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Westminster Hall

Volume 526: debated on Wednesday 30 March 2011

Westminster Hall

Wednesday 30 March 2011

[Mr Graham Brady in the Chair]

Children with Special Educational Needs

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

It is a privilege to serve under your chairmanship, Mr Brady. I am delighted to have secured this debate on provision for children with special educational needs. The Table Office has advised me that at the outset I should declare an interest: my wife is a lawyer who specialises in educational matters, particularly in representing children with special educational needs. It was her frustration and my outrage, on hearing reports from parents, that sparked my personal interest in this subject, many years ago. The Government’s Green Paper on special educational needs prompted my request to the Speaker for this debate. I hope that it will be the first of many held in the House before the publication of the White Paper.

I welcome the approach taken by the Minister, and was fortunate to receive a briefing on her intentions a couple of weeks ago. She and her colleagues have a genuine passion to make a difference on this issue, and acknowledge the waste, delay, frustration and anger that is often felt about the current system. The Green Paper underlines the Government’s wish to develop a less adversarial approach, offer a greater choice to parents, and encourage and facilitate better working and co-operation between schools, local education authorities, health bodies, the independent sector and parents. A multi-agency approach up to the age of 25, with more support from the independent sector and increased opportunities for free schools, will offer choice and continuity. The Green Paper outlines how early identification can make a significant difference to outcomes for individuals, and says that teachers need to be better qualified in identifying special educational needs.

I congratulate my hon. Friend on securing the debate. He alluded to the importance of teacher training; does he agree that one of the great strengths of the Green Paper is not just the emphasis it puts on initial teacher training, but the opportunity for teachers to develop their professionalism throughout their careers? He talks about frustration more generally, but there must be frustration in the teaching profession with the fact that they have not been given the tools to deliver the kind of education that he and I want to see right across the board.

I am grateful to my hon. Friend for underlining an important point that is acknowledged in the Green Paper and, I think, far and wide. Teacher training is extremely important in the initial stages, but so is continued professional development. That is particularly important in relation to school exclusions. Evidence from Mencap suggests that 72% of pupils who have been excluded have special educational needs. I believe strongly that lack of support for a special need is often the cause of disruptive behaviour, and in view of the Government’s plan to change the school exclusion legislation, I hope that changes to SEN policy and teacher training will help reduce that percentage. The exclusion of those pupils is our fault, not theirs, if their needs have not been addressed. The Green Paper also considers how the statementing process should be changed so that resources are used in a more efficient way. That is the area on which I wish to focus today.

I was delighted to see that the Green Paper proposes maintaining the principle of a statement of SEN. It aims to reform the process, so that there is a single education, health and care plan, but still recognises the need for statutory protection for parents and pupils with regard to the provision of SEN support. That is great comfort and reassurance to all parents. The current system is cumbersome, costly and inconsistent, and is seen as being used by some authorities as a delaying tactic to frustrate the wishes of many parents.

In spite of that flawed process, the system is seen by parents as the back-stop that can guarantee a level of provision. If a parent can find their way through the maze, a statement can deliver what they want and what their child needs. Clearly, all sides are spending significant sums of money considering and discussing the matters. The money spent on advocacy and the challenges involved would be better spent on delivering provision. The new approach aims to make the process swifter, simpler and more efficient, but I have some questions and concerns about how and whether all aspects will work, so I want to talk the Chamber through the current process and compare that with my understanding of the proposals in the Green Paper.

The starting point is typically a parent or teacher identifying, or raising a question about, a child’s special educational need. Once the request for assessment has been made, the authority has six weeks to decide whether to assess the child. That will lead to a 10-week period in which the assessment is conducted. If a local authority questions or objects to the need for a statutory assessment, a parent will have to follow a cumbersome process to appeal via a tribunal; that comes with a significant delay. I am aware, for example, of an appeal just to obtain a statutory assessment that was registered on 10 August 2010 and not heard until mid-January 2011.

After the assessment, a decision will be made on whether a statement of SEN is needed; if it is, a proposed statement must be issued within two weeks. The parents are given the proposed statement and an opportunity to make representations within two weeks. After a further six weeks, the local authority will present its final statement.

I congratulate the hon. Gentleman on securing this very important debate. In my constituency, there are a number of schools with children who have special needs. According to the Library research paper, on 9 March 2011, The Daily Telegraph stated:

“Thousands of children will be removed from school ‘special needs’ registers under Government plans to stop teachers over-diagnosing behaviour and learning problems.”

The parents whom I speak to have a real difficulty with that; does the hon. Gentleman agree with them?

I am grateful to the hon. Gentleman for raising that point. That is certainly an issue that causes worry among many parents. However, we need to recognise that the school funding formula almost leads to a perverse incentive for schools to classify children as having SEN. Very often, what is needed is additional support in the classroom, rather than a classification of SEN. It is the perverse incentive that is the root of that problem, but I accept absolutely that the issue needs to be teased out and clarified while the White Paper is being drafted.

The whole statementing process is meant to take 26 weeks, but we need to add in the delays due to the tribunal, which I have mentioned. If a parent is dissatisfied with a statement, they can appeal to the tribunal again. Delays such as the August-to-January delay that I mentioned earlier in relation to the assessment appeal will also be incurred in the case of a statement appeal. Parents who have to go through two appeals and the 26-week statementing process can therefore be left waiting for a total of 16 months to get a statement confirmed. That delay in securing the right SEN support can be damaging, particularly to a young child of four, five or six, as 16 months is a significant percentage of a child’s life.

The Green Paper highlights the Government’s will to speed up the process, and proposes cutting the 26-week period to 20 weeks. That is welcome, but the wait for the tribunal hearing also needs to be addressed if we are genuinely to speed up the process from start to finish. The Green Paper, however, talks about a mediation requirement. In principle, I can see the attraction of that, but I question its merit in practice because of the new delay that that could introduce. An insistence that mediation should take place before the right to appeal would be detrimental due to that delay, and I ask the Minister to allow mediation to take place in parallel with the wait for the tribunal hearing. In reality, discussions already take place right up to the day of the tribunal. It is most frustrating for an authority to agree to something on the morning of a hearing when the parents have been asking for it for the previous six to eight months.

Furthermore, I am not wholly convinced that mediation will work in practice. Parent partnerships already exist to allow for mediation, but few people take up the option because the relationship has usually broken down. We need to consider the pressure on the parent of an autistic child who has to battle month after month with a school and a local education authority, and then face a tribunal.

The Green Paper highlights extended choice for parents, but we need to recognise that legislation already offers parents significant choice. It is often the disagreement caused by the difference between the wishes of parents and the offer from the local education authority that leads to tribunal proceedings.

Might not the term “mediation” often be used to talk the parent out of getting their child statemented, and to let the school authorities off their responsibility to ensure appropriate education for the child?

I am grateful to the hon. Gentleman for that intervention. It underlines a point that I plan to make later about the support that parents need. Mediation could possibly work, but we need to understand the breakdown in relationships and the support that parents therefore need.

I turn to the statement itself and the issues that can lead to disagreements and appeals. More often than not, draft statements are vague and imprecise. Parents will seek to make changes in order to gain an appropriately detailed statement that guarantees the provision that they need. Let me offer an example relating to the provision of speech and language therapy. A poor statement would read, “The child will have access to a communication programme,” whereas a well-prepared statement would record, “The child will have direct speech and language therapy with a therapist once a week for a period of 30 minutes.” That detail is important because if the speech and language therapist is sick for a period or goes on maternity leave, a local authority will rarely move to reappoint a suitably qualified individual, even if they can, given the shortage of therapists. If the provision is specified in a statement, parents can demand it, even from the private or third sector, if necessary. Clearly, it is in the interest of the local education authority to draft a vague statement to prevent such demands reaching the High Court.

That leads me to the backdrop of the tension that develops between parents and local authorities. Parents want a detailed, appropriate statement. They sometimes request that support be given more frequently than is offered, or seek a placement in a specific school, possibly out of county, and that has financial consequences. In a small number of cases, an independent special school is requested. Parents may even press for one-to-one support in a mainstream school. Those demands, which stem from the choice already afforded to parents in current legislation, will always have cost implications. That is usually at the core of the differences between the two parties.

Section 86 of the School Standards and Framework Act 1988 states:

“The duty imposed”—

that is, the duty on the authority to comply with parents’ preferences—

“does not apply…if compliance with the preference would prejudice the provision of efficient education or the efficient use of resources”.

A similar term is used in the Green Paper, which states on page 17:

“unless it would not meet the needs of the child”


“would be incompatible with the efficient education of other children”.

It is obvious why such clauses and statements need to be included in legislation and Green Papers, but as long as they are, we will always end up with parents rightly demanding more for their children and local authorities seeking to reduce provision on the basis of cost. I do not see how legislation could be drafted without such a clause to protect the public purse, but it will always be the point on which disagreements will arise.

One option could be a better definition of what a parent can expect, but that focuses on inputs rather than outputs and runs against the principle of facilitating the best outcomes possible, which is at the core of the Green Paper. I have no doubt that many measures in the Green Paper will make a significant difference in supporting children with special educational needs. Early identification, a multi-agency approach, and assessment by health visitors in particular—the number of health visitors is to increase—are extremely welcome. The simplification of school action and school action plus is welcomed by parents, because they are often seen as a delay to the statutory assessment that I referred to earlier.

The hon. Gentleman mentioned the shortage of speech and language therapists. Would he agree that that is a key component of all this? There is a major shortage of therapists across the whole of the United Kingdom, and the Government need to do something to encourage young people into that profession.

I am grateful for that intervention. Without a doubt, the shortage of speech and language therapy is a significant difficulty, but as I highlighted earlier, if need for it is recorded in the statement of special educational needs, parents can rightly demand it, and can even go to the High Court to secure it. I am familiar with some cases where that has been done. However, I worry about those pupils who need speech and language therapy support but who do not have a statement. The shortage of such support does not make things easy for local authorities, assuming that they have the resources to provide it, and it naturally drives up costs. I am grateful to the hon. Gentleman for raising that point.

Improved training of teachers will make a positive difference in reducing special educational needs later on. The point about speech and language therapy is particularly relevant, because if support is provided early on, soon after screening at the age of two and a half, which is mentioned in the Green Paper, that can save significant sums later. I would like to believe that the Minister recognises the importance of that issue.

Budgets for parents to buy services directly will also help significantly. That is the principle of choice. One example that I can offer relates to sensory integration therapy, which local education authorities fail to recognise but the parents of autistic children value hugely. That service is provided by specially trained occupational therapists.

More explanation is needed of how budgets will be allocated, so that parents can exercise the choice and freedom that we want to give them. Will it be on a banding basis? If so, it will lead to further challenges and appeals aimed at moving the child to a higher band that would give greater access to resources and better provision. The new assessment regime and joint working with various agencies will simplify the process, but there needs to be clarification on whether there will be a single assessment regime as well.

Finally, I want to underline my concern for parents who do not have the capacity to challenge the system. This point was made earlier in an intervention. To get the best chance of securing provision, a parent may employ an advocate, independent speech and language therapists, occupational therapists and educational psychologists to give evidence to challenge the local authority’s case. After all, the local authority has ready access to such services. Clearly, that would be a significant expense for any individual or family, but if their call is that an independent special school costing, say, up to £100,000 a year is the only way to secure provision for their child, paying such experts at the appeal stage could be seen by them as an investment.

My worry is that the parents of some children with special educational needs will not have the necessary capacity; many may have special educational needs themselves. It angers me that those with the resources and the capacity who can work their way through the system will get what they need, but the children of parents who cannot afford it or cannot work their way through the system will be left without appropriate provision. I am sure that the Minister will agree that stopping those who can is not an option, and that the challenge is to deliver a system that provides the right support at the outset to those who cannot.

I am grateful for the support that I have received for this debate, and for the interventions that have been made. I hope the Minister will accept my comments as a positive welcome for the Green Paper.

I am pleased to speak in this debate under your chairmanship, Mr Brady. I congratulate my hon. Friend the Member for Vale of Glamorgan (Alun Cairns). He is a compassionate Conservative, and he has demonstrated that today. I was astonished at the level of expertise he displayed, and I learned a lot from his speech.

As a candidate and now as a Member of Parliament, I have been very pleased to speak to Harlow parents whose children have special needs. I am a supporter of the Harlow Parents of Autistic Children Together, or PACT, and I have often met its chair, Sam Fancett, and vice-chair, Wendy Merry, and others. They are very IT friendly, and we usually speak via Blackberry messenger. I want to raise on their behalf some problems that are sometimes thought to be little things, but actually make a big difference.

First, parents believe that it would be helpful if more special schools could specialise—for example, in autism therapy—instead of being just an alternative to mainstream schools when children can no longer cope. If that is impossible, more mainstream schools could develop a specialised autism unit on site, or a unit could be shared between several schools. At present, I understand that, if a parent chooses a school that is more suited to their child’s needs, but is outside their catchment area, they must provide their own transport, and sign a disclaimer saying that they will never request transport in future. We all know that funds are limited, but there should not be a postcode lottery in such cases. As the free school reforms come through, I urge the Government to look at home-to-school transport and access to expert special education.

Secondly, why are parents of children on the autistic spectrum, especially those with severe difficulties, unable to get a blue badge to park their car? Parents of those children struggle daily, sometimes in extremely difficult situations. They have told me that parking a car when a child is having a meltdown can be highly dangerous. The Government are cracking down on people who abuse blue badges, but will the Minister do what she can to nudge local authorities to make blue badges more available to those with autistic children or children with significant special needs? It is worth taking much stronger action against those who wrongly park in bays for disabled drivers, because that causes incredible difficulties for those with severe disabilities.

Thirdly, on special educational needs, there is a question about arbitrary limits. A constituent of mine, Jackie Stedman, has suffered a constant battle to get a good education for her two children. Again and again, she has run up against problems due to random limits on financial support, which are tied to age rather than to need, or to children’s potential to learn. I accept, of course, the overall need to cut the deficit, and to be careful with our finances, but the sums involved are not significant in the context of the overall budget—in this case, that of Essex county council.

The context is that the council pays for home-to-school transport for Jackie’s two children, who both travel in the same car to the same school, but the council is now saying that, according to the rules, it can pay for one child, and not the other, even though the car will have to make the journey anyway. The absurdity is extraordinary. That is unaffordable for the family, and it feels like a “Little Britain” sketch, when “the computer says no”, just because one of her children is now 16.

I understand the need for local government to set criteria, but the rules sometimes seem arbitrary, and hurt decent families who simply want a good education for their children. A similar problem is seen with therapies offered by local primary care trusts. Sam Fancett gives the example that not all children are offered sensory integration therapy or auditory integration therapy. It depends on their PCT, but those therapies can transform children’s lives, and drastically improve behaviour at an early age. She also queries why speech therapy seems to finish at the end of year 7. Again, that seems to be an arbitrary limit, which does not relate to children’s needs or potential.

A potential casualty of the difficult economy was going to be a Thursday evening session of respite care in a Harlow community centre called Sam’s Place. Thankfully, the council worked hard to rescue it, and I congratulate the leader of Harlow council, Andrew Johnson, Councillor Joel Charles and council officers on their hard work in achieving a solution. One of the lessons that came out of that was that most parents are happy to take on the responsibility of running services for their children, but we cannot ask them to take on legal liabilities, compliance duties and other red tape. Parents with children with special needs have enough to worry about without having to do all that. I know that the Government are looking at such matters in the context of the big society reviews, and I would be grateful if the issue could be specifically considered.

As I have suggested, the solution must involve the big society. At the moment, if someone with an autistic child wants to talk to the local education authority or PCT, it is like trying to get through to a mobile phone company with instructions to press 1, press 2 and so on. Parents need a much more personal service. That may cost a lot of money, but a reduction in the number of appeals and complaints might save money in the long run. Essex county council has been moving towards that, but the results are patchy, and I urge it to use its back-office savings to hire more, dedicated, proper relationship managers—human beings—who would understand the issues and liaise directly with families such as those in the Harlow PACT.

Another problem is that the computer always seems to say no. Why should it say no to parents who are struggling against the odds? Decisions are arbitrary or tied to arbitrary age limits and catchment areas, which are largely random or created for bureaucratic convenience.

My hon. Friend is making some extremely important points about the arbitrary limits. My understanding is that the legislation does not provide for such arbitrary limits. We need to provide for the child, but local authorities use the system to prevent a child from gaining access. If a parent battles through the maze of the statementing process, they may win, but bearing in mind the delays to which I referred, very few, sadly, have the resources or the capacity to do that.

My hon. Friend is exactly right. My point is that given what parents must face, and their difficulties with special needs children, why should they have to battle? Mrs Jackie Stedman has spent years battling with the courts and relevant authorities to try to obtain proper treatment for her children. She has often been successful, but why should she have to go through that in the first place? To borrow a phrase, our public services need to speak “human”, and that means looking at each individual case on its merits, and talking to the parents and children involved.

Perhaps I should have declared an interest earlier, Mr Brady, as a former teacher and still a member of the NASUWT. Does my hon. Friend agree that schools find themselves in the middle of a conundrum? Teachers may see the problem of children on the autistic spectrum or with dyslexia and make a diagnosis, but they are frustrated because the resources and support that parents rightly demand are also lacking for teachers. They want to get on with the job. They may have identified the problem and know the direction of travel, but LEAs are often lacking resources.

My hon. Friend is right. If the teacher is well placed to understand and diagnose the problem, the matter should be sorted out from there. However, they often have to wade through relentless bureaucracy. It does not matter which local authority is involved, it is always “rule this, regulation that.” That is what makes lives difficult.

Parents are used to fighting to get a fair deal for their children, but we must not burden them with tons of forms, legal liabilities and compliance. We have to make it easier. I know that the Minister is looking into the matter, and I would be grateful if she reassured my constituents about the direction of Government policy.

I did not plan to speak in the debate. Many hon. Members take a strong interest in this subject, but there are undoubtedly other meetings and Committees sitting this morning that have prevented them from attending the debate. I anticipated contributions from some of those hon. Members to whom I have often listened when they spoke about this subject. Since I have the opportunity to speak, however, I would like to raise one or two issues.

I congratulate the hon. Member for Vale of Glamorgan (Alun Cairns) on securing the debate. It is an interesting time for such a debate due to the publication of the Green Paper and the consultation. If we return to the subject in a few months, I suspect that we will have heard more from our constituents who are beginning to engage with the process and to look at the issues set out by my hon. Friend the Minister in the Green Paper.

If we look back at educational experiences over the generations, it is clear that there is now—thankfully—more recognition of the needs of pupils. Rather than seeking to exclude or blame pupils for the challenges they face, usually with huge courage and fortitude, there is now more recognition of those problems. Strategies have been developed to support pupils who face those various challenges and experiences.

Of course there is an issue of resources, and the challenge set out in the Green Paper to bring different agencies together and to come forward collectively with solutions is crucial for a number of reasons. As hon. Members have pointed out, families going through such problems often have to pursue multiple challenges with different agencies working alongside each other. Given how the system is currently configured, they have not only to fight with the local authority or even the school, if things have reached that stage, but to take on the local health trust to receive the provision that they need.

During my time representing the larger constituency of North Cornwall, as it was then constituted, I was involved in a fantastic campaign run by a wonderful woman called Sandy Lawrence. Sadly, the boundary has changed so I no longer have the benefit of her experience as a constituent, but she continues to work across Cornwall for children with Down’s syndrome. She brought to my attention the ludicrous provision in place for providing mobility aids for children who are perhaps slow to develop with walking, and pointed out the rather strange rules put in place by the primary care trusts that are split up across Cornwall.

A contract was provided by a neighbouring health trust to supply those pieces of equipment, but the commissioning was simply not up to the job or robust enough. When I, together with Sandy whose campaign it is, began to probe that situation, no one was able to say how much of a service and how many pieces of equipment had been provided for the money handed over by the local PCT, and over what period that had happened and for what purpose. The management information was dreadful. Sandy was going through that experience on behalf of a child who was approaching school age, and that equipment was crucial for engagement and moving into school. That fight was completely separate from anything to do with education, but it is crucial to bring those things together so that collaborative approaches can be drawn up.

Such an approach would also make it harder for different agencies to hide from each other. As we know, when resources are at stake, there is a tendency to say that it is someone else’s problem. If there is any opportunity to pass things on to someone else’s budget, people will grasp that opportunity. That is done not out of a sense of malice, but because people are under pressure. If we could develop a more collaborative approach, we will come up with solutions that will work better for families and children. That would be the case in the sort of situation I have outlined, which has improved drastically.

We know that child and adolescent mental health services are patchy across the country, and in a rural area such as my constituency it is challenging to provide support. The hon. Member for Harlow (Robert Halfon) described the support network of parents in a more urban setting. Such things exist in rural areas, but for all the reasons outlined, there are challenges in getting together because of difficulties with transport that can be acute. The determination to bring health providers to the table for debates and discussions is crucial, and I pay tribute to the Minister for the work that she has done in securing that initial collaboration with the Department of Health. I look forward to working with other hon. Members to ensure that that collaboration is delivered and becomes the reality.

