House of Commons
Tuesday 13 November 2012
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Business before Questions
City of London (Various Powers) Bill [Lords] (By Order)
Second Reading opposed and deferred until Tuesday 20 November (Standing Order No. 20).
Oral Answers to Questions
The Secretary of State was asked—
1. What plans he has to increase the uptake of restorative justice. (127906)
The Government intend to publish a framework for restorative justice that will improve the victim’s awareness and access to restorative justice. We have also introduced legislation to put restorative justice on to a statutory footing for the first time.
I am delighted to see a statutory basis for restorative justice. The Minister is, I hope, aware of the experiments in police-organised restorative justice conferences for victims of serious crime—a study carried out by criminologists from the university of Cambridge from 2001 to 2005—which showed that more than £10 of the costs of crime could be saved for every pound spent on this process. Will he ensure that ring-fenced funding is available for restorative justice, as well as the statutory basis?
I am happy to assure my hon. Friend that we are already investing more than £1.5 million to help build capacity in dealing with restorative justice throughout the criminal justice system and, in particular, for pre-sentence restorative justice, which is what his question refers to. I am also delighted to report that over 18,000 police officers have received training in restorative justice techniques. This is contributing to the greater success of our restorative justice measures.
Will my right hon. Friend come and visit Swindon, where we are piloting neighbourhood justice panels, involving the community in making decisions about wrongdoers and having a real sense of control for the first time in relation to crimes that affect a large number of people in my community?
I would be delighted to visit my hon. Friend. It is always life-enhancing to go to Swindon—I speak as a fan of Reading football club. He is right that pilots have found that restorative justice is associated with an estimated 14% reduction in the frequency of reoffending and, perhaps even more importantly, that 85% of victims who participate in restorative justice are satisfied with the experience. Since we want to put victims at the heart of the criminal justice system, that is an extremely encouraging result.
2. If he will bring forward proposals to ensure that victims of crime receive compensation from those who committed the crime. (127907)
Courts have the power to require offenders to pay compensation to their victims for any injury, loss or damage caused by the offence. Courts also have robust powers to recover unpaid compensation orders and other financial penalties.
Does the Minister agree that there should be a presumption in favour of the victims of crime receiving compensation from offenders? Will she be issuing any guidance to the courts to ensure that that happens?
The Government are committed to ensuring that as many victims as possible receive compensation from offenders. The Legal Aid, Sentencing and Punishment of Offenders Act 2012 places a new duty on courts to consider imposing compensation in any case where the victim has suffered injury, loss or damage. Issuing guidance to courts is a matter for the independent Sentencing Council, not for the Government, but the council’s guidelines already draw the courts’ attention to their powers to impose compensation.
To what extent is this form of compensation a substitute for the criminal injuries compensation scheme, which has been cut to ribbons by the order laid in July this year?
Criminal injuries compensation is state-funded compensation. This is offender-funded compensation; it is completely different.
Would the Minister be open to fresh thinking on this? If, for example, prisoners were given the opportunity to work, earn and keep money for themselves and their families, perhaps they could pay back some of that money to the victims of their crime and also pay tax on it, which would be of benefit to the public, as well as having a rehabilitative effect.
I am happy to look at that if my hon. Friend writes to me.
On 11 October 2011, when Louise Casey, the first victims commissioner, resigned, the former Lord Chancellor said that he was urgently considering the future of the role. Thirteen months on—yesterday, in fact—was the closing date for applications to be Ms Casey’s 10-day-a-month replacement. What signal does it send to victims that this Government first doubt the need for a commissioner, then delay appointing one for more than a year, and finally make it a half-hearted, part-time job?
For a long time, victims have felt completely unsupported by the criminal justice system, and it is my job, as victims Minister, to try and put that right. I am glad to have the opportunity to do so. We are raising money for victims through the victims surcharge and the Prisoners’ Earnings Act 1996, and we are giving victims a louder voice through the appointment of a victims’ commissioner. I look forward to making that appointment, and meeting and working with the commissioner.
3. What plans he has to increase public confidence in community sentences. (127908)
6. What plans he has to increase public confidence in community sentences. (127914)
12. What plans he has to increase public confidence in community sentences. (127922)
14. What plans he has to increase public confidence in community sentences. (127925)
The Government are determined to ensure that community sentences deliver punishment, rehabilitation and reparation. We are legislating to require courts to include a punitive element in every community order, as the public would expect, and to enable the electronic tracking of offenders.
I hope that Justice Ministers will not go soft on introducing an element of shame and real punishment in these new community penalties. I am told that under community payback offenders might wear a yellow vest with the words “community payback” on the back, and that these can be removed if the probation staff think it appropriate. What we need are community punishments where offenders are in the community with orange dayglo boiler suits with the word “offender” on the back to inculcate some sense of shame and to make these tough sentences, not the soft ones we have had up until now.
I have a good deal of sympathy with my hon. Friend. When I have seen community payback in the community, it has been evident that those carrying it out are offenders. They are easily identifiable. That is partly for the reasons he gives, but it is also to ensure that people in the community understand that work is being done to repair some of the damage that these offenders have done in the communities where they are working.
