House of Commons
Tuesday 22 November 2011
The House met at half-past Two o’clock
[Mr Speaker in the Chair]
Business Before Questions
London Local Authorities Bill [Lords] (By Order)
Consideration of Bill, as amended, opposed and deferred until Tuesday 29 November (Standing Order No. 20).
London Local Authorities and Transport for London (No. 2) Bill [Lords] (By Order)
Transport for London (Supplemental Toll Provisions) Bill [Lords] (By Order)
Second Readings opposed and deferred until Tuesday 29 November (Standing Order No. 20).
Oral Answers to Questions
The Secretary of State was asked—
We fully recognise how important front-line staff are to the provision of high-quality care. Local organisations are best placed to plan the work force who are required to deliver safe and high-quality services to patients.
Nothing has changed. As the hon. Gentleman will know, the NHS budget is a protected budget, and during the lifetime of the present Parliament it will receive real-terms increases. What the hon. Gentleman may not know is that the number of full-time equivalent clinical staff working in the NHS today is higher than it was in May 2010 and September 2009.
The reality is, of course, that the report from the Royal College of Nursing revealed that thousands of front-line nursing posts are being cut, and that last night a leaked report on commissioning revealed further bad news for front-line staff: that the Government plan to privatise large swathes of the NHS, making GPs “bit-part players”. Does it remain Government policy to promote, in the words of the report,
“a strong and vibrant market”
in the NHS, and, in the words of the Prime Minister, to
“drive the NHS to be a fantastic business”?
The report that was published at the weekend is deeply flawed. It is outrageous for an organisation to seek to scare people for the sake of cheap publicity. That report is as flawed as the report that was published a year ago. Far from there being the 50,000 cuts to which it referred, since May 2010 the number of doctors has risen by 3,500, the number of consultants by 1,600, the number of registrars by 2,100 and the number of qualified radiography staff by 549. Moreover, the number of managers and administration officers has fallen by 14,000 to release money for improved health care.
Front-line staffing levels come under particular pressure in the winter months because of the incidence of winter flu. Does my right hon. Friend welcome the news that at Kettering general hospital, almost 60% of front-line staff have now been inoculated against flu? That compares very well with last year’s national average of 35%.
I join my hon. Friend in congratulating staff at Kettering general hospital on their responsible attitude, and urge other NHS staff throughout the country to follow their example. I am heartened to note that, as a result of the planning and activity that has taken place in the NHS, more staff are having flu jabs than did so last year.
The public health White Paper “Healthy lives, healthy people” gave details of our response to the Marmot review, and addressed the social determinants of health in people’s lives. I am sure that the hon. Gentleman has read it. Yesterday we launched the University college London institute of health equity with Professor Sir Michael Marmot as its director, supported by the Department. The institute will help to promote the findings of the review across the NHS, public health and local government, and will ensure that health inequalities remain a priority.
Parts of my constituency are more than 1,200 feet above sea level. We know about the impact of cold homes and fuel poverty on health. According to the latest figures, cold has caused 25,000 excess deaths in England and Wales. What discussions has the Minister had with the Chancellor about the need to invest in making our homes warmer to reduce the number of such deaths?
I thank the hon. Gentleman for that question. He will be aware of the 27,500 excess winter deaths that occur across the country, which is an increase of 17% on the deaths that occur at other times of the year. We have invested £30 million in total—£10 million to the Department of Energy and Climate Change and £20 million that local authorities can bid for—which will help to reduce those figures. It is encouraging that despite a very harsh winter last year the number of excess winter deaths has not risen.
There is an access issue when considering the rural dimension of health inequalities. The dispensing doctors play a huge role in meeting need in rural areas, yet there are concerns about changes in regulation that have affected them. Will the Minister or one of her colleagues agree to meet me and representatives of that group to discuss their concerns?
My right hon. Friend the Secretary of State for Health has already agreed to meet some people. The hon. Gentleman is right to say that health inequalities are not just something faced by the urban poor and deprived; they are also an issue in rural areas. We must make sure that people have adequate access.
The Minister will be aware of the emphasis that Professor Michael Marmot places in his review of health inequalities—which I have read, so I can quote it—on
“giving every child the best start in life”,
“fair employment and good work for all”
and on reducing “inequalities in income”. Yet, under this Government, 90% of local councils will be forced to make cuts to Sure Start, unemployment continues to spiral—it is at a 17-year high—and, far from reducing income inequality, the House of Commons Library has calculated that an area such as mine in Hackney, which is one of the poorest in the country, will lose at least £9.6 million in cuts to housing benefit alone and a further £2.84 million through cuts to child tax credit. However desirable some of the organisational changes in public health are in principle, how can the Government possibly make progress on tackling health inequality in that context?
How can the hon. Lady give Government Members lectures on health inequalities, given that those got worse under the previous Government? Life expectancy in Kensington and Chelsea is 85 whereas it is 74 in Blackpool, and that is after 13 years of a Labour Government. Family nurse partnerships have doubled and we are well on track to get the additional 4,200 health visitors. Through the public health Cabinet Sub-Committee we are determined to raise the standard of living for all, by providing new strategies on child poverty, social mobility, tax, pension retirement ages and so on. We are doing something, whereas the previous Government did nothing.
Children's Cardiac Services
The review of children’s congenital heart services is a clinically led, NHS review, independent of government. The Joint Committee of Primary Care Trusts—JCPCT—on behalf of local NHS commissioners, will decide the future pattern of children’s heart surgery services in England. It is expected to make that decision next year.
I thank the Minister for his reply. In view of the Royal Brompton’s judicial review verdict, does he agree that it is imperative that the breakdown of the assessments of all centres and all areas is fully disclosed, so that confidence in the Safe and Sustainable review can be restored?
As the hon. Gentleman will appreciate, it is imperative that Ministers continue to remain totally independent of this review, so that we cannot be accused of interfering. As he knows, the JCPCT has said that it plans to appeal against the decision, and we will have to await the outcome of that.
I fully appreciate the degree of independence that Ministers must preserve, but is there anything that this Minister can say on the methodology of the review to reassure the children’s heart unit at Southampton general hospital, which is rated the best in the country outside London, given that the review was, at one stage, excluding the entire population of the Isle of Wight in its calculations as to whether or not the unit should be in more than one of the four options being put forward?
I am grateful to my hon. Friend for his question, although I will disappoint him by saying that I will not be led from my chosen path and start to voice an opinion. I will say, as I did say during the earlier debate that he attended, that of course it is not set in stone that there will be only four options chosen, as and when—the number could be more. That is dependent on the consultations and the decision of the JCPCT, but he will appreciate that I cannot seek to influence those decisions.
NHS Hospital Debt
Although the overall financial position remains healthy, we will continue to focus on the small number of organisations in the NHS that are struggling to manage their finances. We are working to help all NHS trusts to be sustainable providers of high-quality health care and move forward to foundation trust status. That will include, where appropriate, agreeing solutions to resolve the regrettable legacy of debt from the previous Government.
Despite the fact that the staff of the Royal Cornwall Hospitals NHS Trust have made big strides forward in improving patient care while delivering efficiency savings, the trust is saddled with historic debt, largely as a result of Labour accountancy measures. Does my right hon. Friend agree that that is grossly unfair and will he meet me to find ways of writing off the remaining Labour debt so that my constituents can stop worrying about the future of the only acute hospital in Cornwall?
I am grateful to my hon. Friend and completely concur. I have had the privilege of visiting Treliske hospital and seeing the good work that is being done there. In the course of the last financial year, the trust returned a surplus and it is projecting a surplus this year. As she knows, it has a legacy of debt that is being financed by a working capital loan. As with other NHS trusts, we are looking to ensure that through the process of becoming a foundation trust it will move from having legacy debts from the previous Government’s regime to being financially sustainable year-on-year while meeting the viability and balance sheet criteria for foundation trust status.
When will the Secretary of State get a grip and sort out the problems of PFI long-term funding—[Laughter]—given the fact that Ministers promised to do that six months ago and that we are no nearer a resolution than we were before?
I do not know whether Hansard will record it, but the mirth with which that remark was met is an indication from Members that they know perfectly well, as the hon. Gentleman ought to know, that the previous Labour Government left a terrible legacy of unaffordable PFI projects that were poor value for money when they were introduced. He knows perfectly well the position his local trust has been put in. We are working through that, and out of the work that has been done to resolve that poor legacy, we identified 22 NHS trusts which said that their PFI was an impediment. We are working with all of them to resolve that.
Public Health Funding
For the first time, public health money will be ring-fenced and from April 2013 local authorities will receive that ring-fenced public health grant, targeted at areas with high population need and weighted for inequalities. In the preceding year—that is 2012-13—the shadow allocation will be published to allow local authorities to plan for the following year.