I want to pick up on the point about providers of education that offer an inclusive model. That has been a subject of much debate, and it is right to ensure that special schools exist for those families for whom that is the right solution. At times, however, we do not give enough recognition to those schools that have determined to offer an inclusive programme of education. I recently met with Mr Ewan Murray, the head teacher of Robartes junior school in Bodmin. He spoke about some of the pupils in the school who were let down by other educational environments but who are now thriving. They travel past several other schools in order to get to his school because it specialises in ensuring that everybody works together and provides support.

I sit on the Committee that is considering the Education Bill currently going through the House. The hon. Member for Vale of Glamorgan mentioned the approach taken to exclusion, but the other side of the coin is to ensure that we have confidence in early intervention so that exclusion is a last resort. Head teachers get frustrated if the situation reaches a point at which they need a permanent exclusion but know that an appeal could overturn that and put the child back in the school. There may have been earlier failures, and the Green Paper needs to look at that to identify those problems and to ensure that the situation is dealt with at an early stage.

Under the current system, which is due to change if the Bill is enacted in its current form, if the current appeals panel puts someone back in a school, the relationship with that school has often broken down and can be difficult to rebuild. The measures in the Bill concerning schools retaining an involvement and a responsibility for that pupil, and the provision they receive elsewhere, is a useful model. I welcome the work that will be done on that through pilot schemes and so on. Crucially, we must deal with problems early on so that the situation never gets near exclusion.

I congratulate the hon. Member for Vale of Glamorgan on securing this debate and raising this issue at the time of the consultation. I suspect that we will return to the debate as other hon. Members get more involved and wish to contribute to the process. The determination set out by the Minister in the Green Paper to bring agencies together, particularly those in the health sector, is crucial, and I hope that it comes to fruition. It can make a huge difference for families and children who have been let down in the past.

It is a pleasure to speak under your chairmanship, Mr Brady. I thank the hon. Member for Vale of Glamorgan (Alun Cairns) for bringing this very important subject to the Chamber. I was a little hesitant—I am sure that my hon. Friend the Member for Upper Bann (David Simpson) felt the same—about taking part in the debate, even though I have a passion for the subject, because there is a difference between the arrangements in our part of the United Kingdom under the devolved Administration and those on the mainland. However, we can learn from each other’s experiences, and it is vital that we do. The devolved Administration should examine the current proposals and see what can be taken from them and what can be learned from them.

Some of the statements made by Ministers on this subject are certainly helpful. According to the pack prepared by the Library for the debate, the Government say that they will tackle the problem, which has never been addressed before. It then mentions a number of things that the Government propose. This Minister—the Children’s Minister—says:

“We have heard time and time again that parents are frustrated with endless delays to getting the help their child needs and by being caught in the middle when local services don’t work together.”

The Under-Secretary of State for Health, the hon. Member for Guildford (Anne Milton), who is responsible for public health, says:

“It is vital that children, whatever their needs, get the best possible start in life.”

The Minister for Further Education, Skills and Lifelong Learning says:

“This Government wants to do more to help people overcome barriers that hold them back.”

All those statements are grand, but quite often we have had fancy statements from Ministers in the past. We will judge them by what they do, because statements of special educational needs will, without adequate finances, just be statements.

The hon. Gentleman is talking about statements by Ministers and politicians. Many parents are concerned not only about the statement of special educational needs that their child receives, but about the quality of the education that their child receives. That is about the way in which their child is able to learn and whether their school, whether it be a private school—an independent school—a school in the voluntary aided sector or whatever, is able to assist them. The issue is more the help that is provided, rather than the statement for the child.

Yes. I thank the hon. Gentleman for his intervention. The statements by Ministers that I read out contain fundamental principles that the Government are setting down. There is a review of this area, and the Government intend to make progress. All those fundamental statements by Ministers are important. All I am saying is that we will judge them by the actions thereafter, because the statements by Ministers will amount to nothing but air if they are not followed through and action is not taken to give the best possible educational opportunity to children with special needs.

Like my hon. Friend the Member for Upper Bann, I have special needs schools in my constituency and I know that many parents are battling for their children. When it comes to the statementing of children, my experience as a Member of Parliament is that my constituents have great difficulty in getting help when they really need it. Let us be honest: there are parents who do not have a great interest in the educational attainment of their children. Every parent should have a great interest in that, but not every parent does. Not every parent has the capacity to understand the great need for education for their children and how to get the best possible education for their children with special needs.

There are other parents, who have a real concern, yet they come up against walls, barriers and obstacles, which in the past they were not able to get over. We must ensure that we give the best possible advice and help to parents at what is a critical time, because many of the children whom we are talking about are losing years of their lives educationally that they will never be able to get back. It is vital that parents get the best advice at the right time and that therefore the child gets the best possible education, because that sets the stage not only for their educational attainment, but for their job prospects and everything else. It is vital that parents get help at the appropriate time. If that is what the Minister is setting her mind to, that will be of great help.

The Government also propose to ensure that assessment and plans run from birth to the age of 25. If I may, I will relate some of the experiences that I have had. In Northern Ireland, when children in special schools turn 18, they go outside the education system. They may have a mental capacity of seven, but they have a birth certificate that says that they are 18, and they leave their special school and go outside the education system. I am passionately angry about that, because what other child stops their educational attainment and advancement at seven years of age? No other child is allowed to stop at seven. Because the person has a birth certificate and a body that say that they are 18, they are moved aside. They have very special educational needs, but those needs are not being met after a particular age. That is a disgrace and an indictment of any society that allows it. I have in the past begged Ministers to intervene in this matter; I believe that they must tackle the issue. I trust that we will get answers on that.

Many parents are frustrated when it comes to getting statements for their children. Many do not have a sufficient understanding of what they need to do to get their child statemented and they come up against an education system that fights against that. There is a constant battle and, to be honest, many parents give up. The only person who loses is the child. We are talking about children and young people who need our help. That is where we as politicians come in. We set the guidelines.

Coming from one of the devolved nations as well, I fully agree with the hon. Gentleman. There are lessons to learn from those of us in Wales. I am glad that the Minister is to have a meeting with my colleagues in Autism Cymru to talk about some of the issues; we have managed to fix up a meeting. The hon. Gentleman is right to highlight the corrosive effect on young people. There has been a lot of talk in this debate about the rights of parents, and I absolutely concur with that, but we are also talking about the rights of children. That is why early diagnosis and follow-through are so important. We are stacking up huge problems for children from key stage 1 right the way through the education system and into young adulthood, as the hon. Gentleman said, if we do not address these issues at the earliest opportunity.

I thank the hon. Gentleman for his intervention. I wholeheartedly agree with what he said. May I draw attention to this issue? We have talked about parents battling, but why should parents alone have to battle on this issue? Many do not even know how to battle, and parents should not have to know how to battle. We are putting the responsibility on the parent, and if the parent does not battle, the child loses out.

The hon. Gentleman is making an excellent contribution. I was one of those parents who battled through the system, as I will say in my contribution. Does he agree that more should be done to help to support parents? Often, parents feel that they are the only ones who have ever been through this experience. There is no signposting; it is almost as though the provision that is available is a big secret. Should local authorities provide more information to parents on what is available and how to find their way through the system?

I thank the hon. Lady for her intervention. I wholeheartedly agree. Many parents are in a panic because they do not know at all how to surmount the barriers that are put in their way. They want to do the best for their children—I am speaking about those who want to do the best for their children—and want to battle for their children. Parents have come to me in tears. They say, “I’m fighting for my child, because I will not always be here. Therefore, I want to give my child the best opportunity.” Parents have come to me who are broken mentally because they have tried their best, but it seems that obstacles and barriers are always placed in their way. That is not what our society should be doing. We should be signposting the way. When we come to a barrier, there must be a way over it, if we are to have the best education for our children, and especially those with special needs.

In conclusion, I once again thank the hon. Member for Vale of Glamorgan for bringing this important issue before us. I am delighted that the Government have identified some of the issues and have proposed measures, but the proof of the pie will be in the eating.

It is a pleasure to serve under your chairmanship, Mr Brady. I congratulate the hon. Member for Vale of Glamorgan (Alun Cairns) on securing this important and timely debate. He is a passionate and assiduous advocate for his constituents, and especially for children and young people with special educational needs, and his contribution this morning further underlined that. He showed his expertise and wide knowledge, and I am confident that he will go on to make a name for himself on this issue; indeed, he probably already has this morning. I also pay tribute to other hon. Members for their excellent contributions and interventions. I welcome the fact that we have had some new faces and some new voices on this issue.

As hon. Members will know, I have responsibility for this issue as shadow Children’s Minister, but I also have a personal interest in improving provision for children and young people with special educational needs, because my son is one of those people. He displayed delayed speech development and did not utter his first word until he was three. Then, learning to read just did not happen. Despite the fact that he was obviously very bright and able, and despite my constant appeals to his teachers to help him, he was 10 years old before one amazing teacher, who understood SEN because she happened to have a son with SEN herself, eventually helped. My son was diagnosed as severely dyslexic, although highly intelligent, and he was eventually statemented.

My son missed out on six years of learning because none of his teachers spotted that he was dyslexic until he was nine, when the statementing process began. I did not spot that he was dyslexic, because I had never had a dyslexic child or come across anybody with dyslexia. Even though I was constantly asking what was wrong with my son, it was not until I met the teacher I mentioned and explored the problem with her that he was diagnosed by an educational psychologist.

My son is now thriving, having done well in his GCSEs. He got more than five grade Cs and above, but he would not have got the English baccalaureate, because dyslexics do not do foreign languages, as Members may know. At the moment, he is at college, studying a course he loves, with aspirations of going to university and taking up a career in digital games design. That shows the difference that good provision can make, but I cannot say that we got there without a fight, and hon. Members have already discussed the battles parents face. For too many children and their parents, fighting the system becomes a daily struggle.

Having had those experiences—good and bad—of the current system, I was as pleased as anyone when Ministers announced that they would review it with the intention of removing at least some of that struggle. Having finally seen the Green Paper earlier this month, I am pleased to say that I can, in principle, agree with a lot of the proposals it contains. Many of them have already been discussed, and the expansion of Achievement for All, improved teacher training and a simplified and more holistic assessment process will be positive steps, as long as the new education, health and care plans have the same legal rights as statements with regard to health and social care and not just education. I also broadly support the introduction of personal budgets, provided that there is adequate local commissioning to ensure that there is a choice of services for parents and children and specialised support to help them make their choices. In addition, those who do not want to make a choice, but want it made for them, should not be forced to make one.

Unfortunately, while the Green Paper was being consulted on and drafted, the Government’s policies across the board started to alter the landscape for SEN provision. There are now real concerns right across the sector—I have had been told about them in the numerous briefings I have received, as I am sure other Members have—that the positive proposals to come out of the Green Paper may not work in practice. For example, the Government want schools and the NHS to work more closely together at a local level, yet Ministers are forcing through legislation that will make that much more difficult.

The Government also want children’s centres to be hubs where parents can access specialist help and support for their toddlers, yet they have cut and destabilised the fund that pays for those centres. As we have heard, research by the Daycare Trust estimates that up to 250 centres will close in the coming year, with a far greater number looking to reduce opening hours or services.

In addition, the Government highlight the importance of skilled specialists such as educational psychologists and speech and language therapists, yet councils up and down the country are being forced to lose those professionals right now because of the large, top-heavy funding cuts forced on them by the Minister’s colleagues at the Department for Communities and Local Government. Unfortunately, the Green Paper does not address those realities, which will make it much harder to implement any of the positive proposals in it.

Last week, the Minister told me across the Dispatch Box that she acknowledges that councils have tough decisions to make, and we all know why that is. She said, however, that she hopes the Green Paper will improve provision across the board. I always thought that the point of being a Minister and making policy was to take decisions and make things happen, not just to hope that they do. In this case, unfortunately, I fear that the Government are intent on leaving things to chance and that a system already criticised for being a postcode lottery could become even more of one.

There are real concerns that the Government are ending the assumption of inclusion in favour of an assumption of segregation. Parents should have a choice of school based on which will be best for their child, but what choice will there be if mainstream schools are stripped of the resources to provide for varying levels of need to fund the establishment of academies and free schools?

Given that secondary schools are to be ranked according to the narrow and prescriptive requirements of the English baccalaureate—as I said, no dyslexic child will be able to achieve it, because of the foreign language element—and that the contextual value added measure will be dropped, there is a perverse incentive for head teachers to turn away or put off pupils they know will be more difficult to teach. The admissions and exclusions reforms in the Education Bill, which is currently in Committee, will make it much easier for head teachers to do that. Cuts to legal aid will leave parents struggling even to appeal such decisions.

We know that children on school action and school action plus are already 20 times more likely to be excluded than those with a statement. We know that because having that status means that the needs and progress of such children are recorded. If the support they currently receive is reduced, they will be even more vulnerable to exclusion. I therefore share many parents’ fears that the abolition of that system of recognition could mean many children with real barriers to learning finding that they are no longer able to access specialist support, with the result that they fall further behind in school or are excluded. Effectively, they will be swept under the carpet in terms of the monitoring provided for in the Special Educational Needs (Information) Act 2008. As Members may be aware, I introduced that legislation as a private Member’s Bill so that we could better monitor the progress of all children with SEN. The hon. Member for Vale of Glamorgan tried to introduce a similar Measure in the Welsh Assembly, and I was disappointed to learn that he was not successful in that endeavour.

There may well be over-identification in some instances, but it is clear that there is a lot of under-identification in others, as we have heard. We have only to consider the fact that at least 60%, and sometimes up to 80%, of young offenders are identified as having undiagnosed speech, language and communication difficulties to realise that lots of kids going through the system need help but are not being identified at all. More worryingly, they are more likely to have self-fulfilling labels slapped on them and to be told that they are naughty or lazy.

A greater focus on early identification is bound to throw up a much bigger case load, so how can the Government talk about making arbitrary cuts to the numbers of pupils receiving help? As for those pupils who would benefit from better-trained teachers and programmes such as Achievement for All, how would the Minister ensure that sufficient training and programmes are in place in every school, before sweeping away school action status?

From the feedback I have had from the sector, I could go into minute detail on many points, but I will save that for another day, because I am sure that hon. Members want to hear from the Minister. We actually have more time than usual and I want to ensure she has her full allocation.

I think we can all agree that every child deserves all the support they need to access the curriculum and develop into a capable and well-rounded adult, whether that means complex care packages, adapted teaching or an hour a week with a specialist dyslexia tutor. Whatever comes out of the consultation on the Green Paper, a promise that every child gets the support they need must be central to it.

It is a pleasure to serve under your chairmanship, Mr Brady; I think it is the first time I have been able to do so. I begin by congratulating the hon. Member for Vale of Glamorgan (Alun Cairns) on securing the debate. I am grateful to have this opportunity so soon after we published the Green Paper. It is useful to learn what hon. Members think and hear the feedback from their constituencies. The hon. Gentleman said he hoped there would be other opportunities; I do, too. As hon. Members are able to go into their constituencies and use the consultation to talk to their local groups, they will have the opportunity to bring that feedback to the House, so that we can discuss it.

I am aware that the hon. Gentleman has a long-standing interest in the subject. He also mentioned his wife; that is a real power partnership. We are grateful for the expertise he and other hon. Members brought to a good-quality debate—Members including the hon. Member for Washington and Sunderland West (Mrs Hodgson), who spoke of her experience of battling to get support for her child.

As hon. Members will be aware, the core of the reform that we are trying to bring to the system is quite radical, and it will take time to bed down and to get it right. Unfortunately, I am not able to promise that overnight we will be able to transform the experience radically for every family who has a disabled child or one with special educational needs. In some of the things that we are doing, it will take time to change attitudes and mindsets. That is why we are taking the approach of using pilots—so that we can begin to roll them out and learn from the experience.

Core to the reform is the change to a nought-to-25 system that is more continuous. I want the system to be more focused on outcomes, rather than focusing just on inputs. A lot of the tension arises partly because people get hung up on the question, “How many hours?”, rather than thinking about where we want the child and family to be in 12 months’ time. We should have that type of conversation from the outset. We should look at the child and family and ask: what are the realistic goals? Where do we want to be next year? What are the realistic goals, long term? We should then put in place the right kind of support to get children and families into that position for the long term.

I recognise the focus on outcomes, but does the Minister also recognise that parents can only guarantee the inputs to deliver the outcomes through a statement of special educational needs? Of course, it will be called something different and will have a slightly different form if the Green Paper becomes a White Paper. As I tried to highlight, if a therapist is sick or on maternity leave, provision is rarely replaced during that period. We will not achieve the outcomes unless there is a guarantee of the inputs.

I will come to the specifics of the statementing process. The hon. Gentleman’s contribution on that was helpful. It is about getting the detail right and ensuring that the system works.

I have mentioned that I want a nought-to-25 process, and that it should be more outcomes-focused. It also needs to be a joint assessment process. My hon. Friend the Member for North Cornwall (Dan Rogerson) said that the current system was too costly, often because people go through it several times—something that the hon. Member for Vale of Glamorgan also mentioned. It is very frustrating for families if they have to go through multiple assessments, telling the same story over and over again to professionals. That wastes their time and the professionals’ time. When I have listened to families speaking about their experience, I have been struck by how traumatic it is; they relive the grief they experienced when they first had the diagnosis of the disability or special educational need. Every time they tell the story, they are effectively reliving that initial trauma. When that is combined with the frustration of feeling that nobody is listening to them, it is incredibly stressful for families.

We have to streamline the assessment process, so that families go through fewer hoops, we come up with one plan into which everybody is tied, and people know who is responsible for paying for what, rather than there being an endless fight over where that responsibility sits in different sections of the statement. That picks up the point on which the hon. Member for Vale of Glamorgan ended his contribution. At the moment, unfortunately, one needs to be highly articulate and, too often, financially able, in order to get the best out of the system. That is simply not good enough. We have to make the system simpler and more straightforward, so that every family can get what their child deserves: the best possible support and care.

As a number of hon. Members have said, the current system is cumbersome, costly and inconsistent. The first thing we have tried to do is take some of the adversarial nature out of the process. Again, I cannot promise that we will never have tension between families and services providing for their child; that is not realistic. However, there is a lot we can do to reduce that, so that it does not come immediately, and so that we change the nature of the conversation from the outset.

We want to begin with the idea of a local offer, so that when someone first encounters the local authority or health service, they are not told: “Prove that you need help.” Local services should be coming to parents and saying, “This is what we normally provide; now let’s have the discussion about how we tailor that, and what we need to do for you in your situation.” That should change the relationship from the beginning. That again was a point made by the hon. Member for Vale of Glamorgan. The attempt to get people to talk at the end of the process can be unsuccessful if trust broke down right at the beginning. That was highlighted for us by the Council for Disabled Children, which spoke passionately about the need for a local offer. In areas where that has been developed, it has changed the relationship from the beginning. That has been much more fruitful; even if parents decide to go all the way through the special educational needs and disability tribunal, the nature of the conversation can be much better from the beginning.

Mainstream schools need to be clearer with families about what they would normally provide for children with a range of learning difficulties, disabilities or additional needs. At the moment, there is great inconsistency. It can be difficult for parents to work out whether their child’s needs are greater than those normally provided for in a school—the legal definition of special educational needs. As a consequence, local authorities complain that the tribunal will often make inconsistent decisions about whether a statement is required. It is not in anyone’s interest for all that to be so cloak-and-dagger. Much more can be clearer from the beginning.

The hon. Member for Vale of Glamorgan said that a lot of the detail did not work. He mentioned the tension between outcomes and incomes-focused criteria. I recognise his point, but if we begin with outcomes, it changes the nature of the discussion. We sometimes hear that families will cling to a statement that may not be suitable for their child’s needs, as those needs have changed. That is not in the interests of the family. If we can focus more on the outcomes and the support that we need to provide for a family as we move to an agreed set of goals, families are less likely to cling to unsuitable provision, and more likely to be willing to accept changes that might be right for their child. Focusing on outcomes rather than inputs requires a huge change of mindset. As I said earlier, of all the things that we are trying to do, that will probably take the longest to bed down.

My hon. Friend the Member for North Cornwall said that going around the loop repeatedly is often expensive. If we do not get children the support that they need early enough, that is also expensive; a greater, more serious intervention might be needed later. Many of the families that we spoke to, and the voluntary organisations that we worked with when drawing up the Green Paper, told us that parents use the expensive independent school not always for the education that it provides, but often because it has therapists on tap, particularly speech and language therapists. As a result of the frustration of not being able to get speech and language therapy through other means, some parents will push all the way through the tribunal for the expensive independent provision—but that, of course, comes out of the local authority’s budget, and not the health service budget. In the end, there is no incentive for local services to work together, or to provide a plan that should be paid for jointly. There would be significantly less cost to the public purse in the long term if we could get it right from the beginning.

