Wednesday 23 June 2010
[Mr Joe Benton in the Chair]
Human Tissue (Availability)
Motion made, and Question proposed, That the sitting be now adjourned.—(Stephen Crabb.)
The issue of making samples of human tissue available for use in medical research may seem obscure at first glance, but it has a huge impact on some of the other issues that we commonly discuss in this place, including the development of new medical treatments for common diseases, the safety of patients treated by the NHS, and the ever-controversial matter of scientific experimentation on animals. In today’s debate I shall discuss how increasing the availability of human tissue to the research community would be to our advantage, and shall suggest ways in which the Department of Health might help to make tissue samples more accessible.
I first became aware of the issue because of life sciences activity in my constituency. Glasgow is unfortunate in having one of the highest cancer rates in Europe, but that means that it has become a world-class centre of excellence. The Beatson research centre is based in my constituency, just outside Glasgow, and a new translational research centre is due to be built alongside it shortly.
The area is also a hub for other companies that work in the life sciences industry, such as the biomedical research company Biopta, which is based in Bearsden in East Dunbartonshire. Biopta uses fresh samples of human tissue to test new medical treatments before they get to the stage of clinical trial. Those tissue samples have been removed from patients during surgery and the parts not needed for diagnosis or therapy have been donated, with the patient’s consent, for use by researchers. Tissue is therefore not removed for the purposes of research; it is removed during surgical procedures anyway, most often to help in making a diagnosis, such as during a biopsy. A sample is taken, and in some cases an entire lump may be removed, but usually only a tiny amount of it is needed on a slide for diagnosis by examination under a microscope, and the rest is either incinerated or stored for use by researchers.
When I visited Biopta, the chief executive, David Bunton, explained the benefits of testing with human tissue. First, testing new treatments on tissue samples can help to protect those who volunteer as subjects in clinical trials from harm. I am sure that hon. Members have all seen adverts in newspapers, or perhaps in a doctor’s surgery or hospital, looking for people to give their time to participate in a study of a new medical treatment. Sadly, we have also all heard of clinical trials that have gone badly wrong, when people have become seriously ill; some have even died. By testing treatments on human tissue samples first, it is possible to rule out some potentially harmful treatments before they are tried out on human subjects in clinical trials.
Although there is no guarantee that a treatment that is tested on tissue samples and appears safe will not cause harm to a living person, currently the various techniques involving live tissue samples are the closest we can get to simulating the use of a particular treatment on a real patient. Basically all drugs are tested on human cell lines, but not all of them are tested on human tissue, whose reactions are closer to the behaviour of normal cells in the human body than cell lines in an artificial environment.
As well as posing a potential risk to the health of subjects, unsuccessful clinical trials also cost a great deal in time and resources. One of the biggest barriers to the development of new treatments for diseases is the huge costs and the financial risk involved in trialling treatments, as there is always a risk that they will not work. Many drug companies expect that nine out of 10 drugs taken forward will not reach production. That risk can never be eliminated, but the use of live human tissue samples can rule out some unsuccessful drugs before trials are carried out. That can reduce the costs.
Another reason for using human tissue samples is that it may reduce the need for experiments on animals. I shall touch only briefly on that point, but it is an issue on which many Members, like many of our constituents, feel strongly; other hon. Members may want to speak further about it. I accept that some testing on animals is still necessary for medical research, but of course we should pursue alternatives wherever possible, in line with the approach of replacement, refinement and reduction. Despite the benefits of tissue research that I have explained, vast quantities of residual surgical tissue are regularly incinerated as clinical waste. As a result, there is a shortage of human tissue samples for research.
Many of the diseases for which treatments could be developed by such research are common, and all hon. Members present for the debate will know someone who has suffered from them. Breast Cancer Campaign reports:
“There is a serious lack of access to breast cancer tissue available for breast cancer research. This access issue is hampering progress in breast cancer research: developing new treatments, finding the causes of breast cancer and discovering new breast cancer genes can only be achieved if breast tissue is available to scientists across the UK and worldwide.”
In this country one woman in nine will be diagnosed with breast cancer in her lifetime and 1,000 women and seven men die from it every month.
Another common disease for which no cure has been found is Parkinson’s disease, with which someone in the UK is diagnosed every hour. Researchers in the UK are looking to develop new drugs that could slow down, stop or even reverse the condition, and perhaps find a cure. According to Parkinson’s UK:
“A key challenge is that there is a shortage of human tissue, including intestinal tissue from the gut, available for research. There are then difficulties associated with obtaining it when it actually becomes available. We would therefore welcome any move to increase the amount of tissue which is retained for research purposes, including that which has been removed during surgery. For the first time, it would allow researchers to look at changes in parts of the body in people who are living with Parkinson’s.”
If tissue samples are to be used for research purposes, a number of things need to happen. First, the tissue donor needs to consent to the use of their tissue for the purpose of research. Secondly, tissue needs to be stored in an appropriate condition, and thirdly there needs to be a mechanism for making researchers aware of what tissue is stored where. As to consent, clearly it is important that patients should have the final say in how their tissue is used, but the current process for gathering consent is clearly not working. In a submission to the Academy of Medical Sciences, the Human Tissues Working Party, which includes a range of groups including the Safer Medicines Trust and Biopta, wrote:
“Respect for patients’ rights and wishes must always be paramount, and current regulatory requirements are very good at ensuring that anyone who may not wish to donate their tissues does not do so.”
However, the submission continues:
“The widespread desire amongst members of the public to contribute to medical research in this way frequently goes unfulfilled because many potential donors are not made aware of the possibilities of donation. The situation is often exacerbated by what is widely viewed as a complex and time-consuming bureaucratic process, time constraints amongst staff, a lack of appreciation amongst hospital staff of the importance of high quality tissues.”
The hon. Lady has hit on the key point: often people are just not asked. As with cord blood, for example, I think that if the uses of the tissue and the benefits that can come from it are explained, people will say yes. However, people will generally be asked at a vulnerable time and may be nervous about what is happening and why, and that is an issue that should be addressed.
The hon. Gentleman is right. Often people are not asked, and the timing of the request is a question to be considered.
There is little public awareness of the need for live tissue, and it is fair to say that most people would never think of proactively offering to donate tissue samples for research. As the hon. Member for Alyn and Deeside (Mark Tami) has said, that is not uppermost in the mind of someone approaching a surgical procedure. Therefore, we need to ensure that patients are routinely asked whether they would like to donate.
Currently, it is up to each hospital trust to design and implement its own policy for gaining consent. Before a patient undergoes surgery, he or she will always be asked to sign a consent form giving the hospital the right to operate, and that would also seem like a good opportunity to ask for consent for the use of their tissue for research. Indeed, many hospitals do that, although many more do not.
Last year, I submitted a freedom of information request to every acute trust in England and every health board in Scotland, asking for a copy of their surgical consent forms. I found that, in England, 39% of hospital trusts have an option on their consent form for patients to donate tissue for research but that 61% do not. In Scotland, the situation is even worse—29% of health boards include it on their consent form, but 71% do not. Of those trusts that do not include the option on the form, some said that they had a policy of requiring their staff to ask patients verbally for consent; but others told me that they do not take tissue for research purposes at all.
The situation in Scotland is slightly different. Although the Human Tissue Act 2004 applies in Scotland, the Human Tissue Authority is responsible north of the border only for transplantation, not for regulating the use of tissue for research. However, the National Research Ethics Service is UK-wide, so I see no reason why procedures for gaining consent for the use of tissue cannot also be UK-wide; we would then have some consistency for those having operations, whether they live in Dundee or Doncaster.
The Human Tissues Working Party writes:
“Evidence suggests that the vast majority of patients agree to their surplus tissues being used in research. Moreover, they are equally happy for their tissues to be used by academic, biotech or pharmaceutical laboratories, as they understand that many players are required to bring new treatments to patients.”
Although no nationwide figures are available, research by the NHS Greater Glasgow and Clyde health board shows that only 5% of surgical patients in the area were being given the option to donate residual tissue. One way to increase that figure would be to standardise surgical consent forms across the country, ensuring that the option is always included. I discussed the idea last year with representatives from the Human Tissue Authority, but they argued that researchers and foundation trusts were likely to resent attempts to impose such a one-size-fits-all solution, as they all have different research systems in place.
Perhaps more importantly, the widespread view, articulated by the hon. Member for Alyn and Deeside, seems to be that when patients are about to undergo surgery, they may not be in the best frame of mind to make decisions about how their tissue might be used. They receive a great deal of information at this stage, including legal and medical information, which may be overwhelming; on top of that, they will understandably be nervous about undergoing surgery. Surgeons may also find it inconvenient. A surgeon at one London hospital told the Safer Medicines Trust that surgeons simply do not have time to explain to patients the benefits of donating tissue and simply tick the “no” box on behalf of their patients.
The Greater Glasgow and Clyde health board is taking a great interest in the matter, thanks particularly to the efforts of Professor Barry Gusterson at the university of Glasgow. It says that pre-surgical assessments could present the best opportunity to discuss the question with patients, and is now looking to make that standard practice. There is the potential, with IT developments, for patients checking in for pre-surgical appointments to be given information about tissue donation, and the opportunity at that point to click a box on the screen. However, we need to ensure that patients have information about what will happen to their tissue if they give consent. The health board has produced an information leaflet for patients that explains how and why tissue is stored by researchers, and for how long. That is a brilliant example of how information could be disseminated. I shall send the Minister a copy, and suggest that she share it with hospital trusts in England, Wales and Northern Ireland as an example of best practice.
The Scottish Government are working with schools to promote the benefits of joining the NHS donor register, giving information to young people about how the register works, and offering real life stories about people who have received transplants and the new lease of life that they now enjoy. A similar scheme could be developed for use throughout the UK to make people more aware of the research need for surplus surgical tissues.
In the longer term, we might even aim to reach the stage where hospital staff and the public are so well-informed about the need for surplus tissue for medical research that a system of presumed consent could be implemented. That would, of course, need to follow a national education campaign to explain the benefits of research on human tissue.
The debate about whether consent for organ donation should be opt-in or opt-out has been the subject of heated debate in this place. Indeed, my friend Dr Evan Harris, the former Member for Oxford West and Abingdon, introduced a Bill that would have brought in a system of presumed consent; under it, people would have to have opted out of it if they did not want to donate organs. In that case, of course, the debate was about organs for transplant rather than tissue for research purposes, which is slightly different, but we are still talking about measures that could save people’s lives. Personally, I would favour an opt-out system for tissue taken from live patients, as it would be less controversial; certainly, taking tissue post-mortem is more complex. I would welcome the Minister’s views on whether we could review the Human Tissue Act 2004, and whether the opt-in, opt-out question for live tissue samples might be considered.
The Department of Health carried out a review last year of the impact that human tissue legislation has had on the research community. It found that:
“the majority of participants report that human tissue legislation and subsequent regulation by the HTA had a negative impact on the research sector”.
That, of course, was not the intention of the legislation. The drive to ensure ethical practice is commendable—indeed, it is vital. However, 68% of respondents believed that it has made human tissues harder to obtain, and 61% believe that it has led to the disposal of potentially valuable tissue. Clearly, the use of human tissue for research must be subject to careful regulation to ensure a high standard of ethical practice, but that evidence suggests that the legislation may need to be reviewed.
Once consent has been granted and tissue has been removed, the question is how and where it should be stored in order to ensure that it is available for use by researchers wherever it is needed. Most tissue is stored in hospitals, and it can be difficult for researchers to find out what tissue is stored in which hospitals in various parts of the country, so that they can gain access to types of tissue that they need. There are more than 100 tissue banks in the UK, some publicly funded and some private, but scientists’ access to the tissue is seriously affected by its location—and their personal contacts—and some institutions are more willing than others to share their tissue stores.
Breast Cancer Campaign is in the process of setting up the first national tissue bank for breast cancer researchers in the UK. It will have a policy of equal access for researchers throughout the country. It is being funded through voluntary donations. As well as national tissue banks, there is another option for improving access to tissue samples; creating a database or online system would allow researchers to see what tissue there is and where, and to make requests for it. The national cancer biobanking organisation onCore has tried to set up a virtual network of tissue banks to share tissue with researchers across the country, but it has had limited success.
I maintain that the problem is not one of funding. Primarily, we need better co-ordination and implementation of the processes that need to be implemented, as well as greater awareness among health professionals and members of the public about the importance of human tissue research. Far too often, valuable tissue is incinerated rather than being collected for research purposes, even though collection is not difficult. It is a matter of spreading best practice, giving information to hospital staff and patients and making the gaining of consent part of the routine of surgical operations. When tissue is collected, it is not being made sufficiently accessible to researchers. I hope that the Minister will tell us whether the Department of Health is able to facilitate greater co-ordination across the NHS, and among academic and research institutions, to improve the sharing of information and clinical material such as human tissue.
I am sure that all hon. Members will agree that we should be doing all we can to speed up research into treatments for the diseases that I have mentioned, and the many others that I have not. I look forward to the Minister’s response.
I attended this debate not intending to speak, but I congratulate the hon. Member for East Dunbartonshire (Jo Swinson) on securing it.
I wish to talk about the terrible condition of Parkinson’s disease. Yesterday evening I was making my way home and called my wife, as I routinely do. She informed me that a family member and good friend of ours, who is on holiday in Malta, had suffered an aneurysm, and is on a life-support machine until her family can get to her later today. I have known the lady for many years, and I know that she wants her organs to be donated to medical science, but tragically, she is hundreds of miles away from her family. That quickly brought home to me the fact that we need more research, and that more organs need to be donated to allow research to go ahead.
Parkinson’s disease, as we all know, is a terrible, debilitating condition. Every hour, someone in this country is told that they have Parkinson’s, and, if anything, the situation is getting worse. Parkinson’s UK is an admirable organisation doing its utmost to battle against the condition. Since 1969, it has spent over £45 million on groundbreaking research. At the start of the year, it was supporting 90 research projects worth over £15 million. Parkinson’s UK believes that it should be made easier for researchers to gain access to donated organs.
To be usable for research purposes, the brain must be harvested within 24 hours; however, all too often there are obstacles to that. For example, hospital staff are often reluctant to harvest organs without a death certificate—rightly so, on occasion. When someone dies over the weekend, there is often no one available to sign a death certificate, meaning that the organs, including the brain, cannot be harvested before they deteriorate and become totally unusable. When that happens, Parkinson’s researchers miss out on resources vital to developing better treatments and a cure. It also means that the wishes of the deceased, including those carrying donor cards, and their families simply cannot be followed. Parkinson’s UK is therefore calling for guidance for hospitals on the importance of harvesting organs, including the brain, quickly—within 24 hours—to avoid those obstacles. It also calls for greater public awareness of the importance of donated organs in medical research—an issue that the hon. Member for East Dunbartonshire raised.
The brain is the principal organ affected by Parkinson’s, and it is due to the death of specialised nerve cells in specific areas. However, the condition can also affect other parts of the body. There is emerging evidence, which the hon. Lady touched on, that early pathological changes found in the brain may start in the gut. The condition may actually start there and then spread to the brain. Much more research needs to be carried out in that area to investigate what is happening.
Parkinson’s UK funds a brain bank that makes it possible to look at changes that have happened in the brain once a person has passed away. However, it is also necessary to look at other organs, from people with and without Parkinson’s, particularly when they are alive, if at all possible. That would make it possible to correlate a person’s symptoms with any specific changes within the body; that is as important as looking at cells. A key challenge is the shortage of human tissue, including intestinal tissue from the gut, that is available for research. When it does become available, all too often there are difficulties associated with obtaining it. Parkinson’s UK would welcome a tissue database, as it would enable researchers to locate tissue more easily, thereby obtaining maximum benefit from it.
Does my hon. Friend agree that we need the media to address research properly and to explain why it is being done? Too often, particularly in the tabloid press, we see headlines like “Frankenstein science”, and stories on experimentation for the sake of it, which has never been the case. Such language further undermines the likelihood of people giving consent; they would be more likely to do so if they were fully up to speed with why research was being carried out.
I thank my hon. Friend for raising that point because I was going to come on to that issue. He made it abundantly clear that, regrettably, on too many occasions much of what we encounter day to day, especially in this arena, is driven by media hype and scare stories. His point is spot on. As the hon. Member for East Dunbartonshire said, the situation regarding presumed consent and everything surrounding it is delicate. New Members and those of us who were here previously will encounter over the coming months and years a significant amount of correspondence from people who are deeply concerned about organ donation and the provision of tissue. My hon. Friend the Member for Alyn and Deeside (Mark Tami) is right: when we tackle issues such as this one, we have to have open, honest and sensible adult debate, not driven by hype that, frankly, terrifies people.
I do not wish to say much more in my short contribution. Suffice it to say that the debate is very important indeed, and even that is probably an understatement. I have covered Parkinson’s disease, and I would like the Minister to address the issues surrounding that, the tissue database and how we overcome problems. I suspect that they occur too often, when the harvesting of organs needs to be dealt with very quickly—within 24 hours. How can we handle that better to ensure that we meet the wishes of those who want to give organs at the end of their life to save the lives of others and for research? Making that decision was a significant step for those individuals and we should do whatever is humanly possible to make it easier to respect their wishes.
I congratulate my hon. Friend the Member for East Dunbartonshire (Jo Swinson) on securing the debate. She briefly mentioned animal testing and I would like to pick up on that theme to start my comments. It is clear that further medical research is needed, and I have a background in that area. We heard movingly from the hon. Member for Dumfries and Galloway (Mr Brown) about Parkinson’s, and there are other areas where much greater research is needed, for which one needs some form of human-based model. That has led to the widespread use of animals for experimentation, which leads to concerns—ethical and practical.
The ethical concerns centre around how we should treat animals. While that is important and I very much share the deep concern, it has on occasion led to some extreme positions, which I do not think anyone in the House would support. There are sensible approaches to balancing the need for medical research, which leads to experimentation, with trying to avoid such experiments. I would like to highlight the Fund for the Replacement of Animals in Medical Experiments, which does a very good job in this area. It describes its position as anti-animal experimentation:
“FRAME believes that the current scale of animal experimentation is unacceptable, but recognises that the immediate abolition of all laboratory animal use is not possible. Essential medical research must continue, so that effective treatments for diseases that lessen the length and quality of human and animal life can be found. New products, including medicines and vaccines, and industrial and agricultural chemicals, must be adequately tested, in order to identify potential hazards to human and animal health, and to the environment.”
That nicely sums up the balance, and explains why we need to continue with this research. FRAME then goes on to say that it advocates the three R’s approach—replacement, reduction and refinement. As an aside, I notice that it is very traditional to use the three R’s whether we are talking about reduce, reuse and recycle or reading, writing and arithmetic.
There is a great deal of misunderstanding about animal testing. There is an idea that medical research organisations and pharmaceutical companies want to do animal testing, when in fact most of them would much rather not if alternatives were available. That might be for financial reasons if nothing else. A lot of work has been done to find different ways to test and develop new techniques. I am talking about work on humans, animal models and tissue. Recently, we have seen the idea of human on a chip, in which samples of different human tissues are put on a very small chip so that system interactions can be studied. There has also been work with stem cells and their derived tissues. There has been work in vitro and, increasingly, in silico—trying to use computational methods to work out what is likely to happen without having to perform real-life experiments—in which I was involved before I was elected to this place.
There are disadvantages to all those ideas. Testing on humans is risky; one has to be very careful about any intervention. We know that there have been some sad instances of severe illness and death when humans have tried out new therapies and medicines. We know that there are problems with animals; they often do not provide exactly the right systems. Drugs behave differently in some animals to the way that they do in humans. A lot of work has to be done on systems such as human on a chip, and most of the computational techniques still have a long way to go before they can truly be said to represent what is going on.
I do not want to breach the Haldane principles and suggest what research should be funded, but the topics that I have mentioned would be very interesting for the appropriate bodies to look at rather carefully—whether that is a funding organisation such as FRAME or the National Centre for the Replacement, Refinement and Reduction of Animals in Research. Support for such areas would be very gratefully received and would make a huge difference to many people.
Today we are talking about tissue, and tissue has a huge amount of potential. It occupies a very nice space in the hierarchy, between in vitro and in silico models and full humans with all the attendant risks. A number of tissue banks have been set up, including the UK Biobank. A large number of brain banks have produced some very nice work, typically post mortem, leading to results on Parkinson’s and Alzheimer’s. I shall mention, in particular, the Cambridge brain bank partly because it is in my constituency and partly because my mother was involved with it—as a researcher rather than as a donor. We should try to broaden the spread of these banks and create a proper network. Some of the brain banks have had problems with interacting with other banks and with transferring data. Things are also going on in this area with cancer banks. My hon. Friend the Member for East Dunbartonshire mentioned onCore, which is a national cancer biobanking organisation, and we need to have other such organisations.
There are issues not just with how we collect the samples and store the information, but over funding. Currently, there is not a viable commercial model for tissue banks or networks. From what I have heard, the banks have great difficulty in securing long-term funding. Banks cannot survive on project-based funding, because the value derives at the end of the process and not at the beginning, so there is a need for core funding to support such a network. They have to have a certain level of security.
Let me turn to the topic of consent. We have heard some discussions about whether we should have an opt-in or opt-out system. It would, I believe, be a great step forward if we decided on the opt-in model. If people were asked to opt in, we would see an increase in numbers. I would be concerned if we went to an opt-out system for tissue. There is not public acceptance of that, and I would prefer to get lots of people opting in.
