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Commons Chamber

Volume 507: debated on Tuesday 9 March 2010

House of Commons

Tuesday 9 March 2010

The House met at half-past Two o’clock


[Mr. Speaker in the Chair]

Oral Answers to Questions

Communities and Local Government

The Secretary of State was asked—

Planning Appeals

1. Under what exceptional circumstances planning inspectors may consider representations on planning appeals made after the deadline for submissions has passed. (320996)

Information can be accepted after the deadline when there has been a material change in circumstances or when there are demonstrably good reasons for the deadline to have been missed.

I am grateful to the Minister for that response and for his earlier telephone call to my office. He will be aware that, in a planning appeal in Innsworth in my constituency, although the public inquiry date has passed and the inquiry has finished, a change of details has been submitted by the developer. A rather confusing letter from the Secretary of State’s office purports to reopen the inquiry, but surely that cannot be an open and transparent way of dealing with planning applications. Will the Minister look into this issue further?

The material change of circumstances in that case was the offer from the developer, after the inquiry, to increase the proportion of affordable housing in the proposals—something that I would have assumed that the hon. Gentleman welcomes. Clearly, it would have been wrong if the Secretary of State had not then sought the views of the parties at the inquiry to that change in the proposals. My right hon. Friend the Secretary of State has acted openly and done the right thing in seeking those views. He is currently considering the case carefully.

Efficiency Savings

2. What guidance he has issued to local authorities on achieving efficiency savings without reducing front-line services. (320997)

I asked an expert taskforce, chaired by Sir Steve Bullock, mayor of Lewisham, and Sir Richard Leese, leader of Manchester city council, to look at how best to achieve efficiency savings and protect front-line services. Their report “Putting the Frontline First: Meeting the local government challenge” was published on 1 March. It sets out 10 decisive steps that councils can take to achieve efficiency while delivering high-quality local services. Local people will rightly be intolerant of any council if they are told that front-line services like care provision, libraries or youth services will be cut because it has failed to carry through all the recommendations made in our experts’ taskforce report.

Will my right hon. Friend comment on the disgraceful situation at the now Conservative-led Lancashire county council? It has received a 5.1 per cent. increase in Government grant but has cut the budget by 3 per cent., with the likelihood that 200 to 300 jobs will now be lost. The council is also failing to support the staff at the National Football museum who need an agreement to be reached between Lancashire county council and Manchester city council so that the museum can remain at Preston and in Manchester as well.

First, may I pay tribute to my hon. Friend’s sterling efforts to support the football museum and to retain it for his constituency? He makes an important wider point, because some local authorities are trying to suggest that the cuts that they are making to front-line services in some way reflect cuts in central Government finance or the wider economic circumstances. As he has rightly highlighted, English local authorities received, on average, a 4 per cent. cash increase for the coming year, and the cuts that are being made reflect the decisions of Tory and Liberal local authorities to make them at a local level.

Will the Secretary of State join me in congratulating Hammersmith and Fulham council on delivering a council tax cut for the fourth year in a row while preserving its four-star quality rating for services? Will he also use this occasion to apologise to the leader of the council for saying that the leader had allegedly said of council tenants, “These people are hard to shift”? That is totally and utterly untrue, and it is time that the right hon. Gentleman apologised for that mis-statement.

I prefer the records of the eight Labour London local authorities that have frozen council tax while protecting front-line services. He will be aware of the impact of local decisions to raise charges for elderly people and of housing strategies that seem to be designed to deny security of tenure to people who have long enjoyed secure local housing. I do not share his assessment of his local authority’s record—indeed, far from it; I think it is a warning that should be broadcast to tenants up and down the country, and I will do my very best to make sure that it is.

Ryanair was recently voted the least family- friendly company in the country. In the light of that, what is my right hon. Friend’s view of local authorities that seek to make efficiency savings by instituting two-tier services, with a no-frills basic?

I worry greatly about councils that are proposing what they call a budget-airline or Ryanair approach to local government, with services stripped down to the most basic level. The only people who enjoy decent services are those who can afford to pay for them twice—once through the council tax, and once through charges. For example, I was told the other day that Wolverhampton council has made it part of its standing orders that every service should be charged at a full-cost recovery rate, unless specifically authorised otherwise by a cabinet member.

I think that that approach will leave large numbers of people on middle incomes unable to enjoy decent council services. It is a shame that it is being championed by the Opposition.

The Secretary of State seems very keen to talk about this year’s Budget settlement, but less keen to talk about Government grants looking ahead. What guidance has he received from the Treasury about the scale of future cuts that councils will need to make? Does he really believe that efficiencies alone will be able to halve the deficit?

I certainly believe that the budget reduction programme set out by my right hon. Friend the Chancellor of the Exchequer in the pre-Budget report is a credible one. It can be delivered in local government without damaging front-line services, provided that the hard decisions are taken to deliver efficiencies. My Department set out in the PBR where we expect savings to be made through operational efficiency and through savings on particular local government services. That can be done so that members of the public see their services protected and improved where they use them.

The problem is that the Institute for Fiscal Studies thinks that that is simply not possible, and that deep cuts will follow in years ahead. Given that no credible detail is forthcoming from either the Government or those on the Conservative Front Bench, should the right hon. Gentleman not be doing the responsible thing and advising councils to prepare for the worst-case scenario pointed out by the IFS—that is, reductions of up 23 per cent. over four years from 2011?

The hon. Lady is wrong on both counts. In reply to an earlier question, I said that we have published a report from two respected local government leaders on precisely the measures that local government should be planning to take now to make the most efficient use of the available resources. As the House knows, however, the reality is that there has not yet been a comprehensive spending review for the next three-year settlement because we have been through a year of the most extraordinary economic change. The policies that we have implemented have seen the Government, the country and local government through the crisis, because we rejected the calls from the Opposition to cut our spending last year. It would have been irresponsible to try to project exact levels of spending for four years from today, given the uncertainties of the past year. Clearly, spending plans will have to be set out, but the timing is a matter for my right hon. Friend the Chancellor of the Exchequer.

Given the levels of support that Birmingham city council has had from the Government over the past decade, why does my right hon. Friend feel that it has got itself into such a financial mess, to the extent that thousands of jobs are threatened and services to the public are being put at risk?

I can understand the concern of my hon. Friend and other Birmingham Members of Parliament. It is true that Birmingham has not received the highest rating, shall we say, from the Audit Commission, for the quality of its financial management. The record shows that it has been given resources by the Government for tackling worklessness, but that it has failed to devote them to tackling that problem. It is a shame that Birmingham’s Conservative-Liberal Democrat council is saying that front-line services will have to go, when issues about how the council manages its resources clearly need to be addressed closer to home.

Instead of shamelessly scaremongering, it would have been nice if the Secretary of State had acknowledged that local government has already had considerable success in delivering efficiency savings. Can he understand why councils feel so furious about being instructed to meet the £250 million shortfall in the Prime Minister’s latest commitment to personal care? The Government define a new burden as

“any new policy or initiative which increases the cost of providing local authority services.”

Will he explain which part of that £250 million is not covered by that doctrine?

It is a shame that the hon. Lady has not welcomed the fact that the Prime Minister’s proposals for free care at home for those with the highest needs involve the biggest single transfer of resources from the NHS to local government since the NHS was founded in 1948. It is a massive vote of confidence in the ability of local government to deliver the policy. I believe that the savings that local government is being asked to make can be achieved. As she herself has said, local government has proved its ability to make efficiency savings and to plough them into other front-line services.

We all want to see help for those who most need it. The question is where the money is coming from. The Government must be living in cloud cuckoo land if they believe that the £250 million bill for changes in personal care does not fall under the definition of an unfunded burden. Is it not the case that the efficiency savings earmarked for that policy will not materialise until 2012-13, yet the policy comes into force this year? Can the Minister explain to the House where the shortfall will be found, and whether the figure of £250 million is capped? If not, is it not the case that as well as being unfunded, the policy is uncosted?

In which case, Mr. Speaker, I will respond to the point that we all want to do something to help. I recall that when cross-party talks were taking place in an attempt to establish a consensus on social care, it was the Conservative party which broke out of those in order to launch a cheap-shot poster campaign, rather than try to address the serious issues that concern elderly people in this country.

Regional Regeneration

3. What recent assessment he has made of the effectiveness of Government support for local authority regeneration initiatives delivered regionally. (320998)

An independent report by PricewaterhouseCoopers published in March 2009 established that, on average, every £1 of regional development agency spend, much of which is in partnership with local authorities, will add on average £4.50 of value to their region. The PWC report found that in the Northwest Regional Development Agency area, 41,000 jobs were created or safeguarded, 8,000 businesses were assisted and 48,000 people were helped with training.

Those figures are impressive. Does it not beggar belief that there are those who cannot make up their mind what they should do with regional development agencies, which have been such a great success in regenerating and creating employment in the north-west of England?

My hon. Friend is right. As somebody who meets a number of businesses, I know that they are horrified by the idea that any Government or potential Government would talk about abolishing the regional development agencies. That is the view not only of businesses, but of business organisations such as the Engineering Employers Federation, the CBI and the chambers of commerce. However, I notice that the hon. Member for Meriden (Mrs. Spelman) and the right hon. and learned Member for Rushcliffe (Mr. Clarke) have now written down their policy, in a vague attempt to see if it will last longer than one day.

Last Friday’s edition of Property Week condemned the Government’s track record on regeneration by pointing out that the pathfinder scheme has been responsible for the demolition of more than 16,000 homes, yet has created only 3,700 new homes, with a net loss of 12,000 homes. In short, the scheme has cost £2.2 billion and knocked down four times as many homes as it created. Does the Minister regard that as a success?

