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Commons Chamber

Volume 501: debated on Tuesday 24 November 2009

House of Commons

Tuesday 24 November 2009

The House met at half-past Two o’clock


[Mr. Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked—

NHS Constitution

1. What recent assessment he has made of the effectiveness of the NHS constitution; and if he will make a statement. (300139)

The NHS constitution was based on extensive consultation and has widespread support. It gives real power to patients by describing their rights. The Health Act 2009 gives the constitution its legal underpinning and requires a report on its effectiveness to be published every three years.

Last month Milton Keynes hospital acquiesced to the demands of a pregnant woman by providing an all-white staff for the delivery of her baby. Does the Secretary of State think that this was the correct decision by the hospital, or can we sometimes put patients’ wishes too much to the fore in thinking of hospitals’ actions?

I cannot be alone in finding uncomfortable the situation that the hon. Gentleman describes. I should have thought that it was so for the NHS staff who were on the receiving end of such a request. I know that the trust concerned is conducting an investigation into the request and its handling. I shall be happy to update him when further information is available.

Does my right hon. Friend expect that when the patient consultation on the new constitution has been completed, the wait of 18 weeks or less for a referral from a GP to a consultant or the two-week wait for GP referral for somebody suspected of having cancer will be one of the most popular things that has happened in the national health service in our lifetime? Will he make sure that that is reinforced so that people will expect it for many years to come?

My right hon. Friend the Chairman of the Select Committee is right to say that the outstanding progress the NHS has made on waiting times in the past decade should never be lost. We should lock in that progress and the NHS should not slip back below those standards. The patients charter published on 3 March 1995 gave an 18-month guaranteed waiting time for in-patient treatment. That is the measure of how far the national health service has come in recent times. I expect patients to endorse the proposal on that new right, but the NHS constitution will need to be updated in line with public expectations about the national health service.

The draft NHS constitution includes a right to drugs approved by the National Institute for Health and Clinical Excellence, yet we are witnessing a growing crisis with patients unable to get hold of vital drugs for breast cancer, epilepsy and many other conditions. There is a long list of drugs that are currently unavailable because people are exporting them and profiting from the exchange rate. Is this not a despicable trade? What are the Government doing to stop it?

I understand the concerns that the hon. Gentleman expresses about parallel exports. The medicine supply chain is crucial and we are taking steps in the Department to guarantee the security of crucial medicines. He mentions the right in the constitution to

“treatments . . . recommended by NICE . . . if your doctor says they are clinically appropriate for you.”

We believe that that is an important right for patients. Obviously NICE has a difficult job to do in judging the cost-effectiveness of treatments, but we think it is the right guarantee to make so that, just as we will not see waiting times slip back, there will never be a return, under this Government at least, to the postcode prescribing that we saw in the 1990s.

The right hon. Gentleman is right that there should be an entitlement, yet every day drug companies are reporting 300 to 500 calls from people who cannot get hold of vital medicines. I have a letter that has been circulating to community pharmacists; it includes a price list, with very attractive offers to pharmacists to buy their drugs for export, thereby denying patients in this country vital drugs. What are the Government doing to stop this unethical practice?

On Friday, the Minister of State, my right hon. and learned Friend the Member for North Warwickshire (Mr. O'Brien), published clear guidance to primary care trusts. The issues that the hon. Gentleman raises are crucial. It is vital that patients have access to the medicines that they need. We are taking a range of steps to secure the medicines supply chain, but I understand the points that he is raising. We have taken action and I will continue to work with him to ensure that there is no problem in the supply of medicines.

I declare an interest as someone who suffers from type-2 diabetes. Will my right hon. Friend assure the House that the NHS constitution will properly protect those who have diabetes by giving them an assessment to determine whether they have the illness? It is better to prevent than to treat once somebody has an illness.

I agree entirely that the challenge for the national health service is to become truly preventive—to become a national health service, with the word “health” underlined. My right hon. Friend will know that as well as consulting on the proposed maximum waiting times, we are asking the public whether people aged between 40 and 74 should have a right to an NHS health check every five years. That would take the NHS into new territory. It would take it squarely into preventive territory, and I look forward to hearing whether he and his constituents think that is the right step to take.

The NHS constitution says that patients should have access to NICE-approved drugs. What does it offer a patient with primary liver cancer, for example, who has only one drug as an option for treatment and is told that the NHS will not provide it?

I described the right very clearly in my answer to the hon. Member for North Norfolk (Norman Lamb): it is a right to drugs as approved by NICE. The hon. Member for South Cambridgeshire (Mr. Lansley) should accept—indeed, I think I have heard him say before—that NICE has a very difficult job to do in judging the cost-effectiveness of new treatments. I do not want to return to a situation in which people have different access to drugs and treatments according to where they live. NICE brought order to the system, and has an international reputation for rigour in the assessment of new medicines. I am proud of the difficult job that it does, and when it has made its deliberations, that right carries its recommendations to patients throughout the country.

The Secretary of State did not answer my question, but the answer that he should have given, according to his view, is that the constitution offers patients in those circumstances nothing—they will not have access to that drug. Why will he not follow the policy, which we pressed on him and his predecessors, of a value-based pricing system for new medicines, so that patients are provided with treatments that are clinically best for them, so that the reimbursement price through the NHS then reflects the value of the drug, and so that the Government, the national health service and the drug companies get together to ensure that patients have access to treatments that are clinically effective and best for them? Why will the Government not accept that they should have a policy that puts patients first?

Let me answer the direct point about NICE’s provisional decision on treatments for liver cancer and Nexavar. It is a provisional decision, so every patient in the country has the opportunity to comment on it and the breadth and range of views can be heard. That is everybody’s right—to make their views known. I do not think that the hon. Gentleman could sit in my position and basically say that every new treatment that comes along can be afforded. We have to have some rigour in the system, and in the way that decisions are made. Experts—I stress that word—should advise Ministers on how best to take forward those decisions, and that is what we have in NICE. It does an extremely important job for the Government and, I might add, for the taxpayer, and I should expect the hon. Gentleman to show it a little more support.

About 10 or 12 years ago, I regularly had complaints from constituents who were waiting 18 months, two years and, in some cases, three years for an operation. On the patient guarantee, it is absolutely right that we reaffirm our commitment to waiting list times, and we should laud what we have done to reduce them, but will my right hon. Friend similarly guarantee that we will continue to press as hard as we can to get waiting lists down?

I agree entirely with my hon. Friend, and the whole thrust of the constitution is to translate those targets into permanent rights so that there is no slipping back. My father has just had a heart bypass operation, and he was treated within a matter of weeks. I looked at the patients charter that the Conservative party introduced in 1995, and there was a 12-month standard for an artery bypass graft. How many unlucky people died on those waiting lists for heart bypass operations? That is a world away, and I assure my hon. Friend that under this Labour Government we will never go back to such a situation in the national health service, with people dying waiting for hospital treatment.

NHS Dentistry

2. What recent assessment he has made of the adequacy of NHS dental provision; and if he will make a statement. (300140)

More than 27.6 million people saw an NHS dentist in the 24 months ending June 2009. That is almost 750,000 more than in the same period ending June 2008.

I thank the Minister for her answer. Paul Bason, a constituent of mine and a dentist, came to see me and told me that he has a major problem, because when someone needs a root canal operation on their teeth the current dental contract incentivises him to remove the tooth rather than to perform an operation. Does the Minister think that the contract is conducive to good dental practice?

No, I do not. We have discussed that issue and root canal work many times in the House, and I suggest that the primary care trust in the hon. Gentleman’s constituency speaks to the dentist concerned. Some root canal work is extremely complicated, so if the dentist cannot carry out the required clinical procedure, he can refer the patient to an NHS hospital, where a consultant will see them.

May I wish the Secretary of State’s father a speedy recovery?

In 1999, Tony Blair promised access for all to an NHS dentist by 2001. Since the contract was rejigged, more than 1 million people now do not have access to an NHS dentist—an increase of half a million. When will Tony Blair’s promise be fulfilled?

I believe that the hon. Gentleman will be aware of the increase in dentistry and dental practice over the past two to three years, particularly in his own area. Oxfordshire has a contract with an existing practice to provide short-term provision, initially for 500 additional patients. In Oxfordshire, the number of dentists increased from 262 in March 2007 to 309 in March 2009. I hope that I am known in the House for my caring attitude to staff and to Members. Later this afternoon, I am opening a dental practice in Horseferry road in Westminster, which I am sure that residents and people who work in this area will be able to use.

Will my hon. Friend agree to meet me to discuss the plight of lab technicians who make crowns and dentures for dentists? With dentists using cheaper foreign options, our domestic industry is dying on its feet.

I am sure that the whole House would agree that when our armed forces come home on leave they need the best possible treatment from the NHS. Does the Minister therefore agree that it is abhorrent that when a serviceman comes home on leave and needs dental treatment he is turned away by the PCT because there is no funding stream for that treatment and sent back to barracks for treatment? Is that not wrong in the NHS in the 21st century?

If the hon. Gentleman would like to give me evidence of that, I would be very interested to look at it.

Human Trafficking

3. If he will issue guidance to health care practitioners on the likely health care problems experienced by trafficked persons which might not present immediately. (300141)

Multi-agency guidance for all front-line practitioners on meeting the needs of trafficked people was issued last month. It includes a specific section on how front-line health practitioners should respond to the needs of trafficking victims, including those who might not present themselves immediately.

As many trafficked people have suffered from the most appalling mental and physical abuse requiring ongoing medical support and counselling, could I mention to the Minister the in-depth counselling service of the Helen Bamber Foundation in London, which gives wonderful ongoing counselling support to trafficked victims as well as to those who are found to have suffered torture? Will she consider extending that kind of in-depth counselling service to other parts of the country where more and more trafficked people are coming forward?