The topic of organ donation was also raised. It is my strong belief that it should be on an opt-out basis, and I would have supported the Human Tissue Bill proposed by Dr. Evan Harris, the former Member for Oxford West and Abingdon. Why is there a difference between the two? One reason relates to public acceptability and the other to timeliness. While we benefit from having a larger and more thorough bank of information, individual instances of information missing are not critical; it is a general problem, but not a critical one. With organ donation, organs are individual lives, and there is a specific issue of timeliness. As my hon. Friend the Member for East Dunbartonshire mentioned, in the future we will be able to have an opt-out system for tissue. It will be nice to see a real acceptance of the benefits of research for everybody in this area.
There are also issues about the ease and clarity of consent. The advantages of a national system and how easily it can be established have been discussed. There are also questions about how much information should be stored with tissue, and that needs further thought. Should the data be anonymised? Should it be tied in to medical histories and to details of other phenotypes that were observed—other interactions that happened? Should it be tied in with a DNA profile from that tissue?
On that cue—I find it very hard not to talk about DNA as that is what I used to work on—let me say that there is an interesting asymmetry in the Human Tissue Act 2008 between DNA and tissue in terms of whose consent is required. The Human Tissue Act, which regulates tissue, stipulates that there is a hierarchy of consent before a tissue can be obtained from somebody who has died. Although we are mostly talking about tissue samples from those who are still living, post-mortem tissue is incredibly valuable as well. A spouse can refuse permission to use a tissue sample even though the benefit may accrue to those relatives who are biologically related. With DNA, there is no hierarchy of consent, and any relative can consent. Typically, the people who are asked are those with a genetic relationship. That gives rise to some interesting asymmetries, because it means that different people could be consenting for different aspects, whereas the DNA would typically be derived from the tissue. That will lead to problems in the future and we need to consider it. In general, DNA and the future of DNA technology and testing will be a topic that requires further thought from this House. It may be an appropriate topic at some stage for a debate such as this.
There have been a lot of drives for improvement as the cost of sequencing has plummeted—from costs in the order of billions for the first sequence down towards the £10,000 mark and heading very rapidly towards the £1,000 mark in the near future. That means that we are starting to see more and more projects in which everybody, or every baby at birth, is being sequenced. We will see some real effects on health—I hope that the Minister will be able to comment on some of those—both in research angles, through genome-wide association studies, and in areas such as personalised genomic medicine. I am sure that the Minister is aware of the House of Lords’ Select Committee report on the subject. Schemes are ready to be cascaded down through the NHS. For example, free foetal DNA testing allows Down’s syndrome screening at a very early age—at about six weeks into a pregnancy. A pinprick of blood is taken and the RNA is then sequenced. It is amazing that we can do that, and such a scheme is ready to go through the NHS in a matter of a few years.
In conclusion, let me support my hon. Friend and urge the Government to take action to support this work because it is in the interests of science and research, of reducing animal experimentation and of patients.
It is a pleasure to make my first outing as the shadow spokesman for public health under your chairmanship, Mr Benton. I congratulate the hon. Member for East Dunbartonshire (Jo Swinson) on securing such an important debate. Having listened to her this morning, I feel that I know a lot more about the subject. She is well known in the House for her campaigning work on this issue. Her early-day motion 212, which she tabled in the previous Parliament, attracted the support of 64 hon. Members, and I am sure that a version of the same early-day motion will make its appearance through the course of this Parliament.
It was interesting to hear about the hon. Lady’s strong constituency link with the subject. I was certainly unaware that her constituency was a hub for research into life sciences. I also want to congratulate her on her tenacity. Using the Freedom of Information Act to get the data on the hospitals is the work of someone who pays great attention to detail. In fact, she found that there are huge differences between hospitals. It might be interesting to drill down into the information that she has to see whether there are geographical differences, or differences between foundation trusts, in respect of how samples are collected. The challenge for Ministers is to try to get everybody up to the level of the best, and it is clear that there is a very long way to go to achieve that.
I congratulate the Minister, who has responsibility for public health, on her appointment. She has been in a shadow public health role since July 2007. She had a distinguished career in the NHS for 25 years, including working as a district nurse. She also worked in hospitals, in research and, of course, in palliative care, so I am very interested to hear her comments in this debate. Furthermore, she is possibly one of the very few Conservative MPs who has served as a trade union steward, for the Royal College of Nursing, so I will also be interested to hear whether she has any response to yesterday’s Budget. We welcome her, and her experience, to her new post. Her direct experience of front-line working in the public sector will no doubt stand her in very good stead.
I also want to congratulate the hon. Members who have contributed to today’s debate. I know that my hon. Friend the Member for Alyn and Deeside (Mark Tami) has a very strong interest in the subjects of cord blood and stem cell research; we have debated those issues together on many occasions. He raised a very important point about the general altruism that the public feel.
Most people want to make their own contribution and help to contribute to medical science. Unfortunately, however, the level of knowledge and debate on these types of issues is very low. Part of that is due to the “ick” factor—none of us likes to think of our precious bodies as, first, dying; secondly, being cut in any way, even after death; and, thirdly, being kept in a large fridge with medical scientists examining them. But in fact the reality is that that is how human progress, particularly progress in science, has been made for generations, even centuries.
I also congratulate my hon. Friend the Member for Dumfries and Galloway (Mr Brown) on his contribution to the debate. I send my condolences to the family of his friend who suffered such a terrible tragedy while on holiday and I wish them courage as they fly out to Malta.
My hon. Friend raised the very important issue of the practical barriers that exist in this area, even when hospitals systematically want to collect people’s brains after death. There are also the issues of the death certificate and the conflict that exists between the medical side and the research side. The hon. Member for East Dunbartonshire has really hit on an important issue here, which requires some constructive and creative thought.
I thank my hon. Friend for her very kind comments. There is just one point that I want her to address; I am perhaps returning to the point that I made earlier about how we and the media view this issue. She knows that my particular interest in this area is with the Alder Hey hospital and with children—unfortunately, that interest derives from a personal experience. But the fact is that a lot of medical conditions, such as sarcomas, particularly affect children; indeed, in some cases, medical conditions only affect children.
Given that children are particularly affected by some conditions, it follows that the research into those conditions must focus on children, but we find such research difficult to accept. It is very difficult to accept research on adults, but research on children, which sometimes very unfortunately happens as a result of a child’s death, is even more difficult to accept. However, it is something that we really need to address. As I said, some medical conditions only affect children.
My hon. Friend makes a very important point. Actually, this is one of those issues where the answer of the child involved might be very different from that of a parent. I think that children can be incredibly wise.
Speaking as a mother, the thought of one of my children dying is beyond comprehension, or beyond the limits of my imagination. It would be wrong for someone to ask for a donation from a bereaved parent who was dealing with that level of stress and grief. The time for asking for donation is not at the point of surgery or of death; it is when people are feeling generous and altruistic, when they feel that donation is something that can help other people.
Actually, children themselves are incredibly generous and incredibly thoughtful. Obviously, it is different for babies and toddlers, but children from about the age of six or seven can start to work these things out for themselves. Perhaps there is a role for education in the classroom to get children to talk more seriously about these issues.
I know that the work that the Anthony Nolan Trust has done in increasing the number of people on the bone marrow register is incredible. In Huddersfield and Wakefield—my constituency covered part of Huddersfield until the last boundary change—we had a very brave campaigning journalist at the Huddersfield Examiner who, when he was dying in his mid-20s, launched a huge campaign, including writing a blog about his experience. Through that campaign, he engaged with a lot of young people to get them on to the bone marrow register.
The issue of donating tissue, or blood marrow, is a bit like that of blood donation. I have spoken to my staff about it and said, “The blood lorry is outside, off you go”. There are responses such as, “Well, I don’t fancy rolling up my sleeve and having someone stick a needle in me”. However, if I ask, “If you have an accident on your way home, or your child is ill, would you want blood for your child or yourself?”, the answer of course is, “Yes”. The time to do it is during a tea break or a lunch break from work and not when people are under stress and dealing with a huge range of emotions.
I also congratulate the hon. Member for Cambridge (Dr Huppert) on his contribution to the debate. It is clear that science has lost a great researcher, but science’s loss is certainly the House’s gain. While he was speaking, I had a quick look on my BlackBerry and perhaps after the debate he can explain to me what “nucleic proteins” are, or whatever it was that he was researching—I am not even sure that I have used the right word there—because I got lost after about the first sentence of his contribution.
Computational biology is clearly an emerging area of work in this field and the hon. Gentleman spoke very eloquently about its potential to reduce the need for experiments on animals and, in some cases, to replace high-risk human trials, which would be welcomed by all parts of the House. He also leaves us with the interesting image of a “human on a chip”, which is something that I will go away and reflect upon.
Using his own experience as a researcher, the hon. Gentleman raised the important ethical issue of the anonymisation of samples, and he is absolutely right to do so. Certainly, in any research that I have ever participated in, I have always been told that the donated material will be held completely anonymously and untraceably. Now, however, we are moving forward with this biobank. I was invited to take part in that project. I went along because I was interested and I asked, “Are more women than men coming along?” I was told that, yes, there were, so there were all the usual biases that exist. We come back to the altruism factor and it seems that women tend to be more altruistic than men. I will leave that point hanging; if anyone wants to intervene on me, I am happy to argue the point. [Laughter.]
My hon. Friend is exactly right. Men are certainly less willing to become stem cell donors and bone marrow donors, because we are cowardly and do not like needles. That is a particular problem.
What we must do with bone marrow and stem cell research, as the work of the Anthony Nolan Trust shows, is to put fewer obstacles in the way of donors. When it comes to giving blood, I know from my own point of view that my reaction is really, “Argh”—giving blood really terrifies people. However, mouth swabs can be used to donate other material. If we can get people past that first stage and if they are then approached because they are a potential match, I think that people will say, “I am a potential match and therefore I will go to that next stage and give blood”. If we somehow phase people by saying, “You’ve got to give blood and you must have various tests for things”, then people are less likely to come forward.
Obviously, with bone marrow and stem cell donation, we are not talking about people who have died. It is one of the few areas where someone can save a life by giving something. It is not painful, it does not take that long and someone can actually save somebody else’s life. There are tens of thousands of people out there who do not even know that they are potential life-savers. This issue is not only about how we raise awareness, but how we—
Order. The intervention is too lengthy.
Thank you, Mr Benton. I was listening with interest and totally agreeing with my hon. Friend. Most of us will not have the chance to save someone’s life in the normal way. The chance to be an everyday hero does not come to many of us, and most of us do not have the medical skills that would enable us to be one. However, a person can undergo a small surgical procedure to take bone marrow out of their hip, and someone else will be walking around as a result of their generosity to another human being. I find that profoundly moving.
We need to look at where the responsibility lies for raising awareness. We as politicians are in this room debating the matter, so we are fulfilling our responsibility.
We have heard of the difficulties that the media create in their coverage of these issues, some of which have been difficult. The Alder Hey and Bristol Royal Children’s hospital cases were seen as national scandals, and rightly so, but the scientific community has a huge responsibility in this area. This country has a problem with science. We have a framework that enables us to be world leaders in life sciences and all kinds of areas, and we have a population that is willing to run marathons, to do fun runs for breast cancer and cancer research and to work and raise money. Yet there is a gap.
Presumably, every one of the women who participated in the five-mile fun run in Wakefield—the race for life—did so because they knew someone who had died of or suffered from breast cancer. All those women could have been offered the chance to be screened for blood marrow donation or to talk about tissue sampling. The world of fundraising needs to work more closely with the world of research. I do not know how that would happen, but I think that the scientific community, whether it is researching genetically modified foods, cancer or Parkinson’s, has its own responsibility. However, it has not found its voice in this area.
We have an image of scientists working in their labs in white coats. It has been a long time since I have been in a research lab, so I do not know whether they still wear those coats, but they do not get on the telly. We tend to hear about sensational breakthroughs, but when we read the small print, we find that they are at least five, six or 10 years away. There is media sensationalism about what might be small steps at the beginning, yet no real conversation about the long, arduous and painful work that scientists have to go through to achieve a breakthrough. I agree with the hon. Member for East Dunbartonshire that there is not enough access to tissue samples, but there are difficulties at the interface between the two worlds.
My hon. Friend the Member for Alyn and Deeside mentioned cord blood collection. The Royal College of Midwives has specifically said to its members, “We do not want you to be distracted by cord blood collection while you are trying to deliver a baby.” Obviously, anyone who is assisting at a birth wants a happy baby and a happy mum. The cord blood thing comes much farther down the line. Certainly, that was my experience of giving birth, and I believe that it is probably the experience of most medical professionals.
The scientist is not in the room saying, “By the way, make sure you get the cord blood, and make sure you put it in the fridge quickly.” If a midwife is dealing with a baby that might be in respiratory distress or a mother who is in the middle of a haemorrhage, all other considerations rightly go out of the window. The midwife wants a safe delivery, and the researcher stands in the university lab and weeps as the precious cord blood heads off with the placenta to the incinerator. I do not know whether people still take the placenta home. I certainly was not interested in that; we are back to the “ick” factor.
There is a challenging conflict between the NHS professional who wants to deal sensitively with, for example, a cancer or Parkinson’s patient, and the colleague back at the lab who wants to know whether they have consent to do lab work on the tissue samples. We have heard some interesting suggestions today about how the medical process can support the collection of tissue. Most hospitals have introduced MRSA screening prior to surgical interventions, and that would be a good way of doing it.
The national patient care record—a national database with everyone’s details—is another possibility. The patient could sit with their general practitioner and go through organ and tissue donation. The information could be there in black and white on the computer screen for every medical professional who deals with them at any stage of their life. The decision could also be revoked at any stage.
As the hon. Lady knows, there has been a great deal of concern about uploading data. I hope she agrees that if what she is discussing is to happen at all, a huge amount of data safety and security, and a simple mechanism whereby people can opt out, will be needed. Ideally, they would opt into such a system, rather than being given a limited opportunity to opt out.
I agree with the hon. Gentleman. I know that Liberal Democrats have an antipathy to the national patient care record and have called for it to be scrapped, but it might represent an excellent opportunity to deal with this matter. Of course, people would have to opt in, and nothing I have heard today changes that.
The hon. Member for East Dunbartonshire asked whether people would opt in or opt out. We need to go back and look at consent, which is at the heart of this debate. As we have heard, the Human Tissue Act 2004 created the framework for the removal, storage and use of tissues and organs of the deceased.
We must remember the circumstances that gave birth to the Act. It came about because of public inquiries into the events at Bristol Royal and Alder Hey hospitals, where organs and tissues from children who had died had been removed, stored and used without consent. Scientists have been doing that for generations. I do not think that there is any question about that, and we can understand why they want to progress medical research. However, years—in some cases, decades—later, families discovered that the children who they thought they had buried had not been complete.
The series of moral, ethical and religious issues that came out of that practice had to be, and were, addressed by the Labour Government. The inquiries together with the Isaacs report, which focused on the retention of adult brains following coroners’ post-mortems, revealed that storage and use of organs and tissue without proper consent was commonplace. We as legislators had a duty to change that.
The chief medical officer concluded that the law needed to be changed. We had a wide-ranging public consultation, “Human bodies, human choices”, which set out proposals and led to the Act that created the Human Tissue Authority, which licenses and inspects institutions. The Act is based on the principle that consent should be given by the living. If that key principle is to be changed, it must be changed with a great deal of consent. I do not detect a groundswell of public opinion or hon. Members in this House wishing to reopen the consent issue, despite the efforts of Dr Harris, the former Member for Oxford West and Abingdon.
In the context of the legislation, I agree with the points that the hon. Lady makes about consent being vital. However, would she accept that the current problem is that many people would be happy to consent, but their wishes are not being fulfilled because they are not even being asked?
Absolutely. The hon. Lady makes a valid point, and systems, policies and processes are the only way. It is not laws or our passing Acts in Parliament that will make it happen. This is about the 60% of trusts that do not collect any form of tissue, but get rid of everything. It is about people being made aware—there is an educational side to this—and it is about having a system in place. If we want people to donate their organs, we have to make it as easy as possible, so that they can do it when they open a bank account or go to Boots pharmacy to pick up a prescription. Whatever it is, it has to be made easy.
Most people hope throughout their lives that they will not need a huge amount of surgical intervention. That is what we all hope for, is it not? I believe that the hon. Lady is right that most of those who are unfortunate enough to have repeated operations would like to help other people through medical research.
It is important to say that lifetime consent for a tissue sample is already possible under current legislation, and people may give “generic and enduring” consent for their own sample, but the hon. Lady may be trying to bring to the foreground lifetime consent for any medical research purposes. However, the law in such areas cannot and should not stand still, and we must renew the working of the existing law.
I was interested to hear the hon. Lady’s reference to the Human Tissue Authority’s evaluation of perceptions of how the legislation and regulations that flow from it have affected researchers. The Human Tissue Authority has said that it wants to ensure that researchers have access to high-quality samples by consolidating stocks throughout the sector; that brings us back to the idea of banks. It also wants to reduce the regulatory burden on the research sector by using open-ended rather than fixed-term licences, and moving to a risk-based approach to regulation rather than regulating everyone.
The hon. Lady will be interested to hear that the Nuffield Council on Bioethics is consulting on options for boosting the supply of organs and human tissue. It is clear that a problem is emerging as fertility sciences improve. There is a shortage of organs for transplant, as many hon. Members have said, and of sperm and eggs for donation. I prefer to refer to “sperm” rather than “gametes”, not least because I do not know how to pronounce that latter word. Let us call a sperm a sperm.
Transplant patients and women seeking fertility treatment may travel abroad, often to places where different rules apply or, in the case of organ donation, where there may be an illegal market. We must watch that carefully because moral and ethical considerations may be involved if inducements are offered, whether cash or paying funeral expenses for people who give their organs. Those are some of the issues being debated, and the consultation closes on 13 July. I put that on the record so that any hon. Members who want to participate in the consultation may do so.
New stem cells made by reprogramming adult tissue into induced pluripotent stem cells—iPS cells—which come not from human embryos but from adult skin cells, have been possible only since 2007, so science is already well ahead of legislation in this area. The iPS technique could lead to new breakthroughs for Parkinson’s disease, motor neurone disease, diabetes and paralysis, and that would obviously be very welcome.
My hon. Friend referred to breakthroughs, and stem cells are one of the major areas where breakthroughs are happening. However, we must remember that much research comes to a dead end. Sometimes when we believe that it is going a long way, it does not. The Daily Mail and the Daily Express may say that drinking coffee prevents cancer, and also that it causes cancer. There is no “one size fits all” or one magical cure, so we must go down many routes, knowing that some will be a dead end.
I agree that there is no silver bullet, much as we would like one, and my hon. Friend is right about the red tops’ approach to eating—or not eating—yoghurt, strawberries, blackcurrants or whatever fruit or drink is fashionable. It would be impossible to live our lives by their diet rules, certainly in the House of Commons Tea Room. We need to understand better, and the hon. Member for Cambridge has a responsibility to his former colleagues in Cambridge to be a champion and an advocate in this place—he has already proved in this debate that he will be—in respect of the benefits involved and the management of people’s expectations.
I understand where the research is coming from. The hon. Member for East Dunbartonshire said that researchers are a bit cagey about sharing with other researchers where tissue is held. Someone doing a PhD who has put three or five years of their life into it does not want someone else from a different country or different research institution publishing six months before them; let’s face it, academics are as competitive as the rest of us. I know from my experience at Cranfield School of Management that we loved sharing our research at conferences, but we lived in dread of someone coming up with the same idea and publishing it a bit sooner. It is incumbent on researchers to work out ways and methods of sharing their research in this area.
The hon. Lady is making an important point. A lot of work is taking place on open-access data and open-access publishing with the safeguards that she correctly requires, so that people who have invested a lot of time and effort—for example, in building up a bank—get first priority. I hope that she is aware that many of the research councils are increasingly mandating that data should be made openly available.
The hon. Lady is correct about interaction with the media. She may agree that one problem is the shortage of good science journalists, with a few honourable exceptions.
I thank the hon. Gentleman for that intervention. I was not aware that the research councils were making open access mandatory, but logically it is right that that should be done. Researchers enjoy taxpayers’ money, so it is right that it should be shared for the common good. Most historic scientific breakthroughs have been made through people sharing building blocks with each other, rather than through working in splendid isolation.
The hon. Gentleman is right about science journalists. There is a paucity because they may make two, three or four times as much money working for a big pharmaceutical company. Writing for people who may not be interested or who may even be openly hostile to science may be less alluring than working for a big pharmaceutical company and being at the heart of breakthroughs.
The Human Tissue Authority website is incredibly useful in listing establishments that have human application, research application, post-mortem application, anatomy licences and display licences. I had not realised that the display of human bodies was regulated, but that was controversial a few years ago.
I hope that today’s debate will lead to solid proposals from the Minister. I look forward to hearing what she has to say. We must tread carefully if we are to maintain public confidence in these vital areas and public trust in the medical research community.
I welcome the debate, and congratulate my honourable colleague the Member for East Dunbartonshire (Jo Swinson) on securing this debate. Although we are not great in number, clearly the matter is important to some people, and this has been a brilliant opportunity to have a good run-around with some of the issues. My honourable colleague has worked extremely hard to promote the supply of quality tissue for research, and to encourage closer co-operation between everyone in the sector. If nothing else, the debate has highlighted the need for much greater co-operation.