As I understand it, for the scheme to which the hon. Lady refers, the expenditure so far has been on acquiring the land. It will continue. The Government are looking at ways in which we can intervene in the economy at local, regional and national level to address the problems that have arisen during the economic downturn. The Opposition have a hands-off, “don’t care” attitude to regeneration and economic development.

I know that my right hon. Friend is well aware that the public railway in the centre of Sheffield has been transformed by the actions of the then Labour-controlled city council and Yorkshire Forward working together. She is probably also aware that at a Regional Select Committee hearing recently, every employers body that came to give evidence praised the actions of Yorkshire Forward in helping its members in the recession. For both those reasons, would it not be folly to get rid of Yorkshire Forward and other RDAs, particularly at this time of economic difficulty?

My hon. Friend is absolutely right, and as the Minister for Yorkshire and the Humber I know also how much Yorkshire Forward is valued in terms of the work that it has done. At this point, even talking about removing that help sends completely the wrong message to businesses, because we can put together assistance to help people through into the recovery. For the Opposition to talk about dismantling that help is a very bad approach.

House Building Projects

4. What account his Department takes of the effects on local employment in the construction industry in its decisions on the allocation of funding for house building projects. (320999)

9. What account his Department takes of the effects on local employment in the construction industry in its decisions on the allocation of funding for house building projects. (321004)

In September 2009 we announced that all new housing projects funded with public investment will be required to offer apprenticeships and local labour opportunities. The aim of that policy is to increase opportunities for young and unemployed people who have been particularly hard hit in the current economic climate.

I understand that, but I am sure that the Minister is aware that there are 750,000 empty homes, and that more than 200,000 construction workers are chasing 300 jobs. Does he not accept, therefore, that the Government ought to do more to bring empty homes back into use?

It is precisely because we want to do more in the housing industry that we have announced the £1.5 billion housing pledge to increase the number of homes being developed and to provide jobs in construction.

The Minister completely failed to answer the previous question. In Otley, in my constituency, we lost Lotus Construction last year, with the loss of 80 jobs—an experience common to many constituencies. Considering that on average it costs £10,000 to bring an existing property back into use, compared with £100,000 for a new social house, how can the Minister possibly say that the Government are doing enough to bring homes back into use?

We are investing money in improving existing properties, as well as in building new ones. This Government’s record in supporting the construction industry through the downturn has been absolutely first-class. This has been the first recession in which a Government have invested record amounts to keep the economy moving, protect jobs in construction and provide the skills that the industry will need in the future.

The Government have given Milton Keynes council funding to appoint an officer to start implementing the empty dwelling management order, because the Liberal Democrat-controlled council has done absolutely nothing on it for the past three years, despite the fact that I went to it with lists of empty properties that were prime candidates for the order. Does the Minister agree, however, that house building is required to meet housing need, and that empty homes, although important, are a flea bite compared with the breadth of housing need in places such as Milton Keynes?

My hon. Friend is absolutely right about the need to build more homes, and that is why we are investing record amounts in the house building industry. She is also absolutely right about empty homes, and I congratulate her on her work in Milton Keynes to ensure that they are brought back into use.

Will my hon. Friend welcome the programme, which will create many jobs, to bring 5,300 socially rented homes in my constituency up to and beyond the Government’s decent homes standard, with new kitchens and bathrooms, rewiring, new boilers—[Interruption.]—windows and doors, roofing, chimney repairs, repointing and insulation works? Is not that a good record for a Labour Government and a Labour council?

That is a very good record, and the Opposition were interjecting because they do not value that investment in improving homes for ordinary people. I welcome what my right hon. Friend says. Once again he has demonstrated the faultless judgment that he has exercised over a lifetime’s public service.

This is the fourth Housing Minister whom I have faced over the Dispatch Box, but I congratulate him on having, this weekend, outlasted at least his immediate predecessor, the right hon. Member for Derby, South (Margaret Beckett).

Today, the Library confirmed that house building has fallen to its lowest level, excluding the war years, since 1924, when Ramsay MacDonald became Prime Minister. Is that damning indictment of Labour housing policy a result of the record nine different Housing Ministers, or of Labour’s obstinate refusal to work alongside local people to build more homes?

What complete and utter nonsense. The answer is neither of those reasons. The level has fallen to its lowest level because—the hon. Gentleman may not have noticed this—we have just been through the most extraordinary recession that this country and the world have ever seen. That is why we have invested £1.5 billion this year and next to build 20,000 new affordable homes—investment opposed by the Opposition. Building work has started on more than 80 kickstart projects; the first homes in more than a decade are being built under the local authority new build scheme; and residents in those areas—the families who are desperate to get a home—as well as construction workers and building companies, too, want to know why the Opposition want to cut that spending this year and next and put all those jobs at risk.

Unitary Authorities (Essex)

5. If he will arrange for public consultation to take place in Essex on the subject of establishing unitary authorities. (321000)

The statutory process for establishing unitary authorities requires a council to make a unitary proposal in response to an invitation from the Secretary of State, and does not provide for any public consultation in advance of such an invitation.

I invite the Minister to extend that invitation to Colchester borough council without further ado, because Essex county council is an appalling local authority which should be abolished. May I advise her that, as I told one of her colleagues last year, surveys in Colchester show that 75 per cent. of the population wish to break away from Tory-controlled county hall because, as the only local authority in Essex not run by the Conservatives, my local council suffers political discrimination from the Conservatives at county hall?

As Minister for the East of England, I understand exactly what the hon. Gentleman is saying, and I would advise him to get Colchester council to request the Secretary of State to make such an invitation. I know that the hon. Gentleman has met the Minister for Regional Economic Development and Co-ordination about this, and I understand his concerns well.

Order. I want to make much sharper progress down the Order Paper from now on. I call Mr. Jim Cunningham.

Local Authorities (Recession)

6. What recent representations he has had from local authorities on the effects on them of the recent recession. (321001)

My Department is in regular dialogue with local authorities about the impact of the current economic climate and the commendable measures that most councils are taking to ameliorate this. Their efforts have been helped by above-inflation funding increases from central Government to local authorities overall.

I will be very quick, Mr. Speaker. Can the Minister tell me what the financial impact will be on social cohesion?

Fortunately, the impact on social cohesion has been less than it was in previous recessions in the previous century. In fact, certain statistics such as crime figures have fallen by 8 per cent., whereas in the previous recession they went up by 19 per cent.

Unitary Authority (Norfolk)

7. For what reasons he overruled the advice of his Department’s accounting officer in relation to the value for money of his proposals for unitary restructuring in Norfolk. (321002)

Following the end of the consultation on 19 January, Ministers gave careful consideration to the boundary committee’s advice, the representations we had received, and all other relevant information, including the advice from the permanent secretary. While expressing concern that our proposed approach would impact adversely on the financial position of the public sector as compared with the alternative options available to us, he highlighted the savings that would be achieved by the unitary Norfolk and unitary Devon proposed by the boundary committee.

We had previously been consistently advised that we were not duty bound to choose the cheapest option. We noted that the unitary county option did not command the support of any of the principal councils, including Norfolk county council and Devon county council, and we were reluctant to pursue recommendations that did not meet the broad cross-section of support criteria. We concluded that a unitary Exeter and a unitary Norwich which were locally supported was the best way forward for local people, creating councils far better placed to deliver jobs, growth and services.

In one way, at least, I am grateful for the very long answer given by the Secretary of State, because my further question is this: will he tell us why, in this matter, he has ignored the wishes of the public, only 3 per cent. of whom want his wilful, capricious and cavalier proposal for a unitary Norwich?

I note that three out of the four political parties represented on Norwich city council favour the unitary proposal, and all the parties represented on Exeter city council support that proposal, so that is an indication of support in key places.

Referring to the accounting officer’s letter to the right hon. Gentleman, the Secretary of State for Culture, Media and Sport, the right hon. Member for Exeter (Mr. Bradshaw), made this observation on his blog, which is named “Ben’s Brain Bubbles”:

“The selective leaking of internal correspondence has confirmed the suspicions long held in Exeter (and Norwich) that London-based civil servants have consistently been biased against Exeter and Norwich and have been firmly in the county camp.”   

Does the right hon. Gentleman agree that that very serious allegation warrants investigation, and if so, will he undertake it? If he disagrees, will he now say so on the record and invite his fellow Secretary of State—

Order. The question is of course about Norfolk only, and I know that the Secretary of State will factor that into his reply.

In which case, Mr. Speaker, I take your guidance and will not refer to my right hon. Friend’s blog. [Interruption.]

However, it is a matter of record in a statement issued by my Department that there was no leak of correspondence. It was placed in the public domain and provided to the National Audit Office in a perfectly proper way, and I believe it was also provided to a Member who had raised the topic in correspondence.

Order. I simply point out to the hon. Member for Bromley and Chislehurst (Robert Neill) that he ventilated his views very fully and forcefully, and that points of order come after questions.

Gypsy and Traveller Sites

8. What progress has been made in providing security of tenure for Gypsies and Travellers on local authority sites. (321003)

I begin by paying to tribute to my hon. Friend for her chairing of the all-party group on Gypsy and Traveller law reform. The Government remain committed to bringing security of tenure to local authority Gypsy and Traveller sites, which is a complex issue involving amendments to primary legislation that we must get right. Statutory instruments will be laid as soon as parliamentary time is available.

I am dismayed that Gypsies and Travellers as yet have no security of tenure, bearing in mind that the Connors judgment in the European Court was six years ago and the Government’s proposals to change the law using the Mobile Homes Act 1983 were more than two years ago. There has been intensive discussion with Gypsies and Travellers and with support groups, and I wish to express my extreme dismay. What hope can the Government give Gypsies and Travellers who are living in uncertain situations and who had great hopes of this Government?