May I pay tribute to the hon. Gentleman, who is a passionate advocate for people who rarely have a voice themselves? I, too, congratulate the Helen Bamber Foundation, whose work does indeed help to rebuild the lives of those who have suffered the worst of violations. Provision of services is of course a matter for local health services. However, I will gladly draw the hon. Gentleman’s comments to the attention of the taskforce that the Government have set up, whose work includes looking at the role and the response of health services in respect of trafficked people.

Talking therapies are very important for people who have been through the trauma and post-traumatic stress disorder that are too commonly the fate of those who have been trafficked. In our constituencies, many of us find that there is insufficient access to talking therapies for anyone. Will my hon. Friend talk to PCTs and mental health trusts around the country about ensuring that there is better access to counselling and talking therapies for people with such conditions?

I certainly share the views of my hon. Friend, who makes an absolutely valid point. That is exactly why we have set up the taskforce. It is chaired by Sir George Alberti, who will look specifically at where there are gaps and what role the NHS and health service workers can play in supporting those who have been traumatised in the way that has been described. I hope that will do a lot to plug any gaps such as those that my hon. Friend mentions.

Most of the people who are trafficked into this country are young men and women who are exposed to terrible abuses. Will my hon. Friend have discussions with her counterpart in the Home Office to ensure that any criminal money that is recovered from the people responsible for this trafficking is confiscated and, better still, redirected to the NHS to pay for the health care of these young people?

Again, my hon. Friend makes a very important point. Indeed, the taskforce that I referred to was set up by the Home Secretary and the Health Secretary, and we want particularly to consider how we can support victims of trafficking, work better together across Government and help to bring to justice those who perpetrate this crime. We want to make the advances that my hon. Friend refers to.

Parking Charges (Offsetting)

4. What guidance he has given to NHS trusts on the offsetting of receipts from parking charges against their deficits; and if he will make a statement. (300142)

NHS trusts manage finances locally, including how they eliminate deficits. Parking subsidies need to be approached with care, especially where the trust has a deficit.

The Minister will remember that at the last Health questions, he told me that he did not expect trusts to make a profit out of car parking to pay off deficits. What is he going to do with the letter from the chief executive of Mid Essex Hospital Services NHS Trust that I sent him a month ago, which states that the trust increased car park charges from 1 February 2007 for staff at Broomfield hospital from £40 a year to £200 a year as part of the turnaround scheme to reduce the deficit? That seems directly contrary to what the Minister said last month that trusts should do.

The hon. Gentleman did raise that with me, so I have looked into it. The increase in 2007 for staff was from 77p a week to £3.85 a week. At the moment, the trust apparently charges staff half the annual cost of operating the space. In other words, I am told that the trust subsidises those car parking spaces.

Today the shadow Chancellor has said how tough he wants to be on climate change and how he wants to discourage people from unnecessarily using vehicles and so on. Now, the hon. Member for West Chelmsford (Mr. Burns) wants to ensure that instead of money being put into patient care, it is put into greater subsidies for car parking—

I believe my right hon. and learned Friend’s guidelines suggest to acute trusts that they should provide some free parking to disabled badge holders. In cases where they do not do that, such as at my hospital at Sandwell, what recourse do we have to press them to change?

We have said that we want people with disabilities who are regular visitors to hospital to have access to permits that will enable them to have car parking spaces at a reduced charge. On what can be done, my hon. Friend must of course first approach the hospital, and if that is unsuccessful he should approach the primary care trust.

Smoking Cessation

5. If his Department will take steps to promote the health benefits of low-toxicant smokeless tobacco products as aids for smoking cessation. (300143)

There is no evidence that smokeless tobacco can help people to quit smoking. Such products are tobacco, and they release harmful toxins when used. The Department therefore has no plans to promote that form of tobacco, but we will continue to support smokers in quitting using safer means, including licensed nicotine replacement medicines.

What an arrogant and irresponsible reply that is. Does the Minister not realise that based on the Swedish experience, if snus were legalised in the United Kingdom it would save up to 30,000 lives a year? Does she not realise that even the World Health Organisation recognises snus as a useful harm reduction product?

I am sorry to disappoint the hon. Gentleman, but there are very good reasons for my comments. The Scientific Committee on Emerging and Newly Identified Health Risks, which is both official and independent and provides the European Commission with scientific advice, considered in detail the health effects of smokeless tobacco products and concluded that such products were addictive. I have myself looked at the packaging of such items and seen that even the tobacco industry acknowledges that they are not a safe alternative to cigarettes.

May I associate myself with my hon. Friend the Minister’s remarks? Does she agree that the most effective way to reduce the incidence of smoking is to reduce peer group pressure on young people to take up smoking? What assessment has she made of the role of the ban on smoking in public bars and restaurants in achieving that?

My hon. Friend will know that just this year we celebrated the 10th anniversary of the NHS stop smoking services, which have saved more than 70,000 lives. We know that people are four times as likely to quit with support than without it. The important point that he makes is that two thirds of smokers start before they are 18, and that is why smoke-free legislation and other measures in recent health legislation will contribute to reducing the numbers of new recruits to the tobacco industry.

Social Care Reform

7. When he plans to publish the Government’s response to their consultation on the reform of social care. (300145)

The consultation closed on 13 November. More than 28,000 responses have been received and 37 events held in all parts of the country. The Government’s response to the consultation will be published in the new year.

I am grateful for that reply. The Secretary of State will know that all the options being consulted on, except for the one whereby everyone would pay for themselves, assume that the Government would take attendance allowance and disability living allowance from the over-65s and put them into a social care system, which would take away individual control. That move is opposed by every single organisation representing disabled people. When he publishes those consultation responses, will he listen to them and cancel that aspect of his social care plan?

The hon. Gentleman either has not read the Green Paper or has misunderstood it. The Minister of State, Department of Health, my hon. Friend the Member for Corby (Phil Hope), who has responsibility for care services, has said that the principle of individual budgets, introduced by this Government, would be the cornerstone of any national care service. That control over purchasing care would be replicated in and be at the heart of any new system.

This is an important debate which is at the forefront of many older and disabled people’s minds. The unpleasant campaign that the Conservative party launched last week will frighten vulnerable people about their benefits with misleading claims about what will happen to them. I find it despicable.

Does my right hon. Friend agree that when we are talking about people who are disadvantaged and vulnerable, and who have great fears about their future, playing party politics is disgraceful?

I entirely agree with my hon. Friend. It is utterly disgraceful. There were claims made last week that benefits would be taken away from elderly and disabled people and that some could lose “up to £60” a week. I do not know how the shadow Health Secretary can justify those claims when he knows them to be untrue. We have said clearly that in any new system people would be offered an equivalent level of support. The whole aim of this reform is to provide more support to vulnerable people, not less. It is because the Conservatives have such a threadbare response to these serious issues that they resort to scaremongering and frankly despicable tactics.

Responding to the Green Paper, Age Concern said:

“We oppose funding the National Care Service from Attendance Allowance”.

I agree with Age Concern. The Secretary of State seems to have been thrown into a panic by this subject. Why does he not simply get up now and say that the Government will reject any of the options in the Green Paper that depend on scrapping attendance allowance or disability living allowance for the over-65s?

I will get up and say what I have just said—that every person will get an equivalent level of support, and I have made that clear. The hon. Gentleman went to a press conference last week at which he suggested that money would be taken from those people. That destabilises, upsets and causes anxiety in some of the most vulnerable people in society, and for whose purposes? It is for the purposes of the Conservative party’s election campaign. I find it beneath contempt, and we would do those people a greater service by having a proper debate on the issues.

NHS Governance

8. If he will bring forward proposals to involve more elected representatives in NHS governance structures at local and regional level. (300146)

There are many ways in which elected representatives can be involved in the NHS locally. These include opportunities for elected representatives to seek membership of primary care trusts and strategic health authority boards as non-voting members or non-executive directors. There is joint working by elected representatives, local authorities and primary care trusts in local strategic partnerships and, of course, there is the use of overview and scrutiny powers by local government.

When I want to discuss health matters with a directly elected person in this country, I cannot do it at either the local or regional level. The first person I come across who is directly elected is my hon. Friend, along with his capable colleagues on the Front Bench. Does he not think that that is going a bit too high up the pay grade? Can we not have people who are directly elected and capable at the local council and regional levels?

I know that my hon. Friend plays a huge role in chairing his local strategic partnership, where he has locally elected representatives and members of the primary care trust sitting round the table talking about local needs and issues. However, I might also draw his attention to the new Regional Select Committees, which can hold regional health authorities to account for specific aspects of their performance. [Interruption.] And as you can hear from the noise, Mr. Speaker, the Opposition voted against those regional forms of accountability.

The hon. Member for Shrewsbury and Atcham (Daniel Kawczynski) and I have worked as locally elected representatives on his energetic campaign to prevent the movement of the accident and emergency unit from Shrewsbury hospital. We have now received assurances from the authorities at the hospital that the service will not be moved, but I do not understand what formal mechanism we would have under the current arrangements to object, especially bearing in mind that this is a cross-party issue. How would the Minister advise us to ensure that our constituents’ concerns about any such move are formally registered, given the system that he has been outlining?

I am not familiar with the hon. Gentleman’s specific concern, but in general terms, decisions about reconfiguration, which is what I suspect he is talking about, are clinically led decisions, made by leading local clinicians determining what is in the best interests of patients and services in his constituency and those of his neighbours. I would hope that he, his constituents and other local bodies would make their representations in the normal way, but be guided by the clinicians, who I think probably know what is best for patients in their area.