As the Minister knows, public health problems are much more acute in areas of high deprivation. Wolverhampton primary care trust has been incredibly successful in reducing teenage pregnancies and increasing childhood nutrition. Will she reassure me in detail on exactly what weighting will be given to deprivation so that that good work in Wolverhampton can continue?
We have commissioned advice from the independent Advisory Committee on Resource Allocation and recently completed a survey of current NHS spend on public health. As the hon. Lady says, allocation needs to be weighted for inequalities and we are particularly keen that the committee develops a formula that captures within-area deprivation, which has been an issue in the past. Otherwise, affluent areas with pockets of deprivation tend to be ignored. If we want to improve the health of the poorest fastest, we must consider the heath need and deprivation.
Will the Minister reassure my constituents that when the money is transferred to local authorities, the staff will also be transferred from the NHS to those local authorities? Will there be sufficient resource within them to keep employing some of the excellent staff who currently work in the NHS?
The hon. Gentleman is right to draw attention to the excellent work that has been done despite the fact that public health budgets have not previously been ring-fenced. Indeed, what we have seen previously is PCTs raiding public health budgets for service provision, which is one reason why inequalities in health have got worse. It is extremely important that we transfer expertise, and employment law will ensure that all the transition is managed smoothly.
We are having problems getting reports published by the Department of Health. Will the Minister tell us about the public health outcomes framework by which we will measure progress in tackling and reducing health inequalities? What does the fact that the framework still has not been published say about the Government’s commitment to reducing health inequalities?
I am sure that the hon. Gentleman would not want us to rush this. It is extremely important that for the first time we will have a public health outcomes framework. There was no such framework under the previous Government, so it is important that we get it right. It will be an important signal to local authorities about what we expect them to achieve—with, as I have said, a focus on improving the health of the poorest fastest.
As we transfer public health responsibilities to local Government—something that has been very broadly welcomed—is it not important that in addition to a clear definition of the funds that are going to be transferred, subject to a ring fence, we also have a clear definition of the responsibilities that local authorities will be expected to discharge in the new world? When can we expect that definition to be put into the public arena?
My right hon. Friend is absolutely right. Conditions will be attached to the ring-fenced money to determine how it can be spent, but any expenditure will need to refer to promoting or protecting public health. I hesitate to use the word “shortly”, which the previous Government used on many occasions, but it will be published along with the outcomes framework. It is important that we get it right.
Will the Minister join me in congratulating Kent county council and Dover district council on their enthusiasm for taking over public health responsibilities and on the fact that they are looking at how to expand the resources that are available by considering the co-commissioning of social services with local GPs? Finally, may I inject a note of caution about the new community health trusts?
I am happy to join my hon. Friend in congratulating Kent county council. As he rightly points out, these moves have been welcomed by many local authorities, many of which already do much to improve the health and well-being of their populations. It is extremely important that councils are eager to start, as I know they are, and eager to get that money and see the public health outcomes framework so that they can build on some of the good work they have already done.
Yes, this is not only about resources, as my hon. Friend rightly says. Some 60% of adults are overweight or obese, and those figures are even higher in some areas. It is extremely important not only that any money is followed by that public health outcomes framework, but that it is effective. This is not something we can simply chuck money at, as the previous Government did.
I have commissioned Skills for Health and Skills for Care in partnership with employers, unions, regulators, educators and others to develop a code of conduct and minimum training standards for health care support workers and adult social care workers in England. This will give employers and patients confidence in the employment and standards of staffing at all levels. I expect the final report and recommendations by September 2012.
The Secretary of State knows that I believe in less, not more, regulation, but given the increasing role and responsibilities of health care assistants, particularly with the elderly, does he agree that the time has come both to recognise their increased responsibilities and to provide safeguards at a national level by requiring them to be on a national register?
My hon. Friend will know that health care and social care support workers do responsible jobs and that the responsibility for them lies principally with their employers and the staff who supervise them. We made provision in the White Paper we published last December for a process of assured voluntary registration. What I announced and referred to a moment ago will give a code of conduct and standards that will form a basis for an assured voluntary registration scheme in future.
One key care standard is the time that people have to wait for their treatment. Labour got waiting times down to an historic low, and we warned the Secretary of State what would happen if he relaxed the 18-week standard. Figures show that the number of patients waiting longer than 18 weeks is up by 43% and, despite the U-turn that the Government have made on the use of targets, is not the problem that they have been so fixated on their top-down reorganisation that they lost control of waiting lists? Surely it is time for them to drop the Health and Social Care Bill and focus on the things that really matter to the people using and working in the NHS.
I am sorry, but that was all completely synthetic anger on the hon. Gentleman’s part. The average time that patients have been waiting in the NHS for treatment continues to be between eight and nine weeks. It has been so ever since the last election. The operational standard under the previous Government and now for the 18-week waiting time is that at least 90% of patients who are admitted for treatment should be admitted and treated within 18 weeks, and 95% of outpatients. Both of those operational standards continue to be met. Last week I made it clear that whereas the previous Government abandoned people who went beyond 18 weeks—and there were 250,000 of them who went beyond 18 weeks—we will not abandon those forgotten patients. We will make sure that they, too, are brought into treatment as soon as possible.
Responsibility for the commissioning of all dental services across primary, salaried and secondary care will sit with the NHS Commissioning Board. The vision for commissioning dental services sees dental local professional networks developing and delivering local service plans and quality improvement strategies across all dental services and providing clinical leadership and expertise at local level. This will enable dentists, working with commissioners and other local stakeholders, to ensure that all dental services are integrated and work together in the most efficient way.
I thank the Minister for that answer, but I still do not see why GPs are good enough to commission services locally, but dentists are not. Can he explain exactly how dentists are to be involved, in the same way as GPs are, in commissioning services locally?
I refer the hon. Lady to the answer that I just gave. The vision for commissioning dental services sees dental local professional networks developing and delivering local services and local quality improvement strategies. Beyond that, it involves local health and wellbeing boards working together closely, involving local clinicians through the networks that I referred to earlier. The answer is that local dental clinicians will be fully involved in the ways that I have just described.
Private Finance Initiative Payments
12. What steps his Department plans to take to assist hospitals with the cost of PFI payments. (81806)
A Treasury review identified savings opportunities of up to 5% on annual payments in NHS PFI schemes. The lessons learned from the PFI savings pilot will be applied to all schemes in the PFI pipeline. The previous Government left a £50 billion post-dated cheque to pay for their hospital building programme. Much of it was unaffordable and poor value for money. We are dealing with that unfortunate legacy, including the 22 NHS trusts that identified this as a constraint on their future sustainability.
I thank my right hon. Friend for his response. PFI schemes have undoubtedly undermined the financial stability of many local health economies, as is the case in Coventry and Warwickshire. Can my right hon. Friend assure my constituents that any solution to assist PFI schemes, such as at the University Hospitals Coventry and Warwickshire NHS Trust, will not be to the detriment of my constituents who use the George Eliot hospital in Nuneaton?
Yes, I believe I can give my hon. Friend that assurance. Through the process of working with NHS trusts to see what is necessary for them to become foundation trusts—for example, we are working with University Hospitals Coventry and Warwickshire NHS Trust—it is clear that action taken locally with support can deliver viability and sustainability for the future. I hope the same will be true for the George Eliot hospital, but as a separate trust it will not be as a direct consequence of the steps that are taken at Walsgrave.
I welcome my right hon. Friend’s response to the original question. Poorly negotiated PFI deals for hospitals in the South London Healthcare NHS Trust are causing real financial problems and have led to the downgrading of Queen Mary’s hospital in my borough of Bexley. Does he share my concerns about this injustice, and will he ensure that my constituents get the first-class health care that they need and deserve and look again at this PFI situation?
Yes, of course. My hon. Friend understands very well indeed how difficult are the circumstances of his trust, which includes two PFI hospitals, and Queen Mary’s at Sidcup has suffered from the consequences of those PFIs. I am looking forward to the proposals on the future provision of health services on the Queen Mary’s Sidcup site. South London Healthcare is clearly an extremely challenged trust and we inherited very substantial problems there. We are looking to resolve them with it, but it will need additional national support.
In addition to struggling hospital trusts, many, many community hospitals throughout the country, such as Savernake hospital near Marlborough, are also labouring under the burden of an enormous PFI contract and having the indignity of vital local services hollowed out under that lot’s leadership on the Labour Benches. Will the Secretary of State please tell me what he will do to help those smaller hospitals with vital local services?
As my hon. Friend knows from her conversations with the Minister of State, Department of Health, my right hon. Friend the Member for Chelmsford (Mr Burns), we are very sympathetic to her concerns. By devolving commissioning responsibilities to clinical commissioning groups, I expect the local clinical leadership, understanding fully the contribution that community hospitals can make, to be supportive of that in their commissioning intentions in her constituency and others.