I absolutely understand my hon. Friend’s frustration, and I know of her commitment to the matter. I think she will fully understand my commitment to it, too. I recently became the first Minister to visit a Gypsy and Traveller site. We are completely committed to the issue. I know that she wants me to say that I will consider the timing, but it would be disingenuous of me to say that knowing that in practical terms, it would be impossible to lay an instrument before Parliament this side of a general election, so I can only apologise.

Non-Domestic Rates

10. How much on average was paid by a business in non-domestic rates in (a) 1997-98 and (b) the latest year for which figures are available. (321005)

We do not hold figures for the average bill paid by an individual business for national non-domestic rates in 1997-98 and in more recent years. However, for 1997-98, the figure derived from dividing the net rate yield from local authorities’ rating lists by the number of hereditaments on the local list as at 31 December of the previous year is £6,796, and for 2008-09 the equivalent figure is £11,274. That reflects changes in the retail prices index and the NNDR tax base due to increased economic prosperity.

I thank the Minister for that well researched reply. Fully a third of businesses that are eligible for small business rate relief are not claiming it, according to the Government’s own figures. What will she do either to simplify the system or to make it automatic?

I am afraid the hon. Gentleman’s figures are out of date. Recent figures suggest that 92 per cent. of the relief is being claimed.

May I ask the Minister to look yet again at how empty property tax works at the moment? I have a lot of constituents who have converted agricultural property into workshops, in line with Government policy, and now find it completely impossible to get business tenants despite their best endeavours. They end up with a financial millstone around their neck for following Government policy. Will she look again at the operation of the tax?

I understand the hon. Gentleman’s concern, but if the rateable value of such property is less than £18,000, it should not attract empty property rate relief—or should I have said that it should not attract tax? I will be happy to unscramble that answer by meeting him privately.

I think the hon. Member for Somerton and Frome (Mr. Heath) will need that unscrambled. The hon. Lady’s boss, the Secretary of State, recently said that in his opinion, companies will be helped by his business rates revaluation, but the Government are killing community shops across London with a business rates revaluation that will raise business rates by more than half a billion pounds over the next few years. That will affect the shops that we all—particularly elderly and low-income families—rely on: the newsagents, the launderettes and the convenience stores. Why does the future of those London jobs, businesses and communities matter so little to the Secretary of State?

Once again, the figures are being exaggerated. Sixty per cent. of businesses will not see any rise in their business rates.

Working Neighbourhoods Fund

11. What recent estimate he has made of the proportion of the working neighbourhoods fund which has been allocated to local authorities. (321007)

Since 2008, we have allocated over £1.5 billion of the working neighbourhoods fund to help local authorities with high rates of worklessness to support their communities. That has all been allocated to local authorities.

Of the £1.5 billion allocated, I thank the Secretary of State for the £27 million that has come to Stoke-on-Trent from the working neighbourhood funds. Will he join me in congratulating the jobs, enterprise and training centre in Burslem, the YMCA and the charity Groundwork on the difference they make to helping the long-term unemployed to get back to work?

I am delighted to praise the organisations that my hon. Friend mentions. The JET centres use the working neighbourhoods fund and other sources of money, and the organisations she mentions all play a very valuable role. One of the aims of the working neighbourhoods fund has been to allow local authorities to tailor what they do for workless people to the needs of local areas. In many areas, the sort of voluntary organisations she talks about are key to success.

I understand that no such funding came to Lancashire last year. Will the Secretary of State ensure that local authorities are able to implement the working neighbourhoods fund flexibly, so that they can aid projects to regenerate communities in rural areas such as the one I represent, where we have seen firms, shops and local schools close, or where there are sometimes no rural buses?

The working neighbourhoods fund has been targeted at those areas with the highest levels of worklessness and deprivation. That has been the right thing to do, but it is within the area-based grant, which gives local authorities the maximum flexibility locally in tailoring what they do to local needs. Obviously, other Government initiatives—for example, to help high streets suffering from empty shops—have gone to a wider range of local authorities, including some in rural areas.

North East Lincolnshire council was allocated more than £13 million of working neighbourhoods funding. However, to date, it has used just £1.5 million of that. Will my right hon. Friend tell me what checks are made on councils to see that they are actually using the money for the purpose for which it is intended? I fear that some of my constituents could have lost out because the council has just sat on that money.

That is a very important issue, and I understand that my hon. Friend is meeting my right hon. Friend the Minister for Regional Economic Development and Co-ordination later this week to discuss it. There really is no excuse for local authorities not to spend the money that they have been allocated to help people through the recession and to get into work. There is another crucial issue here. The Government have rightly listened to local authorities that say, “Don’t ring-fence every penny and tell us exactly how to spend it. Trust us.” When that trust breaks down, and when money is not used, there is a real problem, which I hope can be addressed very quickly.

House Building Targets

12. What recent representations he has received on his Department’s target to build 3 million houses by 2020; and if he will make a statement. (321008)

The Department receives a large number of representations on house building. I must tell the hon. Gentleman that almost all of them argue that we should do more to build more homes in all parts of the country, including Lichfield. That is exactly what I have set out to do in my great nine months as Housing Minister.

Oh good! Anyway, of the 3 million homes, he will know that the Government project that 1 million will be built as affordable homes by 2020, but the Home Builders Federation has said that the Government will achieve less than half that number. Has it got that wrong?

No, the HBF is reflecting the fact that, over the last 12 to 18 months, during the most serious recession in this country for 60 years, private sector house building by the HBF’s members has fallen through the floor. At the same time, instead of stepping back, we have increased the investment in building affordable homes and we will build more this year and next year than in any year since we came to government.

Will my right hon. Friend look to ensure that authorities such as Chorley, which are sitting on section 106 money that is meant for social and affordable housing, spend that money and provide the homes that are much needed?

For the first time, I have made available Government grants and backing, on a similar basis to housing associations, to all local councils that are willing to build and want to meet the needs and aspirations that local people have for new homes. That means that this year we have under way the largest council housing building programme for nearly two decades. I am really disappointed that Chorley council is not playing a full part in that programme and not doing more to meet the need for more homes in the area.

Massage Parlours

13. If he will issue guidance to local authorities on the granting of licences for massage parlours. (321009)

My Department has no plans to issue guidance to local authorities on the granting of licences to massage parlours, because in most areas they are treated as ordinary businesses and do not require special licences. However, things are changing and some authorities, particularly in London, now require such businesses to have a licence.

I suggest to the Minister that all local authorities should require special treatment licences but, although it is all well and good to have licences, what will she do to ensure that officials make regular visits to these massage parlours to identify and help victims of human trafficking who are often found there and need to be rescued?

I thank the hon. Gentleman, who has a long and honourable history of concern about this subject. The problem is that most of this issue falls under the Home Office, and another small section of it under the Department for Culture, Media and Sport, so however much I might like to encourage officials in DCLG to pay regular visits to check such establishments, I do not think that I could.

Home Information Packs

It is unfortunate that the Minister has not taken a little more time to review the issue. If he had, he might have looked at Northern Ireland where Ministers introduced energy performance certificates without HIPs. Perhaps after he has done so, he might be able to take the opportunity to come back to the House with a fuller answer.

Despite the difficulties in the housing market, HIPs are helping to speed up the process. A survey of 37,000 transactions—[Interruption.] Well, what happens is that every month, those guys—I am sorry, I mean the Opposition—come along and ask these questions and I have to tell them that a survey of 37,000 transactions showed that when a HIP is available, exchanges were completed more quickly. I accept that HIPs were criticised following their introduction in 2007, but we listened to those criticisms and have made major changes to improve the system, introducing the new property information questionnaire containing basic information that buyers said that they wanted; improving the quality of searches; binding in the practice of using insurance; and providing that HIPs must be available when marketing starts.

Regional Regeneration

16. What his most recent assessment is of the effectiveness of Government support for local authority regeneration initiatives in the north-west; and if he will make a statement. (321014)

Since its inception in 1999 the Northwest Regional Development Agency has consistently met or exceeded all targets set by the Government. In addition, the Government have allocated £480 million to local authorities in the north-west via the working neighbourhoods fund and the local enterprise growth initiative to enable them to tackle worklessness and support enterprise in deprived areas.

A clear indication of the effectiveness of the Government’s plans for regeneration in Blackpool has been the substantial rise—in some instances, 40 per cent.—in the numbers of visitors to the town. Some have come to see the new St. John’s square, the Brilliance project and the new promenade taking shape. Will the Minister continue, therefore, to support regeneration projects in Blackpool and the regional development agency’s excellent work?

First, may I pay tribute to my hon. Friend for all her work on behalf of her constituents in Blackpool? I was glancing through a document on the economic impact of the Northwest Regional Development Agency and noticed that there is a Blackpool masterplan encompassing many of the issues she just mentioned. She is right to say that we need action from the local authority and regional development agency to bring about the kind of economic regeneration to which she referred.

Will the Minister accept that county towns such as Macclesfield could do with assistance from regeneration funds, particularly now when we are seeking to establish in Macclesfield a national silk centre? I hope to meet the chief executive of the Northwest Regional Development Agency shortly. Will the Minister give this project her support?

I am sure that the hon. Gentleman will bring the merits of the silk centre to the attention of the chief executive of the Northwest Regional Development Agency. The hon. Gentleman is making exactly the same point I was making earlier: it is vital to have this kind of strategic assessment of the economic needs of all the region, and I hope that he will put his best efforts into persuading his Front-Bench colleagues that they are wrong to want to abolish the regional development agencies in the way that they have set out.

