Wednesday 10 October 2007
[Dr. William McCrea in the Chair]
Economic Regeneration (Blackpool)
Motion made, and Question proposed, That the sitting be now adjourned.—[Mr. Watts.]
It is a great pleasure to be here and to speak under your chairmanship, Dr. McCrea, and I look forward to the debate.
I always think that I am extremely fortunate to be one of the Members of Parliament for Blackpool and one of the four Members of Parliament for the Fylde coast. Blackpool has been at the centre of this country’s tourism and popular culture for the best part of a century and a half. Wherever in the country I go to meetings or meet people, virtually everybody has heard of Blackpool and virtually everybody has an opinion about it—those opinions may vary, but they are intense.
Seldom, however, has Blackpool been more in the news than in the past year. Our present regeneration predicament and our future hopes—like those of seaside and coastal towns in general—have taken centre stage in a national debate about regeneration. The casino advisory panel’s controversial recommendation in January that east Manchester should be the site for the super-casino sparked an extraordinary chain reaction and campaign of support. That was true not only in Blackpool and across the north-west, with an 11,000-signature petition being handed in on the steps of No. 10, but in both Houses of Parliament. That culminated in the House of Lords’ rejection of the panel’s recommendation at the end of March, and the momentum of debate and argument on the subject has scarcely slackened since.
There was a major Select Committee report on seaside and coastal towns in the spring calling for new Government initiatives, which was followed by a Westminster Hall debate. There were the Prime Minister’s remarks at Prime Minister’s questions in the summer, which spurred the major review of regeneration needs that is now under way at the Department for Communities and Local Government. There is also the report by the Blackpool taskforce, which involves all the local and regional agencies and which was set up as a result of the then Secretary of State’s concession in the heated Commons debate on the issues raised by the casino order that was published last month. In September, we also had the survey report on gambling issues in the United Kingdom over the past 10 years. In addition, we will shortly have a major English Heritage conference on regenerating seaside towns. Finally, of course, we are having this hour-and-a-half debate.
My comments today are made on the basis not only of my 10 years’ experience as a Blackpool MP and my nearly 18 years’ involvement with the town, its issues and arguments, but of my role as the honorary president of the British Resorts and Destinations Association and the chairman of a Back-Bench group of Labour seaside MPs. Over the past 10 years, I have seen that the economic regeneration problems that Blackpool faces are unique and great. Blackpool’s contribution to tourism and leisure in this country has been great, but our problems, difficulties and opportunities echo what other seaside and coastal towns need. Coming from such a town himself, the Minister will well understand that, and I am delighted to see other Members from other seaside and coastal towns here today.
Let me emphasise straight away that there is no churlishness in my introducing this debate. I recognise that there has been significant central and regional government support for Blackpool’s regeneration over the past seven years and I am grateful for that. It is worth briefly reminding people of what that support has included. Some £15 million went into work on phase 1 of Blackpool’s central corridor, and those who come to the town today will see a regenerated and imaginative central corridor, with its famous climbing towers. We have had seafront reconstruction, with £68 million—a major sum—from the Department for Environment, Food and Rural Affairs now being spent on renewing the sea wall and offering other opportunities. We have received significant funding of £10.8 million under the local enterprise growth initiative. There has been money for the new urban regeneration company, which will receive £7 million gross in year 1 and £17 million in year 2, and, of course, there are moneys under the single regeneration budget programme. I might also add, although this is not strictly Government funding, that we have received welcome funding from the Heritage Lottery Fund to regenerate Stanley park, which is one of Blackpool’s major assets, although it has been underused and underexploited in recent years. Finally, the Government announced only last week that they would completely renew and support the development of the lighting programme across Blackpool, which involves £30 million to £31 million.
As I say, I am therefore not at all curmudgeonly about what has been done—indeed, I very much welcome it—but the problem in Blackpool is daunting in scale, systemic and has developed over three decades, if not longer, as Professor Fothergill and others have documented. One could spend an enormous amount of time talking about the process that has brought us to the difficulties that we have today, but I just want to pick out one or two fairly obvious points.
First, there is the systematic decay of Blackpool’s late 19th and early 20th-century infrastructure. I am talking not only about the infrastructure of significant public buildings or areas such as the Winter gardens or the piers, but about promenade and street features, for which it is difficult to obtain lottery grants and which often do not fall within a particular remit. Later, I will talk a little about the trams, and I know that my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) will want to say more about them. For the best part of 50 years, however, no money whatever was put into the infrastructure for Blackpool’s trams.
Of course, other, more powerful forces have driven Blackpool’s decline and problems. Perhaps the major one, which has affected other seaside and coastal towns, has been the loss of the solid one or two-week holiday market. The change in holiday patterns is well understood. I have used this analogy before, and I hope that I am not wearying those hon. Members who have heard it before, but Dean Acheson once said that Britain after Suez had lost an empire but not yet found a role. Blackpool and many other seaside towns have obviously lost the empire of solid one or two-week holidays, and it will not come back, at least not in the same format. At the same time, although it is not a question of such towns’ not yet having found roles—indeed, they are all energetically looking for them—the challenge in terms of Government funding and support is great.
One thing that is not often understood is the impact of skewed demography on Blackpool’s services for residents and visitors. Like many seaside and coastal towns, we have higher-than-average numbers of younger and older people, and that puts a particular strain on what the town can spend on those people. The influx of 10 million to 11 million visitors a year also puts an enormous strain on services. Incidentally, the Government do not yet recognise the need for additional formula funding, and that is certainly true of health spending. Such pressure on local authority funding reduces the amount that local authorities, including those outside Blackpool, can spend on renewing infrastructure and promoting tourism.
I thank my hon. Friend for giving way, and pay tribute to his work in securing the debate, and for his work with the Labour group of seaside MPs. Is he arguing for ring-fenced funding from central Government, similar to what was made available to steel and coal communities, and rural and inner city communities?
I thank my hon. Friend for that intervention. I pay tribute to him, also, for his work in highlighting the similar problems of Welsh seaside towns. The situation is different from what he referred to, in the sense that the coalfield and steel areas were affected by the fairly immediate and dramatic loss of a mono-industry. However, there are similarities. I know that the Government have thus far found it difficult to find an appropriate ring-fenced formula, but there are merits in considering some elements of what was done in relation to the coalfields taskforce. I certainly think that the Minister’s Department needs to look more positively at the issue of an overall regeneration taskforce than its response to the relevant Select Committee report suggested.
The final point that I want to make about funding—I do not want to be too technical—is that seaside towns such as Blackpool suffer from the so-called pepper-pot principle of deprivation. We have severe deprivation in certain areas of Blackpool, but it is in pockets. One of the problems with Government and European funding and grants is that, historically, because of the practice of averaging out across a borough or larger area, we have not attracted the sort of funding that we need in that respect. That is an important issue.
The scale of the challenge is identified by Blackpool council in its response of 5 September about the taskforce to the Minister’s Department. The executive director of regeneration, Jackie Potter, said that, unlike other areas, which are often struggling with single industrial market failures, Blackpool’s case is more complex as it is the compound effect of coastal resort decline and socio-economic and housing market failures. She went on to say that the action plan was therefore designed to tackle these failures and drive regenerations on multiple fronts, based on an understanding that investment solely in developing the economy would not deliver the change required, and that a programme of housing renewal in isolation would not address the underlying causes of market failure. Likewise, she said that it would be crucial to reshape the town’s image to attract a more dynamic population and labour force. She went on to say that that means renewal of the town as a resort, with conferences, attractions, accommodation and infrastructure, regeneration of the town centre as a strong sub-regional centre—that involves retail, education and commerce—and intervention in the housing market.
As I have already said, a problem in the past has been that figures have not picked up the deprivation. However, one or two snapshot figures will remind the Minister and colleagues of the scale of the problem. Official figures describe 29,000 of Blackpool’s residents—a fifth of the population, and obviously a larger proportion in relation to the working population—as income deprived. Three of Blackpool’s assessment zones, which are smaller sub-ward zones, for elderly people’s living standards, are within the most deprived 3 per cent. nationally; 29 of the 94 sub-ward areas in Blackpool, amounting to almost a third of the whole, are within the 10 per cent. of most deprived areas nationally. Blackpool is rated by the Minister’s Department as the 24th most deprived English local authority out of 358. My final statistic is that all 94 of Blackpool’s sub-ward classes are within the most deprived 40 per cent. for ill health and premature deaths nationally.
The challenge of sustaining and building a community is also affected by transience. I do not have much time to talk about transience today. It is a major issue in other seaside and coastal towns. I shall give one example. In schools in two or three of my wards in the centre of Blackpool, the turnover on the school roll can be between 30 and 40 per cent. a year. That is the result of internal transience—people moving around within the town—as well as people coming from outside. One might say, “Well, that is very bad, but how does it affect economic activity and regeneration?” It affects them substantially because it builds up pressure on schools and teachers, and historically it has tended to lead to low skill levels, lower than average achievement and low levels of economic activity. Whatever we do in Blackpool, we need to get the balance right between civic renewal and the needs of the visitor economy and local economy.
There have been major steps in the past 10 years—I pay tribute to the previous Labour administration of Blackpool for this—by way of a new sports centre, a new business enterprise centre, and the building up of local institutions, such as area forums and police and community together meetings. Blackpool has won a series of awards, culminating three or four years ago in an award from the Minister’s predecessor Department, the Office of the Deputy Prime Minister, for the top sustainable community in the country, Grange Park.
I am grateful to the hon. Gentleman, my near neighbour, for giving way, and I apologise for the fact that owing to Select Committee duties I shall not, sadly, be able to stay to the end of the debate. Does he agree that, given the scope and scale of the problems that he has so eloquently outlined this morning, and the impact that Blackpool has on the whole Fylde coast economy, it will require the concerted effort not just of Blackpool council but of the councils of Wyre and Fylde, working together, to try to reach a genuinely lasting solution?
The right hon. Gentleman is right and, in a spirit of cross-party consensus, I pay tribute to the support that he and his colleague, the hon. Member for Lancaster and Wyre (Mr. Wallace), have given me and my hon. Friend the Member for Blackpool, North and Fleetwood on this issue. Of course, what affects Blackpool affects the whole of the Fylde coast. The good news, as the right hon. Gentleman has suggested, is that co-operation is developing between the councils in the area.
What I have described is the reason why, since 2000, debate in Blackpool on how to become a strong, viable, sustainable economy has been a central issue, from the first suggestions of a casino development that were put forward by Marc Etches, the former managing director of Leisure Parcs—to whom I pay tribute for his sustained interest in the regeneration process—to the ideas coming forward for future use of the three piers and the Winter gardens and, finally, the major master plan that was produced in 2003, designed to address so many of the issues, which was instrumental in the setting up of ReBlackpool, the urban regeneration company. That has the distinguished international planner Sir Peter Hall as its chair, and an energetic chief executive in Doug Garrett.
We realised from the beginning that infrastructure investment alone was only a means to an end, and that is where the casinos came in. There was a need for an economic motor. Whatever people’s views are on casinos and where we now go with that issue, the means-to-an-end argument must be clearly understood. The renewal of Blackpool involves, at its heart, the search for a new force—the development of an adequate and sustainable economic generator that will not just initiate but also maintain a virtuous circle of investment, profit, skills and jobs. Without it, even the most visionary schemes of design and planning cannot deliver the full and final renewal that 21st century Blackpool needs.
Blackpool has had a glorious past because its energetic and innovative inhabitants understood better than almost anyone else the business of mass leisure, but we can have a glorious future only if the new forms of leisure and attraction have a viable business sense behind them. That, and no other reason, is why my hon. Friend the Member for Blackpool, North and Fleetwood and I, the members of Blackpool council—nearly all the town’s councillors of all political parties—and most of the major business organisations in the town, supported the idea of casino-led regeneration; it was the only big enough project in the past six years to be potentially on the table with guaranteed bids from multi-million pound enterprises, and the resources to make it happen. However, that does not rule out, nor has it ever ruled out, the options of alternatives or additions to the project, as long as those pass muster in the down-to-earth and pragmatic arena in which Blackpool’s entrepreneurs have always had to contend.
That is why the casino advisory panel’s comments and recommendations were wrong in January, and why its report was shredded by the House of Lords Merits of Statutory Instruments Committee. Outside observers, including Rachel Cooke and James Collard, who wrote excellent articles in The Observer and The Times respectively last August, have understood that if there were to be such a regenerative force, Blackpool would be the place for it. That is why the people of Blackpool were not prepared to take the decision lying down and why we received such a strength of support in the Lords and in the House. Again, I wish to pay tribute to Lord McNally of Blackpool, who led so ably our views and who has been a tireless representative of the town in the Lords and elsewhere.
I do not expect the Minister to go beyond what the Government have already said on the issue, or to offer a review on the issue of the casino regeneration, but he needs to understand the passion and determination that united all but one council member and the vast majority of people in Blackpool, and which brought 11,000 signatures to Downing street. Those signatures were of people not only from Blackpool, but around the north-west. A recent poll in the Blackpool Gazette, which has been tireless in arguing the case for regeneration, showed that the majority still believe that casino-led regeneration might have an important part to play. The Government have a job to convince us that there are alternatives.
The Government have responded to the controversy. The previous Secretary of State for Culture, Media and Sport set up a taskforce an 25 March. The Prime Minister understands our problems, as do others. He gave a personal commitment to finding a solution as recently as the press conference on Monday. The regeneration review set up on 11 July as a response is in the Department for Communities and Local Government. The taskforce to which I referred presented a series of options to the Minister at the beginning of August—I am sure that he will mention that in his speech.
The Minister needs to understand that there is frustration and anxiety resulting from the fact that progress on the matter has been slow. It is now six months since the super-casino debate and three months since the Prime Minister’s announcement. The council has received detailed written requests from and has provided information and background to the Department for Communities and Local Government, but no meeting with officials or the Secretary of State has been fixed. My hon. Friend the Member for Blackpool, North and Fleetwood and I wrote to the Secretary of State in August. The message to the Minister from the people of Blackpool and the broader north-west area is that we urgently need some movement on the issue.
I shall give one example of why that is so. The best part of three years ago, we submitted a bid for the major renewal of the tramway—I am sure that my hon. Friend will say more on that issue. We have jumped through various hoops and we have had some funding for the tramway’s basic renewal, but we have not had a decision from the Department for Transport. Council officials now say that the delays have affected their ability to complete the project on budget and on time. If a decision is not made by that Department soon, the funding schedule might slide, and the project might not be completed until 2012. I appreciate that that is not within the Minister’s or his Department’s direct competence, but it indicates the need for it to liaise with other Departments to look at what can be done.
The taskforce submitted a broad range of proposals. It said at the beginning, and rightly so, that the existing plans would not on their own be enough to provide comprehensive regeneration. In fact, it produced a range of alternative plans and suggestions, including investment in higher education and the housing market, which could go a significant way to addressing some of the regeneration issues. However, at the heart of the matter is the need to give top priority to increasing visitor numbers and to the regeneration of the tourism economy. Blackpool could diversify but, like other seaside towns, its peripherality of 180° means that it will always have greater challenges. A Communities and Local Government Committee report—I pay tribute to that Committee’s Chairman, my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey)—made many of those points and they were debated in the House in May.
The Government need a greater sense of co-ordination on such matters. I am not in favour of setting up meetings with civil servants for the sake of it, but I shall repeat what I said in this Chamber four months ago: without some form of co-ordination between Departments—it is currently led by the Department for Communities and Local Government—and without a sense that people are getting out of their silos, we will not make the progress that we need to make.
Some things have been done. I pay tribute to the Minister of State, Department for Culture, Media and Sport, my right hon. Friend the Member for Barking (Margaret Hodge), who in her previous ministerial post brought together groups of civil servants from the various Departments concerned, but we need a more sustained mechanism, not only for Blackpool, but for other seaside towns.
Blackpool’s regeneration must involve making it an attractive town for people to live in as well as for visitors. It includes getting the townscape right and valuing its heritage. I put forward a number of ideas on how we could do that in a speech to the civic trust in August. I am repeating what I have said on various occasions when I say that an imaginative Government approach to lowering VAT on repair and restoration, and an imaginative package of incentives for businesses to free up space above their premises for low-cost, low-rent accommodation, would make a big impact. Those things are in the air and, as I mentioned, next week an English Heritage coastal towns conference will look at the options open to towns such as Blackpool and at the issues of sustainable heritage, community and economy, which are linked.
At the end of the day, we come back to the question of the economic motor. We need to have one to sustain the virtuous circle. In practical terms, we in Blackpool are in little doubt about what we need. We need a new conference centre, an upgraded tramway system and better direct transport links, an upgraded skills base, and significant retail and new enterprise investment. They are all urgent priorities. We might be able to build a conference centre, but we will not be able to sustain it without income and investment. The question of how and from where we get those things takes us back to the reason why there was such passion and interest in the idea of a super-casino.
Does the hon. Gentleman agree that there is still more than a glimmer of hope and that Blackpool can remain attractive? The pleasure beach attracts some 7 million people a year, which should give hope to any other enterprise that wants to be a part of Blackpool’s regeneration plans that there are still a reasonable number of people around to participate.
The right hon. Gentleman is absolutely right and has given me the cue for what I was about to say. People in Blackpool are not sitting back passively and do not simply expect sums of money or master plans to descend from Government. We have imaginative ideas for retail outlets, restaurants and entertainments, and we have submitted an imaginative bid to a lottery fund with the aim of building the people’s playground along the seafront, but we need some form of incentive to bring in outside investment. That is why the Government need to take seriously the idea of Blackpool having some sort of special status as an investment zone.
We are not passively sitting back. For the past seven years, my hon. Friend the Member for Blackpool, North and Fleetwood and I, the other Fylde MPs and many others have been at the heart of the debate and plans. I am proud of the passion, enthusiasm and dogged insistence of the people of Blackpool. Those things are reflected in the work of ReBlackpool, the regeneration company, the hoteliers and the StayBlackpool organisation, and of the pleasure beach, which has an amazing family history featuring 100 years of investment and innovation in the town. An active civic trust promotes heritage trails and conservation, and the heads of sixth forms and of the Blackpool and the Fylde college are fully aware of the crucial role that further and higher education expansion can play in Blackpool.
We have the support of the Northwest Development Agency. We have a commitment to raising quality among the hoteliers—the No. 1 guest house in Blackpool was recently named the top bed and breakfast in the country. We have a bid in for the theatre museum from the Victoria and Albert museum to come to Blackpool, with exciting ideas to put it in the Winter gardens. There is the people’s playground project. We are not just waiting for the lottery decision; we are going ahead with the St. Chad’s headland. Those who know of them may be interested to know that we recently had a highly successful one-off free concert by the Kaiser Chiefs, and what is still the greatest light show on earth—the illuminations—will be packing people in as a result of a combination of the activities of Dr. Who and Laurence Llewelyn-Bowen.
Blackpool has always had to renew itself. It had to renew itself in the early 20th century to meet changing tourism and other patterns. It did so then through a combination of enlightened public funding, local government funding and private entrepreneurship. That model is still relevant for the 21st century. Blackpool is not looking for a handout from Government or a succession of subsidies, but we are looking for a leg up. We are not looking just for warm words; we are looking for proper liaison, proper co-ordination, a proper response to the taskforce report and a sense of urgency at the heart of Government about how that needs to be addressed. I look to my hon. Friend the Minister and his Department to be at the centre of that argument and to begin to provide some of the solutions.
Several hon. Members rose—
I welcome the opportunity to make a brief contribution to this important debate and, indeed, to congratulate my hon. Friend the Member for Blackpool, South (Mr. Marsden) on securing it. May I also take the opportunity to say how hard he and my hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) have worked on behalf of the residents of Blackpool? It has been a pleasure to work with them over the past 10 years on the Labour seaside group, which lobbies for Government funding for coastal resorts. I hope that we can work together for many more years.
As a near-neighbour of the Blackpool constituencies—I am just a bit further up the coast—I am well aware of the problems that Blackpool faces. Morecambe, like Blackpool, suffered greatly in the 1980s owing to British people taking foreign holidays rather than holidaying in our seaside towns as they had previously done. Guest houses fell out of holiday use and became surplus to requirements. The run-down properties were often purchased by absentee landlords who looked for tenants wherever they could find them. Probation services, social services and mental health agencies saw opportunities to house their clients cheaply, especially with council housing being sold off at that time and in short supply.
My hon. Friend has hit on a key point for seaside regeneration, which is housing. Our Government, the Labour Government, have introduced a national licensing scheme, which has cut down on the ability of slum landlords to make money out of misery. What does my hon. Friend think the impact would have been if such a scheme had been introduced 20 years ago? Would it have halted the decline of slum properties in seaside towns?
