The NHS is facing massive reorganisation, while at the same time seeking the greatest savings in its 62-year history. Respected professional medical bodies warn about the risks to public service of giving private companies the easy pickings. Before pursuing that gamble will the Prime Minister reflect carefully, informed by clinicians and the coalition programme that we agreed last May?
We will listen very carefully to the professionals, but the reason for making modernisation of the NHS such a priority is simply that this country now has European levels of health spending but does not have European levels of success in our health service. Of course, what we want is a level playing field for other organisations to come into the NHS. What we will not have is what we had from Labour, which was a rigged market.
Of course every increase in unemployment is a matter of huge concern, and that is why we are launching the biggest back-to-work programme that this country has ever seen, the Work programme.
There are some very disappointing figures today, particularly on youth unemployment, and I am sure we will talk about that in a moment, but there are some mixed pictures. The claimant count has gone down for the third month in a row, the number of vacancies is up and the average of the independent forecasts published today sees growth revised upwards. The biggest task for this Government, and frankly for this country, is to get to grips with the long-term structural problem of youth unemployment, which has been going up for years in our country and went up by 40% under Labour.
After that complacency, when 50,000 people have lost their job, it is no wonder they rumbled the Prime Minister in Oldham. The truth is that he is cutting too far and too fast, and British people are paying the price.
The Prime Minister mentioned youth unemployment. It is at its highest since 1992, yet he is abolishing the future jobs fund and the new programme does not even come into force until the middle of the year. After these figures, why does he not change his mind, reinstate the future jobs fund and help create an extra 100,000 jobs this year?
First, I think it is a good idea to listen to the answer before reading out the next question. Let me deal specifically with the future jobs fund. We looked very carefully at it and found that it was expensive, badly targeted and did not work. We now have the figures for the future jobs fund. It was five times more expensive than some other employment programmes, it lasted for six months and, within one month, 50% of those taking part were back on benefits. Hardly any of the jobs under the future jobs fund were in the private sector. The scheme in Birmingham, for instance, had just 2% of its jobs in the private sector. Far too many were make-work jobs in the public sector, and they were not solving the problem.
This week, a parents’ campaign group in Battersea moved a big step closer to starting a new free school. Their campaign is supported by Wandsworth council and enjoyed cross-party support before the general election. I hope that my right hon. Friend will join me not only in wishing the new Bolingbroke academy well but in saying to the unions and other people running a campaign of vilification against those parents that it is time to back off.
My hon. Friend speaks for many in supporting the opening up of our education system and saying to academies and free schools, “You are welcome to come in and provide a great education for free to children and parents in our country.” I have to say that it is a very big choice for the Labour party whether it sticks with the programme of reform and opening up education, or whether it sides with the trade unions.
Q2. Leaked figures that I have managed to get hold of show—[Hon. Members: “Oh!”] Calm down. The leaked figures show that police forces in Wales must cut their numbers by 1,600 police officers and staff. The South Wales police force told me this morning that in that one force 688 officers are going to have to disappear. The Prime Minister said on 2 May last year that he would outlaw any front-line cuts. Why is he backing down on his promise? (34266)
I find that the best way of calming down is by reading the hon. Gentleman’s poetry—I find that very instructive. All police forces are facing a difficult financial settlement. I accept that. The context for all this is the vast budget deficit that we were left and the huge mess that we have to clear up. I have the figures for the South Wales police force. Next year, it must find a 5% cut. That will take it back not to some figure of the 1980s, but to the spending it had in 2007-08. Her Majesty’s inspectorate of constabulary has said that it is quite possible to make those sorts of reductions—[Interruption.] If the hon. Gentleman asks a question, he should have the manners to listen to the answer. The fact is that HMIC said that it is possible to achieve those reductions while not losing front-line officers. That is what needs to be delivered.
Does my right hon. Friend agree that the Government’s social security reform programme is the first serious attempt since Beveridge to get back to the principle that—to coin a phrase—we should be offering people a hand up and not a handout?