Health and Wellbeing Boards
The Health and Social Care Bill sets minimum membership for health and wellbeing boards. The boards will provide local system leadership, assessing need and setting the strategy for commissioning health, social care and public health. Ensuring that the board has the benefit of a broad range of opinion and geographical spread is a matter for local decision. However, the Department’s health and wellbeing board national learning network is developing and sharing good practice to inform those decisions.
Does my hon. Friend agree that the ability of a health and wellbeing board to represent democratically the interests of the people in its area would be boosted by having a reasonable number of councillors on it with both geographical representation across the area and political balance?
We are telling local authorities that they can have a majority of elected members on health and wellbeing boards if that is the appropriate way forward for their local community. My hon. Friend’s area, Cambridgeshire county council, recognises the importance of ensuring that there is a geographical spread and a full involvement of local opinion in those boards. There is a special event next January for stakeholders to get information about that, in which I hope my hon. Friend will take part.
Winter Pressures (NHS)
The NHS and social care systems are well prepared for winter. Our Winterwatch summary was first published last Thursday. It showed higher flu vaccination uptake, and I announced additional extracorporeal membrane oxygenation—ECMO—capacity, which will be in place by December. There is always more pressure on the NHS during winter. This year will be no different, but the preparations are in place.
Given the director of immunisation’s recent report on the take-up by medical staff of the flu jab and the local efforts of Dr Alastair Blair, the chair of the Northumberland clinical commissioning group, will the Minister expand on the need for patient protection in the form of flu jabs in hospitals and surgeries around the country?
I would like to take this opportunity not least to commend the work that the chief medical officer has done this year in encouraging health care workers to have their seasonal flu jab. The latest figures are that 29% have done so, compared with 11% at the same point last year. We heard earlier from my hon. Friend the Member for Kettering (Mr Hollobone) how well Kettering has done, and there are hospitals that are demonstrating that a higher level is entirely achievable. I urge staff across the NHS to have their flu vaccination. It is the ethical thing to do, not least to provide protection to their patients.
One of the things that makes the problem of winter pressures much greater is the NHS coping with the biggest reorganisation ever. The public have a right to know the risks that the Government’s policies are placing on our NHS. The Information Commissioner agrees and has judged that the Secretary of State must now release the risk assessments and register for his NHS reorganisation. Will he now obey the law and end his 12-month cover-up?
The Care Quality Commission and Monitor are looking into the affairs of the University Hospitals of Morecambe Bay NHS Foundation Trust. Will my right hon. Friend assure my constituents that whatever the findings, the Government will act upon them quickly?
Social care is vital for reducing winter pressures on the NHS by helping to keep older people out of hospital, but the Government are cutting funding for older people’s social care by £1.3 billion. Delayed discharges from hospitals are already up 11% from this time last year. The Minister responsible for care said in Westminster Hall on 10 November:
“cuts to front-line adult social care services are really beginning to bite.”—[Official Report, 10 November 2011; Vol. 535, c. 178WH.]
Does the Secretary of State agree?
I have to say to the hon. Lady that it was this Government who, through the spending review, gave priority to social care. More than £7 billion was added to the social care budget as a consequence of the steps taken by my right hon. Friend the Secretary of State for Communities and Local Government and by the NHS. This year the NHS is providing an additional £648 million specifically to support adult social care. In addition, I have announced our Warm Homes Healthy People funding for this winter, which will provide additional support for those most urgently in need.
Accident and Emergency Provision
This information is not collected centrally. It is for NHS commissioners to secure high-quality services for their communities. Where a substantial service change is proposed, decisions should be made against the Secretary of State’s four tests, including support from GP commissioners and clear evidence of patient and public engagement.
Broadening the definition of major trauma would have disastrous consequences for many A and E departments, not least those in Bassetlaw and the surrounding towns in south Yorkshire and the north midlands. Can the Minister give an absolute guarantee that the definition of major trauma is not being broadened, so that those hospitals and their A and E departments are not put in jeopardy?
The assurance I can give the hon. Gentleman is that the siting of A and E departments will be a matter of clinical judgment. I can also assure him that £900,000 will be invested in the A and E department at Bassetlaw hospital for improvements, including the creation of a three-bay resuscitation room, a larger waiting area for patients and other improvements to enhance the quality of care for his constituents.
At a recent surprise visit to my local A and E department, at the Conquest hospital, I was delighted to find a very high quality of care. Will the Minister reassure me that any local reconfiguration puts high-quality patient care at the centre of delivery?
I am grateful to my hon. Friend, and I am glad that she had such a positive experience visiting her local A and E. I can categorically tell her that reconfigurations must be carried out in accordance with the Secretary of State’s four tests and that clinical safety and quality of care are paramount.
The Government are committed to publishing a White Paper and a progress report, responding to both the Law Commission and the Dilnot commission recommendations. As part of ongoing work, there have been numerous discussions throughout the Government, including with Her Majesty’s Treasury.
At least 5,000 families a month are having to make decisions about the long-term care of loved ones. Since the election, thousands have had to sell their homes and spend every penny on care. How many more people—and for how much longer—will have to be terrified about their future?
If the hon. Lady had prefaced her question with an apology for failing to sort out the problem for 13 years, I might have taken it more seriously. This Government moved urgently to establish the commission chaired by Andrew Dilnot, we are now actively working through his proposals, and we will come forward with legislation and a White Paper in due course.
There is no doubt that more integration between health and social care is a way of improving the quality of services delivered to the public, and of releasing resources that can then be reinvested in improving services. We know, for example, that the use of reablement services can reduce costs and improve the quality of life outcomes for the people who receive them.
Training (Nurses and Doctors)
Our reforms aim for excellence in education and training and for a better patient experience by ensuring greater accountability for employers in planning and developing their work force while being professionally informed and underpinned by strong academic links. I have always been clear that I want to see greater professional ownership of the standards of education and training, and greater employer engagement in getting work force planning right. We will publish more details on that when the NHS Future Forum reports shortly.
Does the Secretary of State share the concerns that I have picked up in my constituency? First, although we have very good nurses in Huddersfield, national stories about a lack of care for elderly people make all of us worried about the quality of training of some nurses in some institutions. Secondly, will he remember that, with his demolition of the health service, we are moving to a system in which no management training is given to any doctor or GP? Is that not a recipe for chaos?
On the latter point, I have been talking to those in training, and part of their education increasingly includes leadership. That is what we are looking for—clinical leadership, not to turn clinicians into managers. They will work with managers, but they will provide leadership.
On nursing training, the Care Quality Commission’s recent inspection reports, in particular, illustrated the sheer variability of care—sometimes even between wards in the same hospital. On that basis, we should not in any sense damn the quality of nurse training; we need to focus on the quality of nurse leadership—ward by ward, and hospital by hospital.
The new Government’s strategy on human trafficking requires the NHS to ensure that victims of human trafficking are recognised in hospitals and reported. One way of doing that is to improve training for nurses. I have just returned from Moldova, where nurses have a course on human trafficking as part of their training, so that they can recognise victims and help them. Is that something that we could incorporate here?
Strategic Risk Register
Publishing the Department’s risk register would have implications beyond the Department of Health, and we are taking the time granted to us by the Information Commissioner before deciding whether to appeal against his decision requiring its release.
I think I thank the Minister for that response, which at least gives some indication of where the Government are coming from. But, given the widespread concern among the public about the risks posed by the Health and Social Care Bill, and given that the Information Commission has ruled that the register should be published, does the Minister not think that it should be published before Report stage in the House of Lords, so that at the very least the findings can be used to inform the amendments being tabled to rescue the Bill even at this late stage?
No, I do not think that the register should be published before then, in so far as we are still considering whether or how to move forward within the time scale that the Information Commissioner has given us—[Interruption.] Before the hon. Lady gets too pious, I must tell her—I do not say “remind her”, because in the previous Government she will have been too busy tweeting, as the tweeting tsar, to know what the Department of Health was doing—that in September 2009 the right hon. Member for Leigh (Andy Burnham) similarly blocked release of the Department of Health’s strategic risk register, using the non-disclosure provisions under section 36 of the Freedom of Information Act 2000, and that his predecessor, the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson), did the same on two occasions in 2008.
Two, or even three, wrongs do not make a right. Regarding an exemplary risk register, does the Minister consider that the mitigation plans for any risks identified there may serve to reassure Members of the other House, if it were to be published in advance of the conclusion of the Committee stage there?
If the hon. Gentleman had read it, he would know that the important aspect—[Interruption.] He says that he cannot read it, but if he listens for a minute, he will hear that the important parts that are relevant to the Health and Social Care Bill were published in January and September this year in the impact assessment for the Bill.
May I first commend the Health Secretary on his ingenious new approach to cutting delayed discharges? If his appearance on continuous loop on hospital TV does not cut length of stay, I do not know what will. One area where he has been noticeably less forthcoming is on the recent ruling by the Information Commissioner, which could not be clearer: Parliament and the public have the right to know what extra risks and threats his Department expects the NHS to face as a result of this top-down reorganisation. Let us give him one more chance to give us a clear commitment: will he live up to the Prime Minister’s words on transparency and openness and publish the report in full without delay?