Of course such a scheme would have made a huge difference, but there was a lack of interest and investment in coastal towns throughout that period and pockets of deprivation developed that could match anything in our inner cities. Towns such as Blackpool and Morecambe did not wish to advertise their problems too widely, as they were, and still are, in the business of attracting tourists.
Although it is true that the tourism market has changed, with many British people taking their main holiday abroad, there is still huge scope for growth in the short break market and in relation to second holidays. However, to attract tourists, infrastructure needs to be improved greatly. We can see at a glance the difference that a Labour Government have made to our inner cities—I am thinking of cities such as Manchester and Liverpool—with fantastic regeneration projects going ahead, costing tens of millions of pounds in some cases. It is time for the Government to make the same commitment to coastal towns regarding regeneration.
Although I fully accept that people living in seaside towns, in common with the rest of the country, have benefited from the investment in health, education, extra policing, a stable economy and so on that a Labour Government have provided, much nevertheless remains to be done in our resorts, not least to tackle the enormous amount of sub-standard housing that still exists.
My own local council, along with English Partnerships, is well aware of the problems and is examining ways of dealing with them. I ask my hon. Friend the Minister whether he could in the near future visit Morecambe—
And Rhyl, to see some of the important work that is taking place and some of the things that we have already done to turn run-down former guest houses in a state of dereliction into fantastic homes for families in a shared-ownership scheme, which fits so well with Government policies.
I place on the record my thanks to Stephen Matthews, the project director for urban renewal on Lancaster city council, and to Paul Spooner of English Partnerships for their hard work, vision and commitment to addressing these very difficult issues.
If I may, I would like to refer to a letter that I have received from Stephen Matthews that sums up the problems that exist not only in Morecambe but in our resorts generally and on a very large scale in Blackpool. He informs me that
“English Partnerships have made a submission to the Central Programme Review Group at the Treasury in respect of their proposed investment in Chatsworth Gardens in Morecambe’s West End.
As you know, the West End suffers from a complex range of socio-economic issues including extreme unemployment, low incomes and the highest crime levels in the District of Lancaster. The Chatsworth Gardens site area falls within the 0.5 per cent. most deprived Super Output Areas…across England. It is clear that there is a relationship between the socio-economic decline and the housing stock that is typical of the legacy commonly left in declining coastal resorts. The site contains 3-5 storey former bed and breakfast guesthouses which are now used as poor quality privately rented Houses in Multiple Occupation…These currently generate substantial returns for landlords in the West End with ‘high yields’. At the same time they are fuelling social, economic and environmental deprivation and decline and continuing the negative image that currently exists of Morecambe.
The project involves removing around 70 poor quality and inappropriate properties, providing 172 residential units and redeveloping with an innovative new build scheme of 101 purpose-built high quality homes including family housing. All of the new housing will be for private sale not renting. The project will reduce HMO’s and private renting and will bring about a completely different type of housing choice for owner occupiers that would not be delivered without public intervention. In simple terms the project is about taking out inappropriate housing supply that is driving decline and putting back new modern quality homes that will help to stabilise the local community and encourage further private sector investment.
Because of the significant cost of site assembly due mainly to the need to acquire private and often high yield properties, there is a significant cost-value gap on the entire project. This makes the scheme look expensive when considered in purely unit cost terms. The Council and”—
Order. May I gently remind the hon. Lady that the debate is directly on the economic regeneration of Blackpool and that although there are wider issues and certainly there is reference to Blackpool, other hon. Members also want to speak? Therefore, I just gently ask the hon. Lady to remember the time.
I was making the point that the same problems exist in Blackpool and in other seaside resorts with the poor housing stock, but of course I will take advice and move on.
Referring back to the scheme that I mentioned, I sincerely hope that it is allocated the necessary funding and is rolled out both in other parts of my constituency and in other resorts such as Blackpool.
Finally, to end on a high, I am pleased to congratulate one of my constituents, Mr. Ian Hughes, who has produced a national-award-winning design for a 21st-century pier. His concept is called the Beachcomber. It is a marina development with numerous attractions and facilities for locals and visitors. The award will be presented at the British Urban Regeneration Association conference in Blackpool on 31 October. I wish him every success with that exciting and innovative project, and I wish my colleagues in Blackpool every success in their quest to bring about the regeneration of what is still Britain’s premier seaside resort.
I say to my hon. Friend the Member for Morecambe and Lunesdale (Geraldine Smith) that I remember spending holidays in Morecambe as a child. I understand her concerns and welcome her support for Blackpool in this debate.
I congratulate my hon. Friend and neighbour the Member for Blackpool, South (Mr. Marsden) on securing this debate, which is important. He and I have spoken in the House on many occasions on behalf of our town. The regeneration of Blackpool is vital to those of us who live there, as well as to our visitors, and it sends a signal to seaside resorts throughout the country. Although it is about Blackpool, this debate has wider ramifications.
I live in Blackpool. I love living in Blackpool. It is an exciting place—that is why people come to visit and to live there. My hon. Friend and I must maintain a delicate balance between recognising that the town has problems and saying that it is also a smashing place with lots of really nice parts. He and I represent residential suburbia—1920s and 1930s houses. Many people either choose not to work in Blackpool or cannot find jobs there—they travel down to Preston and Manchester, and all over the place—but come back to Blackpool to live by the sea. It is lovely. A couple of weeks ago, I was on North pier watching the final of the international fireworks competition. It was brilliant. Walking back home along the promenade with the illuminations shining amid hundreds of people was a marvellous experience for me, as I live in the town, and equally so for the many visitors.
A lot of exciting developments have taken place in Blackpool recently, most of them funded by central Government and most—in fact, I think all of them—in my hon. Friend’s constituency. Can I put in a plea for my constituency as a postscript to this debate? However, the developments in the town centre and in Blackpool, South benefit my constituency as well—for instance, the Government’s investment in our sea defences and the promenade. South beach is beautiful now. The central promenade is being developed, and exciting proposals have been made for a people’s playground. The central gateway for people driving into the town from the motorway opens up Blackpool and makes it much more pleasant for them, and the Hounds Hill shopping centre is being redeveloped.
For me, one of the most exciting proposals is the Talbot gateway development, which will reconfigure the railway and bus stations. The first thing seen by anybody arriving in Blackpool by train is—I shall not mince words—the horrible old bus station. It is not a welcoming sight. It is proposed to knock it all down and open up the view from a new transport interchange, so that people getting off the train will see the tower and what Blackpool has to offer. They will have a new vision. My question to the Minister is: when will it happen? I know that the council has signed contracts with the developers and the Government have given it the resources to purchase the land in order to facilitate the development, but I am getting impatient. I want to see it happen tomorrow, the day after or some time soon, please.
All those developments are part of the master plan developed by the previous Labour-controlled authority, but supported by all political parties on Blackpool council. The key to the master plan’s development was casino-led regeneration. I endorse everything that my hon. Friend said about it. The casino was the driver for regeneration—a £400 million project using private-sector money that would have included a new conference centre, hotels, entertainments, shops and restaurants. It would have been a whole new experience to bring new visitors into Blackpool. They would have spent money, and that money and the casino company’s profits would have helped in turn to make the conference centre sustainable. I challenge anybody to name a conference centre that supports itself. They are all subsidised, either by local authorities or by private-sector organisations. We need a new conference centre in Blackpool. Much as I love the Winter gardens—the Emperor’s ballroom is a marvellous setting in which to stand and speak from the platform—we need a modern, up-to-date conference centre to attract the conferences that used to come to Blackpool. I shall discuss that at the end of my contribution.
Without the engine to drive our regeneration, even though the Government are investing huge amounts in our infrastructure, we do not have private-sector new product to attract people into the town. We must remember that Blackpool’s regeneration affects the whole Fylde coast, a point made by the right hon. Member for Fylde (Mr. Jack). If Blackpool gets it right, that will help his constituency, the Wyre district, the whole Fylde coast area and well into Lancashire.
Not only does Blackpool’s regeneration help neighbouring districts; it depends on them, for one reason if no other—the availability of land for further development is constrained in Blackpool. We must work with our neighbouring authorities to identify land that can be used to provide employment, and continue our regeneration. I am pleased that the three Fylde coast authorities are working together. They are moving toward a strategic policy alignment and are developing a multi-area agreement, which is exactly what we need.
Blackpool’s regeneration is not just for visitors, to give them new entertainment; it is also for residents. It is a chicken-and-egg situation. Many of my constituents have money to spend, but do not spend it in Blackpool town centre. They do not go shopping in town centre shops. If they did, it would help regenerate the town centre. We must regenerate the town centre to ensure that people who live in Blackpool feel confident going there, as well as to provide a better visit for tourists.
I re-emphasise the point made by my hon. Friend. A lot of people in Blackpool are investing in their businesses. The pleasure beach has been mentioned, and people continue to enjoy visiting the tower, the piers, the zoo, the model village, our seafront and the Grand theatre. I attended an excellent production of “South Pacific” there. It is a beautiful setting. We must consider how we can make the town centre more attractive as part of the regeneration package. My hon. Friend mentioned the detailed report produced by the taskforce, which is to be congratulated on coming up with a Blackpool solution to the complex Blackpool problem. I look forward to the Government’s detailed response.
One of the key elements of the taskforce report is that if we are to diversify and regenerate, we have to do something about the skills base in the town and about employment land. Some interesting suggestions were made in the report about supply-side interventions to improve the skills base and employment. However, there are also problems with transport, and in the limited time that I have left I shall concentrate on those. I also want to say one or two things about the challenges facing the town.
Despite all the developments of which I have spoken, and the fact that the Fylde coast economy contributes £3.9 billion to the gross value added of the central Lancashire city region, the GVA and employment declined between 1990 and 2005. More than a quarter of our working population are economically inactive.
I believe that the Government should look again at the report of the Select Committee on the Department for Communities and Local Government, which highlighted the fact that a disproportionate number of people are on sickness or incapacity benefits in our seaside towns. The Government’s response was to dismiss the report, but they should not. We have a pathways to work pilot scheme to help new claimants, but there are many existing and former claimants.
I thank my hon. Friend for giving way. On that specific point, is she aware that there is a city strategy pilot specifically aimed at seaside towns? It is one of 15 city strategies across the UK, and it is aimed at Rhyl. It is about getting people back to work.
I was in the Chamber when my hon. Friend made that point earlier this week. I thought then that Blackpool wants one of those.
The Select Committee report mentioned seasonal labour. The Government’s response was dismissive, yet when the lights are turned out in November, about 950 people will be going to the jobcentre. It is like a major business closing down; tourism is an industry. What we need from regeneration is a 52-weeks-a-year economy. We do not have that now, even though many people try desperately hard to ensure that hotels stay open for as long as possible. There are real issues about how to encourage our businesses, but that will have to wait for another day because I want to refer briefly to transport.
It is essential that we get the money for the tram. The tram transports not only visitors, but people to work. My constituents in Fleetwood get on the tram to travel to work in the hotels along the promenade. The tramway serves some very deprived wards in Fleetwood and in Blackpool. It has been calculated that if the tramway was to close—God forbid—we would need 45 more buses every hour to transport the 3.4 million passengers who use it. One can imagine the gridlock on the promenade!
Investment in the tramway is key, but so is investment in the A585, the trunk road from the M55 to Fleetwood that skirts Blackpool. We need investment in the A585 to open up more land for economic development as part of Blackpool’s regeneration. Again, I pay tribute to the right hon. Member for Fylde. He and I have worked closely together on that issue. The road starts in his constituency and ends in mine, and runs alongside Blackpool technology park. If we want more development there, we have to ensure that traffic can move on that road. At the moment, the traffic gets stuck, and we do not want that.
I quickly move on to the casino. It is a key point. What other organisations are queuing up to spend £400 million in the centre of Blackpool to bring in new visitors? I am waiting to hear. We want a new product for our visitors. If we had one that generated the income to support a conference centre, I would welcome it. However, the majority of people in Blackpool still think that the casino is the only product that will give us that.
I want Blackpool to have a new casino so that I can welcome colleagues from all political parties to an up-to-date, new conference centre that will give them the facilities that they need. That will bring back all the other conference trade and give us a 52-weeks-a-year economy. It will ensure that our visitors enjoy their stay, that our residents have jobs, and that they can enjoy the town centre and shop there. Blackpool could then satisfy their needs and the needs of our visitors.
I hope, Dr. McCrea, that you will allow me some leeway in describing the successes in my constituency and my home town and how they could benefit Blackpool. I shall drop Blackpool’s name into my speech as often as I can.
I shall concentrate on two key issues that were mentioned by many of those who have spoken—the need for a focus, especially in seaside towns, on joined-up governance. It was a key Labour catchphrase in 1997, but it has drifted a little. We need that focus back, especially in seaside towns. I mentioned earlier in an intervention the importance of housing in the regeneration of seaside towns. Many residents have poor health, so health provision is important; and education and skills are key to raising the skill levels so that the people in those towns can get good jobs in their local communities.
The Department for Work and Pensions has city strategies aimed at getting people on long-term sickness or incapacity benefit back into work. Another key issue is that of policing. People will not come to the town if they feel that it is not safe for them and their families. My plea to the Minister is for joined-up governance for Blackpool, Morecambe and Lunesdale, and Rhyl and Prestatyn in my constituency.
The other need is for ring-fenced funding for seaside towns. I tabled a parliamentary question between seven and eight years ago asking how much the Government had given them. They have been very generous to rural communities in times of crisis and with general subsidies—tens of billions of pounds—and tens of billions have been given also to the coal communities that have suffered with the pit closure programme of the previous Governments. Steel communities—I refer especially to Shotton in north Wales—suffered the biggest layoffs in British industrial history, with 8,000 workers sacked in one day. Such communities have received billions of pounds, as have inner-city areas.
The problems in our seaside communities are just as great, and we need that level of funding to be targeted in our direction. In my area, in Rhyl and Prestatyn, we have managed to get objective 1 money—the highest level of European funding—and that has primed local projects. It makes a difference. It can tilt the balance towards investment in marginal cases. If money was ring-fenced for Blackpool, we could market the town and development sites and attract developers. Focus and ring-fenced funding are the key.
Much has been said today about physical investment in transport, casinos and regeneration. We should also consider the people who live in those communities. In Rhyl, six or seven years ago, I set up an employment group, like my hon. Friend the Member for Blackpool, South (Mr. Marsden), whose constituency had 29,000 people unemployed or low-paid or suffering poverty. I looked at the figures for my constituency and in most of the 32 wards in Denbighshire unemployment had virtually disappeared. Some 50 per cent. of unemployment in the county of Denbighshire was in two wards: Rhyl west and Rhyl south west, which is where I grew up. We need to crack that concentration of poverty and the Department for Work and Pensions’ city strategy pilot projects will provide some of the answers. If the Minister is co-ordinating that project will he take a careful look at the city strategy in Rhyl? I formally invite him to visit my constituency as although many of the functions of regeneration in my constituency are devolved, such as health, housing and education, issues dealt with by the DWP and policing are not.
It is a privilege to serve under your chairmanship, Dr. McCrea.
This has been an extremely interesting debate and I congratulate the hon. Member for Blackpool, South (Mr. Marsden) on painting such a clear picture of the difficulties that he believes Blackpool faces. I also congratulate his colleagues on giving him excellent support. I shall pick out a couple of things he said that struck a chord with me. He mentioned pepper-pot poverty and the fact that small pockets of deprivation are often surrounded by areas of comparative prosperity, which means that a broad-brush statistical approach by the Government does not give him aid or comfort. That is probably a familiar issue to many hon. Members with constituencies across the country and it is certainly familiar to those with constituencies in the north-west. I hope that the Minister will go a step further than anyone else on the Government Front Bench and acknowledge the problems created by such an approach, particularly in Blackpool, but also elsewhere.
I was also struck by the hon. Gentleman saying that Blackpool does not see itself as a victim and that it has always done its best to look after itself. We should congratulate the council and civil authorities in Blackpool on their work, as well as those MPs who have ensured that that is the case. The hon. Gentleman asked for some specific information from the Government and I hope that the Minister will respond to that. I noted that he referred to the impact of a 17.5 per cent. VAT rate on renovations. In a town such as Blackpool it is central to regeneration that existing buildings are brought back into profitable and full use. A situation in which it is cheaper to pull a building down and build a new one at a zero rate of VAT rather than renovate an existing one and pay a 17.5 per cent. rate of VAT is clearly an anomaly that needs to be addressed, not just in Blackpool but elsewhere.
The hon. Gentleman was honest in saying that Blackpool is a place that everyone has heard of and about which everyone has an opinion, not all of which are entirely positive. Blackpool has a proud history, has been the premier resort of the north of England for a long time, and has worked hard to extend its appeal. The hon. Gentleman mentioned the Blackpool illuminations and of course there are also other aspects. Blackpool is fighting hard to maintain its role in the north as a tourist centre, but it needs help. It is a victim of changing lifestyles. If it is cheaper to fly to Florida than catch a train to Blackpool, it is understandable that many people should go to Florida and not to Blackpool, whatever its comparative charms may be. I made my first visit to Blackpool in 1968 when it was pouring with rain and I could not see the top of the tower because of the mist. Again, if it is a choice between a train to Blackpool or a flight to Florida, one can see why people sometimes make a choice adverse to Blackpool.
On a serious note, any visitor to Blackpool recognises that there is a desperate need to upgrade things such as transport links, leisure amenities, and conference facilities. I have attended conferences for three different organisations in Blackpool and I underline the point made by Labour Members that there is a need to tackle deficiencies in conference facilities. Accommodation for visitors no doubt needs to be upgraded but, as the hon. Member for Morecambe and Lunesdale (Geraldine Smith) said, accommodation for those living in Blackpool also needs to be improved. The shortage of social housing and the poor quality of private rental accommodation has been mentioned and the Government have been asked questions about that by those hon. Members who have spoken so far, to which I hope the Minister will respond. The comprehensive spending review was empty on what will happen and what funding will be provided by the Government in relation to those matters, so I should like the Minister to comment on that.
Obviously, we could not have a debate about Blackpool without referring to the casino and I do not want to rehearse that issue again. However, for perhaps almost a decade Blackpool put its hopes for funding regeneration almost exclusively in the casino basket, which has turned out to be a bit of a gamble. Whatever the merits of having a mega-casino in Blackpool, it is fairly clear that it will not happen. The casino advisory panel noted that such a casino
“would be useful to manage decline, but not to reverse decline”.
It is true that there would be economic benefits of £400 million, but there are pros and cons related to that. The social impact would be ambiguous, which is no doubt why the Prime Minister said
“I’ve said I feel there are better ways of regenerating those areas and that's what we're looking at at the moment”
That is why I do not want to concentrate my remarks on asking to have the casino back, but on asking what the Government will do to honour what the Prime Minister believes is the way forward for Blackpool. The Minister now has an opportunity to give an update on the action that will be proposed. It is clear that we can expect something special in the Minister’s reply and I want to give him plenty of scope for that. The Prime Minister also said:
“the Secretary of State for Local Government is co-ordinating the work about what we can actually do... to help…which I accept has specific challenges it has to meet in the near future”
I want to hear exactly how the Minister’s Department and the Secretary of State are responding to the challenge of the situation and the challenge given to his Department by the Prime Minister.
There is plenty of advice about what the Government might do. Indeed, the hon. Member for Blackpool, South and others have described some of the things that could and should be done to regenerate Blackpool. I received a briefing, as I am sure have other hon. Members, from the Noble organisation, which is a major player in the Blackpool leisure economy. It describes itself as being one of the UK’s leading leisure businesses with interests in Blackpool and it has welcomed the switch in thinking away from a new mega-casino to investment funded through a new conference centre. I do not regard myself as an expert on economic regeneration—particularly not in Blackpool—but when a major investor and player in Blackpool offers such advice, it should be listened to. Noble has told me that it
“Welcomes the Government's plans to support further regeneration in Blackpool, support which, in our opinion, would be best focussed on new conference facilities.”
As I said, those of us who have experienced existing conference facilities would certainly support that.
What will the Secretary of State do to honour the Prime Minister’s pledge to Blackpool that there is active planned help for regeneration? Where is the report on the options that are being considered by the Government? In addition, as has been mentioned, can we be assured that there will be a joined-up interdepartmental Government response that links up the investment needed in transport with investment from the Department for Communities and Local Government via the local authority and that the key issues of planning and housing investment will also be linked?
