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Westminster Hall

Volume 507: debated on Wednesday 17 March 2010

Westminster Hall

Wednesday 17 March 2010

[Mr. Joe Benton in the Chair]

Migrant Domestic Workers (Visas)

Motion made, and Question proposed, That the sitting be now adjourned.—(David Wright.)

It is a pleasure to be under your guidance, Mr. Benton, for what is probably the last Adjournment debate of my time in Parliament. I am particularly pleased to have the opportunity to praise the work of not only some superb non-governmental organisations active on this issue but those right hon. and hon. Members who have been more involved with the subject than I have been.

I am a member of the Select Committee on Home Affairs, which in 2008 produced a strong and hard-hitting report on the obscenity of human trafficking. The title of this debate refers to visa rights for migrant domestic workers, but it will become apparent that what we are actually discussing is a secret slavery taking place a stone’s throw away from this building. For the most abused groups of vulnerable workers, the dark ages are still happening, just around the corner from this mother of Parliaments. It is a scar on this country that such things occur within our borders; it is certainly a scar on the conscience of the diplomatic missions that use diplomatic immunity and their privileged position to treat fellow human beings in the most appalling, disgusting, dehumanising and disgraceful manner. It must stop. That will be the thrust of my contribution and, I am sure, the contributions made by other right hon. and hon. Members.

Before I come to the substance of the debate, I would like to thank Kalayaan for its work. Kalayaan is a charity offering direct support to migrant domestic workers. It was instrumental in arguing for the new migrant domestic worker visa, which has worked, as I will demonstrate, but which sadly does not extend to migrant domestic workers employed in diplomatic missions. Kalayaan runs advice sessions with a focus on immigration and employment, as well as an excellent community centre, which I had the privilege to visit the other week. It also runs activities for clients, including English classes, training, and confidence building workshops. It hosts a social area, too—a safe space where migrant domestic workers can meet other people and access advice and support away from the ever-watchful eyes of their wealthy employers.

The newspapers are full of criticism of my trade union, Unite—the old Transport and General Workers Union—of which I am proud to be a member, as I will be until my dying day. I pay tribute to the work of Diana Holland of Unite, who has made the issue of migrant domestic workers a personal crusade. I am delighted that she might be heartened, depending on the Minister’s answers—I know that he wants to agree with me—by the continued progress that we could make on the issue if we used the powers available to us.

The issue involves the abuse of some of the most vulnerable people in our country, if not our society—they are barely in our society. For many of us on the left side of politics, such issues are what brought us into public life and politics in the first place. However, of course, concern does not exist only on the left. We must acknowledge the huge contribution made by the hon. Member for Totnes (Mr. Steen)—I want to call him my hon. Friend—who chairs the all-party parliamentary group on the trafficking of women and children. It is probably one of our most active all-party groups and has an impressive track record, having organised an important meeting with the Minister on 24 November to highlight the abuse of migrant domestic workers and the workings of the migrant domestic worker visa system. His response is still sought.

I understand that the all-party group has set up 11 such groups in Parliaments across Europe. That is a genuine example of how the much-maligned all-party parliamentary group system can forge important links across national boundaries.

I am grateful to the hon. Gentleman—my hon. Friend, if I may call him that. We all feel great affection for the Minister. We enjoy his company and think that he does a jolly good job. It is true that on 24 November, I took a delegation of some of the most senior people in this House and the House of Lords, along with representatives from Kalayaan—a group to which I pay tribute—to see him and explain to him the terrible problem of domestic slavery among diplomatic overseas staff. He understood the point, and the group and I were left in no doubt that he would act on it. However, lovely as it is to see him here, I hope that he will be able to tell us that today is his opportunity to put matters right.

I thank the hon. Gentleman for that intervention. I remain optimistic that when the Minister hears the power of our arguments, he will cast aside the bleating and whining of the Foreign and Commonwealth Office and other powerful vested interests, be forthright and join us as a brother in arms on the issue. I have no doubt about it; at least, I certainly hope that he will if he wants to stay on my Christmas card list.

Before 1997—this is not a party political point—migrant domestic workers had virtually no rights. They were brought into this country by wealthy foreign nationals, and probably by even wealthier British expats, who, I am assured, like continuity in their domestic servants. There was no specific visa. Migrant domestic workers were often given a bizarre “to work with” stamp on their passports. It was a grey area. Alternatively, they were brought in on tourist visas and encouraged to overstay, as they would then have absolutely no rights. Their passports were often confiscated, leaving them totally in thrall to their employers. Migrant domestic workers’ undocumented status effectively created a bonded labour scheme, which was undoubtedly a trigger for abuse.

In the 1997 manifesto, the Labour party committed to introducing a new migrant domestic worker visa that would allow workers independence from their employers. It was launched in 1998. I have no doubt that a Government of almost any political persuasion would have wanted to address the issue, but it is to the credit of this Government and the Minister’s colleagues that the visa was introduced.

The migrant domestic worker visa is now issued to people entering the UK accompanying an employer to work in the employer’s private household. It provides protection against abuse. It provides formal recognition of migrants as workers and allows them to change employers, although not their work sector. Migrant domestic workers are therefore no longer bonded to a specific employer. It was a civilising and thoroughly laudable change, introduced by this Government.

The visa may be renewed annually, provided that the worker continues to be employed full time as a domestic worker in a private household. It provides an escape route from bonded labour for people suffering abuse. I will cite some harrowing case studies later to illustrate what types of abuse occur. Nevertheless, migrant domestic workers across the piece still experience high levels of abuse and exploitation. There is now at least an escape route through the visa system, but that system does not apply to the staff of diplomatic missions. That will be the nub of my argument.

Things nearly went wrong. In 2006, the Government introduced the points-based system, which the Home Affairs Committee considered in some detail. For some reason, initial proposals were made to abolish the migrant domestic worker visa, which would have resulted in the loss of the current protection for migrant domestic workers, who instead would have had to enter the UK on a six-month, non-renewable visa that would tie them completely to their employer and give them no effective access to UK law. However, following campaigning by the all-party group and Kalayaan, the Government gave a welcome response.

In 2008, the Government response to a consultation on visitors to the UK gave a commitment to retaining the migrant domestic worker visa, at least until spring 2011. I shall read into the record the response from the Minister’s predecessor, my right hon. Friend the Member for Birmingham, Hodge Hill (Mr. Byrne):

“In our consultation paper, we set out the current arrangements for overseas domestic workers who accompany their employer to the UK, recognising stakeholder concerns that such workers may be the target of employer abuse and exploitation. We explained that research and analysis was being conducted into the route, following which we would consult further on future arrangements.

We are committed to ensuring that future arrangements concerning overseas domestic workers minimise any risk of abuse or exploitation. In addition, the current route will be preserved and then reviewed as appropriate after the first two years’ operation of the reformed immigration system and when we will have properly road tested our antitrafficking strategy.”

He confirmed that point in a follow-up letter to Diana Holland of Unite, so it is on the record that the Government are committed to that policy, at least until 2011.

Today, the Minister can not only commit this Government to the policy, but say that he will tie the hands of a future Government so that they have to continue with it, because it works. By tying the hands of a future Government, we might untie the hands of people who are forced into mediaeval, feudal slavery. I hope that he will rise to that challenge.

If hon. Members will bear with me, I wish to share some horrific case studies. I apologise for going on at length, Mr. Benton, but this is an important issue and I wish to put the case studies on the record. I am indebted to Kalayaan for this information. I will cite four examples: two from the domestic sector and two from the diplomatic sector. The names have been changed for obvious reasons.

The first case study gives proof that the visa works if the domestic worker understands the rights that they can access. It is the story of Rosy, who comes from Nigeria:

“My name is Rosy. Life was hard ever since my childhood. Fatherless at the age of 8, I had to help my mother to look after my siblings while she was away to work in the farm. I was an out of school youth at the age of 14 because my mother could not afford my education anymore. I had to face humiliation when my boyfriend left me pregnant. A teenage mum at 16, I was too young to face this kind of heavy responsibility but I had to be strong and brave. Without any qualification, I set off in another land in Nigeria in search for a job that would give my daughter and family a better life.”

She went on to work in difficult circumstances.

In 2004, Rosy was offered work in London for people who needed a domestic worker:

“The employer said that I will have the opportunity to be a British citizen and I will be paid 50 pounds per week which was higher compared to my 2000 Naire per month. I was reluctant to accept the job because I was too frightened that I will be all alone in a foreign land with no-one to turn to. But my dream of giving my family a better life had softened my heart to accept the job.”

This is the shocking part:

“My employer is a lawyer. I did not know anything about my legal rights in this country and I only had to depend and believe every single word or command that she has to say. My responsibilities were looking after her two children and fully in charge of all the household chores and in some occasions, looking after her extended family and friends. With long hours of work and no day off, I had to pray for midnight to come so that at least I could rest for a few hours.

My employer began to abuse me both verbally and physically. My ears were already numb from her shouting, calling me illiterate and stupid. Worst, more often, she would twist my ear, pinch and slap me for every little mistake that I had done. She would threaten me and say that the police will arrest me if I cry or talk to anyone. I cried every night and asked God, ‘Is this the life I deserve?’ or ‘Are all people in this country as heartless as my employer?’ or ‘Is it true that, in this country, I could not speak out and cry?’ I thought, gone are those days where people have to work as slaves but I was a slave, a modern slave in these modern days.

One day, I received a call from my brother back home. Worried that something bad was happening with my family back home, I rushed outside to buy an international phone card. However, my employer did not allow me to go outside without asking permission, and she discovered that I had disobeyed her golden rules. She was very angry and began to shout and beat me. She smacked me around my face, head and upper body while chasing me down the stairs. My left eye was bruised and bloodshot after this incident. As I could not bear the pain, I cried very loudly and our neighbour heard the noise and knocked on the door but my employer did not open the door.”

The lawyer did not open the door. Rosy goes on:

“One morning, the neighbour saw my bruised eye and asked about it. I told her everything and she explained to me that my employer had no right to abuse me and that I could report her to the police and most importantly, she said I had the right to speak out. I finally found answers to my questions. This kind and loving woman did everything to help me so that I could get out of that cage where I was treated, not as a human being but as an animal and a slave.

An organisation called Kalayaan helped me with everything I needed and referred me to the Kensington Law Centre who helped me pursue the case against my employer which I won in the Employment Tribunal.”

Hon. Members need to appreciate that without the migrant domestic worker visa, there would have been no opportunity to access the employment rights or the legal protection that other workers enjoy.

Rosy continues:

“I also received support from Liberty. The police’s initial response was that no crime had taken place because it was an employment issue. Thanks to Liberty, the police have now reopened the case and are investigating an allegation of trafficking against my previous employer.

Although the Employment Tribunal found that my employer withheld my wages, abused me verbally and physically and discriminated against me on grounds of my race, I do not feel that I have had justice for the way that I was treated. My employer is a lawyer and I wanted her to know that she is not supposed to treat people in the way she treated me. She should know that she is not above the law. I wanted the police to ask her why she did it and for her to be punished. Most of all, I do not want anyone else to have to go through what I went through.

I am now fully aware of my rights as a worker and as a human being, I dare to challenge and am always ready to face bravely any forms of abuse, discrimination, inequality and slavery in this modern world.”

That was Rosy’s story.

The next story is from the diplomatic sector. The name has again been changed for fear of reprisals. Aliah jumped at the opportunity to work for a diplomat posted to the embassy of a middle eastern country in London, but her dream job soon turned into a nightmare. She found herself trapped for six months in slavery with an employer who routinely abused her. She says:

“At first I was really excited to move to London and work for the diplomat and his wife. The plan was that I would live with the family and be a nanny to their young son. I hoped to learn English, and experience what life was like outside of my country. I thought I could earn some money so that when I came home I could study.

I moved to London with the diplomat a couple of weeks before his wife and child arrived. I quickly realized I had made a terrible mistake in taking the job. From the very first day I was treated like a slave, and it immediately became clear that the diplomat wanted more from me than just to look after his son. He sexually molested me and would become angry when I refused his advances.

In many ways life became even worse when the diplomat’s wife arrived. I was forced to work for 17 hours a day doing all the cooking and cleaning as well as the nanny work and was never allowed a day off. The wife would stand over me and criticize everything I did. She would get violent and throw things at me as well as shouting at me and calling me names.

I was completely trapped like this for 6 months. I was only ever allowed to leave the house to buy milk. I am embarrassed to admit it but I actually used to look forward to going to the shop. It was the only chance I had to see the outside world.

One day the diplomat got really angry with me. His wife had thrown me out of the house and when, after walking around for a few hours, I returned, the diplomat was drunk and furious. I was too scared even to answer as to where I had been, he became really violent, he threw me against the wall and started bashing my head against the front door. I was so scared that I knew I had to escape, when a car passed and stopped I seized my chance.

I ran straight into the street. I didn’t know anybody, didn’t have any identity documents and didn’t have any money. I was crying uncontrollably and bleeding from my head, I was lucky that a man who spoke my language spotted me. Eventually I explained to him that I needed his help and though he was a complete stranger he took me in and agreed to help me.

He took me to the police to report what had happened and they sent me to the hospital. The man then took me to see Kalayaan to see what could be done for me. They agreed to help me seek justice. Despite working for 6 months I had not been paid a penny. But apart from wanting my rightful earnings I really wanted to make sure that the diplomat and his wife were punished for what they did to me.

Lawyers helped me take the case to a tribunal, my employer never responded and on the evidence they had been given, the tribunal ruled in my favour and awarded me compensation for unpaid wages and sexual discrimination. The only problem is that obviously my employers have diplomatic immunity and the Embassy sent them home to avoid further embarrassment.”

That means that Aliah’s employers have escaped punishment and it is impossible for her to receive the compensation and justice that she deserves.

There are countless other cases. I have information about a lady called Chinue from Kenya who was beaten appallingly and psychologically abused by her employer. Luckily, she has been able to find work through the POPPY project and has put her life back on track again. Another case concerns Maria from the Philippines, who worked for the family of a diplomat in his home and agreed to accompany him to London. The conditions were nothing like she expected. She had to sleep on the floor in the hallway outside the bathroom, and she was made to sign something that stated she was receiving more salary than she was. She was forced to work for 18 hours a day, and she was shouted at and called an illiterate idiot or mountain folk by the diplomat’s wife.

Maria came to Kalayaan for advice when she discovered that her only choice was to return to the Philippines because her visa does not cover the diplomatic area. She was distraught at that news. Things got worse in the house. Two months later, Maria was physically attacked by the diplomat’s wife who tried to slash her with a kitchen knife, and Maria fled. She took a case against her employer, but settled for a very low amount because she wanted to move on with her life.

I congratulate the hon. Gentleman on obtaining this important Adjournment debate. It is good to hear the news that the Government will extend the visa scheme until 2011. I sympathise with the hon. Gentleman because we have had four similar cases in my constituency. Does he agree that it is essential we get this right, because we cannot operate some of our most essential services in Great Britain without these people?

I agree entirely. I thank the hon. Gentleman for his contribution and for confirming that the problem is clearly not just confined to London—unless he has moved constituencies. It is useful to hear that such an appalling situation is widespread, as it puts more pressure on the Minister to respond publicly.

The hon. Gentleman need not rush. There is plenty of time and everyone wants to hear what he has to say—I certainly do. May I just mention that the problem is not confined to women? Men are abused too. I recollect that a man who was a diplomatic driver for an embassy spent his life in a garage, where he slept. Does the hon. Gentleman know about that case?

Do I know about that case? I saw that case. I will not name the embassy because it would probably be inappropriate for me to cause an international incident in my last two weeks as an MP. However, I will say that it was a south Asian high commissioner’s residence. If people want to look at my interests in south Asia, they can probably work it out. I was invited to a very salubrious dinner at the high commissioner’s—we all get to go to such things from time to time. I was appalled to walk out of that residence in a palatial part of north London and see that the accommodation of the guy who picked me up—the driver for the high commissioner—was a garage. He showed me where his bed was. Such things are happening with impunity and they are an abuse of immunity.

As we know, the migrant domestic worker visa was introduced from 1998 onwards. People may argue that if we extend the visa to the diplomatic sector, large numbers of people would get protection, and possibly the right to settle permanently in the UK in certain circumstances. It was also argued—I think primarily by civil servants—that introducing the migrant domestic worker visa could lead to abuse and an increase in numbers. I am delighted to say that has not proved to be the case. If we consider the number of non-diplomatic domestic worker visas issued between 2005 and 2009, we see that the figure decreases from 16,908 to 14,897. Let us be clear: the process has not been abused. On extending the scheme to diplomatic staff, the numbers of diplomatic domestic workers visas that have been issued are: 235 in 2005, 324 in 2006, 253 in 2007, and 189 in 2008. Those are tiny numbers. There is no problem with extending the migrant domestic workers visa provision to protection for diplomatic staff. We are talking small numbers, but my goodness, we are talking high levels of abuse.

Figures on the people who were referred to or came voluntarily to Kalayaan—they can be found on its website in its excellent annual report—show that 17 per cent. reported physical assaults, 58 per cent. reported psychological abuse and 59 per cent. were not allowed out of the house without supervision. We allow our pets out of the house without supervision, yet fellow human beings are effectively being shackled in their place of work.

Has the hon. Gentleman had the opportunity to get in touch with the diplomatic service, because there is an organisation that represents diplomats as a whole? Has he taken the matter up with that organisation, because it sounds as if this is such an outrageous abuse that something should be done either by the law or by internal diplomatic activity? The people concerned should be ashamed of themselves.

The hon. Gentleman is absolutely right: they should be ashamed of themselves. I will come to that point later. Unfortunately, I have not had time to take the matter up with organisations representing diplomats. I must say to him that the more I read of these case studies, frankly, the less I want to be in a room with organisations representing diplomats. However, I am sure that those who succeed me in this place will not let the baton drop until we remove the appalling levels of abuse that are happening not just in London but in other parts of the United Kingdom, as I have just heard.

In many cases, workers have absolutely no knowledge of their immigration rights and status. If their passports and papers are confiscated, the employer has the absolute whip hand. Such workers live in fear of criminal prosecution, deportation or any sort of threat—valid or otherwise—that the employer can choose to make. We outlawed slavery in 1833, which was an awfully long time ago. As far as I can see, what is happening is little better than a 21st-century system of slavery.

What needs to be done next? First, as I said, the Minister and his colleagues deserve great praise for not only tackling the abuse of migrant domestic workers in the past by introducing a specific visa, but wanting to extend it beyond the 2011 commitment given by his predecessor in the Government’s response. My first challenge to the Minister is that he takes this opportunity to offer long-term protection for this most vulnerable group of workers, beyond 2011. He can do that today; he can it read it into the record.

Secondly, as I have mentioned, appalling and completely unacceptable abuse is still occurring in some—not all—diplomatic missions in London right now. It is an affront to a civilised society and a scar on the conscience of nations whose representatives are still prepared to treat their fellow human beings as 21st-century slaves. What they do in their own countries is one thing, but what they do in our country is a matter for us and for this Parliament. Frankly, I do not give a flying fig about the representations from the Foreign and Commonwealth Office or the worries about upsetting important international partners. This is a domestic British issue, and it needs to be resolved.

We have confirmation from Government lawyers that extending the migrant workers domestic visa to diplomatic missions would not be in contravention of the Vienna convention on diplomatic relations. What diplomats bring in their diplomatic bags may be a matter for them, but how they treat fellow human beings and how they bring fellow human beings as workers into our country is a matter for us and for our legislative process. Migrant domestic workers suffering abuse at the hands of diplomats must be empowered to access the same employment rights as their counterparts in the domestic sector.

Will the Minister state today that he is prepared to bring an end to the disgraceful abuse of diplomatic domestic workers by a handful of embassies that clearly believe that human rights are a problem for someone else and not for them? Diplomatic immunity can never be used as a cover for feudal servitude, which has no place on this planet, never mind in the capital city of one of the most advanced democracies in the world.

I congratulate the hon. Member for Reading, West (Martin Salter) on his impressive and fluent speech and on raising a critical issue in the way he did, and I thank you, Mr. Benton, for calling me to speak. I will not speak for long, as I am supposed to be, if not looking after, at least involved in an Albanian delegation from the Inter-Parliamentary Union, at a meeting in the IPU Rooms. I hope it will not be seen as a discourtesy to hon. Members if I do not stay for the winding-up speeches, but I will be listening in every other way to what the Minister says.