The right hon. Gentleman may not have been listening to the response I gave to his hon. Friend, which was that the relevant aspects of the risk assessment have been incorporated into the impact assessments published in January and September. [Interruption.] Before he, too, gets too pious, may I remind him that it was he himself who, in September 2009, blocked the publication of his Department’s risk assessment?
I would happily have paid £5 to opt out of that particular pre-scripted loop message. Unlike the Minister and his fellow Front Benchers, I was not subject to a ruling from the Information Commissioner. People watching this today will be left wondering what he and the Secretary of State are so desperate to hide. He can hide the report, but he cannot hide the growing warning signs we are seeing in our NHS: waiting lists up, delayed discharges up, and nurses made redundant. The truth is that he has placed the NHS in the danger zone, with a destabilising and demoralising reorganisation when it most needed stability. He says he wants feedback, so why does he not listen to patients and staff, put the NHS first and drop his dangerous Bill?
It is marvellous how the right hon. Gentleman repeats his soundbite every time he discusses the NHS. I have to tell him that he is wrong. He knows that the NHS has to evolve. He knows that we have to improve and enhance patient care. I think he does himself a disservice by simply joining the ranks of organisations such as 38 Degrees, which is frightening people and getting them, almost zombie-like, to send in e-mails.
My responsibility is to lead the NHS in delivering improved health outcomes in England, to lead a public health service that improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care, which supports and protects vulnerable people.
Is the Secretary of State aware that plans to remove vascular services from Warrington hospital will threaten services such as diabetes care, renal cancer care and the co-operation on stroke that has been built up with Whiston hospital? What will he do to protect those services, or is this part of the plan he discussed in February with NHS North West to reduce the number of acute beds and increase competition?
I will of course answer the question. The answer is that this is entirely driven by clinical issues in a local context. I can tell the hon. Lady that it is very much about trying to improve vascular services, and the judgments being made are local and clinical.
The health and wellbeing boards will have a role not only in leading improvements in public health and social care but, through the joint strategic needs assessment and the strategy derived from that, in establishing how services should respond to the needs of the local population. The clinical commissioning group should respond directly to that, and any specific service configuration changes should form part of the commissioning plan. In addition, the local authority, through its scrutiny role, will have a continuing ability to refer those plans for review.
T4. Will the Secretary of State agree to meet me, and families living with muscle disease, to discuss the urgent problem of primary care trusts refusing to fund vital cough assist machines, which help to prevent serious and very costly winter respiratory infections for those who are unable to use their lung muscles to cough? (81823)
Of course I, or one of my colleagues, will be glad to meet the hon. Lady to discuss that. I might also say that it was important to have announced, as I did last week, the expansion of ECMO—extracorporeal membrane oxygenation—facilities across England. Those facilities present a life-saving opportunity for people with the severest respiratory disease.
T3. My apologies, Mr Speaker, for having missed my question on the Order Paper earlier.Every five minutes someone in the UK suffers from a stroke, and over 1 million people are living with the effects of stroke. That is why I welcome the establishment of the first “life after stroke” centre—a £2 million investment in my constituency. Will my right hon. Friend join me in welcoming this excellent initiative by the Stroke Association? (81822)
Yes, of course I will join my hon. Friend in paying tribute to all the work that I know personally that the Stroke Association has done over a number of years in raising public awareness of the importance of developing stroke services, which has had an impact inside the NHS. We have improving figures in terms of reducing stroke mortality, and I now want to go further in ensuring that we enable people not only to survive stroke but to recover as many as possible of their abilities afterwards.
T5. Will the Minister with responsibility for public health update the House on her plans to review the criteria whereby people with haemophilia who have been infected with hepatitis C can claim stage 2 payments from the Skipton fund? Specifically, will she tell us how she intends to involve patients and carers in that review? (81824)
I know that the right hon. Gentleman has campaigned hard on this issue. I can assure him that I recently met a group of MPs, and constituents of theirs who are suffering from hepatitis. As he knows, there is a wide spectrum of illness associated with chronic hepatitis C infection. We are aware that people could be suffering financial hardship as a result, and I would urge them to apply to the Caxton Foundation. The Department’s expert advisory group on hepatitis C will continue to keep the evidence under review.
T7. In a number of surgeries in my constituency, and in many across the country, physicians’ assistants play a very important role in enhancing capacity. Can my hon. Friend say whether there are any plans in the Department of Health to allow physicians’ assistants to be able to prescribe medication? (81826)
T6. After speculation about the future of the Department of Health’s free nursery milk scheme, will the Secretary of State assure families and nurseries that he recognises the value of free nursery milk in preparing young people for a good future and well-being in life? (81825)
I assure the hon. Gentleman that we do recognise the value of nursery milk. The only shocking thing is that the previous Government presided over a scheme whereby nursery milk is now costing double the retail price, and we urgently need to look at that. We are committed to continuing the scheme, but shocked at what has gone on before.
T8. An independent study of the patient assumptions of the Safe and Sustainable review has confirmed what many of us already knew: that, contrary to the review’s claims, most families in Yorkshire and the Humber will travel not to Newcastle but to Leicester or Liverpool. Will my right hon. Friend seek confirmation from the Safe and Sustainable review body that it will revise its options in the light of that new evidence? (81827)
I am grateful to my hon. Friend and I have heard the important point that he has made. No doubt the Joint Committee of Primary Care Trusts will also hear the point that he has made to me. I am sure that he understands that it would be totally inappropriate for me to give any view that might compromise the independence of Ministers on this independent review.
I do not have a figure for that. If the hon. Lady and others want to discuss it, I would be glad to see evidence of it—and so should NHS employers, because as part of the implementation of “Agenda for Change”, staff should be banded in grades according to independent criteria.
T9. Last year in Westminster Hall, the Under-Secretary of State for Health, my hon. Friend the Member for Guildford (Anne Milton) rightly praised the work of midwives and the Royal College of Midwives. Does she share my concern that locally, there could be a downgrading of community midwives, leading to an overall reduction in the number of midwives in our area? (81828)
I thank my hon. Friend, and I will take this opportunity to praise again the work of midwives and the Royal College of Midwives. It was a pleasure to be at its conference only last week. I would point out that there are now more than 20,000 full-time equivalent midwives. That is an increase of 2.4% on last year. We have record numbers of midwives in training, with 2,493 this year and an increase on that next year. What matters is that we get the right services for women who are pregnant, ensure that they can exercise the choices that they need, and get the right skills mix.
Figures today reveal that older women are being discriminated against in breast cancer treatment, with some 20% of women over 65 receiving chemotherapy compared with some 70% of women under 50. Will the Minister assure the House that those who are over 65 will receive equitable treatment, and that this discrimination will stop?
I am grateful for that question, and I assure the hon. Gentleman that the Government are determined to root out ageism wherever it might be within the NHS. That is why we have made it clear that there will be no exemptions from age discrimination legislation—and that will have to be taken into account by clinicians when they make decisions.
The recent judicial review concerning the unit at the Royal Brompton hospital said that the Safe and Sustainable consultation was unlawful and the review should be quashed. Considering the concern about this matter and the flaws in the review, is it not time for the Minister to indicate when the Government might intervene? Otherwise, there could be further threats of judicial review.
The straightforward answer is no, because the Joint Committee of Primary Care Trusts has said that it intends to appeal. This is an independent review. It would be inappropriate for me or any other Minister to interfere in such a review, because we could be accused of compromising its independence.
The Prime Minister promised a bare-knuckle fight to save A and E and maternity units at King George hospital, Chase Farm hospital and other hospitals that the Secretary of State now plans to close. When will that fight take place, and where can hon. Members purchase tickets for ringside seats?
I heard what the hon. Gentleman said, and I was disappointed that we did not reach his question on the Order Paper earlier, because he has been extremely concerned about the A and E in his own area in Hartlepool. That decision was taken on safety grounds. Emergency care has been provided at the One Life centre. The decision was taken with the support of the local overview and scrutiny committee, which he will appreciate has democratic accountability. That was the right decision. Where there are clinical reasons for taking such decisions, they should be taken.
I thank my hon. Friend for that question. He must be psychic, because I recently visited China, and it was fascinating to meet Ministers there. He will also be very pleased to hear, as I am sure the whole House will, that I visited a hospital and community centre that combines western medicine and traditional Chinese medicine.
The coalition agreement states that public sector employees, including health care employees, will be given a new right to set up employee-led co-operatives to run services. Can the Minister detail how many NHS co-operatives have been established and how many employees are involved in them?