Does the Minister agree that an urgent priority has to be to get a new conference complex built to the highest international standards? Does he accept the argument put by many hon. Members and many commentators that investment should be made not only in the economy and infrastructure but in the housing market to tackle the underlying issues of deprivation? The town has spent perhaps seven or eight years getting further and further into what has turned out to be the cul-de-sac of relying on the casino for regeneration, so what assurance can he give that solid, practical help with regeneration will come from the Government? When will it be forthcoming and when can we expect to hear some solid announcements of fact to settle Blackpool’s difficult situation?
It is a pleasure to see you, Dr. McCrea. We go back a long way, and it is very nice to be under your chairmanship this morning. Like all colleagues present, I welcome the debate and thank the hon. Member for Blackpool, South (Mr. Marsden) for securing it and for the way in which he presented his case; it was informative and he was very straightforward about Blackpool and its pluses and minuses. I am sure that much of what he had to say would be common ground between us all. However, we now know the way to get things done by the Government. If I were to stand here and give a commitment to £2 billion of investment in a new conference centre, within a week it would be Government policy. Tempted though I am—
Encouraged though I am to go down that road, the heart attack that it would give my hon. Friend the shadow Chancellor would not be similarly welcomed, so I shall not do so.
Contributions from other colleagues have been similarly informative and generous. The hon. Member for Morecambe and Lunesdale (Geraldine Smith) spoke. I visited the Midland hotel recently and saw the work that is being done there, and that will be an exciting new destination in her constituency. The hon. Member for Blackpool, North and Fleetwood (Mrs. Humble) described well the attractions of the constituency and of her end of it. I agree with the hon. Member for Vale of Clwyd (Chris Ruane) that when we talk about regeneration we should concentrate not solely on the physical, but on the human, too. He was right to pick up on that point, which was also made by the hon. Member for Hazel Grove (Andrew Stunell).
We all have an affection for Blackpool, produced either by years of experience as politicians or by childhood memories. I was born and brought up in Bury, and visits to Blackpool were occasional but much enjoyed. My parents might have preferred Southport and Lytham, but I loved Blackpool and it has always been good to go there. We all feel keenly and in a particularly special way about Blackpool being such a great and important resort. We all feel very keenly its irrelative decline and want to do something about it.
Since the turn of the millennium, that decline has been quite sharp. There has been a sharp fall in visitor numbers—Blackpool Pleasure Beach Ltd. calculates it at perhaps 7 per cent. a year—accompanied by similar declines in the length of stay and visitor spend. There have also been problems about the spread of houses in multiple occupation and the difficulties relating to young people, drugs and violence and the stags and hens element of an evening economy. Such problems have always been a part of Blackpool, but they are perhaps overemphasised now. There is a general tiredness about the place and it needs revitalisation.
The problems are twofold. First, they are those of a coastal town, and secondly, they are those of Blackpool in particular. I echo many of the comments on coastal towns that the Minister has heard this morning. The Select Committee’s good report on the subject received a disappointing response. Some attempt to move towards a cross-departmental group would be good. The Government were rather light in not recognising the particular problems of employment and benefit issues in coastal towns, and I think that the disinclination to undertake any specific research into the common problems of coastal towns resulted in a missed opportunity. In response to what he has heard today, perhaps the Minister will be able to take that point back to his colleagues and we might see some progress.
Does my hon. Friend agree that one of the problems is that the way in which the revenue support grant is structured is not always very helpful to us? For example, there have been cases regarding transport in which additional moneys are conditional on the provision of bus lanes, even in places where they are not wanted. The biggest thing that affects all the coastal towns, including my constituency of Bournemouth, has been the abolition of the grant for day visitors, which used to be part of the revenue support. The removal of that has been acutely damaging to Blackpool, Bournemouth and all the other major resorts.
My hon. Friend’s point is well made, and it is exactly the sort of thing that was picked up by the coastal towns report, which could well be usefully considered by a cross-departmental group that considered those specific problems. I hope that the Minister will be able to take that back as something constructive from this constructive debate.
A number of agencies are working on Blackpool’s specific issues and concerns. I congratulate the British Urban Regeneration Association—BURA—on its work. It has its own seaside towns network. I met its members recently, and they are very up on those concerns. I have also recently spoken to David Cam of Blackpool Pleasure Beach, to Doug Garrett, the chief executive of ReBlackpool, and to Peter Callow, the new Conservative leader of the council after the party’s stunning success in the May local elections, perhaps on the back of the disappointment of the casino decision.
Interestingly enough, the resilience of the town and the area was shown in the response to the casino decision. The Government have been quite generously treated by colleagues on the other side who might have been really cross. It is not the Minister’s fault, but there is real concern about the decision and the incomprehensible parallel decision that the casino should go to Manchester. However, that is water under the bridge for now and we must ask what can be done in response. The issue is about what will provide the catalyst for regeneration.
I spoke to Peter Callow, the leader of the borough council, which feels that three particular pledges that emerged from the aftermath of the decision, relating to a conference centre, the revitalisation of the tramways and perhaps support for a museum—the Victoria and Albert museum is thinking about doing something in the area—might be concrete responses to the disappointment that is felt. The borough council’s determination to clean up Blackpool and to make it a destination not only for tourists, but for those who work there and want a good quality of life—the point made by the hon. Member for Blackpool, North and Fleetwood—will be important. I welcome and congratulate the borough council on its drive to do that.
What sort of things will make a difference? I talked to David Cam of Blackpool Pleasure Beach, recognising the importance of the beach to the economy of the area, and he made the point that revitalising the promenade is not sufficient in itself. Sea defences schemes have been promulgated down the coast—I went to have a look at what is happening in Cleveleys; it is really good, and I know that it is extending down the coast. However, on its own the promenade is not enough. David Cam made the point that the regeneration of New Brighton, which was envisaged many years ago, did up the prom very well but its hinterland could not be regenerated because there was not the catalyst to bring people in, and its sad decline as a resort was never reversed.
Perhaps it would be interesting to consider having a regeneration zone set aside for economic development in the Blackpool area as part of the response to the taskforce. That could involve the investors who lined up behind the casino scheme, who were there to do something in Blackpool and who recognise that the Government’s role is to clear the pitch and to provide basic investment. Such a process should then allow the private sector, using its own judgment and skills, to come in and ensure that there is a sustainable economic case for development so that it does not continually rely on Government assistance—something that Blackpool would not wish and would not need to do. A combination of ensuring the best possible opportunity to place a convention and conference centre, revitalisation of the tramways and a specific regeneration zone enabling some of the other clearance work that needs to be done in Blackpool might be a useful way to proceed.
We are interested in the possibility of regeneration zones, although I shall not say too much about that in case it, too, appears in the Government programme at some stage. We want more powers to be returned from regional bodies to local authorities, so that those authorities can begin to have more of a whip hand in such decisions instead of relying on regional bodies, and Government relationships with regional bodies, in order to make decisions.
Our tourism taskforce will report later in the year. It is interested in what has been happening in Blackpool and other coastal towns and will make specific proposals at that time. In general, however, I think that the affection for Blackpool felt throughout the House and across political parties is real. That affection is based not just on sentiment, but on the good quality of life and the tremendous skills that it has. Everybody wants to see it revitalised, in which the Government and private sector can play a part. I hope that enough has been said this morning, and in various reports since the casino decision, to give the Government a sense that they could do something to make up for the mistake that they made some months ago.
May I say, Dr. McCrea, what a pleasure it is to serve under your chairmanship for the first time? I congratulate my hon. Friend the Member for Blackpool, South (Mr. Marsden) on securing the debate, and other hon. Members who have contributed.
I commend my hon. Friend’s efforts, and those of other hon. Friends, in promoting the regeneration of the area and especially their commitment to improving the conditions, prospects and quality of life for their constituents, and for visitors to Blackpool. Over the past 12 months, Blackpool has been in the news for a variety of reasons, particularly the casino. That was due in part, I think, to the high quality of parliamentary representation that hon. Members here today provide to the people of Blackpool, Morecambe and Fleetwood.
T he Government recognise that Blackpool has faced deep-seated and long-term deprivation, with severe social and economic challenges over many decades. In many ways Blackpool’s problems with poor health, drugs, alcohol, poor housing, low educational attainment and high crime rates mirror those of many inner-city areas. As has been said throughout this debate, however, Blackpool, as a coastal town, faces other significant problems. Many coastal towns have suffered a gradual decline over the last 50 years with a transient population, falling tourist numbers and the closure of hotels and guest houses.
Blackpool is having to address a long-term cycle of neglect and underinvestment in the resort. But it is not all doom and gloom. I have taken real pleasure from the manner in which hon. Members, and particularly my hon. Friends, have handled this debate. It would have been very easy to feel bitter and resentful, and to say that everything is going down the toilet. However, as we have heard, Blackpool is a great place and has improved a lot over the last decade. There is the ambition to improve further still.
As in my own area of Hartlepool, some people like to slag off the area in which they live. In the era of globalisation, in which investors can go anywhere in the world they like, the first things that they will look at are press cuttings and how people talk about the area in which they live. If people are constantly running down an area, I do not think that others will choose to invest there. However, the dignified, resilient and ambitious manner in which my hon. Friends have promoted Blackpool—recognising the challenges, but showing what a great place it is to live in—is true testimony to the calibre of hon. Members here today.
There is an increasing recognition of the importance of Blackpool at local, regional and national levels. Local partners are rising to the challenge and there are encouraging signs of progress. Investment in local schools and health services has resulted in improvements in school performance and improved health and life expectancy for Blackpool residents. The quality of the local environment is improving with cleaner and safer streets and public spaces. There is a solid base, therefore, on which to build the economic regeneration of Blackpool.
Before I go into greater detail about Blackpool I shall touch on another matter. Hon. Members have mentioned the broader issue of coastal towns. As a Member who represents a coastal town, I would like to comment on that for a moment. The Communities and Local Government Committee report on coastal towns was incredibly useful and informative. However, I think that we have heard today that Blackpool suffers from unique problems, and I would be very reluctant to have a one-size-fits-all approach to coastal towns. My coastal town difficulties will be different from those of Blackpool. I have been to Bournemouth and Brighton recently. They are very different as well. That one-size-fits-all approach is not appropriate.
The Select Committee report did not ask for a one-size-fits-all approach, but recognised the complexity of coastal towns. It clearly said that coastal towns that are also historic seaside resorts have particular and shared problems. Will the Minister look at those former seaside towns and their problems, and liaise with colleagues? This is not a matter just for him. Other Departments need to work together and look at the specific issues in those towns.
My hon. Friend makes a very strong point and I agree with a lot of what she said. The Government are reconsidering their response to the Select Committee’s report on coastal towns, in the light of representations made to the Secretary of State for Communities and Local Government by the Chairman of the Select Committee, my hon. Friend the Member for Milton Keynes, South-West (Dr. Starkey).
My hon. Friend the Member for Blackpool, North and Fleetwood (Mrs. Humble) is absolutely right to say that a cross-departmental approach is the right one to take. My Department is currently working with the Department for Business, Enterprise and Regulatory Reform, the Department for Work and Pensions, the Department for Environment, Food and Rural Affairs, the Department for Culture, Media and Sport and the regional development agencies. We are working with them on cross-cutting policy issues affecting coastal towns in order to see whether current co-ordination arrangements at national and regional levels can be improved. As I have pointed out, as a Member representing a coastal town, I am very keen for those cross-cutting initiatives to take place.
My Department is also developing a regeneration framework as part of the follow-up to the sub-national review of economic development and regeneration in order to identify the kinds of places where regeneration activity might best be focused. I think that it is entirely plausible that those could include coastal towns.
In an Adjournment debate before the recess on the Select Committee’s report, my hon. Friend the Member for Blackpool, South suggested that officials could meet a few times a year to discuss an agenda put to them by bodies such as the British Urban Regeneration Association, in which I know that he has an interest, and the British Resorts and Destinations Association on coastal town regeneration and renewal. I think that there is value in that suggestion and that that level of engagement could be important. We are currently seeking the views of other Departments on that matter.
An awful lot of points have been covered in the debate, and I pledge to write to hon. Members who have participated if I do not get everything across that I would like to. I shall turn to the Blackpool taskforce. Following the decision not to grant Blackpool a regional casino licence, the Government committed £1 million to the Blackpool taskforce, which was set up in March this year to look at long-term regeneration plans for the town. Representatives from Blackpool council, the Northwest Development Agency, English Partnerships, the Government office for the north-west, the urban regeneration company, ReBlackpool, and Business Link Northwest, as part of the regional development agency, have developed an action plan for Blackpool which was presented to the Government in August of this year. In preparing for this debate, I was incredibly impressed by the proposals in the action plan. I really enjoyed reading it and would like it implemented as much as possible.
The action plan complements the north-west regional economic strategy and the regional spatial strategy, and proposes a vision for Blackpool to be developed around three themes: revitalising business and enterprise, transforming access, infrastructure and the environment, and creating sustainable communities. Officials from across Departments with an interest in the programme put forward by Blackpool have had some extremely useful discussions with the urban regeneration company and with the council to follow up the report. We are now actively considering our response and my right hon. Friend the Secretary of State for Communities and Local Government has said that she will meet the taskforce for a further discussion, which we hope will take place shortly. And as my hon. Friend the Member for Blackpool, South said, my right hon. Friend the Prime Minister has played a key role. He has taken a personal interest and wishes to be closely involved.
The taskforce report encapsulates a way forward that covers both activity under way and new projects that could contribute to changing and broadening the economic base of the town and to addressing some of the most deprived areas within it. We recognise that this programme, which covers many of the issues that I had hoped to touch on—I do not think that time will allow me—depends for its success on a co-ordinated effort across a range of local and regional partners and within government; I stress that there has been very active discussion on the taskforce report across all relevant Departments. The response from the council and the urban regeneration company has been extremely helpful in demonstrating the connections between different elements of the taskforce programme.
The projects are being looked at in the round so that, for example, the relationship between improvements to further and higher education in the area, the renewal of the town centre and housing—a major interest of mine—is addressed properly. My Department is ensuring that all the taskforce recommendations are considered and we are looking at the sensitivity of timing on some decisions, including the tramway, which has been mentioned today.
However, it has been made very clear today that there has been some frustration with the level of progress and the pace of change. Given the importance of ensuring a co-ordinated response, I shall go back to my Department and others and stress the importance of ensuring that progress is made and continues to be made. That is a major priority for my Department and for other Departments, and it has the personal endorsement of the Prime Minister, which I do not think will be ending. I give my pledge on that.
Before I say a few words about this democratic issue, perhaps I could dedicate the debate to one of the finest parliamentary democrats, John Garrett, who sadly passed away just a couple of weeks ago. He was an inspiration to many of us in the House, and I hope that this debate conforms to that long tradition.
The Prime Minister devoted his first White Paper to the governance of Britain, and he devoted his first speech to the House as Prime Minister to the topic of the new democratic settlement. He also promised the
“devolution of powers and responsibilities to local government and accountability of our local police and health services to their communities.”
I know that the Minister—keen to ensure that the Prime Minister’s wishes come to fruition—will take those words very seriously.
On the other side of the argument, Simon Milton, who runs the Local Government Association, has called for a “constitutional convention”, which I presume would grow out of the proposed concordat between local and national Government. What is certain is that any local power worth the name must be the right and property of local government, not of the centre. Local power that is loaned by central Government—by edict or even by parliamentary statute—is a sham, because it can be taken away just as quickly as it can be offered. Only Britain has such a dysfunctional political system that does not recognise local autonomy. Other western democracies take for granted independent local government that is backed by constitutional guarantee and genuine financial autonomy. Professor Michael Genovese, one of the foremost scholars of presidential politics, said recently, quoting Jefferson:
“Only on the basis of little republics will people be able and be trained to effectively participate in a mature democracy.”
Those words are as true today as when they were first coined.
As a result of genuine local democracy, people will benefit from activity and involvement locally, making a serious difference to the quality of life in our local communities. Given the reduction of local government over recent decades to little more than an agent of central Government, this proposal would amount to the largest denationalisation ever undertaken and the restoration to the public of their ownership of their own local government.
The centralisers in British politics have had their day. Whatever success they may or may not have had nationally over the past 40 years, they have delivered neither economic nor social progress locally. I speak not only as an MP but as the chair of a local strategic partnership. We see short-term finance, interference, distortion of local priorities, people spending much of their time bidding or working to protect their jobs, and a plethora of schemes and bodies to circumvent local democratic decision making, which is barely understood by anybody but a new cadre of local professionals.
Successive Governments have occasionally served dainty hors d’oeuvres of localism, but the main course has always been the same—a stodgy, lumpy stew of targets, orders and inspections that have been force-fed to local councils by central Governments of all political complexions. I hope that the concordat will offer us not more amuse-bouches but a completely new menu for local democracy.
Almost every business and every other democratic nation has concluded that the economic complexities in modern society are way beyond the capacities of a command economy. They not only speak the language of decentralisation, devolution, local budget holding, participation, and teamworking, but deliver its promises. The European charter of local self-government was signed by our Government, but its spirit still needs to be given form. Only the United Kingdom, and England in particular, stays stuck in a command-style politics that died with Leonid Brezhnev elsewhere in the world. That style is at its starkest and most wasteful in the central control of local government. It robs communities and individuals of the ability and ambition to run their own lives, and it has atrophied political parties of all colours. We know that that has happened throughout the United Kingdom, whatever else we pretend,
Free local democracy will provide more diversity and independence in our political system, in turn leading to more creativity, sensitivity and innovation throughout our society and economy. The mere removal of some of the worst excesses of centralism, such as ending the capping of local spending, democratising quangos, releasing capital receipts and adding a drizzle of “localist” jargon, has not been enough. We must put local independence beyond the reach of central Government, and admit that the gentleman in Whitehall—even if it is a Labour gentleman and a very good friend of mine—does not know best. Petty interference from the centre must be denied any legal or financial basis, and local government must be given unchallengeable legitimacy. That must be done in two ways.
Ambition must be at the heart of the concordat that the Government are to negotiate with local government. It should be able to slot easily into its rightful place in a written constitution, when that day comes, and the vision must be powered by the Prime Minister above all. Local government must be a part of the vision that he has outlined for a new democracy. It must be driven by local government leadership, which needs to get off its knees and argue for two fundamental principles of its own freedom.
First, to guarantee local authorities’ independence, they must be created in law as independent and sovereign entities. They would then be able to undertake, as of right, all the duties and functions for which they are elected locally. That power should be further guaranteed by a legally enforceable definition of subsidiarity in the European constitution. I shall not veer into the debate about the constitution, but it would be nice to have one, and, if we had one, to define subsidiarity so that it could defend British local government in the same way that it seeks to defend it in the other European Union nation states.
In that new settlement, local authorities would be able to do anything not prohibited by law, turning on its head the present injunction that prohibits them from doing anything unless it is expressly allowed by law. Like all public bodies, local government would have to perform its duties within a legitimate national inspection regime, and without infringing the human rights that would be found in a modern and comprehensive British Bill of Rights—another part of Britain’s governance jigsaw that we hope will be proposed in legislative form in the not-too-distant future. Local government could therefore be held to account by any citizen for any arbitrary breach of those rights.
The pull of centralism, however, is so great that even a Government who had created independent local government, as I hope our newly refreshed Government will, might succumb to the temptation to meddle unless such local rights were put constitutionally out of bounds. That could be achieved initially by an amendment to the Parliament Act 1911 that would allow the second Chamber to veto legislation that threatened the agreed rights of local government. In the longer term, such a fundamental bedrock of our democracy needs to be guaranteed by clauses in a written constitution for the United Kingdom. The 10th amendment of the American constitution provides a very helpful starting point.
I entirely endorse the hon. Gentleman’s analysis, but until we obtain the changes that he proposes, we must describe what the Government call “local government” as it really is. It is the agent of central Government, given that it has very little latitude whatever.
Rather than be critical of any Government, I would seek all-party support for where we go from here. If there is to be constitutional change, it will need cross-party agreement if it is to stick and not be unpicked by parliamentary statute. I know that the hon. Gentleman supports the essence of what I have been saying.
I turn to what must be the second fundamental principle. Central to the concordat is that, while we may return ownership of local government to local people, we must also restore control to them. Political independence for councils would mean nothing without financial independence. The bulk of local authority spending—more than half—is now provided by central Government and only a fraction, one eighth, is raised locally by the council tax. That dependency must end. Central Government must be removed from the financial equation and localism given monetary teeth. To do so, a radical new settlement on taxation needs to be implemented.
At present, income tax is first collected from local taxpayers by Her Majesty’s Revenue and Customs and then distributed back to localities via central Government. That essentially technical function of distribution has become politicised and arbitrary because of decades of governmental manipulation and the desire to impose central priorities and targets. In future, the same level of income tax revenue should still be collected by the Revenue, leaving the taxpayer and tax rates completely unaffected financially. However, the precise amount that currently goes to local government should be ring-fenced and go directly to it, not via the centre.