But are patients’ voices being heard in the NHS, and what about these local involvement networks? What assessment has the Minister made of their effectiveness?

The creation of LINks is an important additional form of accountability in the NHS locally, not only to local Members of Parliament and locally elected councillors but directly to service users and patients, who will have an opportunity through LINks to influence the pattern of service, including procurement, provision and quality.

Capital Funding (Hospital Trusts)

Wellingborough is a fast-expanding constituency, with thousands of new homes being built. It has no hospital, and now this discredited Government are closing the hospital out-patient facility. In the neighbouring, highly marginal Labour constituency of Corby, a new hospital and a new out-patient facility are being built. Are this Labour Government buying votes?

I thought the hon. Gentleman’s party was fully in favour of foundation trusts. Kettering general hospital foundation trust wants to build a new unit at Irthlingborough, which is 2.7 miles from the current Rushden clinic that he is talking about. Through its overview and scrutiny committee, Conservative-controlled Northamptonshire county council decided that the move did not need consultation, because it was not a substantial change.

Given the terrific importance of abolishing car parking charges, about which the Secretary of State made such important announcements a couple of years ago, will my right hon. and learned Friend look into the possibility of appropriating those car parks into the capital structure and capital allowances of hospitals, thereby not imposing that revenue drain on them?

I shall of course look into the point that my hon. Friend makes, but I have to say this. We want to ensure, as far as finances allow, that patients and those who visit them can get a permit for free car parking in due course. I will look into the point he makes, but our policy is to move towards patients getting that free car parking in due course.

Alternative Medicine (Regulation)

10. What progress has been made on the regulation of herbal medicine, acupuncture and traditional Chinese medicine; and if he will make a statement. (300148)

The consultation on whether—and if so, how—to regulate practitioners of acupuncture, herbal medicine and traditional Chinese medicine closed on 16 November 2009. We are considering our response to the consultation, and it will be published next year.

Is the Minister aware that the qualified practitioners at the Hydes Herbal Clinic on London road in Leicester—the oldest and largest such clinic operating in this country—want statutory regulation to interface with European legislation as quickly as possible? Will she guarantee that the clinic will still be able to treat, and to prescribe and prepare its own herbs?

I thank the hon. Gentleman for making that point. We have had some 5,000 responses to the consultation, which I welcome. We will move as quickly as possible, and, when taking our decision, we will balance public safety with the risks involved, and look at the principles of better regulation in deciding whether any action would be transparent, accountable, proportionate, consistent and targeted only where action was needed.

Mental Health Services

11. What steps his Department is taking to improve the level of access to mental health services. (300149)

As a result of nine consecutive years of increased spending, access to mental health services has never been higher. Many more staff, more community mental health services and increased access to psychological therapies have transformed services since 1997. Our vision for the future of mental health services and wider public mental well-being, which we are calling New Horizons, will be published shortly and will build on these remarkable achievements.

Lord Layard’s report recently revealed that there are more mentally ill people on incapacity benefit than there are unemployed people on all benefits put together. One in four people will have a mental illness at some stage during their life. However, the 18-week waiting time target applies only to physical ailments, not to mental illness. Why do the Government treat mental health problems as a Cinderella subject, especially when the new NHS constitution states:

“You have the right not to be unlawfully discriminated against in the provision of NHS services including on grounds of…mental health”?

I am pleased to be able to tell the hon. Gentleman that Cinderella has come to the ball. We have increased investment in mental health services by 50 per cent.—£2 billion—since 2001. We have more consultant psychiatrists, more clinical psychologists and more mental health nurses. That investment in the extra services means that individuals will be able to access the mental health services that they need, not least the psychological therapies that we are rolling out across the country, investment in which will rise to a total of £173 million by 2010-11.

During the passage of the Mental Health Act 2007, there were many discussions about providing places of safety, other than police stations, to which seriously mentally ill people could be taken. Has any progress been made on that, please?

Providing such places of safety for people outside police custody has been an important part of developing mental health services for the future, and we continue to drive forward progress in that area. If my hon. Friend has a particular issue in his constituency, I ask him please to write to me and I will be happy to take the matter forward with him.

The Government predicted that the number of community treatment orders needed in the first year of the Mental Health Act 2007 would be 600 to 800, yet in the past year there have been 4,000. That was therefore a gross under-prediction. Will the Minister investigate the impact of this massive under-prediction on the thousands of vulnerable people without sufficient safeguards in place and without sufficient support in the community?

I do not recognise the hon. Lady’s description of those services. It is true to say that there has been use of community treatment orders, but those orders can be made only when a clinician has made a decision that that is the safe and right thing to do, that there is support in the community, and that the individual can be recalled if necessary. That has happened on a number of occasions. I believe that the Mental Health Act has been a success, and that these new orders have provided new opportunities to treat people safely in the community and to keep the community safe.

Independent Sector Treatment Centres

12. What assessment he has made of the use made by the NHS of services commissioned from independent sector treatment centres. (300150)

Independent sector treatment centres have treated more than 2 million NHS patients and helped to reduce waiting times and improve patient choice.

The Care Quality Commission carried out a report on the Eccleshill treatment centre in Bradford at the request of the coroner after the death of my constituent, John Hubley, in 2007. A freedom of information request has shown that in January this year, the centre still did not have adequate risk-management procedures or responses to emergency surgical situations. When can we finally have a debate about NHS use of such facilities? Is it right to send patients there when safety procedures are not adequate?

Debates are a matter for the usual channels. We of course extend our condolences to the family of Dr. John Hubley. The coroner stated that he was satisfied that there was no ongoing system failure at the Eccleshill treatment centre. The Care Quality Commission has looked into this and will continue to monitor it to ensure that quality standards are met, but 96 per cent. of patients who use ISTCs have recorded either excellent or very good quality services.

Working Time Directive

13. What recent assessment he has made of the effect of the European working time directive on NHS staff. (300151)

All NHS staff, with the exception of doctors in training, have been compliant since 1998. In 2004, working time provisions were extended to doctors in training whose maximum hours were reduced to 56 hours by August 2007 and 48 hours by August 2009.

The Royal College of Surgeons said in January this year that we simply do not have the surgeons in the UK to fill the gaps created by the working time directive. Does the Minister agree that it is wrong to put at risk the work of local trusts, including the Norfolk and Norwich University Hospitals NHS Foundation Trust, the safety of patients and the career aspirations of those who wish to become surgeons by her Department’s lack of proper planning for the implementation of the working time directive?

I am sorry to disagree with the hon. Lady. The working time directive is health and safety legislation, and there is strong evidence that tired doctors make mistakes, so reducing working hours to 48 will of course improve patient safety. I know that the Norfolk and Norwich university hospital is looking at its anaesthetic rota and coming to an agreement on it. There has always been a tradition in surgical training that needed to be addressed. The most recent survey of medical education for those in training has shown that this training is now better and safer.

Given that at the last count, only two thirds of junior doctors were compliant with the European working time directive and 77 trusts have had to request a derogation from the directive, and in the light of the fact that the Secretary of State himself does not have to comply with the directive that his own party has forced on our doctors, what action are the Minister and the Secretary of State taking to bring forward the long-delayed review of junior doctors’ training to ensure that doctors’ skills and training—and, ultimately, patient care—do not suffer as a result of the Government’s failure to negotiate an opt-out?

I can certainly tell the hon. Gentleman one thing—this Labour Government and this Minister have no intention ever of returning to the long and dangerous hours that all our doctors and surgeons used to have to work, because I actually worked with those doctors at the time. Any one of them would tell the hon. Gentleman how serious that practice was, as mistakes were made. Along with the medical education authorities, the British Medical Association and all the Royal Colleges, we take patient safety very seriously. The report that the hon. Gentleman mentioned will be looked at and we will report back on it, I believe, early next year.

Health Visitors (Greater London)

14. How many health visitors were employed in Greater London in (a) 1997 and (b) 2009; and if he will make a statement. (300152)

In the last decade, child health services have developed based on research and the healthy child programme. In the London strategic health authority region, 1,876 health visitors were employed in 1997. Following the change and the extensive child health programmes, we now deliver child health by a range of practitioners. The latest figures show that at 30 September 2008 there were 1,577 health visitors.

Does the Minister accept that after 12 and a half years in office, we are losing nationally one health visitor on average every 30 hours, that the professions reckon that we need another 8,000 to plug the gaps and that there are some places where there are two and a half as many people on a health visitor’s case load as was recommended as safe by the inquiry into baby Peter’s death?

We recognise that there is a shortage of health visitors, but, as I said in my earlier answer, we are delivering the child health strategy in a different way. Health visitors now lead teams. The 21 Sure Start centres in Southwark, part of the hon. Gentleman’s constituency, serve as a focal point for local families, and have excellent links with health visitors, nurseries and infant schools.

Unite/CPHVA and the national health service have launched an action on health visiting programme. They are working closely together, especially in London, evaluating return to practice schemes. We value our health visitors greatly. As for their case load, the Secretary of State recently announced that such issues were to be reviewed.

Working Time Directive

15. What recent assessment he has made of the effect on hospital trust budgets of the implementation of the European working time directive. (300153)

This is a matter for local organisations. They make budgetary decisions based on the needs and priorities of the local populations to deliver effective local services.

Three consultants used to provide 24/7 consultant-led paediatrics at Horton general hospital, but it is estimated that it will take between nine and 13 to deliver the service in future. That has implications not only for the trust’s budget, but for the future recruitment of consultants. What plans are the Government making in relation to recruitment as a consequence of the working time directive?

We are in constant discussion with Medical Education England, along with the strategic health authorities, which have strategic responsibility for the planning of their consultants. Money has been made available to assist them in that process.

