ship support and ship repair are starting to reduce costs for both. However, Portsmouth is not resting on its laurels.

I support the hon. Lady’s case for the benefits of Portsmouth dockyard. Does she agree that what is important is the synergistic benefit of all those things coming together? It is vital to keeping costs down and ensuring that more resources are available to our front-line services.

Absolutely. I shall develop that point further. It is a big jigsaw. To take one bit out would mean losing those synergies.

The naval base is continuing its drive for further efficiency savings. Under project dreadnought, a strategy has been devised to reduce costs still further without damaging output. This year, costs have been reduced by £10 million, and plans are already in place to save a further £20 million next year, again without damaging output. The defence industrial strategy published last year pragmatically considered defence levels nationwide and resource allocation for years to come and made it very clear that future capability will not rely on volume but will require mobile, well equipped and well supported forces, whether on land or at sea. It envisaged the development of industry to support a through-life approach to delivering that military capability and taking responsibility for cost and performance risks. Portsmouth naval base is uniquely placed to deliver. But, as the hon. Gentleman mentioned, it can do so only because of the synergies between all the interlocked elements located there. To take away part of that jigsaw would be to lose those synergies.

The noble Lord Drayson made it clear when launching the defence industrial strategy that it was not a job creation scheme. If British industry and British workers are to benefit from defence contracts, they must demonstrate that they have accepted a partnership and risk-sharing approach. Portsmouth has not just accepted that; it has embraced it. Portsmouth is not looking back to its historic past and asking for special favours. It is looking forward to a modern and inspiring partnership for naval support in the future, delivering effective support at a price that the MOD can afford. Headline figures about the cost of maintaining Portsmouth naval base are meaningless without a full understanding of the synergies and interdependencies between different naval establishments and our industrial partners. Portsmouth has demonstrated that it is willing to take hard financial decisions in order to deliver resources to the front line. What is more, we have demonstrated that we have already delivered some of those savings.

I move to the military-strategic case. Current plans are to base Type 45 destroyers and the new aircraft carriers in Portsmouth. The decision was made after long and expensive studies of the various options, and Portsmouth was chosen for good reasons. All the facilities to support Type 45 destroyers already exist in Portsmouth. Critically, in addition to normal base facilities, the principal anti-air missile systems will be tested and stored in nearly Gosport and loaded on to ships in Portsmouth naval base. The safety of PAAMS missiles is paramount and permission is governed by a robust system of licences. Transferring the ships to another naval base would mean transporting the missiles by road from Gosport, with substantial safety and security implications. No other naval base has a sufficient explosives licence to load PAAMS missiles on to a warship, and achieving such a licence might not be possible at any cost.

I turn to the new aircraft carriers. Portsmouth has invested some £40 million in new jetties in preparation for the carriers, and it has the infrastructure to support the ships and their people. We should bear in mind that 50 per cent. of the Navy’s service accommodation is based in Portsmouth. Where will the crews of those very large ships live if they are based somewhere else? Realistically, where else could the carriers be based? They cannot get into Devonport, as they are too big. Faslane only has 15 m jetties, not the required 35 m jetties that Portsmouth has. Also, would we seriously want to base our flagship aircraft carriers in the same place as our Trident submarines? Portsmouth is unencumbered by major nuclear facilities and the associated risks and costs. Operational and ammunition-laden warships cannot be berthed near nuclear facilities. Uniquely among our naval bases, Portsmouth can emergency-dock a warship carrying fuel and weapons. However, military-strategic considerations are not just about hardware. We must consider recruitment and retention, and the wider issue of the British public’s attitude to armed forces and defence expenditure.

Before the hon. Lady moves to that particular part of the military-strategic aspect, does she agree that the Government’s welcome decision yesterday to renew the nuclear deterrent because of the unpredictability of future threats means that concentrating all our major naval warships in a single port on the south coast is a reckless strategic gamble that should not be considered?

I could not agree more. Does the hon. Gentleman mean a single naval port on the Scottish coast?

No, I meant if two went down to one.

I understand the point. In my view, we should still be considering a three-dockyard strategy to keep the military-strategic figures.