One of the most important local authority regeneration initiatives is the proposed Mersey gateway bridge, which will provide hundreds of construction jobs and thousands of jobs thereafter. Will my right hon. Friend speak to her opposite number in the Department for Transport to ensure that we get a decision quickly, because the planning inspection decision comes from within that Department? We need a quick decision to get on with the project, create those jobs and sort out the congestion in my constituency.

I pay tribute to the work that my hon. Friend has done on this matter. When I was a Transport Minister, I met him and colleagues from the council to discuss the project, and I know how valuable it is to the local economy, so I shall certainly bring his point to the attention of Transport Ministers.

Topical Questions

Much has been achieved on antisocial behaviour, and the number of people who think that it is a problem in their neighbourhood has fallen to the lowest level since records began. However, there are still communities where such behaviour causes problems, and people need to feel confident that they, with the police and local councils, can tackle the problem. Last month, we began training up to 10,000 community champions to join their neighbours, police and councils to take a stand against antisocial behaviour.

I am delighted to hear that my right hon. Friend is focusing on tackling antisocial behaviour. In view of the importance of local authorities working with the police to drive down crime, will he encourage local authorities across England to follow the experience in Cardiff, where a joint analysis, involving the NHS, of violent incidents has led to a reduction in violent incidents by more than 40 per cent. in terms of the numbers of people coming through the doors of accident and emergency departments requiring treatment?

Yes, I will. I understand that lessons from the Cardiff approach are being followed through in Leicestershire and Tyne and Wear. More generally, the Total Place approach, which we are pioneering and which is looking at all public service spending, will encourage the health service, local authorities, the police and others to work together much more closely to tackle such problems in the future.

T2. Given that school transport comes out of the general local government funding formula, and not the education budget, and that it is being reviewed, will sparsity be looked at carefully given that it has a huge impact now in scattered areas such as Northumberland? Potentially, that impact will be even greater when education is compulsory up to 18. (321022)

Obviously, local authorities receive funding. Northumberland has just received a 2.9 per cent. increase in funding and has the flexibility to use it as it wishes. However, we will consider the point that the right hon. Gentleman has raised.

T4. Is my right hon. Friend concerned about some local councils charging extra for some lesser services, but in the meantime keeping council tax low for political purposes and not meeting the needs of the poor and the needy? (321024)

I am concerned about that. Charging for some local services has always been part of the operation of local government, but some local authorities now seem to have a deliberate strategy of keeping basic services as basic as possible and allowing people on middle incomes to get a decent service only if they are prepared to pay twice. That is not the way that I want to see local government services going, and my hon. Friend is quite right to highlight those political parties that are indulging in that approach.

T3. Will the Secretary of State take this opportunity to address the question put to him earlier by my hon. Friend the Member for Meriden (Mrs. Spelman); namely, where will the funding come from in the current financial year to provide for the Government’s proposals on social care? (321023)

As I set out earlier, local government has already planned to make efficiency savings. We believe that it can make the additional savings needed to fund services for the new policy, which comes in not at the beginning of the coming year, but halfway through it. The hon. Gentleman will recognise that, as I said earlier, the policy will be accompanied by the biggest transfer of funding into local government from the national health service since the establishment of the NHS in 1948. I hope that he will welcome that.

T9. Does the Minister share my concern and that of many other Blackpool residents that our local Conservative council is refusing to put in an extra £148,000 to repair the many potholes that have appeared after the winter, when it has £6.8 million in reserves? (321029)

I share my hon. Friend’s concern about that. The weather has been exceptionally severe. That is why, in acknowledging the problems of the severe weather, the Government have trebled funding to local authorities to invest in their roads, and last year we announced new funding to help them better assess the condition of their roads.

T5. I am sure that the Secretary of State is aware that the mortgage repossession scheme operated by Rochdale council has been one of the most successful in the country in keeping people in their own homes. However, funding for that scheme nationally is available only until next year. What steps will the Secretary of State take to ensure that funding is available when the current funding finishes next year? (321025)

I welcome the hon. Gentleman’s recognition that the steps that we have taken locally and nationally, including on the funding to support the scheme, to try to help people struggling with their mortgages during this recession have been working well. We have put that funding in place for this year and next year. That action—Government action that we have been prepared to take—is one of the reasons why repossessions in this recession are running at around half the rate that they were in the last recession.

May I take the Secretary of State back to the issue of maximising scarce resources, efficiency savings and protecting front-line services, and offer a view? The problem is that since 1974, Labour, Liberal and Conservative Governments and councils—all three parties have been equally to blame—have constantly reorganised local government, creating unnecessary tiers of management. Why do we not return to a lean machine, get rid of the layers of management in local authorities and start calling people “The borough engineer” or “The surveyor”, which people understand, rather than calling them after these God-almighty directorships of something-or-other, which vary from week to week?

May I reassure my hon. Friend that although the report from the taskforce on making efficiencies in local government—

Bullock and Leese. The taskforce does not, as I recall, call for the re-establishment of the position of borough surveyor; none the less, it directly addresses the need to reduce layers of management both within local authorities and, in particular, between them in areas with two-tier councils.

T6. From next month lap dancing will have to be licensed by local authorities. Will the Secretary of State look into whether the income from the lap dancing licence should go into paying officials to spot whether the conditions are being met and whether any of the girls dancing in a club may have been trafficked? (321026)

I am sorry to give the hon. Gentleman a disappointing answer, but his question does not really fall under the remit of my Department. He will have to address it to the Department for Culture, Media and Sport or to the Home Office.

Do those on the Front Bench agree that local authorities that are paying compensation for bullying ought to offer better training and that they should be better employers? Should not the public also have a right to know how much money is being paid out in such circumstances?

I am on record as being very much in favour of people having as much knowledge as possible about local authorities’ spending. We have set out measures over the past few months to ensure that that happens. We also believe that people working in local government, which is a vital public service, deserve the best quality of human resources management, as it is called in the jargon these days. What that really means is treating people properly and with respect.

T7. Thousands of students in Leeds and around the country are still not protected by the tenancy shorthold protection scheme. Last November, the Under-Secretary of State for Communities and Local Government, the hon. Member for Dudley, North (Mr. Austin) said that the Government would shortly be publishing the results of the review, but those people are still not being protected. Will he give us an update and tell us why that is the case? (321027)

T8. A few days ago, the Secretary of State gave permission for 3,000 new homes to be built in Wellingborough north, against the wishes of local residents, local councillors and myself. What democratic credibility can this Government have when the Secretary of State makes such a decision so near to a general election? (321028)

Since I came into the House in 1992, I have held the view that Parliament and this House were sovereign. I do not share the concept that there is a period of time when the House is sitting when decisions should not be taken. Decisions are taken properly and in accordance with the law, after we have considered all the relevant processes. It is only right that Ministers should continue to take decisions as long as the House is sitting as a properly constituted, democratically elected Chamber.

Given the consensus that exists in areas such as south Worcestershire about the need for more homes—and for more affordable homes, in particular—may I urge the Secretary of State, even at this late stage, to tear up the west midlands regional spatial strategy and to allow local communities to decide exactly how many houses they need and precisely where they should go?

It is important that the combination of local, regional and national policy should be used to secure sufficient homes to meet the needs of families in this country in the future. We have rejected calls to scrap regional spatial strategies and planning targets and to leave everything to decision making at local level because we know full well that the house building industry would grind to a halt, that land would not be available, that growth would be slowed and that the needs of this country’s families would not be met. The house building industry is terrified by the prospect of such a policy being brought into play.

Order. I would like to accommodate several more colleagues, but I hope that they will be considerate of each other.

After five years, the south-west regional spatial strategy is still grinding on with unsustainable housing targets that are way in excess of economic reality and local housing need. It has attracted 37,000 objections and run into legal challenges; it has also now clearly run out of time. When will the Government admit defeat and return to local people their right to plan the houses that they need where people want them?

The total number of houses is based not on some whim of central Government but on a hard-headed assessment of need. That need translates into the families of this country who want to know that their children will have homes that they can move into, and that there will be provision for elderly people in the future. Those who pretend that we can simply say that we are not going to provide that housing and that someone else will provide the space in which our children need to live are wrong. It is enormously damaging to suggest that. It is also, frankly, misleading to local people to suggest that the hon. Gentleman’s approach would work. There must be a mature discussion in this country about meeting the needs of people now and in the future, and I am sorry that he does not share that view.

The South West of England Regional Development Agency is pumping millions into the Porton science park in my constituency, in partnership with Wiltshire council, which is regenerating the social and physical infrastructure. Will the Secretary of State have a word with Ministers in the Department of Health, who are talking about supporting the Health Protection Agency in moving nearly 800 of its work force out of the south-west, which needs the jobs, into the overcrowded south-east? Is the Lyons review still living, or is it dead?

I will talk to my right hon. Friend at the Department of Health if the hon. Gentleman will talk to his hon. Friend on the Front Bench to say how crazy it would be to scrap the regional development agency that he values so highly in his constituency, because that is exactly what would happen.

Why is the junior Minister for local government refusing to meet me to discuss the persistently low level of grant given to Sevenoaks district council? It has had an increase of only 7 per cent. over the last 10 years compared to an average for district councils of more than 50 per cent. Will she reconsider?

I apologise to the hon. Gentleman; I was not aware that I was persistently refusing, and I would be most happy to see him.

My local council wants to build and renovate many more affordable homes. Will the Government give Southwark council permission to borrow at the lowest interest rates that the market offers rather than at the highest rates that it is currently locked into?

We are not just making grant available to support councils that want to build affordable homes across the country, including in Southwark, but we are looking at ways of dismantling the system of financing council housing for the future. I hope to be able to update the House on that before long.

How does the Secretary of State reconcile his duty to champion local government with his decision to impose unitary authorities that are not wanted? Does he believe that the gentleman in Whitehall still knows best?