We need not recite the problem, as the hon. Gentleman has explained it. I understand the Minister’s concerns and those of the Government. The issue, roughly, is that developed countries, such as those in western Europe, have staff coming in to assist people who need domestic help, which is nothing special. Between 14,000 and 16,000 people a year get domestic work visas, which do not entitle any of them to live in the UK permanently. I think they must renew the visas yearly—the Minister can correct me—and can go on doing so, although they must also report to the police annually. I do not think they have any right to settle here. The Minister’s advisers will be telling him whether I got that right, but I think I did, largely because he told me about it.

There is no problem on the domestic front, thanks to the Government’s decision to change the rules, as the hon. Member for Reading, West said, and until 2011 it is a totally safe arrangement. The hon. Gentleman asked whether it will go beyond 2011, and I believe the Minister should today state that it will be extended for another three or five years, because it has worked well and been a success.

The problem relates to the small number of domestic workers who come to the UK under a diplomatic visa, which is a restrictive visa, and who often arrive with the officials they worked for in the countries they come from. They might be chauffeurs, domestics or nannies, and often they arrive with a diplomat’s family. The allegation is that the family changes, in the manner of Dr. Jekyll and Mr. Hyde, as soon as they arrive. One must have some regard for the notion that the domestic workers talk to other people and realise that they are getting a pretty rough deal by comparison. I am fully aware of that aspect of the situation, but another aspect is the abuse of domestics.

I pay considerable tribute to Kalayaan, which is a modest organisation that meets in a church in Notting Hill Gate. It has extremely effective staff who have done an amazing job over the years to attract people who are being abused. Kalayaan has become known as a place where abused people can get solace, support and practical help. I pay tribute to the organisation and its workers, who are outstanding. Its runs on a shoestring. In fact, the Government might consider supporting it a little, because they give £1.8 million to the POPPY project and £1.8 million to the UK Human Trafficking Centre, yet they give nothing to an organisation that actually works with people. Perhaps the Minister might respond to that comment in his winding-up speech, because I know he is listening carefully. The Government should be giving money to non-governmental organisations, and not just the big ones.

There is a small number of abused women in that situation. There are examples of rape, sexual abuse and physical abuse through punishment and assaults, and those are a minority. However, the visas prevent those people from moving employment, as there is a bar on moving. The result is that the only way they can escape is to be deported, because once they escape they have no status in this country and must be deported. That is the pattern, so they are between a rock and a hard place.

The hon. Gentleman is coming to an important point about people who are in an invidious position, sometimes in very difficult circumstances. They have been abused and then face an alternative that they believe could be even worse—if they are deported from the United Kingdom their situation may become even worse in their home countries.

That is the problem, and it is more than just that those workers come from poor countries. The real problem is that they go back having failed in the UK, and their small village communities think they are a pariah and that they cannot be employed because something must have happened. They cannot go back easily. They can go back easily once the diplomat’s family returns because that will look like they have been successful, but if they are deported by the British Government, which is the pattern, they have no future at all. That is the picture we have in this country.

Does my hon. Friend agree that much of the attitude that lies behind the behaviour of the diplomatic staff in question is in fact mediaeval? The hon. Member for Reading, West (Martin Salter) mentioned slavery, an issue on which my family were very much involved in the 19th century, along with other Quakers such as Fowell Buxton. They understood that the importance of ensuring that people had their rights was absolute. We have moved on from the whole culture of master and servant, which even I had to learn when I was training to be a lawyer. Do my hon. Friend and the Minister agree that it would be a good idea to ensure that the diplomatic service comes into the modern age and leaves that mediaeval culture?

We always stand in awe when my hon. Friend makes such suggestions. He is perfectly right to say that we need to change the master and servant concept. We are talking about quite a number of embassies and officials who treat their staff like animals, or worse.

It was remiss of me not to refer to the process by which we are all here. Would the hon. Gentleman pay tribute to the excellent piece in The Times in January by Alice Fishburn and Hattie Garlick highlighting the brilliant work of Kalayaan, and some of the case studies to which I referred? I put on the record my thanks to the staff in my office, including Sadie Smith, whom I do not treat like slaves, who drew the matter to my attention and suggested that it was something I might like to get involved in. It is a tribute to the way this Parliament works that a Member can spot an injustice and in a few weeks be here challenging the Minister. Long may it remain that way.

That is also a tribute to the influence and luck of the hon. Gentleman in managing to persuade the Speaker’s Office to pull his name out of the hat for this debate. I pay tribute to his skill in ensuring that it has taken place.

We are talking about hundreds of workers who have a diplomatic domestic visa, but not thousands. Indeed, it could be dozens a year, rather than hundreds, but every one is significant and important. Their lives are ruined as a result of what is happening to them.

When I visited Kalayaan some months ago, I met a girl who was so desperate because of her lifestyle that she escaped from the diplomat’s house and went along bus queues in the street asking for money for food. She was sleeping rough because she did not know what to do. We cannot have that happening in London or in Britain. Just a stroke of the Minister’s pen could change the situation. All we need to do is ensure that the diplomatic visa allows the domestic to move from an employer. That is all it would take, but they are barred from moving from their employer.

Is there perhaps another remedy? Diplomats found to be engaged in activities against the state—infringing our national security, for example—can be requested, in effect told, to get out. If there is clear evidence of abuse by individual diplomats, they should be sanctioned in the same way as other diplomats are sanctioned when they infringe our standards. We know that it is not all diplomats, all embassies or all middle east personnel who are involved, but simply a coterie of people who are thoroughly evil.

That is a perfectly good idea, but where does it leave the domestic? Do they go back with the shamed diplomat?

But the problem is that the domestic is linked to the diplomat’s visa, so if the diplomat is sent home, so is the domestic.

At the risk of engaging in a full debate on the issue, I believe that it is possible in such circumstances, for the sake of protecting the individual concerned, to deal with the problem. We find this so often in other areas of the law. My hon. Friend the Member for Ashford (Damian Green) knows only too well that one can give protection to a person through asylum or something of that kind. It is clear that this problem has to be dealt with, and it is equally clear that there are remedies. It is the diplomat who is at fault, not the person who is the victim.

The problem with what my hon. Friend suggests is that it will bring into the equation all the paraphernalia of refugee status and asylum seeking—all that contraption. I know that my hon. Friend, who is a lawyer, likes to make things complicated, but this is a simple problem. If we simply move diplomatic domestic visas into the ordinary domestic visa group, we will not have the problem of the domestic being forced to stay with a diplomat who treats them badly.

It could be argued that we would be bringing in more domestics through the diplomatic channel who would then move to the domestic market to get away from the diplomat, but we are talking about tiny numbers. We are not talking about an increasing number: I believe that it was 18,600 in 2006 but is now down to about 14,000.

Surely what the hon. Gentleman suggests would deal with the symptom rather than the problem. The problem is the diplomat. We must deal with the problem while giving protection to those who suffer because of the actions of the diplomat.

That is right, of course, and I thank the hon. Gentleman for his intervention. I am trying to find a solution for the victim, who is here in Britain, being abused by a diplomat with diplomatic privilege, and who is linked to the diplomat. Although one could say, “Send the diplomat back”, there is a difficulty with evidence. One of the problems is that victims of human trafficking and abuse will not give evidence, for understandable reasons. They are terrified that their family back home will be abused, but I shall not go down that line.

May I just inform the debate that in a significant number of circumstances, domestic staff in missions are not necessarily nationals of the countries for which they work? Therefore, their status in that country may be jeopardised as well. For example, if a Filipino person working in a middle east country transferred to the UK, their status and livelihood in the country of the mission must also be considered. I do not know whether the hon. Gentleman agrees with that point.

This is developing into a most interesting discussion, and all the points are valid. I am grateful to the Minister for his intervention and for his interest in and concern for the subject. No one has any doubt about that. We need to find a solution, but that is not being dealt with.

As the Minister knows, I went to see him in November with part of my all-party group on trafficking of women and children. I was with the distinguished hon. Member for Oxford, West and Abingdon (Dr. Harris), the right hon. Member for Birmingham, Ladywood (Clare Short), who is a vice-chairman of the group, and my hon. Friend the Member for Wellingborough (Mr. Bone), who is a treasurer of the group. I had support from the other House from none other than Baroness Nicholson of Winterbourne, who is another treasurer, and Baroness Butler-Sloss. All of us were saying, “Do something.”

I know that the Minister has been working hard on the problem, but he has failed, because, as of today, a solution has not been found. There are various solutions, but there is simple one to start with. We will not be able to change all embassy staff, and we cannot start sending all or even some of them back because we do not like them, but we can ensure that all diplomatic domestic visas are domestic visas.

I do not know whether the Minister can tell us how many diplomatic domestic visas are issued every year, but I believe that it is in the hundreds. The total number of domestic visas is in the thousands, so it would not be increased very much. In any case, the number has gone down by 4,000 in the past few years, so it would not be knocked back to what it was.

Every civilised western European country has domestic visas, and there is no problem with them. We have a problem because we have a particular group of visas that locks the domestic into the life and future of a particular diplomat—not even the embassy. Perhaps the Minister could think of a way round that gives the diplomatic visa to the embassy, not to the individual.

All I am saying is that the problem needs to be addressed. My solution is simple, it will not cost anything and it will not give anyone any other rights. All it will mean is that the diplomatic domestic visa, which in the past has prevented people from moving from their employment, would allow them to do so if they needed to. They would report to the police every year, just like everyone else. That is all that needs to be done.

I pay tribute to the hon. Member for Reading, West. He has the problem by the short and curlies. He will pursue it vigorously, as I shall. Kalayaan has been at the receiving end. It says, “What can we do? We are dealing with victims. What can we do about them?” It can give them love, sympathy and support, and there can be tribunal hearings, but that does not solve the problem. Instead, it allows the equipment and machinery that were there in the first place to remain.

Forgive me, Mr. Benton, if I do not carry on in my usual lengthy way. However, if my contribution has been lengthier than usual, it was because of all the excellent interventions that I have taken. I hope that the House will forgive me if I now go to see the Albanians. They have a big problem with human trafficking, although they may deny it. It is interesting that the chief of police in Albania says that the number of people who are trafficked is going down. It is not—they are just not finding them. That is the other side of the story.

I am on the European Scrutiny Committee with my hon. Friend, and have been for many years. He, too, is leaving Parliament, and I would like to place on the record the fact that his work in this field has been outstanding. Whatever criticisms have been made of him, they pale into insignificance compared with the fantastic work that he has done on human trafficking. I have seen him furthering his cause while we have been in other European countries for European Scrutiny Committee meetings. It has been a great pleasure and privilege to work with him in these matters.

I was just about to sit down, but I am glad I did not, because my hon. Friend’s response was kind and quite unprompted. I am moved by what he says and I am grateful to him for saying it.

I have given a full and deserved tribute to the hon. Member for Totnes for the excellent work he has done on this issue. I shall give him some comfort as well. Although I shall be leaving this place shortly, I shall remain a member of my trade union. I am going abroad for a few months, but I pledge to work with him, Unite and Kalayaan on taking the issue forward when I return to the UK.

May I thank the hon. Gentleman for his offer? I am most touched.

The problem can be dealt with. It is a problem that we do not see because it is all underground. There are more people today in domestic and human slavery than there ever were in the 350 years of the African slave trade. That is the scale of it. However, it is not seen because it is all submerged, whereas the African slave trade could be seen: it was a visible thing. We are talking about domestic slavery—it is actually slavery—although Wilberforce and this place were supposed to have abolished it. The Minister, whom we hold in great affection, must not be allowed to drag his feet. We must deal with this matter. He cannot blame the Foreign Office or anybody else. He must take the problem by the short and curlies and solve it.

I am most grateful to you, Mr. Benton, for your chairmanship this morning.

I, too, congratulate the hon. Member for Reading, West (Martin Salter) on securing this Adjournment debate. It is clear that slavery has been banned in this country for some time. Whether there is a claim under the European convention on human rights for anyone who has a diplomatic domestic migrant worker visa is an interesting question that Kalayaan may wish to consider. I understand that people have got ordinary domestic migrant worker visas after having had diplomatic ones—that might be a potential route in one or two cases—but the reality is that there is an arrangement that bonds an employee to an employer, which creates bonded or indentured labour, or slavery; there is no question about that.

The test of whether somebody is in that position is whether they can run away. If they cannot run away without suffering serious sanctions, there is a problem. Changing a diplomatic visa to a non-diplomatic visa would not necessarily extend the visa or increase the person’s other rights—it just gives them a chance to run away from slavery.

I congratulate Kalayaan on its work. In 2008, 27 diplomatic domestic workers were registered at Kalayaan, and in 2009 there were 24. That is a high proportion of the 200 diplomatic domestic worker visas that are issued per year; 253 were issued in 2007 and 189 were issued in 2008. If the arrangement is changed, the behaviour of employers will be modified, because the employer-employee relationship will be changed, and the employees will know that there is a mechanism by which they can establish their rights.

The hon. Gentleman highlights the statistics eloquently. About 200 to 300 visas are issued, and about 10 per cent. of people with those visas find their way to Kalayaan. We hon. Members know, from our casework, that only a tiny proportion of people who suffer from an injustice take action to try to remedy it. The problem could be considerably more widespread than the raw statistics suggest. Does he not agree?

That is true, and I thank the hon. Gentleman for his intervention. People will be here for more than one year at a time, so there are perhaps 500 such people here at any time. We are talking about a high percentage of people being willing to take the risk of a sanction against them—that is the critical thing.

And their families. Those people are willing to, and do, take the risk of a sanction against them. We have quoted the figures of 16,000 and 14,000 ordinary domestic worker visas, and the numbers registered with Kalayaan for 2008 and 2009 respectively were 369 and 354. Although there are a lot more ordinary domestic workers, the relevant proportion is lower, which shows that the nature of the arrangement is different.

There are other issues for the Government to consider; for example, what are they doing about the national minimum wage in respect of migrant domestic workers generally? The Select Committee on Home Affairs understands that the UK Border Agency is issuing visas even though it knows that the minimum wage will not be payable. That sounds unacceptable. What are the Government doing to ensure that access is made available to the limited number of English language courses? Will the Government give us any estimates or figures on the extent to which people are trafficked into domestic labour? That argument takes us on to the points-based system. There is a real challenge in how the matter is handled, because we do not want to create a bond between employer and employee that prevents people from running away.

What steps are the Government taking to deal with fact that, outside the Gangmasters Licensing Authority sector, enforcement of employment law is at times non-existent—an issue that was raised in the Home Affairs Committee report? There is a difficulty with international law and diplomats—there is no question about that—but we come back to the fundamental point, which is the ability to run away. If people are not able to run away, their rights cannot be enforced. Given that only 114 employers have been prosecuted for employing illegal workers since 1997, can the Government tell us how many people, if any, have been prosecuted for offences relating to the ill-treatment of a migrant domestic worker?

What steps are the Government taking to ensure that where offences are suspected to have been committed, legal advice and support is given to the victims to aid prosecution, and to those who wish to bring employment tribunals against their employers? There is a problem with employment law when it comes to diplomatic missions, but there is also the question of whether we should be negotiating with foreign Governments, so that there is a sanction, not against the employer, but the state as a whole.

The Home Affairs Committee found that

“police do not always understand”

the “special status” of migrant domestic workers, and that

“the immigration authorities frequently fail to follow the correct procedures for issuing visas…that would help to identify abuse.”

What steps have the Government taken since the publication of that Committee’s report to raise awareness of those problems with the relevant authorities? The Committee states that the current rules, which are part of a two-year extension, will need to be in place for far longer than two years to ensure protection from exploitation for those people, as various hon. Members have said. What is the Government’s reaction to that?

This is a difficult area, but there is a basic, simple principle: we oppose slavery. Indentured labour is slavery. To avoid slavery, people have to be able to run away without suffering. There will always be an element of suffering, because people will not have a new employer straight away, but they should not have to jump off a cliff to run away: that is not acceptable. There has to be a mechanism for people to leave an abusive employment relationship—to run away from slavery—and not be punished.

May I, too, congratulate the hon. Member for Reading, West (Martin Salter) on securing this debate and on raising this topic, not least because although we are talking about one small corner of the wider area of trafficking and modern-day slavery, it is, as other hon. Members have said, often hidden and paid insufficient attention?

The Minister and I are both veterans of various debates in this place on human trafficking. I frequently observe that the debate is in danger of sliding into one about prostitution and sexual slavery, which is clearly a hugely serious issue facing us, but not the whole story. This is another part of the story. Those of us who have been talking about trafficking and modern-day slavery for many years are always grateful for the opportunity to expose other parts of the wider issue.

In his absence, I should like to pay tribute yet again to the work that my hon. Friend the Member for Totnes (Mr. Steen) does on the all-party group on the trafficking of women and children. That is a model of how to use an all-party group. Those bodies are often rightly excoriated for not contributing much to the enlightenment of humanity, but my hon. Friend’s group has not only exposed problems, but has shifted public policy, and one can pay no higher tribute. I sometimes think I have been paying tribute to him for so long in these debates that even when he has gone I will continue to do so from force of habit.

We often discuss trafficking for sexual exploitation, and that is important, but it is important to consider whether the same solution could apply to the problems in both the diplomatic and non-diplomatic spheres—an issue that has been raised significantly during the debate. There is a huge overlap, but there are clearly different solutions. My first thought on listening to the debate was about something that we could do across the board about domestic exploitation of migrant domestic workers. This country may have been insufficiently clear in sending out a message to those who want to come here from the rest of the world, whether to do a normal job or as diplomats, that it is entirely and completely unacceptable to treat domestic staff in the way illustrated in the examples produced by the hon. Member for Reading, West. I agree with him that the issue is not what is appropriate behaviour for a diplomat—or for anyone—elsewhere in the world, but how people behave in this country.

We all—the Minister representing the Government and all of us as parliamentarians—have a right to say that we in this country represent certain values, including decent behaviour, and abusing domestic staff in the way that Kalayaan exposed is unacceptable. I echo the tributes paid by many hon. Members on both sides of the House to its work. We can all do something to make it clear that people must assume British behaviour if they come here to live and work, whether as diplomats, lawyers or anything else.

I did not hold back in my criticism of abuse by diplomats, but the nub of the problem that led to the Government introducing the migrant domestic worker visa—we have illustrated that it is working well—was that it affected not just foreign nationals; plenty of British expats were happy to behave as feudal barons in their own homes, and they were part of the initial problem that was identified and that led to the visa. Does the hon. Gentleman agree that we should be tough on the diplomats, but should remember that some of our own have fallen short of the standards that we in Britain expect?

I will make a point about the rule of law applying to everyone, which has been brought home to me by the force of this debate.

We know that in the UK, exploitation of labour is common in certain spheres—agriculture, construction, contract cleaning, the care sector and, indeed, the domestic sector. There have been many tragic examples in addition to the terrible and chilling ones that we have heard this morning, such as the Chinese cockle pickers at Morecambe bay and the lorry full of Chinese workers at Folkestone. We must become more effective across the board at combating that.

Reference has frequently been made during the debate to the fact that the Government gave themselves two years after introduction of the points-based system to examine the matter to see what was happening, and I understand that they are gathering facts and research. I hope that the Minister will give us an update on what evidence he has gathered. In terms of whether the current visa system could be integrated into the points-based system, I am not entirely sure how widespread the evidence will be because, with the rest of tier 3 at zero, there will be no obvious comparators. However, I assume that the Government have collected hard evidence on the incidence and possible patterns of abuse, and how best it can be prevented. I look forward to hearing that.

The debate has brought home the importance of hard evidence. I know how difficult it is to get it when many of those who are most capable of giving evidence are prevented from doing so by understandable fears. The exchange between the hon. Member for Birmingham, Yardley (John Hemming), and the hon. Member for Reading, West, was instructive because the debate proceeded on the assumption that what we are seeing, particularly in the diplomatic area, is the tip of the iceberg. The hon. Member for Birmingham, Yardley, rightly said that we all assume from other cases of exploitation and abuse that we hear about in our surgeries that there are many more people out there in that situation than approach their MP or a pressure group about it, but we do not know that. As has been said, the numbers are very small. A few hundred visas are issued every year and a few dozen people approach their MP or a pressure group every year. To proceed in such circumstance with the assumption that we are seeing the tip of the iceberg and not the iceberg itself might be wrong. I am not saying that it is wrong, but we do not know, and we should accept that we do not know. Trying to make policy on the assumption that we are seeing the tip of a large iceberg is dangerous.