Portsmouth makes a major contribution to the British public’s attitude through its naval heritage area. We are the Navy’s shop window. Nelson’s flagship HMS Victory, the first ironclad ship HMS Warrior and Henry VIII’s flagship the Mary Rose are all sited in Portsmouth historic dockyard alongside the naval base. Each year, 400,000 people visit the naval base and the heritage area. More than 8 million people look at the warships, as they pass by on Portsmouth car ferries, and the Trafalgar 200 celebrations last year brought the navy to life for hundreds of thousands of people.

I could go on to explore the wider economic consequences for the city of Portsmouth if the naval base were to close, given that 26,000 people are directly employed in maritime defence in the area, but time is limited and I want to give the hon. Member for Portsmouth, South (Mr. Hancock) an opportunity to make a contribution.

In conclusion, I accept entirely the point made by my right hon. Friend the Secretary of State when he said:

“We need to ensure that the capacity of naval bases is no more and no less than we need to support the needs of the Fleet now and in the years to come”.

However, I hope that I have demonstrated that if the MOD is looking to close Portsmouth naval base as one of the options in the review, it is looking in the wrong place. It is far better that the MOD supports Portsmouth naval base and its industrial partners in making the defence industrial strategy a reality. The city of Portsmouth is a genuine success story: a city proud of its past and looking to its future.

I do not know which bases, if any, will be scheduled for closure as a result of the review, but I know that those that survive will do so because they facilitate a modern and efficient service for combat operations. I hope that I have shown today that Portsmouth naval base does just that. Thousands of jobs in and around Portsmouth and a business sector worth hundreds of millions of pounds hang on the outcome of this review. Portsmouth naval base works—let us keep it working.

I thank the hon. Member for Portsmouth, North (Sarah McCarthy-Fry) for the courtesy of giving me the opportunity to take part in the debate. How right she was to recognise, at the beginning of her excellent and—I hope—persuasive contribution to the debate, the importance of the co-operation that has existed between the local authority, Members of all parties, the unions, the Royal Navy and the partners already in the naval base. It is important to recognise that those partnerships were the foundations of the maritime industrial strategy and when Lord Drayson spoke to the Select Committee on Defence, he emphasised their importance. Moreover, how right the hon. Lady was to put on the record the existence of important and well engaged partnerships that are vital to their future success.

The hon. Lady is also right to recognise that we are not trying to score points. It is not the battle of the bases, as some in the west country have described it in a wholly unfortunate and, in some ways, very mischievous manner. I ask that both the Secretary of State, who gave a commitment to visit the naval base before a final decision was made, and other Ministers in the MOD take the opportunity to visit the city in order to understand what an enormous issue it is for the community in Portsmouth and in south Hampshire generally, and to engage with the partners in the naval base.

Service personnel have benefited enormously from that interaction and through working with Fleet Support Ltd. and VT, which is to the credit of everyone who has put that process together. As we have heard, project dreadnought has already offered significant benefits and will continue to do so. It is not a one-off saving, but an effort on the part of the whole defence community, and the “family” within the naval base, to make those savings ongoing. It is open to close scrutiny and inspection and that process is not a matter of just glossing a report or massaging figures in a particular case. Hard-fought decisions have been taken, some of which have been enormously painful, for the naval base and the Royal Navy, but they have been taken and those savings have been made. Those changes for the better will continue to be made.

I want the final decision to be the best one for the Royal Navy, the defence of the country and the city of Portsmouth and its surrounding area. Our case is well made. The hon. Lady talked about some of the economic issues, and I would add that the base generates about £500 million for the local economy in one form or another. That is an enormous amount of money coming into the city. Most of that process derives from the fact that the traditional home of the Royal Navy is Portsmouth.

When presentations were made at the Defence Committee I tried to explain what I felt was important for Portsmouth. There are five reasons that I see as crucial. First, Portsmouth is the traditional home of the Royal Navy, the home of the Victory and many other historical ships, and it has the only port in the country that could take both new aircraft carriers alongside each other at the same time, which is vital. It is the only base in the country, excluding commercial ports, that has the surface area that allows for the carriers’ overhang to be dealt with satisfactorily and is able to provide for their supply or any other support that is needed.

