House of Commons
Tuesday 10 January 2012
The House met at half-past Two o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
The coalition Government recognise the tremendous contribution that volunteers play in enhancing quality and experience in health and social care, including within hospitals. We are working with partners, including the National Association of Voluntary Service Managers, to strengthen this role during service reform.
Mr Speaker, may I wish you and the House a very happy and healthy new year?
I thank the Minister for his response. I recently attended the local volunteering awards in the West Middlesex hospital in my constituency. Almost 400 volunteers do great work for patients and the hospital. What financial assistance is available to hospitals to support these volunteering projects?
I very much agree with the hon. Lady about the need for NHS trusts to consider their stance on volunteering. Indeed, I suspect Members of all parties have visited hospitals and worked with friends organisations over the Christmas period and have seen the good work that volunteers do in our hospitals. Our aim is to make sure that NHS trusts and commissioners of health and social care have the tools and information they need to make good judgments about investing in volunteering. That was the purpose of the volunteering strategy that we published last year.
We all recognise the huge contribution that volunteers make to the NHS, so will the Minister take this opportunity to recognise the contribution of Clive Peedell, the co-chair of the NHS Consultants Association, who is taking part in Bevan’s run today, highlighting concerns among the medical profession about the impact of the dreadful Health and Social Care Bill?
My hon. Friend raises an important point. I am aware that it is a matter of concern that over a number of years some hospitals have chosen not to use the WRVS or friends organisations’ services. These decisions have to be made by local NHS trust boards, but the purpose of the strategy we published last year is very much to make sure that when the boards make these decisions they are focused on the benefits—the benefits of volunteering for the volunteer, the organisation and the patients.
As far as I am aware, no assessment has been made to analyse the number of unpaid interns. What is very clear, however, is that when NHS organisations are using people to provide services as volunteers, that is clearly separate from what would be regarded as paid employment. That is clear in the strategy we set out last year and clear in the advice and guidance provided by the Cabinet Office as well.
Access to Drugs
Representations received have strongly supported the Government’s “Strategy for UK Life Sciences”, which was published on 5 September. Speeding up clinical trials approval, enabling the unique NHS clinical databanks to support research, the early adoption of new medicines and other initiatives will bring NHS patients the fullest benefit from innovation and will promote growth in UK biosciences.
I am grateful to my hon. Friend. He rightly highlights an area where we are clear that innovation can be considerably supported, and not only by the academic health science centres, which were established under the last Government. As the life sciences strategy set out in early September made clear, we want to create academic health science networks across the NHS so that higher education, industry and the NHS can work together to bring about the greatest possible innovation to the benefit of patients.
The current pharmaceutical price regulation scheme is able to recognise the fact that pharmaceutical companies based here and developing drugs here should be paid a little bit more for their drugs by the NHS on the basis of their worth for the general economy. Will the Secretary of State tell us whether his proposals for value-based prices will affect that?
The right hon. Gentleman will be aware that the existing PPRS does not in any sense directly fund innovation in the United Kingdom. Although it takes account of expenditure on innovation, it cannot identify that expenditure in the United Kingdom as a beneficiary through pharmaceutical pricing. As the right hon. Gentleman knows, we are continuing to discuss with the industry the shape of value-based pricing from January 2014, the purpose being to ensure that we fund the value associated with new medicines: the therapeutic value to patients, the innovative value—which will highlight the UK as a base for research and development—and the societal value.
Paediatric Cardiac Services
The review of children’s congenital heart services is a clinically led NHS review, independent of Government. In conducting it, the Joint Committee of Primary Care Trusts has aimed to be as inclusive as possible in relation to all issues.
As I have said, the review is clinically led and independent of Government, and I am afraid that it would not be appropriate for me, or my colleagues, to intervene. Moreover, the review is the subject of legal proceedings. It will be for the Joint Committee of Primary Care Trusts, on behalf of local commissioners, to decide the future pattern of children’s heart services on the basis of the best available evidence.
It seems nonsensical to deal with the provision of surgical services for adult and child congenital cardiac patients in separate reviews. Given the delay in the review of children’s services, does the Minister not agree that it is time to consider including them in the forthcoming review of adult services?
I am grateful to the hon. Gentleman for his suggestion, but I am afraid that I do not share his view. As he knows, there will be a review of adult services, but it has always been considered most appropriate to deal with paediatric cardiac services before adult care, and that is what we will continue to do.
Although the paediatric heart unit at Southampton general hospital is rated the best in the country outside London, it was included in only one of four options under the review. In the past, the Minister has helpfully hinted he might not be confined to considering only those four options. Can he expand on that?
I can expand on it by saying that it will not be me who considers the options. As I have told my hon. Friend before, this is an independent review. However, as he suggests, the JCPCT may decide on four, six or seven possible sites. It all depends on what the consultation produces, and the clinical decision on what is the most appropriate number of sites, which will happen eventually.
I congratulate my hon. Friend on his championing of Southampton general hospital as the local Member of Parliament.
Cancer Drugs Fund
4. What recent representations he has received on access to the cancer drugs fund; and if he will make a statement. (88269)
We have received a number of supportive representations regarding the cancer drugs fund. Indeed, the Rarer Cancers Foundation recently praised the fund for making additional cancer drugs available to almost 10,000 patients in England since October 2010. It contrasted that access to medicines in England with the lack of such access in Wales.
My right hon. Friend has cited the view of the Rarer Cancers Foundation. Does he agree that this policy has put patients and doctors back at the heart of decision making, and has transformed the ability of cancer patients to obtain clinically effective treatment so that they can gain precious extra time with their families?
My hon. Friend is absolutely right. In the summer of 2010, we learnt from Sir Mike Richards’s review that patients in this country were less likely to have access to the latest cancer medicines within five years of their introduction than those in many other European countries. I am proud that so far the coalition Government have been able, through the cancer drugs fund, to help 10,000 patients to gain access to the latest cancer medicines.
I thank the Minister for that response. Last year, Cancer Research UK revealed that cancer deaths were down 20% since 1985 and survival rates have doubled in the last 40 years. Does the Minister agree that we must continue to research proactively and thereby continue to reduce deaths and ensure continuity of life?
I am grateful to the hon. Gentleman, and he is absolutely right about that, of course. He will also be aware that Cancer Research UK highlighted not only the progress that had been made, but the variation in progress on different cancers. Harking back to the earlier point about innovation, we must focus on how some of these innovations will enable us to deliver improved survival rates for specific cancers, and I announced last month that we would be funding additional scanner facilities in this country—proton beam therapy scanning interventions—in order to enable some of the most difficult cancers, such as brain cancers in children, to be treated in this country effectively.
A cancer patient in my constituency faces an avoidable further round of chemotherapy having waited for the strategic health authority to make an individual funding request decision on the drug Plerixafor, which is not included in the cancer drugs fund. Will the Minister consider broadening the scope of the cancer drugs fund to include such drugs that are critical in cancer patients’ care, in addition to their other uses?
I should be grateful if my hon. Friend would write to me about that. The cancer drugs fund is focused on an identified lack of access to cancer medicines, but if a drug is of particular benefit to a cancer patient, such as in the instance he describes, it should be possible for SHA panels to include it within the scope of the fund.
5. What steps he is taking to ensure drugs approved by the National Institute for Health and Clinical Excellence are made available to all patients in the NHS. (88270)
The NHS is required to fund drugs and technologies recommended in NICE technology appraisals, in line with the NHS constitution. The NHS chief executive’s report “Innovation, Health and Wealth” sets out plans for the introduction of a compliance regime to ensure rapid and consistent implementation of NICE technology appraisal recommendations throughout the NHS.
I greatly welcome the Government’s recent announcement on swift and proper implementation of NICE guidance that allows patients access to innovative treatments. In order for cost-effective treatments to secure NICE guidance approval, in the first instance will the Secretary of State ensure that NICE’s methodology review reinforces the importance of appraisal appropriately reflecting clinical practice when assessing new treatments?
I am grateful to my hon. Friend, who clearly understands that NICE is responsible for the methods it uses in the development of its guidance and that it is undertaking a review of its appraisal methods. I expect that that will be published for consultation this year. NICE should issue final guidance only after careful consideration of the evidence and public consultation with stakeholders, including patient and professional groups.
It is sometimes hard to follow the Secretary of State as he can get lost in his own jargon. Just to be clear: if NICE says that a drug should be available to patients on the NHS wherever they live and whatever their clinical commissioning group, will they get it? Can he give that guarantee today?
The right hon. Gentleman knows perfectly well that that did not happen under the last Government. The NHS chief executive’s innovation report of early December made it clear that we will make certain that when NICE gives a positive appraisal for a medicine, it is automatically included in formularies, and also that we will establish an effective compliance regime in respect of NICE appraisals and establish a new NICE implementation collaborative to make it happen. As the right hon. Gentleman knows perfectly well, the legislation is clear: when NICE gives a positive appraisal, a medicine should be available across the NHS. That was not achieved under his Government. We will achieve that, and the NHS chief executive is setting out to show how that will happen in the future.