I have seen work done in my constituency as part of community sentences tackling projects that would otherwise not have been done, thus benefiting communities and, in particular, reinforcing the merits of work. Does my hon. Friend have any plans to extend the element of work in community sentences?
As I said, we will ensure that, whenever a community order is passed, the sentencer will impose at least one element of punishment. That is what the public would expect. One element of punishment could be community work of the sort my hon. Friend described. It is important that there is a good channel of communication between the community and the organisations within it, and the probation service and those administering community payback in order to ensure that the work is done where people want it done.
Tamworth police, led by Chief Inspector Coxhead, are clear about the potential power of community sentencing and restorative justice, so may I echo my hon. Friend the Member for South Swindon (Mr Buckland) in calling on those on the Treasury Bench to implement with full speed neighbourhood resolution panels, so that communities themselves feel that they have a hand in community sentencing?
I am disappointed not to receive an invitation to Tamworth. None the less, my hon. Friend is absolutely right. It is important that we move forward with the work being done in Staffordshire and elsewhere with neighbourhood justice panels. We want to see what work can be done by and in communities to ensure that low-level offences are dealt with appropriately. The broader point about restorative justice is also right. This is an important innovation, and we can get a great deal out of it—mostly for victims, although there are reoffending benefits as well.
Can my hon. Friend assure me that community orders will continue to address the problems that have caused—or at least contributed to—offending behaviour in the first place, such as drug abuse, alcoholism and mental health problems?
Yes, I can. We are saying that there should be an element of punishment in every community order, unless there are exceptional circumstances, but that does not prevent a sentencer from passing whatever other measures in the order they believe appropriate for the purposes of rehabilitation. My hon. Friend is right to identify some of those, but there are of course many more. This is all about reducing reoffending. That is partly about punishment, but it is also about ensuring that someone does not go right back to the same cycle of offending.
Work in the community is obviously a valuable element of punishment, but it is quite a crowded field, with various voluntary youth organisations and the unemployed also jostling for that work. What other specific types of punishment does the Minister have in mind? Will he give us a flavour of what will happen?
It is first worth pointing out that we have toughened up the work requirement, so we will now expect people sentenced to community payback to go and do it very soon afterwards. We expect them to do it for four days a week and we expect them to do it properly. If they do not, they will have breached the order and there will be consequences. The answer to the hon. Gentleman’s question is that there will be other elements to a community order which can properly be seen as punitive, whether it is a restriction on movement, an exclusion order from certain places or a financial penalty. There is a range of options available to the court, but we think—and I think his constituents would think—that each order should include a punitive element.
The Minister has talked about potential breaches if—as we would probably expect—an increased number of orders are made. What risk assessment has his Department carried out to determine the likely percentage of breaches, and what would be the impact on the Prison Service of having to find additional places?
It does not follow automatically that if someone breaches an order, the penalty would be a period of imprisonment, although that is possible. I think the right thing is to say to people: “If you receive a period of unpaid work as a punishment, we expect you to do it and to do it properly. If you don’t do it properly, you will find yourself back in court, and you may find yourself going to prison.” That is absolutely the right approach.
I welcome much of what the Minister has said this morning, and I am sure there will be support for it in all parts of the Chamber. The key to effective community sentences is also proper supervision. How will he address the legitimate concern, which many people have, that increasing the use of community sentences at the same time as making cuts in probation could lead to less effective community sentences, with offenders being neither properly reformed nor punished?
The right hon. Gentleman will know that we are looking at ways in which we can deliver a better probation service, more rehabilitation for offenders across the board and better outcomes, because this is the key. It is not just about the processes we go through; it is about the outcomes we achieve. We are seeking to reward those who provide rehabilitative services in a way that also reduces reoffending. Doing that will help the offender and the wider community. It is also, incidentally, a good deal for the taxpayer.
4. What progress he has made in developing an evidence-based policy to reduce reoffending. (127909)
The Prime Minister has restated our determination to apply an intelligent approach to reducing reoffending. By 2015, I intend to apply payment by results to the majority of rehabilitation work conducted with offenders in the community. In addition, the National Offender Management Service published its commissioning intentions for the coming financial year on 1 November, clearly stating our commitment to evidence-informed commissioning.
As the House heard earlier, the Ministry of Justice’s own survey has revealed that restorative justice can reduce reoffending by as much as 14%. These methods are being effectively used by probation and prison services in Durham, which has one of the lowest reoffending rates in the north-east. What further steps will the Secretary of State take to ensure that this evidence-based approach is supported and has the necessary resources to be effective?
We are looking to allow for the greater use of restorative justice in the criminal justice system—for example, by allowing an element of restorative justice between a verdict and the sentence in court, to establish whether that can have an impact on the sentence that would otherwise be passed and the likelihood of the offender to reoffend. I would commend all those who are using restorative justice. It is a common-sense early intervention in the criminal justice system and there is no doubt that it is having an impact on offending rates.
When the Secretary of State is developing his evidence-based policy, will he look at the Ministry of Justice’s own figures, which show that the longer people spend in prison, the less likely they are to reoffend, and that the lowest reoffending rate for any sentence handed down by the courts is for indeterminate sentences for public protection?