Secondly, Portsmouth is the home of ship arming. Traditionally, ships would come to Portsmouth from the depot in Gosport to be armed. Are we seriously suggesting that we want to engage in the road transportation of vulnerable missiles? If ships were ported in Devonport, they would have to come to Portsmouth to be armed because it is extremely unlikely, if not impossible, that Devonport will be able to secure the sort of arming licences needed. Thirdly, there is the fact that 50 per cent. of the Royal Navy’s married housing stock and its largest concentration of shore-based personnel in the country is in Portsmouth. Fourthly, it is the traditional home of the Royal Fleet Auxiliary Service, which is very important.

Fifthly, I cannot emphasise enough the importance of the partnership arrangements. I listened carefully to Lord Drayson in his ministerial statements and the Defence Committee looked long and hard at the defence industrial strategy. It is founded upon the belief that we can make partnerships work and that they can deliver real benefits for the MOD, the nation and the communities they serve. Portsmouth is a living testament to that. It would be a sad reflection on that achievement if the Royal Navy and those ships were removed from the city, because they are an integral part of it. It is easy to say that many of those things would not happen, and to say that we would not lose the partnership arrangements because many activities would continue. However, what brings the whole process together is the fact that Portsmouth is the home base for the majority of the Royal Navy’s surface fleet.

I hope that this debate goes part of the way to securing the future of Portsmouth. That is vital for the economy of the city. When I grew up there, 48,000 people worked in the dockyard. As the hon. Lady has said, many changes have taken place and there are now fewer than 200 industrial employees directly employed in the dockyard. However, 26,000 people in the greater Portsmouth area derive their livelihoods from involvement in defence industries. It is vital that that continues, and long may it do so.

I congratulate my hon. Friend the Member for Portsmouth, North (Sarah McCarthy-Fry) on securing the debate on the future of Portsmouth naval base and for giving me the opportunity to speak on this important issue.

I acknowledge the strong links between the naval base and the city of Portsmouth, which go back for more than 800 years. The people of Portsmouth have provided unparalleled support to the Royal Navy in peacetime and in wartime. I am mindful of my announcement of the planning for next year’s commemoration of the 25th anniversary of the Falklands conflict; the role that Portsmouth played in that conflict should be recognised. I believe that my hon. Friend had occasion to visit the Falkland Islands recently and no doubt witnessed at first hand the stability secured by our armed forces that is now enjoyed by the Falkland Islanders.

My right hon. Friend, the Secretary of State for Defence announced on 18 September that we were about to undertake an in-depth review of infrastructure requirements at the naval bases at Devonport and Portsmouth and on the Clyde. He pointed out that the defence industrial strategy published in 2005 laid down a challenge to the UK maritime industry to reduce its overheads and invest in the facilities and skills needed to meet the demands of the Royal Navy’s future warship programme.

We have also made it clear that we cannot expect to rely on the industry alone to achieve the necessary rationalisation to ensure the future affordability of the warship programme. We also need to look at our support capacity at the naval bases, to ensure that it is matched appropriately to the future needs of the Royal Navy. We need to ensure that every penny counts and that resources are rightly focused on the front line. We must not lose sight of the fact that the number of ships requiring maintenance and repair has been steadily declining. As my hon. Friend has heard before, we must be realistic, and look to the future rather than dwell in the past. That is not to say that we should not celebrate the remarkable achievements of the past, but we need to take this opportunity to consider our future support needs in detail.

Could the reason for the fact that fewer ships require maintenance be that although the Government’s strategic defence review in 1998 predicted that we would have 32 frigates and destroyers, that number has been slashed to 25? Might not circumstances arise in which it will be necessary to increase the size of the surface fleet to that which was originally anticipated?

I shall come to that issue about the fleet later in my speech.

It would be remiss of the Ministry of Defence not to review the way in which it supports the fleet and not to see how we can improve efficiencies. The naval base review is an important part of the maritime element of the defence industrial strategy. The terms of reference, which are available for all to see on the MOD’s website, clearly show the intention for a wide-ranging review. The review team is currently looking at a number of options, some of which could radically reduce overheads and naval base capacity. The options range from doing nothing, at one extreme, to closing all three naval bases and building a new naval base at a single location at the other.