Under the current regime of primary care trust commissioning, my constituents in Warwickshire often complain to me that drugs approved by NICE are not always available locally but are available in neighbouring commissioning areas. What steps are being taken to ensure that new NHS commissioning boards and local commissioning groups promote the NHS constitution and the right of patients to access NICE-approved drugs?
My hon. Friend makes exactly the right point, in that what the last Government said happened did not happen: such medicines were not available, and there was a postcode lottery in accessing many of them. That, among other reasons, is why the chief executive of the NHS published his report, which will introduce the NICE compliance strategy. We will require all NICE technology appraisals to be incorporated automatically in the local drug formularies, and the NICE implementation collaboration will support the prompt implementation of NICE guidance.
Last week in my constituency, a community pharmacist refused to issue a blind patient with dosage packs unless they paid an additional fee. What redress will such patients have in the newly reorganised NHS regarding actions such as this by community pharmacists, which in my view are against the Disability Discrimination Act?
I should be grateful if the hon. Lady wrote to me about that case and gave me the opportunity to look at it, which I would be pleased to do. From my point of view, we do not countenance such requirements, through charging, denying patients access to any NHS treatment.
Of course, my hon. Friend will know very well that choice of treatment is a shared decision between patients and their clinicians. NICE appraisals are about whether treatments are available in the NHS and giving information to clinicians about their relative clinical and cost-effectiveness, not prescribing that treatments should be available in specific circumstances.
I and my officials have worked closely with the Department of Energy and Climate Change on the development and implementation of the cold weather plan for England, which aims to reduce the health impacts of cold weather on vulnerable people. We have also put £30 million into the warm homes healthy people fund to fund local authority projects to reduce the impact of cold weather.
The Marmot report confirmed that cold homes are bad for our health. My local newspaper has highlighted the case of a low-income working family who have to choose between food and heat every day, with no help from their energy provider. Will the Minister ensure that energy companies do more to tackle fuel poverty, so that the NHS does not have to foot the bill for their profit?
As I said, my colleagues in DECC are working closely with the energy companies. I point out to the hon. Gentleman that this coalition Government are the first to put in place the cold weather plan to reduce those 27,000 excess winter deaths. Perhaps his local paper would like to contact the Welsh Assembly Government to see what they are doing.
Fuel poverty clearly shows the link between housing, health care and well-being. Last week, the Prime Minister called for a merger of health and social care. Does the Minister agree with me that if we are to have a true merger of health and social care, housing—through health and wellbeing boards and other mechanisms—has to be a key ingredient of that?
Of course, my hon. Friend is absolutely right that the integration of health and social care is critical, particularly for issues such as this. The changes we are making to public health and the movement of public health into local authorities will only ensure better integration, so that we can reduce those 27,000 excess deaths.
The Department of Health funds the national confidential inquiry into suicide and homicide by people with mental illness. The Department is funding an investigation of self-harm, and the National Institute for Health Research is funding a range of further research relevant to suicide prevention.
The Minister will be aware that core funding for research into the causes, effects and geographical spread of suicide and its frequent precursor, self-harm, is essential. More than 200,000 people present at accident and emergency with self-harm. I am very concerned to hear that the ongoing funding for the multi-centre study of self-harm is potentially at risk. Will he agree to meet me and the research project leads to discuss this and ensure that that research continues?
The hon. Lady chairs the all-party group on suicide and self-harm prevention. She does a lot of important work in this House in that regard, and I would be only too happy to talk to her about research priorities in this area. The Government are examining the research priorities to support the new strategy, which we plan to publish in the near future.
I pay tribute to the hon. Member for Bridgend (Mrs Moon), who has done fantastic work on the prevention of suicide. It is not the Department of Health’s job to regulate the worldwide web, but what work has the Department done on examining the link between the watching of violent websites—and, indeed, looking at websites that promote or facilitate suicide—and the actual carrying out of suicide?
My hon. Friend makes a very important point, which has been raised by a number of charities, including Papyrus, during the consultation on the draft strategy. It is important to stress that the internet industry has been willing to engage in positive initiatives, not the least of which is Facebook and Google’s work with the Samaritans to make sure that whenever anyone types in “suicide” a link to the Samaritans always appears first. However, more needs to be done and we need the industry to tackle those darker sides of the internet to make sure that they do not prey on vulnerable people and do not peddle suicide.
Given the crucial role that the chief coroner was to have had in monitoring and advising the Department of Health on the incidence of suicide across the nation, will the Minister liaise with the Lord Chancellor to ensure that a chief coroner is appointed speedily and that powers are put in place quickly to make sure that this work can be done?
Telecare and Telehealth Services (Congleton)
I am pleased to say that patients in Congleton who have health conditions such as heart failure or chronic respiratory disease can already benefit from these technologies. I am committed to supporting the use of telehealth and telecare services by working with industry to improve the lives of 3 million people across the country who are living at home with long-term conditions.
I thank the Secretary of State for that reply, and indeed innovative schemes in my constituency and across the Cheshire East council area, such as DemenShare, are already using this technology. But what other schemes and advances will the Government introduce for an area that has the highest level of elderly people per population head in the north-west of England and where the number of over-65s will grow by 50% and the number of over-85s is set to more than double by 2025?
I am grateful to my hon. Friend for her question. She rightly talks about this increasing number of older people in the community and rightly says that we want to support them to be independent and to improve their quality of life.
The whole system demonstrator programme was the largest trial of telehealth systems anywhere in the world. In the three pilot areas of Kent, Cornwall and Newham, it demonstrated a reduction in mortality among older people of 45%; a 21% reduction in emergency admissions; a 24% reduction in planned admissions to hospital; and a 15% reduction in emergency department visits. Those are dramatic benefits, which is why we are so determined to ensure, over the next five years, that we reach out to older people who are living at home with long-term conditions and improve their quality of life in this way.
Group B Streptococcus
The UK National Screening Committee is reviewing the evidence for screening for group B streptococcus carriage in pregnant women, and I am sure that my hon. Friend will be pleased to hear about that. The committee will review the international literature, and a public consultation on the results will open in spring 2012.
Group B streptococcus is the UK’s most common cause of life-threatening infection for newborn babies. Will my hon. Friend agree to meet me and Group B Strep Support, the excellent campaign group, to see how calls for a national screening programme might best be advanced?
I am certainly happy to meet my hon. Friend. I should point out that the Royal College of Obstetricians and Gynaecologists is updating its guidelines and that NICE is also developing guidance. The issue is complex, however, and even testing is not 100% effective. Women who produce a positive result during pregnancy might be negative during labour and, more importantly, those who are negative during pregnancy might be positive during labour. It is important that we get the most up-to-date evidence and ensure that we reduce the tragic consequences of this infection.
I welcome the Minister’s statement, but may I urge her to consider carefully the kind of testing, as the false negatives and positives to which she refers come with the current testing and there are better tests? About 340 babies are affected every year of which one in 10 dies and one in five is permanently disabled. This is a very serious matter and I hope she will do all she can to deal with it.
I will certainly do all I can to deal with it. As the right hon. Lady says, the consequences are tragic but this is a complex area that has changed quite rapidly. I think the US is now at a similar level of infection to us, but what remains a challenge is ensuring that we have an effective test that does not produce false positive or, more seriously, false negative results and that we have effective treatment that works in 100% of cases.
NHS Reorganisation Cost
The cost of the NHS modernisation is estimated to be between £1.2 billion and £1.3 billion. That will save £4.5 billion over this Parliament, and £1.5 billion per year thereafter. We will reinvest every penny saved in front-line services.
I am grateful for that answer. The Minister will be aware that the figure he has given is about half what the primary care trusts believe they are required to keep back to fund the reorganisation: they put it at £3.4 billion. Given his answer today, will he write to South Birmingham primary care trust to tell it that it no longer has to hold back £25 million for that purpose and that it can use that money to cut the 18-week waiting list, which has risen by 36% since he assumed office?
May I say, in the nicest possible way, that I think the hon. Gentleman is a tiny bit confused? I think he is confusing the one-off costs of the modernisation with the 2% hold-back figures used by the PCTs, which put aside money—a process instigated by the right hon. Member for Leigh (Andy Burnham), which we carried on—that can be used if a PCT gets into financial problems. If it does not get into financial problems, it can then use the money to invest in front-line services.
The Conservative-led coalition should be congratulated on introducing a measure that will get rid of red tape and bureaucracy by getting rid of strategic health authorities and primary care trusts. Do the Labour Opposition not look like dinosaurs when they try to defend those bodies?
I am very grateful to my hon. Friend and I am always reassured when he congratulates the coalition Government, as it suggests to me that we are getting something right. My hon. Friend is absolutely right. As everyone who understands health policy in this country recognises, the NHS must evolve to meet changing needs and we are improving effectiveness and efficiency and saving money by cutting out administration and bureaucracy so that we can reinvest in front-line services to look after the health interests of all our constituents.
Figures revealed to the Opposition under freedom of information procedures show that GPs will receive up to £115 an hour for commissioning health care services on top of their existing salary. It makes no sense at all to take GPs away from patient care to become part-time accountants. When the NHS needs every penny it can get, patients will be astounded to hear that the Government plan to pay GPs twice. This comes at a time when 48,000 nursing posts are being axed and £3.5 billion is being set aside for the Minister’s bureaucratic upheaval. Will he now accept that the NHS can ill afford for money to be wasted on a top-down reorganisation that few want? Is it not now time for him to scrap the Bill?