I hope that the Minister will tell us that his Department has obtained evidence of absolute numbers, and of the percentage of domestic workers who are brought here and then abused—a percentage on which the Department can reliably base future policy.

I hesitate to criticise a fellow Reading football club fan, and I know that the hon. Gentleman is supportive of the issue, but there is a certain strangeness in the argument that although it might be okay to right a wrong that affects 10 per cent. of people, the fact that we do not know whether it might affect 15, 20 or 25 per cent. is an excuse for doing nothing. Let me press the hon. Gentleman, as I pressed the Minister: would a future Conservative Government extend the migrant domestic worker visa to diplomatic domestic workers—yes or no?

I will come to that. The hon. Gentleman said that he was trying to tie down the present and future Governments, but it is sensible that the current Minister—and any future Minister, whether that is me or someone else—should proceed on the basis of hard evidence. Different solutions may be necessary, depending on the scale of the problem. It has struck me during the debate that people are saying that there is a solution. I suspect that there are two or three solutions. We all want to clear the problem up, and any sensible Government who want to eradicate it may have to take several different steps, which will have to be based on evidence of the scale of the problem.

The hon. Gentleman is saying that one instance is one too many, and that the Government must do something about the problem. That is true, but he has been in the House long enough to know that such reasoning is often not the basis for the best and most effective policy making. I want to ensure that we eradicate abuse, and to do so effectively we need better evidence than we have at the moment. That is why I hope that the Minister can produce that evidence.

Is there not clear evidence of bonded, indentured employment? That is the challenge that must be resolved.

That is certainly one of the challenges that must be resolved, but there are others, including the potential for things to fall out of the part of the system that we are talking about; that could lead to routes to settlement that the Government are very concerned about, and I have a lot of sympathy for them on that. There are a number of complex issues, and I repeat that we need to find solutions based on evidence.

The Home Affairs Committee has recommended that we keep what is essentially a special visa regime for the type of worker that we are discussing. That recommendation was treated with great reluctance by the Home Office when it introduced the points-based system. I appreciate the desire of any bureaucracy for a tidy system. God knows the immigration system is complex enough, and was complex enough before the introduction of the points-based system, so I can appreciate why those involved in running it wish to simplify it as much as possible and not to create special exemptions.

I am glad to have the support of the Minister on that, but he will be well aware that purity in pursuit of that aim is not possible and not practical. We have exceptions in corners of the system. We have, for instance, a seasonal agricultural workers scheme. In certain areas, it is sensible—

The Minister surprisingly mentions Gurkhas from a sedentary position. If I were him, I would not bring that subject up, but he has done.

The very serious area that we are discussing is possibly an area for exemption. I can give the hon. Member for Reading, West, some comfort, in that it has occurred to me that although it may not be ideal to have a special visa regime in this area, that may be the least worst option. It may contribute to greater complexity in the system, but it may be a possibility.

To return to the diplomatic issue, a worker should be given the right to run away from abuse, but that does not deal with the problem; the abuser is the person who must be looked at. I put it to the hon. Gentleman that if one worker runs away, another is likely to come and fill their place, so that abuse and exploitation will continue. Surely the solution is twofold: there must be protection of the worker, but there must also be prosecution of the offender.

I take that point. To move directly on to the point about diplomats, I share some of the impatience of the hon. Member for Reading, West, with diplomatic niceties in this area. Everyone in the debate, including him, was carefully tiptoeing around, not naming embassies or countries.

I thank the hon. Gentleman for giving way. I was disappointed by his weasel words when he did not give a clear commitment on what he would do if he were fortunate enough to be the Minister, but on reflection, it is probably incumbent on me to say that it was at the residence of the Pakistan high commissioner of several years ago that I witnessed what I described. I hope that the situation has now been remedied.

I am grateful to the hon. Gentleman for saying that, although I suspect that his colleagues may not be. It is interesting to observe that, on the whole, we have avoided naming and shaming, whereas in other areas we do not avoid that. I have seen lists of parking fines for which various embassies in London are responsible. That information is in the public domain, and it is presumably put there by arms of the British Government. Parking illegally is irritating, but it is much less serious than the issues that we are discussing today. The Government could consider that.

That answers part of the point made by the hon. Member for South Antrim (Dr. McCrea). If it is known on the diplomatic circuit around the world that if people come to this country and behave in the ways described, they will at the very least be removed from their country’s embassy or high commission in this country and sent back to their own country, presumably in some kind of disgrace, that will act as a huge and effective deterrent. Indeed, it might quite quickly wipe out that type of behaviour. That would do a huge amount of good for what may be dozens or hundreds of people—we do not know.

We should not give up on the criminal law and the criminal justice system. Everyone who is doing what has been described is committing a criminal offence in this country. To say that for various reasons it is difficult to collect evidence, and that we therefore have to find a new way of stopping people committing that criminal offence, seems to me a counsel of despair. I know that it is difficult for the police to collect evidence, but there are other areas of life where that is so. The hon. Member for Birmingham, Yardley, made the point about the paucity of prosecutions for exploitation more widely. It would be interesting to know whether any prosecutions have taken place in the area that we are discussing.

I have a final detailed point. The issue must come under the Government’s general anti-trafficking strategy. One of the things that most worries me is that the Metropolitan police’s anti-trafficking unit has been absorbed into the clubs and vice unit. That sends a clear signal that that force is now looking at human trafficking purely as a sexual exploitation issue; the type of exploitation that we are discussing is therefore likely to fall below the radar.

One conclusion that I reach is that our current anti-trafficking measures are not adequate, particularly in the area that we are discussing. That is one reason why a Conservative Government would introduce a specialist border police force. My second conclusion is that we should not give up on normal legal procedures and on naming and shaming embassies if necessary. My third conclusion—I know that this will disappoint the hon. Member for Reading, West—is that the long-term solution depends on harder evidence than we have before us today, unless the Minister is about to produce some. Individual cases are clearly hugely distressing and shameful, even if there is not a huge number of them. The long-term solution must depend on that evidence, but I can assure the hon. Gentleman and the House more widely that if there is a Conservative Government after the next election, we will regard the eradication of modern-day slavery in this country as a very serious and important part of our work.

It is a pleasure to speak under your chairmanship in this important debate, Mr. Benton. The traditional congratulations to my hon. Friend the Member for Reading, West (Martin Salter) on securing the debate would clearly be inadequate today. I suspect that this will be his last Adjournment debate, so it is right and timely to pay tribute to him, as I did on the day that he announced his retirement from Parliament. His work as a Member of Parliament has been incredible. I am thinking of the successes he has had from the positions he has held on the Home Affairs Committee and the all-party group on Gurkha rights, where he played an incredibly helpful role. His membership of Amnesty International has guided his work. I checked before the debate and my hon. Friend’s declarations of political interest included India and Pakistan, so I have narrowed it down, but it was useful that he clarified the matter, especially as Pakistan day is next week.

I have a detailed prepared speech, but I think that hon. Members want me to answer two questions: one on domestic workers and one on domestic workers in diplomatic households. The hon. Member for Totnes (Mr. Steen) has had to leave us, but I undertook to provide answers to his questions. The hon. Member for Birmingham, Yardley (John Hemming) had a detailed list of questions that I might not cover now, but if he remains unsatisfied on those questions, I will of course write to him with the information.

Let me clarify something. On the route for domestic workers that we have discussed with Unite and Kalayaan, which are represented in the Chamber today, the commitment was to look at the system within two years of the introduction of that aspect of the rules. That will take us to November 2010, which is slightly before the date that hon. Members were looking at. Let me make it clear that the Government’s policy objective is to review how the system is working. We have been given some figures today, and hon. Members will remember that the original fear was that there would be a pull factor and that the ability to transfer the visa might encourage people to use that route.

The hon. Member for Ashford (Damian Green) made a valid point about evidence, because there are two other criteria that one would need to look at. One is the effect on settlement applications and the desire in the Borders, Citizenship and Immigration Act 2009 to separate residency from automaticity of settlement rights. At the moment, people in the category we are discussing have rights to apply, but one needs to look at the effect of any proposals.

The hard information that my hon. Friend has given us shows, however, that the numbers using the domestic worker route are actually going down. There may be wider factors at play, including economic factors, although I have seen no evidence of that. Of course, that analysis assumes a rather little Englander view of the economic recession, because we remain a relatively wealthy country.

Let me just put on record the fact that the decline in the numbers applying for migrant domestic worker visas covered 2005, 2006 and 2007, when the economy was in much healthier shape than it is now. Irrespective of the economic circumstances, the general trend is down.

Yes, my hon. Friend is absolutely right. I will not repeat the figures, but what he says continues to be the case. Of course, there may be consequential changes in other areas of the immigration system, and the points-based system may have opened up other routes, although I have seen no evidence of that, particularly given that tier 3 is closed. Interestingly, the passenger arrivals data on the nationalities of domestic workers show that 36 per cent. of those in the category we are discussing are Filipino, 20 per cent. are Indian and 12 per cent. are Indonesian; their countries are the top three countries of origin, and they would not be covered by tiers 1 and 2 or, indeed, aspects of tier 5.

To answer the question, my commitment is that the Government will review how the system is working. We will not change our policy of providing protection to domestic workers. I would not wish to rule out the possibility that there may be a better way of providing protection, but there is no intention on the part of the Government to get rid of that protection. There is the caveat that one would need to look at the evidence, although that evidence would relate to how the system is working, not to whether it should be there.

I am grateful to my hon. Friend for that. I think that what he has said is progress. To be clear, the Government are saying that the protection will continue beyond 2011, in its current form or a new, improved form.

Yes. To repeat, the difficulty, as the hon. Member for Birmingham, Yardley and others have said, is that although the Government are aware of a number of cases, there are strong reasons why cases would not come forward. Therefore, one cannot look just at the transparent evidence available to the Government. It is really a question of reviewing how the protection is working, not whether it should be there. I do not rule out another way of providing protection—it would be foolish to do that—but there is no intention on the part of the Government to remove that protection. Indeed, the conversations that we have had with Kalayaan and hon. Members have been aimed at improving the system as best we can.

The hon. Member for Ashford made a very wise point—he has obviously started to think about policy in detail. It is true that the great advantage of the points-based system is its simplicity. It is also true that although relatively small numbers take the diplomatic route—the numbers for entry and potential settlement via the domestic servant route are actually significant—that is the third such exception that I have dealt with today. There are many such cases of special interests—I will not say special pleading, because this cause is clearly valid. That, however, is the Government’s policy on the first question.

On the second question, I cannot give the positive answer today that I had wanted to give. The timing of the debate is fortunate from the point of view of raising the issue, but it is unfortunate from my point of view because the Government’s deliberations have not been concluded. Those are not, I hope, weasel words. Let me give some of the background.

I was asked about the figures. Complaints from diplomatic domestic servants are forwarded to the Foreign and Commonwealth Office, which is aware of two cases involving allegations of abuse in the past 12 months. To emphasise the point, those are just the cases that the Foreign Office has been made aware of. As the hon. Member for Birmingham, Yardley said, if someone cannot run away, they cannot be protected, and I think there is consensus in the House on that. I am not suggesting that there are only two cases of abuse; those two cases are the ones we are aware of.

It would be illuminating for hon. Members if I explained how the cases proceeded. Both complaints were referred to the FCO by the police. The first is the subject of a police investigation and a request for the waiver of criminal immunity to allow the diplomat to give evidence to rebut the allegations or to help to confirm to the police that there is a case to answer. In the second case, the police decided that no criminal offence had been committed. As has been suggested, therefore, there is the possibility, at the end of the road, that the diplomatic position would be withdrawn. As the hon. Member for Ashford rightly said, there is also the criminal justice route.

The question is whether the ability to transfer the visa to another employer would provide better protection for people we are not aware of because they have not come forward with complaints. We are undertaking investigations, but the issue is complicated because of our relationship with the diplomatic service and our reciprocal diplomatic arrangements. However, there is no question that we are putting those diplomatic relations above the interests of victims.

I can confirm that the Vienna convention does not preclude us from allowing a private servant to switch employment to outside the mission. The issue is the convention’s definition of interfering

“unduly with the performance of the functions of the mission.”

We have to be on strong ground on that point.

Of course, I understand the point that we should not put the protection of diplomatic relations above the interests of victims of violent, physical or, indeed, verbal abuse. We are working to solve the problem. Our policy is to look at the suggested solution of switching visas. As I said, the timing of the debate is fortunate in terms of raising the issue, but it is unfortunate for me in that I have not yet concluded my deliberations. However, my experience based on eight years as a Minister is that it is better to get things right than to respond to an Adjournment debate or a question in the House just because it might make my life easier now.

Port Business Rates

It is a delight to speak under your chairmanship, Mr. Benton. I am grateful for the opportunity to have this short debate on port business rates, but appalled by the fact that it is still necessary to do so. To outline the position quickly, Parliament decided in 2003 that all companies operating at our ports would pay business rates in the same way as other businesses. Previously, some of them had paid an unspecified amount, in lieu of rates, in the fees to their landlords, such as Associated British Ports in Goole. That change was to begin in 2005. That in itself was not particularly controversial, and as I have often said, none of the affected companies that I have spoken to have ever said that they are not willing to pay their taxes in the same way as others. However, none of them, and I would guess none of us, foresaw what was to come.

The Valuation Office Agency failed to assess the companies before 2005, and by the time that the liabilities were beginning to appear, it was 2008 and not only were rate bills due but there was backdating to 2005. During that period, of course, the companies had continued to pay, via their fees to their landlords, and it is accepted by all that there is no legal recourse for the recovery of that money. Indeed, Associated British Ports made it clear in a meeting with me that it had no intention of making any repayments, as its own overall liability had been increased, even if that was not true specifically at Goole.

Companies had to pay rates for a second time for years for which the accounts had been signed off, and there was a new liability to be paid as well. In addition, there was huge concern that the rateable values were wrong and the figures were much too high. That was raised with the Government at the time by several hon. Members who represent ports. I am delighted that my hon. Friend the Member for Cleethorpes (Shona McIsaac) is present for the debate, along with the right hon. Member for Haltemprice and Howden (David Davis)—whom I regard as a friend on these occasions and who continues to share an interest in this matter and, indeed, in the port of Goole, which borders his constituency. Many of us made the point at that time that we were deeply concerned about where the situation was heading.

The Government offered some assistance. Their response was to announce that the historic debt could be paid, interest-free, over an eight-year period and that there would be a fast-track appeal process, through the Valuation Office Agency, when there was doubt whether the rateable value was correct. There is much more I could say about that, but this is a relatively short debate. I want only to say that that offer was not as helpful as it sounds.

I do not want to delay the hon. Gentleman, who has fought very hard on the issue, but may I ask whether he agrees that the Select Committee on the Treasury was right in its comment on the Government’s response? It said:

“We are not impressed by the Government’s decision to wash its hands of problems which arise, in part, from its own insensitive handling of port rate revaluation. We recommend that the Government urgently reviews the impact of the revaluation on port occupiers, and publishes its findings.”

I agree entirely with the Select Committee. One of the heartening things about the campaign is the fact that it has attracted support from all the main political parties and that cross-party groups, such as the Select Committee, have been firm in advocating that the Government should do more. The fast-track appeal is one relevant instance. In a famous episode of “Yes Minister”, Sir Humphrey was trying to explain to the Minister that things should always be given a title that was the exact opposite of what was going to happen; so if something was intended to suppress information, it should be called “Freedom of Information”. I can only think that that logic was applied to the fast-track appeal. “Fast” is not the word that springs to mind to describe what some of my local companies have gone through. That case has been made over and again; fast-tracking has not happened.

The eight-year spread does not take away the fact that the debt is held on the books, leaving some companies at least technically insolvent. I realise that Her Majesty’s Revenue and Customs has said that it is content if companies can show that they can pay over the period in question, whatever the technical status of their books; but companies still need access to finance to be able to operate, and we are already in a world where that is more difficult. Technical insolvency is not a status that helps. It makes things very difficult.

This is in one respect nothing to do with the situation in question, but it shows how difficult things have been for local companies. There is a system of transitional relief to help in dealing with sudden changes in rates liabilities. To put that into context for Goole, companies tell me that under the old system the rateable value of Goole docks was £298,000. According to the Valuation Office Agency, the valuation was set at £3.1 million in 2008, yet because of the arbitrary high values attached to the individual companies in the 2005 rating list, there was in effect no transitional relief.

All that has been put to Ministers privately and on the record, and as the right hon. Member for Haltemprice and Howden has said, the Treasury Committee added its weight to the concerns that I and other right hon. and hon. Members have raised. We continue to be told that, on top of the measures already taken by the Government, colleagues in the Government continue to monitor the position and to discuss what more can be done. However, in the absence of further action, the clock continues to move on. Councils are required to collect the business rates. Indeed, the financial consequences for council taxpayers if they do not do so are onerous. The figures are quite large, certainly in the case of East Riding of Yorkshire council, so with some reluctance councils have begun the process of making collections.

The result in my constituency is that Scotline has ceased to trade—I fear that this may just be the first such case—because it was presented with a bill of just over £700,000 for current and backdated rates, with £200,000 owed now. The company has a turnover of just £800,000. Of course it has known about the situation, and in January 2009—not January 2010—it took its case to the Valuation Office Agency, requesting the fast-track appeal that the Government had offered. To back up its case, it pointed out that it had been charged for a large warehouse that it did not own and for a common wharf to which it merely had access, as do many other companies on the port. Despite its pleas no reassessment was forthcoming. Eventually, the council issued a summons. The company went into liquidation on 25 February, and 10 people lost their jobs.

If the story ended there, that would be bad enough. However, in this world of “You couldn’t make it up”, what happened next is almost more unbelievable. Last week, the company received a letter saying that the fast-track reassessment was complete and its liability was not £700,000 but £114,500. That fast-track reassessment took 14 months and arrived days after the company folded.

I congratulate my hon. Friend on securing the debate, which I think is the second that we have had in Westminster Hall on this subject. Given what he has just revealed about what Scotline’s liability should have been, does he think that there is a case for investigating the Valuation Office Agency?

The Treasury Committee made the point well that the Valuation Office Agency, which is a Government agency, has let down the ports and the companies badly. Even at this late stage, it has a duty to ensure that everyone is asked to pay on the basis of a fair rateable value that is comparable to others. It should be borne in mind that some companies in the ports have always paid business rates in the normal way, and it is important that all the companies should have a level playing field. My experience is that a number of companies have been given rateable values that are completely out of kilter with the businesses that they run and the properties that they use. Paying is putting them into immediate difficulties, but they face the further long-term unfairness of continuing to be unfairly rated compared with some of their competitors.

Scotline’s chief executive, Peter Millat, said in a press statement issued after the company went into liquidation that if the revaluation had been more timely the company would not have folded and no jobs would have been lost. It is truly unbelievable that the agency should have taken so long when so much was at stake and that, despite many warnings about the declining position, the Government should have allowed it to happen on their watch. The problem affects not only Scotline; other companies are hanging on, waiting for something to happen or for sensible revaluations to reduce their liabilities.

I spoke earlier about East Riding of Yorkshire council, but I am aware also of the efforts that have been made by Hull city council and North East Lincolnshire council, which cover all the Humber ports—although I realise that the problem affects not only them. They have held off as long as possible and have tried to do the best that they can to support the industries in their areas, but they, too, are now under pressure. To put this into context, we should consider how much it is costing the UK economy. I was grateful to receive a briefing before the debate from the Federation of Small Businesses. It estimates that those companies are being chased for more than £33 million and that 150,000 jobs in UK ports are in jeopardy as a result.