My hon. Friend the Member for Vale of Glamorgan spoke about delays in the system. It is clearly ridiculous for small children to have to wait six months for the necessary support, because they are at a critical period in their development. Anything that we can do to speed up that process is important. I hope that the joint process, the single assessment process, will remove some of the delays. Many delays are the result of local authorities having to co-ordinate the expertise of various professionals; that is particularly so with professional input on health.

One of our first priorities, even before we get to the joint process, is the statementing process; we want people to contribute sooner, more quickly, more rapidly and more efficiently. It is not good for families to have to wait. The nub of what we are doing is reducing delay in the short term. As for the longer term, I hope that the pilots will show that having one process speeds things up. That is a key objective in getting people to work together.

The Minister rightly focuses on the cut proposed in the Green Paper from 26 weeks to 20 weeks. I referred in my speech to a delay in a tribunal taking place; it took from 10 August last year until mid-January for the case to come to the tribunal. That was far longer than it took to get the published statement. We should not forget that a case could be taken to tribunal twice—once regarding the statutory assessment, and once regarding the statement. What consideration has the Minister given to that? It would be a significant step forward if that wait was curtailed to a reasonable length.

The hon. Gentleman need not panic; I wrote everything down. I may not be able to cover every point that he raised as I cannot scribble that quickly, but he raises the very point that I wanted to deal with next.

I turn first, however, to what the hon. Gentleman said about mediation; he asked whether it would introduce extra delay. That is absolutely not the intention. When we roll it out, we want to make it clear to local authorities that the addition of mediation should not delay the process of going to the tribunal. The quality of conversation ought to be better from the outset, so I hope that the process will be more successful.

The other key point to make about mediation is that it needs to be high-quality. If people are simply going through the motions, it will add extra frustration for everyone concerned. In the Green Paper, we point to some examples of good practice, particularly in the west midlands. Independent mediation there has made a real difference to the solutions that parents are being given, and people have not had to go through the tribunal process. Parents were happier because they had much better conversations with local providers.

I turn to tribunal delays. I was concerned to hear of the example given by the hon. Gentleman. The tribunal in England aims to hear cases within 22 weeks of the appeal being registered. We regularly meet the tribunal at an official level and raise the matter with it, but we will raise the specific point that the hon. Gentleman makes. It would help to know whether the case was in England or Wales.

That is helpful. We will raise that case with the tribunal. Personal budgets were alluded to by a number of Members, particularly the hon. Member for Harlow (Robert Halfon). I hope that they will cut some of the frustration for families. They are a choice, not an obligation; families will not be obliged to take up personal budgets. We realise that not every family will want to do so, but some will believe that they would be better able to make choices about how family life was run if they had the freedom to decide how to care for their child. That needs to be trialled. Some small-scale pilots have been run for disabled children in recent years with some elements of the health budget, and we will build on that.

In the Green Paper, we are consulting on what should be included in the scheme. One suggestion is that we include school transport, which was mentioned by the hon. Member for Harlow. I hope that will give families more freedom to decide which school their children could attend. The obvious thing to include in personal budgets is key equipment such as speech and language aids, which were mentioned earlier, and wheelchairs. I have experience of this as a constituency MP, and I know from being involved with the Green Paper that delays in the provision of wheelchairs are unfortunately extremely common. Indeed, the wait can sometimes be so long that children have grown out of the wheelchair by the time it arrives. That is utterly ridiculous. It is a waste of public money, and the impact on the child can be considerable. Indeed, one child in my constituency was not able to attend school while waiting for a new wheelchair because the old one was the wrong size and was giving him sores. That is not good enough.

Another obvious candidate for a personal budget is therapy, particularly speech and language therapy. That raises the subject of adequate provision, which was mentioned by the hon. Member for Harlow. I have no doubt that the joint strategic needs assessment process needs to be better at picking up needs, from the ground upwards. The Green Paper commits the Department of Health to ensuring that the needs assessment is done in a way that responds to the needs of families with disabled children in the area. I hope that that deals with the point raised by the hon. Gentleman.

That point is crucial, and it could represent a huge step forward. We are obviously focusing on younger people, and my experience as a constituency MP is that direct payment with personal budgeting has worked for social care; there is often an element of health care as well, but at the moment that cannot be provided through primary care trusts with a direct payment model. That is incredibly frustrating, and it is a barrier to getting a package that works for families. I have had that experience with families who are caring for older people, and I believe that lessons can be learned right the way across.

Absolutely. We intend rolling that out as a legal entitlement, and that will bite on local services. Local authorities are going to have to budget, rather than agreeing to put something in a plan and then dodging the responsibility for paying for it. If parents are legally entitled to request provision—local services will not know which parents will request it—local services will have to budget for that. We expect that services will be provided on the ground, but we need to test the system with pilots to ensure that there is a bite on all services. We want to ensure that all families get the services that they have been promised, and do not find themselves in the same position as before, where something would be written in section 3 or 5 of a statement but not be provided by local health services.

My hon. Friend the Member for Ceredigion (Mr Williams) has spoken on a number of occasions about the frustration of teachers. He said that it is not only parents who are frustrated; teachers often feel inadequately prepared to work with children with a range of additional specialist needs. However, the hon. Member for Washington and Sunderland West told us that one inspirational teacher made the difference for her child. That is the point. We hear many fantastic examples of professionals who lead practice, but even one professional who believes in a child and who takes responsibility can make such a difference. They can be teachers or other professionals with whom the family come into contact. That kind of practice needs to be much more common, which is why we propose improving initial teacher training. We will use both special and mainstream schools for teaching purposes to ensure that professionals learn from the good practice of others. We will also focus on continuing professional development, using both online specialist material, some of which was launched last week, and scholarship funds to ensure that teachers and teaching assistants have access to funds to gain a greater specialism.

The point about teaching assistants is new; we have a new way of thinking about their role. As many families know, teaching assistants often have more experience than the classroom teacher of working with children with additional needs. By giving them an opportunity to develop their career, we may well bring to the teaching profession many more individuals who have a real background, interest and focus on this subject.

Let me touch on the issue of choice, to which the hon. Member for Washington and Sunderland West and my hon. Friend the Member for North Cornwall referred. The point about trying to reverse the bias is exactly about choice. If there is currently a bias in one direction or another, that is not about choice. The focus of our Green Paper is on improving choice for families, so that they can make decisions about what is best for their child. Too often, however, it ends up being Hobson’s choice, because they feel that the mainstream school does not have the capability to support their child. That is why we want a focus on teacher training and the Achievement for All pilot.

I want to focus on Achievement for All and to pick up the point about over-diagnosis raised by the hon. Member for South Antrim (Dr McCrea). Achievement for All is a pilot programme that ran in 10 local authorities and 450 schools. Schools and parents found that it substantially increased the attainment of children in schools. That was true in special schools, in which children might have highly complex needs and a statement, and in mainstream schools, in which children might be on school action or school action plus. The improvement in attainment stemmed from the quality of the interaction between the school and parents, and between teachers and the child.

Under the pilot, there is a greater focus on setting goals, on monitoring the attainment of those goals and on sharing information with families and making sure that they are involved in their child’s attainment. Head teachers said that when they used the programme it changed their mindset; it was about not money, but attitude. That attitude affected not just the children with whom teachers were working on the SEN register, but all the children in the school who had additional needs.

Some Members implied that we were arbitrarily taking children off the SEN register. Though the powers of Government are great, they are not great enough to mandate the press to report what we say accurately. Unfortunately, the press like to write about numbers. They multiplied our figures and came up with a large number that may or may not be our target. I was very clear with them at the press briefing, as I have been clear with them since, that the Government do not have a target for the number of children they want off the SEN register. What we want is schools to work with children to ensure they fulfil their potential.

When Achievement for All was rolled out in some schools, it was found that the increase in attainment was so great that children no longer needed to be on the SEN register. Surely that should be welcomed by everybody. This is not about arbitrarily reducing numbers.

I am listening with great interest to the Minister. She has clarified many of the points that have been raised. The media may have come to their conclusions because they felt that the figure of 21% of children being diagnosed with SEN was too high. I definitely read that in the media.

Unfortunately, I am not in control of what the media write. Ofsted said that too many children are diagnosed with special educational needs; it said the number could be as high as one in four. Let me repeat that we are not setting a target for the number of children we want off the SEN register.

We have changed the school action and school action plus criteria because schools said that they were bureaucratic and not very helpful. At the start of this debate, there was an exchange about whether there is a financial incentive for schools to use school action and school action plus. There is no financial incentive, because in most cases the funds are already delegated to schools. We have got rid of contextual value added, which Ofsted said was an incentive, in terms of league tables. The issue is much more complex. Teachers will sometimes label children as having SEN because they think that that is the right thing to do; we should not always assume malicious motives. Teachers believe that the right thing to do is to label a child as having SEN, whereas what they probably need to do is work closely with that child, raise their attainment, and work out what the barriers are that are preventing them from moving forward.

It is important to identify need at an early stage. This morning, Dame Clare Tickell launched her report on the review of the early years foundation stage. It will take us some time to go through the detail of her recommendations, but one of the things that she has picked up—this was also picked up in our Green Paper and by the hon. Member for Nottingham North (Mr Allen) in his review a few months ago—was whether we could make better use of the two-and-a-half-year-old check and link it with the early years foundation stage, so that we pick up need at an early age. That is particularly important for speech and language issues. Dame Clare has recommended that the new foundation building blocks of the EYFS be focused particularly on communication needs, personal, emotional and social development, and physical development. I hope that the suggestion will help improve the system for professionals working in early years.

I realise that there is very little time left. Will the Minister comment on my remarks about the blue badge issue?

I was concerned to hear the hon. Gentleman’s point about the particular difficulties that families with autism face. Families with a disabled child face complicated and diverse barriers to living a normal life, and that is an issue that should not be addressed by the Department for Education alone. I will take up his point with the Department for Communities and Local Government.

In the last couple of minutes that I have left, let me pick up on as many points as I can. The Department of Health is considering the future training and development of speech and language therapists as part of its wider consultation on the work force.

Exclusions were referred to by a number of hon. Members. The proposals laid out in the Education Bill and in the schools White Paper will substantially improve the situation for vulnerable young people because it will make schools responsible for what happens to them after they leave that school. The other proposal that we have put in our Green Paper is that if a child’s behaviour is not responding to normal behavioural management techniques, or if they are being repeatedly excluded on a short-term basis, schools should, as a matter of course, do some kind of multi-agency assessment, which could be done through the common assessment framework. They should use their local multi-agency assessment process as a system for questioning why a child’s behaviour is out of control. I hope that will reduce the number of children who end up being excluded. More importantly, we need to ensure that we put in place the right kind of support for a child, whether it is helping with a situation in their family, or with a mental health problem.

I thought that I would have loads of time to cover all the points, but that is clearly not the case. There is a long consultation period now of four months, and a long period of implementation. I am grateful to hon. Members for their points and I will ensure that they are fed into our formal consultation process. I encourage hon. Members to engage with their local parents’ forums and groups to ensure that, when we respond to the consultation, we really take into account what families and children want. It is important that we get this right because the care of those children really matters.


It is a pleasure to serve under your chairmanship today, Mr Brady.

I will start this debate with a quote:

“This place isn’t nice enough for me. I want somewhere posher, with a swimming pool if possible.”

Those are not the words of someone complaining about the gym facilities at the House of Commons. They are the words of one of London’s most prolific squatters about his latest free home in Hampstead, as reported in the Evening Standard last week. We are all covering his council tax contributions, his electricity bills and his gas bills, and we are all paying for the police to investigate each time a new break-in is reported.

As my hon. Friend the Minister stated in a recent letter to me, squatting is

“the unauthorised occupation of property belonging to another person and amounts to trespass on land”.

Some forms of trespass are criminal, such as those that take place on licensed aerodromes and railways, but I am focusing today on all the other forms of squatting. They relate to offices, flats and houses; to empty and occupied buildings, and to private and public property. These forms of squatting are unlawful but not criminal.

Squatting is a huge problem in Hove and Portslade and I have been campaigning on the issue since I was elected to Parliament. I am delighted that my hon. Friend the Minister and our right hon. Friend the Minister for Housing and Local Government have made joint announcements on the issue. I am also grateful to the organisations, such as Landlord Action, that have helped me to raise awareness of this issue around the country.

The Ministers’ announcements will be widely welcomed by those who have been adversely affected by squatters. I will make the case today that time is of the essence. The problem is getting worse, not better. However, there are two sides to this story and getting to the crux of the matter is not just about cracking down on trespassers themselves.

I wish to dispel the myth, once and for all, that squatters and homeless people are one and the same. My constituency has both wealth and deprivation. It is a Mecca for every character imaginable, which makes it such a wonderfully diverse place to live in. Homelessness is an issue locally, but we have a fantastic support network of local charities, including Emmaus, Brighton Housing Trust, Off The Fence and the YMCA, which look after a great number of vulnerable people. It is our duty to look after such people and I fully support the excellent work being carried out in this area.

Tackling homelessness is also a high priority for Brighton and Hove city council. The council is working hard to reduce the number of empty properties in the city and last year alone 168 long-term empty properties were brought back into use. In 1997, 200 council-owned properties were long-term empty but that figure is now down to just 28.

However, putting considerable resources into removing squatters and paying for the damage that they inevitably cause places a strain on council services. In the past 18 months, there have been 10 instances of squatting in council-owned properties in Brighton and Hove, which has cost local people more than £30,000 in legal bills alone. The repair bill for one particular property was £40,000, which again had to be picked up by the residents of Brighton and Hove. Squatters are damaging buildings that are in the process of refurbishment, which only exacerbates the housing shortage.

In my experience, squatters do not fit the profile of the kind of vulnerable people that we should be looking out for. I am generalising of course, but for the purpose of this discussion I want to make the point that serial squatters know the law. They submit freedom of information requests to councils to find out where there are empty buildings; they are “web-savvy” and highly resourceful; they run rings around the law, and what these professional squatters lack in respect for other people’s property they make up for in guile and tenacity. They are organised and frequently menacing.

Is my hon. Friend aware of the Shelter website, which I was quite horrified to read? As he knows, my constituency has a persistent problem of squatters. But Shelter has a guide to squatting, about how to keep on the right side of the law, on its website. Does he agree that it is reprehensible to encourage people in this illegal activity?

I thank my hon. Friend for that intervention and I very much agree with him. I will go on to make some specific points about “The Squatters Handbook” shortly.

I said that squatters know the law well but the absolute opposite is true when it comes to the public in general, who would be shocked if they knew just how powerless they are to take on squatters. Many members of the public do not find that out until it is too late. Section 6 of the Criminal Law Act 1977 makes it an offence to use violence, or threats of violence, to gain access to premises when

“there is someone present on those premises…who is opposed to the entry”.

That section is what is usually referred to as squatters’ rights, but I do not believe that it exists to assist squatting. It is in place to prevent unscrupulous landlords from using violence or intimidation to evict legitimate tenants. Squatters, therefore, have such rights only by accident.

A local resident asked me a question in my local paper, The Argus:

“If squatting is a practice that is socially unacceptable, how is leaving a property empty for more than a year any more acceptable?”

My answer is simple—it is not acceptable at all. I have contacted my local council on a number of occasions about the issue of empty buildings belonging to exploitative developers. We should be careful, though, not to embrace squatting on the principle that “our enemy’s enemy is a friend”. We must get tough on bad landlords—and soon—but buildings can be temporarily empty for all sorts of reasons and many of those reasons are entirely acceptable.

One reason why a house remains empty is the death of the occupier. Such a house can very often lie dormant for months, sometimes years, while the family and the executors sort out probate, and it can be very worrying and distressing if squatters move in during that time.

My hon. Friend makes an excellent point. Squatting can be very distressing for those who are affected by it.

Let us take the case of 40 Wilbury Villas in Hove. As I have said, Brighton and Hove city council is carrying out a huge refurbishment project on a number of properties. Those properties are public assets, which should be in use and let to those who have been deemed to be most in need of them. No. 40 Wilbury Villas is one such property and work on it was planned. However, when a particularly vigilant neighbour spotted the locks being changed, he knew that something was up. Straight away, a notice appeared on the door listing the rights of squatters. It was downhill from then on, as an endless stream of professional squatters turned up for their share of the spoils.

It is interesting that the notice on the door was selective about the laws that it mentioned. Many of the crimes that go hand in hand with squatting were conveniently left off that notice. There was nothing on the subject of breaking and entering; nothing on breach of the peace; nothing on the misuse of drugs; nothing on criminal damage; nothing on antisocial behaviour; nothing on non-payment of council tax; nothing on arson; nothing on robbery; nothing on unauthorised works to listed buildings; nothing on using utilities without contacting the suppliers, and there was certainly nothing on fly-tipping.

I have discussed the issue of squatting with Sussex police, and its powers are limited. There are not always witnesses in cases of squatting, so arrest is often difficult. Protected intended occupiers and displaced residential occupiers have some protection, but not enough. Incidentally, members of the same group of squatters that took over 40 Wilbury Villas then took over another property nearby, Park House. Once again, a historic building was damaged and as a result refurbishment of the property will now be more expensive.

Is there any way that the local authority could cut off the services to a property occupied by squatters and not reinstate those services? I understand that, such is their knowledge of the law, squatters are able to phone up and have the services reconnected. Is there not a position within the law whereby the services can be cut off right away because a payment has to be made?

The hon. Gentleman makes a good point. However, I believe that local authorities cannot cut off services. If the squatters contact the electricity suppliers legally and use the electricity legally, the police are powerless to go and arrest them. There might be some other points about non-payment that could lead to services being disconnected, but I do not believe that services can be disconnected on other grounds. However, I will be interested to hear what the Minister has to say on that point.

Mr Brady, please forgive me when I say that I was sceptical when I read that my hon. Friend the Minister and my right hon. Friend the Minister for Housing and Local Government had jointly released the guide, “Advice on dealing with squatters in your home”. The guide is actually very good and to the point, and I recommend it to anybody who owns a property that has been invaded by squatters, or to anybody who is a neighbour of a property with squatters. Squatters themselves will not need to read it. As my hon. Friend the Member for Finchley and Golders Green (Mike Freer) mentioned earlier, they have their own guide, “The Squatters Handbook”. Like the notice on the door at 40 Wilbury Villas, that handbook is sadly very selective, both when it comes to rights in the law and in its morality.

As I alluded to earlier, I have little sympathy for landlords who use loopholes in the planning system to run down buildings or for landlords who simply do not care that their properties are in a poor state. Compared to other countries, however, the UK has very few empty buildings. In Spain and Italy, more than 20% of the sorts of properties that we are discussing today were empty in 2009; in Germany, the figure was 8.2% and in France 6.1%. The current UK figure is between 3% and 4%. Among comparable countries, only the Netherlands and Sweden had lower figures, at 2.2% and 1.7% respectively. We can do better, of course, but the problem is not one of empty buildings. Business rates, council tax enforcement and compulsory purchase are all deterrents to leaving properties empty, but there is some scope for improving the system.

My recent early-day motion 1545 calling for squatting to be criminalised has attracted cross-party support. Members of the public are getting tired of hearing that squatters are getting so much for free when they themselves are struggling to get by. They are also fed up with the antisocial behaviour of, and general mess caused by, squatters. High-profile campaigns run by The Daily Telegraph and the Evening Standard are certainly helping to highlight what is really going on.

The extent of the problem was highlighted in a parliamentary question that I recently asked to determine which Departments had been affected by squatting. A number of Departments have fallen foul of squatters, including the Ministry of Justice, one of whose buildings was occupied by squatters twice in one year, with interim possession orders being sought to remove the squatters on each occasion. If the Ministry of Justice has problems, what chance have the rest of us got?

Fortunately, we do not need to look far for a solution. In Scotland, this form of trespass is already a criminal offence. I am aware that the Government have the matter under review, but I am concerned that the proposals will not go far enough. I welcome the announcement that squatting is likely to be criminalised, but the devil will be in the detail. Properties can be destroyed very quickly, and it should be possible to remove squatters instantly, as any delay results in further damage and destruction. There should be tough penalties and a criminal record.

I will end, as I began, with a worrying quote from our friend in Hampstead who wants a free swimming pool:

“Law changes will never stop us. The Government can say all they want but squatting will still go on…There is nothing they can do.”

I hope that he is wrong.

I congratulate my hon. Friend the Member for Hove (Mike Weatherley) on securing this debate on a very serious issue. Like him, I have become increasingly concerned about the distress and misery that squatters can cause to commercial property owners and home owners alike. In his excellent contribution, he identified the costs not only to individuals but to wider society, including the costs associated with enforcement by the police, and with all the public agencies that have to clean up after squatting incidents, either through the legal process or literally, when properties have been invaded. There should, therefore, be no doubt about the seriousness with which the issue is taken and the perniciousness of the crime.