May I say clearly to my hon. Friend that I share his view? I think prison is a very important part of the criminal justice system, I believe that offenders should serve a prison sentence appropriate for the crime they have committed and I have given a clear commitment that there will be no strategy under my leadership of the Ministry of Justice to reduce the number of prison places artificially. I want to see the right people going to prison in the first place.
The hon. Member for Shipley (Philip Davies) spookily teed that up rather nicely for me. We all want to see policies based on evidence. The evidence tells us that the most effective means of protecting the public from convicted sex offenders is to keep them behind bars for as long as it takes to stop them being a threat. The Government took away so-called indeterminate sentences. It was a dangerous mistake and we said so at the time. When will the Secretary of State put that right and protect our citizens?
We have introduced longer determinate sentences to deal with the most serious offenders and, unlike the previous Government, we have introduced a “two strikes and you’re out rule” for the worst sex offenders, to ensure that if they offend for a second time, they will go to jail for the rest of their lives.
Criminal Injuries Compensation Scheme
5. What progress he has made on reform of the criminal injuries compensation scheme. (127913)
13. What progress he has made on reform of the criminal injuries compensation scheme. (127924)
The criminal injuries compensation scheme 2012 was approved by the House yesterday. Having already been approved by the other place, it now has the approval of Parliament and will be implemented by the Criminal Injuries Compensation Authority on 27 November this year.
Given that the scheme will no longer pay out for criminal injuries such as a broken jaw, and that the awards for more serious injuries are not being increased, will the Minister confirm that the spin is just not true and that the changes represent a cut of £50 million for innocent victims?
Absolutely not. The aim is to provide proper compensation for those who have suffered serious criminal injuries. When the injuries are less serious, prompt, practical victim service provision will be provided, which is what victims say that they need. In addition to that, up to £50 million will be provided for victims from the victim surcharge.
In the consultation on the cuts to the criminal injuries compensation scheme, the Ministry of Justice promised to protect payments to the most vulnerable and seriously injured victims of crime. Why, then, will the most severe cuts affecting compensation for loss of earnings fall on more than 1,000 of the most seriously injured victims of crime and on the dependants of murder victims? Have not the innocent victims of crime suffered enough?
We are of course concerned about all victims. The scheme provides some payment in recognition of loss of earnings, but it was never designed to compensate for a full lifetime’s loss of earnings. Eligible applicants will receive a clear, predictable sum that will supplement other amounts that they may receive from other sources, such as state benefits. Our changes to the scheme should also allow victims to receive payments in a much speedier manner.
Do not the changes confirm the important principle that, although the state is not liable for compensating for the criminal actions of others, it has a particular responsibility for the victims of serious crime, to ensure that they do not have to wait months or even years for compensation from an unsustainable scheme?
Yes, I agree completely with my hon. Friend. Our reforms have put the criminal injuries compensation scheme on to a sustainable footing, which will enable future generations of victims to benefit.
Will the Minister tell the House what consultations on the matter of the reform of the criminal injuries compensation scheme were held with the devolved Administrations?
We talked to them as a matter of routine. I will write to the hon. Gentleman with further details.
Having butchered the criminal injuries compensation scheme by £50 million, starving blameless victims of financial redress, will the Minister tell us when we will see the details of the hastily cobbled-together hardship fund? Will she also tell us whether the fund will be topped up when those in hardship exceed the mere 700 or so whom the scheme is likely to cover, instead of the 30,000 who will lose out as a result of these changes?
I am not going to take any lessons from a party that put this country in the most awful financial difficulties—[Interruption.] Absolutely not. The current system is not sustainable or sensible, and it needs to be simplified. As I have already said, the new victim surcharge will raise up to £50 million for victims services.
7. What plans he has to review prisoners’ entitlement to privileges. (127915)
It is really important that we ensure that the public have confidence in the prison system, and it is crucial that they are assured that any privileges earned in prison are gained through hard work and appropriate behaviour. In the light of this, the Prisons Minister and I have immediately moved to start a review of the policy around the incentives scheme for prisoners. We need to be confident that the system of incentives has credibility with the public. There are important operational reasons for the original policy, but we need to be clear that the incentives are pitched at the right level.
Many of my constituents feel that some of the privileges provided in our prisons are far too soft on the inmates. How is my right hon. Friend preparing to reverse the tradition whereby many of our prison inmates have been left to pass their time in an enforced situation in which they are completely idle most of the day, with little or no meaningful activity?
First, I am quite prepared to make changes to the incentive regime in our prisons if it proves necessary to do so. I am absolutely clear that prisons should be places that rehabilitate, not places to which people have any desire to go back. It is equally important, however, that we have within our prisons proper processes to ensure that prisoners are trained and given work experience. One of the achievements of the current Government over the last few months is that we have seen a steady increase, under the stewardship of the previous Secretary of State, which the current ministerial team is now taking on, in the number of hours worked by prisoners in our prisons. That has got to be right.