I will gladly write to the hon. Gentleman if my recollection is wrong, but I think that something in the order of 25,000 staff have been transferred into social enterprises since the election. That represents something like £900 million-worth of NHS activity across England.
Pension reform is important to those of my constituents who work in the public sector—and, indeed, to the taxpayers who do not. With that in mind, does the Secretary of State agree that the heath service unions should work constructively with the Government on public sector pension reform rather than go on strike next week, potentially putting patients’ lives at risk?
Yes, I am grateful to my hon. Friend. It is very important to me that NHS staff, and other public servants, are valued in their remuneration, including the pensions that they receive. That is precisely why I have myself engaged in discussion with the NHS trade unions and staff side and continue to be engaged directly in negotiations with them about that, on the basis of the conditional offer that the Chief Secretary to the Treasury announced to the House recently, which I think would be fair to NHS staff and to taxpayers. On that basis, I think it is completely irresponsible and unacceptable for some unions in the NHS—not the Royal College of Nursing or the British Medical Association—to intend to go on strike next week.
Today’s report by Macmillan Cancer Support showed that over the past 40 years there has been virtually no improvement in life expectancy for those diagnosed with a brain tumour. Brain Tumour UK and experts such as my city’s own Professor David Walker are calling for action to improve diagnosis and treatment. What action is the Department taking to address their concerns?
I am grateful to the hon. Lady for her question. Macmillan has done a very good job by highlighting the need to focus on survival rates with regard not only to brain cancers but to lung cancers. Through our outcomes strategy, we are focusing on earlier diagnosis and ensuring that the care pathway is faster and delivers the appropriate treatments at the right time.
There are 3,000 cases each year of early stage inoperable lung cancer, but as yet no national stereotactic body radiotherapy treatment for lung cancer. What number of patients does the Secretary of State consider to be the appropriate threshold at which he will instruct his Department to establish a national lung cancer tariff?
I am grateful to my hon. Friend for that question. I do not think I am in a position to say what figure is appropriate, but the national clinical director for cancer has already indicated to the NHS that he wishes us to develop a national tariff for stereotactic radiotherapy. A quarter of centres across the country already provide it, and our intention is to ensure that that is supported by a national tariff as soon as possible.
Regrettably, there are still many thousands of attacks by dangerous dogs every year that end up with people in A and E, and occasional fatalities. Has the Secretary of State carried out any assessment of the cost to the NHS of treatment for attacks by dangerous dogs? If not, may I ask him to instruct his officials to do so?
With your permission, Mr Speaker, I should like to make a statement on the Government’s final decisions about coastguard modernisation in the light of responses received to the second round of consultation, which ended on 6 October 2011.
I should first like to remind the House that the plans for coastguard modernisation announced by my right hon. Friend the Member for Runnymede and Weybridge (Mr Hammond) in his statement on 14 July, following the first round of consultation, are not about altering the arrangements for front-line rescue services around our coasts. Rescue activities will continue to be carried out as they are today by the 3,500 community volunteers in the Coastguard Rescue Service; the lifeboats operated by the Royal National Lifeboat Institution; independent lifeboats operated by volunteer groups; and our search and rescue helicopters. The bravery and commitment shown by those providing front-line services have served this country well and will continue to do so.
The plans we have announced specifically include an increase in the number of regular coastguard officers who provide operational leadership to support the 3,500 volunteers in the Coastguard Rescue Service, whom I mentioned. These plans therefore reflect the importance we attach to continuing the delivery of a first-class local rescue service directly serving citizens and recreational mariners.
The decision announced on 14 July, and the further details I am announcing today, are about modernising the coastguard co-ordination function only. Modernisation is needed to address the limited resilience of current rescue co-ordination arrangements, which have changed little since the removal of the visual watch in the 1970s. Modernisation will provide the operational resilience needed; distribute work more effectively and efficiently around coastguard centres; make the most of the professional skills of our regular coastguards with levels of reward that match their responsibilities; and deliver improved support and co-ordination for our Coastguard Rescue Service and our search and rescue partners.
The original proposals, which we consulted on last December, had been discussed and developed over several years by the previous Government. We said at the outset that we would have a genuine consultation and that we expected the outcome of the process to be improved and more resilient plans.
We made it clear in July that we had listened to the views expressed in the first consultation. As a result, we announced that, in implementing a nationally networked system, we would retain more coastguard centres than originally proposed; keep all these centres operating 24/7; and retain more regular coastguard jobs. These plans will keep open at least one of each of the paired coastguard centres. Operational pairs have experience and knowledge in managing incidents across their shared geographical areas. Keeping at least one centre from each pair will therefore ensure that that experience and local knowledge is retained. In addition, as we explained in July, the operational costs of retaining the 10 centres overall plus a small centre in London will be offset by operating only one national maritime operations centre—MOC—with an unmanned back-up in Dover, rather than the two that were previously planned.
The second consultation exercise, which is what this statement is about, invited views on four specific issues: the retention of both the centres at Stornoway and Shetland and their operation on a 24/7 basis; the change to a single maritime operations centre with an unmanned back-up in Dover; the retention of Holyhead rather than its paired centre at Liverpool; and the retention of Milford Haven rather than its paired centre at Swansea.
The second consultation closed on 6 October. I should like again to thank all those who engaged in the process, including those in the service, members of the public and Members from both sides of the House. All responses were read and examined by an independent team, which has helped to develop the modernisation proposals. I am making its report on the issues identified in the consultation available today on the Maritime and Coastguard Agency website, and it will be available in the Library of the House.
Let me now turn to the specific questions we posed in the second consultation. The support for keeping open both the centres at Stornoway and on Shetland was overwhelming, so I can confirm that we will keep them both open on a 24/7 basis.
On the move to a single maritime centre, concerns were expressed about having both an unmanned centre and its back-up in the south, when they should be geographically separated, and about the possible reduction in capabilities at Aberdeen to co-ordinate oil or gas incidents if there was not to be a second main centre in Aberdeen. However, we continue to believe that with more centres remaining open on a 24/7 basis, there is sufficient cover not to need a second nationally networked system. Consequently, there will be one network in the south.
We also believe that the back-up at Dover is sufficiently distant from the maritime operations centre in the Portsmouth-Southampton area—I shall return to that later—to provide the necessary resilience while minimising costs. However, we will retain additional specialist staff in Aberdeen to maintain the Maritime and Coastguard Agency’s close links with the oil and gas sector. Those jobs will remain.
On the choice of Holyhead rather than Liverpool, representations were received stressing the scale and proximity of maritime and tourist activities at both locations; questioning the importance of the Welsh language considerations highlighted in the first consultation; and concerning the running-cost advantages and higher disposal costs for Liverpool. We considered the responses carefully, but as we made clear in July, we have identified no operational or financial reasons for preferring one location to the other. In particular there are no significant differences in running costs.
In the light of comments in the first consultation, it is also our view that familiarity with Welsh place names, rather than speaking Welsh, must be an important consideration supporting the retention of Holyhead. As a result, I have concluded that Holyhead should form part of the nationally networked system and that the co-ordination function at Liverpool will close. We plan to maintain a marine office, coastguard rescue team, coastal operational hub and a radio mast at the Liverpool site.
Representations were also received about the proximity, particularly of maritime activities, at Milford Haven and Swansea. The representations concerned the perceived risks of having a centre so close to liquefied natural gas terminals at Milford Haven; better transport links in Swansea; and the wider potential recruitment pool in the Swansea area. I must reiterate, however, that within the nationally networked system, which will co-ordinate incidents in this area, there are no operational reasons for choosing one or other of these sites. Similarly, as was explained in July, we are satisfied that there are no considerations that favour either location.
In addition, we have not recently experienced any recruitment problems at Milford Haven. As a result, I have concluded that it remains right that the choice of Milford Haven as the site for a continuing coastguard co-ordination centre should reflect the Department for Transport’s continuing substantial levels of employment in Swansea. This means that we will no longer have a coastguard co-ordination function at Swansea, but we plan that the building will remain in use as a coastal operations hub for the volunteer rescue teams. It will be at that site.
Having reached these decisions, I am today publishing a short summary document that sets out a clear blueprint for the operation of the nationally networked coastguard co-ordination service comprising a single national operations centre in the Portsmouth area—again, I shall return to that—a back-up national operations centre at Dover; and centres at the MCA sites at Humber, Aberdeen, Shetland, Stornoway, Belfast, Holyhead, Milford Haven and Falmouth. This blueprint also sets out the previously announced provisional timetable for the closure of the other existing co-ordination centres before 31 March 2015. The centre at Solent will be replaced by the new maritime operations centre. This timetable remains our best estimate of when these centres will close, although clearly it will need to be kept under review to match operational requirements.
The document also explains—and I stress this point—the strong commitment to the coastguard presence that will be retained at the existing MCA sites at Liverpool, Swansea and the Thames, even after the co-ordination centre function ends. There will be a similarly strong presence in the Clyde area, but not at the existing site.