The proposals we are putting forward are indeed wanted in Exeter and in Norwich. My right hon. Friend the Minister for Regional Economic Development and Co-ordination and I propose having a unitary council for Exeter and one for Norwich, which I think is the right thing to do.

Further to the question put by the hon. Member for Thurrock (Andrew Mackinlay), does the Secretary of State believe that the pay packages of senior council officers have increased for selfish reasons to indefensible levels? Does he believe, as I do, that it is time that we slimmed down these fat cats?

It is very clear that over a period of time in which the average pay of council workers has gone up by £6,000 a year, the average pay of chief executives has gone up by £40,000 a year. Although I pay tribute to the vast majority of those people with a lifetime of public service, things have got out of hand at the top. That is why we have required from April the publication of the full details of every named post in which an individual is paid more than £150,000 a year, and details of the pay in £5,000 bands from £50,000 upwards. I will also talk to local government about what further measures we can take when it is proposed to create or fill one of these very highly paid posts.

Turning to the earlier question about Hammersmith and Fulham, the Secretary of State seemed entirely unaware of the quote that he had made about the leader of the council, so let me take him back to the opening line of his party conference speech, when he said:

“‘They are hard to get rid of’, the Tory Leader of Hammersmith and Fulham moans about his council tenants.”

That was an invented quote, which has been repeated many times by his colleagues, including in the document, “Cameron’s Councils”. Will he finally take the opportunity to withdraw this disgraceful slur on one of the best-run councils in the country?

I am grateful to the hon. Gentleman for drawing attention to the publication “Cameron’s Councils”, because it sets out for everybody the very clear warning of what it would be like if people were so ill advised as to elect a Conservative Government.

Point of Order

I rise to make a point of order, Mr. Speaker, of which I gave your office notice yesterday, in connection with the shameful behaviour of the Department for Work and Pensions in failing to answer written parliamentary questions tabled by me and other Front-Bench colleagues—specifically,questions 316961 and 316962. What action are you able to take, to ensure that Government Ministers are indeed accountable to all Members? These questions were asked more than a calendar month ago, and I suspect that the Department wishes to bury bad news by not answering them. How can you help me, Sir?

I thank the hon. Gentleman both for his point of order and for giving me notice of it. Let me reiterate the position that is expected of Ministers in all Departments: timely replies should be provided to written parliamentary questions.

I was waiting for what I regarded as the crux of the hon. Gentleman’s inquiry, namely the length of time for which he had been waiting. For him to table a question and find a month later that he had not received any reply—or, at any rate, had received no substantive reply—was not satisfactory.

The hon. Gentleman will be aware of the new system that I have introduced, which gives better transparency to the record of Departments in answering questions. I had hoped that that would serve to shame Departments into superior performance. If it has not, we may have to look at the thing again, but it really will not do.

Hydrofluorocarbons Limitation

Motion for leave to bring in a Bill (Standing Order No. 23)

I beg to move,

That leave be given to bring in a Bill to make provision for limiting the use of hydrofluorocarbons in certain premises; and for connected purposes.

The purpose of the Bill is to bring an end to the use of hydrofluorocarbons, or HFCs, in the refrigeration units of large supermarkets—

Order. I apologise for interrupting the hon. Gentleman, and I hope that the clock can be stopped, but I should be grateful if Members who are leaving the Chamber would do so quickly and quietly. The noise is very discourteous to the Member who has the Floor. I hope that we can have some regard to the way in which our proceedings are viewed by people outside this place.

Thank you, Mr. Speaker.

Last year, I presented a similar Bill in an attempt to persuade the Government to regulate for the complete phasing out of HFCs in large supermarkets. Today, I shall attempt to impress on them three facts which I hope will convince them that it is time to act. HFCs are extremely harmful in terms of global warming and represent a growing proportion of our emissions. There is little to suggest that current European Union and United Kingdom regulation in the field has encouraged large retailers to speed up the process of eradicating the use of HFCs in their stores, and there is nothing in EU regulation to prevent the Government from regulating in this regard.

According to Greenpeace, HFCs can be up to 20,000 times more damaging in terms of global warming than carbon dioxide. The most common gas used in supermarket refrigeration, HFC-404A, is 3,800 times more harmful than carbon dioxide. It is predicted that by 2020 HFC emissions will be equivalent to between 2 billion and 2.6 billion tonnes of carbon dioxide, approximately four times the level of the United Kingdom’s annual greenhouse gas emissions. In 2005, stationary refrigeration units were the biggest source of F-gas emissions in the UK, and within that total, supermarkets account for more than half the emissions. Phasing out the HFCs in supermarkets has the potential to save more than 175 million tonnes of carbon dioxide equivalence between now and 2050. That is equivalent to a quarter of the UK’s annual carbon dioxide emissions.

The potential impact of gases on global warming is averaged over 100 years, which reflects the extraordinarily long time that gases responsible for global warming remain in the atmosphere and add to the problem. HFCs do not last for 100 years. The evidence is that global warming is accelerating. Prompt action now to remove gases that are 4,000 times more harmful than carbon dioxide and do not linger as long as other harmful gases has the attraction of buying much-needed time for other greenhouse gas mitigating measures to take effect. I hope the Minister will accept that the time to act is now.

I presented my Bill last year in response to a report from the Environmental Investigation Agency on the use of hydrofluorocarbons in supermarket refrigeration units. I commend the agency on its work. Its report was prompted by the announcement by a group of large supermarkets that they intend to move away from the use of HFCs. The EIA carried out its survey to monitor progress in August 2008. Its conclusions were not encouraging—the best-performing supermarket succeeded in reducing its HFC use in only three out of 620 stores.

The figures for other supermarkets were just four out of 1,700 stores and one out of 2,250 stores. I shall not name and shame the supermarkets involved, because the response in this area has been so mixed. The stated view from many in the industry is that regulation in this area would create the confidence across the industry to plan ahead, knowing that the supermarkets are all operating within the same framework. Such an approach would bring about the stated objective of the Department, which is to eradicate the use of HFCs. That view still applies today.

Following the presentation of my Bill last year, my hon. Friend the Minister of State, Department for Environment, Food and Rural Affairs wrote a letter to the EIA on 11 November in which he accepted that supermarkets were the “big emitters” and that

“reducing their emissions is a key focus of Defra’s work to reduce HFC emissions overall.”

He went on to say that in the short term the Government anticipate that

“with the comprehensive EU and GB regulatory framework now fully in force, significant reductions”—

in the use of HFCs—

“will be achieved in the next few years.”

I am sorry to say that there is little evidence that that is moving companies in the right direction.

In August 2009, the EIA carried out a further study of large supermarkets to see how far they had got in moving away from being dependent on these extremely harmful gases. Only 2 per cent. of the major stores in the UK are running HFC-free refrigeration systems—only 46 are now HFC-free compared with 14 last year. One of the largest supermarkets has experimented but has reneged on its promise to switch all its stores away from the use of HFCs, while one major chain continues to use HCFCs—hydrochlorofluorocarbons—which are supposed to be phased out this year. Aldi, Morrisons and Sainsbury’s refused to share their data on leakages, and so I shall make an exception in naming them. The level of the leakages emitted into the atmosphere reported to the EIA ranged from 14 to 17 per cent. of HFCs, so I am afraid that my hon. Friend’s confidence that the current regulatory regimes in the EU and the UK are sufficient to meet the urgent need for action on HFCs is misplaced. I hope that he will accept the argument that the time to regulate has come.

My third point is that nothing in the competition rules prevents the Government from regulating in this area. May I refer the Minister to article 95 of the treaty establishing the Economic Community which, following the passage of the treaty of Lisbon—I pardon him if he starts to fall asleep as I read this technical section—became article 114 of the treaty on the functioning of the European Community, TFEC? While on the approximation of laws, I should mention that paragraphs 4, 5, 6 and 7 of the article are the most relevant. They clearly demonstrate the need for the Government to make a case for the eradication of HFCs here in the UK—nothing is preventing the Government from making that case.

The Commission would then be required to consider whether this form of practice was aimed at seeking advantage over other EU countries or companies that operate within those countries and whether the UK was seeking to exclude those people from free trade with the UK. Those paragraphs contain clear powers for the UK to regulate to tackle environmental issues. Nothing excludes the UK from acting in this area and preventing the further use of HFCs in the future.

So, in conclusion, may I urge my hon. Friends in the Department to take on board the three arguments that I have made today and to agree to meet me and the EIA in the near future to discuss ways in which we can make a case to the European Commission that we are not breaching European competition laws, that there is scientific evidence that proves that it is necessary for us to act in this field, that current European and UK regulations are not moving the large supermarket chains along the road of eradicating hydrofluorocarbons and that action in the UK is absolutely necessary? With that, I commend the Bill to the House.

I rise to comment on this Bill, provoked by the question of why we need such legislation in the first place. I agree with the intentions and objectives of the hon. Member for Eltham (Clive Efford), but I am extremely worried about the situation in which we find ourselves. We always talk about the environment, as do the supermarkets, yet they do not feel compelled to act without the threat of legislation. Like the hon. Gentleman, I have heard the supermarkets making various claims on this matter, as well as various general commitments to phasing out the hydrofluorocarbon-related refrigeration units that he has described. However, as he has rightly pointed out, the reality is far from the public relations commitments. If the supermarkets are serious about the environment and about improving their environmental footprint, as they incessantly tell us in their advertising, they ought to be making a formal statement about what date they will set for themselves to phase out the refrigeration units in question—perhaps 31 December 2015, which would give them half a decade to finish the job.