Human tissue-based research is vital for advances in medical science. That is an obvious statement, but it needs to be reiterated. We want better and more effective treatments, and if that essential research is to flourish, everyone involved in procuring, storing and using tissue must work together. None of that work can take place without the generosity of people who are willing to allow their tissue to be used for the benefit of others. We can proceed only if we have their trust and confidence in what I believe is a difficult climate. The public’s trust of anyone outside their immediate family is low, so this is a good time to raise the matter.
My honourable colleague outlined some of the significant benefits of using human tissue. It allows for testing to reduce harm, reduces the need to use animals, and allows for placement refinement and reduction, which the hon. Member for Cambridge (Dr Huppert) also discussed at some length. I should point out that I am in the fortunate position of having a group of people to advise me, so I know all sorts of little facts that I did not know when I was an Opposition spokesperson. I should possibly have started my speech by congratulating the hon. Member for Wakefield (Mary Creagh) and thanking her for her kind comments.
My colleague the hon. Member for East Dunbartonshire said that the Human Tissue Act 2004 applied to Scotland, but I understand that there is separate Scottish legislation—the Human Tissue (Scotland) Act 2006. I am sure that she is aware of that Act, but I thought I would mention it for the sake of clarity.
The hon. Member for Dumfries and Galloway (Mr Brown) mentioned people who suffer from Parkinson’s. My mother-in-law suffered from Parkinson’s and, during my career, I have nursed many people who suffer from the illness, which is very cruel. Parkinson’s is very difficult not only for the individual to live with, but for those around them. Donated organs can clearly make a difference to research in that field, and I know that many people who suffer from Parkinson’s and their families look forward to a day when there is real relief from the symptoms and in time, I hope, a cure.
Of course, Parkinson’s is not the only illness, and there is possibly more publicity than ever for some of the severe, enduring and sometimes life-limiting illnesses that people have to go through. It is a shame that the opportunity is not always taken to highlight the difference that we can make as individuals who are not necessarily connected with people suffering from such illnesses. One of the ways that we can make a difference is by donating tissue.
The hon. Member for Dumfries and Galloway mentioned the tissue database. We are possibly in a fortunate position in the new coalition Government. I do not feel entirely responsible for what went on before I came into post, so this is a brilliant time to raise with Ministers some of the issues that hon. Members know create obstacles, particularly in relation to the subject that we are discussing today. This is an opportunity to raise issues, and I always welcome any feedback people can give me.
The hon. Member for Alyn and Deeside (Mark Tami) mentioned the need for media support. There is no doubt that the media have a huge role to play. The recent death from cervical cancer of a celebrity meant that the incidence of cervical screening shot through the roof. There is no doubt that the media have both a responsibility and, to some extent, a duty to raise some of the issues, as we all do.
Further to the comments of the hon. Member for Cambridge (Dr Huppert), the problem is that the tabloid press provides a twisted, simplistic view of science, but the scientific press is too detailed and writes and speaks in a language that ordinary people do not understand. We need somehow to get a balance that crosses those two divides.
I thank the hon. Gentleman for his intervention; he is absolutely right. I agree with the hon. Member for Wakefield—I call a sperm a sperm. The hon. Member for Cambridge strayed into areas that are way beyond me, but such matters are important. I welcome him to the House. At the last election, we lost a number of scientists and it is extremely important to have voices such as his in the House to inform journalists, particularly if there is not sufficiently extensive scientific journalism out there, although I am not in any position to judge on that matter. Such issues are important, and perhaps we should all take the opportunity to send a copy of this debate to our local press. That will perhaps highlight the issue of organ donation locally; we all have our responsibilities.
The issue of consent was raised. Legislation in that area was reviewed following revelations about the widespread retention of organs and tissue without the consent or knowledge of families, as the hon. Member for Wakefield mentioned. The Human Tissue Act 2004 makes it clear that consent is required for the storage or use of organs and tissue for research, whether they are taken from people during their life or after death.
As was mentioned, we know from talking to patients and their families that the vast majority of people are extremely supportive of tissue research and, when asked, will happily consent to their tissue being used. However, my colleague the hon. Member for East Dunbartonshire is rightly concerned that we should not waste opportunities to tap into that incredible good will. She suggested the use of generic consent for the retention of tissue, which could be sought at the same time as consent for other medical procedures—for example, surgery or a diagnostic biopsy. I entirely agree that people should be given the opportunity to donate tissue, but consent is not a straightforward issue.
I am not sure that a top-down approach is the best way to proceed with dealing with the matter. The good practice we seek cannot be imposed from the top, and history is littered with examples where a top-down approach simply somehow relieves professionals of their responsibility; they believe that they are no longer responsible for the matter. Increasingly, we find that organisations are tailoring their consent procedures to local needs; for example, there may be specialist clinics, where specific risks can be addressed. We are aware of successful and innovative approaches that have led to greater efficiency and a better experience for the patient or person. Innovative thinking must be encouraged and not constrained. I am often concerned about the latter happening with anything that takes a top-down approach.
I am sympathetic to what the hon. Lady is saying about enabling local decision making, but does she accept that there is a risk that if we have very different consent procedures across the country, it will hamper researchers and industry further? It would mean that when it came to accessing tissue samples, some would be available under certain consent rules and others would be available under others. That complexity is itself a real barrier and a problem.
As with many things, it is a matter of balance. I heard my honourable colleague’s words about what the Department of Health must do. I do not know whether the Department of Health holds the solutions in this case. I really believe that the matter needs to be dealt with locally. Anyone who has first-hand experience of routine procedures knows that they can be quite unsettling for people. Most people about to undergo surgery are understandably nervous. The hon. Member for Alyn and Deeside expressed his visible concern about donating even blood. I suggest that he comes to see me afterwards—I will give him a talking to and get rid of his nerves.
We are dependent on the professionalism and humanity of health care professionals around the country, and we can draw on their experience to find the right time to discuss tissue research. Dealing with the issue is a question of trust—trust in the relationship between clinicians and patients, trust in local health organisations to provide the right information to people, and trust in health professionals to maintain the separation between treatment and research.
My colleague the hon. Member for East Dunbartonshire mentioned the fact that it might not be convenient for a surgeon to seek consent for tissue donation. I would suggest that it is not necessarily a matter of whether it is convenient; it is about whether it is appropriate. That is the difficulty. It is also true that clinicians can duck the issue and find it difficult to talk about. That also needs addressing. However, I do think that the solutions lie with the organisations and the clinicians, and should not come from the centre.
The hon. Lady mentioned the issues of trust and getting information across on issues such as bone marrow donation and stem cells. However, there is also the matter of getting information across to minority communities, where levels of donation are very low. If, for example, a child is diagnosed with a particular condition, their odds of finding a donor are very slim compared with those of a child from the white population. We need to get information across to people and educate them about what is being done.
I thank the hon. Gentleman for his intervention. It is interesting that this is the first time that we have referred to the differences between ethnic groups, and that is an extremely important matter, but there is a resource out there that we do not necessarily use, which is the faith leaders in communities, who can perhaps raise the issue. That is why we need to send tentacles out, perhaps even from this debate, to ensure that we get the messages across in many different settings. We mentioned children; perhaps the issue should be talked about in school.
The Minister says that this is not a matter for the Department of Health, but is she not even a little curious about which hospitals do systematically collect and process the material, and about the 60% or so that do not? I am very curious about that. Her Department could easily map, with the resources that it has, where the hot spots and cold spots are. It could use the transparency that we have under the Freedom of Information Act almost to shame the hospitals that do not do it, or it could at least have a conversation with those that do not do it systematically, perhaps because they are not attached to a university or because they are not teaching hospitals. We could examine how we could encourage hospitals to do it and educate the staff about the wider benefits to the community.
The hon. Lady is right. I think that in the end it is the differences that will spread good practice and drive up standards and professionalism in this area. She is right to say that we must examine why some places are so good on this. One example that I heard about recently is that of a trust that sends combined, personalised leaflets about consent to treatment to patients along with pre-operative medication. My colleague the hon. Member for East Dunbartonshire mentioned that. That trust is giving patients the time and chance to think about their treatments in advance. That is the type of innovative practice that we want. I do not believe that a standardised form is the answer.
I would also have some misgivings about routinely seeking consent to use tissue for research unless we could be confident that there was a good chance of its being used. One of the key complaints from the families affected by organ retention scandals was that everyone tried to justify the practice of routinely retaining tissue in the name of research, when in fact most of the material had never been used. There is a test that is applied to children, called the Gillick competence. We do not often use the opportunities that we have to raise the issue with children, or to ask them what they want to do.
Let me clarify that there are no plans to revisit the question of an opt-out system. Certainly, on a personal level, I would not be happy with such a system. It would require an extensive information and education campaign, and there would be ethical and practical issues if people were able to opt out of some types of research but not others. No doubt some people would be happy to give tissue for some types of research but not others. Everyone feels so differently about the issue; it is a very difficult area.
My colleague the hon. Member for East Dunbartonshire also raised the prospect of a tissue database and mentioned the work undertaken by onCore. I understand that onCore was originally set up to collect and store tissue in a national bank for cancer research. It now focuses mainly on bio-banking activity, and that shift reflects the research community’s local initiatives.
I also understand that there have been excellent developments through the National Cancer Research Institute’s informatics initiative. For example, there is the oncology information exchange, a free-to-use computer portal for sharing information on resources for cancer research, including tissue collections.
At the heart of the debate is the issue of improving access to tissue for research. Some initiatives are under way, and there are some examples of good practice, but a common cause of concern is the complexity of the regulatory and governance regimes. A lack of confidence and misconceptions about requirements have meant that residual tissue from diagnostic procedures may be archived for purposes such as clinical audit, but not available for research. Perhaps the appropriate consent has not been secured or the licence to store tissue for research has not been obtained from the Human Tissue Authority. Either way, the effect has been to stifle research, which is not what we want. Researchers complain of local resistance to new research programmes because they are perceived as being too risky or beset with rules and regulations. Efforts are being made to help NHS organisations to overcome those perceptions.
The HTA, in collaboration with the National Research Ethics Service, has set out the licensing, ethical approval and consent requirements to enable diagnostic archives to operate as tissue banks. The HTA’s annual review tells the story of Guy’s and St Thomas’ NHS Foundation Trust, which was one of the first establishments to license its archive of diagnostic histopathology specimens as a research resource. A histopathologist from the trust said that
“support from the HTA was very helpful for us in approaching our Trust management with proposals to license our diagnostic archive for research and upgrade consent processes”.
That is precisely the type of collaborative and supportive approach that we want and it is typified by a joint enterprise between the HTA and the National Research Ethics Service, which has helped to open up access even further.
I look forward to the outcome of the consultation by the Nuffield Council on Bioethics. This is clearly a dynamic issue, and I personally would like to keep it as such. It is about raising awareness and about the role that we in this place can play in raising the issue in our constituencies and with a wider audience. That is not just down to the scientists or those with a scientific background in this place, although their expertise is very valuable. The media can play a role. The organ donation taskforce report raised the issue of awareness, and there have been a number of reasonably successful campaigns in the past year, but I cannot re-emphasise enough how important it is to have public trust and confidence in the systems in place. It is important that we do not have burdensome legislation. It is important to raise awareness among all types of clinicians in training and to raise awareness among members of the public. Possibly it is a question of just changing the culture, so that people think, “I can change what’s happening in the area in which I work.” Sometimes we perceive barriers when they do not exist.
We have raised the issue of the differences between men and women, so I suggest that the men go hence and give blood. It is true that there are gender differences. It is extremely difficult to get men to go to their doctor with symptoms, particularly concerning anything below the waist. It is an issue to get men to come forward and donate tissue and blood. It is important and perhaps incumbent on all of us at certain times in the year to seek an opportunity to demonstrate by example that we are prepared to do that.
I thank my colleague the hon. Member for East Dunbartonshire not only for her contribution, but for allowing us all to have quite a collaborative discussion about the issue. There is no single solution. The NHS, the research community, clinicians and Government agencies have a part to play. In particular, the Government have a role in facilitating, but at the end of the day, they cannot take action on the ground. I hope that I have been able to reassure my honourable colleague and other hon. Members that some progress has been made, and that the various initiatives allow us to be more optimistic about the future. I reiterate that my door is open, and officials in the Department would be pleased to hear from anyone with examples of attempts to make progress that have been frustrated by rules, regulations or bureaucracy that prevent research in this important area from going ahead.
New Roads (Hertfordshire)
It is good to serve under your chairmanship this morning, Mr Benton. The debate is about the adoption of roads in Hertfordshire, about which my hon. Friend the Member for Kettering (Mr Hollobone), who is in the Chamber, has also had an important debate. Highways adoption is a pressing concern countrywide, and its importance is signified by the fact that this is the second such debate in this Parliament alone. My hon. Friend also raised the issue in the previous Parliament, and I pay tribute to him for his tenacity. We both cried “Snap!” when we got back to the House and saw that we were trying to secure a debate on the same topic.
I thank the Minister for his considered replies to my hon. Friend’s debate on 10 June. I wish to pick up where my hon. Friend left off and to have second stab at the issue, which I hope to move forward even more. I noted with interest the Minister’s comments about the current position and the measures that are in place, but I hope that he will be able to update us on his thoughts and give us some hope of a speedy resolution.
Unadopted roads—particularly residential roads—are a particular issue in Hertfordshire, where we have experienced a large amount of development. Up-to-date information about the scale of the problem is not available, but it is estimated that 40,000 roads in England and Wales are unadopted. I am not particularly concerned about farm tracks or roads that residents wish to keep unadopted; I am talking about the tens of thousands of roads on new residential developments. Let me make it clear that when I say “new” I do not mean brand-new, but relatively new.
Worryingly, residents are frequently unaware of the status of their road until they try to consult their council about a problem. As we know, some roads have been unadopted for 10 years or more. The people who live on them often struggle to access public services and to meet the maintenance costs for which they are personally liable. More importantly, these roads materially inconvenience residents, creating an unfair situation in which householders pay significant amounts of council tax for services that they do not receive.
Hertfordshire contains significant areas of green belt. In areas such as my constituency, the focus has understandably been on the usage of brownfield sites for new development. One such site is the old City hospital site, where there is a problem with unadopted roads. That was highlighted to me when I talked to residents over the campaign period. They are frustrated that people visiting the current City hospital park on their roads to avoid the hospital’s car-parking charges. They are powerless to combat the problem because the local authority cannot do anything about rogue parkers. Children who live in these roads are also put at risk by the increased volume of traffic outside their homes. Furthermore, hospital visitors avoid paying parking fees, and local authorities, which raise significant amounts from legitimate parking schemes and city centre car parks, will be keen to see roads formally adopted and brought under proper control. Most of St Albans has a residents’ parking zone, so something surely needs to be done to protect residents who are affected by the blight that I have described.
It can be difficult living on an unadopted road. Street lights might go out, but no one will repair them. Vehicles can be dumped, but the police can do nothing. People use the busy roads as a car park, but there are no parking attendants. Residents cannot get parking permits, zones or controlling. Importantly, dangerous pavements also go unrepaired. Unadopted highways can lead to issues with maintenance, street cleaning, lack of pedestrian facilities, lighting and drainage. As time goes by, such issues make it harder for those living in the road to sell their properties.
Speeding is an even greater concern. For safety reasons, St Albans wishes to adopt a “20’s Plenty” city centre speed limit, but some city centre roads in new developments are not adopted, so the speed limit is not enforceable. The issue came up on the doorsteps. People are puzzled as to why recently constructed roads, which often look superior to the potholed roads that we are famous for in Hertfordshire, are not formally adopted.
I called the debate because my council wants action. Hertfordshire recognises that we in Parliament need to help it. Indeed, in 2009, Herts county council highways and transport cabinet panel formally recommended actively involving MPs, with the aim of exploring the possibility of altering legislation to address the problem. In many areas in my constituency where new housing developments have been built, the local authority has subsequently failed to adopt the roads. I have consulted Herts county council, which shares local people’s frustration about unadopted roads, but it is often frustrated by the limited mechanisms available to it to tackle the issue. There has been concern, and people have voiced the belief, that local authorities may not wish to adopt roads for reasons of their own, but Herts assures me that that is not the case.
One issue that has been raised with me over the years is that people buying a property are assured that the road is being considered for adoption. I know that this is a case of caveat emptor, but if someone is told that a road is seriously being considered for adoption—a woolly phrase if ever I heard one—they would expect it to be adopted within a reasonable time. One constituent, who contacted me last year, bought their home in 2006. The road was built approximately 10 years ago and was unadopted at the time of purchase, but inquiries seemed to suggest that it would be adopted shortly. However, four years later it has still not been adopted, and my constituent is understandably frustrated. Many purchasers who have been given similar assurances that their road is indeed progressing towards adoption feel duped. This seems to be a frequent issue when prospective purchasers do the searches; they are given the impression that the road is in the process of being adopted, but nothing is really being done to progress that.
A report to Herts county council in November 2009 looked for a new approach to highway adoption. The report was formulated in response to the concerns of many of my constituents, as well as district councils and developers, about the time that it was taking to adopt roads in new developments. At present, Herts county council, which has responsibility for all non-trunk roads in the county, is responsible for the adoption and subsequent maintenance of roads. The guiding principle in the adoption of new roads is that they should have wider utility than simply providing access to a small number of properties. As a result, short cul-de-sacs are routinely not adopted, and commercial and industrial roads are also not adopted. Herts county council tells me that all parties need more clarity over the extent of adoption and that the extent of highway adoption should form part of any planning approval for developments involving the construction of new highways. It also believes that it would be helpful if road signs on unadopted roads made it clear that they were not adopted, so that there was no confusion.
As I said, we have no idea of the number of unadopted roads, because the most recent survey was in 1972. It is vital, if we are to tackle the problem, that we gather more information about its extent. In his recent response to my hon. Friend the Member for Kettering, who is in the Chamber because he feels so passionately about this matter, the Minister stated that
“knowing the number of unadopted roads would not really provide the context, because the vast majority…are not really relevant to the issues in question”.—[Official Report, 10 June 2010; Vol. 511, c. 578.]
However, it might be helpful for the Government to have some idea of the scale of the problem. I am aware of the need to limit public expenditure at present, and a full survey would be prohibitively expensive, but closer working between the Minister, his Department and local authorities might help us all. Will the Minister therefore undertake to arrange for his officials to write to every relevant authority in England and Wales to seek an estimate of the extent of the problem in its area? In his recent debate on the issue, my hon. Friend the Member for Kettering listed 14 local authorities, my own among them, with which he had been in correspondence over the problems of unadopted roads. Their experiences are surely not atypical, which is why a thorough investigation of the issues is necessary, and it need not be expensive.
Let me give an example of the extent of the problem. In just one borough in Hertfordshire—Hertsmere—more than 626 out of 2,165 sections of streets, footways and other highways are not maintained. That represents nearly a quarter of the sections of Hertsmere’s roads. As I said, a lot of the data dates back to the 1970s, and there has been a huge expansion in building since then, so it would be helpful to get a sense of the extent of the problem. Will the Minister agree to undertake such an exercise and to place a copy of the information that is collected in the Library, so that other hon. Members can see the extent of the problem?
Where the construction of a new estate is involved, a local highways authority can, under section 38 of the Highways Act 1980, adopt a road by agreement with the owner. Essentially, the developer of an estate can enter into an agreement with the highways authority to construct streets to the authority’s satisfaction and in accordance with its specification. The road then becomes a highway maintainable at public expense. I should add that section 38 cannot be used if the owner cannot be traced. However, Hertfordshire county council tells me that under the current system, when local planning authorities grant permission for a development that includes new roads, they cannot impose planning conditions regarding the extent of highway adoption or the timing of the adoption process, nor do they have any power to force the developer to put a road up for adoption. Perhaps that can be looked at under the new Government’s fresh approach to planning.
In the previous Parliament, the use and inadequacies of section 106 funding were seriously examined, and section 38 might be a suitable topic for the Department for Communities and Local Government to look at with the Department for Transport in a cross-cutting report. There are no incentives for developers to enter into section 38 agreements, and developers currently initiate the process dictating whether they enter into a section 38 adoption. However, in the current economic climate there is a risk that even fewer section 38 agreements may be entered into, because developers do not have resources to fund the bond of such an agreement.
There are several reasons why a road often does not progress to adoption; I shall not list them in this short debate. My council tells me that it has concerns about the inability of local authorities to oblige developers to enter into a section 38 agreement so that highways can be adopted. I understand from the Minister’s recent reply to my hon. Friend the Member for Kettering that the Government are investigating options to alter legislation to address the problem. After the thought that he may have gone through since the last debate, will the Minister update us today on the progress of the investigations or give us a hint of the trajectory that his thought process might take?
It would be remiss of me not to pay a huge tribute to my hon. Friend for her excellent speech. She is hitting all the right buttons for me. On the Minister’s welcome point about looking at legislation on section 38 agreements, I hope that he will advise her about the point that, even if developers enter into section 38 agreements and have bonded funds, local authorities cannot access those bonded funds without the permission of the developer. Often the developer has to go bust before the local authority can access the moneys.
I thank my hon. Friend for his valuable point. He has done sterling work on the matter. What he says is true. It seems that people are caught in the dilemma that although the money is in place, no one can access it. They are therefore powerless to do anything about the road that is unadopted. I am hoping that the Minister will give us his thoughts today, think outside the box and tell us what he could do.