It is nice that the hon. Gentleman got the mantra in at the end—I have been expecting it all through this Question Time. He is wrong; what is important and what this modernisation has at its heart is the need for GPs to commission care for patients, because GPs are best equipped to know the needs of their patients. That is the way forward. Also, we are cutting bureaucracy and administration by 45% so that we can reinvest that money in front-line services. We want to spend money on health care and on improving outcomes, not on managers and bureaucracy.
May I congratulate the Secretary of State and the Prime Minister on the productive ward initiative? The NHS document “Top Tips for spreading The Productive Ward” says:
“Set a realistic time scale. Take your time and do not rush. Take small steps and complete them before moving on to the next.”
Is this advice generally applicable to NHS reform?
As the hon. Gentleman recognised at the beginning of his question, this is important and excellent advice for nurses and other health care professionals to give care, consideration and attention to all patients so that they can be looked after in an appropriate and caring way. That is the way forward to making the health service more responsive to the needs of patients and to the improvement of health outcomes.
The hon. Lady raises an extremely important point. The whole purpose of the modernisation of the NHS is to enable it to meet the challenges of an ageing population, an increased drugs bill and new medical procedures, so that we can ensure that patients get their treatments, within the responsibilities of the NHS constitution, and do not have to wait undue lengths of time for treatment.
Health and Social Care Bill
The Government have listened to representations throughout the passage of the Health and Social Care Bill. In addition to the consultation on the White Paper, the NHS Future Forum has undertaken two engagement exercises. The first involved 6,700 people directly and received more than 28,000 comments and e-mails, and the second involved more than 12,000 people at more than 300 events. Ministers have also continued to meet and to receive representations from a range of interested parties on a regular basis, and we will continue to do so.
I thank the Minister for that response. May I ask what specific representations he has had on children’s well-being? Is he aware that the Children’s Society will this Thursday publish its 2012 “Good Childhood” report, which will include a specific report on how central and local government could improve and promote positive well-being among children? Will the Minister and the Secretary of State meet the Children’s Society to discuss that important report?
Throughout the consultation process there have been comments and responses to proposals across the whole of the health area, including on children’s health and well-being. Obviously, I cannot comment on a report that will not be published until later this week, but I or one of my ministerial colleagues would be more than happy to meet the Children’s Society once the report has been published if the society thinks that a meeting to discuss the report’s contents would be worth while.
Against the background of the recommendation of the NHS Future Forum that a key priority for the future is greater integration between health care and social care—a priority that was explicitly endorsed last week by the Prime Minister—does my right hon. Friend agree that the key opportunity in the Bill, through the health and wellbeing boards, is to drive that agenda, which has been much talked about for many, many years now, and actually to start to deliver on that rhetoric?
My right hon. Friend is absolutely right; of course, when he was Secretary of State he did a considerable amount of work to lay the ground rules for the move towards greater integration, because that is the way forward. My right hon. Friend makes a very valid point: it is the way forward and we fully recognise that. We are deeply committed to achieving that aim, and that is why my right hon. Friend the Secretary of State has added an extra £150 million to the existing £300 million, to facilitate progress towards it.
May I tell the Secretary of State and the Minister that he will receive more representations on his Bill later this week from two hospital doctors who, early this morning, began a 160 mile run to protest against his Bill, from Bevan’s statue in Cardiff to his Department? [Interruption.] The Secretary of State should listen. Let me remind him why people are so angry. Nobody voted for the Bill. It was ruled out by the coalition agreement, and it is now the unelected House deciding the future of the NHS, passing amendments that he was too scared to table in this House.
Will the Minister today have the courage to admit that it is now the Government’s intention to allow NHS hospitals to make 49% of their income, effectively devoting half of their beds, from the treatment of private patients?
May I say a happy new year to the right hon. Gentleman as well? I believe that his analysis of the support for the Bill is flawed, because there are a number of areas where a number of organisations warmly welcome its contents. For example, the BMA voted in favour of GP commissioning at its special general meeting last year.
On the question of 49%, the shadow Secretary of State has been uncharacteristically forgetful, because of course he will appreciate that the cap applies only to foundation trusts, not to non-foundation trusts, and that is no different today from what it will be after the modernisation—and it was a policy that his Government brought in.
No, it was not. That policy would never, ever have come forward under a Labour Government—and I know that the right hon. Gentleman has not denied it. We, the Opposition, will now make it our business to tell every single patient in England about his plans for the NHS. People can finally see the Bill for what it is: a privatisation plan for the NHS. England’s hospitals will never be the same again if the Bill gets through: an explosion of private work; longer waits for NHS patients; profits before patient care. Will not the only choice on offer for patients be the old Tory choice in the NHS: wait longer or pay to go private?
I am afraid that the shadow Secretary of State is just totally wrong. This Government have no intention to and will not privatise the national health service. We want to improve patient outcomes and the patient experience. The right hon. Gentleman should look again at the 49% that he talks about, because we are not changing the situation, particularly because it does not apply to trusts at the moment; it is only for foundation trusts.
Bowel Cancer Screening
The IT system to support the pilots of flexible sigmoidoscopy screening is under development and local bowel screening programmes will be invited to become pilot sites shortly. We remain determined to deliver our cancer outcomes strategy commitment of 60% coverage across England by March 2015.
The Government rightly chose two out of the three pathfinder sites to be in the north-east, at South of Tyne and Tees. When will the date be given for local screening centres to be invited to bid to become pilot sites and have patients as a future part of that bowel cancer screening programme?
NHS Reorganisation Cost
The cost of the NHS modernisation is estimated to be between £1.2 billion and £1.3 billion. That will save £4.5 billion over this Parliament, and a further £1.5 billion each year thereafter. [Hon. Members: “It is a different question.”] It is the same question. We do not have a local breakdown of these figures, as that will depend on local decisions.
Perhaps the right hon. Gentleman will ask the House of Commons Library for the answer so that he can give it to me next time, and also look at the increase in the number of managers in Wirral over the past five years. The number has gone up by more than a quarter. With that size increase, why are those staff not being used to pilot his reorganisation?
The right hon. Gentleman is absolutely right. There was a significant increase in managers in the NHS in the last two or three years of his Government. Since we came to power, there are just under 15,000 fewer managers and administrators, and 3,700 extra doctors.
The Minister is well aware of the reforms to the NHS in my English constituency, but many of my constituents question whether they are getting value for money in view of the expansion of population in Newark over the next couple of years. Will he look again, please, at the Newark health care review?
A and E and Maternity Departments
The reconfiguration of local health services, including A and E and maternity services, is and will remain a fundamentally local process. What matters is that decisions about service changes are clinically driven, and that patients and the public are involved in those changes to ensure that they get the highest quality care.
I refer to the answer that the Minister just gave to the hon. Member for Newark (Patrick Mercer). The buck stops with the Minister. Would he like to congratulate the SOS Save Our Services group in Bassetlaw, which in the past two months has overturned the proposals to downgrade A and E and maternity services at Bassetlaw hospital? Is that not a good example of the real big society?
As the hon. Gentleman knows, on 20 May 2010 my right hon. Friend the Secretary of State brought in the four conditions that had to be met for reconfiguration, which included paying attention to the views of local stakeholders and the medical profession. So, as the hon. Gentleman rightly says, the decision has been taken not to proceed with the changes at Bassetlaw hospital. No doubt he also welcomes the £900,000 that is being invested to expand and improve Bassetlaw hospital’s A and E facility.
The whole House will note that the moratorium on hospital and ward closures has clearly ended, but as my hon. Friend the Member for Bassetlaw (John Mann) rightly said, the NHS risk registers held by regional and local health boards around the country clearly showed the risks associated with closures and the downgrading of hospital wards. The Government’s Health and Social Care Bill poses risks to the safety and quality of services, yet the Secretary of State has appealed against the Information Commissioner’s ruling that the NHS national risk register should be published. Members of both Houses may be denied the opportunity to scrutinise the real risks that the Bill poses to the NHS before they are asked to vote on it for a final time. Will the Minister give a binding commitment that the risk register produced by his Department will be published in full before the Bill returns from the Lords?
The right hon. Member for Leigh (Andy Burnham) did not publish a risk register during his tenure. His predecessor, the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson), did not publish the risk register on two occasions during his tenure. The bits relevant to the Health and Social Care Bill have been made public, but we will not be publishing the risk register because, as the hon. Gentleman knows, my right hon. Friend the Secretary of State is appealing, as he is entitled to do, against the Information Commissioner’s decision—[Interruption.] We have a right of appeal, which we are exercising, and we will have to wait until a decision has been reached on appeal. Until then, no we will not be publishing the risk register, because it is not necessary or appropriate.
The public health reforms have at their very heart the prevention of ill health and its associated costs, and the hon. Gentleman in his question clearly recognises the critical impact that intervening early can have. The health visitor work force are an important part of early intervention. We picked up a very demoralised and depleted health visitor work force, so I am pleased to report that training commissions for health visitors are up 200%, and we plan to double the number of family nurse partnerships available by 2015. We are also developing a vision for school nursing.