I turn to what we might hope and expect my hon. Friend the Minister to do. In some respects, I feel sorry for her, as it all happened before she took over her present brief. However, as a colleague once said to me, “That’s why you get a car.” She comes from the Department for Communities and Local Government, which has offered the limited assistance that we have so far secured. I guess that she shares my despair at the way the agency has acted and how the promise of a fast-track procedure simply raises a laugh whenever it is mentioned locally.

I have had private and public meetings about this, but we should be candid about it: DCLG would like to do more but cannot persuade the Treasury. I mean no offence to my hon. Friend the Minister, but I took the matter up directly with the Chancellor last week. I explained to him the difficulties that we were having and my belief—I do not think that I am wrong—that that is where the block is to be found. It is fair to say that my right hon. Friend was unaware of the reality of what had happened to Scotline, and especially about the cut in liability made after it went out of business. He offered to speak to his officials, and I sincerely hope that that will enable the Government to move matters forward. Too many jobs are at risk to do nothing.

My personal view is that retrospective rates should be cancelled; as companies cannot get their money back from their landlords, they will be paying twice. The agency should be made to finish all revaluations as an immediate priority, and councils should impose no financial penalties in respect of non-collection during this period, which should have a short but fixed time scale. If companies still have outstanding liabilities, there needs to be a deal to ensure that they cannot be placed in a position where they could go out of business through no fault of their own.

The problem has attracted strong support from all parties. I note from today’s Grimsby Telegraph that Lord Bates, Opposition spokesman for the DCLG in the other place, has issued a statement saying that the Conservative party is in favour of a moratorium. Although that does not cancel the retrospection, it nevertheless offers a breathing space while rational decisions are made. At the very least, it would be a sensible start. The Government should respond in a similar way, content in the knowledge that other political parties would support them. The Government need to act as soon as possible. The clock is ticking; companies are folding; jobs are going. The Minister and her colleagues need to deliver. The problem is caused by their actions and their agency, and they need to resolve it.

It is a pleasure, Mr. Benton, to serve under your chairmanship. It is also a pleasure to respond to my hon. Friend the Member for Brigg and Goole (Mr. Cawsey) on a subject that is difficult because of the consequences of its complexity.

I congratulate my hon. Friend on giving such an extremely clear outline of what has happened. The situation arose from changes of ownership in the ports about 40 years ago. Previously, the port authorities paid the business rates of the businesses that operated within the ports. The situation has changed over the years, and that transition is the crux of the problem.

It became clear that some properties that should have been separately rated had not been separately rated. It became equally clear that some properties were still paying what they considered to be their business rates to the port authority, but that some were not. The result was a loss not only to the Treasury but to the other businesses that had to make up the shortfall, because not all the business rates liability was being collected.

It became obvious in 2006 that the problem existed in the country’s 55 ports. The Government undertook a review. The delay that my hon. Friend mentioned was not only caused by the fact that the mills of Government grind exceeding slow, as he will know from watching “Yes Minister”. The review started in 2006 and took approximately two years, ending in 2008. The result was that ratepayers in 725 properties became liable for backdated bills.

Backdated bills are a feature of the business rate system, which is 100 years old. Every year, individual companies are found, for one reason or another, not to have paid all their liability, and they have to pay back that money. This is the first time that we have had a sector-specific review, and it obviously led to a great deal of hardship. I very much regret what has happened to Scotline in my hon. Friend’s constituency. This is not a time to lose jobs, and I regret what has occurred.

One reason why the problem arose is that the system is so ancient. There is no requirement for potential ratepayers or the port authorities to inform the Valuation Office Agency that a separate hereditament may exist—I may have mispronounced that word, Mr. Benton. For example, if my hon. Friend decided to rent out his office in Parliament to my hon. Friend the Member for Cleethorpes (Shona McIsaac), it would become liable for business rates—if he were allowed to do so; I am using it as an example. However, there is no obligation on either of my hon. Friends to inform the Valuation Office Agency. It can therefore take quite a long time for the agency to find out where those separate heredi—

I thank the right hon. Member for Haltemprice and Howden (David Davis)—it can be difficult to find out where they exist. As a result, although there is no guilty party there is a lack of transparency in the system. On top of that, if the Valuation Office Agency discovered that my hon. Friend had rented his office to my hon. Friend the Member for Cleethorpes it would have a legal duty to investigate it and to charge.

Some companies continued to pay their fees to landlords, as my hon. Friend mentioned, and some are finding it difficult to get those fees back. The problem for Government is that the matter is not something in which we can interfere; it is between the port authorities and their businesses. In fact, some companies have had to pay rates twice, which does not seem in the least fair.

My Department announced that historical debt could be paid interest-free over an eight-year period, as my hon. Friend mentioned, and that there would be a fast-track appeal process via the Valuation Office Agency. However, once again, between the Government view and the business view of what constitutes fast track, there is a huge gulf—

Yes, and my hon. Friend illustrated that gulf marvellously well.

We now have a situation in which a company such as Scotline has ceased to trade because of the time taken by the Valuation Office Agency to arrive at the correct liability. I have heard the details of the situation in my hon. Friend’s constituency and I have talked in huge detail about other specialist areas of valuation, such as the vexed question of petrol stations. I shall not go into that in any detail because you might be in danger of falling asleep, Mr. Benton. However, the question is vexed and keeps the owners of petrol stations and this Minister awake at night. Another specialist area is that of telecoms, with the differential ways in which BT and the fibre-optic providers are measured. That case has gone as far as the European courts and the Court of Appeal in this country.

I have spoken to Treasury Ministers because, owing to the way Government responsibilities are split, the Valuation Office Agency falls under the Treasury, whereas the structure for collection, which is local authorities—billing authorities—falls under my Department. I am in discussion with Treasury Ministers about what we can do to make the fast-track process truly fast track, and the system more responsive to the needs of business. I shall keep my hon. Friend informed of progress. I am taking the issue up as a matter of urgency—I am speaking to a Treasury Minister tomorrow—because I am aware of the cliff we are all facing.

Like the hon. Member for Brigg and Goole (Mr. Cawsey), I am incredibly sympathetic to the Minister’s position. She is caught in a “Yes Minister” time warp, with fast track being measured in geological time—

Indeed.

In the middle of all the complexity—the legal history and the antiquity of the system—the simple fact is that there are two injustices. One injustice is that the Government make a mistake and individuals or companies pay. The other injustice is that we are in effect subjecting our corporate citizens and their employees to double taxation. Both injustices are clear—whatever the reason, whoever the blame lands on, I do not care. I do care that constituents of virtually all the MPs in the Chamber are suffering. In the current economic circumstance, the only thing that can help is that whatever form such help takes, whether moratorium, cancellation or whatever, it has to be incredibly quick—not quick in geological time, but quick as in the next few weeks.

I take the right hon. Gentleman’s point. As someone who came into this place at the ancient age of 54, with a business background, I found the geological time that is occasionally also Government time difficult to deal with.

None of what I have said diminishes the impact of backdated rates, combined with the current economic climate, on port-based ratepayers. We understand and sympathise with their plight, which is partly why we introduced the schedule of payments scheme and went in for an unprecedented eight years. The scheme is providing help, but there are still instances, as with Scotline, when that help comes too late or is not sufficient.

The fundamental issue is that we cannot selectively let some businesses off a legally established tax, actively disadvantaging companies that have paid it. Members present understand that, so we have to find a way through.

In conclusion, the Government and this Minister are as concerned as Members about the impact of backdated rates liability.

My hon. Friend is reaching the end of her comments. We welcome her sympathy, but it is important to have something tangible as well.

What companies need to know at this point in time is when the revaluations will be complete. Companies are trying to make arrangements to keep their businesses going while the revaluations happen. Scotline has been a shock through the entire system, because the company went and then the revaluation came. Every affected business I know fears that for itself. If the Minister can do no more today—I understand that conversations are still ongoing, not least the ones with the Chancellor that I alluded to—will she, please, at least give us an assurance that she will get back to us with some indication of when those decisions will be made and complete, so that the companies will know what their liabilities are and that they are fairly set?

My hon. Friend has been a Minister himself and understands the constraints under which we sometimes operate. However, I give the Chamber my assurance that we shall do everything in my power and the Secretary of State’s power. I am glad that my hon. Friend has prayed in aid our right hon. Friend the Chancellor of the Exchequer, because that will be most useful. I shall report back to concerned Members about progress. We intend to move forward as swiftly as possible, because as we all know there is only an extremely short period in which to operate.

I commend my hon. Friend the Member for Great Grimsby (Mr. Mitchell), who is in the Chamber today, for the work he has done on the issue. He has certainly kept my correspondence section extremely busy.

Sitting suspended.

London Hospitals

[Mr. George Howarth in the Chair]

It is a pleasure to stand before you this afternoon, Mr. Howarth. I am delighted to have secured this important debate on the vital issue of the future of London hospitals.

London is a world city, but its health care is not world class. It faces extreme health challenges, with the highest rates of child poverty, chlamydia, gonorrhoea and syphilis. It has 40 per cent. of the UK’s tuberculosis cases and 52 per cent. of its HIV cases, the highest number of dependent drug users, and the highest rates of teenage pregnancies. Sadly, London tops the list in many other areas as well.

NHS London has sweeping plans that would monumentally change the delivery of health care in London. Through the local prism what is happening in my sector—the north central London sector—and specifically around the Whittington hospital, I will demonstrate what is happening across London. The proposals are being fought across the capital by all parties. I have no doubt that my hon. Friends and other hon. Members will wish to put their local situations on the record.

Shocking health inequalities exist in London. For example, a man will live seven and a half years longer in Kensington than in Haringey. We have six infant deaths per 1,000 live births in Haringey, against a London average of 4.8 per cent. We desperately need better health care to address such inequalities, and we welcome the fact that a review is under way. However, we are worried about the way in which the review is being conducted, the work that is not being done, the use of wrong and dangerous assumptions, the appalling lack of proper or meaningful consultation with local people, the absence of real clinical evidence and the neglect of key aspects that impact on medical training. Despite such a flawed, unsafe and unsound process, the juggernaut proceeds relentlessly. No proper case is being made that demonstrates that our health inequalities in Haringey will be reduced by the proposals of the north central London sector review panel.

The first news of the potential closure of the Whittington accident and emergency department was revealed in a leaked letter from Rachel Tyndall, who chairs the review panel. That letter was sent to the chief executive officers and the medical directors of all the relevant hospitals in the sector. It proposed four options, each one of which included the closure of the Whittington hospital’s A and E department. It is an understatement to say that there was shock and horror at the possibility, let alone at the fact that no other possibility was proposed. In the public interest, I leaked the letter to everyone I could. How dare it be that that was the first that we in the sector knew of the proposal? In the furore that followed, the letter was hastily withdrawn, and we were told that no decisions had been made, and that various options and scenarios would be put to a public consultation next autumn.

That letter may have been withdrawn, but it showed us the way in which the thinking was going. A strategic plan has now been drawn up by north central, London. Seven draft options affect the Whittington hospital in three different ways. Under scenarios 1, 2 and 3, described disarmingly as the “do minimum” scenario, the Whittington loses in-patient paediatric services, and possibly obstetrics, too. Under scenarios 4 and 5, we also lose 24/7 A and E cover, and under scenarios 6 and 7 we lose A and E altogether.

I should like to talk today about the evidence base. The Minister himself said in debate:

“We need to see strong clinical evidence for any change to the status of the Whittington…unless the case for change is established, there will be no change…I do not see any justification for closure of the A and E at this time”.—[Official Report, 9 March 2010; Vol. 507, c. 171-172.]

I was jolly glad to hear that, as were colleagues across the House, I am sure. There is no clinical evidence at this point in time. Nor is there any evidence that the 45,000 people who could not be treated at any facility other than a proper A and E department could be dealt with by an alternative hospital.

The hon. Lady is making a tremendously powerful case about the situation in her area. Is she aware that in south-east London, a similar situation occurred, and the consultation there was just a sham?

I thank the hon. Gentleman for his comments, and yes, I am aware of that, because I attended a debate last week at which I heard hon. Members from across the House say how poor the consultation had been.

Is the hon. Lady aware that even though a consultation is taking place on cutting A and E and other services at King George’s hospital, which services my Ilford, North, constituency, wards are already being closed? There is allegedly a consultation going on in which people’s views are being listened to, but those responsible are trying to bring about the closures by stealth before the consultation has even finished.

I thank the hon. Gentleman for his intervention. Some of us think that decisions have been made behind closed doors.

I thank the hon. Lady for giving way and for securing this debate. I, like her, heard the Minister’s reply last week, and we have had a number of discussions and debates about the Whittington. Does she not think that it would be in everybody’s interest if the plan to downgrade the Whittington from a district general hospital with an A and E was simply dropped, and we were guaranteed the continuation of the hospital in its current very successful form?

That is an excellent suggestion, but I suspect that it will not be the instant reaction to this debate. I wish that it was.

As I was saying, there is no evidence that those 45,000 people who need A and E services could be treated elsewhere. There is no evidence of a business plan, or of other facilities in the community that could deal with the 40 per cent. of cases that the sector claims could be treated by other means. Moreover, there is no evidence of how people would get to the alternative A and E at the Royal Free hospital.

I have to say to the Minister that the proposal is one of the worst presented cases for change that I have ever seen. That is putting aside the magnitude of the change that is envisaged. There is no case for the closure of the A and E, paediatrics, obstetrics or maternity departments. If a medical or clinical practitioner wanted to make a change in procedures or practice, however small, no NHS trust would allow it unless it was evidence-based. Why on earth should health planners not have to operate to that same standard of evidence? We have reached a point at which the options suggest that the Whittington A and E could be closed without that evidence. Lord Darzi was quite clear that any change had to be evidence-based, and that nothing could or should change until other provision was in place.

I want to move on to the specific issue of the Whittington. First, the review is being carried out under a false premise. North central London bases its review on the premise that 40 per cent. of current A and E visits could be dealt with by other means, such as by GPs out of hours, urgent care centres and polyclinics. Even worse, NHS London says that 50 to 60 per cent. of cases do not need to go to A and E. That figure is false. The Department of Health commissioned a report, “Primary Care and Emergency Departments”, which has just been published; it is dated March 2010. Paragraph 1.2, under the heading “Main findings”, concluded:

“When we used a consistent definition and a consistent denominator of all emergency department cases we found that the proportion that could be classified as primary care cases (types that are regularly seen in general practice) was between 10 per cent. and 30 per cent.”

So it is not 40, 50, or 60 per cent. of people who go to A and E who can be treated by other means; it is between 10 and 30 per cent. Moreover, where there is a high level of deprivation, that figure moves towards the 10 per cent., rather than the 30 per cent. NCL is using data that we now know to be incorrect to support its proposal. Anything that follows that is based on that flawed data is unsound.

I really thank my hon. Friend for the points that she is making. Is she aware that many of the cases where people are identified as possible candidates for treatment in more of a primary care setting can only be put into that category after the person has gone through the high-level testing that is only available in the context of an A and E department? The number is also false from that perspective.

The point that my hon. Friend is making is incredibly important and relates to the problem of the secrecy that we have seen in this area. These assumptions, both in the primary care analysis that she is citing and in some of the financial evidence that we have seen in some of the leaked documents, must be challenged. However, because these documents are being kept secret, the public, Members of Parliament, elected councils and so on cannot scrutinise them properly and hold the people who produce them to account.

I thank my hon. Friend for that intervention and what he says is entirely the case. That is what is so mystifying about the process; why would these people not put these documents into the public domain, so that the documents can be scrutinised and challenged and so that these people can be held to account?

I congratulate the hon. Lady on securing this debate. She and her Liberal Democrat colleagues set the bar in terms of community politics.

Is not one of the reasons for the delay in the process the timing of the general election and the desire not to have a full discussion on this matter, so that voters cannot express their view on it? Is it not disappointing that the Labour party is very happy with the delay? Unfortunately, even the Conservative party proposed in a recent motion in the House that the consultation on the issue should be postponed until it was improved, which would further delay it until after the general election.

The hon. Gentleman makes an excellent point about timing and the general election. I fear that, once this issue is kicked into the long grass on the other side of the election, things will go off the boil and the pressure points will not be quite so powerful.

The hon. Lady is being enormously generous in giving way so often. I need to respond to the comments that were made in the last intervention. The Conservative party’s position on this issue was made quite clear in the debate in the main Chamber that the hon. Member for Croydon, Central (Mr. Pelling) just referred to. It is that these documents should be made public now.

That is categorically our position. Most of the documents are in front of me now and they should be made public now. Then there should be a clinical debate from the bottom up, so that clinicians, GPs and patients, rather than the Department of Health bureaucracy next door in Richmond house, can decide what happens to the NHS in London.

I thank the hon. Gentleman, but I hear from sedentary remarks from my hon. Friend the Member for Richmond Park (Susan Kramer) behind me that that has not always been his view.

Anyway, as I was saying, NCL is using data to support its proposals that we now know to be incorrect, so everything that follows is unsound. I suggest to the Minister that on that basis alone NCL should be sent back to the drawing board, at the very least. Does he agree?

Looking at that statistical base for the Whittington, we now know that, out of the 83,000 people who visited its A and E department last year, 15,000 people were admitted to hospital and a further 30,000 people were examined, tested and released, which relates to the point made by my hon. Friend the Member for Richmond Park. Those 30,000 people could not have been released without first enjoying the facilities and receiving the care offered by a proper A and E department. Therefore, if NCL decides to close our local A and E department and replace it with urgent care centres or whatever, it will have to explain in detail how it proposes to care for 45,000 patients a year who need neither to be admitted to hospital as emergency cases nor to be subject to urgent investigations that are not within the scope of an urgent care centre. That statistic is evidence that our local population need an A and E department at the Whittington.

The aspiration to provide local health care services closer to people’s homes is admirable, but such services are not a replacement for A and E. Moreover, those services out in the community do not exist—they are nowhere near the required standard.

I am very grateful to the hon. Lady for giving way and I congratulate her on securing this debate. I am listening with care to her argument. I just want to be clear about one point. Does she think that there is merit in giving clinicians the ability to have a space in which to discuss what the best proposals are for London?

I am coming on to the issue of whether this process is clinically led or not. If I really believed that the clinicians had been consulted and had a full part in this process, I might accede to what the Minister is saying. However, every member of staff that I have spoken to, at every level of the Whittington, has told me that that is not the case. Based on my conversations with those staff, my understanding is that they are not at all happy with the proposals.

I am grateful to the hon. Lady for giving way again. I just want to be clear on one point. She seems to be saying that if clinicians were able to become involved in this process—I appreciate that she is saying that some of them may not be involved—and there was that policy space, she would favour giving them that space to have these discussions.

I wish that the clinicians had had that space before today. I hope that they will still be engaged, but we would not have arrived at this point if they had been involved in discussions before now.

I congratulate my hon. Friend on securing this debate, and she is most generous in giving way. Does she agree that what is concerning is that financial imperatives are driving the process—they come first—so that even if clinicians are involved, they are tied to dealing with the financial problem?

My hon. Friend makes a good point. One of the fears that stalk us all is that finance is driving the process and that the claim that better clinical outcomes will be delivered is all smoke and mirrors.

I was talking about the 40 per cent. of patients whom NCL say can be treated by other means; in other words, the non-emergency cases that are currently seen in the A and E. But where is the evidence to support that assertion by NCL? Where are the GPs who will field those 30,000 extra cases out of hours? The most recent NHS patient survey found that there is already widespread concern about the performance of out-of-hours services, particularly in Haringey, which is coming off worse than most other parts of London.

Polyclinics are central to NCL’s vision for London, but there is no statistical base on which to judge whether they will work or deliver improved health outcomes. The evaluation of polyclinics has barely commenced. The contract to carry out the evaluation of polyclinics was only awarded in January, and I understand that the specification is still being debated. The King’s Fund report, “Under One Roof: Will polyclinics deliver integrated care?” is sceptical about polyclinics. The report argues that

“a major centralisation of primary care is unlikely to be beneficial to patients”.

The report examines polyclinics abroad, as well as health centres that were created under the local improvement finance trusts. Dr. Laurence Buckman said:

“The report provides scientific, logical and international evidence that polyclinics won’t deliver the things the government believes they will”.