8. What plans he has to introduce a payment by results scheme to reduce reoffending. (127917)
By 2015, I intend to apply payment by results to the majority of rehabilitation work conducted with offenders in the community. Providers will be commissioned to rehabilitate offenders, and those who are successful at reducing reoffending will be rewarded. I will announce detailed proposals shortly.
Studies such as the recent report from the Prison Reform Trust show that women have higher rates of reoffending. Will my right hon. Friend update the House on plans to divert women from custody in the first place, particularly those with short sentences?
I do agree. One of the first prisons I visited was Holloway. I saw at first hand the very different challenge we face with women offenders. One of the earliest steps I took was to separate ministerial responsibility for men and women in our prisons, asking the Under-Secretary of State for Justice, my hon. Friend the Member for Maidstone and The Weald (Mrs Grant) to take on the role of Minister with responsibility for women in prisons, and to look at whether we are getting the regime right and how we should adapt it to reflect the very different challenges we face with women in our prisons.
EU Justice and Home Affairs Directives
9. What consideration the Government has given to the UK opting out en masse from EU Justice and Home Affairs directives. (127918)
As my right hon. Friend the Home Secretary announced to this House on 15 October, the Government are currently minded to opt out of the measures included in the 2014 decision en bloc, and to consider which measures it is in our national interest to rejoin. This is a complex issue, and we are considering carefully the individual merits of each measure, continuing to work with law enforcement and criminal justice partners to do so. We are committed to a vote in both Houses before we finalise our decision.
I am grateful to my right hon. Friend. Will he tell me whether he is considering undertaking international co-operation on EU justice and home affairs rather than simply looking at the option of opting back in to specific EU directives?
I give my hon. Friend that assurance. It is absolutely clear that we can work with international partners effectively in fighting crime, as we do with non-EU allies around the world, without necessarily handing over sovereignty over these measures to the European Court of Justice. We are looking very carefully at where there is good reason to opt back in and it is in the national interest to do so, but we will not take those decisions lightly.
I think Jeremy Corbyn wants to ask a question.
Yes. [Interruption.] I am fully awake, thank you.
The Members behind the Secretary of State are determined to break with so much to do with European law and Europe as a whole. Does the right hon. Gentleman not recognise that the European convention on human rights, the European Court of Human Rights and all the advantages that have been given to people who would otherwise be denied human rights across Europe are very important, and that we should dedicate ourselves to supporting that principle even though at times a European court, just like a UK court, can make decisions that are inconvenient and are seen to be unhelpful to national Governments? That is the whole principle of the independence of the judicial system.
The European convention on human rights was written in the 1950s by Conservatives at a time when Stalin was in power in Russia and people were being sent to the gulags without trial. What has happened over 40 or 50 years is that the judgments around the human rights framework have moved a long way from the original intentions of the authors of the convention. That is why it is my strong belief that change has to happen.
Employment and Support Allowance Appeals
10. What progress he has made in encouraging tribunal judges to supply feedback to Department for Work and Pensions decision-makers on the reasons for successful employment and support allowance appeals. (127920)
The provision of feedback on tribunals’ decisions is a matter for the judiciary, but new arrangements were introduced in July. They were agreed by the chamber president and the Department for Work and Pensions, and allow judges to select reasons for their decisions from an agreed list.
At the weekend, I spoke to a constituent who was making her second appeal in a year. She was told that there would not be a decision for four months, although the number of tribunal members appointed in Scotland has doubled in the last year. Does her experience not illustrate the huge importance of ensuring that proper reasons for decisions are given to DWP decision-makers, so that the decisions are right in the first place? That would be better than the provision of a drop-down menu or a very limited selection of reasons.
Her Majesty’s Courts and Tribunals Service is working closely with the DWP to improve the quality of the original decisions and also the reconsideration process, so that only appropriate appeals reach the tribunal. As for waiting times, dealing with matters in a timely fashion is of course very important. I am pleased to announce that the waiting time between the receipt of an appeal to disposal has fallen from 22 weeks to 19.3 weeks, and that in Scotland it is down to 12.6 weeks.
Foreign National Prisoners
11. How many foreign national prisoners were repatriated to their home country to serve their custodial sentence in 2011. (127921)
The simple answer is “Not nearly enough.” In 2011, 32 foreign national prisoners and one British national were sent to other countries to serve their sentences. The number of prisoners being repatriated is still unacceptably small, as it has been for a number of years under both Governments. I am not satisfied with that, and I am determined to push the numbers up, but the House should be aware that this is a difficult issue. We need the collaboration of other countries, and we are working hard to secure it.
What a dismal record. Back in November 2010, the Prime Minister said that he would “personally” lead a new drive to remove foreign prisoners. Given that the number repatriated in 2011 was just a third of the number in Labour’s last year in government, is this not yet another illustration of a Prime Minister who over-promises but under-delivers?
I will not take any lectures from a party that was responsible for the levels of immigration to this country that we have seen over the past decade. There are now fewer foreign nationals in our prisons than was the case under Labour. I intend to continue the drive both to deport people when they have finished their sentences, and to deport them through prisoner transfer agreements as soon as we possibly can.