My hon. Friend is entirely right. This is a very bold and radical reform that basically will mean that every single person who is on welfare will always be better off in work or always better off doing more hours of work. Even the Opposition would accept that so many reforms have simply moved the poverty trap up the income scale. We should always make it worth while for people to work harder or to work more, and that is what our reforms will do.
Q3. Fuel prices in Northern Ireland currently average 135p per litre and rising, forcing many motorists to go into the Republic of Ireland to fill their vehicles, which is a major loss to the British Exchequer. Because of the land border, will the Prime Minister consider introducing in Northern Ireland a rural rebate scheme similar to that in Scotland? (34267)
I understand the cross-border problem that the hon. Gentleman raises and that fuel smuggling between Northern Ireland and the Republic has been a real problem. The Chief Secretary to the Treasury would have heard him ask for the expansion of the scheme that was in the Budget. Obviously, we are looking hard at how we can help families and motorists with their fuel and motoring bills. However, I would say this: everyone should remember that the last four increases in fuel duty were all put through in the last Labour Budget.
I know that, like me, the Prime Minister is a fan of the teaching of British history in schools. Does he think that when the political history of the past 13 years is written, it will advise pupils to borrow, borrow and borrow through the boom, or will it advise them to learn from Labour’s mistakes?
I hope we can get into the curriculum the idea that we should fix the roof while the sun is shining. What we heard at the weekend from the right hon. Member for Doncaster North (Edward Miliband) was interesting: he has now had nine months to digest Labour’s mistakes, and he has come up with the answer that they did not spend too much and they did not borrow too much, and his message to the British people is, “Vote for me and we’d do it all over again.”
We want waiting times and waiting lists to come down. [Interruption.] The whole aim of these NHS reforms is to make sure we get the value for the money we put in. [Interruption.] I have to ask the right hon. Gentleman this: it is clear now that Labour—[Interruption.]
I would love to know what your answer was, Mr Speaker.
The point is this: we are putting the money in—£10.6 billion extra during this Parliament; money that, by the way, the Labour party does not support—but we want to get value for that money because, frankly, today we do not have the right outcomes for cancer and for heart disease. We want to do better. Is the right hon. Gentleman in favour of reform, or is he going to oppose it all?
I notice that the Prime Minister did not answer the question. Patients want to know something quite simple: how long will they have to wait for treatment? They all remember waiting for years under the last Conservative Government, and they know that we now have the shortest waiting times in history because of what the Labour Government did. If the Prime Minister thinks his reforms are so good, why cannot he give us a simple guarantee that waiting times will not rise?
Waiting times will rise if we stop putting the money into the NHS. The right hon. Gentleman’s shadow Chancellor is not here today, but this is what he said about our plan to increase NHS spending by more than inflation every year: “There is no logic” or rationale to it. That is the answer: we get investment in the NHS from this coalition Government, but we would get cuts from the Labour party.
The Prime Minister cannot make a guarantee because he has abolished the guarantees. He has abolished the guarantees that Labour brought in, such as the 18-week waiting list guarantee. He is taking the “national” out of the national health service. Patients are worried, and doctors and nurses say his reforms are extremely risky and potentially disastrous. Why is he so arrogant as to think he is right and all the people who say he is wrong are wrong?
First, the right hon. Gentleman is simply wrong: the waiting time points he made are written into the NHS constitution and will stay under this Government. So, first of all, he is wrong. The second point is that we will not be able to get waiting times down and improve our public health in this country unless we cut bureaucracy in the NHS. That is what this is about. We are spending £1.4 billion—a one-off—to save £1.7 billion every year. That will save £5 billion by the end of this Parliament. If the right hon. Gentleman opposes the reforms, where will that money come from?
The Prime Minister has obviously not noticed that people are not convinced by his reforms. Even the GP sitting on his own Benches said this is like tossing a hand grenade into the NHS. Is not the truth that, just like on every other issue, we get broken promises from this Prime Minister? He is breaking his promise on no top-down reorganisation of the NHS; he is breaking his promise on a real-terms rise in NHS funding; he is breaking his promise for 3,000 more midwives; and he is breaking his promise to put patients first. It is the same old story: you can’t trust the Tories on the NHS.