Topical Questions

Tomorrow the Government will publish the personal care at home Bill, which will benefit about 400,000 of the most vulnerable people in our society. On the same day, I will address a conference at the London School of Hygiene and Tropical Medicine to raise awareness of the human health costs of inaction on climate change in the lead-up to the Copenhagen summit.

The people of Cumbria have been in all our thoughts over recent days. Today my hon. Friend the Under-Secretary of State for Health spoke to Sue Page, chief executive of NHS Cumbria, and passed our thanks—the thanks of the whole House, I am sure—to the NHS staff and health professionals who have done so much to help local people to pull through during some very dark hours.

I am assured that emergency measures are in operation, including the use of Cockermouth community hospital as a general practice. In Workington, emergency measures are providing the full range of primary care services for people in the north of the town. My hon. Friend the Under-Secretary will visit the affected areas on Friday, and any further steps that are necessary will be taken.

Following concerns raised about the generic substitution of epilepsy medicine, what decisions has the Secretary of State made on whether such medicines should be excluded from the pharmaceutical price regulation scheme?

We intend to launch a 12-week consultation, which I hope will begin before Christmas. We therefore do not expect to be in a position to implement generic substitution until next year. However, we will wish to examine those issues as part of our wider consultation.

T5. Cans of super-strength lager carry the message “Enjoy responsibly” or “Please drink responsibly”, yet they contain four and a half units, which is more than the maximum recommended daily intake. Given that super-strength drinks are a major killer of vulnerable homeless people, would it not be more responsible for the Department to ban half-litre cans and to introduce a super-strength tax on beers and ciders containing more than, say, 6 per cent. of alcohol per volume, as recommended by the Thames Reach charity in my constituency? (300168)

I note the clear recommendation from that organisation in my hon. Friend’s constituency. Whatever the strength of the lager or other alcohol that people drink, they should understand how strong the drink is, how much they are drinking and the health risks involved. As my hon. Friend knows, tax is a matter for the Chancellor, but I will ensure that his comments are drawn to the Chancellor’s attention.

T2. According to the Jeanette Crizzle trust, of which I have the honour to be a trustee, fewer than 7 per cent. of secondary schools have taken part in the Department’s Give and Let Live organ donor education programme. What is the Secretary of State going to do to improve participation rates? (300165)

This is obviously a very important issue. There were reports in the news again today that not enough good organs were available for donation. I think that we can reach across the House and agree that the matter is crucially important. There is more that we can do to encourage people voluntarily to join the organ donation register. Progress has been made recently, but there can be no let-up. I hope that the hon. Gentleman will work with us, and will support all our efforts to boost awareness and the number of people joining the register.

Will my right hon. Friend take a personal interest in the two capital building projects, part of the £1.2 billion committed to Liverpool hospitals by the Government, the Liverpool university hospital and the Royal Liverpool children’s hospital, both of which are critical to the future delivery of hospital services to Liverpool?

I visited Liverpool yesterday and spoke to the chief executive and chair of the Royal Liverpool and Broadgreen University Hospitals NHS Trust. The scheme has important health benefits for the city and region, but also has wider economic benefits. I can assure my right hon. Friend that I am paying close attention to both of the schemes that she mentions. Obviously there is pressure on capital budgets in the current climate but I recognise that these are important schemes.

T3. Is the Secretary of State aware that the future of the nation’s community dental practices has been put at serious risk because of guidance HTM 01-05? Will he agree to meet me and some dentists from my constituency so that they can explain what are clearly the unintended consequences of this guidance note? (300166)

There is a new village near Chorley called Buckshaw, and thousands of new homes are being developed in Chorley. My concern is that there is a drag factor between the population and the funding given to primary care trusts. What can we do to ensure that Chorley gets the right amount of funding for its primary care trust?

The NHS is constantly looking to ensure that we keep up to date with the way in which populations change in particular areas. PCTs must ensure that those data go to the Department so that the appropriate decisions on finances can be made.

T4. At a recent surgery, a constituent raised the problem of having an above-inflation increase at a private care home for his mother. It can be difficult to move people from those homes, so there is no competition with other businesses. What tools are at the Government’s disposal to deal with this and to regulate private care homes so that they cannot simply charge anything willy-nilly, knowing that people cannot access another care home? (300167)

The quality of care provided by private care homes is subject to regulatory control by the Care Quality Commission. They are independent and fee levels negotiated with local authorities are a matter for local authorities. If the hon. Gentleman has a particular issue on that, he should first discuss it with the local authority, but recent legislation means that an individual may be able to complain to the local authority ombudsman.

Further to the incident at Milton Keynes general hospital when a maternity patient demanded all-white staff, may I clarify to the Minister that I spoke directly to the chair of the hospital trust, who assured me that the patient’s request had not been acceded to and that she was treated by the duty team—a mixed team—for her caesarean? It would appear that the hospital did follow the NHS code in dealing with what was clearly a difficult and sensitive incident. I would be grateful if the Minister made sure that the accurate account of what happened is accentuated and that the hospital is congratulated.

I am grateful to my hon. Friend for that important clarification. We would want to ensure that no unfair suggestion is made about NHS staff who do their best for all of her constituents at all times. There is of course no place for racism in the NHS, nor for any discriminatory behaviour towards NHS staff. On that there can never be a compromise, but we have heard the clarification given by my hon. Friend today.

T6. A Bethlem Royal hospital in-patient who had previously been convicted of murder absconded while on a shopping trip to West Wickham. As we would expect of one of the best trusts in the country, Bethlem reacted very professionally in giving reassurance to the public about its procedures for such circumstances, but would it be worth checking whether there are sufficient resources to support such activities for in-patients outside hospital? (300169)

I am grateful to the hon. Gentleman for bringing this case to my attention. Whether a patient who has been detained under the Mental Health Acts can leave a hospital or unit under escort on a visit is always a clinical decision. The hon. Gentleman described the mental health trust involved in this case as one of the best in the country, and it is the responsibility of individual trusts to ensure that patients in their care do not abscond from secure services.

The hon. Gentleman referred to resources. As I said earlier, investment in mental health services has increased for nine consecutive years, and by some 50 per cent. or £2 billion in real terms. I understand that the South London and Maudsley NHS Foundation Trust will be carefully reviewing the incident the hon. Gentleman raised and that it will change policies and procedures for escorting patients if that is found to be necessary.

May I mention how proud my constituents are of the new Haywood hospital alongside the University Hospital of North Staffordshire NHS Trust’s new hospital? Will my hon. Friend the Minister take a very close look at investment and capital funding, however, and will he in particular look at the pace of change, as our area is still distant from the target, and at the importance of the market forces factor, so that we can make sure we get our full allocation of capital funding across north Staffordshire?

My hon. Friend is a doughty fighter for Staffordshire and for ensuring that funding goes in the direction of her constituents. I will, of course, look at the issues she raises and see if I can be helpful.

T7. Paul Bason, a Lichfield-Staffordshire dentist who came to see me, raised, among other issues, the question of training. He says that after graduating in dentistry people have to have a year in vocational training, which is a good thing, but he asks whether there will be enough vocational trainers for the next batch of graduate dentists, and he thinks that perhaps there will not be. (300170)

We have to accept that there is competition for training places in some areas and that it is necessary for some new graduates to move out of their home area. Over the country as a whole, however, we make sufficient training places available for training new graduates.

The roll-out programme for ultrasound screening against aneurysms of the aortic artery is inadequate. How and when will this treatment, which will save up to 6,000 lives a year among men aged over 60, be available? It is desperately needed, especially in working-class areas where the greatest indices of health poverty exist, such as my area.

When rolling out any new technique within the national health service, we have to prepare the work force. This screening has been in progress. It has taken off better in some areas than in others, but we are looking at this and we are particularly concerned that we get it right because of the number of lives that will be saved.

T8. Constituents are being told that GP surgeries have to use up their initial allocation of 500 flu vaccines before they can order further supplies, even if the surgery knows there are a further 1,500 or so patients still to be vaccinated. What is the Secretary of State doing to ensure that surgeries have adequate and timely supplies of vaccines so that all vulnerable people can be vaccinated as soon as possible? (300171)

It is very important that surgeries have a ready supply of vaccines so they continue with the programme of vaccinating priority groups. We were aware that some surgeries may be coming to the end of the vaccination of priority groups at around this time, which is why we took the decision to extend the vaccination campaign to children aged between six months and five years. I take the point the hon. Lady raises very seriously. We want to ensure continuity of supply of vaccines to all surgeries around the country. We are confident that all GP surgeries have had a supply of vaccine, but we will continue to take a close look around the country to ensure that all surgeries have enough vaccine to be able to continue vaccinating in the priority groups.

Having five years ago been given exclusive rights to dip its corporate snout into the private finance initiative hospital trough, Laing O'Rourke must have industrial-strength chutzpah now to sue the Secretary of State for Health for abortive costs on that collapsed project. Does that not lay to rest, once and for all, the illusion that PFI transfers risk to the private sector?

PFI has produced a large number of hospitals and clinical facilities for the NHS; it has, in many areas, been an enormous success. What I would say is that sometimes difficulties arise and we must deal with them.

T9. Who takes responsibility in government for the fact that figures released today show that there were nearly 40,000 extra deaths last winter in this country because of cold? That is the highest figure for nearly 10 years. What will the Department of Health and other Departments do to have a proper insulation strategy for homes in Britain, rather than a piecemeal system that leaves many people dying when they would survive in other countries? (300172)

Obviously, the causes of winter deaths in excess are complex. The fact that last year’s winter was colder than average will explain some of the extra deaths, but I assure the House that the Government are working hard, and will continue to do so, to improve the uptake of grants, benefits and sources of advice, so that homes are more energy efficient and people have the help they need with heating and bills.