Will my right hon. Friend make it a departmental priority to negotiate compulsory prisoner transfer agreements with Commonwealth member countries, especially Nigeria and Jamaica, which seem to be the source of most of the foreign national offenders in our prisons?
I can give my hon. Friend an absolute assurance to that effect. The prisons Minister—my hon. Friend the Member for Kenilworth and Southam (Jeremy Wright)—and I have met our Jamaican counterparts during the last few weeks. We are focusing our efforts to negotiate compulsory transfer agreements on the countries where the problem is greatest. Of course, what we inherited from the previous Government were voluntary agreements, which, as we all know, have a limited effect.
15. What plans he has to use training and education to reduce reoffending. (127926)
We fully recognise the importance of training and education in improving an offender’s chances of employment and thereby reducing reoffending. That is central to the reforms set out in the joint Ministry of Justice and Department for Business, Innovation and Skills strategy “Making Prisons Work”. My officials are also working with the Department for Work and Pensions to provide enhanced employment support via the Work programme.
I have three prisons in my constituency—[Hon. Members: “Well done!”] Yes! They work very closely together, and have an excellent record of effective education and training. Will my right hon. Friend agree to visit Sheppey to see for himself the good work that is being done to reduce reoffending?
I pay tribute to all the staff who work in the three prisons in my hon. Friend’s constituency. I should be delighted to visit Sheppey in the next few months and see, with him, the work that is being done. I also pay tribute to my hon. Friend’s constituents—not just those who work in the Prison Service, but those who provide it with support services. What Sheppey is doing for the criminal justice system is enormously important.
Training for work and cutting back on drug use are two proven ways of reducing reoffending. Will the Secretary of State therefore comment on the independent monitoring board report on HMP Risley, showing that, because of Government cuts, training is being cut back and illegal drug use is increasing, thereby undermining officers’ past good work? That is likely to impose a further cost on the community if offending goes up as a result.
It is simply not the case that we are seeing the kind of problems the hon. Lady mentions across the prison system. The reality is that we have no choice but to deal with the financial challenges left behind by the previous Government. The trick is delivering a more effective system for less money, and that is what we are doing.
16. What steps he plans to take to reduce the number of offenders serving repeated short sentences. (127927)
We recognise that those sentenced to short custodial sentences have high reoffending rates and we are looking to see how best to deliver rehabilitation for this group. By the end of 2015 we intend to apply the payment-by-results approach right across our rehabilitation work with offenders, so that fewer of them, including those who have been sentenced to short terms, return to prison.
One of the concerns in the wider community is that people get into a cycle of offending, prison and then reoffending. One problem is that the courts are so slow in processing their cases that they cannot be punished in time and be kept inside when they deserve imprisonment. What is the Minister going to do about reducing the time it takes the courts to process reoffenders, and what will he do, too, about extending their sentences?
We are keen to see greater efficiencies throughout the criminal justice system, which will assist in addressing the problem my hon. Friend describes. The other issue, of course, is that those sentenced to very short terms—12 months or shorter—have very little assistance or intervention when their period of custodial imprisonment has ended. There is no period of licence, and we want to look at ways in which we can ensure that people in that group, who do offend at very high rates, receive the intervention they need to reduce their reoffending rates.
17. Whether he has made a comparative assessment of the number of claims for compensation for whiplash injuries in courts in (a) the UK, (b) France and (c) Germany. (127928)
We have not conducted comparative assessments, but we know that whiplash claims are higher in England and Wales than elsewhere. The increase in whiplash claims at a time when there are fewer reported road traffic accidents is unacceptable. The Government will consult shortly on measures to tackle the cost of whiplash claims.
The very high level of claims in the UK pushes up insurance premiums for ordinary people by hundreds of pounds a year. In Germany, two medical opinions are required before claims go forward. Are we considering introducing that here, and what other measures are we considering to sort out this industry?
The Government are committed to finding ways of tackling fraudulent whiplash claims. We are about to consult on increasing the small claims threshold for personal injury claims arising from road traffic accidents from £1,000 to £5,000. We are also about to consult on the creation of independent medical panels, which could improve diagnosis, transparency, consistency and identification in respect of exaggerated injuries.
18. What plans he has to reduce the number of young people within the criminal justice system. (127929)
Reducing the number of young people in the criminal justice system continues to be a priority for this Government, and a range of work is going on to prevent youth offending. Youth offending teams play a key role, and cross-Government initiatives such as the troubled families programme, the liaison and diversion programme and the ending gang and youth violence programme demonstrate a co-ordinated approach to this issue.
The Minister will know that members of the Justice Committee were told on a recent visit to YOI Hindley that breaches frequently occur when young people are released from custody and return to their community, from which they are often excluded by order of the court. That, of course, negatively hits reoffending figures, and the same circle continues to be drawn. Will the Minister work with colleagues across Government to make sure that young offenders leaving the secure estate have far better resettlement plans, as that is one sure-fire way to reduce reoffending?