Central Government spending on local services in England and Wales is £54.6 billion and the income tax take is £109 billion, so in effect about 50 per cent. of the income tax take would become local, with 50 per cent. going to the Chancellor, as it does now. That redistribution could take place via the Local Government Association or an independent commission, legally separate and dislocated from Whitehall. Yes, what we did for the Bank of England we must do for local government. Such a body would receive local government’s slice of income tax directly from HMRC, and be charged with distributing it to councils and equalising it on exactly the same basis as the Department responsible for local government currently does.
There is no reason why most of such a commission’s members should not be elected councillors from all parties. Local government’s national bodies have shown themselves to be mature and confident in working cross-party and co-operating among themselves, and there is no reason why they could not perform the task. The amounts of income tax going to national and local expenditure would then be clearly identified on payslips as national income tax and local income tax, which would be a massive aid to accountability and to individuals in knowing the reality of what they pay for local services. It would be seen clearly and visibly, and therefore aid accountability.
I agree wholeheartedly with the argument that my hon. Friend is putting forward. On finance, is he saying that there should be no role for central Government in determining the distribution formula for different local authorities? That seems to me to be one of the essential political judgments that should remain the responsibility of central Government. I accept completely his argument about the need for greater financial autonomy at a local level.
I think that we—people from the localities—are perfectly capable of making such decisions. I do not need to abrogate that decision to a civil servant in the Department for Communities and Local Government. I am quite content that a sensible formula could be arrived at by ourselves, the Local Government Association and the people who wish this to succeed, rather than having nanny decide the formula for us. I know that that is not what my hon. Friend is saying, but if we are to mature and grow we need to look after ourselves and to take responsibility. That, in itself, can be quite a frightening task.
Central Government would still have the ability to intervene, as other federal Governments do in western democracies, for specific, time-limited purposes such as helping out with urban regeneration for five years—moving in and out, as often occurs in other democracies that have the maturity to run their local and national affairs without that involving a contradiction. It is only in the UK—the last country in the empire—that we feel that everybody has to be told what to do from the centre.
I hope that local councils, assured that the funding of most of their expenditure was secure, would then be free to raise the remaining part of their income from a menu of revenue-raising powers ranging from property taxes to sales taxes. Decisions on local tax and rates could be taken by local representatives and perhaps even endorsed in local referendums. My guess is that local authorities would mostly rely for their income on the local tax that I have described, a returned business rate and a property tax to meet their expenditures. Of course, they would continue to receive rental income from their own housing, which, incidentally, might well have a dramatic revival if freed from central Government control.
In a mature democracy, local authorities would be confident and competent enough to raise and spend what they decided was appropriate, always needing to balance service delivery and revenue raising with the electoral consequences of no taxation without explanation. Citizens, knowing what they paid and why, and holding their local representatives to account, would constitute a far firmer discipline and stronger bulwark against central interference than any statute that we might want to pass in this place. They would own their local government once again.
Local authorities already have a record of financial expertise and economic management that bears comparison with a central Government who so often wish to lecture them. However, as a constitutional safeguard, local authorities would be obliged to operate a balanced budget provision—the self-discipline operated by most American state governments. Annual income would have to match annual spending, and local borrowing, provided that its costs were met from annual income, need not be controlled by Whitehall or appear in the old public sector borrowing requirement, which we now call the public sector net cash requirement.
Throwing away the crutch of central Government will be frightening as well as exciting. There will be no one else to blame any more. However, devoted public service has always characterised local councillors of all parties, and they will respond to their liberty. Let local people decide on their spending and their services, on their electoral system or the use of direct democracy.
Returning real decision-making power to local areas would also give a much-needed stimulus to local political parties. Many individuals—we all know them—have opted out of local politics. They do not want to be rubber-stamping the decisions of local and regional bureaucrats. We have lost a lot of good people that way. They would be drawn back into public service, and once again it would really matter who got elected locally and how well they were politically prepared and technically trained to handle the onerous local duties of independent local government. We would re-create that invaluable network of citizen politicians of all parties, in touch with their communities and close to their constituents, empowered and empowering their local areas.
An era is ending. The current agency relationship between the centre and the localities cannot be sustained. Now is the time for some bold leadership and to let go—to release and return power to our local communities. I hope that the Minister will make a bold response and that it will be matched by a vision from leaders in local government, who have so far by and large shown themselves to be happy just to quibble over the scraps, rather than fight for their freedom. They should seize the opportunity that the concordat presents for independence and autonomy and remake our local government, making it fit for the next 100 years.
I congratulate my hon. Friend the Member for Nottingham, North (Mr. Allen) on securing this worthwhile and interesting debate. I shall attempt to respond not with mechanistic, localist jargon, or indeed by invoking the spirit of Leonid Brezhnev, but I hope more in the spirit of glasnost and perestroika. The debate is about the constitutional status of local government, as my hon. Friend said. I also congratulate and thank my hon. Friend the Member for Bury, North (Mr. Chaytor) for his contribution, with which I agree, and the hon. Member for St. Ives (Andrew George) for taking part.
While I agree with much of what my hon. Friend the Member for Nottingham, North said, I must begin by making two contentions. First, it is the freedom and flexibility on the ground and willingness between partners to co-operate that deliver the best outcomes. I know that we agree on that. The issue is not the constitutional status of those partners, but what happens on the ground. Secondly, the Government have taken successive and radical steps—recently in particular, but also in the past decade—to deliver more freedom and much more flexibility, and we are committed to doing more. However, my hon. Friend’s comments concern me, because they mean that there are people in local government who are not taking best advantage of some of the opportunities available to them.
My hon. Friend challenges local leaders to display vision and leadership. I suggest that the freedom and flexibility that the Government provide to local leaders offers them that opportunity. Their challenge is to work together with local partners, including local strategic partnerships—my hon. Friend is the only MP I know of who chairs his own local strategic partnership, One Nottingham—to achieve the best outcomes for local people.
The Government are committed to localism and devolution. Successive policies and legislation have returned power to local authorities and strengthened their roles as local leaders, although that is not to say that there is not still much more to do. The last election manifesto contained the commitment that the Government would
“build upon our unprecedented programme of constitutional reform embedding a culture of devolved government at the centre and self-government in our communities.”
The provisions of the local government White Paper and the Local Government and Public Involvement in Health Bill take that further and represent a new settlement between local and central Government—a transfer of power from Whitehall to the town hall, alongside devolution, and right to the doorstep.
So where are we now? We face a big opportunity and, at the same time, a big challenge. It is time to turn devolution into a reality in our local communities and show what local democracy can achieve with all the tools that we are trying to provide to local government. The new local area agreements coming in next year take devolution a step further. They give local government greater space to deliver for communities and ensure that local communities have a bigger say in influencing the future of where they live. They put a premium on all local partners working together to deliver better services and deliver a big cut in red tape. They also provide local authorities with greater freedom to direct funding towards local priorities and will lead to real debate between Whitehall, local authorities and communities about the future of their areas.
My hon. Friend talked about the hand of Whitehall and the burdens that it places on local government, but the new LAAs will reduce the number of indicators from about 1,200 to about 200, of which only about 35 will be answerable to central Government. We have to get the balance right in this House. I have taken part in several debates both wearing this hat and as an education Minister, and recall one, in particular, when the Education and Inspections Bill was going through Parliament, in which I was lobbied hard by Members about the need to enforce on local government the statutory need for a youth service. So there are bare minimum standards out there, and it is important that we support local government in retaining them for the benefit of our communities.
LAAs will ensure that public services meet people’s needs. As they bring different people together, they have the potential to be the best solution to some of the complex, cross-cutting problems that we face in our communities.
I shall come to the concordat in the next five minutes. My hon. Friend referred to it several times, and it is important, but a lot of work on it is ongoing. I hope to be able to give him more detail on it as the autumn progresses. I shall be keen to correspond with him in detail on the progress that we are making, because he is right that it is important in relation to balance and the day-to-day work between central and local government and our councillors.
My hon. Friend describes an inherent paradox in our plans between centralism and devolution. He argues that agreeing a single set of indicators across government will lead to less flexibility, not more. I do not agree. LAAs are not a centralising measure; indeed, they are quite the opposite. They are a genuine central/local negotiation that allows local leaders to have direction over funding. The outcome is a deal that hands over responsibility and frees funding for local government and local partners to take the actions that they decide are best for their areas. The new agreements give room for local authorities and their partners to focus on the issues that local partners think are most important.
My hon. Friend also mentioned leadership. The success of devolution and the new localism depends, in part, on strong leadership in local government—leadership that recognises and tackles local priorities, forms active partnerships and gives local communities and local people a bigger say in what happens in their areas. As strategic leaders for their areas, it is the responsibility of local authorities to ensure the social, environmental and economic well-being of their communities. The role of a strategic leader is not to deliver everything oneself, but to use one’s influence and democratic mandate to make sure that the services that people need and the priorities for the area are tackled.
Last week, the Department for Communities and Local Government published a report highlighting the link between stable and powerful political leadership and customer satisfaction with services. As my colleague the Minister for Local Government said in welcoming the report:
“This study shows that giving councils a more visible and effective leadership role has led to faster decision making, better services and improved public satisfaction.”
Having stronger local leadership will allow local government to invoke many of the powers that make it more responsive to the local communities that my hon. Friend talks about.
In the context of leadership, will the Minister admit into the talks about the concordat between local and national Government, if the LGA leadership wants it, a discussion about the concept of constitutionally independent local government? Has anything been ruled out of those discussions?
I do not want the concordat to be a dry paper, and I am sure that we need to have an in-depth and worthwhile discussion on it. However, I disagree with the principle of having something that is constitutionally independent of Government rather than statutorily independent, because, as I said at the outset, this issue is about delivery on the ground. That is what matters most to local people.
In the time available, I shall respond to some of the comments that have been made about funding, particularly on a point made by my hon. Friend the Member for Bury, North. We must not leave some of the very important decisions about Government funding to a quango. We must ultimately accept, as a Government and as Ministers, when we have formulae for local government, that we are accountable. We in central Government are accountable for those decisions and that should continue to be the case, although we must also respect local decisions and accept that people must decide locally how best to spend those resources. They might have innovative ideas for the future about how best to raise more resources.
I have not been able to cover as many points as I would have liked to in the time available, so I will write to my hon. Friend, if that is agreeable to him. I hope to keep the dialogue between us ongoing as we move towards a concordat.
Sitting suspended until half-past Two o’clock.
Smaller General Hospitals
I suspect that the Minister’s effective response to this debate will be short. In so far as the reconfiguration of local hospital services is concerned, I imagine that she will say, first, that such reconfiguration is a matter for local medical opinion, and, secondly, that Ministers will act in such matters on the advice of the independent reconfiguration panel. If the Minister were to say that, she would be wrong.
Local general practitioners are against the cuts, as are those hospital staff who have been able to speak out against them. Patients and local residents are petitioning and rallying against the cuts to general hospitals in their tens of thousands. In my constituency, local medical opinion is overwhelmingly against the proposed changes to services at Horton general hospital, but it has simply been ignored, and, although the existence of the IRP is welcome, it can, of course, only advise the Government within the policy parameters set by them.
For example, the Government have given some clear indications as to what they consider should be the minimum size of a consultant-led maternity unit, although it should be observed that our European neighbours safely manage consultant-led maternity units substantially smaller than those in the UK. Indeed, the existing maternity unit at the John Radcliffe in Oxford is already larger than practically every consultant-led maternity unit in Germany, France, Holland and Belgium.
I believe that everyone can understand, after the turmoil of the junior doctors’ training fiasco and the somewhat patronising approach of the previous Secretary of State, that when the present Secretary of State came to office, he was keen to give the impression of drawing a line in the sand and to institute a year-long review of the national health service. I suppose he hoped that that would buy him time to sort out what was going on in the NHS, to try to understand why so much extra investment has led to so little by way of improved outcomes and, in the meantime, to try to shuffle off any difficult decisions to the IRP. Indeed, a study published at the beginning of this month found that health services in the UK are some of the worst in Europe. The UK is in the same league as countries such as Slovenia and Hungary, which spend far less on health, and is languishing below Estonia and the Czech Republic in respect of health care.
Unfortunately for the Secretary of State and his ministerial colleagues, the approach of seeking to shuffle off decisions was completely undermined as soon as the present Prime Minister walked into No. 10, because one of his first actions was to appoint to the health ministerial team Professor Darzi, now Lord Darzi of Denham. On the day that Lord Darzi was appointed, he observed to The Guardian that:
“The days of the district general hospital…are over.”
Indeed, he went on to say in that interview that in the not too distant future there will be far fewer general hospitals in London, and that many of them would be replaced by what he described as “polyclinics”. Ministers have doubtless seen that the Government’s proposals for downgrading general hospitals in London and replacing them with polyclinics have been attacked by the British Medical Association. Dr. Hamish Meldrum, the BMA council chairman, recently observed that costly, unproven polyclinics could lead to
“a damaging fragmentation of care.”
Ministers would do well to reread Lord Darzi’s report, “Health care for London”. On page 26, he compares productivity in various types of hospital. He concludes that the best results outside London are achieved by small general hospitals. On page 49, in discussing the proposals for more midwife-led care, Lord Darzi states:
“Prompt transfers are vital—the Royal College of Obstetricians and Gynaecologists recommends that such transfers should ideally take fifteen to twenty minutes.”
Lord Darzi clearly has not considered the Oxford Radcliffe Hospitals NHS Trust’s proposals for the Horton.
It is not just in London that the Government are presiding over a damaging fragmentation of care of hospital NHS services, but in the rest of the country. Some 25 to 30 general hospitals in England are threatened by substantial downgrading, through which maternity services and accident and emergency services could close, or combinations of various services could be downgraded or closed. If such changes go ahead, hospitals will no longer be general hospitals but simply a collection of medical services.
On maternity services, does my hon. Friend and constituency neighbour agree that there is little chance indeed of making the journey with a complicated obstetric case from Banbury to the John Radcliffe in less than 40 minutes, even with the bells down and no traffic? Does he also agree that there is a wide rural hinterland in both our constituencies, from which transfers would be even farther and even more critically dangerous?
I entirely agree with my hon. Friend. We know the geography of north Oxfordshire. I was amazed today to discover that the Oxford Radcliffe trust had told Radio Oxford that it thought that a journey could be made in 30 minutes. I challenge the trust to organise a trial any time that it wants; I would happily take part. It is inconceivable that it could demonstrate to the local newspapers that it is possible to get from Banbury to Oxford in 30 minutes, even with a blue light. Everyone who lives in north Oxfordshire knows that that is just not possible—like so many other things, it is just totally aspirational.
As the Minister will doubtless observe, some changes have the support of some parts of the medical establishment, but that is very much a consequence of the Government’s substantially reducing the amount of time that junior doctors will spend in training. We are rapidly moving to a training-led NHS, rather than a patient-led NHS.
Does my hon. Friend share my dismay regarding the advisers whom the Government have chosen to take forward their proposals on the NHS? It is hardly surprising that the review is going in the direction that it is, with a focus on tertiary centres, as the advisers are Lord Darzi, Roger Boyle and George Alberti. Excellent though they are, they have no experience of primary or intermediate health care, and it is hardly surprising that general practitioners therefore feel that they are being marginalised in the Government’s plans, almost exclusively in the interests of highly specialist and tertiary centres.
I entirely agree with my hon. Friend. As I shall show the House, GPs feel that they are being not only marginalised but patronised as a result of the way in which the changes are taking place.
The medical establishment’s attitude, to which my hon. Friend the Member for Westbury (Dr. Murrison) just referred, was effectively demonstrated by the dean for medical training in the Thames valley, who gave evidence to the health overview and scrutiny committee on the proposed downgrading at the Horton hospital. The dean was asked by the committee why it would not be possible to send doctors who are in training on rotation from the John Radcliffe in Oxford to the Horton in Banbury. After all, both hospitals are in the same NHS hospital trust. The dean responded to the effect that it would be unreasonable to expect junior doctors to travel the 26 miles from Oxford to Banbury. I believe that the dean was somewhat surprised by the wry laughter around the council chamber in which the meeting took place. Everyone said, “Hang on a moment, the Oxford Radcliffe NHS trust is expecting huge numbers of patients and their families, sick children, concerned parents and mothers in labour to make the 26-mile journey from Banbury to Oxford.”
Indeed, on the trust’s own figures—putting its own best case—it is expecting as a consequence of its changes that hundreds of mothers in labour will have to be transferred from the Horton to the John Radcliffe. I am thinking of mothers such as my constituent Alison Bentley, who enjoyed a trouble-free pregnancy, but whose baby’s cord dropped beneath the neck during delivery. To prevent brain damage to the baby or death by oxygen starvation, Mrs. Bentley had to be placed on all fours while a midwife physically prevented the baby’s head from being delivered.
In future, such a mother in those circumstances would have to be put in an ambulance and sent on an hour’s journey to Oxford, so it is not surprising that the Royal College of Midwives is vigorously opposing the removal of consultant-led obstetric services at the Horton. It is not surprising that Judy Slessar, the regional organiser of the RCM, recently observed:
“The RCM does not consider the Oxford Radcliffe Hospitals Trust has provided a strong enough argument to transfer services to Oxford.”
What the Government are presiding over is a fragmentation of NHS hospital services. My straightforward question to the Minister is, how do the Government explain to my constituents and the constituents of many parliamentary colleagues how a comprehensive downgrading of services at the Horton in Banbury is in any way an improvement in NHS services for the hundreds of thousands of people from Oxfordshire, Warwickshire and Northamptonshire who look to it as their local general hospital? Of course, perhaps it would help Ministers to answer that question if they could be bothered to come to Banbury, or at least to understand that the Horton is a general hospital. I am glad to say that my hon. Friend the Member for South Cambridgeshire (Mr. Lansley), the shadow Secretary of State for Health, has taken the time and trouble to come to Banbury to talk to those who are concerned about the future of the Horton, as have my hon. Friends the Members for Eddisbury (Mr. O'Brien), and for Guildford (Anne Milton), who has recently joined the Conservative shadow health team.
When the chair of the Oxford Radcliffe patient and public involvement forum wrote to the Secretary of State specifically inviting him to Banbury—we must bear it in mind that the Government set up such forums to be the voice for patients and the public—he could not be bothered to reply. Instead, a letter from an official in the Department’s events and visits unit wrote saying:
“Regrettably due to heavy diary and Ministerial commitments the Secretary of State is unable to accept your invitation.”
That is civil service-speak for saying that the Secretary of State could not be bothered to come to Banbury. Perhaps he did not want to face up to the local PPIF, which expressed on the record considerable concern at the lack of proper consultation by the trust. Jacqueline Pearce-Jervis, the chair of the forum, observed in a letter to me:
“The truth is, as we all know, consultation has been minimal…the public are telling us that no attempt whatsoever has been made to talk to young mothers or, older people.”
The Minister might like to invite the ambulance services to a party for all paramedics who have delivered babies before they could get the mothers to hospital, and then consider how many more would have to be invited if every maternity unit led by consultants in England were closed down.
I entirely agree with my hon. Friend, and with his early-day motion about births on the road. We are getting into a crazy situation in which our constituents must contemplate whether they will have their babies in a hospital or in an ambulance somewhere between their home and a hospital.
We on the Isle of Wight are lucky that we kept one district general hospital open. Low levels of maternity were observed following the threat to the island, yet we kept the hospital open. On the mainland, smaller hospitals have closed or are threatened, at least partly by the EU working directive. Does my hon. Friend agree that it is an unnecessary directive that adds to the problems faced by general hospitals?
Yes, but the Government must explain how, when every other country in the European Union is covered by the same directive, France, Germany, Belgium and Holland still manage to have consultant-led maternity units substantially smaller than those here, and are not setting an arbitrary figure for a minimum size for consultant-led midwife units.
Is my hon. Friend aware that in my area, despite overwhelming opposition from local people and all GPs bar one, who happens to work for the primary care trust, to proposals to downgrade maternity, those proposals are being proceeded with and the EU working time directive is often being quoted? Is my hon. Friend aware that, as I understand it, the Government would be well within their rights to apply for a derogation from that directive, at least until 2012, but have not lifted a finger to do so?
My hon. Friend makes two good points. First, the Government have made absolutely no attempt to obtain a derogation from the European working time directive. Secondly, Ministers say that reconfiguration of local services is a matter for local medical opinion—and then completely ignore the views of local general practitioners as though they simply do not exist.