The introduction of the family nurse partnership and the enhancement of the amount of money available to it is a great credit to the previous Labour Government and the current coalition Government. It enables single teen mums to get one-to-one help from a health visitor. Given the economic circumstances, does the Minister accept that we need to be a bit more inventive to ensure that that very good scheme goes even further? Will she discuss with the city of Nottingham and its health service a payment-by-results system to extend the family nurse partnerships further?
Yes, we are supporting the development of social investment and outcome-based funding models, and I am pleased that the hon. Gentleman has raised the issue of being innovative about how we do that, because it is important. We had a rather static situation previously, so I welcome his interest in developing and testing a payment-by-results scheme in Nottingham, and we will be interested to see his detailed proposals and how that develops locally soon. What matters are the results that we get from the schemes.
I pay tribute to the hon. Member for Nottingham North (Mr Allen) for his work on early intervention and applaud the efforts made by the Minister to recruit more health visitors, but when will the Government be able to deliver the additional health visitors on the ground, trained and in service, in order to reverse the cuts in the health visitor service under the previous Government?
My hon. Friend is right; we picked up a very depleted and demoralised health visitor work force. We have 26 health visitor early-implement sites and, as I said, a 200% increase in planned training commissions for health visitors. Turning this round takes a long time. I am sorry that we could not get started on it earlier, but this will have the critical impact: 4,200 health visitors by the end of this Parliament will give us the results that we need in turning round the fortunes of some of the most vulnerable families in this country.
Early intervention can transform health for children and young people and prevent bigger and more expensive problems down the line, yet the Government have cut funding for early intervention programmes, including Sure Start, teenage pregnancy and mental health in schools, by 11% this year and 7.5% next year. Is not the reality that it is this Government who are depleting and demoralising the health visitor work force, and that their short-sighted, short-term policies will make it harder to prevent poor health and cost us all more in the long run?
The reality is that the Government are picking up a very depleted health visitor work force. School nurses, health visitors and the family nurse partnership are all critical. We picked up a very sorry state of affairs. The hon. Lady is right; early intervention matters, which is why we are doing it. I am just sorry that the previous Government did not take the action that was needed.
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.
My right hon. Friend will be aware that a significant number of private clinics that fitted women with Poly Implant Prothese breast implants are no longer in business. Will he advise the House on how he plans to strengthen not just the regulation of clinics offering cosmetic surgery, but the products that they use?
I am grateful to my hon. Friend. I not only laid before the House a written statement this morning, but will, with permission, make a statement on the subject tomorrow. We have been very clear about the support the NHS will give to women who have had implants through the NHS, and we expect private companies to do the same. Not all will do so, and to that extent I make it clear that the NHS is there to support women in their clinical needs, whatever their circumstances.
The Secretary of State will be aware that thousands of women are worried and frightened about this issue. The statements he has made are welcome, but what practical help can he offer women whose private providers have not yet committed to offering free replacements?
This is important, as the hon. Lady says. All the way through we have wanted to be absolutely clear that any woman who is worried should be able to go to her general practitioner. The NHS is there to support any women in their clinical needs, whatever their circumstances. I have made it clear that I expect private providers to match the NHS support through information and access to specialist advice, imaging and investigation, as necessary, and through the removal of implants if it is decided that that is necessary. If private providers will not do that, let me be clear, as I will explain further tomorrow, that the NHS remains available to support women in their clinical needs.
T5. Does my hon. Friend the Minister believe that the Government’s aim of stopping people smoking is in any way helped by the chairman of the all-party group on smoking and health, the hon. Member for Bristol West (Stephen Williams), using a private letter that I sent to him, and copied to the Minister, to castigate me and make untrue allegations in my local newspaper last Thursday? (88295)
Order. I was doing my best to listen attentively—it is very difficult to hear clearly when there is so much noise. If there is to be a reference to another right hon. or hon. Member, advance notice of it should be provided. These courtesies must be observed. They are there for a good reason.
I remind my hon. Friend that smoking kills over 80,000 people a year in the UK. We have published our tobacco control plan, are implementing the display ban and hope to consult soon on the future of plain packaging. The important thing to remember about improving public health is that it is not a party political issue. I cannot comment on the specifics of the case he mentions, but this is a matter that interests everyone across the House.
T2. The people of Newcastle are more likely to die early from cancer, health disease and stroke. On average, a child born in Newcastle today is expected to die five years before a child born in the Secretary of State’s constituency, so why is he changing the health funding formula so that in Newcastle we will lose 2.5% of our funding, whereas his constituency will see a rise of 2.1%? (88292)
Let me remind the hon. Lady—she might not have noticed this—that before the Christmas recess I announced funding for the next financial year for all primary care trusts in England, and the increase for all primary care trusts is 2.8%. In contrast to the previous Government, we are setting out to reduce health inequalities, not least by focusing resources on public health on the basis of an objective measurement of disparities in health outcomes.
A BBC Essex investigation into Rushcliffe’s Partridge care home in my constituency has uncovered shocking allegations of abuse and neglect. Will the Minister urge the Care Quality Commission to step in now with an inquiry and take whatever legal action is necessary to protect the elderly residents? Will he meet me and my constituent Lesley Minchin who has a relative who has suffered as a result of what has been going on in the care home?
I certainly share my hon. Friend’s concerns. BBC Essex’s reports of abuse and degrading treatment in that care home are cause for concern. The CQC is due to publish a report shortly and I am certainly happy to meet my hon. Friend to discuss the matter further. The Government are determined to shine a light on abuse wherever it is found and to root it out of the system to ensure that people are treated with dignity and respect and get the care they need.
T3. Does the Health Secretary agree with the Prime Minister that our nurses need greater supervision by patients’ groups on the ward to ensure that they are doing their jobs correctly, or does he recognise the tremendous job that they and their professional clinical managers are doing despite the huge cuts that the Health Secretary has forced on their numbers? (88293)
I do indeed agree with the Prime Minister, but I would not characterise what he said in the way that the hon. Gentleman does. I was very interested to see a number of letters in The Times just this morning that highlighted that in the past, under patient and public involvement forums and community health councils, there was a direct public interest in seeing what happened in hospitals and in inspection. Through the Health and Social Care Bill and the establishment of HealthWatch, we will enable the public—representatives of patients—to be involved directly in assessing the quality of the environment in which patients are looked after. They will not supervise nurses. Nurses will be responsible for the experience and care of patients, but the public have a right to be participants in inspection—
When the Government introduced the Health and Social Care Bill a year ago, they did so with the claim that the NHS fails in comparison with its European counterparts with regard to patient outcomes. Now we know that that is not the case, will the Government withdraw the Bill?
I do not agree with that characterisation of why we instituted the Health and Social Care Bill or of the current situation. For example, the OECD published in October its latest assessment of health in a number of countries. In too many respects—for example, in relation to serious respiratory disease—we have very poor outcomes relative to other countries. What we are setting out to do in any case is to deliver continuously improving outcomes and to get among the best in the world. In too many respects we are not yet among the best in the world.
It is precisely because the Prime Minister and I listen to nurses that we met them and made it clear that we will support best practice. The hon. Gentleman and his colleagues should support nurse leadership on the wards. Nurses can see—through best practice, if they talk to patients about their experience every hour—that they can deliver better care. We will support nurses to deliver better care; he should support us in doing so.
T6. In a written answer on 12 December, the Minister of State, Department of Health, the hon. Member for Sutton and Cheam (Paul Burstow), who has responsibility for care services, told me that the Government felt that:“Local community hospitals provide a vital community resource to support patients in need of rehabilitation, recuperation and respite care”—[Official Report, 12 December 2011; Vol. 537, c. 560W.]What steps will the Government take to prevent the closure of the Chaloner Ward at Guisborough hospital and financially secure that hospital’s vital future? (88296)
The Prime Minister speaks of the “health and safety monster”; does the Minister believe it is right that advertising for personal injury lawyers should be displayed in hospital A and E departments, which many might think would feed the monster and make it bigger?
I am very grateful to my hon. Friend for raising that, because it is an important issue. As he might be aware, there are rules and regulations: it is not acceptable for that sort of advertising in NHS hospitals. I would hope that any trusts behaving in that way immediately review their procedures.
T8. Yesterday, I had a meeting with Patricia Osborne, the chief executive of the Brittle Bone Society, a UK-wide organisation that is headquartered in my constituency. It was made clear to me that given the current funding squeeze across the voluntary sector, the society is concerned about its ability to provide the vital services that it currently provides. Also troubling the society is the lack of support for adult sufferers of osteogenesis imperfecta. What can the Secretary of State tell me about the Government continuing to support that important society, and what more can they do to support adults with that condition? (88299)
The hon. Gentleman will know that the Department of Health continues to support the voluntary sector considerably through section 64 funding and related support. If he wishes to write to me about the specific circumstances of the Brittle Bone Society, I will be glad to reply to him.