It is the same old feeble pre-scripted lines. The right hon. Gentleman practises them every week; I am sure they sound fantastic when they are spoken before the bathroom mirror. The facts are these: this Government are putting the money into the NHS, but the Opposition do not support that; this Government are cutting the bureaucracy in the NHS, but they do not support that; and this Government are reforming the NHS so that we get the best in Europe, but they do not support that. So this is the right hon. Gentleman’s policy: no to the money, keep the bureaucracy, do not reform the NHS. I would go back to the blank sheet of paper.
Prime Minister, our Government say that we want to help disabled people back to work. Two years ago, my constituent, Mr Robert Oxley, a father of four, had a serious motorcycle accident, which resulted in one leg being amputated and the other leg no longer functioning. A year later, he recovered and his firm gave him back his job, which he has been able to continue for a year through disability living allowance and Motability. Regrettably, those in charge, including callous cretins on the tribunal, have taken away his DLA and took away his Motability car on Monday, and he is now out of work—or he will be. May I ask the Prime Minister where in that story the words “fairness” and “all in it together” feature?
I am very happy to take up the hon. Gentleman’s case. We have all seen cases in our constituencies where tribunals have come to conclusions that completely fly in the face of common sense. I am very happy to take up that case, have a look at it and see what can be done. We should do what we can to help disabled people, particularly with the mobility needs that they have. Having filled out those forms myself, I know just how soul destroying and complicated it can be and how much we need to help people who cannot get around to make sure that they do.
Q4. The Prime Minister will be aware that my constituents in inner-city Manchester have some of the worst health and, brutally, die younger than people in other parts of the country. If he will not give a guarantee about waiting lists nationally, will he make a solemn and binding pledge to my constituents that at least in the inner cities waiting lists will not go up, either in number or in time? (34268)
The pledge I would make is this. As the hon. Gentleman has just revealed, we have health inequalities in our country that are as bad as those in Victorian times. Let us be frank: we have those after a decade of increased money going into the NHS and we are not getting it right. That is the reason for carrying out these reforms. If we just stay where we are, as seems now to be the policy of the Labour party, we will lag behind on cancer, we will lag behind on heart disease and his constituents will die younger than mine because we do not have a fair system. Let us reform it and sort it out.
Q5. The Prime Minister has repeated his claim that the Government are putting more money into the NHS, yet the County Durham and Darlington NHS Foundation Trust has been told that it must make cuts of 16% over the next four years. Why? (34269)
Let me remind the hon. Lady that her own shadow Chancellor said that there is “no logic”—[Interruption.] This is an answer. He said that there is “no logic” or rationale to our policy of real-terms increases in the NHS. What we are cutting in the NHS is the bureaucracy of the NHS. Since 2002, under Labour, the primary care trusts and the strategic health authorities increased their spending on themselves—on their bureaucracy—by 120%. We can go on spending this money and not put it into patient care and better public health, but I think that that is wrong. That is why we are making these changes.
Q6. Severe disruptions to train services in the winter of 2009 led to David Quarmby carrying out an urgent service and severe weather audit. This winter saw massive disruption to services, with Network Rail leaving trains stranded south of the river, causing a 75% cut in peak services over Christmas for my constituents. What steps are the Government going to take to shake up Network Rail and bring about a radical improvement to our train services? (34270)
My hon. Friend makes a very good point and that is why my right hon. Friend the Secretary of State for Transport has commissioned an independent audit of how transport operations performed during the worst weather in December. We have to look at some particular issues, such as the frozen third rail that affected so many services. She is right to call to account Network Rail and the train operators. We want to make sure that they improve the service that they provide and the way in which they communicate with the public when things are not going right.