A few days ago, work began on Bolton One, which is a £30 million project delivering a new swimming pool, a walk-in health centre and teaching facilities for the university of Bolton. Will the Minister congratulate that university, Bolton council and Bolton primary care trust on this innovate new partnership?

T10. There are concerns about the future of the Feilding Palmer cottage hospital in Lutterworth, in my constituency. It is much valued by local people and there has been talk of it closing. People like to be treated close to their home, and I believe that such an approach is public policy for all parties. Therefore, will the Minister inform PCTs that they should make every effort to allow local people to decide where they are treated and that where people have a facility such as the Feilding Palmer cottage hospital they may be treated close to home, rather than 20 miles away in the city of Leicester? (300173)

What is also shared by the Front-Bench team of the hon. Gentleman’s party and our Front-Bench team is the view that reconfigurations—changes that are being made—should be clinically led and locally decided.

Today’s Western Morning News reported that Cornwall council is holding an urgent meeting to discuss the relocation of upper gastro-intestinal cancer services to Derriford. Devon county council has also requested that the Secretary of State re-examine the issue. Will he agree to a meeting to discuss the impact of this central policy on local access to services?

I am happy to agree to meet the hon. Lady and some of her parliamentary colleagues, but may I just say that we also need to accept that decisions have to be made in the health service about where facilities are placed? Such decisions are difficult and they are best arrived at locally.

What advice can the Minister give to a constituent whose eight-year-old son is suspected of having Asperger’s syndrome and who is having to wait three years before a test might confirm that? He could pay £1,000 for a test to be carried out privately, but that would not necessarily be accepted by the local education authority. Is this not a disgrace?

Decisions on the care of children with autism will come under the remit of the children and young people’s plan, the legislation for which was recently passed. It will make sure that disabled children and children with autism in an area are covered by a plan that will determine the level of need locally and the services to meet that need.

Points of Order

On a point of order, Mr. Speaker. This morning, the Select Committee on Reform of the House of Commons produced an extremely important report. Unfortunately, at last Thursday’s business questions the Leader of the House declined to say when the report might be debated and declined to come to give a statement to the House today on how the Government might respond to it. Could you use your good offices to advance the case made by this excellent report and, indeed, to give the House an opportunity to debate it, so that we may add to or subtract from it as we see fit?

The hon. Gentleman is anticipating business questions and asking a business question on Tuesday that would be suitable subject matter for a question on Thursday. I am, very properly, conscious of and focused on this subject. I am watching events with close interest, as he would expect. He might want to raise the matter on Thursday. There will be opportunities—and soon, I am sure—for these matters further to be considered and it is right that they should be, with a clear indication of how events should proceed.

On a point of order, Mr. Speaker. Can you use your good offices to see whether we can have a feed of the Chilcot inquiry into Iraq on our parliamentary channels? There is considerable interest in the inquiry. I am aware that if one has a BBC red button, one can push that, but we have no such buttons on our sets.

I understand that in technical terms the matter is relatively straightforward. I have noted what the right hon. Lady says, although I am not quite sure that it constitutes a point of order. As always, I want to be helpful and I know that she has the interests of the House at heart. I will ask officials to be in contact with her with a view to seeing whether her request, which I suspect will be reflected elsewhere in the House, can be accommodated.

In business questions last week, I raised with the Leader of the House the question of the House’s ability to scrutinise Government Bills, particularly on Report and particularly in relation to the Equality Bill, which is her Bill. She accepted that she had given undertakings to consult Opposition parties about how that would be dealt with, given that it is a huge Bill with many amendments and that there will be multiple groups of amendments. However, without any consultation, only one day has been allocated and that will not be sufficient to even touch proper scrutiny. Have you heard from the Leader of the House whether there will be reconsideration of that provisional business? An announcement on Thursday might be very late for business scheduled for next Wednesday and it is very difficult for the House to provide scrutiny if we do not get good notice as well as sufficient time.

I think that the hon. Gentleman has a lot in common today with the hon. Member for North Essex (Mr. Jenkin), at least in the sense that he is asking a business question on Tuesday that could reasonably be asked on Thursday. I also remember very distinctly the list of dates recited by the hon. Member for Oxford, West and Abingdon (Dr. Harris) in the House last week on which he had previously made the request for due consideration on Report over two days of the matters in question. I feel sure that the concerns that he has again articulated will have been heard by those on the Front Bench and by the Leader of the House. I have no power to influence the matter further, but he has raised an extremely important concern. He might be tempted to raise it again, and I feel sure that if it is raised again it will be heard.

Debate on the Address

[4th Day]

Debate resumed (Order, 18 November).

Question again proposed,

That an humble Address be presented to Her Majesty, as follows:

Most Gracious Sovereign,

We, Your Majesty’s most dutiful and loyal subjects, the Commons of the United Kingdom of Great Britain and Northern Ireland, in Parliament assembled, beg leave to offer our humble thanks to Your Majesty for the Gracious Speech which Your Majesty has addressed to both Houses of Parliament.

Energy and Climate Change and Environment, Food and Rural Affairs

It is a great privilege to open this debate on the Gracious Speech and its plans on energy and the environment.

The debate comes as people in Cumbria are battling the worst flooding in memory and I want to start by paying tribute to PC Bill Barker, who tragically lost his life, and to others who have lost their lives around the country. I am sure the thoughts of the whole House are with their families.

We thank the emergency services for the work that they are doing and hope that the people who have been forced out of their homes can return to them as soon as possible. Such flooding will become more frequent because of climate change, which makes the Flood and Water Management Bill, overseen by my right hon. Friend the Secretary of State for Environment, Food and Rural Affairs, so important. The Bill is a crucial part of implementing Sir Michael Pitt’s recommendations.

We must act not just to adapt to climate change but to prevent it. That is the focus of my Department’s work and the Energy Bill, announced in the Queen’s Speech. The context of that Bill is the crucial starting point for this debate on the Gracious Speech, because I believe that we need candour above all on the reasons why we must act on climate change, the scale of the challenge that we face and what we need to do about that challenge.

There is a real danger to this argument, which is that somehow it is suggested that the science of climate change is in doubt. It is very important that we show that it is not. Today, the Met Office, the National Environment Research Council and the Royal Society issued a joint statement, and it is worth mentioning some of the key points. They say that global carbon dioxide concentrations continue to rise and that the decade 2000-09 has been warmer on average than any other decade in the previous 150 years. They add that Arctic summer sea ice cover declined suddenly in 2007 and 2008, and that there is

“increasing evidence of continued and accelerating sea level rises around the world.”

Those organisations also say that the science has become clearer and that, if anything, the dangers are becoming more pronounced.

Does the Secretary of State get very frustrated, as I do, by the small number of deniers who still think that climate change is not happening? Anyone who comes to Montgomeryshire today will see a large swathe of my constituency under water, something that is happening more and more frequently. The reality is that climate change is happening, we have caused it and, as he rightly points out, we have to fix it.

I agree. In the year or so that I have been doing this job, I have learned that we have to remake the case for the science each time we talk about these issues. There are too many noises off from people who say that the science is somehow not proven, or that experts differ. Let us be clear: the overwhelming consensus of scientific evidence says that climate change is happening and that it is man-made.

My goodness, what a range of choices. I give way first to my hon. Friend the Member for Stoke-on-Trent, North (Joan Walley).

I am so grateful to my right hon. Friend. On that point, does he agree that the 10:10 campaign is doing a great deal to promote awareness of the seriousness of the situation that we face, which is backed up by the scientific evidence? Do we not need more local initiatives so that everyone can understand the big picture and take action locally as well?

My right hon. Friend has touched on part of the problem, which is that some people are in denial. However, the majority of the world recognises that the problem has an impact on everybody. What can he do to ensure that there is international collaboration on good, positive schemes, such as carbon capture and the other initiatives that are emerging? Does he agree that we must ensure that developing countries such as China, Brazil and India also get that technology?

My hon. Friend makes an extremely eloquent point, and one of the most important purposes of the upcoming Copenhagen summit is precisely to encourage the sort of co-operation that he mentions. We must also ensure that all countries take action, and that is a central part of tackling the problem.

The right hon. Gentleman started by talking about flooding, and many of us who represent constituencies that flood have been raising these issues for many years. The river in Shrewsbury has been rising again, threatening the town. When he makes announcements about future plans for flood defences, will the Government ensure that there is considerable debate about wet washland schemes and about managing rivers across large areas, rather than piecemeal defences?

My right hon. Friend the Secretary of State for Environment, Food and Rural Affairs assures me that that is an important part of the debate. It is worth saying that we have increased flood defence spending, but the point that the hon. Gentleman makes is absolutely correct.

I believe that the science is clear. I also believe that the case for action does not rest simply on the environmental catastrophe that awaits if we do not act: there is also a positive argument, to which the Energy Bill in the Queen’s Speech speaks.

I could not agree more with the Secretary of State when he says that we need to have confidence in the science. Does he therefore agree with the remarks of George Monbiot in The Guardian today? He says:

“The emails extracted…from the climatic research unit at the University of East Anglia could scarcely be more damaging…There appears to be evidence here of attempts to prevent scientific data from being released, and even to destroy material that was subject to a freedom of information request.

Worse still, some of the emails suggest efforts to prevent the publication of work by climate sceptics, or to keep it out of a report by the Intergovernmental Panel on Climate Change.”

He concludes:

“I believe that the head of the unit, Phil Jones, should now resign. Some of the data discussed in the emails should be re-analysed.”

Will the right hon. Gentleman comment on that?