It seems to me that it would be unhelpful for me to divide the House on this matter—it would be a poor use of the Chamber’s time—but I want to put on the record my view that if no action is unilaterally taken by the supermarkets without this legislation, we cannot accept their claims that they take the environment seriously. I fear that not only will the supermarkets give us more words without action, but when it comes down to a fairly straightforward change of the type that the hon. Gentleman wants to see, they will be resistant for purely economic reasons. The environment is more important than that.

Let us see whether this ten-minute Bill causes the supermarkets to act and to make a commitment to act in the next few days. If they do not, not only will I be disappointed by the claimed intentions of supermarkets not being followed up with action, but I will also feel that the prognosis for the environment as a whole is grim indeed.

Question put (Standing Order No. 23) and agreed to.


That Clive Efford, Steve Webb, Norman Baker, Peter Bottomley, Andrew George, Mr. David Drew, Jim Dowd, Mr. Michael Meacher, Mr. Andrew Dismore, Ms Karen Buck, John Austin and Mrs. Ann Cryer present the Bill.

Clive Efford accordingly presented the Bill.

Bill read the First time; to be read a Second time on Friday 30 April and to be printed (Bill 81).

Opposition Day

[5th Allotted Day]

Health Care in London

I inform the House that I have selected the amendment in the name of the Prime Minister. The House will also be conscious that I have imposed a limit of eight minutes on Back-Bench contributions both in this debate and in the second Opposition day debate.

I beg to move,

That this House recognises that London has some of the leading hospitals and healthcare services and expertise in the world; notes with concern that some areas of London have the worst outcomes for stroke, heart disease and cancer in the country; is alarmed that health inequalities in the capital rank among the worst in the country; believes in improving services to meet the needs of London’s 7.5 million inhabitants; calls for the delivery of a public health strategy geared towards the reduction of health inequalities; calls on NHS London to halt the implementation of current sector-wide reconfiguration proposals across London, including accident and emergency services, until a more effective public consultation is in place; further calls for service configurations that are soundly evidence-based and which meet the choice of patients and the referral intentions of local GPs; further believes that consultant-led obstetric departments and maternity units should not be closed, whilst they are safe, accessible and responsive to a continuing need; and calls on NHS London and the Department of Health to publish the details of the commitments made at the time of the Olympics bid to fund healthcare services in the capital, and to disclose what the current estimate is of the cost of providing services for the Olympics and how it is proposed that this should be funded.

Members of the House, particularly the many with London constituencies, will be aware that for the past two years there has been a process called Healthcare for London, which has increasingly sought to prescribe to the health economies across London how they should design their services, which services should be provided and by whom, and, by implication therefore, where patients should go for their treatment. The purpose of the debate is to give the House, for what I think is the first time, the opportunity to express a view on how we want health care services in London to be provided in future. We want literally to fire a shot across the bows of those in the upper hierarchies of the NHS who want to determine these things without reference to the public whom they serve, to the general practitioners who refer patients, or to the patients themselves, who have a right to exercise choice. We also want to give the House an opportunity to set out how it wishes Healthcare for London to be improved in the years ahead.

My first point is at the heart of improving health outcomes. We need to focus on improving public health in London, which has some of the greatest health inequalities in the country. At ward level, between Tottenham and Kensington and Chelsea, for example, there is a disparity in life expectancy of 17 years. I know that such disparities exist in other parts of the country, but those are very pronounced. We feel the issue even more keenly when we see such relative wealth and poverty side by side in London, where nearly one in four children live in poverty.

There are many specific health problems that are greater in London than anywhere else in the country. The level of sexually transmitted infections is higher in London than anywhere else, and the level of alcohol abuse and dependency is higher than in any other region in the country, as is the level of drug use and abuse. We know—not least because London is where many refugees, asylum seekers and, indeed, rough sleepers are found—that London has 40 per cent. of the total number of tuberculosis cases in the country and more than 50 per cent. of HIV cases. The importance of having an effective public health strategy must be at the heart of this issue.

I commend the Mayor of London for the health inequalities strategy that he published last October. I shall not dwell on that at length, although there is plenty of reason to do so, because time will not permit it. The document that I published with my right hon. Friend the Member for Witney (Mr. Cameron) in February was about focusing on public health, having a dedicated public health budget and having a health premium that is intended to support successful local strategies.

In the London context, I want to make it clear that if we were given the opportunity to do so by the electorate of London, we would equip the local NHS with individual London boroughs to pursue locally owned strategies to improve public health. We also intend that the NHS should co-operate, on a London basis, directly with the Mayor of London to pursue the health inequalities strategy. Given the particular characteristic of London as a city with city-wide government, we want that city-wide government to bear down on the particular public health challenges that I have mentioned and to exploit opportunities for promoting better health in London, and I know from my conversations with the Mayor that he is immensely keen to do that.

I share the hon. Gentleman’s concern about health inequalities in London, and I am curious to know how much money he would transfer from Chelsea to Haringey, for example, to deal with those relative inequalities.

As the Minister is in no position to tell us what the spending in individual primary care trusts will be beyond 2010-11, I shall not take any lectures from him on this. What we are clear about—this has never happened under a Labour Government—is having a direct focus on public health outcomes and a determination to use the resources of the NHS to reward successful strategies. It is understood as well in Kensington and Chelsea as it is in Haringey or Tottenham that the places with the worst current health outcomes should be where we focus our public health resources not only to improve everybody’s health but to narrow those health inequalities.

In a second, as I want to make the point set out in our motion. We have previously given Ministers a chance to be clear about what implications and opportunities will arise for the NHS and London through the Olympics. Clearly, the games represent a very great opportunity in public health terms, and we have to make sure that the legacy will be realised. However, some very particular costs will arise in 2012 itself, and I think, from what he said two or three weeks ago, that the Minister has estimated them to be in the order of some £30 million.

When he replies, I hope that the Minister will tell us precisely what the costs are. What commitments on costs have been given to the London Organising Committee of the Olympic Games, and how does he intend them to be met in the NHS in London during 2012?

I thank the hon. Gentleman for giving way. On the subject of implications, will he make it clear to the House whether there are any implications for the Better Healthcare Closer to Home programme, which affects residents in Sutton and Merton? The programme would provide a new hospital on the St. Helier site, and local care hospitals in the area. Will he confirm that the argument that he is deploying today about what should happen with the NHS in London will have no implications for that programme?

I assure the hon. Gentleman that what I have said about public health will not impact directly on the availability of NHS services. I remind the House about the current level of spending on public health care in London through the Healthy Living programme. [Interruption.] The Minister might be interested in this, because 13 primary care trusts in London spend more on management than they do on public health under the Healthy Living programme.

Across London, the average spend on the Healthy Living programme is £38 a head, and average management costs are more than £30 a head. The total for management costs in London is £246 million a year, and that shows a rise of 22 per cent. in just the past three years. We want to cut those management costs by a third over the next four years. We will reinvest all the money, because we aim to protect the NHS budget and increase it in real terms every year. That means that we will be able to ensure that we have less bureaucracy and more promotion of public health.

No areas of public health are more important than drug abuse and drug treatment. A great deal of public money has gone into them, targets have been set and a huge amount of management brought to bear, yet very little has been achieved in terms of outcomes or recovery from addictions. Is not that a prime example of Labour failure?

Yes; my hon. Friend has made a very important point. We have to be focused on results. I am afraid that for too long parts of the country have said, “We have relatively poor outcomes, so we must have more money,” yet the money has never been used to deliver proper results.

I make no pretence about the fact that it is a tough call. In straitened financial circumstances, we intend that the dedicated public health budget will rise in real terms, but we have to ensure that that will deliver results. As we made clear in our public health green paper, we believe that we stand a much better chance of achieving those results if we engage properly with local authorities and the NHS as a local strategy, with voluntary-sector bodies as deliverers. That approach will help charities and voluntary-sector organisations, when the results come through from the services that they provide, to believe that their funding will be locked in on a more permanent basis. That will be better than the constant flow of short-term initiatives that have so undermined them in the past.

No, as I want to make some points about the Healthcare for London programme.

In January, NHS London published an overall strategic plan, and we have begun to see some of the so-called “sector plans” for different areas of London. The plan for outer north-east London has been published and the one for north-west London has been leaked. In addition, people are speculating about what the implications might be for other places across London.

There are questions about the assumptions underlying the NHS London approach. It does not help that the text of the document published in January by NHS London is confusing and erroneous. The notes relating to the scenarios and the funding figures were transposed, they did not include the base case at all, and they were wrong. For example, there was a reference to 2.3 per cent. per annum funding growth in the next spending review period, which should have been minus 2.3 per cent. Essentially, NHS London is assuming that there will be unchanged real terms funding for the NHS all the way through to 2016-17. Alongside that, it assumes 3.5 per cent. cost inflation in the NHS. We need to challenge the assumption that costs can be accommodated in that way. NHS London also assumes 4 per cent. a year demand growth, which is not in line with the projections of national demand growth produced by the King’s Fund and the Institute for Fiscal Studies.

We know what NHS London set out to do—make a set of assumptions, arrive at a big funding shortfall in 2017, and tell everyone that they must do the things that NHS London is calling for them to do—but let us leave that on one side.

Under any reasonable set of assumptions, we have to deliver efficiency savings and improving productivity in the NHS, including in London, in ways that have not been adopted in the past. Over the past 10 years, when funding for the NHS has more than doubled, how is it possible that in London there is still legacy debt of more than £500 million for the NHS trusts and a worrying number of financially challenged trusts, and very few of the changes that should have taken place in the NHS to redesign services and deliver care more appropriately and more effectively have happened? Perhaps the Minister will explain.

The moment when the financial pressures are assumed to begin is the moment when NHS London feels that it must start taking the management action necessary to respond to it. There has been a dereliction of duty. After a 20 per cent. increase in management costs and a £25 million management consultancy cost the year before last, many of the things that needed to be done have not been done.