Is the Minister concerned not only that there is criticism of polyclinics but that, as yet, they have no evidential basis? There are no data sets and no proof that polyclinics will deliver beneficial outcomes, yet we already have draconian proposals. Moreover, a Department of Health spokesperson has said that it was not policy to impose polyclinics outside London. So will the Minister say whether it is policy to impose them in London?

I wonder whether the hon. Lady has found any confusion among her constituents about what a polyclinic is. Many people do not understand the term, and if they had something wrong with them, they would not be clear whether they were supposed to go to their GP, to A and E or to a polyclinic.

I am not sure that the clinicians or health powers, let alone ordinary people in my constituency, understand what a polyclinic is.

I thank the hon. Lady very much for giving way, and I congratulate her on securing this debate. Although there is consultation, the Government are insisting on a lot of these changes. Does she therefore agree that the primary concern is the morale of the ordinary staff? The ordinary doctors and nurses are already under pressure, and this process certainly does not help.

Indeed. That is why openness, accountability and transparency would be extremely helpful. I will now make progress, because other Members want to speak.

Urgent care centres are also central to NCL’s vision for London. Data suggest that Government plans to replace A and E departments with new urgent care centres run by GPs and nurses could actually swamp existing practices with unresolved cases. One of the first urgent care centres in the country to open is sending up to 40 per cent. of its patients back to their GPs. Such new centres are being developed as a gateway to emergency and urgent care, in a bid to free up A and E departments. However, GPs’ leaders have attacked those plans as lacking an evidence base. That follows a recent warning from the College of Emergency Medicine that it had “serious concerns” about urgent care centres, which it said were being imposed for reasons of cost and without evidence of “clinical or financial benefits”.

I now want to talk about the need for A and E, because why would anyone go to A and E if they did not need to? The answer is that the Whittington is situated in one of the most socially deprived areas in the United Kingdom. Many patients are not registered with a GP; many of them are probably not registered in this country. Many people who are not registered with a GP cannot get appointments. People get sick out of hours. Many people do not speak any English and many people are elderly or infirm. A and E staff know that, when people who are so disadvantaged get ill, they wait until their symptoms are extremely bad before they see a doctor. Consequently, when they present themselves, they are at a critical stage in their illness and need urgent care. The Whittington is there to give it to them, but they must go to A and E first.

Moreover, the north central sector is culturally and ethnically diverse. The 2001 Haringey census said that 51 per cent. of the population came from black and ethnic minority communities. That is important for health care, as many people from black and Mediterranean backgrounds can be affected by sickle-cell anaemia and thalassaemia; the Whittington hospital treats more people with those conditions than any hospital in the country. Access to A and E is essential for them, as those who go into crisis need urgent and appropriate attention. That is evidence that the Whittington A and E is vital.

Why damage University college London medical school? It is world-class: fifth in the UK, first in London and 20th in the world. If we want to make London a world-class city, what on earth are we doing destroying one part of it that is already world-class? Some 33 per cent. of UCL medical students are on the Whittington campus. The hospital is central to the university. We cannot teach the doctors of the future without A and E. If it goes, education at UCL medical school will be thrown into crisis, because students there cannot be pushed over to the Royal Free hospital or University college hospital. Where is the evaluation work on that aspect of the proposals? Does the Minister share my concern about what closing the A and E will do to the overall standing, status and education of our doctors of the future?

Why damage Middlesex university? It may be less well known, but the Whittington is also a key partner in that university, which teaches nurses, radiographers, dieticians and physiotherapists. The Whittington cannot function without those professionals, who work with the hospital in teams, and they cannot be taught without an A and E. If the hospital closes, that will all fall apart like a house of cards.

Why damage a hospital of national excellence? In national comparisons of hospitals, the Whittington has consistently performed superbly. In October 2009, the Care Quality Commission confirmed the Whittington’s good quality of service and excellent financial management. In November 2009, the Dr. Foster quality accounts, which rank every hospital in England, identified the Whittington as one of the safest hospitals in the country, giving it an overall rating of 21st out of 145. That is all evidence-based.

We are told that the situation is all about improved clinical outcomes and that it will be good for us. The sector points time after time to stroke and trauma specialist centres as evidence of improved outcomes. Those emergencies are relatively easily diagnosed, and we know that early intervention is critical and can make a difference. The problem comes when NHS bosses extrapolate from that across the A and E health spectrum. It is a complete red herring, as the vast majority of A and E patients do not present with clear symptoms; that is the whole point of A and E.

The volume and nature of cases currently arriving in our A and E departments demand that 24/7 A and E be continued on safety grounds. No one, least of all NHS London, has produced evidence of health care benefits to support the proposals. I have not met a single local person who does not think that closing the A and E is sheer madness.

To me, and seemingly to the entire population of Hornsey and Wood Green, the clue is in the title “emergency”. That means nearby, local and accessible, not only by ambulance. At no point when developing options has the sector team made proper use of the information it already holds or can access on the location of service users, the location of users of specific forms of delivery and delivery locations, users’ social and ethnic make-up and the accessibility of existing and proposed new delivery systems to public transport service users.

Using Google, the Highgate Society researched journey times from a wide number of postcodes where users would normally access the Whittington, and what those journeys would look like if those users had to transfer to the alternative A and E at the Royal Free hospital. Journey times for all but four of the 23 postcodes sampled were longer by up to 40 minutes. On the Transport for London route planner, Crouch End Broadway—not the most difficult part of my constituency from which to access the Whittington—is 21 minutes from the Whittington but 50 minutes from the Royal Free hospital and 39 minutes from UCH. The journey involves a bus, two tube lines and a six-minute walk at the end.

On that basis alone, any proposal to send A and E cases to the Royal Free hospital would threaten health outcomes, not improve them. In addition, the Royal Free hospital is already under pressure, with 90,000 cases of its own. It is on a confined site to which access by public transport is terrible. Parking is impossible, and even the London ambulance service does not like going there.

On finance, the Minister said in an Adjournment debate on 2 December:

“I have made it very clear to managers in the NHS that there should be no slash-and-burn cuts”.—[Official Report, 2 December 2009; Vol. 501, c. 1257.]

At the same time, NHS London is saying that savings of £355 million a year until 2017 are being required of the acute sector of north central London. Can the Minister confirm that? Have the Government made any other requests in terms of reducing costs or lowering funding?

The hon. Lady is being generous in giving way. To make it clear, we are seeking savings in order to reinvest them in NHS facilities. It is not about taking money out of the NHS; it is about finding savings within the system, particularly from back-office processes, to reinvest in front-line health care. The money will stay in the NHS.

I understand about seeking savings from back-office amalgamations across the deal, but the complexity of the new arrangements often eats up any savings made from the merger in the first place.

The 82-page “North Central London NHS Strategy Plan 2010-2014” barely touches on funding issues. At no point when developing the options does the team appear to have accessed information from the NHS regarding the unit costs of delivering different classes of service to service users, the aggregate costs of different service delivery units, the current account costs of disruption while personnel are reconfigured into new locations, teams and specialities or the capital costs of closing some facilities and opening others. Until those costs are known, it seems somewhat unprofessional not to include, at the very least as an option, leaving the current configuration as it is. For all we know, that might yield the best savings.

Nor has any serious analysis been made of how required savings will be found while improving quality of service, what savings might be garnered from the change to urgent care centres and polyclinics, how much it will cost to reconfigure services or what the potentially huge costs will be of re-engineering the Royal Free hospital and improving access for the London ambulance service, which would have to make an additional 120 journeys a day.

The report says nothing about where the resources will come from. There is no evidence that health care will be improved by any of the measures that I have mentioned. I have seen no work on what cost-benefit might be attributed to the well-being that a patient derives from being in a hospital near home, relatives and friends.

We in Hornsey and Wood Green are extremely cynical about consultation. Does the Minister agree that the much-vaunted public consultation by NCL, which comprised 80 people from across five boroughs, was derisory? It cannot possibly be considered of any value to consult 80 people from five boroughs. At no public meeting has any research been quoted regarding user preferences or user satisfaction. That is wholly contrary to practice in the commercial sector and the Government’s own guidelines on personalisation of public services. Collecting satisfaction data through diverse contact points should be a routine element of the management of service delivery.

At the public meeting I organised, which nearly 400 people attended, one questioner asked what would happen if everyone opposed the proposal to close the A and E. Richard Sumray, chair of Haringey PCT, refused to say that it would be enough to stop the process, answering that he could not say what would be in the consultation. No wonder we are cynical. Perhaps the Minister will be more direct. What volume of opposition does he consider necessary before he would be willing to uphold the wishes of local people?

In an answer to my early written questions to the Minister about the issue, I was told that it was a matter for local decision making. As a Liberal Democrat, I would love it if it actually were local decision making, but it is not. My hon. Friend the Member for North Norfolk (Norman Lamb), who leads on health for the Liberal Democrats, said in response to the Minister’s assertions that such decisions were local:

“Who are these local decisions taken by? They are taken by people who have no legitimacy; they have been appointed nationally, so there is no accountability to the communities”.—[Official Report, 9 March 2010; Vol. 507, c. 181.]

We want to be able to hold such organisations to proper account. We will oppose any loss of services imposed by unelected, unaccountable quangos. Such decisions should be local and determined openly and transparently by democratically accountable bodies. If it was up to us, we would simply stop the process dead in its tracks until that happened.

In conclusion, the process is critically flawed, untested, unwanted and dangerous. Does the Minister agree with me that time, energy and resources would be far better spent in finding ways to keep the Whittington A and E, paediatrics and maternity services open if local people want them, and that we should focus on delivering the health care that local people need, want and deserve?

Order. A number of people are trying to get in. I intend to call the two Front-Bench speakers for the winding-up speeches—[Hon. Members: “Three.”] Yes, at 3. Hon. Members who catch my eye and contribute to the debate must be as brief as possible to enable as many people as possible to speak.

It is good that we are discussing health, not education or maths. I will be brief, Mr. Howarth.

I congratulate the hon. Member for Hornsey and Wood Green (Lynne Featherstone) on securing this debate. She rightly concentrated on the local issues facing the Whittington hospital, which is in my constituency and serves many neighbouring areas. I will say a few words about it and make a couple of general points. I will be as brief as I can because other hon. Members wish to speak and it is important that they do.

We debated this matter in the House last week, and I secured an Adjournment debate on the Whittington hospital not long ago. The Minister has acknowledged that he is fully aware of the huge strength of local feeling from all sections of the community, all political parties and all leading opinion formers in the relevant boroughs of Camden, Islington and Haringey on the plans for the Whittington hospital and the north London area. There have been two public meetings in my constituency with an aggregate attendance of about 700 or 750. The hon. Lady held a meeting attended by 400 people and 5,000 people attended a public demonstration in March.

On the march, all sections of the community, all ages and a huge variety of political opinions were represented. There was a genuine feeling of support and affection for the local hospital, and a feeling that the way in which the NHS operates is not accountable to the public, local representatives or anybody else. I am sure the Minister sometimes feels that decisions are made in the NHS without the degree of accountability that there would be in a local authority. There is no feeling that those who make the decisions will be held to account for what they do. That sense of frustration is behind a great deal of what is being said and done locally.

The health situation in my borough is difficult. It is not the most prosperous part of the country, despite what the media and popular press say about the Islington lifestyle, with the restaurants, coffee bars and the pine furniture around Tufnell Park.

Well, in my area, we are talking about Labour voters. My point is that the borough is one of the most deprived in London, and is therefore one of the most deprived parts of the country. Its image belies a great deal of poverty. The same can be said about most parts of London, which is an interesting microcosm of the world in that rich and poor live side by side and there is desperate poverty alongside huge personal disposable wealth.

I thank the Government for recognising since 1997 the link between poverty and ill health. As Secretary of State for Health, my right hon. Friend the Member for Holborn and St. Pancras (Frank Dobson) recognised the importance of putting more money into deprived areas, putting more effort into improving public health through anti-smoking campaigns and obesity campaigns, giving instant cancer treatment where possible and all the other improvements that have been introduced. There have been tangible improvements: the death rate, the infant mortality rate and the instance of many notifiable diseases have done down as a result of those campaigns. They have gone down everywhere, although not anywhere near fast enough.

We still have huge problems with alcohol, substance misuse, teenage pregnancy, hypertension, obesity, cancer and heart disease. There are a series of issues to be dealt with. Improving people’s living standards, housing conditions, diet and health knowledge are key in improving the health of the nation. I am sure there is common ground on that point. It is also important that we have a national health service that is fully accessible.

I have been the Member of Parliament for Islington, North since 1983, an elected representative in Haringey or Islington since 1974 and have been in and out of the Whittington hospital on hundreds of occasions. I know the place very well and I know many of the local health services and facilities very well. We have been through difficult times: parts of the Whittington hospital have been closed, various wards were closed because of funding crises in the 1980s and early 1990s, and we have been through a desperate shortage of GPs. Those things have changed and the health service has improved—I am the first to recognise that.

I have read with great interest the plans for changes in health care in London. Obviously, we want everyone to go to a local health centre where possible and to be treated and dealt with appropriately. We all want a better public health system. I have here a copy of the weighty north central London strategic plan. It outlines the kind of changes the health authorities want to develop. I agree with the hon. Lady that the plans seem to have been developed behind closed doors by planners without obvious signs of clinical support from anybody. That is the point I make to the Minister.

Hordes of GPs have not been telling me that they want the Whittington hospital to be downgraded, that they want A and E facilities to be concentrated at University College hospital and North Middlesex hospital, or that other matters should be transferred to regional trauma centres. I have not come across that, but I have come across professors in various departments, surgeons, consultants, administrators and many others who have the deepest concern about what is going on and want transparency and openness in the process. They correctly feel that if the Whittington A and E department is closed, the large population of 80,000 people who use it every year will have nowhere to go. That compares with 70,000 people who use the Royal Free, 100,000 who use UCH and a large number who use North Middlesex. If the Whittington A and E department closes, there will be no A and E department in the boroughs of Haringey and Islington.

The former chief executive of Islington primary care trust, who is now chief executive of the north central health authority, said that there would be waking-hours surgeries in place of the services that are lost. That conjures up the image of people ensuring that they have heart attacks before 8 o’clock at night because after that they would have to go somewhere else. People are given the illusion that there is an A and E department when it is not there all the time. In my book, either there is a blue-light 24/7 department or there is no A and E department at all. I hope that the Minister will acknowledge that. I am sure he understands the point I am making.

The consultation was not due to start until the summer. I had an Adjournment debate in the House, which provoked flurries of letters from people in various parts. We had the demonstration, which provoked a statement on the NHS Islington website acknowledging that a large number of people were upset about the proposals and inviting further comments. That was good, although it is a pity it did not happen some months before. I understand that some kind of consultation is going on today, although I am rather unclear about who has been invited to it or how they got invited.

It is simply not good enough to take a semi-secret approach to developing plans and to spring them on the public at a later date; local people’s wishes are out in the open now. I have no problem whatever with improving GP services, and I have no problem with developing regional trauma centres, because I can see the sense in high-quality treatment for people with serious, major conditions, but such things should not be an alternative to an A and E department.

I am told that, behind all that, the proposals are all to do with saving £500 million from the north central area health authority budget. I do not know where that figure has come from; it has not come from the Minister or the Treasury, and nobody, as far as I am aware, says that a Government source has said it is the figure we must work from. Somebody somewhere is second-guessing the future, deciding what the expenditure will be and developing plans to fit in with it, and that is not good enough.

We live in a democracy, so we expect public officials to be accountable and public services to be developed in the public interest. As elected Members of Parliament, we expect those responsible to make their plans open to the public, just as elected councillors would expect local authorities to do. We expect the public to respond to the plans and we expect that decisions will ultimately be made, presumably in Parliament. However, it sometimes seems to me, as a local MP, that we do not really know what is going on and that the secrecy applies just as much to MPs as it does to anybody else.

Whatever the outcome of this process, I hope that the big lesson learned across the whole of London is that we want much more effective accountability for how the NHS plans and develops its services. The development of borough scrutiny committees is a good thing, as is the development of borough to local PCT scrutiny in cases where boundaries are coterminous. Such things work well, but we also have regional groupings in London, which have no parallel scrutiny whatever, unless all the local authorities—five in this case—successfully get together to set up a wider scrutiny arrangement. So far, that has not happened, although there are suggestions that it might.

I am proud to represent my area in Parliament. I am proud of the work that has been done at the Whittington hospital. I am proud of the amount of money that has been put into the hospital over the past 10 years—the new wards, the new facilities, the new equipment and the increased staff numbers. The hospital has a very good performance record on treating casualties, on maternity, on the children’s A and E department and on all the specialties that go with that. If the A and E is closed, however, the hospital is dead, because it will not be a general hospital any more.

I appeal to the Minister to look carefully into this issue. If there is some way in which he can intervene and say, “We are not going to destroy this valuable A and E department and, with it, the hospital,” I would be very happy. Above all, however, tens of thousands of people across north London, who do not have access to cars and who cannot easily go to a local hospital because there is none, will feel a lot happier and a lot more secure. We have a rising, increasingly young and diverse population, and we have a yawning gap between the rich and the poor. The NHS is our NHS, and it should be accountable to us, not anybody else.

It is a pleasure to follow the hon. Member for Islington, North (Jeremy Corbyn), because we have similar problems in south-east London. If the A and E at Queen Mary’s, Sidcup, is closed, Bexley will be the only borough in the area with no A and E.

I congratulate the hon. Member for Hornsey and Wood Green (Lynne Featherstone) on securing the debate. The issue is of real concern across the whole of our capital city. In my part of south-east London, the health care trust is amalgamating three hospitals—the Princess Royal University hospital in Bromley, the Queen Elizabeth in Woolwich and Queen Mary’s—for financial reasons, not for reasons of clinical need. The Minister is well aware of the problems in my area, although he does not take them on board. Often, he just trots out public relations spin. His response in last week’s debate was rather regrettable, because he did not deal with the concerns of people in my area. There are four key issues. I will be brief, Mr. Howarth, in view of your strictures on getting as many people as possible into the debate.

I feel that I need to interrupt the hon. Gentleman, because I was not spouting spin, as he put it. I criticised the Conservative party for having absolutely no policy of any seriousness on the NHS in London other than that of taking budgets from GPs. That is just an abdication of responsibility, and that is what the hon. Gentleman did not like to hear.

That is absolute nonsense. I was raising the position in south-east London, which the Minister will not address with any vigour, although he should. That is lamentable.

There are four issues: accountability, consultation, secrecy and the adequate provision of health care—all issues that concern my part of south-east London. On all counts, the Government, the Minister and the people in NHS London making the decisions following the setting out of the Darzi vision, or whatever it was called, have been found wanting.

We recently had a letter from Ruth Carnall suggesting that polyclinics were the answer, and that a polyclinic would go on the site of Queen Mary’s, Sidcup. As we know, Labour is downgrading the hospital’s A and E and its maternity and children’s services, and there are real concerns about that. There was recently an outbreak of norovirus at a nearby hospital, which forced the hospital to send more A and E patients to Queen Mary’s. If Queen Mary’s did not have an A and E, where would such patients go? That is a real concern in my area. Under the provisions, people will have to travel further to access emergency care.

I very much regret the proposal to have a polyclinic on the site of Queen Mary’s. As the hon. Member for Islington, North, said, once we start downgrading services, a hospital is no longer really the proper hospital that people in our areas need, but a local facility. I commend the hon. Member for Hornsey and Wood Green on her exposition of the situation in her area; that situation is, regrettably, replicated in mine.

Since the introduction of the Licensing Act 2003, which allowed 24-hour drinking, the number of hospital admissions due to acute alcohol intoxication has doubled, and the number of admissions wholly attributable to alcohol has increased by 70 per cent. That, too, is having an impact on A and E, particularly during the night, when, under the proposals, hospital A and E departments would not be available to take people in, as the hon. Member for Islington, North said.

I am really concerned that we are rushing through changes without sensible thought, consultation and discussion. I have respect for the Minister, and some of his work has been commendable, but he is, regrettably, blinkered on this issue. He will not look at the whole issue of secrecy and consultation. The proposals for change in my area are not clinically led, but financially led, because Queen Mary’s, Sidcup, is the only hospital in the group that did not come under the private finance initiative. Why have the costs for the PFI-funded Queen Elizabeth hospital in Woolwich spiralled to £799 million, when the building’s estimated cost was £96 million? That issue also needs to be looked at. I am really concerned that we are reducing the number of hospital beds across most of the capital, and particularly in my area, when increasing numbers of patients are seeking A and E treatment, and when numbers of emergency admissions are rising.