I recently made a freedom of information request to all 170 acute trusts asking for the estimated total cost of missed out-patient and surgery appointments. So far, 61 have come back to me, and the cost is already over £1 billion. Will the Secretary of State seriously consider what we can do to tackle the enormous cost of missed appointments in the NHS?
Yes. My hon. Friend makes an important point, and it is something the NHS must focus on. There are considerable opportunities through new technologies substantially to reduce the extent of missed appointments, including through things such as text messaging. What is frustrating is that, sometimes, appointments are missed because patients have not been adequately contacted by hospitals. As for people who abuse the NHS, I hope we will give them no excuses for not meeting their obligation to attend appointments.
Can the Secretary of State intervene with those involved with the health for outer north-east London programme to get them to allow the Barking, Havering and Redbridge University Hospitals NHS Trust to use the births and maternity capacity at King George hospital to take pressure off Queen’s?
As the hon. Gentleman knows, following the independent reconfiguration panel report, which I accepted in full, the Barking, Havering and Redbridge Trust is looking to manage safely its maternity services, while improving the quality at Queen’s. It is doing that in close co-operation with NHS London and, indeed, with the advice of the Care Quality Commission, following the commission’s inspections. I will continue to be closely involved in that, and we will continue to support the Barking, Havering and Redbridge Trust in improving services for the hon. Gentleman’s constituents and others.
Time does not permit me to mention all the things that could be achieved, but let me just say that we are clear about the need, for example, to tackle below-cost selling of alcohol, and we are doing that; to stimulate more community alcohol partnerships, and we are doing that; and to accelerate public understanding of the consequences of alcohol abuse, and we are doing that, not least through Change4Life, additionally, during this year. There is more, but we will say much more in our alcohol strategy soon.
When the Secretary of State, together with the Prime Minister, visited Salford Royal hospital last week to praise the nurse leadership, was he aware that the hospital has cut 200 posts this year and is about to cut a further 200 posts over the next two years as a result of having to take 15% out of its budget? Does he not agree that nurse leadership is important, but that we also need the nurses on the wards to be able to deliver effective patient care?
Of course I had an opportunity to talk to the chief executive, the nursing director and others at Salford Royal, and I was tremendously impressed, as was the Prime Minister, by the quality and leadership of the nursing, which demonstrated what he was saying about nursing—that there is best practice inside the NHS, and we need to spread it. The right hon. Lady is confusing a cost-improvement programme with a cut. I think Members on both sides of the House understand that the NHS is having to make efficiency savings, which involves shifting some resources from the acute sector and hospitals into the community. Right across the NHS, we have an increase of over £3 billion this year; next year, we have a 2.5% or 2.8% increase everywhere.
This morning, I made a written statement to the House announcing my decision to give the go-ahead to High Speed 2—a national high-speed rail network. With the exception of High Speed 1—a 68-mile stretch of line—it will be the first major national railway line to be built in Britain since the Grand Central line opened to passengers in 1899. I would like to provide Members with further detail of the substance of, and rationale for, my decisions.
I weighed up the evidence after one of the largest public consultations in our history. We wrote to more than 172,000 people living or working near the proposed line from London to the west midlands, visited communities along the 140-mile route and held 41 days of roadshows attended by almost 30,000 people over the five-month consultation period. Almost 55,000 responses were received from individuals, businesses and organisations across the country representing a wide spectrum of views. Many of those views were expressed strongly both in favour of and against high-speed rail, and I have considered them carefully in making my decisions.
Since becoming Secretary of State for Transport, I have examined all the available evidence, including the work undertaken by my right hon. Friend the Member for Runnymede and Weybridge (Mr Hammond) and by the previous Labour Administration in developing the consultation proposals, the evidence submitted during the consultation, and the further work undertaken by my Department and HS2 Ltd. My decision had to consider not only the full environmental impact of HS2 but its benefits to our economy, jobs and our competitiveness not just today but decades into the future.
I also had to be clear about the implications of not investing in high-speed rail—about how it would affect our leading cities, and how that would affect the road network and aviation. Generating growth, helping people back to work and supporting Britain’s companies and wealth creators so that they can compete and win in the global marketplace are at the top of the Government’s priority list, and, from day one in office, the coalition has had a laser focus on investing in and modernising our country’s transport infrastructure with unprecedented levels of investment.
When it came to HS2, I could have made the easy choice: I could have gone for the short-term option, relying on a patch-and-mend approach and leaving our rail networks overstretched, overburdened and less resilient. But let us be clear: the price for that would have been paid in lost business, lower growth, fewer jobs and more misery for passengers on a network without the capacity to cope. We would have failed future generations depending on us to create the prosperous country that they will want to live in.
Good government is about acting in the long-term national interest and about taking decisions, however difficult, to improve people’s quality of life and the country’s economic prospects not just for the next four or five years but for the next four or five decades. Our Victorian predecessors would have been immensely proud to see their railways providing massive benefit today —more than 100 years later—but as a result of today’s announcement the railway revolution that they started is happening again. We are ready for a new chapter in Britain’s transport history—one designed to boost our economy and our country just as the first coming of the railways or the motorways did for previous generations.
That is why I have given the green light to HS2. In spite of the challenges of rising demand, our railways have been a huge success since privatisation. Passenger demand is growing year on year, particularly in the inter-city market. I recognise, however, that further rounds of upgrades to our major north-south lines, even if they offer apparently good value for money, can only provide a short-term fix—one that is incapable of meeting the long-term challenge. In truth, they could add only limited further capacity; they could not offer the step change in performance that passengers wish and need to see.
What is more, upgrades would consign rail passengers and the vitally important rail freight industry to years, if not decades, of future engineering disruption, delay and unreliability—something that users of the west coast main line will remember only too well. The question, therefore, is not, “Do we build new lines?” but, “What type of line should we build?” And when we weigh up the economic and social rewards, there is only one answer: high-speed rail. A high-speed line will deliver £6.2 billion more in benefits to the country than a line running at conventional speeds, at an extra cost of only £1.4 billion. Therefore, by slashing journey times, as well as providing the step change in rail capacity that we need to keep the country moving, a high-speed line will give a return on the additional investment of more than four to one. A modern, reliable and fast service between our major cities and international gateways, as befitting the 21st century, will transform the way we travel, and promote Britain’s economic and social prosperity.
HS2 will be built in two phases, to ensure delivery of its benefits at the earliest possible opportunity. Phase 1 will link London to the west midlands, as well as delivering a direct connection to the continent through the channel tunnel via High Speed 1. Even in the first phase, cities and towns off the HS2 network—such as Stockport, Warrington, Liverpool, Preston and Glasgow—will be served by trains able to use both HS2 and inter-city lines, saving over half an hour on journeys to London. Phase 2 will provide onward legs to Manchester and Leeds, with intermediate stations in the east midlands and South Yorkshire, plus a direct connection to our international hub, Heathrow airport. HS2 will also mean substantial time savings between Britain’s cities, reducing Birmingham-to-Leeds journeys from two hours to just 57 minutes, and Manchester-to-London journeys from two hours eight minutes to only one hour eight minutes. Edinburgh and Glasgow will benefit from a three-and-a-half hour journey time from London, encouraging modal shift from short-haul flights to high-speed rail.
In delivering HS2, I look forward to working with the Scottish Government and others to identify and evaluate options for developing the high-speed network and further reducing journey times. However, I want to emphasise to the House that in making my decisions, I have been particularly mindful of our responsibility to safeguard the countryside and its wildlife, and to protect local communities as far as possible. I have worked hard to look at more tunnelling, to lower the route into cutting to reduce visibility, and to move the route away from homes wherever viable. I have looked hard at how we can better protect our landscape, our wildlife and our heritage. For that reason, my engineers have carefully re-examined the route in the light of all the evidence. I can therefore announce a package of alterations that I believe will significantly reduce the railway’s impact.
Those improvements include a longer, continuous tunnel under the Chilterns from Little Missenden to the M25, and a new 2.75-mile bored tunnel along the Northolt corridor to avoid major works to the Chiltern line and impacts on local communities in the Ruislip area. Of the 13 miles through the Chilterns area of outstanding natural beauty, less than 2 miles will be at or above the surface. The rest will be in deep cutting or tunnel. There will also be a longer green tunnel past Chipping Warden and Aston le Walls, and another longer green tunnel to reduce impacts around Wendover, as well as an extension to the green tunnel at South Heath. There will also be a green tunnel past Greatworth. Those are just a few examples from the suite of improvements detailed in full in the Command Paper that I presented to the House this morning.
The changes will bring significant benefits to communities and the environment. Compared with the consultation route, there will be a more than 50% increase in tunnel or green tunnel, now totalling around 22.5 miles. In addition, around 56.5 miles will be partially or totally hidden in cutting, as a key way of helping to reduce noise in neighbouring communities, and 10 miles less track along viaduct or embankment. In all, that means that around 79 miles—more than half the route—will be mitigated by tunnel or cutting. The revised tunnel alignment through the Chilterns will avoid an important water aquifier—[Hon. Members: “Aquifer.”]—aquifer—significantly reducing impacts on water. You see, Mr Speaker, I am always happy to listen to people when they see a better way of doing things.