Finally, I would like to say something about the location of the new national maritime operations centre. With the full support of my right hon. Friend the Secretary of State for Communities and Local Government, I am pleased to inform the House that the maritime operations centre will be housed in the vacant fire control centre building in Fareham—the significance of that with a former fireman standing here will be obvious. The building’s existing facilities mean that the maritime operations centre can be established quickly, allowing for an extensive programme of tests and trials to prove and refine the new concept of operations for maritime rescue co-ordination. Those tests and trials will be an important element in addressing the understandable concerns from many professional coastguards about the operation of the new system and will ensure no reduction in capabilities in the transition period. The choice of Fareham also makes best use of the Government’s existing estate and minimises up-front costs, offering best value for money.
I understand, of course, that the closure of some existing co-ordination centres and the loss of some coastguard jobs will come as a disappointment to those directly affected. However, the decisions that I have announced today will deliver the modernised, nationally networked and fully resilient coastguard service that we require for the future, while also reducing costs. Critically, these decisions will enable us better to support our coastguard volunteers and the front-line rescue capabilities on which the public and mariners depend. I commend this statement to the House.
I thank the Minister for an advance copy of his statement. I would expect no less a courtesy from a former fellow fireman, but it is especially generous coming from someone who served with the Essex brigade to someone from London. I apologise to the Minister and to you, Mr Speaker, that my hon. Friend the Member for Garston and Halewood (Maria Eagle), the shadow Secretary of State, is not present. She has pursued the issue vigorously, as have the shadow Secretary of State for Education and the shadow Leader of the House. She is particularly frustrated at being unable to be here today, especially as her own station is to close.
I also thank the Minister for making today’s statement, ending the prolonged concern and uncertainty in coastguard communities. These exercises take time, and I know that the Minister made a considerable personal effort in travelling to various parts of the country to meet and engage with staff and others. That is to his credit. He will also have listened to the respected chief executive of the MCA, Sir Alan Massey, and the highly regarded chief coastguard, Rod Johnson. I, too, would like to take this opportunity to express our support for them and the entire coastguard service, which so professionally co-ordinates the first-class search and rescue capability around our coast.
As a member of the Worshipful Company of Shipwrights, as former shipping Minister and now as shadow shipping Minister, I, like the Minister, am proud to wear the red ensign badge, in solidarity with and respect for British shipping in all its aspects. I have no doubt that the Minister has done his best within the limits set by the Treasury and his departmental budget; but equally, I have no doubt that these proposals are at least partly driven by financial constraints. He knows the concerns out there about shipping safety owing to the loss of Nimrods, the ending of the emergency towing vessel contract and the outstanding review of the air-sea search and rescue service. The Select Committee on Transport, under the excellent chairmanship of my hon. Friend the Member for Liverpool, Riverside (Mrs Ellman), echoed that concern when it said:
“The evidence…raises serious concerns that safety will be jeopardised if these proposals proceed.”
In that case the Government were right to look again and amend their original proposals.
I would be grateful if the Minister responded to a few questions. In the original plan he envisaged two operational centres, we assumed for resilience. Can he reassure the House that the non-staffed back-up will be able to do the job if the main centre crashes? Can he also say how quickly it would be up and running under such circumstances? Can he tell us how many coastguards will remain in full-time employment after this modernisation programme? I think he said that there would be more, but I assume that that is against the original consultation document, not the present establishment. Part of our review in government was about addressing low pay among coastguards historically, compared with similar staff, with similar duties, in the other emergency services. Given that remaining staff will be undertaking more work with more responsibilities and that we anticipate they will need to be upskilled, will this modernisation address that historic anomaly? My last question is when we can expect a statement on the future of the air-sea search and rescue service.
In conclusion, we welcome the Minister’s acceptance of the need to keep both Shetland and Stornoway, and we are relieved that the Department proposes 24/7 cover at all the remaining stations. His decision to retain one of each pair of twinned stations is an acknowledgement that the question of local knowledge weighed heavily on him and his officials. I am sure he will understand, however, that in a number of communities out there now, there will be real disappointment and even anger today. I look forward to hearing the Minister’s answers.
I thank my friend for his comments: we agree on most things, but occasionally disagree; perhaps we will disagree a little bit today. Let me answer the hon. Gentleman’s four specific questions.
In the original proposal, which we inherited from the previous Administration, two MOCs were required, not least because the majority of the stations would have gone part time. They are no longer going part time; they are 24/7, so the resilience within the system, which is not there today, will give us the communications resilience that we need. If we need to move into the unmanned MOC we will do so. We looked at this carefully and found that in 99.9% of cases we would not have to do this, even if the MOC went down initially, because the other stations will pick it up, and we are moving towards the Dover MOC.
Pay is a real issue: £13,500 as a basic salary for someone working in the emergency services is a disgrace. I know that the shadow Minister looked at this carefully when he was in my position, which is why the original proposals were on his former desk and on the desk of the Minister before him and the one before that. We have done something about it so that we have pay, conditions and promotion opportunities for the people who serve so well.
In the original proposals I inherited, coastguard staffing levels would have gone down to 244. Under the proposals I have announced today, the staffing level will be 314. The shadow Minister will have to wait for the Secretary of State to make her announcement on search and rescue helicopters.
The Prime Minister told this House on 30 March:
“We want to make changes only if they improve coastguard support that people in fishing communities and elsewhere get…If that is not the case, we will obviously have to reconsider reforms”.—[Official Report, 30 March 2011; Vol. 526, c. 336.]
If, as many sea users at all levels from rear admirals to professional yachtsmen believe, the trial of a new control centre demonstrates the loss of local knowledge to be an added danger to any sea user, will the Minister reconsider his plans for closing any coastguard co-ordination centres, as the Prime Minister has already mentioned?
I thank my hon. Friend for her important question. One point in having Fareham open so early is that we will be able to trial the new system early, which will mean that no centres will close before the robustness of the system is demonstrated. Should there be any blips in the system, I can assure my hon. Friend that no station will close until we have the level of resilience that we do not have today.
The Minister’s proposals mean a cut in staffing levels covering the Clyde area of 56% in comparison with a UK average cut of 33%. I see nothing in the statement that changes that. Why does the Minister think that the Clyde, which is the busiest area for call-out, should have a disproportionately higher cut in staffing?
I am sorry if I misled the hon. Lady, but Clyde will close as a co-ordination centre. It is already paired with Belfast. Belfast regularly covers the resilience and has the local knowledge that is necessary. That is why we took the decision to keep one of every pair open. I understand that it is sad for the hon. Lady, but there will be coastguards working in the Clyde area, although it will not be a co-ordination centre.
Whilst welcoming the sensible concessions made, not least with regard to the west coast, the Minches and the northern waters—I have to say that the earlier suggestions flew in the face of all common sense—I ask the Minister whether he will none the less accept that there is a considerable element of gamble here. Given the warnings from the seafarers and the emergency services, who have done this job successfully for generations, about what might occur, will the Minister at least confirm from the Dispatch Box today that if circumstances merit it, he would be willing to reopen this entire recasting and go back to the drawing board?
I respect the right hon. Gentleman’s views, but we took this action because the original proposals were flawed. They were not my proposals; they were the last Government’s proposals.
The point of introducing the resilience that does not currently exist is to end the scaremongering about safety. Safety standards are not good today, but they will be good from now on because of that resilience. In most of the coastguard stations that I visited around the country, including stations in Scotland, I was told, “We know that we have to cut the number of stations to nine or 10.”
I recognise that significant changes have been made since the Government’s original proposals, but what work has been done to ensure that, notwithstanding the scale of the closures, local knowledge will be retained so that lives can be safeguarded?
I fully respect the Chairman of the Select Committee on Transport, whose report helped me to decide how to proceed. The point of keeping one centre in a pair which regularly covers the topography of the other centre’s area is to retain the local knowledge about which so many of those who were consulted expressed concern. I know that there will be disappointment in some parts of the country, but the resilience to which I have referred is more important. We need a 21st-century coastguard.
My constituents will be very disappointed that the new maritime operations centre will not be based at the Daedalus site. Can the Minister assure us that the hugely experienced coastguards who will lose their jobs at Lee-on-Solent will be helped to find work at the new Fareham site?
I thank my hon. Friend for that important question. When possible we need to retain the experience that we have at the co-ordination centres, particularly the one at the Solent, and we have no intention of making compulsory redundancies there. There will be more job offers at the new MOC, and I hope that as many people as possible transfer to it.
I thank the Minister for letting me see his statement in advance, and for the communication in which he has engaged with my hon. Friend the Member for Na h-Eileanan an Iar (Mr MacNeil).