My hon. Friend makes a powerful point. Is he aware that that concern is particularly reinforced in south-east London, where it seems that underlying assumptions based on a crisis-driven need to amalgamate three trusts into a huge super-trust are distorting the assumptions and the long-term planning, reinforced by the suggestion in documents seen by the South London Healthcare Trust, that the principal driver of this is to “right-size”—in other words, financially rectify—the enormous historic deficit that it inherited?

My hon. Friend makes an important point. Experience suggests that merging three failing organisations does not make one big successful organisation. I hope I am proved wrong and that the South London Healthcare Trust succeeds in its objectives, but I am afraid that past evidence does not necessarily support that, and the trust has a massive debt.

The central issue is that NHS London is making extreme assumptions about the ability to transfer activity from within hospitals to a community context. Alongside that, it is assuming dramatic reductions in cost, which are not proven.

My hon. Friend is making a powerful case. He has visited our area, south-east London, regularly to see at first hand the problems of health care that we had. The regrettable reorganisation that my hon. Friend the Member for Bromley and Chislehurst (Robert Neill) referred to is causing great concern locally about the provision and quality of health care that constituents will receive. There is failure in our area. What reassurance can my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) give our area about the future?

I hope that I can give the reassurance that decisions will be made locally in relation to local needs, local patients’ choice and GP referral decisions. My visit with my hon. Friend to his constituency, and the example of Queen Mary’s hospital in Sidcup, begin to give the lie to the Government’s amendment—in that none of the changes will happen unless and until new services have been developed. That is far from the case at the moment, and it is assumed that patients who are denied access to hospital services will simply be accommodated elsewhere in the community at a lower cost. The assumptions are literally heroic, stating that it will be possible for 55 per cent. of out-patient and 60 per cent. of accident and emergency attendances to take place in the community rather than in the hospital.

The Government cite the National Primary Care Research and Development Centre, which just over two years ago undertook a study on care closer to home, but that does not for a minute justify the 55 per cent. out-patients figure. All the examples are small-scale, and none systematically demonstrates a reduction in cost if one maintains quality, not least because good-quality community services often have to be delivered by the same hospital specialists—or certainly with them, and as a result of their training and co-operation. The Government cannot point to any evidence that supports their assumptions.

My constituents are hugely concerned about the future of Barnet hospital and Chase Farm hospital. Does my hon. Friend share their anger that the whole NHS London process has been so secretive, compounding fears that it is all about suiting the agenda of NHS managers, not patients?

I entirely agree. My hon. Friend knows about this, because she, other hon. Friends and I have been to see the management of Barnet and Chase Farm Hospitals NHS Trust over five years to try to work out what they propose to do with Chase Farm hospital, and to argue the case for it. Time and again, in the private conversations that we have had, it was clear that options were not being presented. It was also perfectly clear that the management sought to prejudice the public consultation by tying up in advance the views of all the clinicians whom they employed. That is not satisfactory, either.

Does my hon. Friend agree that there is no better example of things not being done that ought to be done than the redevelopment of Purley War Memorial hospital, which is part of the Mayday Healthcare NHS Trust? In 2001 a pledge was given at the Government Dispatch Box to redevelop that hospital. Nine years later, nothing has happened and there are still no concrete plans for redevelopment. Can my hon. Friend assure me that a future Conservative Government will get behind the local authorities and deliver something for the people of south Croydon?

I am glad that my hon. Friend has made that point, because I can give him that assurance. Indeed, I have made it very clear to the chief executive of the Mayday Healthcare NHS Trust that I shall support its action in seeking to develop Purley War Memorial hospital, and I am very pleased that Croydon council is getting behind the project, too, because the planning authority and the NHS trust must be willing to make it happen. That redevelopment is very important, because if the trust is to become a foundation trust that service needs to be provided and that project needs to go ahead.

I, too, deplore the secrecy of the process. Will the hon. Gentleman therefore join me, and his hon. Friends, in calling for the publication of many documents, including the McKinsey report that lies behind the process, and in my own area, the south-west London strategic plan, which contains many of the options that so concern people?

I entirely agree that it would be very helpful if those management consultancy reports were published. However, our every step has been taken not on the basis of speculating or scaremongering, but entirely on the basis of trying to identify clear evidence. I must confess that I was therefore rather disturbed to find that, according to the associate editor of the Daily Mirror, Liberal Democrat activists openly boasted that they had stirred up the campaign about the closure of Kingston hospital. No document had been published and there was no documentary evidence to support the closure claim, and the chairman and chief executive of the Kingston Hospital NHS Trust have completely refuted it. My hon. Friend the Member for Hemel Hempstead (Mike Penning) has been to Kingston hospital to discuss this, and he can vouch for that fact.

I promised you, Mr. Speaker, that I would confine myself to taking interventions from those who are currently seeking to intervene, and no more than that.

My hon. Friend will know that the north-west London commissioning partnership is looking at closing five of the eight A and E departments in that sector. At the same time NHS London, in its letter of 22 January 2010, suggested that there should be only one site in the huge Imperial College Healthcare NHS Trust area. What does he think might be the implications of that for the residents of Hammersmith and Fulham, and the royal borough of Kensington and Chelsea?

I am grateful to my hon. Friend, who makes a very important point. One of the assumptions is a 60 per cent. transfer of accident and emergency cases out of A and E and into the community. A study on primary care and emergency departments commissioned, and published last Friday, by the Department of Health, said that, of arrivals at A and E,

“We found that the proportion that could be classified as primary care cases was between 10 per cent. and 30 per cent.”

It went on to say:

“There is good evidence that the majority of patients choose the correct level of care. A few do not and it is always a risk to plan for the few rather than the many.”

In north-west London—we have seen the documentation on that area—it is astonishing to make this proposal and talk about such a massive transfer out of A and E, given last year’s figures. In Chelsea and Westminster the rate of A and E attendances has gone up by 4 per cent.; in Ealing the figure is up by 1 per cent.; for Imperial, taking Charing Cross and Hammersmith together, it is up by 9 per cent.; in North West London Hospitals it is up by 15 per cent.; in Hillingdon it is up by 6 per cent.; and in West Middlesex it is up by 5 per cent. All those hospital emergency departments have people pouring in. It is simply not true to say that there is any evidence to support the proposition that the services in the community that would justify the proposed closure of emergency departments have been put in place.

I will give way to my right hon. Friend the Member for Chingford and Woodford Green (Mr. Duncan Smith), and then take interventions from those who are standing, but I will stop there.

Will my hon. Friend bear in mind the fact that we have had exactly this problem in north-east London, where there is a shortfall in spending between the north-west and the north-east? The drive to close Whipps Cross is mainly down to the zealotry of officials, now released from secrecy, and people not telling the truth about it. They talk about pushing stuff out into the community, but in our area there has been a 10 per cent. fall in the number of health visitors, and the caseloads in relation to children under five are at least double that recommended by Lord Laming. It is an utter disaster, but we cannot get those people to face up to that.

My right hon. Friend makes an extremely important point. Putting a walk-in centre or an urgent care centre on the front of a hospital is a perfectly reasonable and sensible idea, but when that happened at Whipps Cross the net effect was 2,000 fewer patients a month attending the emergency department at Whipps Cross, but 4,000 extra patients a month attending the urgent care centre. We should not assume that that leads to lower costs, as it might stimulate demand.

The hon. Gentleman referred to Barnet hospital and Chase Farm hospital, which we have discussed before. He knows that I do not support any downgrading of my local A and E, but we have won an important step forward in relation to a 24-hour doctor-led service for the future. These changes will not take place until 2013. He must also know that in an interview with The London Daily News the Conservatives have said that their position is

“not a guarantee that we will keep A&E”.

In “Enfield News”, which is hand-delivered by the Conservatives, they have said:

“It is impossible to make commitments”.

Does not that say it all about the Tories on the NHS—no commitment?

Time and again I have told the right hon. Lady that we have been committed, over years, to defending the right of local people and local commissioners—general practitioners—in Enfield to determine what services should be provided for them at Chase Farm. It is a disgrace that local people have been ignored in what is being pushed through there. She should talk to the hon. Member for Pendle (Mr. Prentice) to see how good he thinks it is to get rid of an emergency department and put in an urgent care centre, because the local people in Burnley did not accept it. Of course I shall not have a top-down Conservative approach replacing a top-down Labour approach. What we will have is a structure that listens to patients and responds to local GPs, allowing them to be sure that they can put services in place.

My hon. Friend made a comment about Kingston hospital. I was so concerned about some of the campaigning that has gone on, including a challenge in newspapers to me as Conservative MP for Wimbledon, that I met Healthcare for South West London last Friday, and was told that nothing was going to happen. The hon. Member for Kingston and Surbiton (Mr. Davey) has suggested that there should be transparency. Perhaps he and his colleagues would like to publish the evidence that they have on these matters.

I can tell my hon. Friend that after the election, one of two things will happen. There will be either a Labour-derived, top-down plan that threatens to turn many of London’s major hospitals into what Labour terms “local hospitals”, which in some cases seems to mean a move from an emergency department to a GP-led urgent care service—a potentially serious retrograde step when attendance at A and E is rising—or a Conservative approach of trying to allow GPs, local authorities and local people to design services that respond to patient need and choice and provide referral opportunities. If patients are arriving at an A and E department, they should be handled appropriately there.

May I say that the hon. Gentleman’s remarks at the beginning about health inequality in London were very well made and struck the mood of the House? I profoundly hope that we can discuss this matter without descending into party political rancour. On his point about A and E admissions, Ealing hospital—I was there at the opening, not all that long ago—was built to treat 25,000 people a year but deals with 100,000 a year. Does he agree that although we may well move to a polyclinic model in future, we cannot do that now, and we cannot abandon people in A and E? This is not a matter of Labour and Conservative, but a matter of life and death.