Against that background of ministerial indifference and poor consultation, it is perhaps not surprising that as recently as a couple of weeks ago, during the Labour party conference, the hon. Member for Exeter (Mr. Bradshaw)—another Health Minister—was on the Bill Heine show on BBC Radio Oxford describing the Horton as “a small cottage hospital”. The Government’s intention may be that it becomes a small cottage hospital, but it has for many years been a general hospital, and everyone locally is determined to do everything possible to keep the Horton general.
I am conscious that a number of colleagues understandably wish to contribute to this debate, and I suspect that one and half hours is far too short to do justice to the importance of the issues. I want to focus briefly on the proposed changes to services at the Horton.
At the moment, the Horton has a 24/7 consultant-led children’s service to look after sick children. That came about following the tragic death of a little boy in the 1970s because, at the time, the Horton did not have the necessary facilities. That little boy’s death demonstrated that for a sick child, Oxford is often simply and tragically just too far away. Following his death, Barbara Castle set up a statutory public inquiry, which directed that there should be 24/7 children’s services at the Horton. What is now being proposed will take us back 40 years. What is now being proposed is that no sick child will be admitted as a patient to the Horton, and during evenings and weekends—bar about three hours on Sundays—there will no longer be any consultant-led children’s services at the Horton.
That will present every GP and every parent with a considerable conundrum: if they have a sick child, do they take their child to the Horton, which is nearby but might not be able to treat the sick child, or do they start the journey to Oxford? Ministers who are too busy to visit Banbury will probably not know that it contains three wards—Ruscote, Grimsbury and Neithrop— with some of the highest social needs in south-east England, and many people who simply do not have access to a car, so for them, getting a sick child to Oxford will be something of a nightmare.
An indication of the trust’s desperation is that in its most recent proposed service reconfiguration, it announced:
“Transition arrangements should include an education programme to advise parents and the public about the new service and what to do with a sick child out of hours.”
Will my constituents and those of neighbouring Members of Parliament be expected to recognise illnesses such as meningitis? How do the Government explain to local parents that the removal of those services is in some way an improvement in the NHS? Without 24/7 consultant-led paediatrics, there can no longer be a special care baby unit, and the trust is also proposing that the Horton will no longer have a consultant-led maternity unit, but that it will become the largest midwife-led maternity unit in the country.
Ministers make much play of the fact that the reconfiguration of medical services should be informed by local medical opinion. When the trust’s proposals were first promulgated, they were met with an excoriating response from the north Oxfordshire and south Northamptonshire general practitioner forum, with some 86 GPs supporting a joint submission in which they said:
“We remain opposed to the proposals on the grounds of safety, sustainability and the reduction of access to basic health care and choice for our patients, which will affect especially the most vulnerable. We have little confidence in the process of consultation and the spirit in which it was conducted.”
On paediatrics, the GPs observed that much of their discussions
“with the Oxford Consultants are centred around our genuine concerns about safety—we have highlighted these areas to them in a detailed and specific way. Their response has been a reactive and a rather inadequate ‘sticking plaster approach’ which would seem to confirm the fundamentally flawed nature of the proposed model in the first place. It would seem quite inappropriate to take forward such a flawed proposal.”
The GPs described the proposals for maternity services as inhumane, and said:
“Under the proposed model mothers who may fail to progress, or show signs of foetal distress in the second stage of labour, or who have prolapsed cord or haemorrhage would require very rapid transfer to Oxford. Given the numbers involved this would carry significant risk and would be inhumane…babies born in need of immediate resuscitation would incur a transit time of approximately one hour. The idea that paediatric cover could be provided safely from Oxford in these circumstances is false and dangerous.”
The GPs continued:
“Without 24 hour paediatric cover locally, the A&E Department could not continue to accept paediatric emergencies. If proposals to remove local emergency surgical services are carried through, it will also lack surgical cover for acutely ill surgical patients. The domino effect would lead to the result of downgrading to a minor injuries unit in the mid to longer term.”
There would be no accident and emergency department. The GPs concluded:
“We believe that these proposals and the tenor of discussions relating to them pose a risk to the overall integrity and sustainability of the Horton as a General Hospital. They undermine the morale of its staff and impact adversely on recruitment and retention of high quality personnel. Far from creating excellence in health care…they betray a lack of will, vision and imagination and consequently degrade it.”
Clearly, it was impossible for the trust to assert that it was introducing service changes at the Horton hospital on the grounds of safety, when every GP whose patients were within the Horton’s catchment area described the proposals as unsafe and inhumane. The trust took the original proposals off the table, ceased the consultation and established two clinical working parties. Somewhat bizarrely, it refused to disclose the names and professional qualifications of any of the members of the two working parties, which somewhat undermined any confidence in the integrity of their work. The changes consequent on the work done by the clinical working parties were fairly cosmetic, and if the clinical working parties were an exercise intended to persuade local GPs of the need for downgrading services, they failed.
Giving evidence to the health overview and scrutiny committee, Dr. Richard Lehman and Dr. Emma Haskew, representing the local GP forum, reported that they had carried out a further survey of the original 86 GPs. Some 56 remained clearly opposed to changes and they could find only three who supported them, and that was on the basis that they were the “least worst option”. I am not sure what that phrase means—how does the “least worst option” differ from the worst option? I do not want NHS hospital services for my constituents to be provided on the basis that they are the “least worst option”. The present views of local GPs on the changes were well summarised in a recent letter from Charles Perrott, the lead partner of the health centre in Brackley, which is in the constituency of my hon. Friend the Member for Daventry (Mr. Boswell). It states:
“Many of us have seen cases where delays in treatment would have resulted in death or disability had the Horton hospital not been available…It is true that for specialised conditions the outcomes in the specialist centres are better, but one has to be able to get to the hospital first. The overall population-based mortality rates (as opposed to hospital mortality rates) will rise if frontier hospitals such as the Horton General are not able to provide the full range of general services such as paediatrics and obstetrics.”
Senior local GPs are still making it clear that they believe that local mortality rates will rise and that delays in treatment will result in death and disability as a consequence of the changes.
Another group that the trust must persuade about the wisdom of the changes is the midwives at the Horton. After all, they will go from working in a consultant-led unit to working in the largest midwife-led unit in the country. That unit will be 26 miles and approximately one hour’s ambulance journey away from the nearest consultant obstetrician. The midwives at the Horton have made their views clear. The Banbury branch of the Royal College of Midwives, in a letter to the Banbury Guardian, stated:
“The branch wishes to make it clear that the majority of its midwife members have expressed their support for maintaining the full range of maternity and paediatric services at the Horton. The current service provides true choice for the benefit of women, their babies and families…The branch notes an article of August 30 which quotes comments made by the clinical working group that the proposals were the ‘safest option’…The branch does not consider the changes to be the safest option when compared with the present service. Over the past few weeks, it has been made clear through the Banbury Guardian by local women of the wide variety of situations that have been dealt with successfully by the Horton and that they wish the full coverage of the current service to continue.”
Since then, articles such as that by Professor James Drife in the British Medical Journal have been published. He is a specialist in obstetrics and gynaecology at Leeds university, and he has made it clear that the lives of women and babies will be put at risk under the Government’s plans to encourage births at midwife-led units. I am sure that the Minister has noted that Professor Drife observed in his article that thousands of women may need to be rushed to hospitals from such units if complications arise that put the lives of mother and child at risk.
The Minister wrote a letter to me in anticipation of this debate. It states that
“it is vital that the views of local people are taken into consideration which is why service improvement proposals are subject to full consultation.”
I must tell the Minister that local people have made their views extremely clear.
May I say something to my hon. Friend on the issue of consultation? I know that this debate is about the downgrading of a local general hospital. However, in the New Forest in Romsey, we have been fighting to save our community hospitals. We experienced all the techniques of bogus consultation options. Eventually, after huge public displeasure and demonstrations, which are almost unheard of in our part of the world, the PCT said that it had changed its mind. Even now, it is attempting to convert community hospitals into clinics—to do anything, rather than have in-patient beds. When it comes to democratic opinion, PCTs—sadly—have a great deal to learn.
My hon. Friend is correct that such service reconfigurations are characterised, almost universally, by bogus consultation.
Local people make their views clear. Some 35,000 local people signed a petition against the downgrading of the Horton, which was presented to No. 10 Downing street, and I presented a petition of some 15,000 signatures to the House. The Minister will find that the independent reconfiguration panel will receive hundreds, potentially thousands, of individual letters from local people setting out the reasons why the existing services at the Horton are valuable to them and why they wish to retain them.
Indeed, with the help of the “Keep the Horton General” campaign, ably led by George Parish, a local Labour district councillor, local people have done pretty well everything that it is permissible to do in a democratic society to demonstrate their almost total opposition to, and collective concern about, the proposals. Huge churches have been packed full, and there have been petitions, rallies and marches. We had “Hands around the Horton”, at which local people formed a huge chain of support around the hospital, but they do not believe that Ministers are listening. They cannot understand why the Secretary of State cannot be bothered to come to Banbury. They do not understand why the Minister of State, the hon. Member for Exeter, referred on Radio Oxford to the Horton as a “small cottage hospital”. If Ministers do not recognise general hospitals, there is a problem for us all.
Local people were totally bemused when the Minister of State, the right hon. Member for Bristol, South (Dawn Primarolo) accused my right hon. Friend the Member for Witney (Mr. Cameron) of scaremongering by including the Horton on the list of general hospitals currently threatened by the Government. Even today, at Prime Minister’s questions, the Prime Minister suggested that there is no threat to the Horton. That is deeply insulting to local people, and the Prime Minister would do well to ensure that he is properly briefed by Ministers and officials before making such ludicrous assertions. When Ministers in the Department do not recognise that the Horton is being threatened by the Government, they are clearly not living in the real world but in some parallel universe.
Local people find it insulting when the Prime Minister starts talking about citizens’ juries, and when he clearly does not know what is going on. Why do we need citizens’ juries when local people have made clear their views in a 35,000-signature petition presented to Downing street, and in a 15,000-signature petition that I presented to the House?
A stakeholder group, including representatives of patient, community and public bodies, rejected the clinical group’s support for the trust’s proposals, saying that they
“represented a significant downgrading of access to services and a worsening of choice for women and children”.
Against the background of such comprehensive local and medical professional opposition to the trust’s proposals, it was perhaps not surprising that the trust could not find a single witness—other than members of its own staff—to give evidence to the health overview and scrutiny committee in support of the proposals, or that the committee unanimously decided that the proposals should be referred to the IRP. Incidentally, that is the first time in the four years of its existence that the committee has made such a recommendation, so it was clearly not lightly made.
One of the fundamental principles of the NHS is, rightly, equity of access, but if the Government’s proposed changes go ahead at the Horton and at other general hospitals, my constituents and thousands of other people in the country will not have equity of access. Intolerably, they are going to have services that are less safe.
Dr. Richard Lehman, the senior partner in one of Banbury’s fastest-growing GP practices, describes the trust’s proposals thus:
“It is as if a third of the mothers in my practice are being randomised without their informed consent to a kind of provision which has never been shown to be safe and on basic first principles is very unlikely to be safe. If somebody tried to carry this out as a clinical trial, I cannot believe that any Ethics Committee would give it a second look.”
Next year is the 60th anniversary of the founding of the NHS. If the Government continue to undermine general hospitals, they will be undermining a fundamental principle of the NHS.
There are concerns about whether the John Radcliffe hospital could cope with the increase in the number of sick children as a consequence of their no longer being treated at the Horton. Figures sent to me by staff at the Horton show that the children’s ward was used as a safety net for the John Radcliffe on 18 occasions during July. So for more than half of July, the JR was full so far as new admissions of sick children was concerned, and had to refer them to the Horton. Indeed, statistics show that the Horton children’s ward was also on call for Milton Keynes, Stoke Mandeville, and the Royal Berkshire and Kettering hospitals. July is not a winter month, when pressures are high. If there are no 24-hour children’s services at the Horton and if the John Radcliffe is unable to take them, where are the children who currently go to the Horton going to go? Will they go to Swindon or Reading?
On a weekly or sometimes daily basis, GPs all over north Oxfordshire are told that the John Radcliffe cannot cope and that they should refer patients to the Horton. For example, on Tuesday 2 October, Thames Valley Emergency Access sent an e-mail to many GP practices stating:
“We have been advised by the Ops Team at the JRH that capacity remains tight today in all areas especially in adult and paed. medicine. As a result of this they would like you to refer adult and paed. medical admissions to the Horton Hospital in Banbury.”
Exactly the same thing happened the next day, Wednesday 3 October, and again on Friday 5 October. On three out of the past five days in the last working week, the JR was unable to accept new admissions, and the Horton had to shoulder the burden.
What about this week? Yesterday, 9 October, exactly the same thing happened. JR wanted all adult and paediatric medical admissions to go to the Horton, and said that
“there are also issues with Gynae”,
so GPs were asked to
“refer Gynae patients to the Horton.”
Exactly the same thing happened today. On the day of this debate, the JR is asking adult and paediatric medical admissions to go to the Horton. That rather prompts the question: on what day is the John Radcliffe able to accept admissions? If downgrading of services goes ahead at the Horton, it will not be possible to send such patients there. Where are they going to go? Who will be responsible if things go wrong?
Catherine Hopkins, a qualified midwife who is now a solicitor in Oxford, has a practice that is devoted almost entirely to helping parents of children who have been brain-damaged during birth. She says:
“It is not sufficient to say that women will be carefully screened and high risk cases will be delivered at the consultant unit at the JR. How many emergency Caesarean sections were there at the Horton last year? I question what would have happened to those who would not have been assessed as having high risk pregnancies. If the current proposals are put in place, when a midwife at the proposed new unit decides a woman in her care needs emergency medical attention, the mother, possibly in an advanced stage of labour, will have to be transferred by ambulance to a consultant unit. The clinical Working Group found that an ambulance transfer from the Horton to the JR could be achieved in 48 minutes. This delay could lead to serious damage occurring to mother or child. As a former midwife and solicitor who acts for children brain-damaged in the course of their birth, I believe that (negligence) claims of this sort could rise as a result of this proposal.”
Interestingly, there appears to be no evidence of the Department of Health having done any work on the safety and risk of midwife-led units—no assessment of whether there are any greater risks to mothers and babies inherent in a midwife-led unit. In this instance, on the trust’s own figures, a significant number of mothers who start labour in the MLU will need to transfer during labour to a consultant-led unit. On the trust’s most optimistic figures, a significant number of mothers who start in the midwife-led unit will—not might but will—have to be transferred during labour some 26 miles to a consultant-led unit. It should not be forgotten there are many occasions when the M40 between Banbury and Oxford is closed, either due to bad weather such as fog or snow or due to road traffic accidents, which appear to be becoming, sadly, all too common between junctions nine and 10. As I said, I understand that the trust today told Radio Oxford that the journey could be achieved in 30 minutes—that is complete hogwash.
It is not only the Horton that faces this threat. I commend my hon. Friend the Member for Worthing, West (Peter Bottomley) for his early-day motion on births on the road. It is tragic that hon. Members are having to table early-day motions asking that the strategic health authority guide the local primary care trust in maintaining consultant-led maternity services at Worthing, with the aim of reducing the number of babies born before arrival at hospital. This is third-world medicine.
What is the degree and range of added risk to mothers and babies of such moves? GPs locally have reviewed all the major medical journals for the past nine years, and no work at all appears to have been done on considering whether and to what extent larger midwife-led units may increase risk to mothers and babies. Indeed, I understand that there will be no sound data on this matter until September 2009, when the National Perinatal Epidemiology Unit is due to report.
Will my hon. Friend accept, and will the Minister listen to, what is said by the Royal College of Obstetricians and Gynaecologists, which very clearly says that if there is to be a midwife-led unit, it ought to be through the wall from a consultant-led unit, not 20, 40 or 60 minutes away?
I entirely agree with my hon. Friend. It is significant that the largest midwife-led unit at present is next door to a consultant-led unit. The idea that it will now be some 26 miles away from a consultant is crazy.
In August, I wrote to the Secretary of State, asking a straightforward question:
“In these circumstances, how can the Government be confident that encouraging downgrading of Consultant-Led Units and replacing them in a number of instances with Midwife-Led Units is safe as the Government appears not to have done any work on this issue whatsoever?”
I am still awaiting a reply to that letter.
Ministers say that the changes are being driven in part by their having to implement the European Union working time directive, but other countries in Europe are also obviously equally covered by that directive. How are they managing to continue to have consultant-led maternity services in much smaller units?
Jim Thornton, professor of obstetrics and gynaecology at the university of Nottingham, has observed that
“Previous experience with mega mergers (of maternity units) like this has not been good”,
“Previous experience with freestanding Midwife-Led Units created after Consultant-Led Units closed has not been good. Examples. Wakefield—on edge of closure, only open working hours. Hull—ditto. Southport—Midwife-Led Unit created when Consultant-Led Unit closed proved non viable and has now closed.”
Professor Thornton goes on to give examples of at least seven free-standing MLUs that have recently closed or are closing soon. Why are the Government intent on creating new large midwife-led units, when the experience is that many of the MLUs created when a consultant-led unit closed have proved unviable and are closing?
On the proposals to downgrade children’s services, what response are the Government giving to the report of the children’s surgical forum of the Royal College of Surgeons, which in July concluded:
“The current downward trend of provision of general paediatric surgery in General Hospitals needs to be halted and reversed”?
It is not just consultant-led maternity units across the country that the Government want to downgrade, but a significant number of accident and emergency units. Many of the same concerns apply. An academic study published in August by the medical care research unit at Sheffield university carefully collated statistical evidence for what might seem a blindingly obvious conclusion: that there is a direct correlation between the distance that emergency patients must travel to receive hospital treatment and an increased risk of mortality. Put bluntly, the further away a victim is from a hospital with accident and emergency provision, the more likely they are to die from their illness or injury. One might think that conclusion so obviously a matter of common sense that it is difficult to understand how any Minister can attempt to maintain that the closure of local accident and emergency departments in favour of regional—which is to say, fewer—centres for emergency treatment somehow benefits NHS patients. One cannot benefit from elite specialist care if one is dead on arrival.
The trust’s response to the concerns of professionals, patients and residents has been wholly inadequate. It is simply no substitute for consultant-led services to have, as the trust proposes in its revised proposals, a phone line for midwives in Banbury to call doctors in Oxford for advice in an emergency. General hospitals cannot be run like NHS Direct.
I hope that the Secretary of State, who is still comparatively new in his post, will sit down with Ministers and officials and look again at the collective impact of the Government’s policies on general hospitals. Unless he can be confident that patients will not be put at risk, the Horton and other general hospitals should not be downgraded. Medical science may have improved since the 1970s, but the journey to Oxford has not. We believe in general hospitals; the Government, seemingly, do not. GPs, nurses, midwives and patients all wish to see existing general hospitals thrive, and I simply want the Government to produce policies that enable us to keep the Horton general.
Order. I trust that it will be helpful to hon. Members to know that I intend to commence the winding-up speeches at 3.30 pm. A number of hon. Members wish to speak, so I trust that, when speeches are being made, that will be taken into account. I call Dr. Taylor.
Thank you, Dr. McCrea. I thank the hon. Member for Banbury (Tony Baldry) for raising this absolutely vital issue. I shall concentrate on generalities rather than specific cases.
I am sure that not many hon. Members read the British Journal of Healthcare Management, but I happened to be reading it on the train on the way home one day not that long ago and I nearly fell off my seat because the political commentator was suggesting to the Prime Minister that I should be the next Health Secretary. I have been waiting ever since to be asked for advice and I am about to give advice that I think will help the Minister in her response and that I know will help all the Opposition Members, because in the past few weeks, an absolutely vital paper has been published. The only people I am doing down are people such as me, who might want to stand for election again to protect their hospitals.
The Academy of Medical Royal Colleges is a group consisting of the presidents of all the royal colleges, including GPs, anaesthetists, physicians and surgeons. They have all come together with a working party and published a paper called “Acute Healthcare Services: Report of a Working Party”. To my amazement and pleasure, it is written in a patient-friendly, authoritative way. It goes away from the Royal College of Surgeons saying that every hospital has to serve populations of 500,000 people, which is quite impracticable. I shall talk briefly about the report, commending it to everybody to look at.
The foreword, on one of the introductory pages, states that the three main challenges to which the paper responds are to ensure that any change should be to improve safety and quality, to consider the impact of the European working time directive and to recognise the interdependency of acute services—if we take away one service, another is likely to fall down. The foreword goes on to state:
“There is evidence that for some very serious conditions, care in specialised units is associated with better outcomes.”