That is certainly an unusual alliance—George Monbiot and the right hon. Gentleman. In all seriousness, my view is that there should be maximum transparency about the data that exist. I know that in debate on related questions, one of my ministerial colleagues talked to the right hon. Gentleman about the way in which the Met Office was seeking permission for the release of the raw data; the right hon. Gentleman has been campaigning for that. Maximum transparency can only help the case of those who believe that climate change is real and man-made; that is important. I will not comment on the e-mails, because I have not seen the detail, but I clearly say to him that transparency is important.

The only other point that I would make to the right hon. Gentleman is that we should be cautious about using leaked partial e-mails to cast doubt on the scientific consensus, because that is dangerous and irresponsible. The scientific consensus is clear. Although there must be transparency of data, we should be responsible in how we talk about the issues. Let us be clear: the more we cast doubt on such questions, the more we question the case for action. The case for action involves making difficult decisions—a point that I shall come on to.

May I assure the right hon. Gentleman that my constituents need no convincing that climate change is real? The evidence is before our eyes in Cumbria today. Does he agree that denial and scepticism are basically an excuse for copping out and not taking the action that we need to take? As for the events that we are witnessing this week in Cumbria, we sometimes refer to such events as incidents that take place once in 100 or 1,000 years. Does he agree that that is unfortunate and inaccurate language? It might be accurate to say those sorts of things when looking backwards, but looking forward, such events will become much more regular because of the climate change to which he refers.

Indeed. The hon. Gentleman is right: the standard will change over time. There was severe flooding in my constituency in 2007. That had last happened in the 1950s, but the flooding was described as a once-in-100-years or once-in-1,000-years event. The way that we talk about such matters needs to change.

The Secretary of State is being very generous in giving way. I am sure that he will agree that if we are to reduce our carbon footprint, it is important to lower domestic fuel consumption, including fuel bills, wherever possible. Some months ago, I raised with him the idea that we should oblige energy companies to print on all domestic bills whether customers are on the company’s cheapest tariff, and if they are not, the company should put how much the customer would save by changing or switching. He kindly said that it was an ingenious idea, yet recently I received a letter from his Department saying that the Government could no longer support it. What has changed his mind?

We absolutely support the idea; indeed, Ofgem is bringing in regulations to ensure that people get an annual statement about where they can get a better tariff from the company concerned. I hope that that will reassure the hon. Gentleman.

I briefly want to mention the positive case. There are real gains for our economy if we make the low-carbon transition and if, at Copenhagen, the world signals that it will make the low-carbon transition. There would be jobs in new industries, including the wind industry. The money allocated in the Budget by my right hon. Friend the Chancellor is already being used to help wind companies such as Clipper in north-east England, which is developing the largest offshore wind blade in the world; it is larger than a jumbo jet. There is money for wave and tidal power, and money for venture capital investment in green industry.

The point is both to avoid environmental calamity down the road and to talk about the positive benefits for our economy, energy security and quality of life. However, the scale of the challenge is enormous. Nowhere will that be more clear than at Copenhagen, and my hon. Friend the Member for Chorley (Mr. Hoyle) referred to the issues. The UK is determined to play its part in getting an ambitious agreement at Copenhagen. That is why we have committed to 34 per cent. reductions in our carbon emissions by 2020, to more as part of an ambitious agreement at Copenhagen, and to 80 per cent. cuts by 2050.

It is worth asking, “What do 80 per cent. cuts by 2050 mean?” because that is very much the context of this debate. They mean huge ambition—near zero-carbon homes, substantial cuts in transport, and near zero-carbon energy. That shows the scale of the challenge. At the same time, because of electric cars and the electrification of rail and heating, it will in all likelihood—in a sense, this is the biggest challenge—mean more use of electricity, which must be low carbon. That is what makes the decarbonisation of our energy supply the most important and urgent task that we face, and that is what the Energy Bill in the Gracious Speech addresses.

One of the greatest polluters is the marine industry, which deploys large supertankers. As the Secretary of State will be aware, at the moment a considerable number of supertankers are carrying oil in very sensitive areas off the shore of the UK, waiting for the price of fuel to increase. Is that a matter of concern to him, and is there anything that he proposes to—or, indeed, can—do about it?

Controlling the movement of supertankers is tough, but maritime shipping and aviation are important, and must be part of the Copenhagen deal in my view. Unless we can get action across the board, including in the sector to which the hon. Gentleman referred, we will find it much harder to tackle the problem.

The Secretary of State has repeated that shipping, like aviation, is hugely important if we are to get the right climate in future. Why, then, does the parliamentary answer that I have just received say that of the 38 people his Department is sending to Copenhagen at least 19 are flying there, given that perfectly adequate, and probably cheaper, rail journeys are available?

I hate to tell the hon. Gentleman this, but I think we might be taking more than 38 people to Copenhagen. However, I am sure that as many of them as possible will travel by train, and I am sure that we will investigate all the possibilities for getting there.

The Minister briefly mentioned electric cars—indeed, the Prime Minister mentioned them at the G8 in 2008, when he said that the UK should be at the forefront of the electric car revolution. However, with the exception of the efforts by the Mayor of London in the capital, very little appears to have been done, while our competitors are streets ahead, even gas-guzzling America, which has increased its total of electric cars by 27 per cent. on average since 1992. What is the Minister going to do about it?

The hon. Gentleman obviously did not notice the incentive that we have unveiled precisely to encourage electric cars in this country, as well as the charging points that my right hon. Friend the Secretary of State for Communities and Local Government discussed last week.

That takes me to the issue of energy, and I repeat that we face big challenges in that area. No one should pretend the scale of the challenge is not huge. Our plans will mean that approximately 10,000 wind turbines will be built between now and 2020, as part of the strategy for achieving 30 per cent. renewable electricity by 2020. It means having nuclear power stations, which is why we made national policy statements on that two weeks ago. That requires hard decisions, and we should be honest about that. It requires giving people a voice—that is important in the new planning process—but it also means, in my view, facing down those who would say no to wind, or to nuclear, or to clean coal. The scale of the challenge that we face is enormous, and it requires a culture change, as our countryside is going to change, because we need a low-carbon energy infrastructure. It also means driving forward on clean coal and saying no to those who oppose it.

One clean-coal power station in the UK has already received a provisional allocation of €160 million in funding. In the new year, we will announce how we will spend the £90 million to be allocated for engineering and design as part of the next stage of our carbon capture and storage competition. The crucial thing about the Energy Bill is that it legislates for a clean-coal levy to provide funding for up to four demonstration projects. That will provide funding of up to £9.5 billion over the coming two decades—the largest single investment in CCS of any country in the world, including the United States.

I am always pleased to hear the Minister’s words on clean coal, as he knows. However, we talk glibly about “up to four” demonstrations, and we talk about ensuring that those things happen without providing the finance to do so properly. When will we know exactly how many demonstrations there will be, and when will we know when the money will be available to get them moving?

The plan is that the money starts to flow from 2011, subject to the House passing the Energy Bill. The levy is precisely designed to give the certain stream of funding that the hon. Gentleman mentions. Our view was that in difficult fiscal times it was right to make this investment and to provide a clear and certain stream of funding. That is the plan.

With 800 million tonnes of coal in north-east Leicestershire ready to be extracted, I would be the first to support the advance of clean coal technology, but does the Secretary of State recognise that in the interim, there is a risk of an expansion of open-cast coal, which is one of the most environmentally damaging activities that we can see in the midlands of England? That should be headed off, should it not?

It is important to say that the position on open-cast mining has not changed and the planning guidance has not changed. The Government’s position is as it has been. It is for that planning guidance to be properly interpreted.

I am grateful to the Secretary of State, who is being extremely generous with his time. On clean coal, he says that already one plant has received a funding allocation for a carbon capture and storage project, but the 2003 energy White Paper referred to CCS technologies and the need for projects. We have lost five or six years. The Secretary of State is in no position to brag about speedy progress on carbon capture.

I am in a position not to brag but to say that it is important that we are doing what many hon. Members called for—providing certainty about the stream of funding. Provided that the Bill gets through the House, it will provide the certain stream of funding that I know the hon. Gentleman wants.

I welcome the Secretary of State’s support for carbon capture. In West Fife there is certainly support for Longannet being one of those carbon capture demonstration projects, but I fear that the timetable is slipping; 2014 is a date that is not mentioned any more. Can the Secretary of State give an assurance that the pilots and the roll-out of carbon capture are not being subtly delayed?

No, they are not, and 2014 has always been part of our criteria for the competition. That remains the case. The hon. Gentleman will know that, as with any procurement, the rules cannot be changed half way through the process, so the rules are as they have always been.

I was saying what the case is. There is a UK case, which all hon. Members are aware of, and there is a global case. On its own, coal accounts for around a third of all global CO2 emissions. That is why it is so necessary to make progress on CCS, and why we should make our contribution in the UK. It is also—this goes to my point about the economic opportunity for Britain in tackling climate change—a huge economic opportunity. I pay tribute to regional development agencies and others who are working on potential clusters in their own areas. That is true in Yorkshire and in other parts of the country. All these can be eligible for the levy and the funding that that will provide. The possibilities are significant. Independent estimates say that we could have up to 60,000 jobs in the UK as a result of moving towards CCS, with the demonstration projects that I have talked about as the hub.

In respect of our low carbon and energy infrastructure, there are difficult decisions to be made on renewables, nuclear and clean coal, but the other half of the equation is the cost that we face. It is important that we face up to those costs. The low carbon transition plan was clear about the costs and the impacts on bills. The CCS levy will add 2 or 3 per cent. to electricity bills by 2020, as we have set out. The only way we take people with us in this process is by showing that the price impacts can be fair.

I have already given way to the hon. Gentleman. I want to make progress.