I am extremely grateful for my hon. Friend’s compliments about the guidance issued by the Minister for Housing and Local Government and me. My hon. Friend came to it with a proper degree of scepticism about whether it would be of any use. I am extremely grateful that, having examined it, he has referred to its utility. That is only the first stage of the process, so let me take Members through the further action that we are contemplating.

My hon. Friend has not been alone in raising the matter, both directly with me in questions and publicly, with this debate. He is joined by our hon. Friend the Member for Chatham and Aylesford (Tracey Crouch) who came to see me before Christmas to discuss the damage that squatters caused to commercial buildings supervised by one of her constituents. The extent of the damage and the cost to her constituents are appalling. She was accompanied by Steve Cross, head of security for a development company, who made it clear that squatters were costing his company many thousands of pounds because of the direct damage to the buildings, the problems caused to neighbours with loud parties, litter and rubbish, and the amount of time it takes to sort things out—sometimes six to 12 weeks for a court order to be granted and then finally enforced. We all know that the legal process is tricky, particularly for someone coming to it for the first time, and it is almost inevitably expensive, with court costs to be borne as well.

Since Christmas, we have seen a succession of newspaper reports about squatters occupying high-value residential properties in London, and there have been reports on the consequences of squatting in local papers all around the country, including, as my hon. Friend the Member for Hove has said, in his constituency. The situation is not confined to the capital, and I suspect that the picture is similar in other large towns, but we do not have a precise idea of how many squatters there are nationwide. We do know, however, that 360 applications for interim possession orders were made in the civil courts last year. An interim possession order is an accelerated process, specifically designed for evicting squatters. It provides an indicator of how many households are blighted by squatting each year, but that figure is probably only the tip of the iceberg.

It is because we are aware of the misery that squatters can cause that we intend to strengthen the law, and consider how to strengthen its enforcement. I hope that my hon. Friend will bear with me, however, because we are yet to complete the cross-departmental process of analysing our own Ministry of Justice internal suggestions before publishing a formal consultation. We are going through the internal agreement processes. Nevertheless, I would like to leave him with a clear steer on our approach.

Is there a role for the UK Border Agency here, alongside the police? I am not saying that this is always the case, but I am aware that in some cases squatters might be in the country illegally.

I certainly hope that if there were any reliable evidence that the people involved were in the country illegally, the UKBA would be engaged in initiating appropriate proceedings to remove them from the United Kingdom. I had not considered that angle in preparing my remarks for the debate, but the obvious answer is yes, one would expect the appropriate authorities—in this case the UKBA—to be properly engaged in exercising their responsibilities, in the same way as they would be in any other circumstance.

We will want to examine the existing squatting laws to see whether they can be appropriately strengthened because, having listened to my hon. Friend the Member for Hove, the issues that were raised at Justice questions yesterday, and the conduct of the whole public debate, it is pretty clear to me where the public are on this issue and I am confident that measures to strengthen the law would have significant support.

Is the Minister considering full criminalisation of squatting as part of those measures? In my constituency and elsewhere, there are serial squatters who just move from one property to another when they are evicted. In one instance in my constituency, they kicked a hole in the wall and moved next door. The police are powerless to have any damages or continuing action taken out against the squatters. Without the criminal process, they are just moved on and then do it again.

That is, of course, one of the things that we are considering, and it has been pointed out that in Scotland squatting is a criminal offence. That offence, however, is extremely widely drawn and for that reason the tariff of punishment is extremely low. It is at the very bottom of the scale—a level 1 offence—with a fine not exceeding £200.

Perhaps I could help the Minister on that point. I understand that squatting is a criminal offence under the Trespass (Scotland) Act 1865, which states that the maximum penalty is a fine or 21 days’ imprisonment. That is a slightly firmer penalty than in the information the Minister has, and I urge the Government to adopt it.

That might have been the position in 1865, but I am afraid that the Criminal Justice Act 1982 restricted punishment to a fine not exceeding level 1, which is currently £200.

It is important to establish that penalties in Scotland are too lenient. The fine is indeed £200 for an offence. The penalty for non-payment of that fine is 21 days.

I am grateful for that clarification.

Squatting is almost inevitably accompanied by a series of criminal offences, such as criminal damage or breaking into the property in the first place. The improper use of utilities was discussed. Using someone else’s electricity is theft, subject to a maximum sentence of seven years. The unlawful abstraction of electricity is also a criminal offence, with a maximum sentence of five years. There are numerous avenues.

To lay out the picture in the time that I have left, the main criminal law provisions on squatting are set out in sections 6 and 7 of the Criminal Law Act 1977. I will deal with section 6 first, as it has given rise to the popular notion of squatters’ rights. Section 6 of the 1977 Act states that it is an offence for a person to use violence to enter a property where someone inside is opposed to their entry. The offence was designed to stop unscrupulous landlords from using violence to evict legitimate tenants, but its existence has led some squatters to display so-called section 6 notices on the door of properties notifying the property owner that it would be an offence for him to break back in.

The offence does not apply to displaced residential occupiers who break back into their own homes, but it prevents commercial property owners from breaking back into their commercial premises when someone inside objects. One option that we have been considering, therefore, is whether section 6 could be amended to give non-residential property owners the same rights as displaced residential occupiers to break back into their property. We think that that would effectively render section 6 notices meaningless. After my discussions with my hon. Friend the Member for Chatham and Aylesford, I am strongly attracted to that option.

Section 7 of the Act includes an offence that is committed where a squatter refuses to leave a home when required to do so by a displaced residential occupier or a protected intending occupier of the property. Under the current law, the squatter has a defence if they can prove either that they did not believe that the person requiring them to leave was, or was acting on behalf of, a displaced residential occupier or a protected intending occupier, or that the premises were not used mainly for residential purposes and that they were not on any part of the premises used wholly or mainly for residential purposes.

Another option that we are considering is whether that offence could be strengthened to protect other types of property owner, so that owners of non-residential property would have the same protection as displaced residential occupiers. At present it is an offence, for example, for a squatter to refuse to leave somebody’s home, but it is not an offence for them to refuse to leave a person’s place of work. I appreciate that the actions of squatters may cause serious financial hardship in either scenario and am considering whether the law should apply equally to both.

We are examining internally the potential consequences of the available options to ensure that they do not overlap with other areas, such as landlord and tenant matters. The public consultation will give us another opportunity to ensure that our proposals work as we would all wish. The necessity of ensuring that we get it right and of engaging in a proper consultation process means that we will not be able to move as swiftly as I suspect my hon. Friend the Member for Hove would like. We must also identify the appropriate legislative vehicle if legislation is required. No doubt we will hope for right hon. and hon. Friends’ assistance in getting any required legislative changes on to the statute book as soon as is practicable, but that is all for the future and depends on our conclusions.

Each option that I have described could have an impact on the criminal justice system. For example, the police and the Crown Prosecution Service might incur additional costs if asked to enforce new offences. The criminal courts might have to process a greater number of cases, although the impact might be partially offset by a reduction in civil claims. Depending on the penalty imposed for any new offence, there might also be an impact on the prison population. In the current economic climate, we must ensure that such impacts are carefully assessed and shown to be affordable. As I have said, a consultation would assist us in that process. We should be in a position to announce our plans in more detail soon.

Regardless of whatever changes we make to the law in future, we must work closely with enforcement authorities to ensure that existing offences are enforced as effectively as possible. In addition to the offences under the 1977 Act that I mentioned, the police can arrest squatters for offences such as criminal damage, burglary, theft or the unauthorised use of utilities if there is sufficient evidence of guilt. The offences all bear a maximum sentence of imprisonment. The offence of criminal damage has a maximum sentence of three months in less serious cases, rising to 10 years in the most serious cases. Burglary carries a maximum sentence of 14 years for dwellings and 10 years for other properties. For theft, the maximum sentence is seven years, and for the offence of abstracting electricity, the maximum sentence is five years’ imprisonment.

There is another offence that applies to squatters. It is an offence for a squatter to fail to leave a property within 24 hours of being served with an interim possession order and to return to the property as a trespasser within one year of the order. Interim possession orders were introduced in 1995 to make the process of gaining possession of one’s property easier and quicker. They are civil orders, but as I said, they are backed up by a criminal sanction with a maximum penalty of six months’ imprisonment. My officials are in discussions with the police to ascertain whether there are specific difficulties in enforcing those offences and how any potential barriers might be overcome.

We must also ensure that property owners have the information that they need to get squatters out of their properties as quickly and painlessly as possible. That is why we have published new guidance on the Directgov website outlining the circumstances in which squatters should be reported to the police. As my hon. Friend will have seen, the guidance also includes advice on how to apply for a possession order in the civil courts, a process that is alien to many people until they are confronted by the appalling situation of finding their property improperly occupied by squatters.

I thank my hon. Friend for bringing this issue to our attention. This debate is only the latest emanation of concern about it. I have written to many hon. Members from all parties who have raised it with me in correspondence, a series of oral and written parliamentary questions have been asked and hon. Members have sought meetings with me about it, so I am grateful for the opportunity to respond to the debate and to make it clear that the Justice Secretary and I are determined to tackle the issue and to bring relief to the victims of this particularly distressing and pernicious crime.

Sitting suspended.

NHS (Public Satisfaction)

[Hugh Bayley in the Chair]

I would like to thank the Speaker’s Office for selecting the subject of public satisfaction with the NHS for debate. I will focus on three pieces of research, and on the Government’s attempts to prevent information getting into the public domain, to prevent scrutiny of policy and to cut funding for future sources of information, all while failing to inform Parliament. The three surveys are “Public Perceptions of the NHS and Social Care” by Ipsos MORI from March 2010, the general lifestyle survey by the Office for National Statistics, and the British social attitudes survey by the National Centre for Social Research.

The first survey, “Public Perceptions of the NHS and Social Care” by Ipsos MORI, has been carried out every six months since 2000. It recently emerged that the latest results, from last year, were being withheld from the public domain. Ministers were accused of burying good news because the information clearly shows increasing levels of public satisfaction. On 22 March 2011, the Secretary of State was questioned about that by the Select Committee on Health, and particularly by my hon. Friend the Member for Walsall South (Valerie Vaz). The Secretary of State’s defence was that as previous surveys had not been released, he would not release the information from March 2010. The reality is that the previous data were only ever released following questions by the Opposition. From March 2007, the then Opposition stopped asking for the information, and we can only assume that that was because the level of public satisfaction was increasing, and it did not exactly serve their purpose to draw that information into the public domain.

I want to emphasise what my hon. Friend says. I can recount a conversation I had with a local general practitioner, who told me that in the 1980s, a constituent of mine in need of a hip replacement came to see him. He could not get her a place anywhere within the health service. My constituency is deprived, and it was impossible for her or her family to get treatment privately, so she had to suffer in silence. That would not happen nowadays. My GP, who represents my constituents, told me that that has not happened to him since the early 1990s. Is that not the evidence we need to show that the health service has improved significantly in recent years?

I agree with my hon. Friend. I have had exactly the same experience. We were both elected in 1997, and when I became an MP, I regularly had people come to see me with orthopaedic problems who had been waiting for operations for two to two and a half years. Some of them were in serious pain and unable to work. In the past few years, the complaints I have been hearing are that people have not had an operation for four or six months. It is a completely different world.

May I put the hon. Gentleman out of his misery before we start the debate on a false premise? He is absolutely right: the previous Government did not publish the 2008, 2009 and 2010 surveys, to which he refers. It may be of interest to him to know that the 2010 report was published following a written answer by the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow) in December 2010, and placed in the Library.

If the Minister will calm down a bit, I will come to that. After the Secretary of State appeared before the Health Committee, it emerged that data until 2010 had been placed in the Library, and the results until December 2009 are on the Ipsos MORI website. I was granted this debate on 24 March and the data were released the following day, Friday 25 March, on the Department of Health website. Previously, the data had not been on the Department’s website. It might be a coincidence, but it struck me that that was a fairly good time to bury good news: it was the day before 500,000 people tramped through central London on the TUC march in opposition to the cuts. The fact that the data were not initially released is unsurprising, given that polling showed a 72% satisfaction rating. Ipsos MORI concluded in the report:

“This level of satisfaction has now been recorded for over a year…suggesting that there has been a…positive shift in the public’s perceptions of the NHS. Pride in the NHS also continues to climb and is at its highest recorded level”.

Pride in the NHS is at its highest ever recorded level—an interesting statistic. We might hear a comment from the Minister about that.

The report has some very good news about public attitudes to the NHS. Why would Government, who are in control of the NHS, not want to publish such a report?

I will leave that to the Minister to answer, because I have not finished my comments about the suppression of statistics.

My story does not end with the original survey on public perceptions of the NHS. The second of the three surveys is the general lifestyle survey, carried out every year by the ONS on behalf of Government Departments, but that has had its funding withdrawn by the NHS information centre, for reasons best known to the Government. However, Sir Michael Scholar, head of the UK Statistics Authority, has warned that the decision may break the Government’s rules on consultation. I should point out that the general lifestyle survey provides statistics on public health and does not involve NHS satisfaction rates. It produces figures, information and statistics for testing Government policy and holding Governments to account; it is important that the information be available for holding Ministers to account. If the decision to withhold funding for the general lifestyle survey stands, the information will not be available to us in future.

The Department of Health also intends to withdraw funding for health and NHS satisfaction questions in the British social attitudes survey. The survey will be familiar to many Members. It is carried out annually by the NCSR, which is a pretty respected body, both nationally and internationally. The withdrawal of funding was not announced to the House of Commons, but was leaked over the weekend to Health Policy Insight, which published an interesting editorial that condemned the decision to withdraw funding in fairly colourful language.

The British social attitudes survey charts how NHS satisfaction started at 55% in 1983, which was the year the first survey was published. That plummeted to 35% by the time the Conservative Government left office in 1997. The latest satisfaction rate is 64%, which, according to John Appleby from the King’s Fund, is the highest level of satisfaction since the survey began in 1983, and part of a continuous upward trend since 2002. He said:

“The NHS must have been doing something right to earn this extra satisfaction”.

There is also an interesting quote from the director of the Nuffield Trust, Jennifer Dixon:

“I suspect that public satisfaction will decline because the pressurised financial climate will result in staff unrest, cuts, and the spectre of rationing but also because of the relaxation of some of the process targets that the public hold dear, such as waiting times.”

She continued:

“To overload reform on top of that is the problem and to do both at the same time is very risky.”

I emphasise “very risky”.

The reason for killing off such research is fairly clear. The aim is to obscure the results of Government policies so that they cannot be exposed to the proper scrutiny that we all want, and to prevent comparisons with the records of previous Governments—Labour and Tory. If the information is not available, the records of previous Governments cannot be compared with the record of this Government.

There are a number of questions that I should like the Minister to answer. Will the “Public Perceptions of the NHS and Social Care” survey by Ipsos MORI continue to be funded and to be reported on? If it is not to be continued, will the research be replaced? The research is very detailed and heavyweight. I can provide it to the Minister, although I assume he already has it. I do not intend to imply that Ministers intend to cut funding for that research, but because of other decisions, we start to wonder whether that might be the conclusion.

The Government have decided, apparently without telling Parliament, to axe funding for two other crucial pieces of independent research: the British social attitudes survey, which I mentioned, and the general lifestyle survey, conducted by the ONS, which I also mentioned. Ministers have sneaked out the information that funding is to be cut in a fairly underhand way. Many Labour Members suspect that it is being done so that we cannot draw comparisons with previous Governments. The information will not be available to allow us to say, “Government policies were working but funding has been cut, which is having an effect on public perceptions and services.”

Public perception is crucial. My impression and that of piles of research is that public perceptions are improving and are at an all-time high, but that does not satisfy Ministers, who are engaging in the biggest reorganisation of the NHS since Nye Bevan created it in 1947. If information is in the public domain showing that the public are very happy with the NHS, particularly acute and GP treatments, it does not serve the purposes of a Government who are committed to the wholesale reorganisation of one of the most beloved institutions of British society. I look forward to what the Minister has to say.

Five Members wish to speak and we have about 50 minutes for debate; they can do the calculations for themselves.

The hon. Member for Leyton and Wanstead (John Cryer) makes his own points in his own way. Both my parents started to work for the NHS on the day it came into being: my father as a doctor and my mother as a nurse. Throughout the 60-plus years of its existence there has been enormous pride in the NHS, among those who work in it and among the community as a whole.

The interesting notion advanced by the Opposition is that because people are generally satisfied with their doctors, all is well with the NHS. Of course people are overwhelmingly happy with their GPs. By and large, we have freedom of choice over our GP, and if we are not happy with services we change our GP. It is of concern that a recent survey of NHS users found that one in five failed to get a prompt GP appointment when they asked for it, but that notwithstanding it is not surprising that nine out of 10 patients are satisfied with their GP surgeries. That is not the point. The point is that we have an ageing and more complex population who will rightly make increasing demands on the NHS. Unsurprisingly, most people have greatest contact with the NHS in the last years of their lives.

I do not want to put the hon. Gentleman off his stride, but is he not slightly missing the point made by the hon. Member for Leyton and Wanstead (John Cryer), which was not simply that people are satisfied with the NHS but that they are progressively more satisfied, which is a more surprising finding, is it not?

I have not missed the point at all. The point being made by the hon. Member for Leyton and Wanstead is that nine out of 10 people are satisfied with their GPs, so somehow all is well with the NHS and nothing need change. If my hon. Friend the Member for Southport (John Pugh) had read the report of the Public Accounts Committee, chaired by the former Labour Minister of State, the right hon. Member for Barking (Margaret Hodge), he would know that it concludes that although the previous Government increased the amount of money going into the NHS that did not lead to greater outputs. The report makes sobering reading, and I am concerned that more parliamentary colleagues have not read it and that it has not received the attention in the House that it deserves.

The point effectively made by the hon. Member for Southport (John Pugh) is that satisfaction rates are not remaining level but climbing markedly. The British social attitudes survey shows that in 1983 satisfaction stood at 55% and plummeted to 35% in 1997. It is now up to 64%. According to Ipsos MORI, 90% of outpatients, 88% of inpatients and 81% of accident and emergency patients are satisfied—the highest levels ever recorded.

The hon. Gentleman, again, makes his own point in his own way. He says, and I understand him, that members of the public are satisfied with the NHS so nothing need change. I am not sure whether he has read the unanimous PAC report that was published only weeks ago, but I remind Members that it says:

“The level of hospital activity has not kept pace with the increased resources as hospitals focused on meeting national targets, but not on improving productivity, and productivity has actually fallen over the last decade…Though the increased money going into the NHS has helped to reduce waiting times, improve facilities, and deliver higher quality care, the Department promised at the same time to improve productivity. It failed and, in future, the Department needs to have a more explicit focus on improving hospital productivity if it is to deliver its ambitious savings targets without healthcare services suffering.”

Does the hon. Gentleman agree that it is notoriously difficult to measure productivity in crude terms—activity, outcomes and so on—and that the quality of the output, which perhaps reflects the greater investment of resources, is not included in the survey?

I am sorry to hear the apologia of Opposition Members, who are confronted with concerns about what is happening in the NHS. I commend to the hon. Gentleman the National Audit Office report published on 17 December 2010, “Management of NHS hospital productivity”. The NAO has no difficulty in measuring NHS productivity, and neither does the PAC. Before Opposition Members jump up, they should remember that the Labour party left the NHS with a huge, unpaid overdraft of £60 billion. It is a staggering fact that of the £65 billion of hospital building works carried out in the 13 years of the Labour Government, only £5 billion was paid for. Despite a number of very generous private finance initiative projects, the NHS still has an overdraft and must pay for £60 billion of hospital building works. The previous Government, while they may have put more money into the NHS, saw no improvement in outcomes and have left the NHS with a substantial overdraft.

As the Chair of the Health Committee, my right hon. Friend the Member for Charnwood (Mr Dorrell), has observed, even if, as intended, the Government manage to ensure that spending on the NHS is ring-fenced and runs ahead of inflation, the NHS, in the next few years, has to become substantially more efficient in how it uses its assets, and treats and looks after patients—hence the need for reforms. Let us be clear. The reforms are about cutting bureaucracy and improving patient care and have been proposed by the coalition Government to improve the NHS and to ensure that we maintain public satisfaction and support for the NHS. We need to ensure that the Health and Social Care Bill, which is going through Parliament, delivers those reforms in the best possible way.

I have no doubt that Ministers will give proper attention to the report next week of the Health Committee and that, in due course, the Government will have regard to any constructive suggestions from the other place to ensure that the Bill is as clear and effective as possible. In any health system, however, difficult decisions have to be made about how one best utilises finite resources. However much money as a country we commit to the NHS, that money will be finite. Choices will have to be made about how that money is best spent: at one end of the spectrum, about whether and in what circumstances people get treated for varicose veins; and at the other end of the spectrum about when, and how often, major and significant, complex and expensive invasive surgery takes place. It seems to me that it makes extremely good sense for those decisions to be made in a collegiate manner, on behalf of their patients, by GPs. It seems to me to make very good sense to allow GPs, individually and collegiately, to make value judgments about the quality of services being provided by individual hospital providers for their patients.