Q7. Does the Prime Minister see the conflict of interest in private health care companies, which stand to benefit most from his health care reforms, donating £750,000 to the Conservative party? Is that what he means by “We are all in it together”? (34271)
Let me tell the hon. Gentleman the big difference between the health reforms that we are proposing and what the Labour Government did. The Labour Government rigged the market in favour of a few hand-picked independent private sector suppliers. That is what they did; what we are saying is that there should be a level playing field. Before the hon. Gentleman complains about it, he should have a look at his own party’s manifesto—and I quote it almost directly— which said that the private sector should be allowed into the NHS alongside the NHS. Those are the words from the Labour manifesto, written by his right hon. Friend the Member for Doncaster North (Edward Miliband).
My hon. Friend will know that there is a long-standing convention, quite rightly, that a serving Prime Minister does not and cannot order the release of papers that refer to a previous Prime Minister. That is why the Cabinet Secretary will be looking at this issue, which is a matter for him. Anyone unhappy with the conclusions is clearly able to write to Tony Blair to make their views known. For my own part, I hope this inquiry can be as open and clear as possible so that we get to the bottom of the very important issues it is looking at.
Q8. As the Prime Minister will be aware, I spent most of my working life in schools and colleges, so I have overwhelming evidence of the benefits of the education maintenance allowance. It brings benefits to teenagers from modest backgrounds in terms of their employability skills and in raising their achievement. May I urge the Prime Minister to go back to the position when he pledged to support EMA, so that we can support our economy as we move forward? (34272)
As the hon. Gentleman knows, the problem is that we want more people to stay on in school, but we have to look at the working of the current system. The Labour Government commissioned research and found that 90% of those on EMA would have attended school in any event. We also have to look at the context in which EMA was introduced into this country. Let me cite what the hon. Gentleman’s parliamentary colleague, the former Prime Minister said at the time:
“We will fund this major advance in educational opportunity from savings that we have made from our success in reducing… debt.”—[Official Report, 15 July 2002; Vol. 389, c. 29.]
Is it any surprise that we are having to look at these spending programmes and work out how to get better value for money to clear up the mess we have been left?
Q9. My constituents in Corby and East Northamptonshire are still suffering today from the disastrous top-down housing targets imposed by the Labour Government. Can my right hon. Friend assure me that the Localism Bill will restore planning power to local people in Corby and east Northamptonshire? (34273)
I can give my hon. Friend that assurance. The failure of top-down housing targets was that they not only created huge unease around the country but did not result in the building of very many houses, as house building fell to such a low level. Our more local version will make sure that where councils go ahead and build houses, they will benefit from doing so.
While we all welcome the comparative calm during the referendum in southern Sudan, does the right hon. Gentleman accept that hundreds of thousands of southerners are seeking to move back home from the north? Will he ensure that they have the maximum protection as well as the maximum of humanitarian aid?
I think the right hon. Gentleman is quite right to highlight what a relative success the process has been so far, given some of the warnings made about the dangers of the referendum and the process being followed. Part of the reason for that—I pay tribute to previous Governments as well—is that the countries that care about the Sudan and want this to work well have put in a huge amount of effort. I include my right hon. Friend the Foreign Secretary, who chaired the key meeting on the subject at the United Nations. I will certainly listen to what was said, and we should make sure that the movement of people is carried out in the best way possible.
Q10. Does my right hon. Friend agree that as part of the NHS reforms we must tackle straight away the fact that senior management in both NHS trusts and primary care trusts are being rewarded for failure by being promoted or given large pay-offs and that it should stop now? (34274)
My hon. Friend is entirely right. There have been too many occasions on which a manager in the NHS has failed in one PCT or strategic health authority and gone on and failed in another. One answer to this issue is the greater transparency that we are bringing to all such arrangements so that people can see how much they are paid, what the results are and how successful they were before they go on and land another well-paid job.
The Government announced this week that they will not extend to Northern Ireland the UK rules on political party donations at this time. Will the Prime Minister clarify what was the greatest driver for that decision? Was it the security concerns or the lobbying of local parties that simply do not want to be exposed to transparency?