If an open consultation had taken place, a different decision would have resulted. As in the case mentioned by the hon. Member for Hornsey and Wood Green, there was a consultation, but as I said in my intervention on her, it was a sham, because the decisions had already been made before the consultation took place, and the Minister must take that on board. It appears that the decisions taken were those proposed in the first place. We had four alternative proposals, but one of them—keeping Queen Mary’s, Sidcup, open—was not on the agenda.

So we did not have a proper consultation at all in our area on the future of our local hospital. I very much regret that an issue so critical for the whole of London is being quickly swept under the carpet so that the Government can move on without considering patients’ needs, real care and the availability of services in the area. Of course we welcome the opportunity to have dialysis and cancer treatment services at Queen Mary’s, Sidcup, but not if that is at the expense of a valuable, vital local service. If that is lost, we shall not get it back, and the patients will be the ones to suffer.

The debate so far has been useful. I hope—I beg—that the Minister will consider my area, and that he will not give the party political line that he did when he intervened on me, but will consider the issues of patients and care, and the concerns about secrecy, accountability and consultation. I ask him to respond to those issues—I know that he can, as an honourable chap—for the sake of people in my area who feel that the Government do not care.

My arithmetic suggests that I have three minutes and 20 seconds. It is important for me to take part in the debate; I feel that I owe my return to good health to the NHS. There is great loyalty to the NHS, and all parties will reflect that.

The consultation process is a matter of concern. We often had debates 30 years ago about how the ability to influence education was a secret garden. In some ways, perhaps that is applicable to the consultation process that we are considering, which has in many ways already taken place internally, within the NHS. We political representatives are sceptical and wonder whether decisions have already been made. As the hon. Member for Hornsey and Wood Green (Lynne Featherstone) said, people probably feel “consulted out”; they are consulted, but that is an empty process.

That feeling that the process is an empty one is highlighted by the way in which the Government seem happy for the issue to be delayed until after the election. The Opposition Front-Bench spokesman may think that I am being irksome, but I was surprised that, in the motion that went before the House, the Opposition suggested that there should be a delay in the consultation until the proposals that were being pushed forward were cancelled. It would be unfortunate if that led the Conservative party to say that there should be a delay until after the election. It is important that the consultation should happen as part of the election process; that is the real empowerment of electors.

The debate would be helped by a realisation that the work done by Lord Darzi relied on quite a small database to justify the centres of excellence approach. In many medical matters, it is much better to be treated quickly by a medically qualified person than to be taken miles across busy suburban London to be treated.

I now come to how we could inform the debate, given the suggestion that there is to be a significant change in provision. It was not the case when I was at Oxford, but students these days are often required to include academic references when they make certain propositions. The Government seem not to be doing that. They are not willing to publish the McKinsey report, but even Labour Ministers and Members are calling for it to be brought forward. There have also been freedom of information requests. Will the Minister of State say now that the report can be published?

Many of us have copies of the proposals, which we have been given in confidence. Bearing in mind that they have now been widely circulated, is it not best for the Minister to give the London NHS some guidance? Please may we now be allowed formally to publish the proposals, so that the quality of debate can be higher?

The hon. Gentleman makes a good point. We had an Opposition day debate last week; perhaps there could have been better communication after it, but nothing has really happened as a result of raising those concerns.

That is an excellent point, and I am sure that other hon. Members have excellent points to make, so I shall finish my remarks there.

I congratulate my hon. Friend the Member for Hornsey and Wood Green (Lynne Featherstone), who is an excellent campaigner for her constituents on this issue. What is happening in the area that she and the hon. Member for Islington, North (Jeremy Corbyn) represent should be a warning to the rest of London about what could happen if we do not campaign cross-party and work against such threats, and for greater openness.

This is the third debate in the past two months in which my hon. Friend the Member for Richmond Park (Susan Kramer) and I have argued the case against the threats to Kingston’s accident and emergency and maternity services—and, indeed, its in-patient paediatrics, and potentially its elective surgery services, too. I make no apology for wanting to speak on the subject again, because yesterday we took a petition of more than 15,000 signatures to Downing street to try to make our points to No. 10.

We want to keep raising the issue for three major reasons. First, when we raised it initially we were accused by our political opponents of scaremongering. The evidence that we have now heard from hon. Members across the House is that that is not true. I wish that those who made the accusation would apologise, so we could get on with the campaign and work in a cross-party way in Kingston.

Secondly, as the hon. Member for Croydon, Central (Mr. Pelling) said, the documents that set out the detail of what is going on need to be put in the public domain. My hon. Friend the Member for Richmond Park and I have benefited from leaks from senior NHS people, which we have made public. We have put them on our websites to show the sorts of threats that are faced in south-west London by Kingston hospital, Mayday University hospital in Croydon, and St. Helier hospital in Carshalton. They are clear about those threats. We have heard that there is much more: we have heard about the McKinsey report, and those documents should be put in the public domain. My hon. Friend the Member for Richmond Park has tried 57 freedom of information requests, but the Government and various elements of the health service refuse to publish the documents. The Minister should put his foot down today and show leadership. He should ask NHS London to publish those important documents.

We also need to make things clear to the public. The consultation timetable in many areas is relatively short. My hon. Friend the Member for Richmond Park and I attended a briefing with two senior NHS executives last week, and they talked about putting their shortlist of closure proposals into the public domain in October, with the formal consultation concluding by next January. Those things are upon us. The assumptions behind the work and the proposals that are to come out in the autumn are already there, but we cannot challenge them. As I have said, some of those assumptions deserve to be challenged, because they are flawed.

The third reason why I want to keep arguing the case is the excellent services at Kingston hospital. I have said from the start that it is unthinkable that they should be closed, because they are so good, whether that is judged by reports from independent groups such as Dr. Foster, or by NHS inspectors. It is not that we resist change. In my area—at least on the Surbiton site—polyclinics are being introduced not to undermine the hospital, but to support health services locally. The polyclinic that is proposed for Surbiton hospital is really an excuse for us locally to put modern investment into the site; it will not replace services at Kingston, but take some of the excess pressure from it.

The number of attendances at A and E goes up year by year, and that is very difficult for the Kingston site. With a rebuilt polyclinic on the Surbiton hospital site, we can get better GP premises and more investment in primary care services. That makes sense and would work if we kept Kingston hospital. Kingston hospital’s chief executive and board are happy with the proposal for the polyclinic at Surbiton hospital, and see it as something that could improve their services. I accept that things may be different elsewhere, because all areas are different, but the polyclinic on the Surbiton hospital site could support the future of Kingston hospital.

Other hon. Members may want to contribute quickly, so I shall keep my final remarks short, but I want to question the Minister. He says that the proposal should be clinically led, and we wish it was, but clearly it is not. It is financially led. In all the documents that we have seen, and at all the meetings that we have held, the arguments have not been made on a clinical basis at all. They are very different from the arguments made for centralisation of stroke and cardiac provision, or for polyclinics. The arguments in this secret exercise are not clinical, and it is about time that the Minister faced up to that.

I shall use my minute as best I can. It is a shame that we have to rush these things, because the issue is obviously of great importance to everyone in London. I notice from the annunciator that the business in the main Chamber seems to be about to finish. It is a shame that three hours will be wasted there, when we could be discussing this matter in the main Chamber.

When we have these debates, it becomes very clear that our hospitals in London are much loved and much used. Yes, there will sometimes be criticism—we all have criticisms that something has gone wrong here and there—but our hospitals are much loved and much used.

There have been some excellent speeches, and I agree with everything that has been said, but one thing we must think about is whether we are dealing with the issue from the viewpoint of what people want. In other words, we want to keep the good local hospitals we have, and we should be considering how we can maintain them, not how we can get rid of some of them. I have no problem with the concept of stroke and major trauma departments going to specialist hospitals, but I do have a problem with accident and emergency and possibly maternity departments disappearing from all those hospitals—regardless of where they are in London—because once they go, the viability of that hospital will go.

I say to the Minister that we know what our constituents want, what we want and what the country wants. We and the NHS have a duty to try to continue to use the hospitals we have. It is no good trying to cover the issue up in some way and saying that it is a wonderful exercise, because that simply will not wash with the general population.

I echo the remarks of the hon. Member for Uxbridge (Mr. Randall): we need more time to debate the issue properly, so that the expressions of concern can go further and we can dwell on the detail. An awful lot of detail needs to be challenged and, frankly, exposed. I congratulate my hon. Friend the Member for Hornsey and Wood Green (Lynne Featherstone) on securing the debate, and all hon. Members who have taken part.

The speeches made today have demonstrated the clamour among local communities for greater accountability. There is a demand for full disclosure and an absolute belief that we should have genuine, robust public consultation that is not just about rubber-stamping an outcome, but about influencing an outcome, so that people feel some ownership of the decisions that are being made. None of that is happening in the processes that hon. Members have described today. Undoubtedly, that is driving their concerns about the real threats that are articulated in documents, such as the one from Kingston. Such threats would lead to the closure of A and E departments and maternities around London.

My first point is a local one. I thank the Minister for the very engaging and engaged way in which he has taken forward the outline business case for investment in a patient wing at St. Helier hospital. My hon. Friend the Member for Carshalton and Wallington (Tom Brake) and the hon. Member for Mitcham and Morden (Siobhain McDonagh) also appreciate that. It has demonstrated what Ministers can do when they engage with strategic health authorities and local NHS organisations. That leads us to ask why the same thing does not appear to have happened in relation to the wider genuine concern welling up in communities around London that the processes of consideration—dressed up in clinical language—about how to make the books balance are about to lead to deep and damaging cuts in services.

The clinical language itself shows the falsity of the approach. There is talk of a 70 per cent. reduction in A and E visits and a 30 per cent. reduction in visits to GPs. Surely that is just unobtainable.

That is a fair point. One of the frustrating things is that Ministers understandably tell us that decisions about budgets and how services are organised are local decisions. My hon. Friend the Member for Hornsey and Wood Green and others who have contributed to the debate pointed out that, therefore, the argument is made that Ministers are not directly accountable for those things. Yet how can we have genuine local accountability when primary care trusts are made up of people who are nationally appointed and who are largely, if not entirely, unknown by the communities that they are meant to serve? As a consequence, PCTs cannot offer genuine and meaningful accountability for the choices they make about the allocated resources that they are spending.

A good example is the £150 million that was trumpeted by the Minister of State, the hon. Member for Corby (Phil Hope) to pay for respite breaks for carers. Hon. Members were challenged to go back to our PCTs and dig out the figures. It was impossible to find those figures; many PCTs were reluctant to provide them. The same is true when it comes to the proposals for the reconfiguration and reorganisation of services. We are finding that it is difficult to get the detail on to the public agenda and out into the public domain, so that people can start to ask meaningful questions.

My hon. Friend the Member for North Norfolk (Norman Lamb), who speaks for the Liberal Democrats on these issues, is genuinely concerned about the lack of accountability and transparency surrounding the whole process. After reading last week’s debate and the exchanges between the Minister and my hon. Friend, I am led to ask whether the Minister or his ministerial colleagues have authorised the processes that are going on in London. Is he aware of them in any detail, and can he say what the strategic health authority, which he oversees, is telling him about those processes and what the timetable is? Alternatively, is the Minister being kept in the dark like the rest of us? Have NHS managers gone AWOL and decided to take control of the matter, as seems to be suggested in the NHS Confederation pamphlet that came out this week. That document states:

“The NHS cannot and should not wait for government action to respond to the financial challenge.”

Have we lost political control of the NHS and, therefore, accountability for it? Will the Minister give us some reassurance that he and his colleagues are still ultimately accountable and in charge? If not, and if we are simply constantly reassured that clinicians are involved in the process, my hon. Friends and I fear that clinicians are being held hostage to a process that is about budgets. That is not good enough. Yes, the process should be clinically led; but, it has to be clinically led solely on the basis of clinical judgments. Even when the process is carried out on the basis of clinical judgments, the public deserve the right to be able to test the assumptions. That is what has been missing until now; we need the ability to test the assumptions.

As was mentioned by the hon. Member for Croydon, Central (Mr. Pelling), requests were made for the publication of the McKinsey report in exchanges last week. The Minister indicated that Ruth Carnall, chief executive of NHS London, would, of course, be listening to the debate and would act on the basis of what she had heard. As has been said, in the week since that debate, nothing has been published, nothing has been said and nothing has changed in relation to the nature of the process that is going on. That report should have been published. Although the Minister may feel unable to instruct, I hope he will ask NHS London to put the report into the public domain, because we ought to have the opportunity to see what it has to say.

This is an important debate about the very essence of what we should expect of a public service. Such a service should be open and transparent, so we need full disclosure. Those involved should understand that consultation must be held at a formative stage and that it is not just an end-of-process thing done to tick a box before implementing what they had decided would be done anyway. Such a service should be accountable to us in this place and, more important, to those who send us here. It should be accountable at the ballot box; it is not now, but it needs to be in the future, as that is the only sure-fire way of ensuring we have an NHS that people are confident in and that will deliver the services we demand.

As other Members have said, it is a pleasure to take part in a third debate on the future of NHS London. I reiterate the comments commending the hon. Member for Hornsey and Wood Green (Lynne Featherstone) for securing the debate. I also commend her for the tone in which she made her speech on behalf of her constituents, which was eminently sensible.

Like many of the discussions we have had on the subject, this debate is about trust and whether people can trust us as politicians and the Government to produce for them the health service that they deserve in the 21st century. The NHS has £110 billion of taxpayers’ money, but can people feel safe that the NHS around them is free at the point of delivery and that their needs and those of GPs will be understood?

The Minister has said today and on several other occasions that the reviews are being clinically led. He said that because the public trust clinicians a lot more than politicians. That is eminently sensible. However, the truth is that the process is not being led by clinicians.

The debate started with Lord Darzi’s earlier report on his vision for the future of the NHS in London. I spoke with him before he became a peer when he was an adviser to the Health Committee, of which I had the honour of being a member. He is a highly intelligent and highly skilled surgeon, but when I pushed him on his report bits of it started to flake off, because it was a vision. When he gave evidence to the Committee on the report we asked him how much of the estate in London would go under his vision, but he gave no answer, even though I pushed him extensively.

We have not spoken about the fact that 15 per cent. of the NHS estate in London is currently sitting empty. That is where some of the savings could be made tomorrow morning and where some income could come in straight away. I know the economic climate out there is difficult, but instead of leaving the estate to become even more decrepit and for some developer to come along, let us be forward-thinking about it.

I am afraid that the clinician argument is fundamentally flawed, which is shown on page 3 of NHS London’s document “Delivering Healthcare for London”, the whole premise of which is the shortfall in funding. Several assumptions are made in that document, the final one being that there will be a shortfall of between £1.5 billion and £1.7 billon in 2016-17. I have no confidence in the document, because when one reads it one finds that it is not only fundamentally flawed in its assumptions, but flawed simply in its maths. It assumes funding growth of 2.3 per cent., but that figure is actually a cut of 2.3 per cent., because the minus sign has been left out. That does not give my constituents, or any others, much faith.

I mention my constituents because we have always come into London for specialist services. With the demise of some of the hospitals in my area, it is obvious that more and more of those services will be required in London.

The hon. Member for Islington, North (Jeremy Corbyn) and others raised concerns about the consultation and about whether the public are being duped. Are we being asked to take part in a consultation on something that has already been decided? That is happening in my constituency, where 82 per cent. of my constituents said no to the closure of the A and E, but it went ahead. As several Members have said, if one loses the A and E, one loses the hospital. Let us have no illusions about that, because the hospital loses its intensive care, its high-dependency unit, its beds and its theatres. Those will all go if the A and E goes, because that is the back-up a hospital requires for an A and E.

My hon. Friend the Member for Bexleyheath and Crayford (Mr. Evennett) alluded to the worries in south-east London. He has every right to be concerned, because if those sorts of cuts are made to the front of A and E, the services behind it will go immediately.

Does the hon. Gentleman acknowledge that often plans are drawn up for health service changes from which clinicians themselves feel excluded? The changes seem to have some motor of their own that pushes them along until they eventually reach the light of day without support from anyone, and yet somehow they end up becoming fact.

The hon. Gentleman has touched on an important point. Clinicians are not only often excluded, but gagged and not allowed to tell the people they serve about their concerns. If they do, their careers are put at risk. That has happened in my constituency and it is happening today. Some of the clinicians who have been speaking to me have been leaking documents to me that the Minister says he has not seen. If he indicates that he would like me to supply them to him I will be happy to do so. I have all of them but one, for the whole of London. I would have hoped that he had seen them, because the Government cannot exclude themselves from a report from NHS London that is based on deficits in the funding supplied by the Government and the assumptions based on that, which mean cuts proposed for London.

I will not give way because I want to give the Minister sufficient time to respond. When we go further into the document, we find the assumption that hospitals can only stop—it is stop—people going to an A and E and get them to go elsewhere by physically closing the A and E, because when one is open people will invariably go to it. Some of the assumptions are dramatic, such as the one that polyclinics in the primary care sector could take up to 60 per cent. of A and E attendances. Funding models have been based on that assumption.

However, attendances at A and E increased last year, even in areas where polyclinics are open. In areas of London represented by Members who are not here today, but which I have visited in recent weeks—such as areas of north-west London—A and E attendances went up by 15 per cent. last year alone, even though some of those hospitals have bolted on GP-led triage at the front so that they can get some of the people who we would all accept should not be going to A and E to another triage point.

The point is that the public trust an A and E. They will go to an A and E. We can sometimes address the problems of access to GPs, which can be why people go to A and Es, but to assume that we can get 60 per cent. of the public who need services to decide not to go to an A and E is beyond belief.

One document that has not been withheld is the Government’s own report, “Primary Care and Emergency Departments”, which they commissioned from David Carson, Henry Clay and Rick Stern. Their assumptions are astonishing, because they actually agree with what our constituents are saying:

“We were surprised to find that there is no evidence that providing primary care in emergency departments could tackle rising costs to help to avoid unnecessary admissions.”

That is just one excerpt from the press release for that report. In it, the experts and clinicians state that proposals to try to close A and E departments and get people into primary care fundamentally will not work. The Government want to bury that conclusion. They did not want it to come out or to have the debates we have had for the past three weeks.

Should the policy go ahead? No, it must be stopped in its tracks because the whole premise is fundamentally flawed, as shown in the Government’s own documentation. As the shadow Health Minister and the shadow Secretary of State have told NHS London, we have promised a real-terms growth in NHS funding. The Government are not reinvesting money elsewhere in the NHS, which is what the Minister has said they will do. They assume that there will be cuts in NHS funding, and that is stated on page 3, right at the start of the document “Delivering Healthcare for London”. It is imperative that the Minister does not shirk his responsibilities.

The hon. Member for Sutton and Cheam (Mr. Burstow), the Liberal Democrat spokesman, said that Ministers cannot tell NHS London to publish those documents, but they can and they should because they are paid to take responsibility. They should tell NHS London to publish the documents so that we know what the proposals are and can debate them. We could then robustly refute most of the assumptions and look at what is best for the constituents of London, from the bottom up, from GPs and patients, rather than from the top down.

It is not a case of scaring people. I have visited many hospitals in the past few weeks and I know that NHS staff are really worried. They do a fantastic job, but at the moment their morale is low and they are genuinely worried that they will be unable to deliver the sort of care London deserves. We must not scare people, and I am afraid that I have to reiterate the point that the Liberal Democrats have been scaring people in Kingston, which is fundamentally wrong. We should have a proper debate so that the clinicians feel comfortable about telling us publicly what London needs. We should listen to them, rather than to the top-down Treasury officials who are trying to cut money from the NHS, which is what the Government want to do.

I begin by congratulating the hon. Member for Hornsey and Wood Green (Lynne Featherstone) on securing the debate and on recognising the hard work and dedication of clinicians and staff leading the changes to the NHS in that constituency and across the rest of the capital. Her constituents deserve the very best of health care, and that is what we want to ensure they are provided with. Despite the best efforts of NHS staff, I do not believe that they are currently getting the very best.