As the hon. Member for Leyton and Wanstead made clear when introducing this debate, patients trust their GPs and I see no reason why we should not, collectively, trust GPs to commission the best available services in the NHS. Critics of the reforms have sought to present them as something that they are not. However, as the Prime Minister has made clear on a number of occasions:

“we have ruled out price competition in the NHS.”

He went gone on to make it clear that

“we must avoid cherry-picking by the private sector in the NHS.”—[Official Report, 16 March 2011; Vol. 525, c. 292.]

I am happy to give way to the hon. Gentleman, but I would just make the observation that I suspect that quite a number of his colleagues wish to contribute to the debate, and that every time I allow an intervention it probably reduces the time that they have.

I am very grateful to the hon. Gentleman, both for giving way and for his valuable advice that I will hold dear to my heart.

May I just point out that, although the exposure to EU competition laws—he is referring indirectly to that—is not in the Bill, primary care trusts are officially regarded as state enterprises? As state enterprises, they are not exposed to EU competition law. The new consortia that will replace them, because they are not state enterprises, will be exposed to EU competition law, and will therefore expose the NHS, generally, to EU competition law. Does he support that?

Again, that is a slightly bizarre argument from the hon. Gentleman. There has been much talk about competition in the NHS, which is surprising as the Labour party appeared to be in favour of competition in its own election manifesto. The coalition Government have made it clear that the only competition that will exist in the NHS is competition on quality, not price. The Secretary of State could not have made that clearer in the House when he said:

“At the point when a patient exercises choice or a GP undertakes a referral, the price of providers will be the same. By extension, competition must be on the basis of quality.”—[Official Report, 16 March 2011; Vol. 525, c. 387.]

To deal with another misrepresentation, EU competition law already exists and the health reform proposals do nothing to change that. They do not, in any way, extend competition law. The Bill makes it absolutely clear that any competition can only be on quality, not on price. In any event, I find it strange that the Labour party and others suddenly seem to be coming forward to express concerns about the private sector in the NHS, when it was the previous Labour Government who, for example, in Banbury set up a privately run, privately managed, privately owned independent treatment centre and a privately managed, privately owned independent Darzi GP centre. The previous Labour Government, bizarrely, gave the private sector—because their contracting was so poor—some £250 million for operations that were never carried out. However, given that they have left the NHS with an overdraft of £60 billion, I suppose that they would consider £250 million thrown away on operations that were never actually carried out as, possibly by their standards, small change.

We have to realise, with an ageing population, more extensive treatments and new drugs becoming available, that we have to tackle bureaucracy in the NHS. We need to reform the NHS to make sure that it is as efficient and as effective as possible. We are ensuring that patients have choice—choice based on quality and from whom they receive care. There is simply no issue on this, in that the Labour Party said in its manifesto at the general election, and I am sure that the hon. Member for Leyton and Wanstead has read it:

“Patients requiring elective care will have the right, in law, to choose from any provider who meets NHS standards of quality”.

We have made it absolutely clear, under the coalition Government, that the NHS will remain free at the point of need, paid for from general taxation, and be based entirely on need, not on the ability to pay. Those are fundamental principles of the NHS. They have been fundamental principles of the NHS ever since it came into being, and the coalition parties are, I am sure, determined not to undermine, in any way, any of the rights in the NHS constitution. Indeed, the coalition Government are seeking to protect the NHS, throughout the duration of the Parliament, by increasing NHS funding by £10.7 billion. A substantial number of GP groups, all over England, have volunteered as pathfinders to demonstrate how GP commissioning can work. GPs throughout Oxfordshire are coming together to form a suitable GP consortium.

Let me tell the House what is being said by those in my constituency who are involved in the GP consortium. Local GP Dr Judith Wright, who is co-ordinating the north Oxfordshire GPs, has said:

“Andrew Lansley’s proposals will give power to local GPs to decide how that budget should be spent to meet local health needs. Priorities will be decided by doctors through a process informed by patients, local authorities, public health and secondary care”.

Dr Wright went on to observe:

“I believe that GPs are best placed to be able to meet this challenge. Collectively they know the health needs of their local population. They can act as a catalyst for change. They will have a role in deciding the destination of local services and the route to get there.”

Andrew McHugh, who is the practice manager at Horsefair surgery in Banbury, observed:

“The health budget is a finite resource. Andrew Lansley’s proposals will give power to local GPs to decide how that budget is spent in order to meet local health needs. Priorities will be decided by doctors through a process informed by democratically accountable public and patient involvement. We need to be looking for innovative ways of spending the health budget wisely.”

In a recent issue of Prospect magazine, Ali Parsa pointed out that, as a nation:

“We used to spend 3 per cent of our GDP on healthcare in the 1980s…6 per cent in the 1990s, 9 per cent now and on our way to 12 per cent.”

In the current financial climate, that is unsustainable. Business as usual is not an option. We need to review what treatments are provided to ensure they are clinically effective and cost-effective—in other words, evidence-based practice. I think that Dr Judith Wright and Andrew McHugh’s comments are extremely balanced and sensible.

I just came from a meeting of the British Medical Association about two hours ago. Its members asked me very clearly to pass this message on to the party on the Government Benches: will they please stop using the fact that GPs are becoming involved to suggest that they support the moves? They see becoming involved in terms of having no alternative—they say that it is being forced on them and that they are becoming engaged in the interests of their patients, not because they believe in what is being done.

May I suggest to the hon. Gentleman and to others that they actually start listening to what is being said? They might start by noting what was said in their own election manifesto. They might start listening to what the Prime Minister and the Secretary of State are saying on the Floor of the House of Commons, and the hon. Gentleman might as well do them the courtesy of just listening to what GPs in my constituency are saying on the record. It is clear that he is not listening. If he wishes to have a dialogue of the unlistening, that is a matter for him. The changes that the NHS needs are straightforward: less waste, more involvement, power to GPs and front-line doctors, nurses and other health professionals, and putting patients first. There is not really an intellectual divide on this matter. Indeed, the shadow Secretary of State earlier observed:

“The general aims of reform are sound—greater role for clinicians in commissioning care, more involvement of patients, less bureaucracy and greater priority on improving health outcomes”.

I could not have put it better. As for less bureaucracy, ever since the coalition Government came to office, one of the things they have cut in the NHS is bureaucracy. That has resulted in 2,000 fewer managers since the general election, but, interestingly, 2,500 more doctors.

I have every confidence in the Secretary of State for Health. He and his ministerial team, while we were in opposition, took considerable efforts to visit Banbury on a number of occasions to understand the challenges being faced by the Horton general hospital and to meet with GPs. As he observed to local GPs before the general election, GP commissioning will enable those GPs in north Oxfordshire, south Northamptonshire and south Warwickshire who wish to send their patients to the Horton hospital to do so, confident that the money will follow the patient.

Again, I do not think it surprising that the shadow Secretary of State should have observed:

“No one in the House of Commons knows more about the NHS than Andrew Lansley—except perhaps Stephen Dorrell. But Andrew Lansley spent six years in Opposition as shadow health secretary. No one has visited more of the NHS. No one has talked to more the NHS…these plans are consistent, coherent and comprehensive. I would expect nothing less from Andrew Lansley.”

If Opposition Members are not willing to listen to me, perhaps they would be willing to listen to the shadow Secretary of State.

The Secretary of State, when in opposition, visited my constituency at least three times, and I believe I am correct in saying that every member of the Government ministerial team in the Commons visited my constituency at least once, to understand the challenges and needs of hospitals such as the Horton. The Royal College of General Practitioners said that it believes that there should be more clinical commissioning. Even the British Medical Association has confirmed that it believes that GP-led commissioning is the right way forward. Indeed, the only opponents to the proposals appear to be the Labour party and the trade unions, but, given what the Labour party did when it was in office, and what it stated in its manifesto and even more recently, one can only conclude that, now that it is in opposition, it seeks to jump on every passing bandwagon, feels obliged to say whatever will keep the trade unions happy and seeks to block every sensible reform.

The views of the trade unions on all of this are as depressing as they are, perhaps, predictable, and in the category of trade union I also place the BMA. It is right to recall that the BMA opposed GP fundholding, longer opening hours for GP surgeries, which clearly would have been for the benefit of patients, and foundation hospitals. In fact, I cannot think of a single NHS reform over the years which it has not opposed, or a single one on which it has been in the vanguard.

No one pretends that health care systems around the world are facing anything other than enormous challenges. That is no less so in the UK. We need to be sure that patients and taxpayers get the best value possible for every pound spent in the NHS. We need the best possible outcomes in the NHS, whether for stroke victims, heart attack victims or those who have long-term medical conditions. The reforms are about building on the strengths of the NHS, improving it and making it better able to tackle the challenges of the 21st century. That is how we will ensure that people will rightly continue to be supportive of, and satisfied and happy with, the NHS, which we all want to be the best possible health service in the world.

I congratulate my hon. Friend the Member for Leyton and Wanstead (John Cryer) on introducing a debate on such an important subject, and on the balanced way in which he opened it. I should declare that I am the co-chair with Lord Rix of the all-party group on learning disability. It is on that subject that I wish to speak in the five or six minutes that I hope to take.

I would like to make it clear that although I shall make several criticisms of aspects of the national health service, I stand second to no one in my regard for it or, as a GMB member, in my respect for those who work for the NHS, including the trade unions. They are helping to create their big society—a meaningful society—and making the NHS something of which we are all very proud.

The learning disability group has been helped considerably by Mencap. Today, I shall rely on its research and the many conclusions that it has reached. It published “Death by indifference” in 2007. Indeed, I had a debate in this Hall when the Labour Government were in power, so I hope that I will not be regarded as party political.

The report highlighted the tragic consequences of deep-rooted institutional discrimination in the NHS against people with a learning disability. In many cases, NHS staff did not know about the specific needs of people with a learning disability and did not take the time to understand and meet those needs. People with a learning disability are some of the most vulnerable members of society and have some of the most profound health care needs. Although the Government investigated the issue in the independent inquiry led by Sir Jonathan Michael, in a poll conducted on behalf of Mencap, almost one half of doctors, or 47%, and one third of nurses, or 37%, said that people with a learning disability received a poorer standard of health care than the rest of the population. In the same poll, 39% of doctors and 34% of nurses went as far as saying that people with a learning disability were discriminated against in the NHS.

I want to deal with the NHS complaints system. The unnecessary deaths—sadly, that has been the case—of people with a learning disability do nothing to increase public confidence in the ability of the NHS to give effective care to those vulnerable members of society who are most in need of it. However, that is compounded by the malfunctioning NHS complaints system which, as a result of being time-consuming, defensive and too heavily weighted in favour of health professionals, refuses to learn from previous mistakes in order to drive up standards and increase public confidence.

Following its “Death by indifference” report, Mencap has helped a number of families through the complaints system. It is revealing that not a single family has ever said they felt that justice had been achieved through the local complaints procedure. That is due to the overwhelming desire of NHS trusts to stand up for their staff, the potential conflicts of interest when NHS staff investigate complaints made about people working in the same trust, and a fundamental lack of understanding about what learning disability is.

The same issues are evident when the complaints are escalated to the parliamentary and health service ombudsman. NHS trusts have disproportionate access to support, in comparison with the families going through the complaints process. In addition, the time scales given for complaints to be dealt with are usually longer than expected and only succeed in drawing out a family’s grief.

I would like to conclude with a few comments on this theme. In light of tragic cases of misunderstanding in administering health care to vulnerable people, public confidence in the NHS understandably has been undermined. The defensive nature of the NHS complaints system, however, means that the NHS does not learn valuable lessons which could help prevent unnecessary deaths from occurring in the future. Public and patient confidence in the NHS will be improved only with greater accountability and transparency so that people can see that efforts are being made to drive up standards. The complaints process is central to that and therefore requires a fundamental overhaul to make it a more impartial and reflective system. That is necessary to drive up health outcomes across the NHS and to increase public confidence in it.

Putting aside his conspiracy theory, I congratulate the hon. Member for Leyton and Wanstead (John Cryer) on initiating this important and timely event. I say that it is timely, but it is not timely for the poor Minister, who was unwell yesterday, and who does not look too good today. I understand that his colleague, the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), is now also smitten, so the casualties from the Committee considering the Health and Social Care Bill are on the increase.

There may be good reasons for substantial change in the NHS, and one of those that has been given is not that the public are not satisfied with the NHS, but that they should not be satisfied with it. It must be conceded, of course, that the case for radical change is lessened a little if the public are increasingly satisfied with what goes on. The hon. Gentleman has drawn attention to, and put beyond all doubt, the fact that the public are satisfied with the NHS, and we should have that important truth out in the open. Whatever we do in policy, it is important that we are evidence-led, and a wanton disregard for evidence when making policy is wicked and morally irresponsible.

If we ignore the conspiracy theory aspects of the hon. Gentleman’s contribution, it is clear that he has done the House a service by drawing attention to the truth that the public are broadly satisfied with the NHS. We cannot be as confident, however, about the explanations for that. It is most unlikely that public satisfaction is unconnected with things such as decreased waiting lists and increased investment. It is also most unlikely that it is unconnected with the dedication and skill of NHS staff, which remain no matter what politicians decide in this place.

However, satisfaction can be linked to other things, such as sentiment. Some years ago, research into the NHS produced some rather puzzling outcomes. If people in general were asked about the NHS, they had a fairly negative view, but if they were asked about their personal treatment at the hands of the NHS, they were thoroughly satisfied. That was explained by the way in which the media portrayed the NHS and the way in which stories about the NHS appeared in the media.

Another interesting bit of data, which the hon. Gentleman did not allude to, indicates that we are talking not just about a switch in what the media, and therefore the public, are saying. Reports about the NHS by NHS workers themselves have been increasingly positive. Worryingly, there was a stage when a lot of them would give a rather bad account of what was going on in the NHS when they were asked about it. Recently, the data have shown quite conclusively that people working in the NHS speak more positively about it. Such people are more immune to changes in media tone.

The debate so far, however, has been not so much about whether people are satisfied, which we can all take as read, as about whether they should be satisfied. Clearly, that depends not on whether they are satisfied with the NHS, but on whether the NHS actually does its job, which is to make people more healthy, not more satisfied. To give an example, people often feel very satisfied and contented with small maternity units, but such units sometimes have higher infant mortality rates, and outcomes are actually less satisfactory.

Patient-reported outcome measures—PROMs—sometimes show a different picture from clinical outcomes. We have mentioned independent treatment centres, and a lot of evidence seems to show that people are very satisfied with them, although the satisfaction is more to do with the catering and reception arrangements than with the clinical outcomes.

The moot question, therefore, is whether patients have reasonable grounds for dissatisfaction or satisfaction with NHS, whether or not they actually express any—always bearing it in mind that what the public are reluctant to fund, they should not complain about. However, the real question, given the funding that the public have set aside for the NHS, is whether the NHS has delivered the outcomes that people could rationally expect.

When pressed on the issue, senior Government politicians, up to and including the Prime Minister, talk about three issues: cancer and heart disease outcomes, bureaucracy and unimpressive productivity, which are presented as legitimate gripes. It is sometimes tempting to believe that politicians need to find faults in public services because they like reforming them, and I am sometimes inclined to think that we should redefine public services as anything a politician wants to reform. However, there is a need to find out whether there are any real grounds for dissatisfaction with the service we currently have. Unless we can find genuine grounds for people to be dissatisfied, whether or not they are, we should not have overly radical disturbance or upheaval in the system.

Can we make a case for public dissatisfaction? Let me briefly take the three issues I mentioned in turn. We certainly should not bang on about the cardiovascular field. I had the unnerving experience the other day of listening to the Prime Minister at Prime Minister’s questions tell the House how poor our outcomes were when set against those of comparable countries. Later, I attended an event organised by the British Heart Foundation to celebrate world-beating progress. That was a very puzzling experience. The King’s Fund has adequately exposed the myth about heart disease outcomes, and no one in the Department of Health should embarrass the Prime Minister any longer with briefings that disappoint and depress those who are better informed on this issue.

Last week, the Prime Minister notably stuck to the safer ground of cancer outcomes. To be fair, despite sharp falls in mortality among males and excellent progress on breast cancer treatment, we do not seem to excel our peers, and there is clearly work to be done. When looking at the issue, however, we should not use just the old research done by Professor Coleman 10 years ago, because the data on the issue is quite weak. If there are poor outcomes on cancer, however, it is not obvious why it therefore follows that structural and organisational upheaval is the solution, particularly as the prime cause of poor cancer outcomes, as far as I can tell, is late referral by GPs, and the prime solution is a more integrated service and strong regional clinical networks. It is a fact that we spend less on the treatment of cancer than the countries we compare ourselves with.

Turning to the other flaws, there are legitimate objects for criticism from time to time. On bureaucracy, I assume that everybody here understands that the administrative costs of running the NHS compare very favourably with those of running health systems in other parts of the world; that is not a debateable point. Even if those costs are higher than we would wish, they certainly compare favourably.

It is quite true, as the hon. Member for Banbury (Tony Baldry) and the Public Accounts Committee have said, that productivity has not increased linearly or proportionally with investment, but that is true of business sectors, too. That is a common phenomenon; every extra pound does not give us the same amount in increased productivity. The wonder is that people expect life to be that simple. If that is a real problem, however, it is a poor argument for giving GPs all the money to spend, especially when the National Audit Office research, which has been quoted, shows that giving GPs extra money under the contract would not necessarily give us a vast increase in overall productivity. If we drew a graph showing the rise in income and the outcomes at GP surgeries—I can give hon. Members copies of the PAC report—we would find a phenomenon similar to that described by the hon. Member for Banbury with respect to hospitals. There does not, therefore, seem to be quite as clear-cut a case as one might wish to justify a case for public dissatisfaction, and the public might have a case for not being as dissatisfied as all that.

I want to refer Members to an excellent document from the Commonwealth Fund, which contains up-to-date research on many health systems across the world that are comparable to that in the UK. The research includes a number of indicators that are very favourable to our system, and this is copper-bottomed research. It shows that the UK has lower than average spending; that, according to UK citizens, our system needs less changing than those of our peers—that is what people in our country say and what people in other countries do not say to the same extent; that it inspires the greatest confidence in terms of effective treatment; that it requires the citizen to fork out the fewest additional payments; and that it is among the best for quick appointments, access and diagnosis. It is not perfect, and I have not undermined the case for all sorts of changes in the NHS, but as we say in Lancashire, “Mustn’t grumble.” There is a case for looking at what we have delivered and perhaps celebrating it.

As Government, as parties and as politicians in general, we can certainly make a case for reform, and that case can be made independently of this debate. What I cannot convince myself of at the moment—indeed, none of us can—is that the public are dissatisfied with the NHS. They are not. Nor can I convince myself that they have grounds for dissatisfaction that go beyond those one would find in any health service, anywhere in the world at any time.

It might help Mr Anderson and Mr Morris if I say that the two Front Benchers have each agreed to speak for 10 minutes, which leaves a further 20 minutes for debate: 10 minutes for each of you. Mr Anderson.

I congratulate my hon. Friend the Member for Leyton and Wanstead (John Cryer) on getting this debate. Like the hon. Member for Banbury (Tony Baldry), I stand here as the son of a nurse, though she stopped work before the NHS was created. Through her lifetime she saw the improvements in the NHS. I also stand as a man whose niece is fighting for her life in intensive care in the Royal Victoria Infirmary, Newcastle. She is a young girl of 40 years old. I call her a girl because from the day she was born she has been hit by muscular dystrophy. She has needed the NHS from the first minute of her life. It has been there for every moment, as it was for one of my sisters, who sadly died at 53 of the same disease. The NHS was always there for them, never perfect, but second to none when compared with health services around the world. Those of us fortunate to have better health have always been prepared to pay to ensure that those who need help were able to get it.

Due to my experience with muscular dystrophy, I have the privilege of being the chairman of the all-party parliamentary group on the subject. That group has shown what we as parliamentarians can do together. We have come together, across the parties, and made huge improvements in the past few years in ensuring that specialist commissioning groups have worked with the all-party group here and with PCTs on the ground, making real improvements in the lives of people suffering from muscular dystrophy. We had a meeting about a month ago in this House. People came from across the country and across the political spectrum, and there were also professionals in the health service. They were all concerned about the direction of travel on which the Government are bent. Their concerns are: will they still be able to access the things they need? Will specialised commissioning groups still be able to work together to deliver the services they want? They have genuine concerns that the all-party group will take forward with the Minister as the debate continues.

This debate is about satisfaction. Why is satisfaction up? There are a number of reasons. Although I have some issues with the hon. Member for Banbury, I agree with him in that I have campaigned against the private finance initiative since before the previous Government took office, since the early 1990s, when the idea was first floated by the former Secretary of State for Health and now Lord Chancellor and Secretary of State for Justice, the right hon. and learned Member for Rushcliffe (Mr Clarke). I opposed it back then, and I have thought it the wrong direction for my Government to take over the past 13 years. The truth is that my Government had to do something.