My hon. Friend makes a very good point, and I look forward to receiving the Select Committee report on this matter, which we are expecting shortly. I am happy to assure my hon. Friend that we are working not only with other Departments, including the Department for Communities and Local Government, but with the Youth Justice Board to ensure that young people have access to suitable accommodation on release from custody. The YJB is also working to improve resettlement on release from custody by encouraging local services to work more collaboratively to ensure that young people have suitable accommodation, which is an essential step in stopping them reoffending.
Under Labour, the number of first-time offenders fell by a third. Does the Minister believe it is realistic to think that that trend can continue when the cuts to local authorities are as deep as they are? He says he has a co-ordinated approach, but what is happening in practice?
I am happy to tell the hon. Lady that I do not need to project that things are carrying on in the right direction—they are carrying on in the right direction. In the past year, the number of first-time entrants to the youth justice system has fallen by 20%, from 45,900 to 36,700. I am grateful to her for giving me the chance to give those figures to the House.
19. What progress he has made in tackling corporate offences of fraud, bribery and money laundering. (127930)
The coalition has a clear commitment to tackling corporate offending: we implemented the Bribery Act 2010 from July 2011; we published the “Fighting Fraud Together” strategy, which is led by the National Fraud Authority; we established the Economic Crime Command in 2011, as part of the National Crime Agency; and we introduced provisions on deferred prosecution agreements in England and Wales in the Crime and Courts Bill.
Clearly the infrastructure is in place for prosecuting these offences. Will my right hon. Friend work closely with the Serious Fraud Office to ensure that prosecutions are brought against corporate bodies when offences have been committed?
My hon. Friend makes an important point, but of course the SFO acts independently of Government. As I said, the Government take all forms of economic crime seriously and what we can do is provide the SFO and other prosecutorial bodies with the tools they need to carry out their roles. That is why, for example, we introduced clauses to provide for the deferred prosecution agreements, which we think will be a valuable tool. They have tough requirements, such as a financial penalty, reparation for victims and repayments of profits. That kind of practical tool in the hands of the prosecutors will make us much more effective at fighting economic crime.
We are ahead of schedule, but the hon. Member for Easington (Grahame M Morris) is in his place and we can safely proceed to topical questions.
T1. If he will make a statement on his departmental responsibilities. (127931)
With your permission, Mr Speaker, I would just like to say a few words about the Abu Qatada case. I strongly support the comments that the Home Secretary made yesterday, and would indicate to the House that my Department will do everything it can to support the Home Office in its efforts to get Abu Qatada deported. All of us believe that the law should not operate in this way, and this case underlines my view that there is a real need for major changes to the way in which the European human rights framework operates.
May I refer the Under-Secretary of State for Justice, the hon. Member for Maidstone and The Weald (Mrs Grant) back to the answer she gave a few moments ago in response to the hon. Member for Warrington South (David Mowat)? Given the importance of this to victims of workplace accidents and industrial diseases, will the Minister meet a small delegation of Labour MPs to receive representations on the implications of the proposal to amend the ceiling on small claims compensation?
Yes, I would be happy to meet the hon. Gentleman and the delegation.
T3. Is it not rather counter-intuitive, given the Secretary of State’s excellent views, to be closing rather than opening prisons? Why then are the Government consulting on closing Lincoln prison, which, as far as I know, has caused no trouble to the community since Eamon de Valera escaped from it during the first world war, and which provides 400 jobs, and humanely and safely locks our local villains away? (127933)
First, let me explain the context to my hon. Friend. We are in the middle of a programme of new for old in the Prison Service; we are bringing on stream new capacity as well as closing down old capacity, as part of a drive to bring down the overall cost of running the Prison Service by making the unit cost of each place cheaper. We are looking at a number of options, and no decisions have been taken on Lincoln prison. There is no proposal to close it, and I can assure him that I will personally be looking carefully at this issue, as I am well aware of the geographical circumstances of Lincoln, particularly the lack of good transport to other locations in the prison system.
The Justice Secretary referred to the Abu Qatada case. We have also recently heard the ruling of Reading county court, which held that a same-sex couple had been discriminated against by a bed and breakfast owner who refused to let them stay in her B and B. Will the Lord Chancellor and Secretary of State for Justice join me in welcoming that ruling?
As the right hon. Gentleman knows, I never comment on individual cases, but I voted for the law behind that case and stand by the decision I took at the time to vote for it.
Three minutes ago, the Justice Secretary commented on a case from yesterday. Three minutes later, he is unwilling to comment on a case from three weeks ago. He looks uncomfortable—does he think that he was wrong when, as shadow Home Secretary, he said:
“B and Bs should be able to turn away gay couples”?
Will he now apologise for those comments and commend the Equality Act 2010, which is doing so much to tackle discrimination in this country?
I was not aware that I was accountable to the House for Opposition roles, but I will say again to the right hon. Gentleman that I voted for the law as it stands and I stand by that decision.
T4. Does my right hon. Friend have plans to use the opportunities provided by new technology in tracking offenders? (127934)
Yes, we do. It will be important to consider the opportunities that GPS-based technology, in particular, gives us in the monitoring of offenders not just to enforce elements of a community order, such as an exclusion order, but to act as a deterrent for those offenders who might be minded to reoffend.