There will also be a reduction in the impacts on ancient woodlands and heritage sites. Communities affected will benefit from the changes, with a near 50 % reduction in the number of dwellings at risk of land take, and the number of households experiencing noticeably increased noise levels reducing by a third, to just over 3,000 properties.
I have always been clear in my mind, however, that, whatever the mitigation measures, there can be little comfort to someone in knowing that the country will benefit enormously from HS2 when it is their house, or their business, that has to be knocked down to make way for it. The meeting that I had with MPs earlier last year allowed many of those representing communities along the proposed route to communicate the views of their constituents to me directly.
So, to help people, we will bring in a package of compensation measures over and above those that affected homeowners are already entitled to under law. These include: a streamlined purchase scheme to simplify the statutory blight process for property owners; a sale and rent back scheme to give homeowners within the safeguarded area more flexibility; a streamlined small claims scheme for any construction damage; and a package of measures to reinforce confidence in properties above tunnels.
Homeowners will be offered before and after surveys, a thorough assessment of the impact of similar tunnels, an explanation of the measures that will be taken to prevent perceptible vibration impacts, financial compensation for the compulsory purchase of subsoil, and a legally binding promise that HS2 will be permanently responsible for resolving any related settlement or subsidence issues. There will be also be a refreshed hardship-based property purchase scheme, and, finally, we will work constructively, and in a structured way, with local authorities along the line of route to minimise the negative consequences of HS2 and maximise the benefits.
Having made the decision to press on with HS2, my intention is to drive it forward as fast as is practicable, so that we can gain from its benefits as early as possible and end the unwelcome uncertainty for those affected. A key part of this will be to engage fully and actively with organisations, communities and individuals along the whole route of the Y network. People presented legitimate concerns in the consultation and, even though we have made significant improvements, I am keen to work hard with local communities so that as many concerns as possible are properly addressed.
I have instructed HS2 Ltd to undertake a range of activities to prepare for and deliver both phases of the network. It is my intention to introduce a hybrid Bill in the House by the end of 2013, including a detailed environmental impact assessment to provide the necessary powers to construct and operate the line from London to Birmingham. I have instructed HS2 Ltd to deliver this project at pace, but within milestones that will stand the test of time and with regular reporting to me on progress. The Major Projects Authority, which this Government launched last March to improve the performance of major Government projects in delivering on time and in budget, will provide critical support and oversight.
This spring, we will consult on the draft directions for safeguarding the proposed route from London to the west midlands, as well as separately consulting on detailed compensation proposals. I aim to bring final safeguarding directions and an agreed compensation policy into effect later in the year. In March this year, HS2 Ltd will advise me on the route and station options to Manchester and Leeds, and in autumn 2012, we will start an engagement programme on a preferred route to discuss local views.
I warmly welcome the political consensus on HS2, on the basis that it will help to ensure that the planning and construction of this transformational scheme are carried through to completion. HS2 matters to the long-term success and prosperity of the whole of Britain. It will help to create jobs, support growth and regenerate our regions. It will better connect communities and improve people’s opportunities, and, with its potential to attract people and freight on to trains and away from long-distance road journeys and short-haul flying, combined with the increasing decarbonisation of the grid, HS2 will be an important part of transport’s low-carbon future.
Britain has faced such challenges before. The Victorian railway pioneers had the vision to build a rail network that has promoted growth and created jobs for more than a century. Those innovators transformed this country’s fortunes. Our industries flourished, our exports multiplied, and our economy grew wealthy. Half a century later, another generation had the vision to start building the motorway network. Post-war planners developed the motorway network, connecting major cities and transforming the capacity of our road network. Half a century on again, we now need to do for our Victorian railway what previous generations did for our road network. The time has come again to seize the moment, to be ambitious and to show the world that this is a can-do country. The lesson from history—and the lessons from our global competitors—is that no matter how hard times are, we cannot stop planning for the future or investing in our infrastructure if we want Britain to flourish. HS2 will be the backbone of a new transport system for the 21st century, offering the vital capacity that we need to compete and grow as a country. It will transform the economic shape and balance of our country, linking our major cities to a level previous generations could only dream of. By backing HS2, this Government are backing Britain, and I commend this statement to the House.
Order. I thank the Secretary of State for her statement, which was nevertheless significantly in excess of the allotted time for ministerial statements. An allowance for that will be made in the response from the shadow Secretary of State. The House can rest assured, as it can always rest assured, that I have the interests of Back Benchers at heart. They need not worry; if they want to get in, they will be heard.
May I begin by thanking the Secretary of State for advance sight of her statement? I welcome her decision today. As the right hon. Lady was generous enough to say, it was the previous Labour Government who started us on the journey that has now reached this important milestone. I pay tribute to the former Prime Minister, my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown), for having the boldness to set out a vision for a new high-speed rail line to address the capacity issues on our existing mainlines while cutting journey times across Britain. This is a vital project for the country, and I welcome the decision to give the green light to this investment in the face of considerable opposition—not least from many of the Secretary of State’s own colleagues, including from inside the Cabinet.
Labour Members believe that it is vital that the new high-speed line is built—not just between London and Birmingham, but on to Manchester and Leeds. So while I welcome the commitment given today to the whole HS2 scheme, there will be disappointment that the Government’s announcement has stopped short of committing to legislating for the entire route to Manchester and Leeds in this Parliament. That was always Labour’s intention, as confirmed by the former Transport Secretary Lord Adonis in his evidence to the Transport Select Committee—a position the Select Committee said had merit.
Of course it is right that a single Bill would need to await completion of preparatory work for the second phase of the route. However, by introducing it later in this Parliament and carrying it over to the next, as we did with the legislation for Crossrail, we would secure Parliament’s approval for the whole route at an earlier date than under the Government’s plans. That would, of course, open up the possibility, if it proved feasible, of beginning construction in the north as well as the south—something that the Transport Select Committee urged the Government to consider. The Secretary of State should do so and the Government should think again on the issue of using a single piece of legislation to make HS2 possible all the way to the top of the Y route. At the very least, will the Secretary of State agree, as a minimum, to follow the Transport Select Committee’s recommendation to include a “purpose clause” in the hybrid Bill that she plans, providing statutory force to the commitment to continue the scheme to Manchester and Leeds?
Turning to other issues in the statement, the Secretary of State says that there will be “direct links to Heathrow airport and the continent via the HS1 line”. There will be disappointment that the Government have not accepted the case—not least in her own team—to build a transport hub at Heathrow, enabling a direct connection between the airport, HS2, Crossrail and the Great Western mainline at one site. The Minister of State, Department for Transport, the right hon. Member for Chipping Barnet (Mrs Villiers) is on record as saying that
“failing to take high speed rail through Heathrow…would be a big mistake”.
This is a failure to learn the lessons of successful high-speed rail schemes across the world. When the Government claim this route would cost more, they fail to include the cost of building the spur; and when the Government claim it would increase journey times, they fail to make clear that this hub would be instead of Old Oak Common and would allow for non-stopping services.
Can the Secretary of State confirm the cost of building the separate spur to Heathrow? Can she confirm that the Government’s intention is to enable at least the possibility of direct services between Heathrow and the continent at the end of phase 2? Can the right hon. Lady tell the House what discussions she has had with the European Commission over the potential for EU funding towards the costs of HS2? Is it correct that the decision not to take the route via Heathrow and the concerns over the planned link to HSl mean that such support is less likely to be forthcoming?
In respect of Scotland, the Secretary of State has said that HS2
“will form a foundation for a potentially wider high speed network in years to come.”
Can she confirm that the Government still intend to begin discussions with the Scottish Government on the future development of the network to Scotland during the next Parliament? When do they expect to start work on the business case for further extensions beyond the Y?
As for what the Secretary of State said about mitigation and costs, I welcome the steps that she has taken to address some of the concerns that led the Labour party to propose its alternative route, although none of these measures addresses the impact on the Chilterns as effectively as would a route via Heathrow. It is the Government’s own stubbornness that has forced them to commit themselves to significant additional spending to prevent a Cabinet resignation.
Will the Secretary of State tell us what the extra cost of each of the new mitigation proposals that she has announced today will be, and whether those costs will be met within the existing cost envelope for HS2? What assessment of value for money has she made in respect of the costs of these measures, compared with those of offering greater protection to the Chilterns through a different alignment? I welcome the mitigation measures proposed for London, although there remains a significant impact on the area around Euston station. Will the Secretary of State assure the local community in Camden that she will listen to their concerns, and will take appropriate steps to mitigate the impact of the redevelopment of Euston station? What discussions has she had with Transport for London on how best to address the concerns that have been raised about the impact of the very large increase in the numbers arriving at Euston on HS2?
There has been considerable debate about the affordability of building the line, but not about the affordability of using it once it opens. I note that the Secretary of State had nothing to say about that in her statement. Does she agree with us that now is the time to move the debate from whether we should build to discussing the type of high-speed rail network that we want to see in this country? Her predecessor as Secretary of State—I am pleased to see that he is present—told the Transport Committee:
“If you are working in a factory in Manchester you might never get on HS2, but you will certainly be benefiting from it if the salesman and sales director of your company is routinely hopping on it to go and meet customers, to jet around the world from Heathrow in a way that brings in orders that keep you employed.”