I am told that another option is the advance payments code under the 1980 Act, which was designed to secure payment of the expenses of completing roadworks in unadopted roads next to new buildings, and to ensure that the street works authority could complete the roadworks if a developer failed to complete them. The code was apparently introduced to guard against the post-war problem of small, speculative developers, but my local authorities tell me that it offers little protection for them on today’s large developments where access roads may not contain houses adjacent to the road and are therefore not covered by the code, or where there might be many properties, each of which has to be dealt with separately, so that strict time constraints preclude that action.
The advance payments code is not implemented by Hertfordshire county council and has not been for at least 30 years. Surely that shows that it is a toothless tiger that needs to be revisited as a piece of defunct legislation. I am told that the code is highly resource-intensive and that it gives little protection against the problems currently besetting Hertfordshire, not least because we are a two-tier authority, and planning is the responsibility of the district council. Hertfordshire county council says that other highways authorities that follow the code are in the minority and are mostly single-tier authorities where the necessary communication between planners and highway engineers is more easily achieved.
I just wish to touch on one further issue today. I want to give the Minister plenty of time to respond; perhaps my hon. Friend the Member for Kettering and I may come back at him occasionally. I want to highlight a particular impact that delays in the adoption of roads have had in recent months. We all remember that dreadful cold snap in January and its effect on roads in many areas. In Hertfordshire, we felt it particularly acutely and it exacerbated an already dire situation regarding road surfaces in the area. As a result of two harsh cold snaps in two years, the problem is now reaching a tipping point for our roads. It has also affected unadopted roads. Those roads were not gritted. They were also liable to damage by the weather. Some roads that were already in a dire situation have got worse. Some roads still awaiting adoption have now deteriorated in the interim period and they are even less likely to lose their orphan status.
As for the question of timing, 10 years is a very long time in the life of a road. My constituent said that his house was built 10 years ago, and since then significant damage has been done, especially if utilities have been digging up the road and compromising its integrity. I shall be grateful if the Minister will say in his reply what steps are being taken to speed up the process so that such situations do not arise in the future, with the inevitable knock-on consequence for people waiting for their roads to be adopted.
On a final note, my hon. Friend the Member for Kettering stated that he was open, as I am, to practical suggestions as long as they place the cost on the appropriate people and can be implemented quickly, to enable authorities to manage the situation better. In these harsh economic times, that is exactly the right tone. It should be for the people who have benefited from the new estates and developments to make roads up to standard, which are then adopted with all rapidity. There needs to be a purposefulness on the part of the developer to bring that about.
My local authority has a great deal of expertise, and I know that it will welcome the chance to make practical suggestions to the Minister. Is he willing to meet representatives of Hertfordshire county council to discuss the issue in more depth, or even consider calling there once he has ascertained the seriousness of the problem in the country, bringing the authorities together for an open, round-table discussion? Since the problems vary greatly from area to area, people might throw their hands up in the air and say, “Nothing can be done”, but I do not believe that that is the case. Given all the expertise around the country highlighting the problems to the Minister and making practical suggestions, perhaps that is something that he could put as a feather in his cap. It would be an easy win relatively early in this Parliament, and prevent the problem from happening any more.
I welcome the fact that planning is being given back to people to decide at a local level. However, the Minister should be aware that in district councils there are many people who are willing to serve their area but do not necessarily know how to put in place a tough agreement to ensure that when they grant permission for a development, it has roads that are fit for purpose and can be readily adopted. The two-tier council approach that we have in Hertfordshire and other areas is part of the problem. Is the Minister able to give us any comfort on how we can have input from local authorities and how we can ensure that local people who wish to take control of planning are not left with a load of white elephants in the form of buildings on unadopted roads? Perhaps he can tell us whether he is able to get a sense of the scope of the problem by writing to local authorities, so that we can have the information at our fingertips.
I thank my hon. Friend the Member for St Albans (Mrs Main) for, and congratulate her on, securing this debate on an issue that is clearly important to her, her constituents, and the constituents of my hon. Friend the Member for Kettering (Mr Hollobone) and many other Members up and down the country. I know that she has tabled an early-day motion on the subject. I assure her from the beginning that I am sympathetic to her concerns. I know that the issue has resonance with other Members; the last time I checked, her early-day motion had secured the support of 15 Members from both sides of the House, and perhaps that figure has now increased. As she knows, the debate that my hon. Friend the Member for Kettering secured recently was his second such debate in recent months, and I was pleased to be able to respond to it.
It is right to acknowledge at the outset that many developers routinely build roads in new developments to a high standard and in good time, and in many cases they are ready for adoption by the local highways authority. Where developers take the right approach, home owners should have little cause for concern. However, I am only too aware that that is not always the case. Some developers drag their feet in bringing the roads up to an adoptable standard, and as a result, even many years after a development has been completed, some home owners find that the roads remain unfinished and unsuitable for adoption by the highways authority. That is not acceptable.
My hon. Friend the Member for St Albans spoke eloquently about the problems that can arise in such cases. The obvious point is that poor road quality is a daily frustration for residents, but I am aware that in more extreme cases, there are concerns about damage to vehicles, the ability to enforce speed limits, and the removal of abandoned vehicles. Such problems can and do occur on unadopted roads. The issue of access for emergency vehicles has also rightly been raised with us.
I am aware that the concerns are not confined to my hon. Friend’s constituency. As she mentioned, it was estimated that there were around 40,000 unadopted roads across the country in 1972. Since then, some roads will have been adopted, while new roads will have been built but not yet adopted. As a result, there have been calls for the Government to conduct a national survey of private roads to bring the estimate up to date—something to which she referred.
While I am sympathetic to the problem, I am not convinced about the value of such a survey. First, any survey of private streets would reveal a large number of streets that are never likely to be suitable for adoption, and in which my hon. Friend is not interested—farm tracks, service roads, back alleys and suchlike. Secondly, any survey would reveal some private residential streets where the residents bought their properties in the full knowledge that they would retain responsibility for ongoing maintenance, and probably—or perhaps—benefited from that being reflected in the purchase price. In many of those cases, residents are quite happy to live on a private street.
In a specimen survey of 600 private streets, 63 were suitable for adoption, but only in 17 cases did the majority of the frontagers want the street adopted; that leaves 46. I accept that that is a small survey, but it might give some flavour of the position out there in the country. To deliver useful conclusions, any national survey would need to identify not only the number of private streets, but the number of streets that could be made suitable for adoption, and that residents actually wanted adopted. As I am sure my hon. Friend will appreciate, such a survey would be large-scale, costing a significant amount of taxpayers’ money, and I am not persuaded that it would offer value for money, particularly at this time. I am not sure how such a survey would help us move forward. We are fully aware of the problem and sympathise.
I completely accept that a survey would not be a value-for-money thing and is not likely to happen. That is why I believe that talking to the local authorities might be useful. They will be aware of which roads people would like adopted but are frustrated that they cannot have adopted, and in which cases roads are not adopted, but nobody wants them adopted and everyone is fine with that. That is why I felt that talking to the local authorities could be the way forward.
I agree with that, and we are talking to local authorities. I will come to that in a moment. The issue is not quantifying to the nth degree exactly how many unadopted roads there are, but ensuring that we have a full picture in the Department of the problems that arise, so that we can identify solutions to move forward. That is what I am trying to do in my role.
There must be two elements to any sensible strategy. The first element is to ensure that the best possible use is made of the powers already available to local authorities. They are not perfect, but the powers are there. I spoke in some detail to my hon. Friend the Member for Kettering about the existing tools, including planning conditions, adoption agreements and the advance payments code. I accept that there are limitations in respect of some of those matters. The second element is to consider whether the existing tools can be made more effective through changes in legislation.
On best use of the existing tools, as I indicated in a previous debate on the subject, planning circular 11/95 sets out the uses for planning conditions, and the courts have further clarified their use, setting out clear criteria. Rather than occupying the time of the House by repeating what I said previously, I refer my hon. Friend the Member for St Albans to that previous debate for further background information on that point.
The circular also states that conditions may be imposed to ensure that the development proceeds in line with locally defined needs. For example, a condition may be imposed to ensure that necessary infrastructure is in place before full occupancy of the site. I understand that this type of condition has been used to secure highway infrastructure where a development would have an adverse impact on the highway network. That is particularly important where sites are to be delivered in phases, as it allows a compromise between the needs of the developer to build and sell the site in phases, and the needs of the highways authority to ensure a safe and suitable standard of road.
The planning condition route allows the local authority and the developer to discuss and agree the needs of the site, and to take them into account for the benefit of future occupiers of the development. The Planning Inspectorate can provide model conditions to give guidance to local authorities where particularly problematic issues have been identified. My hon. Friend the Member for St Albans might like to know that at the request of the Department for Transport, and indeed the Department for Communities and Local Government, the Planning Inspectorate is developing a model condition to assist with the problems raised in places such as Kettering and St Albans.
My hon. Friend referred in passing—indirectly, at least—to problems potentially arising between two-tier authorities. I am familiar with that situation in my constituency, where we have a district and a county council. This is not necessarily a legislative problem, but in some cases local authorities—district and county—do not work together as well as they might. It is important that that is pursued from a local angle. Clearly, any changes to local government functions are a matter not for the Department for Transport but for my colleagues in the Department for Communities and Local Government.
Coming back to the model condition, it could offer increased consistency and certainty for authorities, some of which have voiced uncertainty about how planning conditions can be used robustly to specify highway standards, in line with the national policy set out in planning circular 11/95. I accept that no model condition would offer a one-size-fits-all solution; it would need to be adapted by individual authorities to suit the circumstances of particular developments. A carefully designed model planning condition that can be adapted for use in particular local circumstances could offer a useful way forward. Local councils in the constituency of my hon. Friend the Member for Kettering have certainly indicated that they would find that helpful.
I said in response to the previous debate on the subject that I would be prepared to explore potential legislative options, and I am happy to reaffirm that commitment. There are two particular aspects of primary legislation that have been identified by highways authorities as being in need of review. The first is the so-called advance payments code, to which my hon. Friend the Member for St Albans referred, which forms part of the Highways Act 1980. The original purpose of the code was to allow highways authorities to secure a payment or security from developers to cover the cost of making up the road to an adoptable standard, in the event that a developer failed to do so. The payment or security would be available when a development reached a certain stage, at which point the frontagers could require the carrying out of street works and the subsequent adoption of the road. In effect, the deposit or security covers the liability of the owners of the new homes for the cost of making up the street that would otherwise fall to them.
My hon. Friend the Member for Kettering was concerned that funds under section 38 cannot be accessed by the highways authority unless the developer goes bust. We understand from the local authorities with which we have discussed the matter that they have difficulty accessing funds deposited by developers, and we will examine that issue with authority representatives as part of our review of section 38 and other elements of legislation. I hope that is helpful to my hon. Friend.
Currently, under the Highways Act 1980, there is a six-week window in which the highways authority can request a deposit or security. I am aware that the usefulness of the code is weakened because, in many cases, there is no longer any reliable mechanism to make the highways authority aware of the start of works on a particular development, particularly in a two-tier arrangement. As a result, the authority will not necessarily become aware of the need to request a deposit or security until after the six-week window has passed. I think that there is a good case for extending that window, but I am advised that unfortunately that would require primary legislation to amend the Highways Act 1980. That has become the issue, rather than the assessment of the applicability or suitability of the existing condition.
Before I move on to my conclusion, I will refer to the second aspect of legislation that is in need of review, which is section 38 of the Highways Act 1980.
Before the Minister moves on, may I quickly intervene?
Very briefly, as I have only two minutes left.
Is it possible for guidance to be issued, if there is no wish to amend the primary legislation?
We will look at how far we can get down the track. We want to get as far down it as possible, including through changes to legislation, if we can make them. Certainly we will do what we can short of introducing legislation, if that approach is necessary.
Section 38 of the Highways Act 1980 is a well-used mechanism that can be very effective where a developer is prepared to commit to making up new roads to an adoptable standard. I am aware, however, that the existing arrangements place no obligation on developers to enter into such an agreement, even if the authority is clear that that would be squarely in the public interest. In the debate on 10 June, I indicated to my hon. Friend the Member for Kettering that I was exploring that matter with the Department for Communities and Local Government to see whether we could have
“options for legislation, including empowering local authorities to require developers to enter into section 38 agreements.”—[Official Report, 10 June 2010; Vol. 511, c. 578.]
We have had initial discussions with representatives of the Department for Communities and Local Government on the subject. They were not unsympathetic, but the issue, both in that case and with regard to advance payments under the Highways Act 1980, is simply finding a window for legislation. Both my hon. Friends will be aware that the coalition Government’s commitment is to give priority in legislation to the elements that were included in the coalition agreement, so that we can be seen to be delivering properly on what we promised the public. It is a question of how much traffic one can get on the bridge at any time. That does not mean that action will not happen, but it means that the issue will have to take its place in the queue. We will do our best in our Department to try to find a way to progress the matter, either through primary legislation or through some other means that helps move matters forward in a productive way.
The Department for Transport had a constructive meeting earlier this year with council representatives from the Kettering constituency, which was helpful in establishing the nature of the concerns and providing an initial view of some potential solutions. I am now keen to move forward by inviting—
[Mr Joe Benton in the Chair]
The events of 2 June will never be forgotten by my community. An ordinary day in England’s most remote and, in my opinion, outstandingly beautiful constituency ended with the senseless loss of 12 members of a remarkable community—the community into which I was born and where I was raised and still live.
Nothing that I or anyone in the Chamber can do or say will undo the wrong done to my community. Nothing can, perhaps nothing should, ever erase the memory of those events. The west Cumbrian community will be defined more by its response to those events—indeed, it is already being so defined—than by the events themselves. The collective response that is sweeping across west Cumbria is, I believe, to those in many other parts of the country, an enviable response.
A number of lessons are to be learned from the events of 2 June, and we will by no means hear an exhaustive summary of them today. One of the most remarkable lessons—it is a source of the greatest pride for me and other west Cumbrians—is that something that we have always known can now be seen by the rest of the country. It is that our area, our community, our home—the towns of Egremont and Whitehaven, and the villages of Seascale and Boot—represent the kind of Britain that much of the rest of the country longs to be like. That view is strongly shared by His Royal Highness the Prince of Wales, and by a number of the media commentators who have written about the events of recent weeks. This is not false sentimentality. Many communities outside the metropolitan areas of the United Kingdom are very much like that.
I have touched on the fact that the purpose of today’s debate is not to rake over the facts. They are not yet exhaustively understood, and will be examined in due course. However, given what we know at the moment, I wish to learn what the lessons of the tragedy are for my community and our country. There may be lessons for the police, the emergency services, local authorities, and Members of Parliament as legislators—but it does not necessarily follow that there will be.
Parliament will not serve my community or the country well by rushing to make judgments because of the need to be seen to be doing something in response to the tragedy. Equally, should clear lessons require us to act, in the form of new legislation or practices, the House would betray my constituents and the people of this country by not acting swiftly, decisively and in concert.
My community has shown itself at its best in recent weeks—in truth, we usually do at such times—and it is time for Parliament to follow our example. That means acting with solemnity, dignity and purpose. As Tony Parsons, the author and Daily Mirror columnist put it, my community is trying to “understand the senseless”. So, too, must the country. In trying to reach that understanding, we must learn from the destructive behaviour demonstrated by so many in the print and broadcast media over recent weeks.
Communities dealing with the aftershock of seismic tragedies such as that which took place on 2 June are the worst places to be invaded by the media. In such situations, there is no place for the media’s invented exclusives, its prurience and voyeurism, its mawkish brutality and its cold-blooded pursuit of profit at the expense of the families of those most affected. Everyone expects intense media coverage of tragedies such as that which affected Cumbria, but do people really expect the news to give way to entertainment? I wish to talk about the behaviour of much of the media in recent weeks, and the anger and dismay that it has caused among my community.
May I say how grateful I am to the Minister who is to reply to the debate? These are not exclusively Home Office matters; I have some sympathy for him, as his brief cannot cover them exhaustively.
I return to Tony Parsons, and to reflecting on the piece to which I referred earlier. It was printed under the headline “The haven of decency that will remain unbroken”. He wrote that west Cumbria
“feels like an England that many of us remember from our childhoods…An England that we thought had disappeared into the mists of history. It is not a flashy place. It is not a place that ever gets much attention. But it is still out there. And among all the horror, we are reminded that it is still real. And that it represents all that is best about this country and our people. No place was less built for violence, and madness, and the mayhem of the modern world. No place deserves it less.”
I cannot describe the effect that those words have had on my community, how grateful we were that we had been seen as we see ourselves, and that our culture and our values had been recognised. How fitting it was. It was a small way of remembering those who had been taken from us. I can only hope that those words helped to fetch some comfort for the families of those who lost family members.
Parsons observed that when Cumbria
“gets attention from the leering outer world, it is seen through a prism of prejudice and ignorance…It is not too much to say that the communities of Cumbria could teach a lesson to us all.”
“While we hear so much about the ugly face of the modern world, we forget that there is a Britain that is emphatically unbroken. And where all those old virtues—decency, tolerance, kindness, innocence and goodness—still prevail and thrive.”
I wholeheartedly endorse the sentiments that my hon. Friend expresses. In Barrow and Furness in southern Cumbria—I have the huge privilege of being the new Member for that constituency—I see that spirit every day. Barrow and the surrounding area was once considered part of Lancaster, and many in the area still retain a great affinity with Lancashire. Indeed, if we were to ask, some would say that they would like to move back to being part of it. Does my hon. Friend agree that the tragedy and the many difficulties that the Cumbrian people have experienced in recent months underline the fact that there is a Cumbrian spirit and a Cumbrian community? Indeed, such ties bind my constituency with his and the people of that great region.
I thank my hon. Friend for that intervention. He has been a Member for only a short time, but I know of the huge esteem in which he is held by his constituents. I am personally grateful to him for making the trip to Whitehaven on the weekend after the shootings to pay tribute, on behalf of his constituents and everybody in the Furness region, to people 40 miles to the north. We were standing shoulder to shoulder. My hon. Friend is absolutely right to talk about community spirit and community values. One of the lessons that we need to learn is that that spirit and those values do not come about by accident; there is a deep cultural purpose to those values, but they are supported, helped and strengthened by policy decisions taken by the House. There will be a time to address such matters, but it is not now. I am grateful to my hon. Friend for his comments.
Tony Parsons continued his article by saying:
“No, this Britain is not broken.”
That is the spirit to which my hon. Friend alluded. Perhaps most fittingly, Parsons gave us—or at least me—a simple phrase that encapsulates not simply the area but those whom I represent. Home to England’s deepest lake and tallest mountain, he wrote that we have
“a beauty that is beyond landscape.”
When that was read out in church on the Sunday after the tragedy, I am told that it had a remarkable effect on a usually stoic congregation. It certainly had a remarkable effect on me, and I will always be grateful. Why is it important? It is because the media, perhaps the most important force in our society—more so even than politics and politicians, even those in the Chamber today; we kid ourselves if we say that that is not so—have the ability to achieve so much good. We all know that the truth will set us free—it is a well-known phrase and a cliché, but it is true—so why do the media turn their collective back when they have the capacity to achieve so much good, so readily and so often?
The media local to the tragedy—the Whitehaven News, the News & Star, the North West Evening Mail, Border television, BBC Radio Cumbria and “Look North”—reported the tragedy with a care and diligence entirely different from that of the national media. That is because they are rooted in the area and care about the people about whom they are reporting. They understand the power of their roles and the effects of carrying them out in particular ways. The Whitehaven News was particularly impressive, as just one week before, it had reported the tragic deaths of Kieran Goulding and Chloe Walker, constituents who were killed in the Keswick bus crash. Like the News & Star, the Whitehaven News understands the role that it plays in my community and how it can help the community’s healing process—not the families’ healing process, perhaps, but certainly the community’s. To give a parallel—I know that this is a difficult issue—certain national newspapers have elicited feelings in my community similar to those that were elicited in Liverpool by the way that the Hillsborough tragedy was reported.
The first lesson of the tragedy is that communities such as mine have a lot to teach other parts of the country about the power of community, cohesion, social justice, compassion and solidarity. Social policy must protect and strengthen those values and virtues. The second lesson is not to seek to curb the freedom of the press or broader media, but to seek a better, enforceable code of conduct for the media. Certain desperate, spiteful journalists have written some dreadfully inaccurate copy simply because members of the community would not speak to them on learning that they were journalists. That reflects badly on those journalists; naming them would surprise nobody and so serves no purpose today.
I come to the second lesson. One price we pay for a free press is its freedom to write such misleading and opinionated bile. However, press intrusion is not a price anyone has ever agreed to pay. Nobody ever agreed to have journalists camped on their doorsteps while they were in the immediate aftermath of bereavement; to have friends and family members offered money if they spoke to, or obtained a photo of, a distraught relative of one of those who died; or to have six-figure sums paid for exclusives, or smaller sums paid to them if they could tell the whereabouts or movements of certain individuals, even if those individuals would be going to school that day.
If the west Cumbrian community demonstrates just how far from being broken Britain really is, then behaviour like that from certain sections of the media demonstrates just how dysfunctional and broken the media’s values are, and that their attempts to infect decent society with their values are iniquitous and wrong. I know journalists who have had their stomachs turned by the actions of some in their fold—they are far from being all the same—but surely such behaviour cannot be sanctioned and must be stopped. To that end, I will write to the National Union of Journalists and the Press Complaints Commission to seek meetings, and to discuss how the issue can be taken forward and how professional codes of practice can be improved significantly. I have spent so much time talking about the media because the activities of certain sections of them have weighed particularly heavily on the community in recent weeks. They have caused particular distress, anger and concern, and I feel duty-bound to articulate those concerns today.