T2. The Association of Child Abuse Lawyers has expressed great concern about drastic changes to the rules on legal costs that are due in April next year. They believe that those changes could have serious implications for the victims of childhood abuse. Is the Secretary of State aware of those concerns and what does he propose to do about them, especially in view of recent events? (127932)
It is nice to get a serious question from the Opposition. These are sensitive issues and we have had to take difficult decisions about the legal aid system. We have the most expensive legal aid system in Europe and, given the financial challenges we inherited, no change was not an option. We will, of course, continue to review the impact of the changes we have made to ensure that there are no unintended consequences. I will not be afraid to reconsider some of those issues if it proves that what we have done has created a major problem.
T5. Will the Secretary of State urgently review the proposed changes to the Bail Act 1976 contained in the Legal Aid, Sentencing and Punishment of Offenders Act 2012? In some cases, magistrates will be forced to free defendants who they know will fail to surrender, will commit further offences while on bail and, in some cases, will go on to intimidate witnesses? To make matters worse, as the 2012 Act stands, if those offenders breach their bail conditions, the magistrates’ hands will be tied and they will have no choice but to rebail them. Is this not a ridiculous state of affairs? (127936)
The one point on which I will take issue with my hon. Friend is the fact that he talks about magistrates “knowing” that someone will commit an offence in the future. It is reasonably well established in British law that people are innocent until they are proved guilty—
Have you seen the Bail Act?
To suggest, as the shadow Justice Secretary is doing from a sedentary position, that he, or a magistrate, knows who will commit a crime in the future seems to me to be an absolute breach of all the traditions of our justice system. Of course, if an offender goes on to commit another offence while on bail, including intimidation of a witness, that offence will be considered in its own right. If it could attract a sentence of imprisonment, the option of remand is still open to magistrates. I think we should stick by the basic tenets of justice.
In his response to my hon. Friend the Member for City of Durham (Roberta Blackman-Woods) on the question of payment by results and reoffending, the Secretary of State talked about the importance of evidence. Will he share with the House his assessment of the reasons behind the failure of the Mayor of London’s Project Heron at Feltham?
Of course I am not responsible for the Mayor of London’s projects. On the question of our whole approach to the rehabilitation of offenders and the introduction of payment by results, the nature of payment by results means that we provide incentives to providers to deliver what works best. There is constant pressure in a payment- by-results system to find best practice and apply it in a way that delivers best results for offenders and for the taxpayer.
T6. The social impact bond from Peterborough prison to reduce reoffending was launched just over a year ago. Full results will only be available after year four. What assessment has the Secretary of State made so far of the effects of the work done? Has it reduced reoffending? (127937)
We have not yet done the assessment—the detailed work—but I think there are good grounds for believing that good work has been done, and I will provide more information in due course.
The lessons from the Qatada case are that it is quite difficult to deport people to jurisdictions that do not adhere to, as a basis, the UN convention on torture, for example. What is the Department doing to encourage jurisdictions outside Europe to sign up to a higher standard of international law, so that there is a greater sense of parallel of the rights of justice in this country, in Europe and in other parts of the world?
Of course, it is the role of Britain and other democratic nations to encourage non-democratic countries around the world to adopt democratic principles, the rule of law and a proper fair, independent judiciary. But I have to say that I do not believe it was ever the intention of those who created the human rights framework to which we are currently subject that people who have an avowed intent to do damage to this country should be able to use human rights laws to prevent their deportation back to their country of origin.
T7. Does the Secretary of State believe that the election of police and crime commissioners on Thursday will help restore public confidence in the way that offences are dealt with in local communities? (127938)
I agree with my hon. Friend, not least because although they are police and crime commissioners, people may have focused too much on the policing aspect. The crime reduction aspect is at the heart of what these new elected bodies will do, and crime prevention and some of the things that we have been discussing earlier this morning, such as restorative justice, will play a very important part in each locality in improving the criminal justice system and improving public confidence in the criminal justice system. The PCCs will play a significant part in that.
Harassment, threatening behaviour and bullying on social media are all increasing. What training has the Department put in place to enable probation officers, magistrates, judges and the court services to deal with that?
The hon. Lady is right that it is an increasing problem, and we will want to ensure that all those who have responsibility in this area understand it, and understand the reach of it. Of course, she will be aware that it is a problem that has, sadly, found its way into prisons also, so we want to ensure that we do everything we can to stamp it out, as she says.
T8. I wonder whether the Secretary of State might update the House on discussions he has had with the Home Office about deporting foreign national prisoners straight away when they complete their sentence in the UK. (127940)
We have regular contacts at both ministerial and official level and, of course, we now have the benefit of the presence of the former Immigration Minister, who brings knowledge of both sides of that challenge to our team. We intend to continue to work as hard as we can to secure the deportation of offenders after their sentences, as well as to transfer prisoners when we can during their sentences.
Has the Secretary of State any concerns that the provisions in the criminal injuries compensation scheme voted on by the House last night in terms of sex abuse victims aged between 13 and 15 are a dangerous and dubious legislative signal to be sent by this Parliament as its first legislative signal in the wake of the scandal concerning Jimmy Savile?