Nobody would argue with going to a specialist unit for a major head injury, a major chest injury or a ruptured aortic aneurism. The foreword goes on to say:
“However, these conditions together only account for a small percentage of acute care episodes. The evidence is much less clear for the majority of common conditions that make up 95 per cent. of acute care. There is evidence that larger emergency departments have longer waiting times. Big is not necessarily better.”
A little later, the report lists 15 key issues, and I shall read just one or two of them:
“Patients should have good access to emergency care but for some serious acute conditions they and their relatives may have to travel further…The population and patients should be involved in shaping proposals to change services at an early stage. This will need an honest discussion of the real reasons for change”—
not the sort of spin that we are used to in consultations. Most importantly, the report says:
“Plans to redesign services which involve moving services from a particular site must not be fully implemented until replacement services are established and their safety audited.”
That did not happen in my area, despite requests that it should. Elsewhere in the list, the report repeats:
“Although there is evidence to suggest that the centralisation of services to deal with complex or specialised work provides better outcomes for patients, evidence for centralisation of non-complex and high volume cases does not exist.”
The report also goes into the difficulties that payment by results may produce and the effect of losing some elective work to other providers, which may put a strain on acute general hospital services.
The report does not shy away from politics. Recently, many medical commentators have said, “Let’s get politics out of hospital reconfigurations,” but the report says:
“The reorganisation of services always provokes intense public and political interest. This is completely understandable.”
Of course it is understandable, because we all represent our own people.
Crucially, the report then gives a spectrum of proposed acute and emergency care services, which is supremely sensible. The first level, obviously, is primary care. Then there are community hospital and urgent care centres. The report then goes on to local hospitals, which is the group into which Kidderminster used to fit, although it does not now. Banbury certainly fits into that group and so, too, amazingly, do some tiny hospitals that have been changed, such as the Montagu hospital in Mexborough, which has precisely 115 beds, and Hexham in Northumberland, which has only 98 beds. Local hospitals provide 24-hour services, including A and E, acute medicine, including computed tomography, laboratory services and level-3 critical care. That is what local people want and need. Of course Lord Darzi can recommend changes in London, because it is unique and there probably are far too many hospitals, but he cannot do the same thing in country areas.
The report later says that medical emergencies mostly involve those over 65 years. Such people represent the largest group of patients admitted to hospital and they all require rapid access to care, with only a small percentage needing specialist services.
There are qualms about the possibility that it may not be safe for a hospital that loses acute emergency surgery to have unselected medical admissions. I am sorry that the hon. Member for Grantham and Stamford (Mr. Davies) is not here, because Grantham has bitten the bullet in that respect. Its A and E department has been slightly downgraded and it has produced an entirely sensible list of exclusions—people who should not go there. Referring to those who should go there, the department’s document says, in heavy type:
“A patient may be brought to Grantham and District Hospital if they require immediate Airway and/or Breathing resuscitation.”
It is essential for everybody to have that on their doorstep.
I thank the hon. Gentleman for that intervention. In fact, the paper from Grantham—it is on the internet, and I got it only yesterday—is exemplary. The Academy of Medical Royal Colleges goes on to say that there will obviously be local changes, because different places will need slightly different arrangements.
I must mention clinical networks, because they are essential. Where we are combining the work of certain hospitals, they must work together. If we are to get networks going, there must be a high level of leadership from clinicians, and clinicians must agree to the proposals. The report says:
“Successful networks cannot be imposed from above”—
they must be the wish of those involved.
Let me say a quick word about paediatrics, because paediatrics and obstetrics are special cases, and they are discussed to a degree in the report. Speaking of paediatrics, the report says that, even at the lowest level—the urgent care centre in a community hospital—
“Staff should be competent in the initial assessment of children, including recognition of the sick child”.
The first thing that a doctor or nurse must learn is how to tell when somebody is really ill.
The report puts into stark perspective the myths about cardiac and stroke care that Ministers and national directors have promulgated. Only a small minority of hospitals can do urgent coronary angioplasty, while only a minuscule proportion can give thrombolytic drugs to people with acute strokes, and the report lists them.
To finish, the report is hugely important. At last, there is a blueprint for acute health care services, including acute general hospital services, which has been written with staff and patient input. It gives the independent reconfiguration panel an absolute standard to work to when faced with controversial, contested reconfigurations. The Secretary of State has promised to refer all such cases to the panel, and if its recommendations agree with the report, I hope that he will support them.
I am pleased to support my hon. Friend the Member for Banbury (Tony Baldry) in this debate, which is central to the interests of all our constituents. He covered an enormous amount of ground at great speed—indeed, if he were a horse, I would breed from him.
The Prime Minister speaks about rebuilding trust in politics and reconnecting people with the political process, but what can those words mean when Ministers have given me and other hon. Members assurances on the Floor of the House in the recent past about the future of A and E facilities at the Princess Royal hospital in Haywards Heath and elsewhere—an issue that could hardly be of more importance and concern to our people—and then reneged on those promises within two years? The Government should be truly ashamed of treating people in that way.
The proposals for the future of the Princess Royal hospital in my constituency include downgrading the A and E and the loss of all elective surgery and of our wonderful maternity services. The proposals across West Sussex more widely, which cover the Princess Royal hospital, the Worthing hospitals and St. Richard’s hospital in Chichester, are wholly unacceptable and unsuitable and would undermine the safety and accessibility of acute services in West Sussex. I take great heart from what the hon. Member for Wyre Forest (Dr. Taylor) said. I have indeed read the paper that he mentioned and I very much hope that the Government will pay close attention to what it says.
Tens of thousands of people have made their views on this matter known in the only way they know how. More than 300,000 people have signed petitions and 25,000 have marched. This weekend, in Haywards Heath, the support the Princess Royal campaign will have a march, which 10,000 people will, I hope, attend. People feel, rightly, that they have paid their taxes and that they are entitled to high-quality local and accessible services.
I know that the Minister is an excellent person, and I hope that she will not be got to, because I trust her judgment. However, I hope that she understands that this is the fourth time in seven years that the Princess Royal hospital has come up for review. That is no way to run a health service or to look after patients. Above all, it is no way to treat the staff. The staff at the Princess Royal know perfectly well that there is no clinical evidence in support of the changes, although they must of course be cautious about saying so.
On the face of it, the proposals are absurd. The Princess Royal is 15 miles south of one of the biggest international airports in the world, 5 miles from a very busy motorway, and at the centre of one of the fastest-growing places in the United Kingdom, which has an increasing, and increasingly young, population. It sits in West Sussex, which, I do not have to remind the Minister, covers more than 770 square miles, and has a population of more than 750,000 people, a struggling transport infrastructure and a growing and ageing population.
As the hon. Gentleman said in a speech in the House of Commons just before the House rose for the summer recess, to which I paid particular attention, infrastructure is about more than roads, railways, sewers and health and social services. It underpins national and local well-being, and people in my constituency, and elsewhere, know that and will make a powerful case to the Minister. Most importantly, the people in Mid-Sussex, and across the county of West Sussex, who have been through an awful lot with the health services in the past seven years, want an assurance from the Minister, if the so-called consultation is to be seen to be real—I hope that she intends it to be real—that the powerful, detailed and knowledgeable views expressed locally will be listened to, and that attention will be paid to them when it comes to the shake-up at the end of the process.
I speak this afternoon on behalf of my hon. Friends the Members for Worthing, West (Peter Bottomley), for East Worthing and Shoreham (Tim Loughton), for Arundel and South Downs (Nick Herbert), for Wealden (Charles Hendry) and for Chichester (Mr. Tyrie) and the hon. Member for Lewes (Norman Baker). All the campaigns in West Sussex to save our hospitals are emphatically all-party, and they embrace all shades and none of political and social opinion. They are not to be despised by a slippery and thoroughly unreliable Government.
Finally, I should like the Government to know that Dr. Herry Ashby, a magnificent and inspirational GP in Newick in East Sussex, has 180 letters from GPs in the Mid-Sussex and Lewes area, representing 300,000 patients, saying that they believe that the proposals relating to the Princess Royal, and other wider changes, are untenable and clinically unsafe, and that they will not support them. Across Worthing and Chichester, opinion is just the same. We look to the Government to resolve those matters in a way that is serviceable and reliable to our constituents; perhaps the hon. Member for Wyre Forest has given the Government a good signpost.
It is a pleasure to follow my hon. Friend the Member for Mid-Sussex (Mr. Soames). We have had two powerful speeches about saving hospitals, and I congratulate my hon. Friend the Member for Banbury (Tony Baldry) on securing such an important debate. I also feel very sorry for the Minister. I know that she is an excellent Minister, but not a single Labour Back-Bench MP has bothered to turn up to support her in the debate, whereas there are Conservatives, Liberals and independent Members in the Chamber today.
I will not, the Minister will be pleased to hear, campaign today to save a hospital. There are hundreds of thousands of my constituents in Wellingborough, Rushton and east Northamptonshire who do not have a hospital. It takes them the best part of 40 minutes to get to the nearest hospital, and if one were to travel by public transport, it would take up to two hours. The hospitals that they must go to are at Kettering and Northampton. They are full to bursting point. There is no room for them to expand. Yet the Government have said that Wellingborough must be at the heart of a growth area, with 52,000 new houses to be built in the next 10 years or so. Even the Government, in their policy document, say that there should be a new general hospital in the area. There are no plans for such a hospital. Yet the same Government, who say that Northamptonshire should have a certain amount of money for its primary care trust, have, every year since the formula was devised, deliberately underfunded Northamptonshire. I am saying to the Government: take the money that you should have given Northamptonshire, build the hospital for Wellingborough and Rushton and relieve the pressure on the other two hospitals, in Northampton and Kettering.
I have a listening to Wellingborough and Rushton campaign. The idea is to discuss local issues. Unofficially, two weeks ago, I launched a campaign for a hospital in our area. I have had more than 1,000 letters—people bothering to write to me, put on a stamp, and post their letters—before we have even launched the campaign. I hope that the Minister will consider the issue and realise that in a growth area it is really necessary to have a hospital to serve the people.
Several hon. Members rose—
Order. I am trying to allow as many hon. Members as possible to speak in the debate. The last two to speak have been very considerate in the time that they have taken, and I should deeply appreciate it if others would bear that in mind.
I congratulate the hon. Member for Banbury (Tony Baldry) on an excellent exposé of some of the issues that have affected all of us when reconfigurations and district general hospitals have been under consideration. Rochdale infirmary has just been through such a process. Our hospital is being downgraded. We are losing maternity, paediatrics, acute medical and acute surgical services, and our accident and emergency is being downgraded to an urgent care centre. The hospital is situated in a ward where the average morbidity rate is the fifth highest in the country, the average lifespan being 68 years of age. The changes are from a Government who talk about delivering services locally, where people need them. We are losing those services. A petition against the proposals has been signed by 44,000 people, all in vain.
I want to talk about the process that we went through. When he was appointed, the Prime Minister talked about restoring trust in politics. If the way in which we were treated is an example, he is even more cynical than his predecessor. The decision to downgrade Rochdale was announced on the Friday before the August bank holiday. At 4.30 on that evening I got through to someone at the Minister’s office, who refused to confirm to me that a statement was to be made the following morning, even though I had an e-mail that had been sent out to the press and media inviting them to the press conference. That is a disgraceful way to behave. It is totally contrary to the way in which Members of the House should be treated, but it is typically cynical. The fact that there are no Labour Members present illustrates that point. As the hon. Member for Wyre Forest (Dr. Taylor) eloquently said, there are alternative methods and ways. The Government need to start listening, because the people are not satisfied, and will not put up with this disgraceful way of running the health service.
May I briefly make a small correction to something that was said earlier; there are Labour Members here. The Minister and her Parliamentary Private Secretary the hon. Member for Crawley (Laura Moffatt) are here, and the Minister will be as concerned about what is happening in the county as the rest of us are.
I have two points to add. First, in my part of West Sussex the chief executive of the primary care trust has constantly said that there is clinical support for the proposals. We asked whether GPs had been consulted. The answer appears to be no. We put out non-judgmental questions to GPs. Of the first to respond, one said that he could see the point of the proposals, but wanted to remain anonymous, and 50 said that they opposed them, and gave their names. When we asked the consultants and other medical staff at the hospital, and midwives—who are also clinicians—they opposed the proposals.
At the primary care trust meeting on Monday in Worthing, at the Pavilion theatre, at 7 pm, probably nine out of 10 of those who attend will not be able to get in. Nine hundred will be able to attend. I expect up to 10,000 will not be able to. I hope that those who are there will hear the primary care trust announce that it will put to Sir Graham Catto proposals developed by clinicians in Worthing and the district—with, hopefully, people in Chichester as well—which can be considered on all fours with the three inadequate proposals that have been considered up to now.
The consultation has so far been nearly a disaster. It can be rescued; if the Minister has a chance, will she tell the strategic health authority and the primary care trust to take the representations of councils, clinicians and Members of Parliament seriously? They speak with the people who will try to be at that meeting.
I shall not. Perhaps I should have been told afterwards, Dr. McCrea, but I shall be brief in any case. I am grateful to the Front-Bench spokesman for allowing me to speak, as we are now over the allotted time.
Within my constituency, which comprises west Cornwall and the Isles of Scilly, we have been in campaign mode for a very long time—in fact, we have been in perpetual campaign mode for many years on behalf of West Cornwall hospital in Penzance and St. Michael’s hospital in Hayle. That is one of the inevitable consequences for Members of Parliament who represent areas with small general hospitals.
I appreciate fully that it is neither possible nor appropriate for Ministers or the Government to micro-manage the delivery of health services in local areas, but they do set the context in which such decisions are taken. The Royal Cornwall Hospitals NHS Trust, within which West Cornwall and St. Michael’s hospitals fall, faced financial difficulties last year. Depending on how it is defined, the trust faced a deficit of up to £58 million for which it had to find solutions. Inevitably, panic-laden and highly regrettable decisions were taken at the time. Under effectively new management and a new primary care trust, things are turning around. I welcome some of the Royal Cornwall Hospitals NHS Trust’s proposals to reconfigure and put right some of the decisions taken last year to downgrade services at West Cornwall and St. Michael’s hospitals.
It is worth making a more general point. Listening to the points made by the hon. Member for Banbury (Tony Baldry) respecting obstetric services in his constituency, one can understand the situation in remote rural areas. For example, if things go wrong in the delivery suite at St. Mary’s hospital on the Isles of Scilly due to the unpredictability of such circumstances, there are massive challenges in removing the mother to the nearest obstetric unit, which is more than 60 miles away, with more than 25 miles of sea between St. Mary’s and the mainland. The Government must not presuppose that we live in semi-suburban, landlocked middle England. Many of us represent areas for which suburban solutions involving the closure of small general hospitals do not apply—the remoter areas of the United Kingdom.
In December, the Government redefined the term “accident and emergency”. Minor injury units can now be defined as accident and emergency units. I feel that that is perhaps a cynical ploy to allow the Government to say that they have kept A and E units open simply by redefining them as level 1, 2 and 3 A and E units. I am worried that that ploy might be used.
The terminology in this debate must be reflected on. I hope that the Government will give us some stability on that and recognise that in some areas, the trade-off between emergency services and planned surgical events is often used to allow—or rather persuade—a local community to accept the downgrading of its services. Although I accept that the Government’s role is limited in many ways, they can recognise the difficulties in many areas in their funding formula, provide clarity and stability in definitions and acknowledge that the country is not a single homogenous suburb.
I congratulate the hon. Member for Banbury (Tony Baldry) on securing this debate. We have a lot more in common than one might think—not simply charm and good looks—as we were the only two candidates in the last election who were opposed by the independent Your party, backed by Martin Bell. I do not know quite why we were selected, but the candidate opposing me stood as a hospital campaigner, spending appreciable sums in doing so.
I had a lot of sympathy for that person, because what he fears could, despite ministerial protestations, come to pass. It happened in my constituency back in 2003, and it was proposed earlier this year. I was confronted with the reconfiguration of two hospitals. There were maternity statistics, which meant certain things to clinicians, and arguments about doctors’ hours and the working time directive. Maternity went. When maternity went, paediatrics went, and then, most shamefully, so did children’s A and E. Every child in the large seaside town I represent, as well as their anxious parents, must travel out of town along a winding road to receive any assurance or help from the NHS. As the hon. Member for Banbury observed in his speech, the midwife-led unit went shortly after; it was regarded as uneconomical.
That is what happened. The local primary care trust now finds it wholly anomalous and may do something about it, but there are general issues for any local district general hospital. Working patterns have changed. Junior doctors are an issue, as is the working time directive. Patient stays have shortened, expectations have been raised and finances have been stretched. An issue of clinical efficiency approaches us from two directions. It is argued that routine services are better delivered in the community, and it is argued from the other direction that many high-tech services are better delivered in less local specialist hospitals.
Some of those considerations undoubtedly have substance, but there is also strong support everywhere for district general hospitals. How much a politician is prepared to take on board the suggested implications in any one case tends to vary inversely with a DGH’s geographical proximity to his constituency boundaries. Ministers are no exception in that respect; they behave in precisely the same way.
I have two points to make. One is that many suggested implications of the balance of consideration are false and do not follow—I am following the same line as the hon. Member for Wyre Forest (Dr. Taylor). The other is that the dilemma of the DGH that confronts us is a legitimate matter for genuine democratic decision and not decision by quango.
To address the first point, delivery in the community, which the Government talk about and most people seem broadly to support, does not mean not delivering in the DGH. The new renal dialysis unit in my constituency, about which I recently wrote to the Minister, will be on the DGH site, which is a wholly welcome development for patients. On the other hand, blood tests have been moved away from the infirmary and into the community clinic. It so happens that the community clinic is right at the end of my constituency, and people must now travel further to have blood tests. That is not ideal.
A district general hospital, as my examples prove, often represents a critical clinical mass where a variety of services can be accessed, cross-fertilisation of disciplines can occur and support services, which are quite important to most patients, can congregate. The clinics, which seem to be the new solution on the block, are the equivalent of the NHS corner shop—and the rise of the supermarket should tell us something about general public preference.
On the second point, patients need no encouragement to seek the best cure wherever they can find it, but ill people have no particular incentive to travel any further than is necessary. Clinicians are another matter. I am worried when the Government say constantly that the matter will all be decided by clinicians; historically, clinicians have been blissfully uninterested in the patient’s journey. The Shields report, which reconfigured my hospital’s services, said that the reconfiguration would involve severe transport problems, but that is simply not a matter for the NHS; it is for somebody else to resolve. I tried to add to the recent Local Government and Public Involvement in Health Bill a clause saying that any consultation about reconfiguration should necessarily also be a consultation with transport authorities, but the Government resisted that proposal.
The wider patient experience is constantly neglected. Consultants’ time is regarded as precious and patients’ as infinitely expendable. We have all had the experience of turning up at an outpatient surgery at 10 o’clock, finding that about 40 other people have turned up for the same appointment and waiting for two hours. Everyone knows that realistically, highly specialist care needs highly specialist hospitals, which cannot be everywhere. Patients in my neck of the woods do not hesitate to travel further for cancer care, for example. However, good secondary medical care should be available in most towns; it should be networked with specialist units and care, and act as a filter and a resource to back up those units. We ought to make a case for district general hospitals being supported by and supporting the local community.
We have to accept that there is a trade-off to be made between clinical excellence and availability. I make my position clear: clinicians and hospital and PCT executives have important advice to offer on how that trade-off is to be managed. Ultimately, however, the matter should be negotiated by local democratic bodies; it should not be the local decision making of which the Government speak, which is essentially decision making by appointees. As the people of Banbury have witnessed, that is profoundly alienating and ultimately profoundly insulting.
Lord Darzi has put PCTs across the country into consultation mode. My worry is that unless something is done about the accountability of decision makers, we may get the kind of consultation that gives consultation itself a bad name. That frustration will be so strong and so marked that it will certainly deny the Labour party any prospect of a fourth term. I listened with interest to the Secretary of State speaking earlier today of increased accountability. He was questioned on the matter, but his responses were enigmatic. In no sense were they precise. It is on that issue that things need to be made clear and changed radically.
I congratulate my hon. Friend the Member for Banbury (Tony Baldry) on acquiring this debate. It is on a subject close to my heart, and those who know me will know that I have been banging on about the future of the Hemel hospital for a lot longer than I have been a Member of the House. For those who do not know, this is my first outing on the Front Bench—a fact of which I am very proud. I am also proud to see so many of my Conservative colleagues here today, along with members of other parties. One of my colleagues said earlier that there was a Labour MP on the Back Benches, but I think that she has to be here; the Minister needs someone to hold her hand. It is obvious that the people of Banbury are not alone. I am pleased that they understand so much about the hospital’s future, and having such an excellent MP to represent them is so important.