Until recently, London had some of the worst health care provision in the country. In 2007, London was performing poorly on waiting times, mortality rates and patient experience, relative to other strategic health authority areas. According to a MORI poll conducted in 2009, 37 per cent. of Londoners were unhappy with the time it takes to see a GP. Another result found that Londoners relied disproportionately on A and E. A recent study of unscheduled care concluded that 87 per cent. of children and young people attending A and E could have been better treated in a primary or community care setting. That is simply not an acceptable way for things to continue in our capital city.

The policy that we have set out in “Healthcare for London” is about giving Londoners what they deserve in terms of better health care and high-quality, clinically appropriate treatment when they need it. But change is difficult. It makes people feel insecure. After the 1980s, when everything was based on cuts, the assumption was that the NHS was all financially driven, and then a bunch of politicians stand up and say, “Of course it is, because it is the Labour party.” That is not the basis of what Lord Darzi set out, nor the basis upon which he got clinicians all around the capital and, indeed, the country to support his approach.

I will give way in just a moment.

Lord Darzi did that by engaging clinicians on the quality of care, and that is the basis upon which change must be made. However, let us be clear about this and, just for once, be honest with our constituents. It is important that hon. Members are honest with their constituents. Change does require change. It requires that hospitals and what people have been used to in the past must change, and that means—[Interruption.] Perhaps the hon. Member for Croydon, Central (Mr. Pelling) should settle down. I have said that I will give way in a moment, if he will just calm down a little. He is chuntering from a sedentary position. I realise that he is now independent, and I can see why his party would want him—

Order. The Minister has indicated that he intends to give way. The hon. Gentleman should accept that assurance and await the opportunity to speak.

Perhaps a little less aggression from the hon. Gentleman might be in order on this occasion.

It is important that NHS provision in London is clinically based on quality, and not financially driven. I have been very clear with managers in London and around the country that the NHS has priorities. The first priority is patient safety and patient care, and the second relates to targets and finance—in that order.

Today, thanks to major improvements in A and E and waiting times and, for example, the inclusion of cancer scores as of last summer, NHS London has improved significantly. Not only are 28 new hospital schemes, worth £1.8 billion, already open to patients and another three, worth £1.2 billion, under construction, but we are also seeing improvements in the constituency of the hon. Member for Hornsey and Wood Green at University College hospital in north central London and with the £30 million scheme at the Whittington, which I shall return to in a moment.

In January, only three people waited more than 13 weeks for an out-patient appointment, down from more than 40,000—indeed, 43,639—in 1998. That is a massive improvement in health care in London. We have also seen improvements in terms of strokes and heart attacks. Significant changes are taking place in London.

I promised to give way to the hon. Gentleman. He has now calmed down and let the vibrations settle a little, so I shall give way to him.

I think that the Minister is quite wrong to describe my behaviour as aggressive, and I greatly resent the suggestion.

The Minister is being very earnest, and I believe that the electorate understand and appreciate that approach. Nevertheless, would it not be right to say that the information that we are not allowed to share strongly leads with the financial concerns of NHS London? It is unfair to state that the changes are not driven by finance. The officials’ papers that we are not allowed to discuss deal with the significant financial pressures that the London NHS faces. Therefore, finance is a significant driver of the changes. Does he accept that?

I have not said that managers should be unconcerned about finance—that would be ridiculous. One expects managers and clinicians to care, first and foremost, about the quality of health care in London. Secondly, and in that order, finances and how care is delivered come into it. The taxpayer does not have unlimited money, nor does the NHS. Perhaps we all wish that it did, but at the same time, such issues have to be looked at in terms of priorities.

The Minister is being very sincere about the fact that we cannot have change without change—I totally accept that—but the thesis of my 25-minute contribution was that there is no evidential base in the public domain on which to argue for that change or to bring people along with it. That is the point that the Minister needs to answer.

I have already said that health care in London is improving. I should add that NHS budgets for PCTs are increasing by 5.5 per cent. overall this year and by 5.5 per cent. next year, if this Government are re-elected. I cannot speak for the other lot, if they were to get in. Things are improving.

I can also tell the hon. Lady that it is clear that clinicians are behind the process of change. A number of eminent clinicians have today written a letter calling for “Healthcare for London” to be developed and become the basis on which change takes place. They say that it is

“the best opportunity for a generation to truly transform the NHS. It is now or never.”

The messages in the letter, which is signed by leading clinicians, are clear: the NHS must invest in prevention, not just treatment, and concentrate specialist expertise for those who are ill in centres of excellence; people who do not need to be treated in hospital should be treated as close to home as possible; and clinicians should be at the heart of all decision making. Londoners endorsed the overall vision in an extensive consultation, with more than 40,000 people attending meetings and roadshows, and visiting the website.

The letter has been signed by eminent clinicians such as Adrian Newland, the professor of haematology at Barts; Dr. Daghni Rajasingham, consultant obstetrician; Denise Chaffer, the director of nursing at the Mayday Healthcare NHS Trust; Professor Dame Donna Kinnair, director of nursing at NHS Southwark; Dr. Fionna Moore, the medical director of the London Ambulance Service; Dr. Geraldine Strathdee, consultant psychiatrist and director of clinical services at Oxleas NHS Foundation Trust; Matt Thompson, professor of vascular surgery—[Interruption.] I could go on. This is a long list of eminent clinicians who are anxious that the attempt by some politicians to frustrate the process for short-term political purposes should not be allowed to happen.

No, I have only a few minutes, so I hope that the hon. Lady will forgive me. I appreciate that this is her debate, but I want to deal with her suggestion that somehow there is secrecy.

We have tried to give clinicians a space where they can debate some of these issues and discuss what is best for London. They do not want to engage in public controversy. That takes time and energy, which they would rather spend on their patients. We need to give them the ability to discuss what is best for London, and how best to deliver health care. If every time they have a discussion and put something on paper, or there is a minute of a meeting or a report, it has to be put out in the public arena, so that Liberal Democrat MPs can attack them over their lack of evidence and so on, they will withdraw from engaging in the discussion of health care for London. The result will be that patients in London—patients whom the hon. Lady and her colleagues represent—will suffer because they will not have input from those clinicians.

Clinicians are asking for that space and for the ability to discuss and come forward with reasonable proposals. That was the basis on which Darzi put together his proposals, and it is on that basis that we are trying to ensure that clinicians have the space to have discussions. I hope that the beneficiaries of that will be people in London, who are looking for good health care.

I have only a few seconds, and I want to say something about the Whittington. We have invested £30 million in it, and we want to ensure that the hospital continues to develop. I have seen no evidence that A and E at Whittington should close. I would want to see a good clinical case—I have never seen one—for closing it. We have invested money in the hospital, and we want to ensure that it can continue to develop for the people of London. We will ensure that any case is looked at with care. I am sceptical about closing A and E at Whittington, and I would find it difficult to accept the case for that to occur.

Rural Payments Agency

It is a great privilege to be in Westminster Hall, talking about my concerns about the Rural Payments Agency. If I were debating with the previous Minister, this would be a case of more vets, rather than more doctors.

The Rural Payments Agency has been set up to make life simpler for farmers by distributing European Union allowances efficiently and fairly, but it does precisely the opposite. Some farmers are being paid too much; some too little; and, in many cases, some are paid absolutely nothing at all. It has driven some of them to distraction and others, I am afraid, to bankruptcy. I fear that a few may come dangerously close to ending their lives, because of the antics of a dreadful agency. My constituency relies on agriculture, which is the biggest industry that we have by some way, but it is always vulnerable to the weather, disease and, worst of all, stupid bureaucracy.

The RPA came in with an overdose of stupidity and a typically dangerous political target that the Government were trying to hit. The aim of the new payments agency was to give a 30 per cent. boost to arable farmers, increasing their incomes and putting the screws on livestock farming instead. Survival is the name of the game for many livestock farms in south-west England. The agency now operates the most complicated system to assess farm incomes that is run by the most inefficient computer and managed by a team of blundering idiots. The cost of administrating the single farm payment is six times higher in England than in Scotland, because the RPA chose the most absurd way of doing things.

A couple of weeks ago the Public Administration Committee, of which I am a member, took evidence from the two clowns who are responsible: one is the permanent secretary at the Department for Environment, Food and Rural Affairs, a lady answering to the name of Miss Ghosh, and the other is Mr. Cooper, the chief executive of the Rural Payments Agency. They would be out of place on any Somerset farm, because I doubt whether either of them has wellies or whether, if even they have, they have ever got them dirty. Their performance before the Committee was far from impressive. They were like a comedy duo: Tommy Cooper and Golly Ghosh. Golly giggled a lot and Tommy Cooper made a whole load of public money disappear—just like that. They preside over a festering dung heap of an agency, but they continue to say that everything is getting better. They are so far out of touch that it is laughable. Unfortunately, the joke—it is no joke—is on my farmers. I intend to spell out how bad it is.

Dealing with the RPA is like playing Russian roulette. The odds are dangerously weighted against you. Sooner or later the system will do your head in. Before this debate, I checked what one Somerset farming expert told me, because I did not believe him. He said, “Ian, pick up the telephone and dial 0845 6037777, then see what happens.” So I did. The recorded voice of a female android told me that I was now connected—

Order. I understand that the hon. Gentleman has strong feelings about this, but I think he should moderate some of his language.

Mr. Howarth, I stand in awe of you. Thank you for pulling me up on that. I apologise.

I am not sure if the android was going wrong. Unfortunately, all the voices there are computer-generated. I was told to press 1 for the nice-sounding robot who would tell me that I was being held in a long queue, to press 2 for a different voice repeating that five minutes later, to press 3 for a chorus of dreadful music—the sort of thing that is heard at a crematorium just before the coffin slides behind the curtains—and to press 4 to have my head examined. I gave up after 56 minutes. If I was a farmer, such a pointless waste of valuable time would make my blood boil. The only consolation—the Minister should be pleased—is that those voices did not keep interrupting the silence to tell me that my call was valuable. For that, I thank them. But at no stage did I manage to speak to a human being.

There are probably some very talented, caring people at the RPA—I am sure that there are; most organisations have them—but people cannot get through to speak to them. The whole system is a conspiracy to drive us all mad. It seems to have been devised by a vicious Dr. Strangelove with some bizarre grudge against the farming community.

Here is another real-life reminder of RPA madness from Somerset. Yesterday, a man sat down to study the “Single Payment Scheme Booklet 2010”, which is not much of a title, I am afraid, but bestsellers do not come out of Departments. He got to page 46 where it says, helpfully, “How do I apply for the uplands transitional payment?” That is fair question for Exmoor. However, the answer was, “Sorry mate, you’ve got the wrong booklet. You need the ‘Uplands Transitional Payment 2011 Explanatory Booklet’. Go to our website and download it.” So off he clicked, into cyberspace, where there are no recorded voices. He got as far as the Rural Payments Agency download page, where a message mysteriously appeared, saying, “No information on this item is available”. How on earth can people fill in forms if the RPA will not tell them where they are? The computers at the RPA always seem to say no. I have a horrid suspicion why.

The civil servants at the old Ministry of Agriculture, Fisheries and Food knew virtually nothing about computers. I am in the same boat. Quill pens? Yes. In that respect, they are the same as me. Combine harvesters? Probably. But computers? No. MAFF and DEFRA hired a global giant to advise and equip them for the digital age. They signed up with IBM. I have had good cause to mention IBM in the House before—in this Chamber, in fact—on numerous occasions. IBM may be huge and it may be rich, but it ought to carry a health warning. It has been involved in so many Government computer contracts that go wrong that it is embarrassing. It promises the earth and always charges the earth, but its products rarely do what it says on the tin.

IBM was hired to provide the back-up for MAFF and DEFRA. When the Rural Payments Agency came along, IBM designed the mapping technology, too. Everything depends on having good maps in this game. Maps provide the proof that officials need before they can arrange farm payments. We all know that that is so: that is the system. But the technology does not work properly. Farmers found that there were errors; the errors affected how much money they got; and things became chaotic. Guess what—they start again from scratch. They are still compiling detailed mapping. The system is wildly behind schedule.

Many other European Governments allow farmers to alter their maps online, but not here. Why not? We do not because we cannot, because IBM cannot make the system work.

I recently met representatives of my farming community, who have also expressed their frustration at the manner in which the Rural Payments Agency functions. Running parallel to that is the unbelievable quantity of totally indigestible complex legislation that drives them mad and does not achieve its objectives. Does my hon. Friend agree that the Europeanisation of the farming community and of agriculture, and the complexity and over-regulation that goes with it, is one reason why the agricultural community is in such distress?

I would never disagree with my hon. Friend. He is right. The whole thing is a shambles. It came partly from Europe, but the vast majority is home-made mess.

The reality is far removed from the original glitzy promises made when the RPA launched. I quote a cheesy statement made long before the Minister was appointed:

“An ambitious programme of business change to improve services to customers, reducing the cost base and opening new channels for rural communities.”

When reading such language from any Department, one knows that there will be a bit of pie in the sky. I am sure that IBM did that. I can visualise them drooling in financial anticipation. Every time the Government get involved, it is Christmas for IBM, because there is lots of extra work.

In 2003, the RPA hired Accenture. In 2004, Accenture won IBM’s business partner leadership award. Both companies swear by a second-rate system called SAP, which we have encountered so many times that it is almost getting exhausting. SAP is causing huge problems in Somerset, because IBM have done the same as it is doing to the Minister and the RPA. Southwest One, which we have to put up with down there, is a classic example of how not to do things, but it is on a tiny scale compared to what is happening. The public sector organisations that signed up are in a complete mess. The IBM team that installed all the bits that did not work properly at Southwest One were the self-same people who installed all the bits that did not work properly at the RPA. The names are the same. Hon. Members may be beginning to get the picture, and it is a sorry one.

Giant outfits such as IBM may easily pull the wool over the eyes of naive councils and—dare I say it?—big Departments. Let me remind the Chamber of some up-to-date news. It emerged this week that a secret national communication system called SCOPE, which was intended to keep 007 and his mates in touch, has collapsed. That is nothing to do with the RPA, but the principle is the same. Its system, which was designed by IBM, did not work and so far the Government have failed to get a brass farthing back. In fact, they are still paying.

If Smiley’s people cannot handle the likes of IBM, how on earth can the minnows who run the RPA do so? They are out of their depth when they try. As with every Department, they lacked the internal know-how. That is not a criticism; it is a fact. They only thing that they contributed was a fancy name. The RPA wanted to call its new computer RITA. I do not know whether the Minister knew that. It is a great name, but little did it know that RITA was destined to become a high-maintenance meter maid. Every time the RPA changed things to try and make the system work better, RITA demanded more money. As RITA was built and run by big computer companies, that involved huge sums.

Why do the big companies such as IBM always get the business? The official answer is that only big companies have the finance if compensation is ever involved, but it never is. When a Government computer project collapses, they never take the supplier to court because they do not want civil servants to give evidence and prove how useless the system was. There has never been a Government court case against any big supplier. They always settle quickly and quietly to avoid embarrassment, so the big firms end up keeping the money—our money.

IBM’s friends at Accenture signed up with the RPA for a system costing no more than £76 million. Four years later, that price was £350 million. Last year, the National Audit Office produced one of its most damning reports ever and said that the RPA’s system should be ditched. It revealed that the RPA shelled out £20 million in one year for 100 specialists from Accenture to fix the failed system.

I will simplify those gobsmacking sums for the sake of hon. Members. The RPA was paying £200,000 for each specialist, which is more than the cost of hiring 100 Prime Ministers. Meanwhile, IBM was busy doing what it seems to do best—making a sow’s ear out of a silk purse at our expense. It managed to lose data discs containing every detail about every payment for 100,000 farmers. A great deal of confidential information, including all their bank account details, was on those discs, 39 of which were lost, although 37 were eventually found, having been put on the wrong shelves at an IBM data centre. That was done not by the Government, but by IBM. Two discs vanished into thin air and have never been found at the IBM data centre. Yet IBM is still in charge of the data, and Accenture is still employed. What on earth is going on?

It is about time the fresh air of transparency was allowed to blow into the secret world of public sector computing. My party already has detailed policy commitments to stop those costly deals being made in the dark. Will the Minister consider doing the same? We are paying for those deals, and we deserve to see the small print. Parliament, not just Departments, should see it. If that happened, I suspect that the Conservatives might even win the forthcoming election.

Perhaps the Tommy Cooper of the RPA should also watch his back. It is not decent for a career civil servant on a very generous salary—£145,000 a year—to globetrot to and from the Indian headquarters of those giant computer companies. Last year, he claimed £40,000 extra for travel and hotels, including business-class flights, to Bangalore and five-star hotels. He also picked up an £11,000 bonus. I do not understand the purpose of rewarding failure. I thought we had grown out of that culture.

Bonus payments of £1.8 million have been paid to the top people at the RPA over the past five years. So while my farmers were under pressure and going broke, the RPA was living it up. That is not fair. It is a sorry story, and I am afraid that it is not over. The Minister may have prepared soothing words and small apologies, and I suspect that he will want to say that things are getting better. Fine, that is what the Government do. Well things jolly well ought to be better; they cannot get much worse.

Up on Exmoor, a farming constituent is currently the subject of an RPA trial. Tommy Cooper’s team is conducting an experiment to try to put new codes into the computers, supposedly to make life easier. It has re-recorded my constituent’s farm and managed to lose all his old codes, so he risks not being paid because the computer no longer recognises him as a farmer. Welcome to the continuing chaos of the RPA, which will drop people in it, drop them in it again, and then drop them in it yet again. The situation is so bad and so chronically inefficient that the European Union fined the agency £75 million, and I am afraid that that is a bill that we pick up.

The way in which the RPA works makes the mafia look honest. It is going wrong too often. It never supplies calculations or background information. It tries to claw back money and sends out threatening letters, but it still provides no explanation to the farmers of west Somerset and Bridgwater. They were told that they would receive the paperwork after they had paid up and that, if they did not pay up, they would not receive subsidies. Those are the tactics of a mob, not a Government agency.

The RPA has been investigated by the National Audit Office, the Select Committee on Public Accounts, the Select Committee on Environment, Food and Rural Affairs, the ombudsman and now the Select Committee on Public Administration. Why does no one have a good word to say about it? It has made, and is still making, the lives of some of my farmers almost impossible. That must stop. I do not want to hear another rendition of “Things can only get better”. We have just about had enough.

Order. I take it that the hon. Gentleman has the authority of the hon. Member for Bridgwater (Mr. Liddell-Grainger) to speak.

I have indeed. I spoke to my hon. Friend the Member for Bridgwater (Mr. Liddell-Grainger) earlier, and I hope that the Minister will not mind if I make a brief contribution.

I have the gravest reservations about the Rural Payments Agency because of the experience of my constituents. I need not repeat the catalogue that my hon. Friend recited, because it is on the record. He described admirably the technical difficulties and the enormous number of bodies that have looked into the agency and found it wanting. However, the buck does not stop with the agency. I believe strongly that the Government have a direct responsibility, as my hon. Friend clearly indicated; that is why the Minister is here to answer on behalf of the Department for Environment, Food and Rural Affairs.

The root of the problem is the creation of a body to satisfy the requirements of the European Union’s legal framework for farming. That is the agency’s raison d’être. The technical difficulties and absurdities to which my hon. Friend referred have a life of their own. The root and origin of the problem is the fact that the agency is attempting to do something in the face of massive complications and over-regulation, which are causing deep anxiety to my constituents.

The problem is serious. My farmers are deeply worried about how the system operates, and they told me the other day that they could not understand why the Ministry is described as the Department for Environment, Food and Rural Affairs when “agriculture” is the most appropriate word to use in the nomenclature of a Department with responsibilities to the farmers of this country. Why can we not simply return to describing the Department as a Ministry of agriculture, so that farmers can have confidence that the Government are working for them and for the country at large?

It is a pleasure to see you presiding in the Chair this afternoon, Mr. Howarth. I hope it is in order for me to express my appreciation of your consideration yesterday, when I was not feeling quite as well as I do today.

I congratulate the hon. Member for Bridgwater (Mr. Liddell-Grainger) on securing the debate. I welcome the opportunity to respond to the issues raised, and to explain our work to build on the improvements of the past few years, as the Rural Payments Agency aims to provide a more consistent, reliable and cost-effective service.