Is that not precisely the wrong approach to high-speed rail? Does the Secretary of State agree that we need a high-speed rail network that is affordable for the many and not the few—a network that is not a “rich man’s toy” or simply a business class service?
Today we have reached an important stage in the development of high-speed rail in this country, a process begun by Labour. I hope that the Secretary of State will consider the issues that we have raised. This is a major scheme which deserves proper scrutiny. We have raised questions with the clear intention of ensuring that we have the best possible high-speed rail network, one that the country needs and deserves. We strongly support the building of HS2. [Hon. Members: “Hurray!”] I said that in the first sentence of my reply. I look forward to working on a cross-party basis with the Secretary of State and her colleagues to ensure that parliamentary approval is secured, and that this vital project can move ahead and become a reality.
I am delighted to hear that the Labour party supports our high-speed rail proposals. As I think even Labour Members would have to admit, the original proposal did indeed come from my party. I must point out that high-speed rail did not feature in the Labour Government’s 2007 White Paper setting out the 30-year vision for the railways. However, we are pleased that Labour has belatedly seen the real potential of a high-speed rail network in Britain.
The hon. Member for Garston and Halewood (Maria Eagle) asked about legislation for the full Y network. I am considering whether it is possible for us to build that into the hybrid Bill, but I can give a categorical assurance that I have decided that we should go ahead with the full Y network. I have also announced today the final decision on the route of phase 1 of that network.
The hon. Lady asked about Heathrow, which has clearly been an important aspect of the issue. HS2 will go directly to Heathrow. That will happen as part of phase 2. People will be able to get on a high-speed train in Birmingham that goes direct to Heathrow. The hon. Lady raised the question of whether HS2 should go directly via Heathrow. The last Labour Transport Secretary of State, Lord Adonis, looked at that, and he concluded— as did I and my predecessor, my right hon. Friend the Member for Runnymede and Weybridge (Mr Hammond) —that that is not the most cost-effective or line-effective route for the line to take. It would be a longer line, and it would be more expensive.
The hon. Lady asked whether we will seek EU funding. The business case we have presented to the House today is based on a working assumption that the £32 billion cost of this railway will come from the rail budget—that it will be taxpayer-funded. The business case would improve if we were able to get private sector and EU funding. We believe that this is a high-value project and we will look to see whether we can secure such contributions, especially from the private sector, and they would make that business case even stronger than it already is.
I am keen to talk with the Scottish Government about their aspirations for high-speed rail further north. Their desire to see this project go ahead underlines its strategic value to the entire UK, not just the London-to-Birmingham part of our country.
On mitigation, the hon. Lady raised the important question of how we tackled the issue of the line going through an area of outstanding natural beauty in the Chilterns. I want to emphasise that I looked very hard along the entire line. I understood the specific concerns people had in respect of this AONB, and I took them very seriously, but I looked at the whole line to see how we could mitigate its impact on local communities wherever possible, because that is important and the right thing to do. The changes in the Chilterns that we have made will result in that stretch of the line costing in the region of £250 million to £300 million less, because the engineering solutions we have found will involve less use of deep cutting. That will mean that we have less spoil, and the removal of spoil is often what causes huge expense. I hope that provides some reassurance to the hon. Lady. For some parts of this route, improving the line is good not only for local communities but for the business case for the line.
The hon. Lady also raised the question of the redevelopment of Euston station that will happen as part of HS2’s phase 1 proposal. We believe the line coming into Euston can be part and parcel of the regeneration of the Euston area. We must ensure that Euston makes the most of the investment that will go into Euston station. I fully understand that two-thirds of the homes that will be demolished will be next to Euston station, and we will work very closely with Camden council. A number of statutory processes are already in place to provide safeguards for tenants who will be affected, but I can assure the House that I will work very closely with Camden council in considering how we can minimise the impact of the redevelopment of Euston station on current residents. I will, of course, also be delighted to work with the Mayor in considering traffic flows on the tube and how high-speed rail will interact with our tube network.
The hon. Lady asked about affordability and pricing, and I agree that that is very important. The business case we have done assumes a pricing level that is the same as the standard pricing on the current network. That has been the presumption. As we get closer to the finalisation of the route and its development, I am sure we will look at the pricing, but I can assure the hon. Lady that the success of this high-speed railway network will be based on its being used by many people, not a few. I have no doubt that the pricing of the tickets will be set in order to achieve that.
As the city closest to the first non-London station, the potential investment benefits to Coventry are considerable. Is the Secretary of State prepared to meet a delegation to discuss the links between the city and that first station, so that Coventry maximises the benefits from HS2?
The Liberal Democrats were the first party to push for high-speed rail, back in 2004—[Interruption.] I realise that the Opposition may not appreciate the fact. I am delighted that the coalition is going ahead with this, and I congratulate the Transport Secretary on that decision. Phases 1 and 2 will bring great benefits, and the news about phase 2 going to Manchester and Leeds is very welcome. Can she say something about her future aspirations for the connection through to Scotland?
I am sorry, Mr Speaker, if I break into this aura of unanimity. I represent people living around Euston, 350 of whom will lose their homes, and up to now they have received no guarantees whatever from Ministers, the Department or the HS2 project team. The area has already seen the abandonment of the intended rebuilding of a Roman Catholic convent school, part of the site of which will be taken, and a large number of small businesses will be put out of business as a result of this. Also, Euston will be even more overcrowded when the new line comes in, and there are no proposals whatever to improve the connections, by tube or bus, to Euston station to take the extra traffic.
The right hon. Gentleman raises the wider point that we will need a broad-based strategy if HS2 is to come into Euston—the broader regeneration of Euston that I believe can take place alongside HS2 and the redevelopment of Euston station. I am absolutely committed to doing whatever I can: to work with Camden council, and to meet the right hon. Gentleman separately to talk about what we can do to minimise the disruption to local residents while HS2 is being built and in the years beforehand. There are statutory processes that I am very happy to talk through with him in detail, and I look forward to doing that.
My right hon. Friend has been very patient in hearing from me many times about the concerns of my constituents, many of whose communities will be blighted by this high-speed rail line. She is also well aware of my concerns about the economics of the project. How sure is she that the actual costs in their entirety will be kept to the amounts we have been talking about, and how realistic is it for Britain to afford this project at this very difficult time economically?
I would argue that we cannot afford not to do this. The cost to the taxpayer will start once Crossrail has finished. On the overall costs, High Speed 1 was brought in on time and to budget, and our costing includes a substantial allowance for so-called optimism bias, because we know that such projects tend to grow in cost. If anything, I would aim to bring it in under the amount we have budgeted for, but we have allowed for some optimism bias, as we do for these projects.
While thanking the right hon. Lady for switching on the green light, I note that she referred in her statement to “a package of measures to reinforce confidence in properties above tunnels”. That issue affects many of my constituents. When and to whom should my constituents make representations to have their concerns calmed?
One of the things we have seen in recent years is freight switching from road to rail. HS2 will have the advantage of freeing up the capacity on the conventional railway network, which will see that renaissance continue. We hope that it will have even more force behind it than it has had already.
Today’s announcement is very good news for Birmingham. May I say to the right hon. Lady that two things are just as important as our connectivity to London? The first is connectivity to the north, so I ask her to act on the optimistic noises she has made about possibly changing the hybrid Bill to include the second phase. The second is to ensure, as my right hon. Friend the Member for Coventry North East (Mr Ainsworth) said, that HS2 unlocks potential in the local transport network in and around Birmingham and the wider west midlands. Will she take that on board? Those are the things that will really maximise the benefits of HS2 to the midlands.
I will take both those things on board, and indeed I will be in Birmingham tomorrow. When we look at high-speed rail in other countries, we see that the countries that have had the most success with it are those that have looked at projects more broadly, so we must ensure that HS2 provides broader connectivity than just to the areas it drops in at.
It is fair to recognise that the right hon. Member for Holborn and St Pancras (Frank Dobson) makes a valid point about Euston station and the rail capacity of that particular area. Has the Secretary of State given any particular thought to the idea that there should be a nodal link at Old Oak Common, which would link up Crossrail and HS2, thereby ensuring that a large amount of the traffic that would otherwise get caught up in Euston is enabled to go through central London via a different route?
It is essential that the UK has a high-speed rail network, and I welcome today’s statement as it helps to achieve that. The Secretary of State said that she was considering how to include in the hybrid Bill a commitment to the whole of the Y network. Will she tell us more about that? Will she assure us that the money that goes to funding the very important high-speed rail network will not be at the expense of essential investment in the existing classic line to develop both passenger and freight services?
I am actively examining how we can provide more legal assurance in relation to the full Y network. However, we ultimately have to recognise that if this high-speed rail line is going to happen, it will need political will above all else. What I am saying is that the Government have the political will to go ahead with this Y network and that is the thing that matters most. I can assure the hon. Lady that I intend to make sure that we continue to see that level of investment that our current railways so badly need.
Because the Heathrow link will be in phase 2 of the project, my constituents will not know their futures until late 2014. Will the Secretary of State ensure that HS2 Ltd opens up its books and shares the information about the range of options it is considering for the link at the earliest stage?