The hon. Member for Banbury hit the nail on the head when he said that spending on health was 3% of GDP in the 1980s. We know it was 3% because people were being looked after in Victorian hospitals. As my hon. Friend the Member for North Durham (Mr Jones) regularly says, in his area people were being looked after in an old workhouse. That was not good enough for the Labour party, and it was not good enough for the people of this country. That is why we decided that over the period we would increase investment in the NHS, and we increased it by 300%. The people of this country went along with that, including when we put 1% on national insurance contributions. People supported that move because they believed in the service that the NHS delivered. We should never forget that.

During discussions on developing a more capital-intensive NHS, into which a lot of money went, we saw real moves on staff harmonisation, recognising the roles of staff and increasing the responsibilities of people at different levels in the health service. A huge amount of work went into that. While that was happening, other work was being done on improving public health across the board.

The hon. Member for Southport (John Pugh) raised the issue of productivity. It is strange how he defined productivity. I would be interested to read the report from the NAO on defining it, and I am glad that he has brought it to my attention. Productivity used to be measured in the health service by recording when an episode concluded. An episode could be concluded when someone died. A hospital where more people died was more successful in terms of productivity than one where somebody kept coming back and that episode was not concluded. That is a perverse way to look at productivity. The real measure of productivity is that there are twice as many people alive at 85 and over than there were 20 years ago. Should we not celebrate that? Is that not a productivity increase of which we can all be proud? That is the result of the work done.

I am not going to pretend the NHS is perfect. We know it is not perfect; every one of us as constituency MPs will have dealt with issues.

It is not a question of not thinking that it is perfect, but one of wanting constantly to improve it. The hon. Member for Southport (John Pugh) offered a view, with which I concur, that an individual’s experience of the NHS is different from their broad view, based on what they read in the press. The personal experience of the vast majority of people is either positive or very positive. The broad view is less so, which is hardly surprising, since the vast majority of editors of news journals in this country do not regard good news as news at all. It is also true that many people have a positive view of services they perceive to be under threat. Take the example of a local school. There is always a more positive view if it is under threat. The problem in this country is that millions of people, sadly, believe the NHS to be under threat.

I thank my hon. Friend and neighbour: I will discuss that with him later.

As a constituency MP, I have had three cases over the past six years of supporting people making complaints against the NHS. We took them as far as we could, trying to raise resolutions. However, none of those people opposed the NHS as an organisation; it was the specific treatment they had received that they were complaining about. There have actually been hugely improved outcomes, as I know from talking to thousands of ordinary folk across the constituency. How happy they are that we built—thankfully, before this Government got in—a new health and leisure centre in Gateshead. Unlike the Building Schools for the Future money, that was not stopped. We got it built before 7 May last year: thank God for that. The real people who matter—the public—are concerned about where we are going.

We should be thankful for the people who work in the NHS. I get really frustrated and annoyed when I hear coalition Members and the Secretary of State, who seems to take real pleasure in denigrating trade unionists, as if trade unionists were removed from this. The vast majority of trade unionists who represent health workers are hands-on professionals. They are not sitting in an office all day; they are at the coal face. They are not just talking about representing people; they are doing it, day in, day out. It is a disgrace that a party pretending to be the party of the big society should denigrate the people who are part of the largest voluntary group in the country. They stand up for people day in and day out. At the same time as standing up for their colleagues, they work in the service, they represent the service and they fight for the people they take care of. Their voice is important; their voice is informed and should not be ignored.

What do we see? We see Ministers refusing to listen to groups within the health service. I just picked up a report of the Second Reading, when I referred to one of those groups, the King’s Fund. Others include the Ministers’ own colleague, the hon. Member for Totnes (Dr Wollaston); the British Medical Association, denigrated here by the hon. Member for Banbury; the Royal College of Physicians; the Royal College of Nursing and the head of Arthritis Care. Every one of those has been ignored by the Government, on the basis of “We know best.”

Most Conservative Members have had a degree of education way beyond mine. However, in this debate, the words of my hon. Friend the Member for Bolsover (Mr Skinner) should be heeded, when he said that a lot of them have been “educated beyond their intelligence”. If this debate does not show that, nothing else does. The truth is that constantly over the past 13 years, health professionals have said to us, “Let us get on with the job.” The promise the Conservative party gave in opposition was that it would do exactly that; it would let them get on with the job, because there has been far too much meddling in the health service. I agree with that but, now, instead of letting them get on with the job, the Government are turning the health service upside down. Not only will it not work, it will make it much worse. It is a disgrace that it is happening.

It is a pleasure to serve under your chairmanship, Mr Bayley. I pay tribute to my hon. Friend the Member for Leyton and Wanstead (John Cryer) for securing this important debate on public satisfaction with the NHS. Some important issues have been raised by my right hon. and hon. Friends, but I will not rehearse them. Suffice it to say that we are having this debate because information has been released as the result of a debacle in the Department, and I am delighted that the information is now available. There may be a good reason for the Secretary of State wanting to keep the contents of the satisfaction report under wraps. It confirms the outstanding NHS legacy that Labour passed to the Health Secretary in 2010. He inherited a national health service that was rescued from 18 years of Tory mismanagement, and now enjoys the highest rate of public satisfaction in its history.

The Ipsos MORI survey, to which my hon. Friend the Member for Leyton and Wanstead referred, states:

“Public satisfaction with the running of the NHS remains very high at 72%. This high level of satisfaction has now been sustained for over a year making the public’s perception of the NHS a real success story.”

The real reason why the Health Secretary hoped that his Department had not published that report is that it shows him to be completely out of step with the British public. He cites his former boss, Lord Tebbit, as his political hero, but he does not understand what the public so value about the NHS. Instead, he is doing to it exactly what he did to the utilities in the 1980s, when he was working for his hero, Lord Tebbit, by applying 1980s privatisation principles and policies to the health service.

Current polls of public satisfaction with the NHS are all the more important when we consider that the revolution—that is what it is—now under way in the NHS was not described or set out for the British people until some months after the general election. The Conservative manifesto said the Conservatives would

“defend the NHS from Labour’s cuts and reorganisations”,

yet the Government are delivering a real-terms cut in spending, and a radical reorganisation that will undermine the NHS.

Nowhere did the Health Secretary explain his plan to apply 1980s-style privatisation mechanisms to the NHS; to create an economic regulator for health in the form of Monitor, costing upwards of £500 million over the lifetime of this parliament, an issue that was raised by the hon. Member for Banbury (Tony Baldry) in respect of the Government’s commitment to reduce bureaucracy; to expose the NHS to European competition law, which also applies to our utilities; or to handing the £80 billion NHS budget to private bodies with GPs as figureheads, but to which freedom of information provisions will not apply.

Instead, the Health Secretary spent the previous six years as Opposition spokesman doing everything possible to avoid giving any indication of his plans for radical change for the NHS. I am sure that there was no mention of removing the private patient cap to allow uncontrolled focus on profit-making in hospital trusts, a mechanism that will push NHS patients to the back of the queue.

The Secretary of State’s coyness had paid off, because the public, who are overwhelmingly satisfied with the NHS service that Labour had rebuilt over 13 years in government, did not suspect a thing. Health was not raised once in the last prime ministerial debate before the general election.

I want to focus my remarks on how public satisfaction, and in some areas dissatisfaction, might apply to the Health Secretary’s proposals in the Health and Social Care Bill. Now that the Ipsos MORI survey has found its way into the public domain, we may consider its implications for the current upheaval planned by the Secretary of State. Three specific polls in the survey give a clear indication of public preference for the future of the NHS, with between 63% and 65% agreeing with the following statements: first, the

“NHS provides good value for money to taxpayers”;

secondly, the

“NHS provides patients with the best treatment possible”,

and thirdly,

“people are treated with dignity and respect when they use NHS services.”

In-house NHS provision of a high quality is favoured by the public, but the Tory-led proposals in the Health and Social Care Bill threaten that. Over time, as the private sector wins contracts from NHS bodies, the NHS provider that is displaced will have to close, and there is a risk that we will be left with private companies competing with one another for multi-million pound contracts. That is the Lansley vision of the NHS, and it is completely out of step with British public opinion.

People were asked whether major changes or only minor changes were needed in their local health system. The figures for the UK show that 62% believe that only minor changes are needed, which is by far the highest figure on the graph of most of the comparable systems.

I thank the hon. Gentleman for that intervention. His point is a good one, and was well made. There is no need for the revolutionary change that we are facing.

Time is limited, so I shall conclude. Without polling and without understanding the facts, the Government would take a reckless step in the dark. If they do not consider public opinion in their annual surveys, they may end up with a shock in the biggest survey of all—the one planned for May 2015.

It is a pleasure to serve under your chairmanship, Mr Bayley. Unaccustomed as I am to being brief, the national health service is the jewel in the crown of public service provision. It was one of the greatest achievements of the post-war Labour Government. It has served this country well for two generations and, as with the hon. Member for Blaydon (Mr Anderson), my mother was a nurse who came from County Tipperary to train in a hospital here in London.

The national health service was on its knees in 1997, and was proudly rebuilt by a Labour Government. I see the benefits of that in my constituency and Birmingham as a whole in the magnificent Queen Elizabeth hospital, the health centres such as that in Stockland Green, and the walk-in centres such as those in Kingstanding and Erdington high street. They are served by outstanding staff whom I cannot praise too highly. They range from Erdington consortium of 17 doctors who are deeply committed to the NHS—my hon. Friend the Member for Blaydon is right—staff at all levels of the NHS who are a credit to this country

The problem is the Government’s two fundamental broken promises. They promised to protect spending on the NHS, but in fact there will be real-terms decreases in 143 of the 151 primary care trusts this year. The Government promised no more top-down reorganisation. Instead, they have embarked on the most radical and reckless reorganisation possible, which will have serious consequences for the NHS, and will inevitably see the national taken out of the national health service. The Government should think again about their friendless proposals, and I welcome the expressions of concern from both sides of the Chamber about the ill-thought-out, deeply damaging proposals.

It is not just the NHS that will suffer. So too will some of the most vulnerable groups in our society. Like my hon. Friend the Member for Blaydon, I have been a strong supporter of the muscular dystrophy campaign, one of many organisations which has pointed out that, at the moment, because of economies of scale organised through PCTs, we can count on specialist services that those who suffer from this dreadful wasting disease and their families badly need. It asks what will happen in future if we move to GP consortia and a complete change in the nature of the national health service. It believes that it is being let down by the Government, who are making a fundamental mistake, and I hope that they will think again.

It is an essential truth that there is mounting satisfaction with the national health service, just as there was during the Labour Government’s entire period in office. I thank my hon. Friend the Member for Leyton and Wanstead (John Cryer) for securing a debate on this important subject. It is a pleasure to serve under your chairmanship, Mr Bayley, for the first time.

It has been interesting to hear the different views expressed in this debate. We heard some interesting views from the hon. Member for Banbury (Tony Baldry), and I am glad to hear that his GPs are still speaking to him. Perhaps he should listen to a larger group of people who work in the national health service, because he will find that at the moment it is the NHS versus the Government.

I listened with interest to the hon. Member for Southport (John Pugh), and perhaps we should also put on the record the interest shown by Labour Members. Attending the debate are my hon. Friends the Members for Easington (Grahame M. Morris), for Stalybridge and Hyde (Jonathan Reynolds), for Gateshead (Ian Mearns), for Edmonton (Mr Love), for Wansbeck (Ian Lavery), for Leyton and Wanstead, for Blaydon (Mr Anderson), for Bolton North East (Mr Crausby), and for Birmingham, Erdington (Jack Dromey), and my right hon. Friend the Member for Coatbridge, Chryston and Bellshill (Mr Clarke). I shall give an honorary mention to the hon. Member for Strangford (Jim Shannon), too. I believe they would all speak with one voice: the national health service is popular. It is not perfect, but it is doing a good job. Leave it alone and do the right thing.

In 1997, only 35% of people were very satisfied with the national health service. According to the survey of British social attitudes, that figure rose to 60% under the Labour Government. The NHS became a non-political issue. The Ipsos MORI poll consistently showed that seven out of 10 people described the NHS as a key issue, but by 2009 only one in 10 people felt the NHS to be one of the most important issues for them. As a result, the Conservatives changed their strategy and tried to make the NHS a non-political issue. They tried to adopt it; I remember they did the same with green policies. I was working in the Department of Energy and Climate Change at the time, and for every new idea we thought of, the Conservatives would say, “That is a very good idea; we thought of it first.” They did practically the same thing with the health service.

The Prime Minister led the charge and spoke about the support that his family had received from front-line NHS staff. People wanted to believe him and felt sympathy for him. They understood what he was saying and wanted to believe his promise to protect the NHS. In fact, analysis has shown that attitudes to the Prime Minister changed fundamentally. He went from being seen as an ex-Bullingdon boy and a shadowy ex-adviser to Lord Lamont—

Sitting suspended for a Division in the House.

On resuming—

Before the Division, I was talking about the way in which the former Bullingdon boy and shadowy ex-adviser to Lord Lamont was transformed by his seeming commitment to the national health service. People wanted to believe that he wanted to protect public services. When the Prime Minister summed up his priorities as N-H-S, people wanted to give him the benefit of the doubt.

Before the last election, the Conservatives made two promises about the NHS. First, they promised to increase spending year on year. Secondly, in November 2009, the Prime Minister told the Royal College of Pathologists:

“With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS.”

They have broken both those promises. Although we have heard them claim that the Secretary of State for Health talked about his proposals on a wet Wednesday afternoon in Wimbledon, the people do not believe it; they were not there to hear it, they do not believe that they voted for it, and they certainly did not vote for it when they voted for the Liberal Democrats, because they believed that they were voting for elected primary care trusts when they voted Lib Dem.

The Conservatives are taking a huge risk by undermining the NHS. Nigel Lawson has said that the NHS is

“the closest thing the English have to a religion”.

People meddle with it at their peril. Going into battle with it, as the Government have done, will be toxic for them.

The Conservatives are at long last realising that they have made a profound mistake, but it is too late, because people know that introducing competition into the heart of the national health service is completely at odds with the NHS ethos of equality and co-operation. That the Conservatives are doing all this without a mandate from the people makes it even worse. Their reforms are causing profound unease among health workers and the public.

The Conservatives are so desperate to cover up and to counter opposition that they have been trying to manipulate public opinion with false statistics. To hear the Prime Minister claim that we are behind the rest of Europe on heart disease and cancer was appalling. He was corrected by Professor John Appleby, who has already been quoted. It is simply inaccurate not to put into the mix the fact that the UK had the biggest fall in heart-attack deaths between 1980 and 2006 of any European country. At that rate, we will have one of the lowest death rates for heart disease. It is a similar story for lung cancer and breast cancer—two of the other main killers. That is, of course, as long as standards continue to improve and the NHS is not distracted by things such as a major reorganisation of the entire NHS.

I am grateful to my hon. Friend for putting on the record some of the real health outcomes in this country. The hon. Member for Southport (John Pugh) summed it up when he said that even if those health outcomes were not improving, there is no causal link between that area and the reforms that the Government propose; does my hon. Friend the Member for Islington South and Finsbury (Emily Thornberry) agree?

That is right. It is a little like saying, “There are some difficulties with the national health service, so let’s change it,” without looking to see whether those changes will actually attack the problems. None of us says that the national health service is perfect. More things need to be done, but instead of building on our achievements, the Government are undermining the national health service by taking it by the ankles, turning it upside down and shaking it hard. People do not support them in doing that. Some people even heard the Prime Minister say on the “Today” programme that the national health service was second-rate. However, the penny has finally dropped for the Conservatives and they realise that they are not bringing public opinion with them when they seek to undermine the national health service in this way, so instead they have tried to suppress the information that proves that there is huge public support for our NHS as it is now, fundamentally. That is the story of what has been happening in the last few days.

To begin with, we have the unedifying spectacle of the Secretary of State saying that he will not give out certain information about what the public feel about the national health service. Then he discovers that in fact it has been given out. It is wrong of the Conservatives to suppress information about what the public think about the national health service—information that the public have paid for. It shows what their views are, and gives us a baseline before this forthcoming major trauma for the NHS. Then the Secretary of State says, “Actually, I’ve made a mistake. I gave out the information in any event.” That is the other big concern about the present Government. Not only are their reforms fundamentally driven by their ideology, but they are incompetent. There is much criticism of that.

The bottom and top of it is this: the Conservative party can do whatever they want with statistics. They can spin as they wish with whatever they want. They can say black is white until they are red—or blue—in the face, but the truth will out. The truth is that the public love their NHS. Labour gave the Government the national health service on trust. They should work on what we have achieved and tackle any outstanding problems. My hon. Friend the Member for Easington gave me this quote because he did not have time to use it, but it needs to be said as often as possible. Bevan said:

“The NHS will last as long as there are folk left with the faith to fight for it.”

The NHS does have folk willing to fight for it.

As others have said today, Mr Bayley, it is a pleasure to serve under your chairmanship.

We have had an interesting debate. Some speeches were a continuation of what has been said in the Health and Social Care Bill Committee, and they bordered on fantasy. Other speeches were extremely informative. The speech of my hon. Friend the Member for Banbury (Tony Baldry) was in the latter category, and my hon. Friend the Member for Southport (John Pugh) made a reflective and interesting speech. I listened with extreme interest, as I always do, to the right hon. Member for Coatbridge, Chryston and Bellshill (Mr Clarke), who made a typically thoughtful speech about an area of health and social care on which he is an acknowledged expert. I listened to the hon. Member for Easington (Grahame M. Morris), as I often do these days, and to the hon. Members for Birmingham, Erdington (Jack Dromey) and for Blaydon (Mr Anderson). It was rather like a curate’s egg—parts of it, depending on which hon. Member was speaking, were all right, and other parts slightly broached on to fantasy island.

I congratulate the hon. Member for Leyton and Wanstead (John Cryer) on securing this important debate. He may be surprised to hear that I am in considerable agreement with him on certain areas. I wish to clear up a number of his questions about the surveys. In an intervention on the hon. Gentleman, I alluded to the Ipsos MORI survey. There is something slightly ironic about claiming that we refused to publish it because of its content, given that the previous Government failed to publish similar surveys in 2007, 2008, 2009 and 2010. To say that they did not publish it because the Opposition did not table parliamentary questions asking for it to be published shows breathtaking gall.

The fact is that we published the March 2010 survey following a written answer in December from the Minister of State, Department of Health, my hon. Friend the Member for Sutton and Cheam (Paul Burstow), who is responsible for social care. It was placed in the Library, but it was not placed on the Department of Health website, for which I offer an apology. Some Members referred to the comments of my right hon. Friend the Secretary of State. Those statements were made in good faith but he was given the wrong advice. That is unfortunate, but he made that statement some three months after the results of the survey had been published.

The hon. Member for Leyton and Wanstead asked whether we will continue with the survey. I can tell him that a further survey has been done. It has not been completed, in so far as it has not yet been given to the Department, but that will happen in due course. What happens in future remains to be seen, as no decision has been taken on future exercises. The hon. Gentleman also mentioned the general life-style survey. Again, no decision has been taken. In light of that information, it is incorrect to say that we will not allow it to proceed.

On the question of the British social attitudes survey, things are a little more complex. The hon. Gentleman will be aware that the Department of Health is not the only Department involved; it is a cross-Government survey, and the Department of Health has some interest in it, but not exclusively so. Again, that is being considered, so I cannot give a definitive answer as to what will happen.

Many hon. Members, including the hon. Member for Leyton and Wanstead, pointed out that the last survey published by Ipsos MORI said that public satisfaction with the NHS was relatively high. That is self-evident, and I suspect that all hon. Members, as constituency MPs, will be aware of that from their constituents, their correspondence and just talking to people. As we heard, the most recent research puts overall satisfaction rates at 72%.

If we were discussing the future of any other public service, perhaps the debate would end there. However, we are not here today to discuss other public services, such as local bus services or rubbish collections, vital as they are. We are here to discuss the national health service, which for the public is literally a matter of life and death, and they have a high regard for it. People expect the NHS to be there when they are at their most vulnerable, or when their family members are in greatest need.

One cannot quantify what the NHS means to the people of this country with a smattering of national statistics, however comforting they might seem. The public have never been over-inclined to set great store by the pronouncements of politicians about the brilliance of the NHS, however familiar such pronouncements might be. However, people do not live their lives through the monochrome of MORI’s painstaking statistical analyses. They do not judge the NHS on the numbers. They judge the NHS on their experience of it; it is the NHS staff that they meet, and what they say and do, that ultimately informs their opinion.

The fact that satisfaction rates are relatively high is without doubt a tribute to the fact that those staff treat thousands of patients every day. I am sure that Members on both sides of the Chamber are united in their admiration for the work of staff across the board, and we should congratulate them on doing it day in, day out, when looking after our constituents, ourselves and our families. They do a fantastic job. We should never forget that we owe them a debt of honour and gratitude.