In many ways the RPA has an unenviable task. The payments that it makes are welcomed by recipients, but there can be scepticism about the accompanying European Union rules and regulations. Those rules have laudable aims—the control of public funds, safeguarding the environment and protecting public and animal health—but their practical application can be seen as draconian or disproportionate. Against that background, and given the problems experienced with the introduction of the single payment scheme or SPS in 2005, it is no surprise that strong emotions are generated by the agency’s activities, as was articulated by the hon. Gentleman at the beginning of his contribution. However, I do not intend to dwell on the events of 2005 and 2006. That debate has been held on a number of previous occasions. The main point is that we learn the right lessons from that experience and take forward the recommendations of various reports, including those of the Select Committee on Environment, Food and Rural Affairs and the Public Accounts Committee.

In each scheme since 2005, the agency has met its formal targets and avoided late payment penalties. Under the 2009 scheme, 86,500 farmers received some £1.31 billion within two days of the payment window opening on 1 December. The agency met its target to make 90 per cent. of payments on 24 February, some five weeks ahead of schedule and three months earlier than had been achieved two years previously. Such an improvement to the payment timetable inevitably creates an increased focus on the position of those farmers who remain to be paid. There are around 7,500 such cases, some of which involve complex issues such as probate, business partnership changes and domestic disputes. As hon. Members representing the relevant constituencies can testify, some of the outstanding cases are also connected to specific remote sensing checks, which affect groups of farmers in particular locations.

In all cases, I can assure all concerned that the RPA is working hard to complete the necessary checks and to release payments as soon as possible. Arrangements are also in place to deal with genuine hardship cases that arise before full payments are possible. However, experience tells us that partial payments lead to further problems down the line and are generally to be avoided for that reason. Improvements in payment performance are reflected in customer survey results. Two years ago, those asked about their overall level of satisfaction with the agency rated it 6.2 out of 10 on average; that figure has now risen to 7.4.

Inevitably, challenges remain. Completion of the map upgrade is one of those. The data currently used are based on Ordnance Survey’s 2001 MasterMap information, which is out of date and does not reflect the true position on the ground.

I am sorry; if I get to the end of what I have to say, I shall be happy to give way to the hon. Gentleman, but he has already taken some of the time that I had anticipated having. If he will allow me, I shall get through my remarks and see how much time is left before 4.30.

Given EU requirements to use the most recent mapping information available, no change was not an option. The exercise has been a major logistical one involving over 2 million land parcels. The work was planned carefully, with a trial, then a pilot of 1,000 farmers and a gradual roll-out of the first set of map packs. All 107,000-plus first maps have now been sent, with special arrangements in place for those subject to an inspection during 2009. In line with expectations, a little more than 50,000 people have requested amendments, and more than 70 per cent. of those have had a revised set of maps provided. I have had close involvement in the exercise and have had weekly conversations or meetings with the RPA chief executive to track progress. The exercise has not all been plain sailing, and it is by no means complete, but I hope that all those concerned would acknowledge that the process has been considerably smoother than the last mapping exercise in 2005.

The remaining maps are now being processed and checked, and will be returned to farmers over the coming weeks. Tailored advice is being provided to those who will complete the 2010 application form over the coming weeks and who have yet to be provided with revised maps. To improve customer service more generally for the 2010 scheme, the agency is taking a number of additional steps. Most significantly, this year there is a full SPS online service for the first time. All farmers will be able to apply online for an easier, quicker and reassuring service, which is free to use. Additional drop-in centres will be opened, where farmers can deposit their claims with RPA staff who will perform a basic check on the spot in order to help avoid common errors causing problems at a later stage. Those staff will also offer help in completing the application form online. For the first time, SPS specialists from the RPA will work with the Farmers Weekly Interactive website on a special SPS forum to answer questions posed online by farmers and agents.

Looking further ahead, I announced last September that the Department for Environment, Food and Rural Affairs would undertake a review of the RPA to ensure that the agency was ready to react to changes arising from future common agricultural policy reforms. The review is to consider the RPA’s financial and operational processes and to identify where the RPA might be able to make improvements and efficiencies. The information gathered will also be helpful in responding to the recommendations of the recent reports—referred to earlier by the hon. Member for Bridgwater—by the National Audit Office and the Public Accounts Committee, in particular on tackling outstanding data quality and overpayment issues, on IT improvements and on driving down processing costs.

The review is not scheduled to be completed until the end of the month, and it is too early to give any details on the findings. However, our intention is to report those findings to the House in due course. As my right hon. Friend the Secretary of State said to the National Farmers Union annual general meeting last month, at that point we will sit down with farmers’ representatives and listen to their specific ideas about what more can be done.

However, I can confirm that we will not introduce a minimum payment amount, which is what some have called for. The idea that that would save millions of pounds conveniently ignores, first, the fact that small claims require relatively little processing effort—the larger claims push up the average processing costs—and, secondly, the fact that the claims would still need to be processed to determine whether the value exceeded the given figure. What we have done for the 2010 scheme, after consultation and with the full support of the NFU and others, is introduce a minimum claim area of 1 hectare. Those claims can then be filtered on receipt at the RPA.

I would like to register my appreciation of farmers’ continued patience as the agency continues consistently to raise its performance to the levels that we all want to see. I extend that appreciation to farmers’ representatives; I have met the heads of the NFU, the Country Land and Business Association or CLA, and the Tenant Farmers Association on a number of occasions to discuss progress, and I have always found them constructive in their criticisms. We have another meeting scheduled for next week.

On the statistics, in 2007, 75 per cent. of payments by value had been made by 22 February. In 2008, that percentage of payments had been made by 22 January, and in 2009 it was made by 17 December. In 2007, 90 per cent. of the payments by value had been made by 21 May; in 2008, that was done by 16 March, and in 2009 by 24 February. The hon. Member for Bridgwater said that no progress had been made, but those statistics clearly demonstrate year-on-year progress. I am not in denial, and I am not for a second saying that further improvements are not possible, but the agency is doing everything that it possibly can to improve the situation, and DEFRA is doing the same.

Will the Minister answer my question, if he can, or give some indication of whether the Department is thinking of changing its name from DEFRA to something more along the lines of “the Ministry of agriculture”? That concern is strongly felt by the farming community.

The hon. Gentleman makes a reasonable point, which I have heard articulated in different visits to agricultural communities. Clearly, any future Government would always consider such a point when ensuring that the title of each Department reflects its interests. A split in the references came about when the Department of Energy and Climate Change was created, taking some of DEFRA’s old responsibilities. DEFRA is clearly much more focused on agriculture, because it has a much more specific reference.

At some point in the future, whether the Labour party or the hon. Gentleman’s party is returned after a general election, whoever is the Prime Minister might well want to review the Departments and ensure that the structure is as efficient as possible for the delivery of services to communities. Such a review would always take on board the names of the organisations, although such changes always have a cost, not least because of letterheads, e-mail addresses and the rest of it. However, I understand that many in agriculture would like to see “agriculture” back in the departmental title, but we have no plans to change at the moment. We believe that we fairly reflect the issues and the matters of concern to agriculture. We are certainly doing our best to ensure that they are dealt with as efficiently as possible.

In conclusion, there is more to do, and the RPA and DEFRA will do all that they can to ensure further progress.

Private Rented Sector (Durham)

It is a pleasure to speak under your chairmanship, Mr. Howarth.

I speak this afternoon about an issue that is extremely important to my constituency. When I was elected in 2005, many residents quickly came to me to say that they were very concerned about the lack of balance in our local community and the fact that more and more of the city was being taken over by private rented housing. That was a problem because the housing was empty for a huge part of the year and local residents felt it was destroying our sense of local community.

In response to residents’ concerns, I set up a local group called the balanced and sustainable communities forum, which had representatives from the local council, residents’ groups, the university and the police, to see whether we could find a way forward. We quickly started to lobby the local council to adopt policies to give us a greater mix of housing in the city centre. That included asking the council to have planning policies to promote family housing, to stop giving planning permission to so many apartment blocks, to use selective and/or additional licensing to control better the private rented sector and, overall, to have a strong policy in favour of affordability. Unfortunately, all those requests fell on deaf ears. The local Liberal Democrat council at the time simply did not want to hear us and certainly did not want to respond to the points that we were making.

In addition to setting up the local group, which was pressing for local solutions, I decided that we probably needed a change in legislation if we were really to tackle the issue facing us, so I set up in Parliament the all-party group on balanced and sustainable communities. We campaigned particularly on changing legislation with regard to planning permission for houses in multiple occupation and when the trigger for planning permission for an HMO comes into being, and with regard to further powers to register private landlords.

I emphasise that we were not anti the private rented sector. Indeed, it was always our view, and it remains my view, that responsible landlords have nothing to fear from additional regulation, because responsible landlords generally manage their properties very well. It is the landlords who do not manage their properties well and who need to improve the service they are offering their tenants who are concerned about greater regulation.

There was thus a lot of local and parliamentary activity designed to get the issue on the agenda. One of our early strategies was to hold an Adjournment debate in this very Chamber. My right hon. Friend the Member for Southampton, Itchen (Mr. Denham), who is now Secretary of State for Communities and Local Government, was then arguing alongside me. He, my hon. Friend the Member for Southampton, Test (Dr. Whitehead) and I were arguing that a change was needed in the legislation. I am delighted that today I can stand here and congratulate and thank the Secretary of State and my right hon. Friend the Minister for Housing, and my hon. Friend the Under-Secretary of State for Communities and Local Government who is in the Chamber today. They all listened to what was being said by the all-party group, set up a review of the private rented sector and of HMO licensing and came back with a set of proposals that have been turned into new statutory instruments and other new legislation relating to HMO planning permission and the registration of the private rented sector.

That legislation is very important because it captures exactly what we wanted it to do. In cities such as Durham, most of the HMOs are not huge properties. The previous legislation that required only houses or homes with more than six people to apply for planning permission meant that most of the HMOs were not covered, because most of the houses in Durham are small terraces that do not accommodate six or more people, or they are ex-council or ex-social rented sector housing and also not very big. Therefore the change in legislation whereby it is up to six people suits us very well. I am also very pleased that the Government have decided to go ahead with registering all private sector landlords. That gives us two important tools to better manage private renting in our area.

That is an important step forward, but we still have a problem, which is how we deal with the fact that there are currently too many private rented houses in a particular area. We still require policies that will help us to bring back properties from the private rented sector to provide family houses in order to get a better mix in our communities. We still have the concentration problem. We hope that the local council can buy back some of the properties, and one of my questions for the Minister is whether consideration could be given to a fund that would enable registered social landlords or the council to start to buy back properties, especially now, when market rates are relatively low.

I also want better regulation of the private rented sector. That means that the local council will have to adopt and implement the statutory instruments that are now in place, but it will have to do more. It will have to clamp down on antisocial behaviour and put in place community development policies, because much of what has been lost with the spread of the private rented sector is community spirit and community cohesion.

In Durham, the problems of the private rented sector are exacerbated by some additional policies—or lack of policy. The first issue is a lack of proper conservation area policies in the city centre, which has been a long-standing problem with previous councils of a mixture of political cultures. What we need now is a strong set of conservation area policies from the new council that will help us to tackle some of the problems associated with private renting. The most obvious one is the predominance of “To Let” boards in the city centre. A number of people will know that Durham is a very beautiful city. It has a wonderful heritage, but that heritage is being blighted by the proliferation of “To Let” boards in the city centre. They go up in October or November and stay until February or March. It is unsightly and upsets the local population.

There is also too lax an attitude to the licensing of pubs and clubs locally, which leads to the concentration of a particular type of activity in the city centre. Accompanying that is lack of attention to the concerns raised by city centre residents, not only about their problems with private renting but about the wider society in which private renting operates.

As I said earlier, between 2003 and 2009 there was the council’s complete non-implementation of policies on getting affordable housing back in the city centre, and there were no policies whatever on family housing or mixed communities. If we are to take advantage of the new legislation, we need a whole set of additional policies, primarily put forward and implemented by the local council, to enable changes to the private rented sector to take effect.

We need the council to engage proactively with the local community in deciding what sort of mix it wants in its communities. I can report that that has already begun. Council and planning officers have started a series of meetings with local residents about how to change the city in a way that reflects their concerns. The council is also consulting on what more conservation area policies should achieve, and how they could better reflect Durham’s heritage, ensuring that future development, including any housing development in the city centre, is appropriate and adds to and enhances the city’s wonderful heritage.

Residents are asking for a city centre regeneration plan that has new housing at its core. Local residents are not against new housing or redevelopment, but they want it to be of good quality, and they want it to bring mix into the community. They want policies that, as far as possible, do not bring more luxury apartments into the city centre, especially as people have such trouble selling and renting them at the moment.

In addition to new affordable and family housing, people want better retail provision. That has suffered over the last few years, and people want a vibrant retail sector. They also want the council to make more of the skills that the university brings to the city centre, to bring about regeneration not only of the physical environment but of our economic environment, based on knowledge and a skills transfer between the university and the industrial sector. We absolutely need more of that. There is pressure on the university to build more student accommodation, using some of the available land for purpose-built student accommodation to relieve housing pressure on the city centre, and to free up accommodation so that it can be transferred back to the social rented sector or the council sector.

People want a set of cultural activities that go beyond drinking and that aspect of the night-time economy. That does not mean that they, or I, are against a night-time economy in Durham, but we are arguing for balance; local residents, who are often on the receiving end of the activities of those who have had too much to drink, should be able to go out for the night and enjoy themselves. The view of residents, which I share, is that those activities are out of balance at the moment, and that a wider range of activities should be on offer.

The Government have gone a long way to addressing the concerns of the all-party group on balanced and sustainable communities, and should be applauded for the legislation they have introduced. We now have significant tools to tackle the concentration and spread of private renting throughout the city centre. The legislation needs to be implemented by the county council, but it must done by implementing the policies in the wider framework of regenerating the city centre, not only economically and in its built environment but culturally. Everyone who lives in the city would thus have a much better quality of life.

It is a great pleasure, Mr. Howarth, to serve under your chairmanship. I congratulate my hon. Friend the Member for City of Durham (Dr. Blackman-Woods) on securing this debate. As she said, she led a similar debate in 2007.

My hon. Friend has made herself an expert on the subject of the private rented sector. She promised her constituents that she would work hard to make progress in tackling the problems associated with that sector when she was first elected, and she has been as good as her word. She has kept that promise and worked tirelessly to lobby Ministers on the need for a change in approach.

My hon. Friend established the all-party group on balanced and sustainable communities, which has become one of the most active and successful of such groups. Her work is a fantastic example of what Members of Parliament can do if they listen to local people, understand the concerns of the community, bring those concerns to the Government’s attention and fight and lobby for change. She should be congratulated on everything that she has done. As a result of her work, she can justifiably claim to have changed legislation on the private rented sector. She has achieved more for her constituency in one Parliament than many MPs manage in their careers.

I am grateful to my hon. Friend for giving me the opportunity to set out what the Government are doing to meet the concerns that she has expressed. As she said, private rented housing is essential to maintaining a mixed community. A strong and well functioning private rented sector is a vital component of any housing market, and the recent downturn has further highlighted its importance, both in supporting housing growth and in providing homes for young people just starting out on an independent life.

The sector also houses some of the 13,000-plus young people studying at the ancient and distinguished Durham university, which my hon. Friend represents. Students make a substantial contribution to communities. They help to keep communities alive by helping to sustain and regenerate them. However, some of the challenges of private rented housing are particularly acute in areas with high a concentration of students living in certain parts of university towns and cities.

Houses in multiple occupation also make an important contribution to the private rented sector. However, high concentrations of HMOs have raised local problems in some towns and cities, including those with large numbers of students. That is often characterised as the studentification of an area. The presence of a few unprofessional private landlords with badly managed properties in poor condition can increase the likelihood of tenants such as students experiencing health and safety risks.

We want to support the private rented sector in all the roles that it performs. The packages of measures that we announced on 27 January and 3 February 2010 will do precisely that. On 27 January, we announced that we had decided to change the planning rules by introducing a specific definition of a HMO. The rule changes will mean that, from 6 April 2010, any material change of use from a dwelling house to an HMO will require specific consent from the local planning authority.

As my hon. Friend knows, local authorities are already under a statutory duty to license HMOs. Some 321 licences have been issued in County Durham since the scheme came into being. Many of them are in the city and are the result of my hon. Friend’s work. Local authorities also have the discretion to extend licensing to those HMOs that do not meet the mandatory HMO licensing requirements. On 27 January, we published a short consultation, seeking views on possible changes to the procedures for establishing discretionary schemes under the Housing Act 2004 for licensing landlords. The options on which we have consulted include introducing a general consent that would enable local authorities to introduce discretionary licensing schemes without having to seek the Secretary of State’s specific approval.

I want to congratulate my hon. Friend on the leadership that she has shown in her community. We are keen to ensure that local authorities such as Durham county council see provisions such as the licensing of HMOs under the 2004 Act, as well as other voluntary initiatives, such as landlord accreditation schemes, as a way of developing a partnership with good landlords in their area, and I hope that the local authority will listen to her views and respond to the positive lead that she has taken in her community.

We encourage all local authorities to work closely with university student unions, local landlord organisations, residents’ groups and the police to address the issues that can arise. The measures that we announced on 3 February include a national register of landlords, the regulation of letting and managing agents, mandatory written tenancy agreements and extending the protections of assured shorthold tenancies to a wider range of tenants and local lettings agencies.

Does the Minister agree that the additional measures that the Government have introduced protect tenants as well as local residents and that they should be supported on those grounds as well? Such measures seek to strengthen our tenant legislation, too.

My hon. Friend is absolutely right. Ensuring that tenants get a better deal is a key part of building a stronger private rented sector, which we need in this country. That is in no small part due to the campaigning work that she has undertaken.

We consulted on all the measures that I listed in the summer. They received a positive response, and we intend to legislate on them at the earliest opportunity. The regulatory elements of that package will help, but we want to go further and embed more support into the system now. To that end, we have announced three areas for immediate work. There will be a private sector tenants’ helpline, new research to explore how to capture and disseminate consumer feedback and new scope and support for tenants’ voice.

I should like to deal with a couple of the points that my hon. Friend raised. She asked whether it was possible for us to consider greater support for local authorities to buy back homes. She will be aware that it is possible for registered social landlords to do that at the moment. We encourage local authorities to work closely with RSLs. Provisions are in place for local authorities to take over the management of poorly run properties. Empty dwelling management orders and other management orders can be used to ensure that those homes are not causing problems for the wider community.

My hon. Friend also asked about estate agents’ boards. Like other advertisements, they are subject to planning rules. Briefly, class 3A of the Town and Country Planning (Control of Advertisements) (England) Regulations 2007, which replaced the 1992 regulations, gives deemed consent for advertisement boards to be displayed by firms such as estate agents, chartered surveyors, auctioneers and valuers to advertise land or premises for sale or to let. Only one board for a dwelling may be displayed, and there are strict limits on its size. The board must be removed not later than 14 days after completion of the sale or grant of the tenancy. Local planning authorities have the normal planning powers to enforce the advertisement rules if they consider it necessary. Local authorities may also apply to the Secretary of State for a direction restricting deemed consent of estate agents’ boards in a particular area. Directions have recently been given in Hastings, Leeds and Charnwood.

I thank the Minister for giving way again; he is being very generous. Is he saying that local authorities have the power to stop boards being displayed in a particular area, especially a conservation area? I have been arguing with my local authority about that issue.

Such powers exist, but before a direction is made under regulation 7, the local planning authority would need to convince the Secretary of State that it would improve visual amenity and that there is no other way of effectively controlling the display of estate agents’ boards. If my hon. Friend wants to know more about that, I would be happy to arrange for her to meet officials in our Department, so that she can discuss exactly how the procedure works.

In conclusion, may I reiterate my thanks to my hon. Friend for initiating this debate and to the all-party parliamentary balanced and sustainable communities group for its helpful contribution to tackling private sector housing issues? I hope that the responses that I have outlined will go a long way towards addressing the issues that she has identified, and I look forward to working both with her and the all-party group again.

Question put and agreed to.

Sitting adjourned.