I will look carefully at what the hon. Lady says. The security situation in Northern Ireland is a very difficult and sensitive one at the moment and the Government are giving it a huge amount of time and attention to try to help the devolved authorities in everything they are doing to combat the terrorist threat, but in terms of the specific question she asks perhaps I can write to her and give her a considered response.
Q11. My right hon. Friend will be aware that there have been some pretty disgraceful delaying and filibustering tactics at the other end of the corridor in an attempt to delay the introduction of the Parliamentary Voting System and Constituencies Bill. Will he assure the House that the Government will make no concessions to those who filibuster? (34275)
My hon. Friend is entirely right: we should not make concessions to a bunch, mainly of former MPs, who are supposed to be supporting the right hon. Member for Doncaster North (Edward Miliband), who wants the AV referendum to take place. I have to ask him how, if he is so in favour of the referendum and thinks it so important and so wants to stand on a platform, he has lost control of his party?
Q12. Owens Road Services, a haulier from south Wales working in Blaenau Gwent, has a fleet of 270 lorries. Last year, it bought nearly 11 million litres of fuel, paying more than £6 million in fuel duty, and it has shouldered a 14% increase in fuel bills in the past year. What is the Prime Minister going to do about high fuel bills? (34276)
Let me make two points to the hon. Gentleman. First, there is the point that the fuel duty increases were all part of the previous Labour Government’s Budget. [Interruption.] It is no good hon. Members shaking their heads; they all supported the Budget and voted for it at the time. However, there is another answer, which is that we should look at Britain’s hauliers and see how we can help them with a discount for those that are British-based. We are looking into that and at what can be done, because for many years British hauliers have been disadvantaged against their continental counterparts and we would like to put that right.
Does the Prime Minister agree that what has happened in Burnley with the closure of our accident and emergency unit and the transfer of a children’s ward to Blackburn will not happen when people power takes over, with our GPs, to change the national health service?
The hon. Gentleman is entirely right. Under the previous Government and the previous arrangements, hospital closures and decisions were driven by bureaucrats in Whitehall, strategic health authorities and PCTs, and they did not depend on decisions that patients and GPs were making about the structure of health services in this country. That is the big change we are making. In future, the success of hospitals and health centres will depend on the choices that people make with their GP; that is the big change and it will drive a better health service.
Q13. The north-east illegal moneylending team has a record of catching loan sharks and setting up credit unions in Easterside, Middlesbrough to encourage saving and safe lending. Worryingly, after all that hard work, the Department for Communities and Local Government website has signposted vulnerable people to loan companies offering rates of up to 2,689% APR. In the light of that, will the Prime Minister please meet me to review his decision on the closure of that team? (34277)
I am very happy to arrange a meeting between the hon. Gentleman and the DCLG to discuss this issue. I think there is unity across the House that we should try to encourage credit unions and try to get people out of the hands of loan sharks. That is our policy and that is what we want to do, so I shall happily arrange that meeting.
Q14. I very much welcome my right hon. Friend’s comments earlier about the Localism Bill. Can he confirm that its provisions will apply to applications for onshore wind farms such as those on the Dengie peninsula in my constituency? One of them has already been described as harmful to the local environment, and it is deeply unpopular with the local community. (34278)
I can give my hon. Friend a positive answer. The Localism Bill addresses that issue. As well as doing that, it is important that where local communities are affected by things such as onshore wind, they should make sure that they benefit from those developments. The Localism Bill brings a whole new approach that will much better settle this difficult debate than what has been done until now.
Q15. Today, there is an order before Parliament to proscribe the TTP—Tehrik-e Taliban Pakistan—the Pakistan Taliban. Just one week into the term of office of the Prime Minister’s predecessor, my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown), the right hon. Gentleman demanded to know why my right hon. Friend had not proscribed Hizb ut-Tahrir. Just eight months into the Prime Minister’s term of office, can he explain to the House why he has not fulfilled his manifesto commitment? (34279)