The third lesson, so far, of the Cumbrian tragedy will be to review gun law; that is now essential. It does not necessarily mean that gun law can, will or should change; we must await the full facts of the case before we can assess them through the prism of the gun ownership laws. If any changes to the law could have prevented this tragedy, reduced its chances of happening or mitigated its effects, then it is a reasonable proposition to expect those changes to be made. Certainly, those are the views of some of the family members of those who lost their lives on 2 June. However, we do not yet know if changes are necessary.
The fourth lesson—this is imperative—is that the Government should release the £100 million pledged by the previous Labour Government to rebuild the West Cumberland hospital in Whitehaven. The cheque for the new development was in our hands on election day but taken from us when the new coalition Government were formed. The hospital is the fulcrum of my community and the entire west Cumbrian community, and demonstrated its worth again and again in the days and weeks that followed 2 June. Halfway through the general election campaign this year, that hospital saved my life, and it has saved countless more since. When my community needed it most, it was impeccable. The Prime Minister saw for himself just what a remarkable and valuable group of professionals there are at the West Cumberland hospital. I ask the Government again today to please release the funds required without any further delay.
Demolition of the old hospital has commenced in anticipation of the new-build programme, and any delay beyond September will have serious consequences for the project, for service configuration and for the entire community. Please return to my community the money given to us by the previous Government. The Government must acknowledge the importance of the matter and act in the only human, compassionate way imaginable by returning this money as soon as possible.
There will be other lessons—about the value of GP practices, retained fire fighters, the civil nuclear constabulary, the Church and the essential role played by voluntary agencies. Those lessons need to be brought before the House, and I expect that they will; that should happen soon. I am grateful to the Home Office for the interest it has shown and the time that it has taken to address the issues so far. I expect a full and frank inquiry, the terms of which should be determined principally by my community and the families of those affected.
I expect that the Select Committee on Home Affairs will want to undertake its own investigations, too. I am particularly grateful to the Chair of the Home Affairs Committee, my right hon. Friend the Member for Leicester East (Keith Vaz), for visiting my constituency earlier this week to speak with Cumbria constabulary and Copeland borough council about their experiences in recent weeks. That was extremely beneficial and welcome. For the benefit of all those affected, inquiries should probably be undertaken sooner rather than later, but not in an immediate rushed sense.
It is imperative that no inquiry should begin with the purpose of attributing blame. The conclusions of the Association of Chief Police Officers investigation that is currently under way should be placed in the public domain as soon as it is completed. The Cumbrian constabulary has nothing to hide and is a source of pride among my community. It performed fantastically on 2 June as events unfolded, and I know, through my conversations with it, that it is determined for the full facts of the investigation to be known by the public. No price can be placed on the truth—that is what we seek before anything else. We do not want inquiries that seek to validate opinions or theories; we want the facts, and those facts must be acted on. Other issues, such as the support services in place for the bereaved and applications to the criminal injuries compensation scheme must be addressed, but those are not issues for today. Fundamentally, the concern of politicians must remain once the cameras have moved away.
Finally, none of us will ever forget Michael Pike, Garry Purdham, David Bird, Kevin Commons, Susan Hughes, Kenneth Fishburn, Jane Robinson, Darren Rewcastle, Jennifer and James Jackson, Isaac Dixon and Jamie Clark, and this House owes it to their memories, their families and my community to understand and act on the lessons of 2 June. They deserve nothing less.
Before I call the next speaker, I point out for the benefit of new Members that if they have not already made their maiden speech, they may speak here, but they then forgo their right to a traditional maiden speech in the Chamber. I am sorry, but that is the rule, and I thought that I ought to point it out. At least hon. Members are now aware of that and can keep it in mind.
I endorse the comments of the hon. Member for Copeland (Mr Reed). All of us who represent rural communities—I represent one on the west coast of Wales—can only imagine how dreadful an experience the event that we are discussing must have been. Everyone in the House and elsewhere will be reflecting on the things that the hon. Gentleman put so eloquently, and on the measured response that he and other professionals in his area have so diligently delivered for the rest of us. I should declare a bit of an interest, in that before coming into the House I represented an organisation that had rural communities at its heart. I have been lucky enough to travel to many isolated areas, including the hon. Gentleman’s.
It is sometimes quite difficult to articulate to the wider public exactly what a rural community is—what its strengths are and why we are so passionate about it. It is also sometimes difficult to articulate what a blow an event such as this can be. Of course, it would be a blow to any community, but purely because of where I have worked and where I live, I feel that I understand where the hon. Gentleman is coming from. For that, I am extremely grateful.
The hon. Gentleman made his strongest point when he said that we should proceed from here on the basis of the facts. In the past, there have been occasions when the instant reaction to a dreadful event has been a little too knee-jerk, political and shy of the facts. That has meant that the problem has not been dealt with and that people who should not have been caught up in the aftermath have been punished or penalised. The hon. Gentleman’s approach to this matter has been absolutely right, and has been generally endorsed across the House.
I absolutely endorse the sentiments expressed by the hon. Gentleman and echo his call for our response to be fact-driven, but may I ask him whether he has any examples of knee-jerk and political responses to tragedies and of when the right outcome has not followed on from events?
Yes, I have. Responses such as the Dangerous Dogs Act 1991 and legislation passed by a Conservative Government in relation to handguns did not achieve the objectives that this place and the public wanted, which is why there has been an ongoing debate about their effectiveness. There are also plenty of examples of people who have been adversely affected by the passing of that legislation. People at whom the legislation was aimed have hardly been touched at all, which is why a private Member’s Bill on dangerous dogs is starting its process in the House of Lords as we speak. There are probably more examples, but those are two with which I am familiar.
I want to cover just one area of the four that the hon. Gentleman mentioned. Due to my previous interest in countryside activities, I should like to focus on the shooting community. I must be very careful about that because I do not want to underplay the seriousness of the situation or give any impression that those who shoot, either recreationally or as part of their daily lives, are not sympathetic to the points that the hon. Gentleman made. Moreover, those who shoot are not unrealistic about the fact that many things will need to be reconsidered in the near rather than the distant future by this House and the other place. There is a real awareness that these are important issues, and nobody I know who possesses a shotgun or firearm certificate—professional or otherwise—is in any doubt about the need to get right to the heart of the problem.
Does the hon. Gentleman agree that it is in no one’s interest to have a knee-jerk response? He is talking about the shooting fraternity, but it is not in the interests of the community of west Cumbria, or anywhere else, to have a knee-jerk reaction. What we need, and what my hon. Friend the Member for Copeland (Mr Reed) was asking for, is a thorough inquiry into the matter. I repeat: no one—but no one—wants a knee-jerk reaction.
I absolutely agree. We cannot proceed without the facts. We cannot proceed sensibly until we have had the results of the inquiry by the Association of Chief Police Officers and of other investigations that may be associated with, or just on the fringes of, this particular incident. Yes, of course I endorse what the hon. Gentleman has said.
There is increasing evidence that, in many areas, gun crime is coming down while weapon ownership is going up, and interesting statistics on Scotland have recently been published on that score. Fewer than 0.5% of crimes involving weapons that have resulted in death or injury have involved licensed weapons—shotguns, in particular. As for the safety of the activity across the EU, target-shooting activities are among the safest for members of the public to take part in. If there is a lesson to be drawn from that, it is that any changes in legislation should be about the people who possess and use weapons rather than the weapons themselves. I mentioned the error that the Conservative Government made in relation to handguns. In that instance, they focused too much on the weapon, and not enough on the people who were ultimately going to be using it.
Moreover, there is not much evidence to suggest that shortening the certificate period for weapon ownership would have made much difference in these or other circumstances. Likewise, it is uncertain whether any evidence supports the theory that it is acceptable for people to keep no more than a certain number of guns.
I recognise the hon. Gentleman’s comments about the media. The distinction in approach between the national and regional media resonates with rural communities. The idea that people would have to show a good reason for owning a weapon would be unlikely to make much difference, although I am not talking about this specific incident.
Lastly, let me turn to the thorny issue of mental health checks for people who wish to acquire and use weapons. The shooting community is particularly conscious of the matter and is inclined to investigate it further. Those checks have to find a way of safely predicting dangerousness, and that will be a very complicated medical judgment. GPs, who could be the final arbiters in applications, might be put in a very tricky position as far as potential liability is concerned if it emerged that someone they certified as safe to own and use a weapon subsequently turned out not to be. There may also be GPs who have a fundamental dislike of weapon ownership and shooting-related activities; that might put them and the applicant in a difficult position.
From the perspective of both a rural community and an urban community that has access to and enjoys weapons for whatever purpose, there is a real willingness to engage in the debate that has emerged from this tragic event. I do not think that anybody is under any illusion about the changes, but what I hope we can do is strike a proper balance between the safety of the public and proportionality as far as our freedom to own and use weapons is concerned. If we can achieve that balance as a consequence of the hon. Gentleman’s efforts, we will have made sensible progress.
It is a pleasure to be in a debate under your chairmanship, Mr Benton; I think that this is the first such occasion for me. I am pleased to be following the hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart). One of the great values of this House is that Members come from so many different backgrounds. They are able to give the House their experience and expertise in areas of policy of which some of us have absolutely no experience. I represent an urban constituency, which does not have anything like the open space and rural background of the constituencies of many hon. Members here this afternoon.
I pay tribute to my hon. Friend the Member for Copeland (Mr Reed) for the way in which he has conducted himself as Member of Parliament for the area where the event that we are discussing took place. It must have been a 24/7 experience, the like of which none of us would ever want to be involved in. Of course, we are always there to represent our constituents every moment we are in the House, but what he had to go through was exceptional. He conducted himself with enormous dignity, and he is a credit to his constituency and to this House.
I just want to endorse what my right hon. Friend has said about my hon. Friend the Member for Copeland. However, there is one word that he did not use that I should like to add—it is “leadership”. That is what communities would always want to see in their MP in such difficult circumstances. Throughout this entire tragedy, my hon. Friend has shown real leadership and he is to be commended for that.
Indeed; my hon. Friend is absolutely right to say so. As we are in the business of acknowledging hon. Members, I should say that all the other Members with Cumbrian constituencies who are here today also played their parts in responding to this tragedy—the hon. Member for Penrith and The Border (Rory Stewart) and my hon. Friends the Members for Barrow and Furness (John Woodcock) and for Workington (Tony Cunningham). Those constituencies were just names to me until I went to Whitehaven on Monday. As I went down the motorway, I saw all those constituency names; I am sorry that I did not have a chance to notify the Members that I was driving past, as is the convention, but I tried my very best.
I will speak very briefly as I know that other hon. Members who represent Cumbria wish to be involved in the debate. I was in Whitehaven in Copeland on Monday, at the invitation of my hon. Friend the Member for Copeland, as I had expressed the view that it was important that we not only looked at the overall area of policy that is paramount in this particular case, but recognised, following statements made by the Prime Minister and the Home Secretary, that it was important that Parliament itself should look at the events that had occurred in this tragic set of circumstances.
Of course, those of us who live outside Cumbria send our condolences to the families of those who have died; it must be an awful experience for those families. On Monday, I met the vicar of Egremont and he told me about the funerals that he had conducted and the fact that it is a very close-knit community—everyone knows everyone else. The tragedy is taken very personally.
The hon. Member for Carmarthen West and South Pembrokeshire and my hon. Friend the Member for Copeland are absolutely right: the reaction of politicians, including the Prime Minister and the Home Secretary, was spot on. There was no rush to judgment. There was a careful and measured approach, as was demonstrated by my hon. Friend the Member for Copeland here in Westminster Hall today. That approach was also reflected in the statement of the Prime Minister when he went to Cumbria and by the Home Secretary in her statement to the House, which she made very soon after this tragedy.
It was right to say that we have to wait and see. There must not be a rush to judgment. Let us look at the facts, see exactly what happened and consider, in a careful and measured way, how to proceed. I think that that is what will happen in this particular case.
Nevertheless, I feel that it is important that there should be an urgency about getting to the facts. My hon. Friend and I had a meeting with the deputy chief constable of Cumbria, Stuart Hyde, who talked about a series of inquiries that were taking place. Clearly, the police do not want to leave things in a position where people have any further questions to ask, so there are a series of inquiries. There is the inquiry into the issuing of the gun licence, the inquiry into the circumstances of the day itself and another internal inquiry that the police are conducting. Those inquiries are all very important and very relevant.
At the end of the day, however, judging from the limited time that I spent in Cumbria, the interests of the constituents of my hon. Friend and other Cumbrian MPs will not be served until all the facts of the case come out, so that people know precisely what happened. That is important, although not so much for us to guard against this tragedy happening again—because, although we do not know the full facts yet, we think that this tragedy could have happened anywhere in the country at any time; this was not a premeditated series of events. It is important because it is right that the public should know about the full sequence of events. So I hope that when the Minister responds to the debate, he will tell us something about the timetable that has been placed on the local police force in Cumbria.
Although the deputy chief constable of Cumbria did not ask for additional resources, there may be a resources issue. As a second point of clarification, I seek an assurance from the Minister that, if those additional resources are necessary, they will be provided.
The deputy chief constable spoke intelligently about the fact that Cumbria does not own a helicopter, for example. He also said that, in his view, Cumbria does not need one. A deal had been done with another force—the Greater Manchester force, or perhaps the Merseyside force—to provide a helicopter when it was required. Obviously, not all police forces can have their own helicopters, but there may well be resource implications that need to be examined in the cold light of day.
I hope that in the meantime, before we get to the conclusion of the inquiries, whatever Cumbria’s police ask for and whatever hon. Members feel is appropriate is provided. I know that the Prime Minister has said to my hon. Friend the Member for Copeland that he is keen to know the views of local people; I know that, because my hon. Friend told me so on Monday. If the local people ask for something, I hope that it will be granted.
As we all know, we are in something of a limbo situation. As we speak, there are elections for the membership of the Home Affairs Committee, so that Committee has not yet been formed. However, at our first meeting I will certainly recommend to members of the Committee that we should look at this area, because I think that it is important that Parliament itself should examine the wider issues. We should not necessarily examine the detail of what happened, although of course we will need to take evidence from those involved, but we should examine the wider area of the policy issues that emanate from what has happened.
As I am sure the hon. Member for Carmarthen West and South Pembrokeshire will remind us, we have some of the tightest and strictest gun laws in the world and people will find it amazing that anyone should have been able to do what this person did to the citizens of Cumbria and then to himself. However, the fact is that we will have to look at the issue of gun law in the round. It would be very odd if we did not look at it.
I think that that is what my hon. Friend is talking about; he is not saying that there should be an instant revision of firearms legislation, but that we need to look at firearms legislation in context. The Home Affairs Committee last looked at this issue 10 years ago, when we made certain recommendations about having people on the national register. Immediately, the issue of data sharing is important too. When a gun licence is applied for and the data about that application are held locally, what happens to them? Are they available to others?
So broad issues need to be raised, without our getting into the finer detail of this case, because that is what the people will require. Of course, it is up to the Committee to decide on the inquiries that it carries out. It is not up to the Chairman, even in these days of electing Chairmen and having independence and accountability to Parliament. But I very much hope that this is an issue that we will look at when we have the opportunity to do so.
My hon. Friend mentioned a number of other issues concerning the media and his local hospital. On the media, I think that he has made some very valid points. It is important that we look at how these matters are reported and he is absolutely right to want to write to broadcasters and the Press Complaints Commission asking them to look at the overall handling of this situation.
My hon. Friend is also right to praise his local media, as we all do, because they have a better feel for local people. They are unwilling to trample on the lives of people, either the living or the deceased, because they know that they will be meeting them again. For the national media, it is something of a visit; they may be there 24/7 during the rolling period of a crisis, but they then go away quite swiftly to the next story. My hon. Friend’s concern is about how the story was reported at the time and I was certainly told about examples of cheque-book journalism and other issues of that kind, which really ought to be explored. He is right to raise this whole issue of the media; it is one of the lessons of Cumbria and one of the points that we need to remember.
As for my hon. Friend’s local hospital, I am sure that he makes his case more powerfully than anyone else here can, and I am sure that that case has been heard by Ministers. I wish him well in what he seeks to achieve.
In conclusion, the people of Whitehaven, its local Member of Parliament and the other Members of Parliament who represent the region desperately want to return to normality. I had never been to Whitehaven before Monday. It sounds odd, but I think that the furthest north that I had travelled in England previously was to Carlisle; of course I had been to Scotland before, including to the western isles many years ago on parliamentary business.
On my visit to Whitehaven, I saw a very beautiful place; it was absolutely stunningly beautiful. Local people, including the excellent leader of the local Labour group, Elaine Woodburn, and the local vicar, Richard Lee, wanted to return to normality. They want Whitehaven and Cumbria to be remembered for the beautiful places that they are, rather than for any other reason. We have a duty to ensure that they are able to return to that position. We also have a duty to ensure that all the facts come out. I hope that the Minister will assure us that the Government are also keen that that should happen.
I was not intending to make a maiden speech today, but I can think of no better example of what Parliament is about than the issue that the hon. Member for Copeland (Mr Reed) has brought us. There is a precision, a compassion and a sense of dialogue and openness in this room that I wish was more present on the Floor of the House, so I am proud to be making my maiden speech. The hon. Gentleman’s contribution was immensely deeply felt and measured. He balanced the kind words of Tony Parsons with the horror of cheque-book journalism. His commitment to the West Cumberland hospital really came across, and I very much hope that our Government will be able to sustain the hospital. As the hon. Gentleman said, the Prime Minister was very impressed by his visit.
As the hon. Member for Barrow and Furness (John Woodcock) pointed out, Cumbria is a dense and complex web, which stretches across the artificial boundaries created by the Boundary Commission. Grandchildren of constituents in Brampton were in the hon. Gentleman’s constituency when the shots were fired. In all that we do, I hope that we reflect that dense web of Cumbrian culture in two specific ways. I hope that we look at the lessons of the tragedy in terms, first of distance and secondly of the way in which we conduct the inquiry. Both should reflect Cumbrian approaches.
In terms of distance, we need to understand the sad but powerful lesson that we represent a county defined by its sparse population and long distances. That is why the West Cumberland hospital matters and why we in Penrith and The Border think all the time about what would have happened had some terrible tragedy occurred in Kirkby Stephen, which is an hour and a half from the Carlisle hospital.
In this time of potential budgetary cuts, we need to fight hard to make sure that the police services that got 47 armed officers on the ground within an hour continue to be able to do that. We should also remember that recent events are an argument against hasty amalgamations, against closing our cottage hospitals and turning them into big hospitals, and against amalgamating the Cumbrian police with the Lancashire police. As we have seen, local services are much more responsive and flexible, and they can draw on services available in other parts of the country and make them operate more effectively.
We need to fight for such things. That is partly because although Cumbria is one—although we are a dense web—the needs of people in Copeland are very different from those of people in Penrith and The Border. Although we are one, we are also divided in very sad ways. The life expectancy figures on the west coast are nearly 20 years shorter than those in the east of Cumbria. Those are the kinds of things that we need to work together to overcome. They are also the reason why all our specific services—the police, the fire service and social services—need to be local, adept, flexible and focused on specific communities and to be pragmatic in responding to them.
That brings us to the inquiry. The hon. Member for Copeland talked about Cumbrian virtues. As he said, the fundamental element of Cumbria and of the whole border is people who are slow to react and slow to anger, but who, when they are determined, are resolute and focused. Let us hope that the inquiry reflects those values. As the hon. Gentleman said, we should not rush into anything, but once a decision is made we should stick with it and push it through.
We should not have some grand commission based in London, with people who know nothing about Cumbria, guns or mental health pontificating in an abstract fashion. We need the very virtues that the hon. Gentleman saw in the local newspapers to be part of a local inquiry and a local commission. Those involved should include mental health professionals, the police and, above all, Cumbrians. Too often, our farmers and our teachers are ignored in favour of distant bureaucrats. Let the commission and the inquiry reflect Cumbrian values; let those involved be slow to anger and resolute, but also precise, pragmatic and focused on the exact events of the day of the shootings.
On that point, let me end my maiden speech by saying that it is a great honour to stand in this room with the hon. Gentleman, who is an impressive leader. It is also a great honour to participate in a debate that shows the precision, level of inquiry and openness that I hope can characterise the House as a whole.
If this was the Floor of the House of Commons, I presume that the tradition would be for me to pay tribute to the maiden speech that we have just heard. I know that this is not the Floor of the House, but with your permission, Mr. Benton, I would like to pay tribute to the hon. Member for Penrith and The Border (Rory Stewart). I congratulate him on his excellent and moving maiden speech and thank him for his genuine concern, which was heartfelt. It was very much appreciated by myself and, I am sure, by my hon. Friend the Member for Copeland (Mr Reed).
I pay tribute to the emergency services and the wider community. We can only imagine what the emergency services—the police, the hospital staff, the doctors and the nurses—had to face, given the severity of the gunshot wounds; it must have been absolutely awful for the police officers and the doctors and nurses who looked after people.
The majority of the armed response officers who were involved were not police officers, but Civil Nuclear Constabulary officers. They are not the Minister’s responsibility, although the Home Office often believes that they are. However, I ask the Minister to take a personal interest in the Civil Nuclear Constabulary, which would like a number of issues to be looked at. I pay tribute to its officers, as well as to the police, because they did a fantastic job.