We are acting in the Bill and elsewhere to make the transition as fair as it can be. We are acting to help people reduce the energy that they use, and in the past year 1.5 million households received support to improve their insulation. We are acting to help people meet the higher energy costs of winter through the winter fuel payment, and, as a result of the action that has been taken, in the past year we have eliminated the differential between pre-payment and standard credit customers. In 2008, the average dual-fuel pre-payment customer paid £41 more than the average standard credit dual-fuel customer; now they pay £4 less. But we know that we need to do more, and that is what the Energy Bill tries to do through a series of changes.

The answer that the Secretary of State gave me about the Ofgem annual statement was, I respectfully point out, incorrect. The annual statement will not explain to customers whether they are on the cheapest tariff or what they should do to switch. Will he answer my original question? When he first described the idea, he called it ingenious, but his Department no longer supports it. Why the change?

I do not think that the hon. Gentleman is correct, but if he is I shall be happy to make representations to Ofgem, because we need the fullest information possible for consumers. That is what Ofgem’s planned annual statement is designed to do, and, as it is coming in next year, I am sure that there will be time to influence it.

Let me list three things that the Energy Bill will do. First, it will make social price support mandatory. At the moment, vulnerable customers rely on a voluntary system to receive a reduced rate on energy. The voluntary systems mean that more than 1 million customer accounts have benefited from lower prices, but I fully acknowledge that we need to do more, and that is why we will make compulsory that support and increase the available amount of social price support.

Secondly, the regulator needs stronger powers to deal with abuse, and the Bill will specifically act to prevent the exploitation of market power by energy generators. Thirdly, not only do we need stronger powers for the regulator but we need the regulator to use them, so the Bill will change Ofgem’s remit to reflect the fact—this is very important—that relying on competition alone is insufficient if we are to provide the consumer protection that we need. My message is very clear—the regulator must step in proactively where competition is not sufficient to protect the interests of consumers. We will make that very clear.

A number of people in my constituency would like to use less electricity, but unfortunately the communal heating systems that the local authority refuses to change prohibits them from doing so. Will the Secretary of State look at whether an amendment could be added to the Bill to compel local authorities to get rid of those inefficient and environmentally unfriendly communal heating systems?

I thought that we were rather in favour of community heating, but perhaps not in the case that my hon. Friend talks about. I fear an increase in this trend whereby I receive lots of invitations to add to our Bill, which I am told has to be short and concise. Indeed, I think that it is. However, I shall definitely look at what my hon. Friend has to say on that question.

I support what the Secretary of State said about mandatory social tariffs, but we need to introduce the data-sharing provisions that were passed in a previous Bill. I understand, however, that an ongoing Department for Work and Pensions pilot must end before data sharing can be introduced, so what is the time scale for making it available to energy companies?

I am reassured by the Under-Secretary of State for Energy and Climate Change, my hon. Friend the Member for Stafford (Mr. Kidney), that the regulations will be out this week, so that is a clear sign of delivery by the Department of Energy and Climate Change.

I thank my right hon. Friend for giving way for a second time. Social tariffs drive down electricity bills, but so does energy efficiency. Will he comment on the plans that have been floated to make available to all 25 million households in Britain energy efficiency loans of £6,500? Is he aware that the cost would be about £160 billion, a sum not unadjacent to 10 per cent. of GDP? Is that a cost-effective way of using taxpayers’ money?

My hon. Friend makes his point eloquently. My hon. Friend the Minister of State and the hon. Member for Tunbridge Wells (Greg Clark) have become pen pals on that issue, but I have to say that her letters have been better than his. I shall turn to that subject in a moment.

My message is very clear: the regulator must step in proactively where competition is not sufficient to protect the interests of consumers. Let me also make it clear that the new system of quarterly reporting on wholesale and retail prices that we introduced is designed to bring transparency and fairness for consumers. We look forward to the next quarterly report, because when there is a case for price reductions they need to be passed on to consumers. Taken together, the measures that we have announced in the Queen’s Speech confront the hard choices that we have to make in relation to climate change: hard choices about our energy infrastructure, about energy bills, and about protection for vulnerable consumers.

I search in this debate for that elusive thing, all-party consensus, but on domestic policy I am not optimistic. It has to be said that the Conservatives are outstanding at green image-making. Let us be honest, the image that we all remember—perhaps their finest moment; I think it was the brainchild of the hon. Member for Bexhill and Battle (Gregory Barker)—is the huskies. [Interruption.] There was not a car driving behind the huskies—that was in the case of the bicycle. The test for the Opposition in this debate on the Gracious Address is whether they can match the huskies with clear and concrete policy making. So far, they have not done very well, but the Queen’s Speech represents a chance for them to support us in five particular areas. [Interruption.] The hon. Member for Bexhill and Battle refers to the green investment bank. That policy was announced today. The green investment bank is the first bank in world history to be announced with no money attached to it—it will not be much of a bank, in my view.

This is an opportunity for the Conservative party to join the all-party consensus in this debate. There are five questions that I hope that the hon. Member for Tunbridge Wells will be able to answer—the five tests, one might call them. The Conservatives need to face up to the hard choices that are necessary. First, I say that the CCS levy is necessary: does he agree? I will be interested to hear his reply. Secondly, they need to face up to the hard choices necessary on low-carbon infrastructure in general. We say that it is right to go ahead with the Infrastructure Planning Commission, but the local government spokesman for the Conservatives says that they would abolish the IPC. Business says that it is very worried about that plan because it would set back the process of building our low-carbon infrastructure.

Thirdly, we say that it is wrong that 60 per cent. of wind turbine applications are turned down by Conservative councils, because that will not get us the low-carbon energy infrastructure that we need. [Interruption.] Just to be clear about this, 60 per cent. of such applications made to Conservative councils are turned down. That is not surprising, given that the shadow Business Secretary says:

“My view is that those few wild and open spaces that we have left in Britain should not be used for wind turbines”.

There would be no onshore wind at all under the Conservatives. The hon. Member for Tunbridge Wells will have to tell us whether he agrees with me that we need onshore wind to contribute towards a renewable energy target of 15 per cent. or agrees with his right hon. and learned Friend the shadow Business Secretary.

Fourthly, there is the issue of costs, which was mentioned by my hon. Friend the Member for North-West Leicestershire (David Taylor). The Conservatives cannot simply keep going round promising things that they do not have a clue how they are going to pay for. The latest example is the promise of £6,500 for every household, which would cost £150 billion or more, as my hon. Friend the Minister of State has made clear. They have absolutely no idea how they are going to pay for that policy, and I will be interested to hear what the hon. Member for Tunbridge Wells has to say about it.

Finally, there is the international dimension of climate change. That is not about the huskies—it is about Europe. What are the Conservatives doing in Europe? They are hanging around with climate change deniers in their new grouping. What did Roger Helmer, the Conservative MEP, choose to do this week, of all weeks? He organised a conference of climate change deniers. What kind of signal does that send? I think it sends a ridiculous signal, and I will be interested to hear the views of the hon. Member for Tunbridge Wells. The truth is that on the CCS levy, on energy infrastructure, on costing their policies, and on Europe, the Conservatives are not willing to face up to the hard choices necessary to make the green energy revolution happen.

By contrast, we are willing to face up to the hard choices. We have a clear plan with a clear policy. It is guided by the science, it makes the case for action economically as well as environmentally, and it is about taking the carbon out of our economy. The Queen’s Speech makes an essential contribution to that task and to combating dangerous climate change, adapting to it and ensuring that the low-carbon transition is fair. I commend the Gracious Speech to the House.

I begin by expressing my solidarity with what the Secretary of State said about our concerns for the people of Cumbria and other parts of the country given the devastating floods that they have suffered during recent days. I believe that that part of the country is braced for further inclement weather, so perhaps the Secretary of State for Environment, Food and Rural Affairs might take the trouble in his remarks at the end of the debate to update us on what is going on there. We all know that the family of PC Barker will never be consoled over his loss, but they should know that we are united in admiration for the heroic father of the children in that family.

It is always a pleasure to debate matters with the Secretary of State for Energy and Climate Change. We have seen something of a starfest in these Queen’s Speech debates in recent days. We started with the Secretary of State for Children, Schools and Families, moved on to the Energy Secretary’s brother, the Foreign Secretary, and now we have the right hon. Gentleman himself. One could be forgiven for thinking that this was an early hustings meeting for the future leadership of the Labour party. I suspect that that accounts for the thinness of the attendance on the Labour Benches.

There is a degree of consensus, despite the Secretary of State’s attempts towards the end of his speech to sow the seeds of division, which were not particularly necessary. He mentioned the Energy Bill, but he must realise that at this stage of a Parliament, faced with the current crisis in our energy security, it is so weak and feeble in its contribution to solving the problem as to defy belief. As has been mentioned, we have had news today that last winter, there was a 40 per cent. increase in the number of excess winter deaths—people who sadly died in advance of what was expected. If that is not a clarion call for an urgent increase in the energy efficiency of properties in this country, especially for people who are vulnerable and in need, particularly pensioners, I do not know what is. Yet that fails to appear in any part of the Bill, which is a great disappointment to Conservative Members and, I suspect, to those of all parties.

Unbelievably, the Bill is not purposeful in its intentions. It is timid and provides powers that will need to be enacted in a future Session. It does not get to grips with the urgency of the problem. It fails to take into account the urgency of the opportunity that we have been pointing out, which is a shame, because there is cross-party consensus on addressing our need to close the energy gap that has opened up.

That is the context in which we debate these matters. For the first time since the 1970s this country faces a shortfall in its energy generation capacity and the Government have had to admit that we face power cuts in the decade ahead. It is back to the 1970s—that was disclosed in the Government’s own paper, which was published and announced to the House in July.