No. If the hon. Gentleman will forgive me, I do not have much time.

We should not kid ourselves that that is the whole story. Although some may be only too content with the fact that three quarters of people are happy with the NHS, I am not. High levels of public satisfaction are a genuine compliment to the work of NHS staff, but they do not undermine the case for modernisation or imply that the NHS is perfect or should never change. There is plenty of room for improvement, building on the high satisfaction rates that we already enjoy, as shown by the various surveys mentioned today.

The House will know that although the money going into the NHS has dramatically increased over the last decade, which I welcome, productivity has not. In fact, it has fallen by 0.2% every year since 1997. In hospitals, it has fallen further—by 1.4% a year between 1997 and 2008. However, such statistics can sound quite abstract. We should think about what they actually mean for patients.

Some of the targets and incentives in the current system are simply perverse; far from promoting good-quality care, they encourage poor care. Take maternity services. With antenatal care, the more visits or scans providers can record, the more they are paid. It is in the financial interests of the hospital to provide care on a purely reactive basis, dealing with problems as they arise, rather than preventing them from happening.

The result is poorer health outcomes for the mother and child and a bigger bill for the taxpayer. No midwife or doctor would ever organise the system in such a way. No doctor or nurse working in acute care would design a system in which a hospital would be paid for a mistake rather than be penalised for it. For example, would they pay if a patient were discharged from hospital only to be bounced back into A and E a week or so later because they were not properly treated? No health professional would choose to work in an environment in which they and their colleagues are rewarded not for how well they treat patients, but for how well they process them through the health system.

Hon. Members claim that there is no rationale for our reforms, but they are wrong. I do not claim that the NHS is failing; there is much that is good about it, and much of what it does is internationally acclaimed. None the less, if hon. Members were honest they would accept that there is room for improvement, as was shown by the Ipsos MORI poll.

I do not think that it is right that pensioners over the age of 75 in the primary care trust that serves the constituency of the hon. Member for Leyton and Wanstead are almost twice as likely to be admitted to hospital in an emergency than those over the age of 75 in Devon or Cornwall. I do not think that it is right that, in some parts of the country, people are more than five times more likely to die of heart disease.

In its current form, the NHS cannot hope to cope with the rising demand from our ageing population and the relentless rise in the cost of drugs and treatment. Our health system is no longer battling with infectious disease. The typical patient is not a young man with TB or polio, as it might have been in the 1940s, but someone who is over 75 with probably two, if not more, long-term conditions and social care needs, too. It is a very different problem that requires a very different kind of health service.

Even more importantly, as a nation, we should be aspiring to be as healthy and to live as long as our European neighbours. A recent OECD report found that, if the NHS were to perform as well as the best-performing health systems, we could increase life expectancy by three years. The argument for change could not be clearer.

The ultimate objective of modernisation is to ensure that the quality of care that people receive is on a par with the best available anywhere in the world. To do that, we need to make fundamental changes to the NHS. For example, we need to ensure that it is the GP and not a manager or civil servant in Whitehall who determines the needs and requirements of their patients. A radical extension of patient choice would allow patients to choose not only where they are treated, but which consultant-led team will treat them. Patients could choose their GP and even, where appropriate, their treatment.

There should be greater accountability and transparency in the NHS to give patients the information that they need to make choices and to drive up quality. As the Society for Cardiothoracic Surgery said only last week, publicly reporting on the performance of hospitals and surgeons treating patients with heart disease can improve mortality rates by 50%.

There should also be more independence and freedom for clinicians, so that if local health and social care professionals think that they can deliver better services to support stroke patients, they can set up a social enterprise that will do that. We will give genuine freedom to foundation trusts, so that they can strive to provide the best possible outcomes for patients.

In conclusion, there have been a lot of disingenuous statements about privatisation of the health service and the quality of care. If hon. Members are prepared to listen, I will assure them that we have no intention of privatising the health service. We just want to improve patient care.

Foreign Fishermen (Visas)

This issue is important to my constituency and many other constituencies across the United Kingdom. Along with being in the armed forces, commercial sea fishing represents the most dangerous occupation in the United Kingdom—a fact that would be confirmed by our fishermen and those who represent them. The programme “Deadliest Catch” and the film “The Perfect Storm” illustrate very clearly the issues that fishermen face each and every day.

A combination of increasing regulatory burdens and decreasing financial returns, compounded by the antisocial nature of the job, has led to local UK share fishermen drifting away from the occupation. Although there is a method in place to address the problems, we need some help moving things along, which is why I sought this debate. Although the drifting away is not a universal trend within the industry, the larger part of the fleet, comprising those trawlers targeting certain species such as cod, haddock, whiting and nephrops, has been particularly vulnerable to the trend for the past decade and more.

The take-home wage is a key concern of the fishermen. It does not always reflect the nature of the work, which has been brought into our homes by the TV series “Trawlermen”. Figures from the Sea Fish Industry Authority’s regular economic surveys of the fleet show that the average gross annual wage for a Northern Ireland-based share fisherman works out at approximately £15,000, less their tax and stamp. Other hon. Members will speak on behalf of their areas, but I suspect that the wage will be similar. Given the salaries available in other sectors, it is no wonder that many share fishermen have chosen to leave the industry.

There is a perception that share fishermen are mainly unskilled or unqualified workers, but that is not the case. Regrettably, fishermen’s skills and the qualifications that they are required by law to possess go largely unrecognised outside the fishing sector. The sea fishing industry has changed dramatically over the past few years to become a multi-million-pound industry. Skippers and their crews work on modern, sophisticated vessels and are expected to be highly skilled technicians who are able to act as efficient harvesters of the seas and to operate a range of electronic instruments for safe navigation and for finding fish. Gone are the days of throwing a net over the side of a boat to catch fish; it is much more sophisticated now.

Share fishermen in the UK are self-employed, so they have the option of looking for alternative employment in either the marine or onshore sectors. Trawler owners, on the other hand, still have a business to manage and bank loans to repay. They have a choice. Of course they will pursue every opportunity available to them to enhance the value of their catch or reduce their overheads so that the profit and consequently the crew share can be maximised. I can cite several examples from my constituency of Strangford where trawler owners are working collectively to bulk-purchase fuel and promote the local consumption of their catch. They are doing everything practically and physically possible to improve their profit margins. Despite taking such actions, crewing problems persist. Consequently, trawler owners are forced to look for alternative crewing arrangements.

The European Union and its common fisheries policy possess few positive aspects for our fishing fleet. One such aspect has been to increase the labour pool. With the expansion of the EU eastwards, many citizens of the independent Baltic states have found their way to the periphery of the Union and have been able to secure positions as crew members on board UK-based trawlers. Many of the new recruits to the UK’s fishing industry had previous fishing industry and merchant navy experience. However, they lacked the recognised qualifications required by the Maritime and Coastguard Agency. That obstacle, compounded by language difficulties, was largely overcome. None the less, significant investment was required on the part of the trawler owners, as interpreters were drafted in to assist tutors in delivering the courses that resulted in the mandatory qualifications.

Let me set out where we are, and then I will outline how we can move forward.

The hon. Gentleman has laid out very well the situation of the share fishermen. People come in from other countries to do the work of a share fisherman, and there are many jobs onshore that are dependent on their work. Barratlantic in my constituency has told me that if it loses its three overseas fishermen, it will have to lay off members of staff at its fish factory, because fewer fish will be landed. That underlines how important it is that we manage to keep those skilled men working on our boats in Scotland and Northern Ireland.

I thank the hon. Gentleman for his intervention. The wonderful thing about being an MP—apart from the privilege of being here—is that the issues that are prevalent in the area that I represent are the same as those in Scotland, England and Wales. They are not specific to my constituency alone, which is why we need the help of Westminster, the Government and the Minister.

Despite the difficulties, the first wave of immigrant fishermen addressed many of the crewing problems. However, the economic factors, which are well known to many of us across the UK, meant that many of the immigrants began to return home. UK trawler owners almost found themselves in chapter two of the crewing crisis, and that is where we are today. Consequently, trawler owners and their agents began to look further afield. In 2006, the first Filipino fishermen began to appear in fishing communities around the UK, and particularly in Scotland. The trend started in Scotland and then made its way across the rest of the UK, to England and Northern Ireland.

Filipino fishermen are different from their UK colleagues, in that they tend to be employed. In addition, as the Philippines, like the UK, is surrounded by sea, all the new recruits who came over to the UK tended to have seagoing experience, and indeed fishing experience, with qualifications that on the most part were recognised by the UK, including by the MCA. Furthermore, as I have heard for myself, their knowledge of the English language is impressive. I have spoken to some of these Filipino fishermen in the port of Portavogie, and I must say that they are very clear in what they are telling me.

The first Filipino fishermen arrived in Northern Ireland in 2007 and their numbers in the three ports along the County Down coast increased quickly. They filled, and continue to fill, an important void in trawler crews at a critical time for the industry. Access to the UK was achieved through transit visas, an important condition of which is the requirement that the vessel to which they are attached spend the majority of its fishing time outside UK territorial waters. In fact, these fishermen were not permitted to live on shore. That was probably quite a strict condition, but they none the less tried to keep to it.

As I have mentioned, the primary difference between the Filipino fishermen and other immigrant fishermen from outside the European economic area on the one hand, and UK share fishermen on the other, is that the former group are employed. As such, they have a contract of employment with the trawler owners, and those contracts carry with them obligations for the owners—obligations to do with pay, insurance cover and travel costs. The take-home pay of a British share fisherman varies from trawler to trawler and from week to week, depending on the weather and the danger that they face. Their pay is based on a share of the trawlerman’s profits. If a trawler makes no profit, then the crewmen get no salary, so it is clear that the Filipino fisherman has an advantage that the share fisherman does not. Employed crew members’ contracts stipulate a minimum weekly wage, and bonuses are then paid, which differ from trawler to trawler. Overall, however, when all the costs are accumulated, the share of the profit and the salary paid to any crew member are very similar.

However, a big difference is the fact that, from the outset, the transit visa required non-EEA fishermen to live on board the trawlers. Although their living conditions are no different from those of UK fishermen, the non-EEA fishermen do not get a break from those conditions during their contracts, which can last for several months.

In many of the ports where the Royal National Mission to Deep Sea Fishermen has a presence, immigrant fishermen have availed themselves of the mission’s facilities. Indeed, in some ports, such as Troon and Kilkeel, the mission opened mini-centres to provide rest and relaxation facilities for visiting UK fishermen and immigrant fishermen alike. As always, the mission needs to be commended for the Christian service that it provides, and the Christian witness that it bears to fishermen all over the UK. I pay tribute to it.

Unfortunately, there have been occasions when owners have been accused of abusing crew members. I will put this on record: some crew members have made certain claims. However, I met Filipino fishermen no more than a month ago in Portavogie and spoke to them, basically through an interpreter. I know that some people in this Chamber have difficulty following my accent, so I suspect that the Filipinos in Portavogie probably had even more difficulty. Fortunately, however, we had a translator, and I was able to convey to them that I would be bringing this matter to the House within a short time.

As somebody else who causes some difficulties for Hansard—I am quite proud of that fact—I would like to back up what the hon. Gentleman is saying and talk about another aspect of the issue. In my experience, fishermen who have lost a man because he has returned to the Philippines have not sought to replace him with another Filipino. They have been quite specific in wanting to get the man who they have got to know to come back and work with them. That shows the building of personal relationships, and indeed friendships of a certain kind, between men when they are out fishing together. I find that quite heartening, and it is quite the opposite of some of the scare stories. That has been my experience in this field.

I thank the hon. Gentleman again for his contribution. There is a very strong bond of friendship, loyalty, togetherness and comradeship that comes from being together on a small boat. I do not know if other Members have ever had the chance to get out on a fishing boat. If they have not, they should take the opportunity to go out in one. They would see the small section of the boat that the fishermen sleep in. If they were not claustrophobic before, they certainly would be afterwards, because it is almost incredibly small.

Whenever I have met the Filipino fishermen in Portavogie, an area that I represent back home, I have seen their commitment. When they were wanted at 4 am down in the harbour, they were there. In fact, they were there perhaps half an hour before they were going out on the boats. They were always on time and they worked hard all day. That is how they did things. As the hon. Gentleman has said very clearly, the Filipino fishermen have a strong commitment to work.

I congratulate the hon. Gentleman on securing this important debate. To back up what he has just said, one fishing boat skipper told me that if he goes to sleep at night, he wants to be sure that the person at the wheel is somebody in whom he has complete trust. The bond and the trust that are built up over a number of years are very important, and that is why there is a desire to retain these employees.

I thank the hon. Gentleman for his intervention, which highlights the fact that, right across the UK, the same issues apply to us all. It also highlights our knowledge as elected representatives of immigrant fishermen, and Filipino fishermen in particular, and the need to have them retained in the fishing industry in the areas that we represent.

The hon. Gentleman has been very kind in giving way and sharing his time. One of the difficulties that the people and the companies that want these men to return have raised with me is the cost involved. There are legal fees of £1,250 plus VAT; there are the Home Office fees of £1,000; and there is a further fee of £170 for every sponsor’s certificate issued. Does the hon. Gentleman feel that, especially at this time, those are costs that businesses should not really be facing on an almost continual or cyclical basis? Perhaps the Migration Advisory Council should seek to reclassify these fishermen and put them into the specialisms that they are quite clearly and patently qualified for.

I wholeheartedly agree with the hon. Gentleman about the costs involved. Those costs seem to increase every year, and continuously throughout the year. I am also concerned about them.

Filipino fishermen have had Filipino consular staff down to see them and speak to them about the matters that affect them. I have discussed the issue of the Filipino fishermen with the UK Border Agency on two occasions, and I had occasion to table a question for the Minister for Immigration on the subject just last year. These are important matters for us as representatives of the fishing industry, but I must say that they are even more important for the Filipino fishermen and the trawler skippers for whom they work.

During 2008 and 2009, there were extensive consultations between the UK Border Agency, industrial representatives and others. The UK Border Agency became aware of just how valuable both the non-UK fishermen and the non-EEA fishermen were to the continued safe operation of the fishing industry. That point about safety backs up the points that the hon. Members for Na h-Eileanan an Iar (Mr MacNeil), and for Argyll and Bute (Mr Reid), have made about the safe operation of boats. Whenever the skipper goes to sleep at night, he wants to be sure that the person in charge of the boat knows what they are doing. That is exactly the issue that we are discussing.

The transit visas that I mentioned were due to last some 18 months, expiring in September 2011. That is why we are having this debate in Westminster Hall today. Perhaps we can get an extension to those visas, or some concession or help from the Minister’s Department.

The hon. Gentleman has made a very good point about safety. Earlier, I talked about people getting to know each other and forming a bond. I have been told that one of the reasons why the trawler owners do not want just anybody is that it takes a person time to get used to each individual boat and to know exactly where certain ropes, anchors, grappling hooks and other pieces of equipment are, or where the hauler is controlled, on each individual boat. That is a genuine reason for keeping a man who has experience of a particular boat on that boat, rather than just seeking anybody. I have had fishing employers come to me to ensure that an individual who is skilled and trained on their boat remains on their boat. I wonder if the hon. Gentleman finds exactly the same thing in his area.

The area that I represent is exactly the same. The knowledge that is earned on one boat is perhaps slightly different to the knowledge earned on another. It takes time to get used to a boat. I mentioned that earlier, when I said that today’s fisherman has so much more to learn than his predecessors of 10, 15 or 20 years ago.

I am grateful to the hon. Gentleman for being so generous in giving way. I want to back up the point that he made. This is a highly skilled job, and it should be put on the list of occupations for which employers should be able to get work permits, as long as employers can demonstrate that they have made every effort to recruit fishermen from within the EU. In those circumstances, they should be allowed to obtain visas, particularly to retain the staff whom they already have and in whom they have trust and confidence.

I thank the hon. Gentleman for making that point, because it is the crux of the issue, and of our requests to the Minister and the Department.

Of the 1,500 visas that were allocated, only 70 were taken up. That might prompt the question, “If only 70 people took them up, do we really need them?” but the fact is we do. It was not that the interest was not there. The key experience and skills of the people involved is very important, and those who were able to fill the void before the Filipino fishermen came have now, by and large, gone back to eastern Europe. There have been, and still are, experienced and qualified fishermen working on the trawlers, and the issue today is that fishermen and employers do not want to lose that expertise come September 2011, which is what they say will happen.

On a point of information, the period when only 70 applications were taken up was before the last election, when the hon. Gentleman was not in the House. I can remember it clearly, and people came to see me on the subject. The problems were those of bureaucracy, often in Manila. What with the employment agencies and the visa-issuing authorities in Manila, it was difficult to get people out and across. Had it not been for those bureaucratic hurdles, a lot more than 70 people would have arrived.

I thank the hon. Gentleman for that clarification. Yes, that was before my time. He is absolutely right that there was a pervasive level of bureaucracy that prevented people from applying.

I am conscious of the time, and intend to bring my speech to a conclusion. It remains the case that most people signing on for the dole are dissuaded from seeking a job in the commercial fishing fleet because of the long hours, the low wages, the uncertainties of the weather and the dangers of the job. There is also the question of the investment that trawler owners need to make to train fishermen who might then choose not to stay in the job. Consequently, there is a need for non-EEA or immigrant workers to fill the gaps in onshore occupations, and a clear need for us to retain the fishermen, particularly the Filipinos.

The Migration Advisory Committee recently launched a consultation to update its shortage occupation list, and I encourage the UK fishing industry’s representatives to make representations as part of that process. That would, in basic terms, entail the monetary reward that is available to share fishermen reflecting the sacrifices they make and the skills they have. We need a long-term solution to the crewing problems that the fishing fleets face, and I encourage the UK Border Agency, together with the other agencies involved, to instigate discussions with fishing industry representatives soon. I also call on the Home Office and the UK Border Agency to review the situation regarding the temporary visas that they issued early last year. I am aware that the non-EEA fishermen to whom the visas were issued, together with the trawler owners who employ them, have acted responsibly and sensibly, and I suggest that that could and should be reflected in an extension to the September 2011 expiry date.

In Northern Ireland, as in the rest of the UK, commercial sea fishing is a valuable industry, often based in remote coastal communities. It employs highly qualified technicians, whose skill, and indeed bravery and courage, in harvesting the seas around our islands must be acknowledged. Many of our fishermen’s management responsibilities have been mistakenly surrendered to the EU, but that is a different debate for a different day. Assisting with employment in the sector is, I suggest, a small but very important way in which the House can help the industry.

It is a pleasure to be before you this afternoon, Mr Bayley. I congratulate the hon. Member for Strangford (Jim Shannon) on securing the debate, and on drawing our attention to what is a very important issue in an industry that is very important to the nations represented by Members at the other end of this room. I know that he has tabled many questions, had many meetings, and has an honourable track record in raising the issue of staff who work on these boats, and in presenting the problems that he has encountered.

The fishing industry has had to face many challenges over the years, and those challenges will continue. Non-EEA ship crews travelling to UK ports to join vessels sailing into international waters do not fall within the normal immigration rules. They enter on “to join ship” visas, which allow fresh crews to arrive in the UK and leave on the ship. As many international-going vessels may leave port with no stated destination, awaiting orders to pick up new cargo, “leaving the UK” is defined as sailing beyond the 12-mile territorial limit, and that has been exploited by the fishing industry.

In some instances such exploitation has been permissible when the vessels involved are those that traditionally fish outside the limit—the deep sea fleet. However, inshore fleet vessel owners, who fish within the 12-mile limit, have wrongly taken advantage of the loophole to illegally employ the same cheap foreign labour as their deep sea fleet counterparts, resulting in many of the 1,000 to 1,500 non-EEA fishermen in the UK fishing fleets being employed illegally on very low wages and accommodated in unacceptable conditions while in port. That led to the tragic death of two Filipinos and one Latvian in a fire on a fishing boat in 2008. Although it is right to highlight the pressures on owners in finding crews to operate their vessels, it is simply not acceptable for there to be a race to the bottom, in terms of pay and conditions for those working in the industry.

The previous Government introduced a concession to address the situation with the inshore fleet, agreeing to a quota of up to 1,500 non-renewable fisher visas, to allow the industry time to adjust. There was an 18-month period, which comes to an end in September. Visas were issued on the condition that non-EEA fishermen were paid the minimum wage, and suitable onshore accommodation was provided while they were in port. As has been mentioned, fewer than 70 applications were received before the concession closed, and I note what the hon. Member for Na h-Eileanan an Iar (Mr MacNeil) said about that being due to bureaucracy in the country of origin.