The Health Committee, a Labour-dominated Committee of which I am still a member, issued a report not long ago saying that the devastation in the NHS and the cuts in hospitals were due not only to clinical concerns. Actually, there was little clinical argument; in most parts of the country they were the result of financial deficits, due to the Government’s inability to ensure that nearly £100 billion of taxpayers’ money got to the front line.
Lord Darzi may have been handed a poisoned chalice, but the Government want him to try to help them understand better the needs of hospitals, A and E departments and other specialist health facilities. However, he seems to be at loggerheads with his Front-Bench colleagues. For some time—since long before this Government came to power—there has been a push in the NHS for “big is beautiful”. I note that the Secretary of State was recently in Basildon. Basildon hospital has been hugely expanded, but the nearby Orsett A and E hospital was closed to fund it. I know that because I was brought up in that part of the country.
Lord Darzi says that there does not have to be a population of about 500,000, but that it could be as low as 200,000 or 250,000. If so, we have a real concern about what has already happened. So many facilities, not least in Kidderminster and Hertfordshire, have already been closed on the basis that big is beautiful and that we need facilities to deal with populations of about 500,000. I have to say to my hon. Friend the Member for Banbury that this may be only the start; his concern about the closure of maternity units and A and E units is that they tend to be the first of the problems. Sadly, if they go other facilities will go with them.
The clinicians will argue that if there is no consultant-led maternity ward and the hospital could cope with a birthing unit, it will become unsafe. I cite the example of the Hemel Hempstead general hospital in my constituency. Our consultant-led birthing unit was closed, which left those needing the unit with a 12-mile journey to Watford. We were then given a shiny, brand new birthing unit, but 18 months later it was closed because it was not safe.
If we lose acute A and E, what do we lose with it? We are highly likely to lose acute cardiac units—that has already happened in my hospital—and we will also lose stroke units and almost certainly intensive care beds. Then those involved start looking at elective surgery—but what happens if something goes wrong during elective surgery? We need the acute back-up. I hate to be the bearer of bad tidings, but that is happening across the country.
Many hon. Members have articulated their concerns about their areas, and about specialist provision in their communities. They have shown that one size does not fit all. It is not physically possible. We are not talking only about the southern tip of Cornwall or the top of Scotland—even if we could, given that it is a devolved matter. We are talking about community and district hospitals and about acute A and E hospitals across the country, all of which are very worried.
One factor that concerns me is that the public do engage. I have presented petitions, as so many hon. Members have done. Thousands upon thousands of people have signed petitions and marched the streets, some pushing hospital beds. We have participated in consultation. We were asked, “What do you want to happen?” Our comment was, “Leave us alone.” Indeed, 86 per cent. of the consultees in the West Hertfordshire Hospitals NHS Trust consultation said no to closure, but what happened? They closed it.
What point is there in having bogus consultations? Why do the Government lead the public up the garden path by saying that there will be consultation? What point is there in having independent reconfiguration panels if they can do only what the Government tell them to do? There is no point. Anything to do with such specialist areas must be clinically driven. It must be driven by those who know best. Politicians of whatever party do not know best when it comes to the future of the NHS.
I pay respect to Lord Darzi. He is a consultant. He does not know best for the entire the NHS. He is a specialist in a specific area. Even he has admitted that there are areas where he does not have expertise. Why not listen to the clinicians, the experts and the GPs? Hundreds of GPs are writing from West Sussex saying, “Leave our hospital alone.” Why do the Government not listen? Is it not the job of the Government to listen to those who know?
What is a local general hospital? I am greatly concerned that we are leaving the public in a dangerous situation. Those who drive through my constituency of Hemel Hempstead will see signs everywhere saying, “Hospital: A and E”. There is no A and E; it is a minor injuries unit. If those with acute conditions drive there, the hospital will do its best, but the patients will then be transferred by ambulance to the nearest acute hospital, perhaps to Watford. However, if a blue-light ambulance comes from Hemel with a patient who has an acute need, it will go immediately to Watford. It is wrong to allow any trust—or any politician—to mislead the public into thinking that a hospital has certain facilities when it does not. It will cost lives. It is fundamentally wrong.
It is a crying shame that we are not having a general election. If we had had one, a Conservative Government would have led a moratorium on those closures. We would have been able to protect the services that our constituents so rightly deserve.
I congratulate the hon. Member for Hemel Hempstead (Mike Penning) on his appointment and I welcome him to the Opposition Front Bench. I look forward very much to working with him. I thank all hon. Members who participated in the debate. With your permission, Dr. McCrea, I acknowledge the presence of those in the Public Gallery.
I congratulate the hon. Member for Banbury (Tony Baldry) on his success in the Speaker’s ballot and on initiating this debate on the future of smaller hospitals. I know that he will understand that, as he mentioned at the beginning of his contribution, the matter concerning the Horton General hospital is now with the independent reconfiguration panel and I am personally unable to acknowledge those comments. He will understand that I cannot do so because, as was mentioned, we want to take the politics out of the decision making; that is the purpose of what we are doing.
It is a testament to the popularity and success of the NHS that we have such beloved institutions that are held so dear by the people whom they serve. That is a huge compliment to the national health service locally and all the people who work in it, who provide the best possible care for patients. It is obvious from the numbers of Opposition Members who are in attendance today that they are committed to the NHS—to its funding and its structure in its modern format. As a former nurse who worked in the NHS for more than 25 years, it is extremely encouraging for me to see Opposition Members who are so committed to the NHS and its future. I say to the hon. Members for Wyre Forest (Dr. Taylor), for Mid-Sussex (Mr. Soames) and for Wellingborough (Mr. Bone), who were so complimentary, that I am listening; the Government are listening. That is the whole purpose of the review. The hon. Member for Banbury quoted Lord Darzi and what was quoted or rather misquoted in the newspapers. It is important that I put on record what Lord Darzi actually said:
“I have been widely quoted as saying the “days of the District General Hospital are over”. Let me be clear about what I did and did not say. The days of a one size fits all provider, repeated over and over again in a Metropolitan Capital are over. This does not represent the world-class service that a world-class city deserves. However, in my Report I did describe a key role for “Local Hospitals”. This is where the future of District General Hospital lies.”
It is important that we put that matter to bed once and for all and that we accept what Lord Darzi actually said.
When people talk about the reorganisation of services they think that it is about money, but it is not; it is about safety, quality and what is more convenient. That is why the consultation is taking place with clinicians, patients and user groups across the areas that the local health service serves. Lifestyles, society, medicine, technology and the NHS itself have all changed over the past 60 years, and I am sure that all hon. Members would agree with that. Change is certainly nothing new in the national health service. The NHS has always responded to change and the latest treatments by organising itself to deliver that care. We are responding to a variety of drivers for change. The change that we are asking all clinicians, patients and communities to consider is about clinical practice, clinical safety and delivering services to the user in the best possible quality way. It is not about reorganising staff or health authorities.
As a former nurse, I make no apology for why some of these changes are essential. If we do not keep up with the times, services will not keep on improving. Today we are reaping the benefits of new medical technologies and safer surgery, which means quicker recovery times for patients and shorter lengths of stay in hospital. For example, years ago, in cardiology we had to have beds for patients suffering from heart attacks. Patients were kept in coronary care units for two or three weeks at a time and surgery was not possible. We have advanced our surgery and bypass techniques to the extent that we can look into the coronary arteries on a day-case basis and provide a surgical procedure through the coronary artery. We can also now provide drugs, such as statins, to stop cholesterol building up in the coronary arteries. Thousands and thousands of lives have been saved and with the cessation of smoking people can look forward to having a healthier heart and lifestyle. We look forward to that change; it is a massive change. The needs and the way in which we care for cardiac patients will always change. Medicine is and always should be dynamic.
We need to consider the issue of inappropriate buildings. We love our buildings. I for one was brought into the House to save my local hospital, so I empathise with everybody who has come to this debate. That hospital was to be closed and the land sold off. The issue was not about acquiring services locally and nobody consulted the people in that constituency and community about where we could have services. Such a consultation is what is being suggested in the present format of reconfiguration; it is documented that that is how it is being delivered. The Government, Lord Darzi and myself are committed to that process; it is being clinically led. Now we have an independent review looking at some areas in the country. I do not think that we could be fairer than that.
There was a history of widespread hospital closures in the 80s and that is why people fear the existing consultation. Yes, there is mistrust of the past and people would be right to mistrust what happened in the 80s and 90s. They would be right to mistrust a period when people had to collect money for urgent hospital equipment. People do not have to do that today. We have just seen a settlement to the NHS that is 4 per cent. above what was expected. We know that there is a sense of safety in relation to the health service. Everyone of us who represents a constituency has a duty to ensure that that message is put across because the fear is damaging. The hon. Member for Mid-Sussex mentioned the stress of constant change. I recognise that that is not good for staff or for delivering services. I urge managers and those who are conducting consultations to do so in a manner that reduces stress as far as possible.
We have modernised facilities. We have 54 major new hospitals, more than 2,500 refurbished or replaced GP surgeries, 520 new one-stop centres and more than 60 walk-in centres. We are considering every district general hospital and every area that delivers an aspect of the health service, every area that has specialist nurses and every area that has maternity services, which were mentioned today. I ask all hon. Members to debate with the Royal College of Midwives on having a midwifery-led centre that is in fact safe. Midwife consultants are safe. Yes, different measures of maternity care are required and will require different levels of either obstetrician or midwifery-led care, but that does not mean to say that we should not discuss that issue.
When someone takes an ambulance journey, the practice of paramedics means that it is a very different experience from 10 or 15 years ago. That is because of the knowledge of our paramedics. I would like hon. Members to acknowledge the knowledge that paramedics have and the advancements that we have made in waiting times in accident and emergency departments. Patients are expected in accident and emergency on a controlled arrival because their journey has been controlled by many expert paramedics. That is different from what we offered patients some years ago; it is an advancement, and I hope that all hon. Members recognise the difference.
Yes, there is always anxiety about any change. Yes, there are always problems with consultation. Also, it is not easy to get practitioners to change their practice. Sometimes we have to encourage our peer group to accept change. That is not easy, and that is why the wide scope of Lord Darzi’s review includes all staff and patients; not just the top docs, but everybody concerned. The role and expansion of the primary care team must also be considered. The GPs who are the real backbone of our services and who are willing in many instances to look at change would be grateful for the consultation not to be dealt with in a manner that spreads fear because to do so is unfair. Some 60 years ago Aneurin Bevan said that the NHS will always have to change. Aneurin Bevan asked us to look towards the professions and people of responsibility to consider that change.
I thank everybody for their contribution today. I will listen. I have listened. I will go away and consider what has been said, and in the future, I hope that there will be a consultation process that hon. Members and their constituents can accept.
Mobile Phone Masts
This debate is the first parliamentary opportunity to discuss the mobile telecommunications and health research programme report 2007, which was published on 12 September. I intend to touch very briefly on handsets—not in an attempt to catch out the Minister, but because they featured in the report. I think, therefore, that they are worth discussing today.
It is clearly true to say that mobile phones are very much part of our way of life. I have got one and I suspect that everyone else in the Chamber has as well, with one possible exception. In the UK, there are 70 million mobile phone subscriptions, compared with just 9 million 10 years ago. However, that rapid growth has been accompanied by growing concerns that exposure to radio waves from mobile phones and base stations poses a health risk. Concern about masts has been expressed by residents of the Ridge, in Woodcote, of Green Wrythe lane, in Carshalton, by those living next to the Oaks Park golf club, and by those living just about everywhere else in my constituency and, I suspect, in every other constituency where masts are being erected. Concerns about the health impact of handsets are more muted, possibly because people have a choice of whether they carry a mobile phone. Clearly, they do not have a choice about whether they live next to a mobile phone mast.
The balance of evidence from research to date suggests that no health impacts have been identified. However, gaps in scientific knowledge, particularly about the long-term health impacts of this very new technology have prompted calls for further studies to be conducted, which is happening in the UK and around the world. What are people’s health concerns about masts? The major concern is the possibility that radio waves cause cancer or a greater risk of cancer owing to the heating up of cells in the body. Some studies have shown that there is a greater risk of cancer-related conditions in those situated near telecommunications masts. However, many other studies have suggested that that is just a possibility. I think that people are concerned about the lack of clarity in those different messages.
One of my constituents, Mr. Simon Densley, is here today for the debate. He tracks very carefully the research on mobile phone masts and describes the health concerns in this way:
“They fall roughly into two categories: short and long term. Short term covers immediate and near immediate effects such as headaches, dizziness, extreme irritation, etc. These seem to currently only affect a small percentage of the population. There is research which offers an explanation for this. Also there is thought to be evidence that long term chronic exposure can increase electro-sensitivity over time and therefore the number of people susceptible to these short term effects.”
Later I shall move on to what the mobile telecommunications and health research programme report had to say about that. He also says:
“Long term problems cover anything that can be caused by a long term build up of cellular and neurological damage. Specific symptoms that have been noted in laboratory or epidemiological studies include depression, cancer, leukaemia and brain tumours.”
Mr. Densley’s concerns are echoed by a group of German doctors who launched the Freiburger appeal after noticing a correlation between higher incidents of depression, cancer, leukaemia, brain tumours, heart rhythm disorders, heart attacks and strokes among an increasingly younger population, brain-degenerative diseases and epilepsy, and exposure to pulsed high-frequency microwave radiation, as used by mobile phone masts, wi-fi, terrestrial trunked radio and several other new technologies. That appeal now has nearly 37,000 signatories, of whom—this is important—some 1,000 are medical doctors.
Does the hon. Gentleman share my concern that where groups who live around a mobile phone mast, such as the Shooters Hill residents’ action group, have undertaken their own surveys of health they have shown up huge numbers of concerning brain tumours and other illnesses and afflictions that he has mentioned so far? Does he share my concern that when one checks to see whether that is just a statistical blip, the evidence is not taken at sufficiently detailed low-lying levels to say whether it is? All that can happen, therefore, is that residents can continue to have those concerns with nothing to allay them.
The hon. Gentleman makes a sound point and underlines the need for ongoing research and extensive monitoring. As I said, we are dealing with a new technology, and I do not think that anyone could say hand on heart with total certainty what the possible implications might be down the line a number of years from now.
Let me return to the subject of the Freiburger appeal. It is important to note the number of medical professionals who are signatories to that appeal. We are talking about neurophysicians and people in general medicine, paediatrics and so on. We are not talking about people who do not have a scientific view on those matters, but about people who have an active involvement in health and the possible impacts of telecommunications. Clearly, the medical establishment does not necessarily support the view put forward by the Freiburger appeal.
The World Health Organisation says that one of the main causes of people’s concern is due to newspaper reports that publish new and unconfirmed scientific results, and to people feeling a loss of control over their environment and what is put there. That is certainly something that appears in the appeal and addresses the point that the hon. Member for Stoke-on-Trent, South (Mr. Flello) made about the extent to which local communities have any say on the location of masts.
The WHO goes on to dismiss anecdotal reports of cancer clusters around mobile phone base stations because, in its view, clusters are in any case unevenly distributed and with the number of masts located in the country statistically there would be clusters around mobile phone masts in the way in which there would be clusters around places with no masts. Clearly, medical opinion is not entirely united on mobile phone masts or on handsets and their impact.
On 12 September, the Mobile Operators Association welcomed the report published by the mobile telecommunications and health research programme. In its press release, the MOA said that
“the report concludes none of the research supported by the programme and published so far demonstrates that biological or adverse health effects are produced by radiofrequency exposure from mobile phones”.
If it had used an exact quote, it would have said:
“The six year research programme has found no association between short term mobile phone use and brain cancer.”
That is an area to which I shall refer again, because it is the significant gap in the research that has been conducted to date.
The MOA went on to state that it found the findings reassuring and consistent with the conclusion that there are no adverse health effects, but that there was a need in some areas for more research. It equally underlined the fact that in its view, and that of the report, there were areas where no more research needs to be carried out. When I get to the end of my speech, I shall ask the Minister to clarify whether there are any areas where, in her view, the science is now so well defined that there is no need for further research.
In my constituency, many of the concerns that have been raised have been raised by the parents of young children. In Saltcoats in my constituency, T-Mobile is attempting to erect a mobile phone mast adjacent to Caledonia primary school. Does the hon. Gentleman agree that any research should focus specifically on the effect on young children given the many examples throughout the country of mobile phone masts being erected adjacent to primary schools?
Absolutely. Of course, I shall be asking the Minister whether she would support a precautionary principle that would suggest that no mobile phone masts should be located next to schools or hospitals. I hope that T-Mobile will be receptive. I am pleased that there have recently been a couple of occasions in my constituency where mobile phone operators have appeared to be more willing to listen to representations and not to locate masts close to places where there have been high levels of concern. I hope that the hon. Lady will receive a positive response.
I want to quote Professor Lawrie Challis, who heads up the MTHR programme and acknowledges the need for more investigation. In an interview with The Times on 20 January of this year, in advance of the production of the report, he said:
“It’s encouraging because they found nothing for people who’ve used phones for less than ten years, but there is a hint of something for people using them more.”
Clearly, if the person who heads up the Government’s programme into the impact of mobile phone use and mobile phone masts is of the view that there is a “hint of something” in the effect on people who have been regular users for more than 10 years, we should definitely investigate that.
Sufficient funds are, I hope, available for the research. Nearly £9 million has been contributed to the programme by a variety of sources, including the industry and Government. Although I am absolutely certain that the programme is independent and that the firewall is doing its job so that no influence is being exerted by the operators, I still think that there will be a problem of perception for those who are worried about the technology about the independence of the reports.
Although the weight of the evidence so far suggests that there are no health implications, we need to acknowledge the body of evidence and the support coming from some medical professionals in favour of caution. The industry is responding to that to a certain extent, and it is providing commitments as to how it will address public concerns over whether it is funding reports and research into the subject. It is trying to ensure that emission levels from handsets are clearly indicated. However, on that point, Members might have seen a report published just a few days ago that highlighted the fact that people really have to look if they want to find which mobile has a high emission level and which does not. I purchased a mobile phone for a friend a couple of weeks ago, and I cannot say that anything in the documentation leapt out at me to say whether that mobile phone was high-emitting or not.
On the subject of the obligations of the mobile phone operators, does the hon. Gentleman agree that the five mobile phone companies that operate in the UK should now consider sharing mobile phone masts? That could be one of the major steps that could be taken to reduce the number of mobile phone masts erected. We should be actively considering that now, given the levels of public concern.
The hon. Lady makes a perfectly valid point. My understanding is that two of the operators are seeking to do exactly that, although there may be some competition issues about whether they are allowed to do it. I hope that, if not reducing emissions—I do not believe that it would necessarily do that—it would reduce the visual intrusiveness of a proliferation of masts. I hope that we can have some clarity from the Minister on whether those two operators, or indeed others, will be allowed to share masts. I hope that competition reasons will not get in the way of that happening.
The Government’s position is clearly set out in the Stewart report, which is what Members produce in evidence when they raise issues about mobile phone masts with Ministers. It highlighted some issues on the environmental impact of base stations and the need to discourage the use of mobile phones among young children.
I want to give the Minister a reasonable amount of time to respond to a couple of questions. In light of what the MTHR report said about the need for a substantial ongoing programme of long-term research into the impact of masts, will the Government support that research? How do they see that programme rolling forward, and who should be funding it? On a specific point, would the Government support more research into wi-fi, which has received a lot of coverage in recent months? There are concerns, and some schools have taken out their wi-fi because of health concerns. Do the Government believe that there is a need for more investigation?
Does the Minister agree with the view put forward by the MTHR and the MOA that there are some areas in which the science is now so well defined that there is no need for further research? If that is her view, perhaps she will set out in what areas she believes that to be the case. Given the uncertainty about the long-term health implications of mobile phone use and masts, would she support, as the hon. Lady suggested, the idea of a precautionary principle being adopted around schools and hospitals?
I do not consider myself a luddite in relation to mobile phones. There are genuine concerns about the long-term health impact of phones and masts, and they require the science to be kept under regular review. Detailed monitoring of those subject to the effects of mobile phone handsets and masts needs to be undertaken. I hope that the Minister will be able to reassure me and hundreds of my constituents, and constituents of other Members present, that there will be no no-go areas of research. We need certainty about the health impact of masts and handsets, which will be achieved only through constant monitoring of the science and regular and detailed health assessments.