One of the things that we have always tried to balance is getting assurance about what our lead proposals are so as not to cause unnecessary blight and trying to share information with residents as soon as possible. I believe that we will be able to start informally consulting local groups later this year and in 2013. We will do the formal consultation—the sort that the hon. Gentleman has seen on the first phase of this route—in 2014.
I commend my right hon. Friend on her statement. Will she assure me that she was aware that the chief executive of Manchester city council said last week that this was a most significant decision for the north of England’s economy? Will she confirm that she still expects the monetised value of the scheme overall to be in the order of £50 billion?
I can confirm that when we look at the key people pushing for this scheme, we notice that the key economies and great cities in the north will see the benefits. The monetised total value is upwards of £40 billion, even £50 billion. Ultimately, however, we must recognise that that calculation takes place over a 60-year time frame. Anybody building the railways back in Victorian times would never have counted the benefit we get from them today, which is very real, and the potential benefit of HS2 is significant.
Does the Secretary of State really think that people will believe the costings she has set out, given the past history of building railways and Government schemes? Will she give an assurance that the route will be extended to the north-west as, frankly, most people believe that they have more chance of travelling in the Tardis than on HS2?
In terms of costs, there is safety in two things. High Speed 1 was delivered on time and on budget by the last Conservative Government. I aim to have a much better performance than we saw from the Labour Government on the west coast main line, where a £2 billion planned upgrade mushroomed to £9 billion. Finally, I can assure the hon. Gentleman that his constituents will see the benefit of phase 1 from day one. In many cases, the HS2 trains will be through-running trains that, having saved that time on the high-speed network, will continue their journey further north on conventional lines. I think that will benefit far more cities than just London and Birmingham.
May I advise the Secretary of State that today’s announcement will be heard with concern in Rugby? We currently have an excellent service to London on the recently upgraded west coast main line, but we will be completely bypassed by High Speed 2. What steps will be taken to ensure that cities and towns on the legacy line will retain the speed and frequency of their existing rail links?
Warrington gets its journey cut by half an hour—lucky Warrington. Plymouth is a bigger city than Warrington and we have no high-speed link to the south-west. As regards the concern raised by my hon. Friend the Member for Liverpool, Riverside (Mrs Ellman), the Chair of the Transport Committee, will the Secretary of State confirm that top-slicing will not happen to other budgets and that the south-west main line down to Penzance will still get further investment?
We are about to continue the process on the high-level output specification, or HLOS2, and that will consider future investment in lines such as the great western line, which will be connected to HS2 via the Old Oak Common interchange. That will benefit the hon. Lady’s part of the country as well as everybody else’s.
I welcome the Transport Secretary’s commitment to high-speed rail and the fact that she is keen to have discussions with the Scottish Government about extending the route to Glasgow and Edinburgh, which would bring additional economic benefits of some £25 billion and carbon reductions from more modal shift from air to rail. What does she see as the main barriers to making high-speed rail to and from Scotland a reality and how can we best overcome them?
There are always barriers and challenges in dealing with such significant infrastructure problems, not least money and ensuring that finance is in place. As we have seen with phase 1, we must be incredibly careful that the route minimises the impact on local communities while maximising the economic impact that communities can get out of it. There is a long process to go through as regards talking with the Scottish Government, but I am keen to engage with them on it.
The Secretary of State’s statement will be welcomed throughout the whole of the north of England, as the chief executive of Manchester city council said, but there will be a worry in the back of some people’s minds that we were promised trains through to Paris when the channel tunnel legislation was agreed but we did not get them and that the same thing will happen again. It is not just a matter of political will. People in the north would be reassured if the Secretary of State gave a commitment to align stations and resources to build the routes to Manchester and Leeds as soon as possible.
I can give the hon. Gentleman that commitment. I certainly am not going to take any longer than we need to take to progress the full Y network. One aspect of the first phase that I have not mentioned yet is that it will connect HS2 through to HS1, so there will be that link directly to the channel tunnel and the European high-speed rail network, which will be hugely beneficial.
I have serious concerns about this planned project, particularly regarding the business case. Will the Secretary of State comment on the comparisons that can be drawn with the high-speed rail links in Spain and France? In France, it was the major hub city of Paris that grew, rather than Lyon, and in Spain it was Seville that was caused expense as a price of the growth of Madrid city. There is concern in this country that the north might not get the projected benefit and that instead it might be London that grows and benefits.
I have huge respect for my hon. Friend and I normally agree with her on most things, but I have looked at this case incredibly carefully. Let me say two things. First, cities such as Lyon and Lille have massively benefited from high-speed rail in France. Secondly, let us see what the north thinks. Manchester thinks this project is vital, Birmingham thinks this project is vital, Leeds thinks this project is vital and Sheffield thinks this project is vital. It is time to make it happen.
The Secretary of State will get a very warm welcome in Birmingham tomorrow, but that welcome might be even warmer if she gave a clear commitment to a purpose clause in the hybrid Bill and if she could bring that Bill forward to 2012 rather than 2013.
I do not think I can add anything further to my comments about my commitment to the Y network. In terms of the time it will take us to develop the hybrid Bill, we are doing it as fast as we can. I want to make sure that the Bill comes to the House in a proper and robust state, and that means doing a proper environmental impact statement and working with local communities, which will take some time. This is a big project and we are going to get on with it, but I will make sure that it has the time that all that will take. At the moment, it looks as though the Bill will come to the House in late 2013.
With a benefit-cost ratio of over 2.5, HS2 is a much better business case than Crossrail, which has just been accelerated. Will the Secretary of State consider accelerating phase 2 of this scheme so that it can reach the north before 2032?
I am looking at all the ways in which I can progress this project as fast as possible. At the moment, it looks as though the 2032-33 time frame is the fastest by which we can bring it to fruition. I hope that the House has seen today my desire to get on with this project and I will continually look at ways in which we can deliver it faster.
The previous Secretary of State for Transport is now running Defence, where we are implementing major cuts in each of the armed services. Does this Secretary of State understand why those of us who are concerned about other areas of Government wonder whether these priorities are not rather perverse in the present economic situation?
I absolutely want to see the investment in our armed forces that we need for our country, but we also have to make sure that we look to the future for our transport system and the role that it plays in helping our economy to prosper, grow and create jobs. That is what today’s announcement is all about.
The map that the Secretary of State published today shows the network continuing north of Leeds to join the east coast main line. Is she considering joining that at York, and is she aware that there is a major development site right next to York station? If that is her intention, she needs to state it early to make sure that the land is available.
I am very grateful to the hon. Gentleman for flagging up that opportunity. I have no doubt that over the coming weeks and months he will want to set out some of those ideas in more detail. Over the course of this Parliament, we will be putting significant effort into developing High Speed 2—I think we will spend something like £750 million in total—and I am sure the hon. Gentleman will want to ensure that he puts his views forward.
I absolutely agree with my hon. Friend, and I think it shows that we are right to get on with this project today, but we are also right to work with local communities, and they can see huge benefits from high-speed rail when it comes to their communities.
I cannot make that commitment. We are just at the business of assessing what the line route is—I made my decision on that today, and will continue to develop the phase 2 route. I think decisions about how the train service will be operated are ones for further in the future, but of course we will look to do what we think is best value for the taxpayer and the travelling passenger.
The long-term benefits that High Speed 2 will bring to my Milton Keynes constituents will be welcome, by freeing up capacity on the existing line. However, there is overcrowding now, which will get worse before High Speed 2 opens. Will my right hon. Friend assure me that the Government will continue their impressive record of investment in the classic network, to meet demand in the period before HS2 starts?
I can tell my hon. Friend that there will be 106 extra carriages serving his stretch of line, and I think that shows that this Government are committed to making sure that we get investment in our railways in the short and medium term as well as the long term.
I am as keen on the Secretary of State for Wales as anybody else is, and I am delighted that the Secretary of State for Transport has done so much to keep her in her job, but can she be precise about the amount of money that is being spent on tunnelling in the constituency of the Secretary of State for Wales, because the total amount being spent in Wales on the railways this year is just £500 million?
I would have thought the hon. Gentleman would be pleased, because the route that I announced today will see us spend less money in my right hon. Friend’s part of the country. The way in which he has turned what I took to be the incredibly serious issue of this line impacting local communities in an area of outstanding natural beauty into a pure political point is a disgrace. The Secretary of State for Wales, alongside other MPs, has done a damn good job in representing her constituents, and I think she has probably been a lot more effective than he has been in the past.
I welcome the Secretary of State’s announcement. Many of my constituents work at Tata Steel in Scunthorpe, where rail production is one of their most profitable lines. Can she give me a categorical assurance that everything possible will be done to ensure that the procurement procedures favour British-based companies?
My hon. Friend will know that one of the things I am committed to doing in my role is to bring about a more strategic relationship, in terms of our procurement, with suppliers in the UK, and non-UK suppliers. I think that puts companies in production in the UK in a good position. There is unprecedented investment going into the railways at the moment. I have just announced the biggest railway infrastructure project that this country has seen in over a century. I think that is good news for Britain, but also good news for jobs and good news, hopefully, for companies like Tata.