Both Her Majesty’s Government and the Northern Ireland Assembly Government are clear that people who come from overseas to work within UK territorial waters must enjoy the protections of the national minimum wage, and safe and proper accommodation. The minimum level of pay for skilled workers is £20,000. The minimum wage is circa £13,000. From what has been said, the industry believes that £13,000 is too high. In terms of having a certain standard of living and proper accommodation, the view of the Philippines Government in respect—

I do not think that anyone is saying that it is too high. What we are saying is that there are a number of jobs on land that depend on these people. I know of some men in the Philippines who have been almost in tears on the phone saying that they cannot go back to Scotland because they missed the date on the paperwork. They have lost quite a lot of money. They have been saving up and sending money to their families. They have missed an opportunity. It is a double hit for individual human beings: the people who work ashore in processing factories when product is not landed, and the individuals in the Philippines who are not getting the standard of employment that they might otherwise get.

I hear what the hon. Gentleman says, and I also heard the hon. Member for Strangford praise the work and the ability of the Filipino workers. I understand that, but it has been said that, were it not for the concession, applications would be made under tier 3 of the points-based system for non-skilled workers. There are high unemployment levels in those areas, and the hope and expectation was that, during the 18-month concession period, work would be done to encourage—

Time is short, and I need to make a bit of progress in addressing some of the points raised.

The hon. Member for Strangford raised the issue of the Home Office fees being set at £1,000. The Home Office visa fees were £470, and the legal fees were a decision for the owners themselves. Holders of concessionary visas are not required to sleep onboard the fishing boats, and should be accommodated safely onshore. The concessionary visas would not be allowed under the points-based system. As I said, they fall under tier 3 for non-skilled workers, which is now closed as a point of entry due to the situation in the local area. The Migration Advisory Committee determines the levels and advises Her Majesty’s Government. If there are skills arguments to be made, as hon. Members know, they must be made to the committee, as fishing and skills are devolved to Northern Ireland and Scotland. One key issue is that unemployment remains high across the United Kingdom and in fishing communities. It is for the industry, not Government, to work with the devolved Administrations to increase local engagement in the industry.

Those arguments were outlined by the Minister for Immigration in the previous Government. However, on reflection, he saw that the numbers were small and that the potential loss of employment onshore was great, so he reconsidered and introduced the 18-month intermediate scheme. I make a plea to the Minister to understand that the situation is, unfortunately, still with us. If we lose those men, unemployment on land will increase. As the Member of Parliament for Na h-Eileanan an Iar, the outer Hebrides, I know that it will happen. That is why I make the plea to her to reflect as much, and have as much understanding as the previous Minister for Immigration, who certainly surprised me by changing his opinion remarkably quickly to be practical and sensible. I praise him for that, as I did at the time.

I am conscious of the time. What we have is a skilled work force. We need a concession for them, and we are asking the Minister to use her position within the Department to ensure that we get it. People have tried hard to get workers to take those places. It has not worked, but we have a skilled work force. There is a spin-off onshore. If we do not catch fish at sea, we cannot do further processing on land, and that is what leads to job losses.

In my understanding, the reason that that is not possible is that the work force are designated as non-skilled. I understand what the hon. Gentleman says about the skill of the Filipinos, who are seafaring folk and understand the business, but in terms of the normal visa applications, they would be made under tier 3. The reason that people do not want to do the job is that it is cold, wet and nasty and does not pay brilliantly, not that they cannot learn the skills needed. I assure hon. Members that I am listening to their passionate pleas. I am not standing here like a stone wall; I hear the case being made. Nevertheless, I must push back a bit because of the levels of unemployment in those areas and because there has been the need for a concession.

The UK Border Agency is considering ways to ensure that all UK-based crew, including those whose journeys take them beyond the 12-mile territorial limit but not to foreign ports on a routine basis, will be properly paid and accommodated. Tier 3 of the points-based system for low-skilled labour remains closed, however. As I said, the case for changing that must be made to the Migration Advisory Committee. It is important that that case is made, as the Government can go only so far.

I recognise that the requirements of the concession may have created anomalies between the levels of payment of different fishing fleets and contracted foreign fishing workers working on the same vessels. Foreign fishers have a defined income, as was described, and certainty about income for the period of their contracts, which was obviously a difficulty, but that is coming to an end. The Government’s job—

Motor Sport (Public Highways)

I am delighted to see you in the Chair, Mr Bayley. British motor sport is Britain’s great sport success story. We often hear much about football and other sports, but British motor sport undoubtedly leads the world. One need only look at the first round of this year’s Formula 1 championship to see that although a German driver crossed the finish line in the fastest car, the car was managed, designed and built in Britain, and the team was based here. Eight out of 12 Formula 1 teams are British, as are most F1 drivers and designers. Even some of the lead designers for Ferrari, the bastion of Italian motor sport, are more often than not British.

Our great teams—Williams, McLaren and now Red Bull—have proved on the world stage not only to be forerunners of new technologies and innovators in motoring but developers of British talent. Other companies such as M-Sport and Prodrive support not only Formula 1 but rallies and many other types of sporting activity on the road. Britain is and has been a world leader in motor sport, and I hope that it will continue to be one.

Motor sport is often left behind in the great sports debate. The first few sports pages of our newspapers are often taken up by football, even when the teams are full of overseas players, managed by overseas managers, owned by overseas owners and, often, languishing in the bottom of divisions after millions of pounds spent. I hope that the Government will consider my proposal to help motor sport build on its success and go forward.

We should not forget that 95% of most motor sport is amateur and consists of people participating. It is not just about the glamour and glitz of F1 or world rallying; it is about normal rallying, hill climbing, classic cars, trailing and historical cars. Anyone who lives near or visits a motor race circuit will see that sports go on there all year round, from karting to high-performance sports. Hundreds of thousands of people enjoy motor sport in Britain.

The governing body of motor sport is the Motor Sports Association, the successor to RAC MSA. It has 200,000 members and 750 affiliated motor clubs, and every year it hosts 4,500 events. The industry that feeds into that motor sport has an amazing record, with a turnover of £6 billion a year, only £2.6 billion of which is exported. Some 4,500 companies support the sport. The research and development spend—the spend for the future that trains tomorrow’s engineers and scientists—is 30% of turnover. The aerospace industry, from which I come, would be proud of such a figure, and we should do more to encourage that.

The industries on the back of motor sport—public relations, marketing, sports industry, event management—employ 38,000 people, create another £1.7 billion in turnover and involve 25,000 engineers. That is an incredible asset for this country. Some of those engineers come from my constituency, having gone to Myerscough college, which has its own team and trains young men and women to support motor teams. Some of them have gone on to work in the top flight of world motor sport.

What is wrong with motor sport? Nothing, except that we could do more for it. We could do more to allow events to take place. The problem in England and Wales is that if we want more events, and more diverse events, to take place, we cannot use the roads and highways in the same way as the Isle of Man or Northern Ireland. To do so would mean suspending numerous provisions of the Road Traffic Act 1988. We have a midway point. Something called a traffic regulation order allows access to a road to be suspended, but the provisions of the Highways Acts still apply. Drivers must still average 30 mph on the area of road closed to the public, and rights of way still exist, meaning that unless a uniformed police officer is there to prevent Mr and Mrs Smith from carrying on their business, no one is empowered to prevent them from using it.

That is why we cannot have a Grand Prix in London or a circuit around Birmingham, although other countries can. We should do something about it. That is also why, when Birmingham did have an event, sponsored by the noble Lord Rooker, it took an Act of Parliament to suspend some of the relevant provisions. Amending the 1998 Act or building on a traffic regulation order would fit with the Government’s agenda of empowering local authorities, encouraging tourism and events and putting people in charge of their communities. Perhaps we should look at something along the lines of a traffic suspension order or something that devolves the powers to a local authority.

I am not here to ask that motor sport be allowed to impose itself on communities that do not want it or that the Government give power to an unelected governing body to decide that it wants motor sport when the local community does not. I am here to ask the Government to devolve power to local authorities, so that they can decide whether they want to host an event. That could be in Brecon, north Lancashire, where I am, or north Yorkshire—anywhere they want a rally. It is about places with rarely used lanes and roads, which desperately need inward investment, tourism or to kick-start the season, perhaps, at unfashionable times of the year. Let us empower our local authorities to do that.

I hope that local authorities will realise that they are not on their own. The governing body, the MSA, issues licences for events. In motor sport, one cannot have a race without a licence from the governing body. Along with that licence comes liability cover and all the protection from being sued or from worry about not being experts in the field that my constituents and the local authority would need. I want the Government to empower local authorities to seek events when they want to and to be able to suspend aspects of the 1988 Act, but to do so in conjunction with the people who know about motor sport. I want them to be guided and provided with liability cover, so that we can, perhaps, reap the benefits.

A change would apply not only to motor sport, but to cycling. It is bizarre that some stages of the Tour de France could not happen here if the bikes averaged more than 30 miles an hour. One might deliberately create a race on a road and that in itself could break the current highways law. Therefore, a change is also about empowering local authorities to give cycling events a proper go and getting Britain to the forefront of that sport. We need only go out on a Sunday to realise how big cycling has become. I took a Boris bike out for the first time yesterday, which is the closest I get to it, but I could not find a rack when I got to the other end, so it was a bit of disaster—I digress.

We should seek a change. It is easy and the benefits are clear. On tourism, as we can see with the Jim Clark rally in Scotland and motor sport all over the country, if we bring thousands of tourists into parts of the country that do not normally get them, it is a great thing. On the spend, Lancashire has a great link to the Isle of Man and the tourist trophy—TT—race. Every summer thousands of people pour over to the Isle of Man to see that great, historic race, and they help that island with its tourism very much. We could really benefit from that.

On promoting motor sport, we have to keep recruiting the engineers and drivers of the future. We have to remind people that motor sport is not only about Formula 1, but about local teams, local rallying and local engineering. It reminds people what can be done with engineering. People do not just have to build bridges, but can invent some of the very best in motor sport, materials and so on. It is also about community involvement, such as marshalling, and people getting involved in their area and taking part in a great event. We should not forget the circus coming to town. It is a great unifier in parts of the country.

I understand that people have sought this power since 1928. If the Government support them, and I hope they will, it will have been a long time coming. The previous Labour Government were supportive and never objected in any of my discussions with Labour Ministers, but we have not finally done the deed. I hope that we will. The First Minister of Scotland has spoken up in support of the change—no doubt eying the potential opportunities for the forests in Aberdeenshire and the Western Isles. We cannot take current venues for granted. Forestry Commission charges have a prohibitive effect on some rallying. The British leg of the world rally series is under threat due to some very prohibitive charges. We need to ensure that we are always able to offer alternatives.

I hope that the Minister gives us some good news and realises that the House has been supportive of a change, so it has cross-party support. It is a simple issue and would require bureaucratic measures. It is not a great ideological argument about policy and it is not about imposing our will on different communities. It is about giving power to local authorities, where it suits them, to engage with a successful British sport, promote it and allow all those followers of motor sport and cycling up and down the country to finally get out and race. If they cannot afford a Formula 1 car, they can still get out and race.

Let us not forget education. We can teach young men and women to drive responsibly and learn to drive high-speed performance cars, while teaching them that there is a time for racing and a time for driving on a normal road. That will have a lot of benefits. Perhaps we can divert some of the boy racers away from racing though my village at 2 am and away from tragic accidents, and encourage them to get involved in a motor sport that perhaps becomes more affordable and accessible to a lot of them. They could all play a part in it.

I look forward to the Minister’s response. I have spoken to him in the past about a change, and the Government have been supportive. It would fit with our localism agenda, the big society and with rewarding one of Britain’s great sports and industries.

I believe that this is the first time I have served under your chairmanship, Mr Bayley, since I became a Minister of the Crown, and it is a pleasure to do so this afternoon. I congratulate my hon. Friend and former colleague from the Household Division, the Member for Wear and Preston. I am disappointed that he is not wearing his regimental tie today. [Interruption.] I am sorry, I am not used to his new constituency name. I congratulate my hon. Friend the Member for Wyre and Preston North (Mr Wallace) on securing the debate and on the lobbying he has done for several months on behalf of the industry and his constituents. I hope that I have come to the debate with good news on how we can progress an issue from 1928 into legislation as soon as possible. We can tinker around the edges, but this will require primary legislation.

I would like to touch on the background. My hon. Friend is right to say that motor sport in this country has a proud history. At a recent event, which my hon. Friend attended, I had the honour and privilege to sit next to Nigel Mansell. He is a great hero in our country, who people look up to and aspire to be like. We saw what can be done in the grand prix this weekend. I was proud to be listening to the commentary of a constituent of mine, Anthony Davidson, the former driver. He is still racing, but not in Formula 1 now. It was good to hear him on the radio.

As my hon. Friend said, looking at the history, it is not only about winning, but about the teams that put together the technology and about where that technology is often applied after its use in Formula 1 and the other types of racing around the world. We talked about disc brakes and the anti-lock braking system, both of which come from Formula 1, and were not used in modern vehicles before that. The many safety features that have stemmed from Formula 1 have led to this country having the safest roads in the world.

I am very proud to be the Minister responsible for road safety, as well as for motor sport, and to be able to say in 2011 that we have the safest roads in the world. We will not be complacent, but will continue to drive down the number of deaths and serious injuries on our roads, because 2,222 deaths, by the last count, are too many. At the same time, I am proud to represent this country at road safety meetings I attend around the world, where often people want to know how they can achieve the same safety record. They look up to our record, some of which is due to the excellent education work we have done over the years on drink-driving and the wearing of seatbelts—we need to work on drug-driving—but a huge amount of it is down to technology. Many of the safety features in the vehicles we drive on the roads today come from racing and the investment made in research and development by the great manufactures of this country. That is particularly true of cars, but also of motor cycles, for which, sadly, the safety trends are going in the wrong direction.

My hon. Friend is right to touch on the fact that this is a deregulation issue. I am also Minister responsible for deregulation for the Department for Transport, as well as being the shipping Minister, the devolution Minister, the roads Minister and the roads safety Minister—I could go on. We are trying to empower local communities, not just councils, so that they can say to their council, “Look, we would like to have some sort of event in our patch next year or next week.” It is not all about having Formula 1. That event took place in Birmingham and it had to go through a complicated process, because every time such an event is proposed, an Act of Parliament has to be passed to allow it to proceed. That may have been right and proper in 1928—although I doubt it—but it certainly is not right in 2011.

Let us consider some of the events that could take place. My hon. Friend the Member for Wyre and Preston North talked about rallying as well as cars and Formula 1. When one of my constituents heard that I was responding to this debate, they reminded me that they want to have kart racing in my constituency on an empty industrial estate that has very little traffic at the weekend. We are world leaders in karting—in fact, this year’s runner-up in the British karting championship lives in my constituency. We can also consider other things, such as rallying.

I will speak to my colleagues in other Departments about why we have so much difficulty with regards state ownership—as is the case with the Forestry Commission, before it moves into whatever its future capacity will be in terms of charitable status. State ownership is impairing investment and competition in the UK. The MSA is not proposing that our streets are closed down every weekend in every town, but we have to make sure that there is confidence out there that that will not happen. We are world leaders in motor sports and in cycling. Indeed, the cycling world championships have just taken place. We might not have done as well at those as we did in the Olympics, but I am sure we will do well in 2012.

We should not create a bureaucratic hold-up for such things; instead, we need to ask how we can empower local communities to go forward. With that in mind, I am today announcing a public consultation on how we will amend the legislation, in which we want as many people as possible to participate, so that we can establish how we can deregulate the matter from central Government bureaucratic control, while ensuring that local communities do not have such things imposed on them. Those involved can perhaps come together in a consortium with the MSA, which will issue the licence for any motor sport activity. We are in a very exciting situation. The consultation, which will last for three months, will proceed from today, and I hope that many different people from across the motor sport and other racing industries come forward with innovative ideas. This country is fantastic at innovation, not just in manufacturing but in terms of ideas about how the exciting events that we see around the world can take place in this country.

I spoke to former Ministers for transport about the matter, who said that they would have liked to have dealt with the issue. I think it was on their agenda towards the end of their Administration. It is not a difficult matter, but I have to be honest and say that it will not get into this year’s legislative programme. By the time I have finished consulting, we will have to ensure that we do not interfere with local election issues or with the associated purdah. I am sure that that will not happen because it is not a party political issue; it is simply a case of how we empower local communities to do something that they want to do.

Although I wish it could be a one-clause Bill, some technical issues surround the legislation. My hon. Friend knows, because he has done his homework, that there is no point deregulating to allow races to be held when a 30 mph speed limit is still in place and so on. The right of way issue has been touched on, but, sadly, there are several other issues to consider. In such a positive debate, I do not want to bring up a load of negatives about why such races cannot take place, and I have asked my officials to consult on how we can do it. That is the reverse of what has happened since 1928.

Such an approach will be popular in some areas, but the road safety community has some proper concerns, and I understand that. All events based around racing will be licensed by the MSA, which has a fantastic track record in making sure that such events take place efficiently and safely. If what we are doing is a success—and I am sure that it will be—the biggest thing I need to convince people about is having a structured programme, so that one community that agrees early on does not have a disproportionate number of events imposed on it. We also need to ensure that the motorist, who predominantly pays for our roads, is not inconvenienced too much. That balance is something the Isle of Man has addressed very well. I have been invited to the Isle of Man TT this year but, sadly, family commitments mean that I cannot be there. I would have liked to take my Triumph across the water and, if not raced on the circuit, perhaps been pro enough to drive it, even if I would have been somewhat slower than the racers.

There are some strange legal anomalies regarding motor sport. Technically, the London to Brighton rally is not a race. If it were, we would have to pass an Act of Parliament every year so that it can take place in November. When we are proud of our heritage, that is a ludicrous situation to be in. I have not discovered why, over the years, subsequent Parliaments of all political persuasions have not dealt with the matter. I use this terminology all too often, but doing so is a no-brainer. As long as we have control and are happy that the community is the driver for this, why should Government hinder such an event? With that in mind, as I say, the consultation will last for three months.

I welcome the consultation and congratulate my hon. Friend the Member for Wyre and Preston North (Mr Wallace) on securing the debate. I am very interested in classic cars. From a historical vehicle point of view, will the Minister look at examples overseas? A great historical vehicle event called the grand prix of the ramparts takes place in Angoulême, France. Although our villages might not look exactly the same as those involved with that race, there are areas where similar events could take place. That would be a great bonus to the historical vehicle owners who would enjoy such an event.

My hon. Friend makes a sensible point. This is not about one type of vehicle; it could involve any type of vehicle. It would be up to the MSA and the local community to decide to go ahead. I have already announced that a consultation will take place on whether we can remove classic and vintage vehicles up to a certain age group from the MOT test. The MOT testers do not want to deal with such vehicles because they are trying to test modern vehicles. However, under law, they have to do an MOT test. I was in a 1911 Rolls-Royce the other day that belongs to Lord Montagu. How on earth could an ordinary MOT station dream of doing an MOT on such a vehicle? I have had the honour of being invited to drive the Mille Miglia in Italy this year, which I have to do in a British Jaguar XK150.

Is there any chance that the Minister might need someone to join him and carry his bags because my name is at the top of that list.

I am afraid that my hon. Friend might have to speak to my wife, who has very kindly allowed me to go as long as she is with me.

On a serious note, the debate has been very useful. I pay tribute to my hon. Friend the Member for Wyre and Preston North not just for securing the debate, but for being informative before it took place. That meant I had the chance to do my homework and listen to representations from the MSA and many people in my constituency. I represent one of the most socially deprived wards and one of the most affluent villages, so there is a good spectrum in terms of the excitement about such an event taking place.

Does my hon. Friend agree that what is amazing about motor sport is that the supporters are often low profile? It is only when there is an event such as this, that one receives dozens of e-mails from constituents who come out of woodwork and who one never knew were keen supporters of the sport. Such people take part in club events every weekend.

I never cease to be fascinated by how many people get up in the very early hours of the morning on a weekend to watch Formula 1, like we all did last weekend. We were even up for the practice sessions, which I am sure makes us complete anoraks, but we were up and so were millions and millions of other people. This is not a class issue. This is not about the affluent. One of the reasons why the younger chaps in my constituency tell me that they are always out and about in their go-faster cars is that they do not feel that they have an outlet. I am not saying that they are bad guys—they are not. They are just frustrated. They would like to have an outlet to give them an opportunity. This measure, especially if it is done properly—

Order. There is a Division in the House. If the Minister feels that he can finish in two minutes, I think we could run on. If he wants his full four remaining minutes, we should adjourn.

Mr Bayley, I can always take a hint, so in the space of 90 seconds I will sum up.

I congratulate my hon. Friend the Member for Wyre and Preston North yet again on securing the debate and giving me an opportunity, on behalf of Her Majesty’s Government, to wipe out, in a short period of time—a bit of patience will be needed to get the legislation right—the anomaly that has existed for so many years, since 1928. I hope that local communities will take the opportunity to work with the MSA as a licensing authority to come forward with plans. If they do not, I think everybody would understand, but I suspect that this will be a very popular measure throughout the country. I hope that we can introduce the legislation that will enable local authorities to exercise those controls.

Question put and agreed to.

Sitting adjourned.