One group that we sometimes forget is the Churches. They were in evidence in huge amounts, as was the desperate spiritual need that the community felt. Whatever the denomination, the Churches played a significant part, and I pay tribute to them.
For a couple of weeks after the shootings, I carried around the article that Tony Parsons wrote in the Daily Mirror on the Saturday. I would be in the pub and I would tell people who were talking to me about the tragedy to read it. Not a single person who did was not wiping away a tear when they had finished—it was so moving. We should compare that article with what I can only describe as some of the rubbish that was written. I sent a little handwritten note to Tony Parsons—I hope that he got it—telling him what we in the community felt about his article.
On West Cumberland hospital, I spoke to a senior member of the community, who simply asked, “How on earth could anyone ever dream of not giving us the money?” We should think of what the hospital has been through. We had the floods last November, the terrible tragedy of the Keswick coach accident and then the shootings. How could people even think of not giving the area the money that has been promised? I do not think that they can, but we will continue to fight to make sure that the money is made available and that we get a brand-new hospital.
The weekend after the tragedy, I was standing at the bar in my local pub talking to a friend. We were talking about how awful, difficult and tragic the shootings were and about the enormity of what had happened. My friend looked at me and said, “We’ll get through this though. You know why? Because we’re west Cumbrians.” On that note, I would like to finish.
It is a pleasure and a privilege to serve under your chairmanship, Mr. Benton. I thank and pay tribute to the hon. Member for Copeland (Mr Reed)—I will call him my hon. Friend—for bidding for and getting the debate. I also pay tribute—not out of form, but out of sincerity—to my neighbour, the hon. Member for Penrith and The Border (Rory Stewart). He has stepped out of line in a courageous way and made a maiden speech in an unconventional place and an unconventional manner on an issue that genuinely matters. I am sure that that will be noted by many.
There are not words to describe the horrors of 2 June and what followed, but there are words to describe the response of the community—compassion and solidarity, above all others. As the hon. Member for Workington (Tony Cunningham) and the hon. Member for Copeland said, that response defined and continues to define what happened. The hon. Member for Copeland in many ways embodies that spirit, not just by showing leadership in his community on the tragedy that we are debating, but in his response to the other tragedies that took place only days earlier.
There has been talk about London journalists. I am more used to reading Tony Parsons’s comments about 1970s pop culture than what he writes about modern tragedy in west Cumbria. However, he and other journalists who went there, whose conduct we will perhaps talk about in a moment, came away staggered by the strength of the communities and their response. London journalists make it their business in their line of work to visit the scene of dreadful tragedies. I am not trying to create a league table of community response, but without a doubt they have been staggered by the tremendous solidarity shown in the communities of Cumbria—not just those that were directly affected, but communities throughout the county.
Craig Mackey, the chief constable of Cumbria, who has been a policeman for 25 years, said that the event was by far the most hideous thing he had ever had to deal with—and he has seen some pretty hideous things. As has been mentioned by the hon. Member for Penrith and The Border, NHS staff and experienced police officers had never seen a gunshot wound, never mind several of them in one day. It needs to be said that they dealt with things with stoicism, compassion and professionalism. We expect the emergency services to be outstanding, and they were, under extreme pressure. In many cases they put themselves in harm’s way to provide assistance to stricken people. They dealt with physical and emotional traumas on that hideous day. The police, national health service staff—ambulance drivers, paramedics, doctors and nurses—mountain rescue teams, volunteers and others put themselves in harm’s way to provide assistance when it was important.
My constituency was not touched directly by the shootings, although the towns and villages of Ambleside, Coniston, Grasmere and Hawkshead were put on lockdown for much of that day, as it was feared that the gunman could arrive on the streets at any time. Cumbria is a huge county, but it feels small after such an incident. Connections emerge all over the place. My 25-year-old brother-in-law will not mind my saying that he is a rookie policeman, and for him it has been a baptism of fire; and a close friend of mine happened to be on the campsite at Boot where the final shootings took place. Even aside from such personal connections, if you kick one Cumbrian we all limp; and there is a sense of solidarity and standing together that shines through.
To echo the comments of most of the hon. Members who have spoken, a knee-jerk response from legislators would not be sensible. That does not mean that there should be no response; but hard, tragic cases make bad law, without a shadow of a doubt, and the laws passed in response to previous tragedies have clearly not prevented subsequent ones. We should not jump to conclusions. There is always a sense—which I share—that something must be done; we feel powerless. For now, at least, that something is to support the community and help it to recover. Lessons must be learned thoroughly. It goes without saying that there will be no trial, and that is why a full—and I would say public—inquiry is crucial, on terms set, as has already been said, by the community. That should not be to point the finger at anyone other than the culprit—not the emergency services or anyone else—but an inquiry is necessary to enable us to learn lessons from the tragedy.
There are some lessons that we should not learn. Like the hon. Member for Barrow and Furness (John Woodcock), whom I welcome to the House, I represent a good chunk of what is rightly Lancashire, but some of the patronising stuff written in the media focused on Cumbria being a pitifully small county with a police force that cannot deal with its problems. That is nonsense. Recently there was a proposal to merge Cumbria and Lancashire police forces; that would be the wrong lesson to learn. It would not help the grieving communities to put their police headquarters in Preston rather than Penrith.
Finally, I endorse the comments of the hon. Member for Copeland about the reaction of elements of the media. The media must leave families to grieve and to recover in dignity and peace. We must not, in future, allow them to turn such tragedies into a mawkish circus.
I want briefly to add to what has been said, and to pay tribute to an excellent and unconventional maiden speech by the hon. Member for Penrith and The Border (Rory Stewart), which was quietly powerful. I also want to add to the comments on how my hon. Friend the Member for Copeland (Mr Reed) has conducted himself. All new Members come here wanting to represent our communities in the best way, and we look for examples of ways to do that; my hon. Friend has been an inspiration to me and others by his leadership in such difficult times, speaking out and representing a community in great pain. That will always stay with me.
My constituency is south of my hon. Friend’s, and like that of the hon. Member for Westmorland and Lonsdale (Tim Farron), it was not directly affected, although the town of Broughton was put under lockdown when no one knew where the gunman was going. Also, about 700 people a day travel to Sellafield to work, so there are deep ties, including family ties, there. Everyone knows someone who has moved down from Whitehaven, or moved up, and the family bonds between those areas are incredibly strong. I know that my constituents see the hurt and suffering of their west Cumbrian neighbours, friends and colleagues, and are at a loss to know how to help, but they stand ready, as we all do, to try to help the community through.
I do not want to add to the comments on the national press, because a powerful case has been made about what people have seen at first hand, and the effect on the community. However, I want to mention the local press. I fully endorse the huge value of the community role that it plays throughout the year, in community events big and small—and never does it play that role more fully than in such circumstances as we are debating. The local press and media are going through difficult times; part of that is due to reforms that they are undertaking to try to ensure that they are financially viable at a time when technological change makes that increasingly difficult. However, the Government must continue to look for ways to support local papers and media. I hope that they will think carefully when they consider their policy on public advertising, for example, which has the potential to take out a vital income stream from the local press. That would make things far more difficult. It is so important that we keep such institutions able to serve the community.
I endorse the case that has been made for continued investment in the police and the hospital in the area. They are early examples—there will be so many more of them as the weeks and months go by—of cases where the need to ensure the sustainability of the public finances nationally runs hard against local communities’ needs for continuation of services. No one can pretend that this Government will not face difficult choices, or that any party that had won would not have done so. That is why it is essential that the efficiencies that we make are not driven beyond what is ultimately best for the economy, and do not damage our local communities to such an extent that it will be difficult for them to recover. I am not making a party political point; I simply urge Members on both sides of the House to bear that in mind.
On the inquiry, it is clear that looking at mental health provision in respect of firearms licensing is absolutely necessary, as is a review of mental health provision in the community generally. We do not know—we can never fully know—but it is extraordinarily unlikely that a person would flip overnight from being completely mentally stable to committing such dreadful atrocities. It may be that we are talking about something that it simply was not feasible to have picked up, but that is a point to consider when we look at mental health provision in the wider community.
Finally, I endorse what everyone has said about the need to look at gun licensing thoroughly in the round, and to not make a knee-jerk response, but I urge the Government to come to the matter with an open mind, and not a preconceived idea that legislation to restrict guns is not the way to go; that would steer them on to another path.
We may review the matter and decide that the laws are as tight as they feasibly can be and that, given the balance of risk, the restrictions that would have to be imposed for further tightening would be disproportionate, but it would have been far less likely that a man who had a licence to use firearms for sport would have gone on a lethal killing spree if he had not had access to those guns. That does not prejudge any review of the balance to be struck and the consequences of further tightening, but it is essential that the matter is looked at as a separate question. Clearly, in rural areas such as mine and across the whole of Cumbria, farmers have a real need for firearms, but we must be prepared to take an open-minded look at guns for sport, and all the pros and cons.
Will the hon. Gentleman give way?
I was about to finish, but I shall give way.
I simply want to pick up on the issue of the review of mental health provision, which the hon. Gentleman rightly raised. Most people would be open-minded about such a review, and I agree that it should proceed on the basis of evidence rather than anything else, but surely there can be no distinction between people who own weapons for sport and people who own weapons as part of their livelihood when it comes to mental health assessment.
That is a good point. I was not thinking of that specifically when I spoke about a review of mental health provision, although those issues must form part of it. As I said, it may be impractical to say that guns that are held for sport should not be kept at home but in some kind of secure premises, but it is right that we examine the matter and look at whether a distinction can be made between guns that are needed by farmers, which clearly need to be kept at home, and guns used for sport, which one cannot say need to be kept at home. It may be disproportionately difficult to put in place other arrangements, but I hope that the issue will be properly examined as part of the Government’s inquiry.
It is customary on such occasions to congratulate the Member who secured the debate, but I know that on this occasion my hon. Friend the Member for Copeland (Mr Reed), like me, wishes that we were not here and that the events had not happened—but they did. He spoke movingly and with great dignity and bravery. I want to place on the record the high regard in which I hold him, as a result of not just what has happened in the past few weeks but the work that he has done on behalf of his community and the leadership that he has shown, which has also been shown by my hon. Friends the Members for Workington (Tony Cunningham) and for Barrow and Furness (John Woodcock) and, indeed, all hon. Gentlemen from that part of the world, as their local communities faced such tragedy. Our condolences go to the friends and families of those whose lives were taken.
I wish to pay tribute, as many speakers have, to the emergency services in the affected communities and also from across the north of England as additional resources were brought to bear on these terrible events. I want to place on the record our thanks to the Sellafield police, who have been referred to previously, who played an important role.
It is entirely right that investigations are taking place into what happened in west Cumbria on 2 June. As my right hon. Friend the Member for Leicester East (Keith Vaz) said, issues will be raised around resources and how they were deployed, and the resources that will be available in the future. It will seem incongruous to people for whom this is a raw and recent memory that the chief constable and the police authority in Cumbria should be discussing the loss of dozens of front-line officer posts at a time when the force has faced perhaps its greatest challenge.
We also heard about the West Cumberland hospital. I hope that these matters can be dealt with sensitively. I know that the Minister, who I welcome to his post—I wish that it had been under other circumstances, but I do welcome him—is a decent man, and that he will fight the Home Office corner. I would expect that his colleagues in the Department of Health would do the same. Members of Parliament from that part of the country are fighting the corner on behalf of their constituents, and I expect Ministers to do the same, because public services in this context—the emergency services—are synonymous with public safety.
The Government were entirely right not to rush to legislation, but it would be wrong to dismiss the positive effects of the earlier legislation which was referred to, particularly that following Hungerford and Dunblane. As the hon. Member for Westmorland and Lonsdale (Tim Farron) said, it may not have prevented this tragedy—it did not—but it may have prevented tragedies in other circumstances.
We have one of the strictest gun control regimes in the world, but if there are lessons to be learned we must learn them, and if changes need to be made we must make them. We should await the outcome of the Association of Chief Police Officers peer review of what happened in Cumbria, but there are already existing concerns. I do not want to prejudge that inquiry in any way, but as the hon. Member for Carmarthen West and South Pembrokeshire (Simon Hart) said, questions must be asked, and in the fullness of time we should try to answer them. He and I may have slightly different views, although I am by no means against people using guns as part of their jobs or sporting activities, but was it right, with hindsight, to move from three-year to five-year licences? Is there not a danger that when applying for a licence by post or, heaven forbid, by iPhone, as a media report suggested this week, the police will not make a visit? Such visits are not a statutory obligation, but might keep gun owners on their toes and allow their families to raise any concerns.
Reference was made to health care professionals, but if data protection concerns can be overcome, it would be sensible for health care professionals to be able to flag up any concerns. I accept that such issues might have had little bearing on what happened in west Cumbria, where police checks are carried out, but those concerns are legitimate, and we should discuss every aspect of them. I have looked back at earlier debates on gun control, and much was said about the cost of the bureaucracy that checks might bring, but we must keep people and communities as safe as possible, so we must have a balanced approach.
We await the outcome of the peer review, and I welcome the Government’s commitment to a debate in Parliament. However, I ask, as have many contributors to the debate, that the Government do not close the door to a wider, independent debate and a review of the events in west Cumbria and of gun laws generally. The hon. Member for Carmarthen West and South Pembrokeshire referred to balance and proportionality, which is subjective in this context, so from time to time we need learned and wise but, most importantly, independent voices to bring their views to bear.
I want to hear what the Minister has to say, so I shall finish by saying that in the months and years ahead, the people and communities affected will want to get on with their lives—that is probably happening already—and as far as possible not to be constantly reminded of what happened on 2 June. I represent an urban constituency where there was a gun rampage 20 years ago, albeit with fewer deaths than in Cumbria. Constituents ask me why, when events such as that in Cumbria occur and on their anniversary, the press continue to return to the tragedy that affected their community. The answer, I am sorry to say, is that while we have lazy and easy journalism, we cannot give guarantees that that will not happen, whatever we feel about it. It is incumbent on us, in Government and in Parliament, to stand by those communities, not just now, but in the years ahead.
At around this time three weeks ago, we were all feeling a real sense of shock as the full horror of events in Cumbria became apparent. The last funerals took place on Friday, and I join other hon. Members this afternoon in expressing condolences to the families and friends of all those who were killed or injured. Our thoughts are also with all those who were caught up in some other way in the tragic events. We should remember in particular the police and emergency services, who had to deal with the immediate consequences of the shootings, and who did so with professionalism.
I also want to join the many others who have praised the resilience of the people of Cumbria, who, with true community spirit, have pulled together in their efforts to come to terms with this and other recent tragedies. They are surely an example to all of us.
I thank the hon. Member for Copeland (Mr Reed) for providing this opportunity to debate the lessons that might be learned from the tragic shootings in his constituency on 2 June, and particularly for the sensitive, considered, measured and moving way in which he opened the debate. I would like to add my tribute to those paid by many others, both this afternoon and in recent weeks, for the way in which he dealt with the immediate aftermath of that shocking tragedy, and the way in which he has conducted himself since then.
I fully recognise the depth and range of feeling on the matter and the need for a broad debate. We have started that process today. A range of issues were touched on and, as the hon. Gentleman rightly said, many fall outside my specific ministerial responsibility, but I know that my ministerial colleagues outside this Chamber will read the debate and reflect on the comments that he and others have made this afternoon, particularly about West Cumberland hospital and its funding. I will draw them to the attention of my colleagues in the Department of Health.
An issue that came through strongly is the sense of community among the people of Cumbria. It was made clear in many speeches, including the measured contribution from the hon. Member for Barrow and Furness (John Woodcock), who may not have been in the House long, but has shown clearly how he seeks to represent his constituents. My hon. Friend the Member for Westmorland and Lonsdale (Tim Farron) also referred to the strength of the community and emphasised its sense of purpose. The hon. Member for Copeland talked strongly about solemnity, dignity and purpose, and his comments will resonate clearly.
I pay tribute to the maiden speech by my hon. Friend the Member for Penrith and The Border (Rory Stewart). It was considered and eloquent, but also passionate. I got a sense of my hon. Friend’s constituency and of his priorities as a Member of this House, and that is what new Members of Parliament seek to give in their maiden speeches. He made his extremely well, and I well understand why he chose this debate in which to make his first contribution to the House. In doing so, and in his actions as an MP, he demonstrated why he will be a fine champion for his constituents and those whom he serves. The way he conducted himself during his maiden speech demonstrated the values that he spoke about.
I have been particularly struck by the perception of many people that it is difficult to have in place proportionate controls to deal with those rare occasions when, for no apparent reason, someone suddenly embarks on a series of horrific killings. There has been ready recognition, both this afternoon and earlier, that a knee-jerk response is unlikely to provide a lasting solution, or the one that people seek, and that has been reflected in the contributions this afternoon.
Alongside that, however, there is a strong wish to ensure that we do all we can to learn lessons about both how we respond to future incidents and what we might reasonably do to prevent them, which is what we all fervently wish to do. That approach has been characterised today, and the debate has raised much for us to reflect on. Above all, we should listen carefully to what the local communities are saying. The Minister of State, Ministry of Justice, my right hon. Member for Arundel and South Downs (Nick Herbert), who has responsibility for policing and criminal justice, will return to Cumbria in the near future to talk to local groups about what happened, and to hear more about any concerns that persist.
Cumbria police are busy conducting a huge, complex investigation involving 30 crime scenes, 12 deceased victims, one offender and 11 seriously injured victims. Each incident requires a major investigation of its own—Cumbria is running more than 20 at same time. In the initial phase of the investigation, 100 detectives were working on the case and they searched 225 sq km of the country from land and air. Witnesses are still coming forward and the investigation will take many months to complete. I recognise the desire for answers and the points made by the right hon. Member for Leicester East (Keith Vaz), who I understand was not able to stay for the wind-ups—I pass my congratulations to him on being elected Chair of the Select Committee on Home Affairs—but it is important that the investigation takes its proper course. The Association of Chief Police Officers peer reviews—I will talk more about them in due course—are anticipated to report by this autumn.
We all recognise what a huge amount of work the investigation is for Cumbria police, but I have spoken to chief constable Craig Mackey and he has assured me that the force has the necessary resources and expertise to cope with the task. However, if it becomes necessary, the Government will support any bid from Cumbria police for a special grant to help meet exceptional costs on the force budget. Cumbria police have already received some specialist support from neighbouring forces, including police helicopters and scenes of crime officers. I would like to take this opportunity to formally thank Dumfries and Galloway, Lancashire and the civil nuclear constabulary for all the help that they have provided so far—a point made by the hon. Member for Workington (Tony Cunningham). Local forces stand ready to help should further assistance be required as the investigation progresses.
May I ask for an assurance that there will be proper collaboration between the two relevant Departments? Obviously the police are the responsibility of the Home Office, but the civil nuclear constabulary is the responsibility of the Department of Energy and Climate Change. I would like to make sure that the connection is there and that, when the inquiry takes place, there will be collaboration.
Certainly there is a wider point of discussion on policing and cross-border assistance, and the hon. Gentleman has made an important point about the need for any consideration of the issues to take into account other police forces. He has rightly highlighted the case of the civil nuclear constabulary, and other forces, such as the British transport police, sit within the Department for Transport. When considering policing issues, we need to factor in services that might sit within other Departments, too. He makes his point very effectively.
The hon. Member for Copeland has made a significant contribution to the learning process by securing and leading the debate today. There are, as we know, other reviews in hand that will add to our knowledge. I refer to the peer reviews that ACPO has set up at the request of the chief constable of Cumbria, Craig Mackey. Those reviews will cover firearms licensing procedures, the tactical and strategic police firearms response, and any aspect of the incident that may require further national or local guidance.
The ACPO lead on firearms licensing, Assistant Chief Constable Adrian Whiting, will review the file and the procedures adopted in relation to the award of a firearms licence and shotgun certificate to Mr Bird. He will also consider whether there are any significant gaps or risks in the licensing process. The question of the armed police response and the resources that were available for deployment to the scene will be addressed by the ACPO lead on the police use of firearms, Assistant Chief Constable Simon Chesterman.
Following the conclusion of the first two reviews, there will be an examination of firearms tactics and the ACPO manual to see whether any accumulated learning should lead to changes. I should confirm at this point that the firearms response review will cover the issues previously raised by the shadow Home Secretary about the possible need to absorb lessons from counter-terrorism policing. In picking up the lessons from Stockwell, the police service has already put in place systems to ensure that any tactics developed to deal with counter-terrorism are not developed in isolation, but are picked up by authorised firearms officers across the country. The peer reviews are being led by senior police officers who take the professional lead in their areas of expertise and who are therefore uniquely placed to identify the issues. We expect the findings of both reviews to be published in the autumn.
On firearms licensing, the shootings in Cumbria bring home all too starkly just how dangerous firearms can be in the wrong hands, and it is inevitable that questions will be asked about the UK’s firearms licensing laws. It is widely acknowledged that we already have some of tightest legislative controls in the world when it comes to civilian access to, and possession and use of, firearms. Any firearms held must be accompanied by a certificate that is issued following extensive checks by local police, who must satisfy themselves that an applicant is fit to be entrusted with a firearm and will not present a danger to public safety. Local police must be satisfied that an applicant has a legitimate reason for wanting a firearm—for example, target shooting or deerstalking. The police will visit applicants at home to interview them about their application and to check security. They can seek a medical report from the applicant’s GP if they have concerns about any medical condition.