I emphasise that all options remain open. Ministers and I have made no advance decisions on the future of Portsmouth or the other naval bases. We will reserve judgment until we see the results of the review, which is unlikely to be before spring next year. It is simply far too early to say now what, if any, impact the review will have on Portsmouth.

I should like to clarify the point that my hon. Friend has made about the end of the review. Will the report of the review be available in the spring or will the Department make its decision in the spring?

The review will report in the spring, after which Ministers will have to consider it, but we shall make a decision as soon as possible after that. I well understand that that means a period of uncertainty, to which my hon. Friend alluded, for the naval base and its work force, industry and, more widely, the people of Portsmouth and the surrounding area. It is important, however, for the review to take a carefully considered and objective look at how best to meet the Royal Navy’s future support needs before making its recommendations.

I assure my hon. Friend that the review will take account of all the relevant factors, including the findings from other MOD initiatives, such as the developing surface ship support alliance and the home basing strategy, which was chosen with care to reflect the needs of the fleet, including carrier vessel futures and Type 45 destroyers. As she hon. Friend is aware, on current plans both the Type 45s and the CVFs will be base ported at Portsmouth.

My hon. Friend will be reassured that business improvement activities, such as project dreadnought at Portsmouth, will also be given due weight in the naval base review. The aim of project dreadnought and the efficiency drives at the other naval bases is to deliver savings locally. It is important that those savings should be recognised by the review and taken into account as part of that process. Only by considering all the relevant factors will we be able to determine the best value for money option.

Only when the review has been completed will we be able to quantify the likely costs and savings of any changes to the naval base infrastructure. In the meantime, it would be premature to speculate on what those might be. Initial costs and savings that were identified locally were derived from many sources and have not yet been validated by the naval base review team. The review will, however, be the subject of a robust analysis, including a full investment appraisal, which in turn will be the subject of rigorous scrutiny as it develops.

Can the Minister give an assurance that past, present and future investment plans for the commercial interests in the bases will be taken into full consideration, and that guarantees will be sought to ensure that that investment is delivered?

The hon. Gentleman makes an important point. I have made clear what account we are taking of all the issues to which he and my hon. Friend the Member for Portsmouth, North have alluded, although I shall return to that later.

As with any review on such a scale, the team will engage not only at local and regional levels, but with officials in the Treasury and other Departments as necessary. I am fully aware of the mutually supportive relationships that exist between the naval bases and their local communities, which have been strongly emphasised in this debate. We intend to engage fully with those stakeholders who are likely to be affected by the naval base review, including the Government offices for the regions. Indeed, the Government office for the south-east has been invited, among others, to a meeting with the naval base review team later this week. It will be briefed on the aims and objectives of the review, and on the range of options under consideration. Trade unions, too, will have a part to play. Several informal briefings have already taken place with trade unions and more are planned for the new year.

Like my hon. Friend the Member for Portsmouth, North, I know very well how proud Portsmouth is of its links with the Royal Navy. Ministers have visited the naval base on several occasions, and I hope to do so in the new year. I have noted the recent successes, such as the launch of HMS Clyde, which was built in Portsmouth naval base by VT, and the refit of HMS Richmond, which clearly demonstrated the strength of the partnering arrangement with Fleet Support Ltd. None of that would have been possible without the MOD continually seeking to improve not only its front line, but its support functions. I am aware that previous reviews concluded that three naval bases should be retained, but we are in a fast-changing world and the armed forces must adapt as the strategic context alters. Just as we need to ensure that we have the right balance of capabilities to meet modern threats, so we need to ensure that our supporting infrastructure meets our requirements.

To sum up, I am pleased to have been able to respond to my hon. Friend in this important debate. I sincerely hope that she will feel reassured that the naval base review will take into account many of the issues that she and other hon. Members have raised today; not only that, I hope that I have done enough to reassure her that the review is about securing the best value for money for defence and for the taxpayer. Finally, I reiterate that no decisions have been taken about Portsmouth or any other naval base.

Question put and agreed to.

Adjourned accordingly at three minutes to Two o’clock.