We now know that two out of five Scottish coastguard stations will close, and that we have only an interim contract on the emergency tugs. The Government have announced the scrapping of the entire fleet of fixed-wing long-range search and rescue aircraft, and the future of the air rescue co-ordination centre at Kinloss is still uncertain. Is this not the time to devolve those powers to the Scottish Parliament so that they can be taken seriously?
I thank the Minister for his statement, and pay tribute to the great personal effort that I know he has put into visiting every affected coastguard station to ensure that consultation was both open-ended and reasoned. Can he none the less reassure me that when one of a pair of co-ordination centres closes, there will be a structure in place to ensure that local knowledge is transferred between staff and we do not see a sudden cliff-edge changeover?
The closures are planned for March 2015, so there will be no cliff edge. I repeat that, having studied the results of the consultation extremely carefully, we decided to adopt the pair-based system because the current local knowledge of the topography would be retained. When I visited Swansea—and I expect that a Swansea Member will ask a question shortly—the station was closed while I was meeting the staff, and Milford Haven took over the local knowledge. That sort of thing is happening regularly, and it will introduce more resilience to the system.
I welcome the Minister’s recognition of the unique position of the Aberdeen station and its links with the oil and gas industry. However, although he has accepted that there needs to be a back-up MOC—which was not included in the plans announced last September—I understand that it is to be a part-time empty station in Dover. The Aberdeen station, which was included in the original December proposals, is fully manned, and could act immediately with a full staff complement in an emergency. What assurances can the Minister give about the security of the system in such circumstances?
The Aberdeen station is not fully manned as a MOC today. It is a co-ordination centre. Under the previous proposals, if we had taken out the second MOC there would have been 23 staff in Scotland, whereas 69 will be working for me at the co-ordination centres in Scotland. We considered carefully whether we would need a second MOC if we kept the twin stations open 24/7, and decided that, with the twin stations open and a nationally resilient communications system, we did not need a full-time second MOC.
May I thank my hon. Friend for this difficult statement and for the sensitive way in which he has approached these very difficult decisions? Can he confirm that he is, in effect, announcing the closure of the coastguard centre at Walton-on-the-Naze today? Will he understand how much of a disappointment that is to local people, and to me and my hon. Friend the Member for Clacton (Mr Carswell), who have made representations to him on this matter? How can we ensure that the local knowledge of the locally employed people there is somehow included in the new arrangements, not least in respect of their job opportunities, even if they wish to continue to live locally?
My hon. Friend knows that I have listened very carefully to the consultation, and to delegations from across the House and across the country. Yes, his local station will close, but the station that covers it on a regular basis will stay open, the local knowledge will still be there and, wherever possible, those staff will be transferred to the new stations.
I warmly welcome the confirmation in today’s statement that Northern Ireland’s only coastguard centre will be remaining open in Bangor in my constituency. I am very pleased to put on the record the fact that the Minister listened very carefully to all the political voices raised right across the board in Northern Ireland in support of retaining that coastguard centre. Before he agrees to come back to Bangor at my invitation—we would love to have him back, with the good news—will he kindly confirm that he has sought and obtained reassurances from the Irish Government about the continued availability of Irish helicopters, deployed from Sligo and paid for by the Irish Government, to assist the Northern Ireland coastguard so ably, as they have done in the past?
I thank the hon. Lady for her kind comments. It appears that I was, with my proposals, the only politician in many years to manage to unite all the political parties in Northern Ireland. To be fair, I looked very carefully at where the centre should be; Belfast covered the Clyde, the Clyde covered Belfast and the decision to keep the centre in Belfast was taken for resilience purposes. I have now met two Transport Secretaries from the Republic of Ireland and I understand that they have no plans to remove the excellent service they give us. We will share that service as our new search and rescue helicopter is introduced too.
Does my hon. Friend understand the degree of disappointment that there will be in my constituency that the opportunity of the second consultation has not been taken to provide a reprieve for the station at Fife Ness? Furthermore, is he aware that fishermen, yachtsmen and all the seafarers who use the firth of Forth believe that his decision is profoundly mistaken?
I apologise to my right hon. and learned Friend if I have not been able to make the announcement that he wanted me to make today, but this consultation was not about Fife—that matter was dealt with in the first consultation and it was finished when the previous Secretary of State made his statements to this House. Although there are concerns, our current system has a national emergency service without any national resilience. That cannot be acceptable and I was not willing to sit, as the Minister, and let that carry on.
Will the Minister tell us exactly how much money he will be saving by closing Swansea coastguard station, given that there will be a continued presence at that building? How does that compare with the money he would have saved had he chosen to close the centre at Milford Haven instead?
As I said in my statement, there is almost no difference in the cost savings—the cost is in staff. May I say to the hon. Lady that under the proposals that I inherited only one out of the three centres in Wales would have stayed open and there would have been 10 staff in Wales, whereas there are 46 with my announcement today?
I know that the Minister will appreciate, because we have sent many submissions to him that Portland coastguard should remain open, how devastated my constituents are that this decision has been made. Will he reassure me and my constituents that if the trial at Fareham does not meet expectations, reopening the Portland centre will be at the top of the agenda?
I thank my hon. Friend for reiterating the importance to his constituents of Portland. However, I am sure that he would join me in saying that the front-line emergency personnel—the volunteers—are the most important people here and their resilience and ability to do their job is the most important thing. We will be able to enhance their training and enhance the pay in our coastguard co-ordination centres. Not in a million years could I have been able to afford to build the facility in Fareham. It was folly of the previous Government to do so and I will utilise that building to its best abilities.
I remind the Minister that the two issues that will anger people about the decision on Crosby are those to do with local knowledge of the north-west coast of England and the west of Scotland, which will now be lost, and those to do with the proposal put forward by the staff to host the maritime operations centre at a significant saving. He said in answer to an earlier question that he was not looking at new plans in the second consultation, but would it not have been a good idea for the Government to have done so and to have considered the good ideas coming forward from staff, such as those proposed at Crosby?
On the hon. Gentleman’s second point, the consultation was quite specific about whether we should have one MOC or two MOCs. The second proposal was for a MOC in Aberdeen and I needed to say that we were not going to do that if we were to have the money to keep the other stations open and that we would have the resilience without it. Even though the facilities at Swansea are good, they are nothing compared with the fire control centre I have taken over in Fareham, and I invite any hon. Members to visit that facility. The communications and build quality are second-to-none. As I have said, I could never have afforded to build it so the deal that I have done with the Secretary of State for Communities and Local Government is absolutely brilliant. As the hon. Gentleman knows, when I was at Crosby—on my very first visit—the full-time coastguards told me that having the existing 18 centres was wrong and they suggested there should be nine. I am sorry that Crosby is not one of them.
May I congratulate my hon. Friend on producing a well-balanced package under difficult circumstances? In particular, I welcome the promises on reward for our underpaid coastguards. I join him, too, in welcoming the huge contribution made by volunteers, including Whitstable RNLI. When he makes proposals on search and rescue helicopters, will he look closely at the hybrid arrangements in north America, through which the armed forces reserves offer a very cost-effective approach?
Some of what my hon. Friend has just asked for is above my pay grade and even comes under a completely different Department. The Secretary of State is sitting next to me and I am sure that she has heard the message loud and clear.
May I also reiterate—I hope I mentioned it in my statement—my complete admiration for the volunteers, whether they are in the volunteer lifeboats of the RNLI or the 3,500 plus volunteers who go out on a regular basis and put their lives at risk for us?
It will come as no surprise to the Minister that, as the Member for Inverclyde, where the Clyde coastguard is situated, I am deeply disappointed with today’s announcement, which comes on the back of 800 new engagements in the consultation process, tens of thousands of signatures sent to the Prime Minister in support of retaining the Clyde coastguard and numerous letters from organisations to the Minister. How does the Minister intend to assure people on the west coast of Scotland that safety is paramount and that the loss of the Clyde coastguard station will not mean that the area off the coast of the west of Scotland will be a no-shipping zone?
I know that it is difficult, but hon. Members should be careful about the emotive language that they use. When the Clyde co-ordination centre is not operational for whatever reason, its pair does the job on a regular basis. That happens and it happens around the country. That was why we went to this system and that was part of the submission. If the hon. Gentleman is disappointed by what I have said today, I must say to him that the previous Government’s proposals, which were on my desk when I arrived, were 10 times worse.
There will be great disappointment across south Devon at the announcement of the closure of the Brixham control centre. I know that the hon. Member for Totnes (Dr Wollaston), if she were able to be in the Chamber today, would share my concern. Can the Minister guarantee that there will continue to be a coastguard presence, if not the control centre, in the Torbay area? Will he consider the possibility of bringing other coastguard activities, such as the training of control centre and rescue staff and even volunteers, into the Torbay area to build on the reputation that the coastguard service has built up over decades?
There is acceptance that the quality of Her Majesty’s coastguard is world-renowned. I was at the International Maritime Organisation’s assembly yesterday morning and the leader of the American coastguard was talking to me about that particular point. The proposals we have finished with today will allow us to have more money for full-time staff to train the volunteers, more equipment and a professional career and pay structure that we would all be happy with, rather than the structure we have today.