On that point, I would like to come on to an issue raised by my hon. Friend the Member for Carmarthen West and South Pembrokeshire (Simon Hart). Applicants for firearms certificates must give details of their GP, from whom the police can seek a medical report. That is not limited by time, and the police can approach the GP at any time during the life of a certificate. It is also open to a GP to approach the police at any time to pass on information or possible concerns. However, ACPO is working with medical associations to ensure that any medical concerns are not missed. It is discussing the possibility of placing a marker on NHS patient records, so that a GP will know whether a patient has access to firearms and can notify the police of any concerns about the suitability of that. We are following this process closely and we will feed the outcomes into subsequent work on gun controls as required.
It is only right that we should reflect on whether more might be done in that context to ensure public safety. In doing so, we have to look carefully at the balance between the maintenance of public safety and the legitimate expectations of the vast majority of firearm owners who use their guns safely and responsibly, and who totally condemn those who misuse them. The control of firearms is a complex area that requires careful consideration, a point rightly made by the hon. Member for Tynemouth (Mr Campbell). I thank him for his kind comments and assure him that we will consider all the issues extremely carefully. As he pointed out, we plan to hold a full debate on the issue of firearms before the summer recess, which will provide an opportunity to air in greater depth some of the issues raised today about existing controls.
As I said at the outset, this is the start of a process, and the debate that I just mentioned will provide an opportunity for people who wish to make more detailed comments about firearms legislation to do so. Even then, we should not draw conclusions precipitately. It is important to wait until we have the results of the police investigation and the peer reviews before we decide whether we need to take specific further action, either by issuing further guidance, introducing new procedures or, potentially, changing the law. I reassure the hon. Member for Barrow and Furness that we go into this process with an open mind.
We will also consider at that stage whether there is need for any further inquiry. The Government are committed to supporting the affected communities in this terrible situation, and we want to find out from them how we can best help them. The Department for Communities and Local Government has already asked its emergencies management team, which offers support to local authorities that have suffered disasters and emergencies, to contact the local authorities involved to see what support they require and what assistance they may need. The local authorities were confident that they had the resources available to cope, and that no further assistance was required.
I understand that the Government office for the north-west has contacted Cumbria county council and Copeland district council to offer assistance. Again, no further assistance has been requested at this point in time. We are confident that the local authorities will make immediate contact with the Government office for the north-west should any further assistance be required at a later date. The Government office stands ready to broker mutual aid support with the voluntary sector, should that be necessary.
Copeland and Cumbria councils are working to understand the needs of the families and communities affected, and have put in place arrangements to provide counselling and personal support. In addition, my hon. Friend the Member for Ruislip, Northwood and Pinner (Mr Hurd), the Minister with responsibility for Civil Society, will be visiting Cumbria tomorrow to meet the local authorities and the council for voluntary service to see what extra support or assistance they need.
In conclusion, this is the start of considering the issues that we have debated this afternoon. We have heard much about the spirit of the people of Cumbria and how they have been supporting each other. Such community spirit is truly priceless. For our part, we shall continue to liaise with the Cumbria constabulary to follow up any areas that require further or wider consultation. The learning from the reviews, which is expected in the autumn, will be shared with the public, the wider police service and, of course, the House.
Tolls (Severn Bridges)
I am grateful for the opportunity early in the new Parliament to raise the long-standing issue of the tolls on the Severn bridges and their impact on my constituents and businesses generally in south Wales. I welcome the Minister to his new role. I had a very constructive relationship in the last Parliament with my right hon. Friend the Member for Tooting (Sadiq Khan), who was then the Minister of State in the Department for Transport. I look forward to continuing such a relationship with this Minister. I am very grateful for the cross-party interest in the issue, which is shown by the turnout at this debate, despite the football. I apologise for the fact that the debate is taking place during the match. It was looking encouraging before I came into the Chamber, but I apologise to those hon. Members who are missing it.
The Severn bridge tolls are expensive, inconvenient and inflexible; we know we are in trouble when we are the butt of jokes on “Gavin and Stacey”. In one famous episode, Smithy nearly missed the birth of his child because he was 10p short when crossing the Severn bridges. People cannot pay by credit card, debit card or online. They cannot travel off peak and there are no concessions for those who live locally. However, the tolls continue to rise year on year, even though the service is outdated.
I congratulate the hon. Lady on securing the debate. She mentioned the cross-party nature of the issue. I am sure that I can agree with what I anticipate she is going to say. She will agree that the issue does not affect just her constituents and the M4 corridor; some geographic spread from west Wales is involved as well, reinforcing the point that this is an all-Wales issue, affecting, particularly at this time of year, the tourism sector and, more generally, the business sector. It does not affect just south Wales, but the whole of Wales. It is a totemic issue affecting the whole Welsh economy.
I thank the hon. Gentleman for his intervention and agree that this is an issue for the whole of Wales. In particular, first-time visitors to Wales are an example of that. The issue does have that impact. I receive a bulging postbag on the issue from constituents and businesses and I want to highlight some of the points that they raise with me.
First, will the Minister examine the cost of the tolls? Every year on 1 January, the tolls go up in accordance with the Severn Bridges Act 1992. Under the agreement with Severn River Crossing plc, the company is permitted to collect tolls from both bridges for a concessions period until the project’s target real revenue level is reached or the time limit is up. I understand that at that point, the bridges revert to the Secretary of State’s control.
We are going through tough economic times. Commuters’ hours are being cut and there are pay freezes and high petrol prices, yet the tolls still go up. Severn bridge tolls are among the most expensive in the UK for cars, costing £5.50. My first request to the Minister is that he should examine the issue of toll rises, step in and recommend a freeze in this year’s tolls, particularly in the light of yesterday’s VAT rise. While he is at it, will he also examine whether we could implement a reduction in tolls for those who live locally? That could be worked out by postcode area, for example. Such a scheme has been introduced on the Dartford crossing. It is easier to do on the Humber and the Dartford crossing as there is no concessionaire, but why can we not have a look at doing it in Wales?
The second issue is the payment method for tolls. Currently, people can pay to go over the bridges only by cash, including euros, or by cheque. Those who are unfortunate enough to approach the bridge thinking that they can pay by such new-fangled methods as credit and debit cards are frustrated. Many constituents have regaled me with stories of getting to the tolls, not having the right money, being escorted over the bridge and then being told to go back over the bridge and to go to Gordano services, which is a round trip of about 20 miles. That is hardly a welcome to Wales for first-time visitors and it is not much fun for the long-suffering staff collecting the tolls, who have to put up with frustrated motorists.
My hon. Friend may not recall that I was a member of the 1992 Bill Committee that dealt with this issue. That was a very long time ago. Is it not right that after 18 years, the whole business of the Severn bridge and its tolls should be brought up to date?
I thank my right hon. Friend for his intervention. I agree with him. Progress was made on the method of payment of tolls by the previous Minister and it would be helpful if this Minister could confirm exactly when debit and credit card payments will begin and that the card-handling charge will not be passed on to the traveller. I would not expect Tesco to charge me more for paying by card, and I do not see why the bridges should be any different.
That brings me to the impact of the tolls on business in south Wales. The Severn crossing tolls, which are felt by many people to be a tax on entering Wales, are the highest in the UK for all but the largest vehicles. Light goods vehicles pay £10.90, compared with £2.00 for the Dartford crossing and £4.90 on the Humber. The Skye and Forth bridges are free. Heavy goods vehicles must pay £16.30, but on the Humber the charge is £10.90 or £14.60, depending on size. The Dartford crossing charges just £3.70 per heavy goods vehicle, and the Forth and Skye bridges are free.
An example in my constituency of the burden of the tolls is given by Owens Road Services, a long-standing Welsh company with a base in Newport that represents 1% of the total heavy goods vehicle traffic on the crossing. Owens pays £16,000 a month by standing order account and over £200,000 a year. The annual toll increases just come off the company’s bottom line; they are not passed on to customers because contracts have to be renegotiated and times are hard. The crossing represents a charge on the Welsh logistics industry that is not paid by competitors in England.
I congratulate my hon. Friend on securing the debate. The figures that she has cited illustrate clearly what a burden the tolls are on business. Owens, which also employs many people in my constituency, is really struggling. There is a very fragile situation economically now. Does my hon. Friend agree that we need to have every measure in place to improve the opportunities for businesses to relocate to places such as west Wales, where we know that we need to do as much as we can to help the private sector to grow?
I thank my hon. Friend for her intervention. I agree with her and hope that the Minister will pick up her point in his closing remarks. The industry is already struggling, with more than 3,000 heavy goods vehicle drivers claiming jobseeker’s allowance in Wales alone.
The previous Government froze the tolls on the Humber crossing after a study of the impact on residents and businesses. There has been no study of the Severn that I am aware of, so please could the Department for Transport work with the Welsh Assembly Government to initiate one?
The hon. Lady is being very generous about interventions. As someone who is himself returning to the House, I congratulate her not only on raising this issue, but on continuing the wonderful record of her predecessor, who raised many of these issues, as the right hon. Member for Torfaen (Paul Murphy) will recall.
In relation to the charge, my understanding is that the actual real revenue is not likely to be reached until 2016. Is not the difficulty about abolishing the tolls the fact that the bridge was in essence built by a commercial company at no cost to the Government and was to be funded from the tolls? In that context, my constituents look to the ease of crossing the bridge, rather than having any expectation that in these times the tolls are likely to be either frozen or abolished.
I thank the hon. Gentleman for his intervention, but my constituents feel very strongly that the year-on-year increase in the tolls is very unfair on them locally. I promise that I will come to the concession later. I am not claiming that we should scrap all the tolls when the concession expires.
More than 31,000—31,437—heavy goods vehicles use the bridge each week. That is 4,491 a day. There are clear patterns of movement on the crossing, with most vehicles travelling between peak times. It is clear to me that a more flexible pricing structure, with off-peak travel for business, would offer incentives for people to travel at certain times of the day or night. That would reduce congestion, save on emissions and save companies money at the same time. I ask the Minister also to investigate that issue.
Finally, let us look to the future. According to the Highways Agency study of 2008, the current Severn crossings are being maintained at a constant level and require an annual maintenance expenditure of about 20% of the annual income generated from the tolls. In a few years, when the bridges are expected to be turned over to the Highways Agency—it would be helpful if the Minister confirmed the exact thinking at the moment on what that date might be—the agency will receive the revenue without the burden of debt.
I congratulate the hon. Lady on securing this very important debate. Does she agree that it is imperative that the United Kingdom Government should ensure that the public purse is not left with liabilities for long-term repairs after the bridges are returned to public ownership?
I agree very much with the hon. Gentleman’s point. I know that his party has raised it before.
With the Severn crossing due to come back to public ownership in, say, 2016-17—depending on what the Minister says—the time is right to plan for a smooth transition, with tolls being reduced to a maintenance-only charge. I would appreciate it if the Minister considered the matter. I am really grateful to have had the opportunity of this debate and for the interest shown in it by other hon. Members.
To sum up, I should be grateful if the Minister worked with the Welsh Assembly Government to initiate an economic impact study, stepped in and froze the tolls this year, and looked at things such as off-peak travel for business and concessions for local residents so that we could finally reach a conclusion on the method of payment. As I said, at the start of the new Parliament the time is right, as we approach the end of the concession, to look at what the charges will be after it ends. I am grateful to have had the opportunity to introduce the debate, and I look forward to the Minister’s response.
I wish first to congratulate the hon. Member for Newport East (Jessica Morden) on securing the debate. I thank her very much for her kind welcome to me in my new post. Our commitment to the issue is not in doubt, and I hope that the fact that it is taking place during another event outside the House demonstrates to her constituents her dedication to the issue—assuming, of course, that they will support England.
Before I start to discuss the tolls on the Severn crossings, I wish to make the point that, since 1945, it has been the policy of successive Governments that crossings on estuaries should be paid for by the user rather than by the taxpayer. Successive Governments have taken the view that tolls on all such crossings are justified because the user benefits from the exceptional savings in time and money that those expensive facilities make possible. It is important to make such a point at this stage. It is one that should not be forgotten, not least of all with the present financial difficulties that the Government and country face.
In specific relation to the Severn crossings, it might be helpful if I give a brief outline of their history, some of which is relevant to the issues that have been raised. The first Severn bridge was opened by the Queen in September 1966, providing a direct link from the M4 motorway into Wales, with a toll in place for use of the bridge to pay for the cost of construction. The original bridge continually operated at significantly above its designed traffic capacity, so the then Government said in 1986 that a second bridge would be constructed. In July 1988 they announced that the private sector would be given an opportunity to participate in the scheme and in April 1990 they announced the selection of the bid led by John Laing Ltd with GTM-Entrepose to design, build and finance the second crossing. That consortium was also to take over the maintenance and operation of the existing Severn bridge.
In October of that year, the concession agreement was formally signed between the Government and Severn River Crossing plc, and in February 1992 the Severn Bridges Bill received Royal Assent. The concession agreement was enshrined in an Act of Parliament and commenced in April 1992. Severn River Crossing plc then took over both the operation and maintenance of the present bridge and the construction of the new bridge. The finance arranged by the company covers the cost of construction for the new bridge and pays for the outstanding debt on the present bridge.
Construction of the new bridge started in September 1992 and the new crossing was opened on 5 June 1996 by the Prince of Wales, almost 30 years after the opening of the first bridge. The concession period is limited to a maximum of 30 years. The actual end date will be achieved when the concessionaire has collected a fix sum of money from tolls, which is £995,830,000 at 1989 prices; that is £1.8 billion at today’s prices. As part of the concession agreement, Severn River Crossing plc is authorised to collect tolls to meet its financial obligations. It is worth stressing that that is the company’s only source of income.
Let me make it clear why tolls are collected at the crossings. Tolls are in place to repay the construction and financing costs of the second Severn crossing, the remaining debt from the first existing crossing from 1992 and to maintain and operate both crossings. I have seen no evidence to suggest that the tolls impact on the economic viability of Wales, although I note the concerns of hon. Members about the impact of the tolls in their constituencies. Clearly, there is a cost to the crossing, which is borne by business and those who pay the tolls, but that has to be weighed against the benefits that the crossings provide in terms of more direct access into Wales, allowing users quicker access to markets than would otherwise be the case. However, I am happy to receive and to look at evidence from the Welsh Assembly, hon. Members or others. That is an open invitation to supply such information to me.
Does the Minister agree that in a situation where tolls are not the norm on other roads, it makes a firm such as Owens feel at a distinct disadvantage when it is competing with firms whose distances from the main markets and from the channel ports may be similar, but who do not have to make their route via a tollbridge, and that there is therefore a feeling of economic inequality in that instance?
I do understand that. I mentioned earlier that it is standard practice for estuary crossings to have tolls, no matter where they are. They limit the journey time and deal with—or compensate for—the geography of the area. While I understand that there is a cost involved that would not be there if a crossing were not necessary, the alternative to a toll crossing would be a much longer diversionary route. That is a matter of geography; I am not downplaying the concerns that hon. Members and others have about the impact. As I said, I welcome any further information that they want to give me on that matter, and I will personally look at it.
Would the Minister commit to doing an economic impact study on south Wales with the Welsh Assembly Government?
I do not want to commit to that here, but I will happily receive information that is supplied to me, and I will bear in mind that request as and when it comes in.
The Severn Bridges Act 1992 seeks to apply a clear structure to the tolls to give the concessionaire confidence that it will be able to meet its liabilities and manage the risks that it accepted through the concession agreement. The toll levels were set for three categories of vehicles at the time of tender and are embodied in the Act. The Act sets out the tolling arrangements and the basis for yearly increases in the toll rates. Toll rates are fixed in real terms. The new rates are introduced on 1 January each year and are increased in line with the retail price index using a formula, and rounded to the nearest 10p.
I want to stress an important point: the Secretary of State does not have the authority to set the annual tolls below the level of RPI increase without the concessionaire's agreement. The concessionaire would not be able to agree to anything that would affect their net revenue without compensation and agreement from their shareholders and lenders, which would result, if such an agreement were forthcoming, in a cost to the taxpayer.
Tolls are charged in a westbound direction only from England into Wales. The current toll prices are: £5.50 for cars, £10.90 for vans and £16.40 for vehicles over 3.5 tonnes. I do understand hon. Members’ concerns that those are higher than apply in other crossings.
The Minister made reference to the fact that it is an estuarial crossing, but it is unique in the United Kingdom because it goes into a part of our country that now has a devolved Government. When I served as Secretary of State, some of my conversations with the then First Minister were about how we deal with a situation where tolls are charged to come into Wales but not to go out. The impact on the Welsh economy is very severe, particularly in times such as this. The Minister ought to think a little more about the importance of having a dialogue with his counterpart in Cardiff, because of the importance of this to the Welsh economy in these difficult times.
I am very happy to have dialogue with my counterpart or anyone else in the Welsh Assembly if they wish to do so. The issue has just been raised for the first time with the new Government—this is the first Adjournment debate on it. I am perfectly open to suggestions of dialogue with people from Wales or elsewhere on issues for which my Department is responsible.
I want to talk about VAT, which was raised by the hon. Member for Newport East. When VAT was first applied to the crossings in 2003, following a European Court ruling, there was no increase in the toll to the motorist. Following the Chancellor's statement yesterday, the Highways Agency will discuss adjustments within the concession to accommodate the new 20% VAT rate with Severn River Crossing plc. We do not expect the VAT increase to be passed on through an increase in the tolls, but the concessionaire expects to receive a certain amount of money, and the way in which that can be accommodated without increasing tolls is a matter for negotiation.
I know that the hon. Member for Newport East has an interest in local discount schemes, to which she referred in her opening remarks. Any discounts or exemptions are a matter for the concessionaire to decide, provided that they comply with existing legislation. Where that is not the case, such schemes cannot be introduced without changes to primary legislation and the concession agreement. They would have a financial impact on the concession and the period required for repayment, which would impact all road users. Discounts of around 20% for regular and frequent users are offered by way of a season TAG, whereas blue badge holders and the emergency services are exempt.
I now turn to the matter of card payments, which I know the hon. Lady pursued before the election and, with some justification, can claim to have had some success on in her campaign. In March this year, an amendment was made to the Severn Bridges Regulations 1996 to allow card payments at the tollbooths. She will recognise that there are associated costs with the introduction of card payments, mainly bank transaction charges, which are estimated to be between £7 million and £10 million to the end of the concession, or approximately £1 million per year depending on usage. Implementation is expected to cost around £1.2 million, and the way in which the additional costs will be funded has yet to be agreed. Discussions with the concessionaire to resolve the financial issues regarding the introduction of credit card payments are ongoing, but work to amend the tolling software to allow for the processing of credit and debit cards has started.
One of the drivers—no pun intended—that the hon. Lady will be aware of is the Ryder cup, one of the highest profile sporting events in the world. It is due to be held in Newport between 27 September and 3 October this year, with about 50,000 visitors a day, the majority of whom will come from overseas and will not be flush with money in their pockets to pay the tolls. We want to make progress on the matter, and I hope to have it resolved before the Ryder cup begins. My officials assure me that that will be the case, and I will look into the matter to ensure that that is so.
An hon. Member also raised the issue of motorists being sent back after driving some way and finding that they could not pay by card. I understand that signs are in place close to the bridge, before the last junction, advising motorists of the current arrangements, which is that they can pay only in cash. However, if they arrive at the tolls, I have been assured that they do not necessarily have to make a U-turn; they can be issued with an invoice with an added administration fee of £5. The problem with turning motorists back has been recognised, and that is being dealt with in the way I described as an interim measure. If that was new information to Members present, I hope that that was helpful.
Regarding maintenance, the concessionaire is required to maintain both Severn crossings in accordance with the concession agreement. A rigorous schedule of inspections is carried out and regular review meetings are held between the concessionaire and the Highways Agency.
A programme of cable inspections on the first Severn bridge began in April 2006 after corrosion was found in the suspension cables of bridges of a similar age and construction in other parts of the world. Unfortunately, significant levels of corrosion were found and a programme of works to tackle the corrosion followed. A full dehumidification system has been installed to address the corrosion. The system, which pumps dry air into the cables to reduce humidity, has been operational since December 2008. Reports show that humidity levels within the main cable are below the target level of 40% relative humidity. In addition, an acoustic monitoring system has been installed to track the rate and location of any further deterioration. A second round of inspections is currently under way to gain a detailed understanding of the level of corrosion and to verify the success of the dehumidification process so far. That work is due for completion later this year.
The corrosion of the main cables is a defect that existed before the letting of the concession and unfortunately—from my point of view—is not covered by the concession agreement. Costs associated with this work will therefore be met by the Government. The programme of mitigation and inspection work carried out so far has cost the Government £15 million, with the second round of inspections costing us a further £4 million.
Reports in the local media—and a letter from a Member of the National Assembly for Wales—suggest that the concessionaire will hand back the crossings in a state of disrepair. The suggestion was made earlier that, once the concession ends, the taxpayer will have to foot the bill. Let me make it clear, the concessionaire is bound by the legal terms of the concession, which it signed, to maintain the crossings to an acceptable standard. When the concession ends, the concessionaire is required to carry out any necessary maintenance and repair works on the crossings prior to handover. That is a legally binding commitment and is what I expect them to do.
Does the Minister have an indication of the year in which the concession will end?
I am coming to that. The concession agreement sets out the requirements for transfer of the crossings to the Secretary of State at the end of the concession period. The concession is currently predicted to end in the first half of 2017, when the sum defined in the 1992 Act will have been collected through tolling. The bridges will then be returned to the Secretary of State. However, in order to ensure that tolls do not rise further, there are additional costs that have to be absorbed, both through the VAT increase and the work to ensure that credit cards can be accepted. I am giving the best estimate—it might slip slightly in the light of those two matters, but that is not certain at this stage.