The hon. Gentleman makes a valid point about the need for more energy in the future, and particularly for more renewable energy, so will he tell the House what he is going to do to persuade his party’s council leaders to approve more wind farm applications rather than reject them in the numbers that they are currently rejecting them?

If the hon. Lady will be patient, I will answer the Secretary of State’s question about that in great detail; I have no problem with doing that. However, we should be aware of the chasm that faces us: power cuts that will affect British industry and consumers and be equivalent to an hour’s black-out for a quarter of the British population. What a humiliation it is that we are in that position.

My hon. Friend is talking about the future, but an immediate problem is storage capacity, particularly for gas. Other countries, such as France, have far greater capacity. Does he agree that our current capacity is woefully inadequate, and that the Government have not had their eye on the ball?

My hon. Friend is right and it is completely inadequate. The Energy Bill was an opportunity to take urgent action on this point. Other countries protect themselves against the possibility of interrupted gas supplies, but nothing in the Bill would address that problem.

How did the Conservatives’ policies in the 1980s help to secure energy supplies—they wrecked the coal industry—and will the hon. Gentleman tell us about the power stations that his party constructed in the 1980s and 1990s that would have prevented the crisis that we are now facing?

I do not know whether the hon. Lady is with us on the need to decarbonise our production of electricity, but one of the problems that we face at the moment is the fact that our coal-fired power stations cause nitrogen and sulphur dioxide pollution and contribute disastrously to our climate change objectives. So the unabated reliance on coal that she implies is not the answer.

If Labour Members want a lesson in history, they need only look back some five years, when the Government published an energy White Paper on future energy needs and completely dismissed the idea that nuclear power stations should be recommissioned. That was absolutely ridiculous.

My hon. Friend is right. Indeed, the Government have failed to take the right decisions on all of these different technologies. They have got us into this position because they have failed, over a 12-year period, to take the necessary decisions for our national energy security. That should not be a surprise, because it is the same approach they took on the economy, where they failed to address the problems that were evidently mounting, instead hoping to be able to look the other way and ignore them.

My hon. Friend talks about the weakness of the Energy Bill, but he will recall that the Government passed the Energy Act 2004. I had the honour of leading for the Opposition on that Bill, and while it did a few useful things, it entirely disregarded the problem that we are facing.

It has been a consistent tendency of the Government’s over the past 12 years to behave like an ostrich, put their head in the sand and duck these issues—[Interruption.] Labour Members moan, but let us go through each option in turn. For example, the whole House has known for the past 12 years that North sea oil and gas production would peak and go into decline during the years ahead. There was nothing much to be done about that, but we should have prepared for the inevitability of needing to import greater supplies of gas. What happens in other countries that rely on gas to heat and power their homes? They ensure that they have enough storage capacity to get them through the winter—

As my hon. Friend says, that is a legal requirement in many cases. Have we seen such an approach in the past 12 years from the Government? Of course we have not, and the result is that we have—at the present rate of consumption in the winter—fewer than 15 days’ storage capacity for gas supplies. Germany has 99 days and France has 125 days of storage capacity. As the Secretary of State knows, in February when we faced a combination of a severe winter and the dispute between Russia and Ukraine, which disrupted gas supplies across Europe, we had left in storage just four days worth of gas. If that were this week, that would not be enough to get us to the weekend. That is an abysmal record for this Government. Nor did the problem emerge from a clear, blue sky: it was predictable and foreseeable.

Another example is nuclear energy. We have known for the whole of the past decade that our nuclear fleet would come to the end of its planned life by the end of the decade ahead, but where was the realisation that that would lead to a shortfall in our energy-generating capacity? It was not there. We are now in the ridiculous situation where it is too late for us to renew the contribution from our existing nuclear fleet before it is closed down. We cannot have new nuclear power stations up and running by 2017. Yet again, that is an abdication of responsibility by this Government over 12 years.

When the Government finally publish the long-awaited planning statement on nuclear—indeed, it is six months overdue—they leave it open to further delay through the possibility of judicial review. However, that could have been proofed against if only they had followed the right democratic course and allowed this House to vote on the statement and ratify it, thereby clearly expressing the view of the people through the House, so that when it comes to judicial review, investors can have a greater reliance on it.

The hon. Member for Llanelli (Nia Griffith) mentioned coal. We have known for many years that our most polluting coal-fired power stations would need to be turned off in the years ahead, but have we had a plan to replace them with clean coal capacity? What do you think, Mr. Speaker? Of course we have not. There is a gap there, just as there is a gap in all the other technologies. The Secretary of State trumpeted his proposals in the Energy Bill that will come before us to introduce a levy to pay for that process—or, I should say, to introduce the powers later that would give him the opportunity to introduce a levy to pay for it.

However, given that we have known for so long that coal without CCS is not viable, why has it taken a proposal in the Energy Bill in this Queen’s Speech, so late in the day, for us even to think about how it will be paid for? As my hon. Friend the Member for Preseli Pembrokeshire (Mr. Crabb) said, going down the CCS route was first mooted in 2003, so why were those proposals not in the Queen’s Speech in 2004, 2005, 2006, 2007 or 2008? Only now, in 2009, do we finally get the first inkling that it might be necessary to pass a piece of legislation to turn what I might uncharitably call the right hon. Gentleman’s predecessor’s hot air on the subject into something approaching an idea that could help with our energy security.

When it comes to renewables, again we have an abysmal record in this country. In the first decade of the 12 and a half years in which the Government have been in office, we increased the share of energy that we generated from renewables from 1 to 1.3 per cent. What a completely pathetic increase, especially when we consider that we have some of the best renewable resources in the world, including a coastline that is the envy of Europe in the opportunities that it provides for wind, wave and tidal energy—none of which has been exploited to its full potential, beyond a bare scratching of the surface. At a time when other countries have substantially increased their contributions from renewables, it is shameful that we have failed to take the opportunities that we have had, and in so doing seen the supply chain for many such technologies move to other countries.

Could the hon. Gentleman therefore explain why his party voted against the financial stimulus, which included a £1.4 billion package for sustainable investment, including in the low-carbon economy in my region?

I have just been talking about how the Government’s approach to the economy very much mirrors their approach to energy. Where they have acted, they have acted unsustainably, but more often they have failed to act. We are in the sad position of not being able to afford the profligacy that the hon. Lady mentions.

The hon. Gentleman has just said something significant. He said that we cannot afford the £400 million to which my hon. Friend the Member for Plymouth, Sutton (Linda Gilroy) referred, which is investment in green technology. That is what he said.

No, I am talking about a fiscal stimulus more generally. The right hon. Gentleman knows that we have been talking all week about the proposals that we will make. I will come on to say more about them, but whatever we are talking about—whether gas storage, nuclear, coal or renewables—the Government’s record over 12 years, across the board and on all those technologies, has been to create the problem that is now a national emergency for us to solve.

I assure my hon. Friend that this litany of woe is all too familiar to me. Will he comment on the lamentable record on energy efficiency? The energy that we do not use is the greenest, cheapest and most secure of all.

My hon. Friend is completely right. It is a real disappointment that the Energy Bill does not contain a serious proposal to improve the energy efficiency of our properties. I was asked earlier about our green deal, which has been widely welcomed as offering the opportunity for people to save money on their energy bills. That is much needed—[Interruption.] The Secretary of State might not think that that is the case, but his constituents might advise him that they are struggling to pay their bills at the moment. It is important that we find ways to cut the energy consumption in people’s homes, especially at this time. In so doing, we should also be helping to reduce our CO2 emissions. I cannot for the life of me understand why, when everyone recognises that the best way to save energy and money is to stop wasting energy, the Government have wasted the opportunity provided by the Queen’s Speech and the Energy Bill finally to do something about that.

Does my hon. Friend agree that one of the Government’s biggest omissions has been in not considering rural areas, especially areas such as Devon, which have very old houses that are much more difficult to insulate? They have provided no significant extra funds for such insulation.

My hon. Friend is right. When we were designing our green deal, we were determined that the limit of £6,500 should be high enough to ensure not only that it covered the basic cavity walls and loft insulation available for modern houses, but that houses that are harder to treat—I hesitate to say “hard to treat”, because it is important to get the message out that they can be treated—can be treated in such a way that actually saves money. We need to unlock the savings that people can make, and use them to release to people up front the cost of making those investments.

It is characteristic of the Government to assume that any proposal that they hear about must involve the expenditure of vast amounts of public funds. That is what they assume all the time—[Interruption.] I will enlighten the Secretary of State. When people save money on their energy bills through being more energy efficient, that is costing them less than it otherwise would. That stream of savings continues into the future. Our discussions with the banks have elicited a certain enthusiasm for the proposal that, by taking those savings and capitalising on them, people can get the money up front that is needed to make those investments.

That proposal would benefit everyone in the economy. From day one, it would reduce energy consumption and bills, even after repayment, for the people who engage in such improvements. It would reduce our CO2 emissions and provide work for energy efficiency installers at a time when the construction industry is suffering. It would also provide apprenticeships. It would provide a stimulus to the economy that would not have the effect that the Government’s stimulus is having—namely, to saddle future generations with debts without the means of repaying them. There could not be a better designed policy for the times, and it is a source of sadness to me and others outside the House that the Secretary of State has not had the imagination to put such a proposal into the Queen’s Speech.

One group of people who cannot benefit are local authority tenants living in accommodation with communal heating systems. The only way they can reduce the heat is to open their windows, and they are still billed for the total cost of the heating by the local authority. Does the hon. Gentleman agree that local authorities that refuse to deal with such inefficiency and continue to bill their tenants, who have no choice, need to be tackled robustly and immediately by the Government?