Surely, the most perverse aspect of today’s statement is the proposed closure of Swansea. What justification do the Government give for this? They want to expand the DFT’s economic footprint in west Wales. What is the impact of that? Perhaps the Minister could explain why a so-called employment measure will take jobs away from an area of higher unemployment to protect them in an area of lower unemployment. And how on earth can he justify leaving the Bristol channel, which is one of the most dangerous waters around our country, without a 24-hour coastguard station?
On the first of the two substantive points that the hon. Gentleman raises, the Department and the Secretary of State are responsible for in excess of 5,000 DFT staff in the Swansea area. The economic effect on the small number of staff at Milford Haven is disproportionately beneficial to them compared with what would be the case at Swansea. That is what we have said both in the statement and all the way through. On the second point, when I was at Swansea attending a meeting with the staff, the station was switched off and Milford Haven was covering the very dangerous areas to which the hon. Gentleman refers. If that had not been safe, I am sure the coastguard would not have turned the station off.
I very much welcome the reassurance that the Minister gave to my hon. Friend the Member for South East Cornwall (Sheryll Murray) that the safety of people on our seas will be paramount in all his considerations as the proposals are developed. Will he give me further reassurance that the front-line coastguards at the co-ordination centres that will remain will be given the opportunity to work alongside the coastguards developing the new processes and procedures in the MOCs so that we will truly have the resilient and first-class service that I know he aspires to achieve?
A shocking thing that I found when I took over this job and visited co-ordination centres around the country was the complete lack of co-ordination. The pairs were linked but apart from that there was no national resilience at all. The whole point of doing this is to give us a 21st-century emergency service with that level of communication and skills. Training will be paramount. That will be done not only in the MOCs but across the co-ordination centres because they will be picking up calls from other areas just as the MOCs will be.
Will the Minister clarify the position of the Clyde station given that the lease of the premises is coming to an end at the end of next year? Is that when it will close? This is of great concern given that the maritime operations centre will not be in place then, so there will be no national resilience, and that Belfast is a far smaller station than the Clyde station at the moment. Does he understand the massive concern that we are leading to a situation in which there will be very little cover on the Clyde and far fewer resources than now?
It will not be the case that there will be little cover on the Clyde because that station is paired and the pairing will cover it no matter what. That happens today and has been the case for many years. There is no drawback at all to the front-line emergency services carrying out the rescues. Indeed, the exact opposite is the case—I am enhancing them, I am going to have more paid staff training them and there will be more safety and more cover. I am very aware that the lease on the station is running out, which is why I said in my statement that we will keep a strong footprint in the Clyde area—but it will not be at the existing station.
May I associate myself with the comments of the hon. Member for North Down (Lady Hermon) complimenting the Minister on his accessibility during this exercise? Will he assure us that the reduced number of MOCs, with their extended geographic catchments, will give the same quality and level of support as they previously have to our voluntary search and rescue services, which provide such a strong service on our inland waterways?
I am very aware of the unique geographical situation and size of Northern Ireland’s inland waterways. That is one of the reasons why I gave careful consideration to the question of whether it should be Belfast or Liverpool, and why we kept Belfast. The other reason was the unique situation of a border with another EU member state. Also, Belfast has shown time and again its ability to cover for the Clyde so that the pairing system works.
I commend the Minister for the comprehensive and sympathetic way in which he has gone about his further consultation. I acknowledge that one of the paired stations will remain open on a 24/7 basis, but I am concerned that on the east coast it is not the one at Yarmouth, but the one on Humberside. My concern focuses on the broads and the myriad internal waterways. Concern has been expressed to me by the Broads Authority and the Norfolk and Suffolk Boating Association that local knowledge cannot be provided from the Humberside. Will my hon. Friend consider a station operated on a seasonal basis, much the same as for the Thames, to deal with that area?
I fully understand my hon. Friend’s concerns. If I went down that avenue, I would open up a Pandora’s box and my Secretary of State would shoot me. I have holidayed nearly every year for the past 30 years on the Norfolk broads, especially across Breydon water. I understand the concerns, but I think the cover will be resilient enough. I hope people from Yarmouth transfer to the Humber. The new career and pay structures will make it much more worth while than was ever the case in the past, but I understand my hon. Friend’s concerns.
The rescue facilities in the Liverpool area will be enhanced. We will utilise the buildings that we have so that we do not rent new buildings for the sake of it. We will have more trainers, more enhanced staff, and the volunteers will provide a much better service for the public to rely on.
Although my Milton Keynes South constituency is probably as far from any part of the UK coastline as it is possible to be, I take a close interest in these matters as a member of the Transport Committee. I congratulate the Minister on balancing so many competing priorities and representations so objectively and fairly, but can he confirm to me that he is still reversing a key flaw in the original proposals, which was for only daylight operations at some stations?
That is one of the key aspects that we examined to see where resilience would come from. As we looked at the possibility of not having a second full-time MOC, the only way to provide resilience was for all the remaining stations to be open 24/7. That is why they will all be operational 24 hours, not just with daylight manning.
Pursuant to the question from my hon. Friend the Member for St Helens North (Mr Watts), and given the diversity of risks in Liverpool bay, ranging from the myriad estuaries to complex offshore facilities, is the Minister satisfied that the co-ordination facilities in the Liverpool bay area will be adequate? I share his view about national resilience. Will he look very carefully to make sure that what he is delivering meets what he says?
As an ex-firefighter, I would never in a million years propose something that I did not feel would have the resilience, the technology, the skills and the local topography to allow it to take place. The volunteers in the Liverpool area, particular in the area that I visited, have unbelievable skills, which will be enhanced, not hindered.
Although there will be huge disappointment in Great Yarmouth at the loss of our coastguard station, we note the Minister’s earlier comments about the job opportunities, the local knowledge and the resilience that could be improved with the Humber pair being kept. We are grateful for his recent visit to Great Yarmouth to visit the Caister independent lifeboat. Will he confirm that the Maritime and Coastguard Agency will continue to work as closely with independent lifeboats such as those at Caister and Hemsby as it does with the excellent Royal National Lifeboat Institution?
One of the great things about having the RNLI is that it is a brand known worldwide and a fantastic facility. However, little is known in this country about the volunteer lifeboats. There are huge numbers, including the one that I visited and went out to sea on at Caister recently, where the crew desperately tried to make me seasick, unsuccessfully. I can assure the House that not only will the facility be as good as it is now, but it will be better.
I am sure that the Minister will recognise the bitter disappointment of those in my locality who campaigned so hard to retain both the Liverpool and Clyde facilities, which serve 200 miles of coastline. The Scottish Government Transport Minister failed to recognise the significance of Liverpool to the Solway coast, but did the Secretary of State for Scotland and the Under-Secretary of State make any representations to him about retaining the Clyde facility?
The Scotland Office was fully informed of the proposal. I phoned the Minister yesterday to tell him, and I did the same for the Wales Office. This is a national emergency service, so the House and the Government are fully responsible for it. I understand the concerns, but we must reiterate that at the moment we do not have a national resilience service. If two of these pairs go down, there is no way that we can provide the cover necessary in a 21st-century service. This should have been done years ago, as I know the hon. Gentleman will admit.
I am sure that my hon. Friend is aware that these days in a co-ordination centre binoculars are not the usual piece of equipment used to survey what is going on at sea. The electronic equipment that we use is highly technical and works very well. In times of high need, we will be able to move that around the network so that other less important jobs that are already flowing through can be taken on by other stations or the MOC while new emergencies that are coming on board, with the local knowledge that is so desperately needed, can be facilitated.
May I join the Minister and the shadow Minister in paying tribute to the search and rescue family, including volunteers of coastguard services, for the excellent work that they do in protecting our coastline and coastal waters? May I also thank the Minister for reiterating the strategic importance of Holyhead and invite him to visit it, because he did not have a chance to do so during the consultation period? Will he assure the House that there will be constructive dialogue between management and the work force, including the unions, on this modernisation programme, so that they are fully involved and their ideas and local skills are used to make up this resilience that he talks about? Will he also assure the House that people will be told of redundancy and of any displacement that there will throughout the United Kingdom in plenty of time?
I have been working with the Public and Commercial Services union since day one when I became the Minister. I met its representatives very early on. They have been desperate for this issue to be resolved once and for all. They know the service needs to be modernised and that there had to be closures. They knew that all the way through, and I have discussed that with them fully. They were part of the group that looked at the proposals and the consultation documents that came in. We will work closely with the unions and the non-unionised members of staff, so that we ensure that whatever happens they know. I do not think that there will be any redundancies in Holyhead, but, overall, we will do our level best to make sure that it is natural wastage and that we keep the skills within the service.