Will the Minister indicate whether the UK Government are considering offering joint ownership of the bridges after handover to the Welsh Government?
That matter has not been considered in my short time in office. The hon. Gentleman has raised an issue that I am sure is important to people in Wales and I will ensure that he receives a reply.
The Minister shared with us a figure of £995 million. As I understand it, when we last heard from the Department, the assessment of how much mileage has been made towards that figure was about £682 million. Is the Minister able to update us on the current take, or if not, will he share it later?
I do not have that precise figure at my fingertips, but if comes to me in the next couple of minutes I will tell Members. If it is not possible to do so before half-past 4, I undertake that all Members present will get a written response.
When the Secretary of State takes over the bridges at the end of the concession, the Government are authorised to continue tolling for a further five years following the handover of the crossings, to enable them to cover their own costs incurred, such as the £19 million that I mentioned in respect of the maintenance of the cables. No decisions have been made regarding the operation of the crossings once the concession ends, and therefore we are open to suggestions as to what might be the appropriate position at that stage.
In answer to the question about turnover at July 1989 prices, the present figure is about £648 million, against the final total of £995 million.
In conclusion, I thank not only the hon. Member for Newport East but Members of all parties who contributed to the debate. I and the Department recognise that this is an important issue for Welsh Members in particular. We are bound by the 1992 Act and the agreements entered into at that stage. Within that relatively tight constraint, I am willing to do what I can to address issues that Members have raised and I hope the House has found that helpful.
Accident and Emergency (Westmorland General Hospital)
It is a pleasure to serve under your chairmanship for the second time in an hour, Mr Benton. I wish to express my gratitude for the opportunity to make the case for my local hospital.
The Westmorland general hospital in Kendal sits almost exactly at the geographical centre of the area covered by the University Hospitals of Morecambe Bay NHS Trust. It is one of three hospitals serving the area, along with the Royal Lancaster infirmary and the Furness general hospital at Barrow. Westmorland general hospital serves, in Cumbria: the Lake district, the western part of the Yorkshire dales, South Lakeland district and the southern part of the Eden district. In north Lancashire, it serves large swathes of the Lune valley.
For all those areas, Westmorland general is the closest and most accessible hospital. Indeed, it was built in 1992 expressly to serve those communities as a district general hospital. At that time, it provided full accident and emergency services and acute provision. Since 1992, the population of Westmorland general hospital’s catchment area has grown significantly in comparison to the populations of the other hospitals at Lancaster and Barrow. However, the past 18 years have seen the steady removal of key services from Westmorland general, culminating in the loss of medical emergency services in August 2008.
Since 2008, anyone suffering a suspected cardiovascular emergency, a heart attack or a stroke in the Westmorland general catchment area has been taken by ambulance to Lancaster or Barrow instead. The majority of local health professionals opposed that decision throughout the consultation process in 2006, as did the overwhelming majority of the local population. I presented a petition to this place, with 27,000 signatures opposing the proposals. There were 7,000 responses to the formal consultation, almost all of which opposed the proposal. Some 6,000 people joined a march in opposition to the cuts and 4,000 of us joined a human chain around the hospital to protest. I am proud to have been involved in all of those actions, as they were a key mark of the strength and vitality of our communities and of the clear awareness of the immense danger that the proposals pose to tens of thousands of residents and visitors. The campaign went on for almost three years, but in August 2008 the medical emergency provision closed.
Trust managers—I would say disingenuously—attempted to convince the previous Labour Administration that the opposition to the proposals was simply a case of an emotional and uninformed public and MP against an informed and clinically astute medical community. I can assure the Minister that that is absolutely not the case—it is, indeed, nonsense. As I have already said, the majority of local medical opinion was opposed to the closure. There were some doctors who supported the closure of emergency services, but there were barely any of those who were not also some sort of trust manager, and therefore sticking to the party line. I am seeking the Minister’s help to ensure that safe emergency provision is reinstated for residents and visitors to South Lakeland, the lakes, the dales, the northern part of the Lune valley and the southern part of the Eden district.
The resident catchment population for the Westmorland general hospital is 123,973 individuals, rising to 157,513 when one factors in resident visitors. For the Royal Lancaster infirmary, the resident catchment area is 143,500, rising to 161,886 when factoring in resident visitors. For the Furness general hospital catchment area at Barrow, there are 71,800 residents—78,093 when factoring in resident visitors. The catchment populations of Lancaster and Westmorland are roughly identical, with the catchment area of Barrow less than half their size. An additional factor, of course, is the vast number of non-resident visitors in the Westmorland general hospital catchment area visiting the lakes and the dales, who are as likely as anyone else to fall ill and need emergency treatment. That means that, for most of the year, there will be significantly greater numbers of people in the Westmorland catchment area than in that of either of the other hospitals in the trust area, yet Westmorland general is the only one without medical emergency facilities.
The area served by Westmorland general is much more rural and sparsely populated than the rest of the trust area. Barrow has 10.2 people per hectare, Lancaster 2.81, and Westmorland just 0.6. Many parts of my constituency already face vast distances and a significant trek to get to Westmorland general hospital, but to now force people to go all the way to Lancaster or Barrow is a significant threat to patient safety.
If one had a heart attack in Hawkshead, it might take an ambulance half an hour to arrive. The fastest time it would then take to get to Lancaster hospital would be an hour, but it would be more likely to take 90 minutes. The average patient suffering a heart attack would therefore arrive at Lancaster’s coronary care unit some two hours after they had dialled 999—if they survived. It would take 37 minutes to get to Kendal, rising to 45 if the traffic was sticky. The same, give or take a minute or two, is true for people who fall ill in Chapel Stile, Elterwater, Grasmere or Coniston. It takes 46 minutes at best—it is more likely to take an hour and a quarter—to get from Ambleside to Lancaster, but less than 20 minutes to get to Kendal.
We all know about the golden hour following a heart attack, during which a patient must be stabilised. After the hour is up, the chances of a patient dying or suffering permanent damage rocket. Anecdotally, I know of a great number of deaths that occurred as a consequence of the decision to close down emergency medical services at Westmorland general hospital. I know, from talking to ambulance service staff, that patients have died in the back of ambulances en route to Barrow or Lancaster, but that they would have survived had they been allowed to be taken to Kendal. Such deaths do not show up in statistics, because no one officially dies in an ambulance—they are only designated dead on arrival. I encourage the Minister to dig as deep as she is able to uncover hard evidence of that through coroners’ reports and other similar material.
All acute medical crises have better outcomes the sooner they are treated by a full medical team, a doctor and specialist nurses situated in a fully equipped resuscitation room. It is criminal to reconfigure acute services to lengthen the time that dangerously ill people have to wait before receiving life-saving treatment, especially given that Westmorland general hospital had an excellent record of managing the initial stages of heart attacks and other life-threatening acute cardiac emergencies. I invite the Minister to look at the official statistics, which show clearly that timings at Westmorland general for patients receiving vital treatment were significantly and consistently better than at Lancaster or Barrow. Outcomes were also excellent.
It is not the case that Kendal operated at a lower level or standard than the other two hospitals. Cutting-edge coronary care units are equipped to provide angioplasty services, but the nearest such unit to Morecambe bay is in Blackpool, which is well outside the trust area. It is important to spell out that neither Lancaster nor Barrow provide that function. Indeed, although the expertise and the level and standard of service provided by the coronary care units at Lancaster and Barrow are excellent, they are no more advanced and no better in terms of outcomes, patient experience, safety or survival rates than those that were available at Westmorland general hospital in Kendal just 22 months ago.
Expert opinion suggests that, where it is appropriate, a patient should be thrombolysed by a trained paramedic at the scene before being transported to the nearest specialist centre. In order to allay my fears and those of my constituents, the hospitals trust negotiated with the North West Ambulance Service to provide an additional ambulance service for South Lakeland and a number of additional paramedics to compensate for the closure of acute services at Westmorland general. Those promises were kept, but the figures clearly show that the administration of thrombolysis at the scene almost never happens in South Lakeland. Indeed, in the first six months of operation, only four instances of thrombolysis took place outside a hospital in the south lakes. In the other 95% to 99% of cases, the patient is left waiting at least 30 minutes longer for their treatment than they would have when the Westmorland general’s coronary care unit was open. I can only speculate why that is so—it may be due to a lack of training or a lack of confidence. A paramedic is now being asked to perform the same function alone in an immensely stressful situation, possibly in the presence of distressed relatives, that only 22 months ago would have been performed by a team of experts and experienced coronary care nurses in a specialist unit. I do not blame the paramedics for not thrombolysing, but I blame the trust management for pretending that this practice could ever have been a safe alternative to a coronary care unit at Westmorland General hospital.
There are additional dangers to patients as a result of this decision. Because more than 90% of ambulances from the south lakes now have to make the journey to Lancaster or Barrow to deliver a patient to hospital, the south lakes ambulances tend to be at least 30 minutes further away from their next emergency call than they used to be. That had to have a dramatic effect on response times, and indeed it has. However, some of this lengthening of response times has been covered by the presence of our outstanding volunteer first responder teams, who will usually get to the scene of an emergency before an ambulance and in some cases more than an hour before an ambulance, thus making it appear that the ambulance service has met its response time target when in reality it has not.
To illustrate the situation, I will use one example. In December I went on shift with one of Kendal’s ambulance crews. We responded to a 999 call from a man in his late 80s who had presented with chest pains. He lived roughly a mile from the Westmorland general hospital in Kendal, which 16 months previously would have been able to receive him and treat him. Instead, we had to drive this patient past the Westmorland general hospital on the A65 and take him down the M6 to Lancaster. The patient was clearly afraid and the paramedics were clearly appalled at having to take a potentially dangerously ill person so much further to receive treatment. His frail wife was left behind in Kendal, with no prospect of being able to visit her husband in the coming days, as she would have been able to do at the nearby Westmorland general hospital. Even with blue lights flashing and sirens blaring, it still took us 45 minutes to reach Lancaster’s A and E department. The nature of Lancaster’s traffic system means that, even when other road users pull over in unison to allow an ambulance to pass, it is barely possible to go above more than 15 or 20 mph as a driver attempts to negotiate the traffic.
We stayed with the patient for more than an hour until he was safely admitted and then we left to return to the ambulance station in Kendal. From getting the 999 call to returning to the base and being once again available for the next emergency call, it had taken almost three hours. If we had been allowed to take the patient to Kendal, we could have been back at the base, out and ready to help the next patient in just half an hour.
Again, I can only speculate as to the motives of the trust management who were behind the closure. At the time, financial motives were cited, although those financial pressures have actually alleviated significantly. Mostly, clinical reasons were put forward for the closure, but those clinical reasons were seriously flawed. The solitary piece of clinical evidence used by the hospital trust and the PCT to justify their decision was the Royal College of Physicians’ guidance notes from 2002, which included a recommendation that consultants in acute medical care should not straddle more than one hospital. To follow that guidance to the letter would mean closing acute hospital medical services at either Lancaster or Kendal, so the trust chose to close services at Kendal.
However, the guidance is just that—it is guidance. It is not an edict. Indeed, in an answer to a written question from myself to the former Secretary of State, Patricia Hewitt, it was confirmed that that guidance was only one of a range of considerations that had to be weighed up when trusts were deciding how best to deploy acute medical resources and, crucially, that many trusts, especially in rural areas, had chosen to acknowledge the guidelines but had also chosen to continue to operate the relevant coronary care unit, because of the greater importance of ensuring adequate treatment for patients within the golden hour.
We can look at the example of Fort William hospital, where GPs are recruited to fulfil a cardiac role within the hospital. They are well trained to manage cardiac emergencies, independently if necessary. At Westmorland general hospital, the answer could be to recruit a medical registrar—a grade doctor—and to ensure the presence of such a registrar around the clock with sufficient supporting cardiac-trained nursing staff. The reality is that, before the loss of coronary care services at Westmorland general, a consultant would very rarely be present during the acute stages—as is the case with most other coronary care units—and that the senior house officer or registrar would manage just as well as a consultant. One only needs to look at the outstanding performance indicators from the coronary care unit in Kendal until 22 months ago to see that.
As the Minister will be aware, local geographical and territorial politics can often be just as significant as party politics. In our case, the rural catchment area for Westmorland general seems to have been squeezed out by the more urban interests of the two districts either side of us. That is despite our large and often larger population.
I quote what a senior trust representative told Kendal town councillors when the closure proposal was made. He said:
“We had argued for 10 years with our administration that acute medical services should be transferred from WGH to Lancaster. They had resisted it but when the financial crisis occurred, we saw our opportunity. We recognise that the Consultation process was defective and we argued for accurate costs to be included but the final decision was the one we wanted. That is all that matters.”
I do not have time to give full details of the flaws in the process that led to the closure of Westmorland’s emergency service. Instead, I have chosen to make an outline case for such provision to be returned. In answer to my question about cancer services on 9 June, the Prime Minister made it clear that the present Government do not follow the “one size fits all” mantra of the previous Government that big is always beautiful. I know from his visits and those of the Deputy Prime Minister to Westmorland that they are particularly supportive of our cause.
As someone who lives in the south lakes area and whose family and friends rely on local services, I simply want the safest and most appropriate emergency care for our communities and the hundreds of thousands who visit our communities each year. I ask the Minister to do all that she can to ensure that emergency services are restored to Westmorland general as a matter of urgency.
Thank you for calling me to speak, Mr Benton; we seem to have spent a fair bit of time here today.
I congratulate my colleague the hon. Member for Westmorland and Lonsdale (Tim Farron) on securing this debate. I know that the future of Westmorland general hospital is a matter of long-standing interest and concern to him. He spoke with passion—and some frustration, because he has clearly been fighting a long and hard campaign. As a constituency MP, I have engaged in not dissimilar exercises in connection with a community hospital and a large acute trust hospital. I possibly lost one, but won the other. I know how passionate he must feel—and how passionate his constituents feel, which is demonstrated by the size of the petition that he presented.
I know how important hospital services are to local communities, and how worrying it can be to local people when services are moved. The fact is that change has not always been well managed in the NHS. I assure my honourable colleague that the Government are determined to do these things differently, and to get local populations behind changes in the NHS. We believe that the best decisions are local and that change should be driven by local clinicians and not imposed, top-down, by politicians or decided behind closed doors by managers. That is why we introduced an immediate moratorium on new or pending service reconfigurations.
The Secretary of State for Health has made it clear that all proposed service changes must now pass four crucial tests. First, they must have the support of GP commissioners. Secondly, public and patient engagement must be strengthened; that was at the hub of my colleague’s words. Thirdly, there must be greater clarity about the clinical evidence base for any proposals—a matter also mentioned by my honourable colleague. Fourthly, proposals must take account of patient choice. As a result, the local NHS will have to make its proposals more transparent to the public, more responsive to the views of the clinical community and more firmly grounded in robust clinical evidence.
In the case brought to the House by my honourable colleague, it means that there may be new opportunities for local debate, with new clinical judgments on how services should operate. However—my colleague will be disappointed to hear me say it—this is not an opportunity to revisit reconfigurations that have already been completed. That simply is not possible. That means that the 2006 review will not be reopened, and that the decision will stand. However, I note my honourable colleague’s concerns about valuation and patient safety; the Department of Health has raised them with the primary care trust and the local NHS trust. In case I forget to say so in my concluding remarks, I know that a Health Minister will be happy to meet my honourable colleague.
I understand that following a full public consultation, Cumbria county council’s health and well-being overview and scrutiny committee approved the changes; they were not referred to the Secretary of State for review by the independent reconfiguration panel.
The overview and scrutiny committee did indeed rubber-stamp the proposals, but its process was deemed flawed by an investigation by the independent health commissioner because it did not take any evidence from the non-trust side. It was a completely loaded investigation.
I thank my honourable colleague for that clarification, and it highlights so well what happens when things cease to have public trust and confidence.
My honourable colleague has made the case for acute services to be reinstated at the Westmorland. The NHS trust tells me that the coronary care unit had to be closed on the grounds that it was no longer sustainable or safe. There is an increasingly difficult balance to be drawn between services that are local and accessible and those that have a significant throughput to ensure that clinical safety is maintained. A service might have been safe in the past, but that does not necessarily mean that it will be safe in the future. I understand that, on average, the service treated only three or four patients a week, and that level of throughput is simply not enough and potentially puts patients at risk.
I have two quick things to say. First, will the Minister investigate what evidence there was at the time of the closure for the Westmorland general unit to be deemed less safe than the other two units that we have mentioned at Barrow and Lancaster? Secondly, will she conduct an assessment of the position with regard to the safety of patients now? In other words, what impact has the closure had on the safety of patients or visitors within the South Lakeland area?
There are two issues here: what happened in the past and what happens in the future. The concerns that my honourable colleague has about safety in the future will be examined, and I am sure that Department of Health officials will help with that. I understand that Professor Roger Boyle, the national director for heart disease and strokes, has said that he does not believe that reopening the cardiac unit will be best for the local people, so that should be borne in mind. He feels that it would not be feasible to provide primary angioplasty for severe heart attacks at the Westmorland. He also thinks that for less severe heart attacks, Westmorland cannot provide the most appropriate care, such as early referral for intervention. However, I do recognise my honourable colleague’s legitimate concern over the use of pre-hospital thrombolysis, and over the fact that it is low in Cumbria. Clearly, more work is needed to ensure that heart attack patients in Cumbria get the best possible treatment.
I understand that the trust is listening to my honourable colleague’s concerns and that it is looking to increase the number of cardiologists from three to five across the regions. Those clinicians will be based at the Royal Lancaster infirmary and the Furness general hospital, but they will help to build extra capacity in the treatment of outpatients. That might not be enough here and now, but it is something that my honourable colleague can take away.
I understand that there has never been an accident and emergency department—whatever that means in this day and age—but I am also told by the NHS trust that there would be insufficient volume of patients going through Westmorland to sustain a full A and E department. An A and E department has to have back-up services, such as intensive care and CT scanning, to support the unit, and the Westmorland is not in a position to provide those facilities. The trust’s argument, therefore, is that it is safer for patients to access those services at Barrow or Lancaster, and I appreciate that that is fundamental to this debate and will be fundamental to ongoing discussions, because my honourable colleague believes that the opposite is the case.
My honourable colleague also mentioned travel times, and I am told that the North West Ambulance Service advises that across Cumbria, the average time for it to get to the scene is 10 minutes. He might dispute that, but that is what I have been told. The average time on scene assessing and treating a patient is 20 minutes and the average time from Kendal to Lancaster under normal driving conditions—not with blue lights—is 20 to 30 minutes. I acknowledge that patients on the far reaches of his constituency have further to travel.
I simply reiterate my earlier point: in rural areas, the bulk of those times record the time that the first responder arrives—the ambulance probably arrives another 20 minutes later.
And let us pay tribute to first responders; I have them in my constituency and they do a fantastic job.
It is not always about the time spent getting to the hospital, but the treatment in the first crucial half hour or so.
Provided paramedics can reach the patient quickly, they can provide treatment and stabilise them en route, which is often preferable, and then go to a hospital or an A and E department further away. However, the expertise has to be provided by the ambulance staff. “Dead on arrival” incidents would be reported, and NHS Cumbria has advised me that no such cases have been reported in the past 18 months, but the hon. Gentleman may have data that goes back further.
Unfortunately, when it comes to serving rural populations, the NHS has to balance what is safe with what is desirable. This is very tricky and it is held in the balance. There is no doubt that across the country the NHS is facing considerable challenges, and the local NHS in Cumbria is no different from any other. We made an historic decision, as a coalition Government, to protect health spending during this Parliament and to secure the front-line services that our constituents value so highly, but it is clear that local health services need to change and to become more efficient to secure their long-term future. That will not always be a smooth process; there will be tough calls to make in the future, as there have been in the past, but a clearer and more open process, led by clinicians and putting the local people firmly in the picture, will, I hope, reduce the anxiety that my honourable colleague has spoken about today. I hope that it will also build the trust that we need around such decisions. That is how we can achieve higher standards and better outcomes.
I said to my honourable colleague that I am sure that the Minister will be happy to meet him. The question is: how does my honourable colleague move forward with his constituents and how do we ensure that, even if we cannot right what has happened in the past, we move forward constructively? This is just a suggestion, but if he and local GPs formed a small informed group to work with the trust, I would hope that the local NHS organisations could take into account some of his concerns about the future of health services. What matters now is what happens in the future. I hope that they can provide the service that he wants to see.
I am grateful to the hon. Lady for giving way so often. Would that include the possibility of the local GP community, should they so wish, moving towards something akin to the Fort William situation that I mentioned earlier?
I thank my honourable colleague, but I am always very nervous about stepping outside my pay grade. The crucial thing now is how we and local MPs who have fought closures and reconfigurations move forward constructively; and we cannot reopen what has gone in the past. Local GPs and clinicians forming a group to work with and alongside the local primary care trust could ensure that good and improving decisions are made about NHS services.
It is not always about how close someone lives to a hospital. Across his constituency, life expectancy will vary by 10 years or more, and that has nothing to do with proximity to the hospital, but with deprivation. The issue of health care is much wider than this debate. There is an open door for my honourable colleague, so he feels that he can get the access to Ministers; I hope that will restore his trust and the trust of his local community.
Question put and agreed to.