I congratulate the hon. Member for Carshalton and Wallington (Tom Brake) on securing the debate. I shall confine myself to health issues—I am sure that he will understand why.
Mobile phone technology has raised health worries about masts and base stations in some people’s minds. It is clearly important to understand those worries, answer them on the basis of evidence and ensure that the appropriate protections are in place. I am sure that the hon. Gentleman would agree that the best precautionary principle is for Ministers to be advised of the scientific evidence that exists at the time.
The hon. Gentleman is right that, recognising public concern, the Government set up an independent expert group on mobile phones and health in 1999 to review the health effects of mobile phone technology. He referred to it himself. It was chaired by Sir William Stewart, who now chairs the Health Protection Agency, and the report known as the Stewart report was published in May 2000. It was based on a thorough review of published scientific evidence on health effects, and Government policy on mobile phones is based on the Stewart report recommendations. The headline conclusion of his report was:
“The balance of evidence to date suggests that exposures to mobile phone radiation below national guidelines do not cause adverse health effects to the general population.”
On base stations in particular, he concluded that, looking at the balance of evidence, there was no general risk to the health of people living near base stations, on the basis that exposures were expected to be very small.
The report referred to the national guidelines in place at the time, but Stewart nevertheless recommended that, as a precautionary measure, those guidelines be replaced with more restrictive international guidelines. That has been done. He went on to make another precautionary recommendation in recognition of the incomplete scientific knowledge and significant public concern. It was interesting to learn from the Stewart report that the levels of radio frequency exposure from masts, where people thought they were likely to be high, was substantially less than those from mobile phone handsets held near the head. That led the chief medical officers to issue advice about handsets, which was published in leaflets and is well known.
The Government’s overall response to the Stewart report was to accept its advice on following the precautionary approach. At every point, the Government recognise concerns and follow the scientific evidence. Because of the public concerns, we continue to do that even when the scientific evidence does not point towards harm. On Stewart’s recommendations, we moved to the stricter International Commission on Non-Ionizing Radiation Protection guidelines. By 2001 the industry, Government Departments and their advisers were all working to the international exposure guidelines. The Stewart report also felt that more consultation at the planning stage was called for, and a revision of the planning policy guidance note was therefore introduced by the then Office of the Deputy Prime Minister in 2001, strengthening public consultation and referring specifically, for example, to school governors being informed.
Stewart also recommended an audit of base station radio wave exposure. The first audit was in 2001 and further audits have been carried out every year since. The measurements carried out each year by Ofcom have shown that base station exposures are well below the international guidelines, in many cases tens of thousands or more times below. We continually seek the means to improve ways to communicate with people who are concerned about the perceived health risks associated with masts.
Perhaps my right hon. Friend the Minister can shed some light on this. My understanding is that the international guidelines to which she refers are heating guidelines, so for a person living close to a phone mast it is a heating issue rather than about any other biological effect that the radio waves generate.
With respect to my hon. Friend, I am sure that he will appreciate that Ministers cannot pick and choose when to follow scientific evidence. Particularly when there is public concern in some areas, they need constantly to ensure that, as Stewart recommended, the available scientific evidence is always taken into account. I shall come on to that point.
The Minister has mentioned the scientific evidence; I referred to what Dr. Challis had said about the need to consider the long-term implications. Although compliance with tougher guidelines is welcome, if the longer-term implications reveal that those guidelines were set at too high a level, do we not still have a significant health issue to address?
I shall turn to the evidence, and in particular to the way in which the Government are advised. At any point with regard to health, whether an individual consultant recommends a particular drug when National Institute for Health and Clinical Excellence has evaluated it and said that the quality and impact is not as such, or evidence comes forward that needs to be considered, the approach is to embrace it.
An important development, following the Stewart report, was the establishment of a new research programme: the mobile telecommunications and health research programme. The hon. Gentleman referred to it himself, and I have with me its report, which was published on 12 September, just one month ago. It is a report from 23 completed projects, and therefore a report on the very latest research findings from a very high-quality research programme. None of the research published by the MTHR programme showed that radio frequency emissions from mobile phones affected people’s health, at least in the short term. The hon. Gentleman referred to that point, and I am looking at the conclusions now.
One study specifically analysed whether short-term exposure to radio frequencies from base stations could have an effect on people’s health, and although some people attribute their ill health symptoms to phone masts, the MTHR peer-reviewed study did not find any convincing evidence that their symptoms were caused by exposure to signals from mobile phones or masts.
Although there is no scientifically proven risk to health from base stations, the Government take very seriously the continuing public concern about the possible health effects from mobile phone masts. Indeed, the report touches on that point. I say to the hon. Gentleman that the Government will continue, with the precautionary principle to which he referred, to respond to the public’s concerns and to support high-quality scientific studies that seek to address the very problems that my hon. Friends and the hon. Gentleman have identified in the debate. Ministers from the Department for Communities and Local Government, the Department of Health and the Department for Business, Enterprise and Regulatory Reform regularly meet representatives of mobile phone operators to discuss the matter, and we shall meet again shortly.
In conclusion, the only sensible and—if I could use the word in response to the hon. Gentleman—precautionary way in which the Government should proceed on the matter is to follow the scientific evidence recommended by people who are properly qualified to assess it. That is what we have in the 2007 report. Some issues have been identified for further research, and they will be taken forward. I hope that we can continue to address people’s concerns by providing the evidence that answers their concerns, at all times advised by the scientific evidence.
HMRC Offices (Sunderland)
Good afternoon, Dr. McCrea. It is a pleasure to serve under you.
My purpose this afternoon is to place on record my concern and that of many people in Sunderland about proposals by Her Majesty’s Revenue and Customs to close its two city centre offices, Gilbridge house and Shackleton house, which between them employ 430 people. Although the proposals might make sense to the number crunchers and master strategists at headquarters, they make no sense at all once the wider considerations are taken into account. Indeed, they are in several respects directly contrary to Government policy.
I thank Ministers and the management of HMRC for the wide-ranging and genuine consultation that they have undertaken with all interested parties on the impact of their proposals. I am grateful for my meetings with senior officials and with my right hon. Friend the Minister, who listened courteously to the representations that I made. They are also considering representations from the city council, the relevant trade unions and others. From my right hon. Friend’s predecessor, the Minister of State, Department of Health, my right hon. Friend the Member for Bristol, South (Dawn Primarolo), who has just departed from the Chamber, I welcome the assurance that wider considerations such as the impact on the local economy will be taken into account, as well as the assurance that whatever happens, the very successful drop-in service, which at peak times attracts up to 500 callers a day, will be retained at a city centre location.
Sunderland has come a long way in recent years. In the late 80s and early 90s, the local economy was devastated by the collapse of our shipyard, the colliery and a large swathe of our manufacturing industries. The process continues: only the other day we lost the last part of our historic glass-making industry. Today, thanks to a huge regeneration effort involving the public and private sectors, supported by successive Governments, our city has been transformed. Our once derelict riverside is coming back to life, thousands of new jobs have been created, the shopping centre is thriving and people are starting to want to live in the city centre again. However, the recovery is fragile, and it would not take much to tip the scales in the opposite direction. Acres of brownfield sites are still waiting to be redeveloped, which is why I am so concerned about HMRC’s plans to take several hundred secure and relatively well-paid jobs out of our city centre.
In several respects, the proposals are contrary to Government policy. I had understood—perhaps the Minister will confirm that this is still true—that it was Government policy to devolve civil service jobs from high-cost London and the south-east to areas such as Sunderland, where rents and wages are lower, and which are badly in need of jobs. I see the Minister nodding, I think, so I shall take that as read. Indeed, that is how we came by the Shackleton house jobs in the first place. I may be wrong, but I believe that the building was purpose built as recently as 10 or 12 years ago, precisely to house London tax jobs that were devolved to Sunderland as part of Government regional policy.
I put it to my right hon. Friend that in these days of allegedly joined-up government, it makes no sense at all for one part of the Treasury to seek to devolve jobs to the more deprived regions while another seeks to take them away. It is time that those parts of the same Department met up. I hope that by now my right hon. Friend has introduced them to each other.
It is also policy, or so we say, to encourage job creation in sustainable locations that are well served by public transport, which is precisely what we have: Shackleton house and Gilbridge house are close to the city centre and well served by public transport—bus and metro. The plan is to relocate most employees in two already congested out-of-town business parks—Longbenton near Newcastle, and Waterview Park in Washington. HMRC already employs 6,700 people at Longbenton and 2,300 at Washington. Clearly, it is going through a “big is beautiful” phase. There is no pretence that most of the Sunderland employees will get to their new place of work by anything other than car. Indeed, the consultation document contains a table showing:
“Indicative travelling times (by car).”
The journey times that are suggested to cover distances of 14 or 15 urban miles from their present location are a tad optimistic—at least as regards Longbenton. I would be very surprised if it is possible to get from Sunderland to Longbenton in rush-hour traffic via the frequently congested Tyne tunnel in 32 minutes, and goodness knows how long it would take by public transport.
In terms of planning and environmental policy, the proposal makes no sense at all. That point is made forcefully by the chief executive of Sunderland city council, Mr. Ged Fitzgerald, in the council’s response to the consultation, which I commend to the Minister. He states:
“I consider that the removal of...jobs from a central location within a well-connected city centre and relocating them to a suburban area some distance from urban centres north of the Tyne is fundamentally unsustainable in planning terms, is against current Planning Policy Guidance and is likely to throw additional pressure on transport routes in the Longbenton area which are already struggling to cope with increased traffic.”
“It may also not be in the interests of HMRC in terms of staff retention and staff turnover to have offices located in unsustainable locations away from good sources of labour.”
I also draw my right hon. Friend’s attention to a letter from Mr. David Walker, the chief executive of the Sunderland arc, the urban development company charged with overseeing the regeneration of much of Sunderland’s riverside. The arc is hoping to generate investment of nearly £1 billion, one third of it from the public sector, over the next 15 years. Mr. Walker states:
“The loss of 430 jobs and the creation of over 6,000 square metres of empty floor space at a time when Sunderland arc is trying to build confidence in the private sector market, gives us grave cause for concern.”
He adds that he is
“aware of the emphasis government places on promoting city centre office markets ahead of out of town business parks...I am, therefore, somewhat surprised that this proposed relocation appears to represent a disconnect with other strands of government policy.”
In conclusion, perhaps I might make a suggestion. Instead of moving Inland Revenue jobs out of Sunderland, how about moving some in? As Mr. Walker says, the arc is in the process of putting together a huge investment in state-of-the-art new office space on a site which, by happy coincidence, is exactly opposite Gilbridge and Shackleton houses. If HMRC is consolidating its estate in the north-east, where better than in Sunderland? If that is not possible, how about taking over a couple more floors of Gilbridge house and moving the staff from Shackleton house into it? Whatever happens, I hope that the Minister and her officials will look at the big picture, not just the small one.
It is a pleasure to see you in the Chair this afternoon, Dr. McCrea, and to serve under your chairmanship. It is always a pleasure to hear your lovely accent. I hope that you will not have too much cause to use it in the next 15 minutes.
I am pleased to have an opportunity to respond to the concerns expressed by my hon. Friend the Member for Sunderland, South (Mr. Mullin). His interest in the reorganisation of HMRC in Sunderland and the wider north-east—I see that his neighbouring colleagues, my hon. Friends the Members for Houghton and Washington, East (Mr. Kemp) and for Blaydon (Mr. Anderson) are present—has already been brought to my attention through questions in the House and the consultation process that HMRC has developed, for which I am grateful. At the meeting that we had in July, we were able to discuss in greater detail the concerns that my hon. Friend the Member for Sunderland, South has just expressed.
My hon. Friend has allowed me generous time to respond. As he will be aware, HMRC has designed a systematic process of review, consultation and announcements on decisions that is being implemented across the whole UK. I am grateful for his complimentary remarks on the process. As he rightly said, it is a genuine consultation, and I commend the hard work of the officials involved and the genuine efforts being made to take on board information and intelligence that is often brought up by local people. It helps to influence how the final decision is shaped.
The process is virtually complete for the urban centre of which Sunderland forms a part, and I expect an announcement to be made to staff and trade unions next week. At the same time, Members who have a constituency interest in the area will be notified. However, I reassure my hon. Friend, before he seeks to intervene, that the comments that he made today will be taken into account before a decision is taken.
The conclusions are fairly well formed. I have yet to see them, but there is an opportunity as a result of today’s further debate and discussion to consider the arguments that my hon. Friend made and to have a look at the decision before it is actually communicated. He should consider that the decision is not finally taken until it is announced, if that helps.
I assure my hon. Friend that that is not the case. I have been taking a close interest in the reviews as they have rolled forward, not least because it is impossible to escape the close scrutiny that Members of all parties make of a review as wide-ranging as this one.
This is just a quick point. My hon. Friend the Member for Sunderland, South (Mr. Mullin) mentioned the impact on transport and the road network in the north-east being part of the consultation. Several issues have arisen with the Highways Agency over the past few years. Has it been involved in the consultation, particularly in respect of the impact on the Longbenton site?
I can assure my hon. Friend that all such considerations are taken into account before decisions are finalised. HMRC has developed a formulaic way of assessing whether travel times are appropriate, but it does not just apply a formula. It listens to representations that are made by staff, trade unions and managers in the locations to ensure that the formula that it applies fits the local circumstances, because, obviously, it will not fit all circumstances. HMRC looks closely at all the available advice and experience, particularly the experience of the staff involved, before arriving at a conclusion.
It is important that I re-emphasise why HMRC is conducting the review. It is making significant changes to the way in which it carries out its business, so that it can respond directly to customer demands and to a requirement that we are making of it to maximise operational efficiency. For some years, there has been very little work carried on in the back offices of each of the departments’ buildings that is directly connected to the local community. In other words, the processing work that is being done in the back offices is not necessarily directly connected to the local communities in which they are located.
My hon. Friend the Member for Sunderland, South asked me to ensure that Government policy is coherent, and that the drive to decentralise civil service jobs is maintained. I reassure him that this process fits within that policy, in the sense that we are not drawing jobs back to the centre in Whitehall but are maintaining regional centres.
I shall give way to my hon. Friend in a moment, but first I want to make this point. I readily accept that we are examining the way in which we do much of the processing and routine work, in order to maximise the efficiencies that we know can be gained if people are pooled into larger groups of staff. Unfortunately, all the evidence demonstrates that that is the best way forward.
My hon. Friend the Member for Sunderland, South said that that happens to be the policy of the moment, but that it will go out of fashion and we will go back in 10 years’ time. I have to tell him that, from what I have seen in other Departments that have asked a public sector service to examine how it has been doing such work, the move has been toward larger concentrations of staff performing what are, generally, similar types of activities. There are sound reasons why we need flexibility in how we deploy staff. I shall touch on those after I give way to my hon. Friend the Member for Blaydon.
It is a pleasure to serve under your chairmanship, Dr. McCrea.
The Minister referred to decentralisation, but that decentralisation is from a town that suffered badly during the 1980s and has now turned round. A small number of key people will be decentralised to a site that is bursting at the seams and, from the transport point of view, that is not needed. The problem is not just the traffic on the A19; it is the traffic that will be diverted on to the A1, which is a nightmare. If anyone can travel from Sunderland to Longbenton in 32 minutes, they are driving faster than Lewis Hamilton.
I know the A1 because my parents still live in the north-east, and I have not-so-fond memories of difficult journeys on it. I know the point that my hon. Friend makes.
I want to make one or two further comments to emphasise the way in which the service that HMRC delivers is changing, and how that is impacting on the decision-making process, before I come to directly to the points about Sunderland. I am aware that I have a few minutes in which to do so.
Many customers now choose to telephone HMRC offices and staff or to use the internet to file returns or make claims, so it is right and appropriate for the organisation’s senior management to look at all their operations to ensure that they are run as efficiently as possible. In some work areas, it believes that that need is best served by concentrating work, as I have described, in larger units where processes can be streamlined and improved. In other areas, a more mobile work force is seen as the best solution to meet customer needs. Finally, there must be an emphasis on improving compliance throughout HMRC by matching resources to the risks that it deals with in particular locations.
I want to emphasise some of the key commitments given by the Minister of State, Department of Health, my right hon. Friend the Member for Bristol, South (Dawn Primarolo), who responded to the previous debate. I am happy to confirm her commitment that, whatever the outcome of the review for the offices in which my hon. Friends have shown an interest, the inquiry centre in Sunderland will be maintained and the same level of customer service will be provided. The face-to-face opportunity will continue to be made available to the constituents whom my hon. Friends represent. Staff will not be required to move to an office beyond reasonable daily travel, and that test of reasonability will be rigorously applied.
An established process for managers and staff to discuss options for their future employment, dependent on the outcome of the review, is open, transparent and accessible to the trade unions. I encourage my hon. Friends to consider the experience of staff in areas where the process has taken place and where a fair effort was made to meet the concerns and aspirations of staff who were affected.
Turning to Sunderland and the sustained case that has been made by my hon. Friend the Member for Sunderland, South and the organisations to which he referred, not least the local authority, the proposals to rationalise work and office space throughout Sunderland, Washington and Newcastle were put forward for consultation earlier this year. Staff, trade unions, Members of Parliament and local authorities all contributed to that consultation. Information on travel routes, economic interests in the locations—that is important—the position of other employers and Departments, as well as individual circumstances, will be taken into account. A report summarising those main responses was published in June, and we have listened to the further reaction to the report. I acknowledge the strong representations and I am aware of my hon. Friends’ concerns.
Turning to the jobs that were created in 2005, as recently as 17 September this year the Sunderland Echo carried the story that Northern Rock may be unable to carry through its plans to bring a further 1,500 jobs to the area as a result of its recent difficulties. My hon. Friends’ concerns are real, and I do not wish to minimise them in any way.
I am aware of that, but their representations have been taken into account and considered as part of the review process. All the information that was provided during that consultation and since has been considered and will be reconsidered during the remaining week.
I want to take the opportunity briefly to outline some of the factors that have been considered. The three offices in Sunderland—two in the city centre and one on the outskirts—accommodate some 900 staff in total. Throughout the entire urban centre, HMRC expect to need approximately 4 per cent. fewer staff than they currently employ by 2010. That contrasts with a net reduction through efficiencies that we are requiring HMRC to achieve of around 25 per cent. since it was created. That is a measure of the high level of efficiency that already applies in the areas that we are discussing today.
Public sector jobs in Sunderland increased by more than 8,500, or 33 per cent., between 1997 and 2005. An analysis of the individual travel times for staff suggests a high degree of mobility between existing sites in the area that might allow staff to commute between them. In proposing to move to an efficient structure—notwithstanding my hon. Friend’s comments about the purpose-built building that is being considered for closure—HMRC is confident that the majority of staff can be relocated with their own or similar work nearby. Overall, HMRC estimates that it has up to 40 per cent. too much accommodation throughout the UK, and the position is no different in this area.
I well understand the concerns of people who work in the area about the extra travelling time that might be involved for some if they are relocated to different offices, the availability of transport links from their homes, including private transport, and the A1. I would like to reassure the Chamber that individual members of staff will have the opportunity to discuss their circumstances with managers before any decision is taken on their suitability to relocate, and that that will be backed by a trade union supported appeal process.
Throughout the programme, senior management in HMRC are committed to being open with staff, to explaining the options available to individuals and to exploring how their expectations can be matched with the need to make the operations more efficient. However, I want to make it clear that those are not easy decisions, and they can be made only when all the facts are known.
With the exception of one year, I have been in government for nearly 10 years, and in almost every Department in which I have worked I have had to rationalise to some extent the estate for which I was responsible, so I am battle-scarred from dealing with those processes. I understand how traumatic they can be, and you may be amazed, Dr. McCrea, to learn that when I was first in the Lord Chancellor’s Department, local magistrates courts suddenly became popular when proposals were made for them to be closed. I was the responsible Minister then. I appreciate hon. Members’ concerns and I have a lot confidence in what I have seen of the process being followed in HMRC. The staff taking it forward are to be commended.
When decisions have been announced in this location, as elsewhere, HMRC will begin the process of relocation and release of its surplus accommodation according to the decision. That process will take some time, as individual cases and contractual commitments must be reviewed. As individual buildings are identified for closure, HMRC will publish an individual building impact assessment covering customers, staff, local communities and local diversity. HMRC is keen to match those skills and experience with its aims of achieving a more efficient operation and improving customer service. I welcome this debate as part of the Department’s commitment to the process of consultation and openness. It is a long-term programme that will deliver a more responsive and efficient service for taxpayers and claimants, and I know that in the long run, my hon. Friends want us to achieve that.
Question put and agreed to.
Adjourned accordingly at ten minutes past Five o’clock.