I agree with the hon. Gentleman. That is precisely my point. He is right that Ealing hospital has 100,000 people coming through its doors to its emergency department each year. If it were not there, where would they all go? There is always a case for change, and nothing will be absolutely static, but let us work with the hospitals that we have, and let them start the business of designing new services.

I see the former Secretary of State, the right hon. Member for Holborn and St. Pancras (Frank Dobson), in his place. He was out with his colleagues and others protesting about the possible closure of the emergency department at the Whittington, which is on the same scale. We should work with hospitals in London and say that, yes, we may need to design better services, a care pathway that extends out into the community and services that are more integrated around patients instead of having a primary-secondary divide, but we should give the hospitals the opportunity to deliver those services. We have a lot of hospital sites in London, many of which are accessible to much of the population, and we can deliver services from them rather than shut them down and open polyclinics, as with the absurdity at Sidcup.

In outer south-east London, when the proposals in the “A picture of health” programme were first put forward in October 2007, we were told that they had come from a conference of clinicians, doctors, nurses and midwives who had got together and come up with them. It was on that basis that they were supported. They were reviewed by Dr. George Alberti, who gave them his bill of health, for want of a better expression. The hon. Gentleman says that he is not in favour of top-down planning for our local NHS services, but if our local clinicians have drawn up the proposals, what is the basis of his objections?

I can tell the hon. Gentleman this in one sentence: he should go and talk to his local GPs. I have talked to representatives of the GP community across London, and they share our concerns about the nature of this process and about many of the assumptions that seem to underlie how it will be pursued.

I will give way to my hon. Friend the Member for Hornchurch (James Brokenshire), but then I must finish my speech.

We have heard about the proposals being clinically led, but does my hon. Friend agree that some of the decisions have been made purely on the basis of private finance initiative contracts? The focus has been on hospitals with large PFI contracts. In north-east London, the focus is on centring everything around the Queen’s hospital and putting more pressure on it, and in south-east London, non-PFI hospitals such as Queen Mary’s hospital in Sidcup are effectively squeezed out. The focus is not on health care, but on finance and those PFI hospitals alone.

My hon. Friend is absolutely right, and has a unique perspective in that he sees the problem from both sides of the River Thames. I defer to him because he is responsible for the care of my parents in Hornchurch.

It is astonishing that nowhere in the NHS London document does it say anything about the cost of establishing those polyclinics. In constrained financial circumstances, how absurd is it to spend million pounds shutting down hospital services only to spend millions more opening new polyclinics, sometimes on the same premises, as at the King George in Ilford? What kind of an absurdity is that?

I will not give way, if the hon. Gentlemen will forgive me. Mr. Speaker will not forgive me if I do not make progress.

I have one final point to make. Members from across London feel a similar way about the proposals, the assumptions that are being pursued, the lack of evidence, and the inability of NHS London to justify what it seems to expect will happen. In their amendment, Ministers are saying, “Look, don’t worry; it’ll be fine. Nothing will happen until the other services are already there.” Ara Darzi said last year that there would sometimes need to be double-running to enable the plan to be established, but he has gone, and that plan seems to have disappeared.

I must tell Labour Members that the Government’s amendment is not justified: there is no plan in any of the sectors to establish services in the community and get them up and running, or for a shift in activity away from hospitals, before the point at which hospitals are shut down.


Page 20 of the January 2010 document says:

“Implementing Healthcare for London means a considerable shift in activity from acute to polysystem settings. Unless any surplus capacity can be exited quickly”—

which I think means shutting hospitals—

“there will be significant double running costs. Developing proposals for service change, consulting stakeholders on those proposals and implementing agreed service changes takes too long and is expensive. A speedier approach to reconfiguring services needs to be developed”.

There we have it. The Government’s amendment is not what NHS London is setting out to do: that is in black and white in NHS London’s document. It says, “We don’t want double-running costs; we want to be able to shut hospitals down quickly, and a speedier way of doing that”—but that is not what is in the amendment. I urge the House to support the motion and fire a shot across NHS London’s bows.

Order. Just before I call the Minister to move the Government amendment, I simply state—I think all hon. Members know this—that the longer the speeches from the Front Bench, the fewer opportunities there will be for those sitting on the Back Benches. To move the amendment in the name of the Government, I call the Minister.

I beg to move an amendment, to leave out from “House” to the end of the Question and add:

“recognises that there are health inequalities, particularly around heart disease, stroke and cancer, to be addressed in London; agrees that there is a need to build stronger organisations which are clinically and financially sustainable and provide the best service to their local populations; recognises the importance of the work by Lord Darzi and over 200 clinicians who undertook the Healthcare for London review, which was widely supported and consulted on in London; recognises that trusts have worked closely with their local communities to communicate the aims of the programme; further recognises that lives will be saved because the NHS in London, supported by public consultation and following review and scrutiny by local and pan-London Health Overview and Scrutiny Committees, has agreed to implement new stroke and trauma networks surrounding world-leading major trauma centres and hyper-acute stroke units to ensure that patients receive high quality and innovative care in centres of excellence, expected to save approximately 500 lives a year; acknowledges that there have already been improvements in cardiac outcomes; notes that there must be no further changes to accident and emergency or obstetrics departments unless and until improved access to new services is available and that any changes must be subject to full and formal public consultation; and further notes that the Government is preparing robust planning systems to ensure that NHS London is fully prepared to meet the challenges posed by the London 2012 Olympic Games.”.

In opening, the hon. Member for South Cambridgeshire (Mr. Lansley) took 24 minutes. [Hon. Members: “Thirty-four minutes!”] I apologise. Perhaps I was more generous to him than I should have been. I normally take a lot of interventions, as the House will know, but I will try to make some progress today, because I am conscious that many hon. Members will want to raise their local concerns about NHS London.

I had a lot of sympathy with the hon. Gentleman’s comments on inequalities, and with the motion, which is about a number of those. There is common ground on the need to address those inequalities. The difficulty is that the motion, and indeed his comments, identify a series of problems but offer no possible solution. I can see the opportunist, pre-election attempt to wrong-foot Labour, but the motion and the speech offer no vision, no new ideas, and frankly no agenda for government. They expose the Conservative party as offering no constructive way forward to address the very problems that the hon. Gentleman and his motion identify. We know that there are inequalities in stroke provision, and in heart provision. We know that London has worse outcomes and greater inequalities than other parts of the country. We know that lives are lost because of the current disposition of services. We know that infant mortality rates in Haringey are three times those in Richmond. We know that life expectancy deteriorates by a year for every stop on the Jubilee line from Westminster to Canning Town, from 77 down to 70. There is an over-reliance on A and E because GP practice in deprived areas in some parts of London is inadequate. But the best that the hon. Gentleman can offer is a vague view that we should leave it up to GPs to solve it through their budgets. He says that GPs should put more money into services if they want to keep them, on an ad hoc basis and without any process. That is an abdication of responsibility.

Is my right hon. and learned Friend aware that NHS Islington is currently engaged in a so-called pre-consultation about the future of our greatly loved Whittington hospital? That so-called consultation is as chaotic and incoherent as it is alarming and wrong. Will he instruct NHS Islington to listen to local MPs and the public and dismiss any suggestion that Whittington A and E and maternity unit should close?

As my hon. Friend knows, I have said in a debate on the Floor of the House in December that I have concerns about what is happening in relation to the Whittington. She has fought a strong fight on the issue and spoken to me about it on several occasions. We need to see strong clinical evidence for any change to the status of the Whittington. It is being discussed locally, but the national clinical advisory group will need to look at any case put forward. It is local now, but we have invested £32 million in the Whittington, much of it in A and E, and unless the case for change is established, there will be no change. At the moment I am not convinced of the need for the Whittington A and E to close. Those discussing these things need to know that. I have serious concerns about it and I would want to see a serious clinical case made for saying that the £32 million that the Government have decided to invest in the Whittington should be overridden. I do not see any justification for closure of the A and E at this time, and I would want to hear the case for closing it during the next Parliament. I have seen no such case.

Is there any prospect of any change from this Government to the decision to downgrade Chase Farm hospital’s consultant-led A and E and maternity services despite more than 100,000 attendances at A and E and more than 3,300 births at the hospital?

We are looking with great care at all the various proposals and Chase Farm hospital is the subject of one of those proposals in London. The issues are supposed to be locally driven, locally led and locally determined reconfigurations. The hon. Gentleman and his party seem to think that this is all coming from Whitehall, but that is complete nonsense. These are local decisions, locally arrived at.

I thank my right hon. and learned Friend for his reply to my hon. Friend the Member for Islington, South and Finsbury (Emily Thornberry). The overwhelming case for retention of the Whittington A and E has been made and continues to be made, but we discover that officials from the north central London NHS review are still working on a plan that we believe involves closure of the A and E, and they will not publish that plan for several months. Will he ensure that all the plans are published now so that the public can see what is being thought up by officials?

If my hon. Friend will forgive me, I want to return to the various discussions that have taken place, the minutes and the proposals being circulated. Engaging with clinicians, and how we engage with them, is important.

I welcome the Minister’s remarks because, as he knows, the socio-demographic circumstances around Whittington hospital make the area one of the most deprived in London. My concern is that, of the seven current options, four suggest closing the accident and emergency department. That seems to be a huge waste of resource and energy when the money is needed in front-line services. Will he talk to north central London officials now and stop the process, because, as the hon. Member for Islington, North (Jeremy Corbyn) said, the case has been made for retention of the A and E department?

I hear what the hon. Lady says, but if she reads my comments just now and listens carefully, she will realise that, in a sense, I have addressed some of those points already.