I hear what the hon. Gentleman says, but would point out that our reforms have led to no changes to the 2008 scheme in respect of certain sexual abuse issues. Further guidance has been given on other particular matters. Victims coming forward in the Jimmy Savile case should certainly be able to make applications for compensation.
When innocent people can be framed on social media sites will the Government consider, with some urgency, looking at a certain part of the libel laws? Innocent people do not deserve to be named; they certainly do not deserve to be put through the grilling that certain people have faced. Would the Secretary of State and the Government look at that as a matter of urgency?
I am as concerned as anybody about what has taken place over the last two weeks. It is utterly wrong that anybody should have their name blackened inappropriately and falsely on any form of social media. Of course, the laws of libel apply equally to what is published on a Facebook or Twitter page as they do to what appears in printed form, so those who are damaged in that way have full legal redress to try and get proper justice done.
What discussions are taking place between Ministers and officials in the Ministry of Justice and those in the Department for Work and Pensions in anticipation of the further burden that will be put on the tribunals service when the new personal independence payment comes in next year, because experience shows that the level of appeals resulting from benefit changes is very high?
We will continue to do everything we can to improve the process in both Departments. I am absolutely clear that we want to get the appeals process right, both in the tribunals service and in Jobcentre Plus, where we have introduced a mandatory reconsideration process. Ultimately, the reason we are doing all that is that there are large numbers of people out there who can return to work and make a better lot of their lives, which we want to help them to do, but unless we have a reassessment process, we will never find those people to deliver that help to.
Does the prisons Minister realise that staff at HM Prison Northumberland, who have successfully merged two prisons and earned a positive report from the inspector, are sickened and infuriated that the public sector bid will not go through to the final market testing round because of promises from private sector providers that the Department might lack the capacity to verify?
I understand the disappointment that will be felt by those who put in the public sector bid at HM Prison Northumberland but, as I have explained to my right hon. Friend, the difficulty is that the difference between the public sector bid and those we are taking forward to the next round of the competition was substantial, and it would not have been responsible to ignore that gap. However, I also say to him that this is a two-stage process. It will be important that the Government are satisfied that those who go through to the next round of the competition have the capacity to deliver what they say they can deliver, and we will look carefully at the bids in that context.
When my constituent Michael Dye was killed following a single blow at a football match between Wales and England last year, his family expected justice, but when they got to court the sentence that was given came as a complete surprise to them. What more can be done to ensure that the families of victims of crime have a better awareness of the likely sentence the perpetrators will receive in court?
I have a huge amount of sympathy for a family in that appalling situation. I have sat down and talked with many families who have lost loved ones as a result of violent crime and absolutely accept that our criminal justice system often does not seem responsive enough to their needs, does not explain enough to them what is happening and does not give them details of the process, even to the extent that an offender who has been convicted of a violent crime can be back on the streets without the victims knowing about it. That is why one of the first things I did as Secretary of State was appoint the Under-Secretary of State for Justice, my hon. Friend the Member for Maidstone and The Weald (Mrs Grant), as victims Minister so that there is someone in Government who is a champion for that cause and who will work with the next victims’ commissioner to ensure that we have a system that is as responsive as we can possibly make it.
My understanding is that the Law Society and the Family Law Bar Association have come out in opposition to the fixing of a time limit for courts to conclude care cases, so will the Secretary of State take this opportunity to remind family lawyers, and indeed judges, that the implementation of a 26-week time limit remains a core policy objective and that lawyers should be preparing now to meet those targets?
I can assure my hon. Friend that we have made no changes to the plans. We always listen carefully to outside bodies, but no changes have been made and we are not considering making any.
In view of the Qatada decision, has the Secretary of State considered requiring courts to take into account the likely cost to the public purse of their bail decisions, particularly in serious and high-risk cases?
I am happy to consider that matter further and write to the hon. Gentleman.
In view of what the Secretary of State has rightly said about the case of Abu Qatada, a prominent supporter of al-Qaeda, will he say a word or two about an opponent of al-Qaeda, namely the special forces sergeant who has been sentenced to an 18-month term of military detention for having kept a pistol that was presented to him in gratitude for his services by the Iraqi special forces? I realise that court martial procedures might be outside my right hon. Friend’s immediate area of responsibility, but will he reflect public concern over that very serious matter?
I am aware of the public concern. My hon. Friend will understand that I cannot comment about an individual case, and of course courts-martial fall under the remit of the Ministry of Defence. However, I would always hope that common sense will lie at the heart of every judicial decision in this country.
Will the Minister give an indication of the cut-off date for claims under the criminal injuries compensation scheme? Victims of crime and their representatives need to know that date. Will it be Friday 23 November? Will it be Monday 26 November?
It will be 27 November this year.
Does the Minister have an assessment of how curfew orders have been working since their hours and length were increased last year?
I will have to check to be certain, but I think that the changes made by the Legal Aid, Sentencing and Punishment of Offenders Act 2012 have not yet come into force. However, my hon. Friend puts his finger on the opportunity for us to have available not only more hours spent under curfew but curfew orders that last for a longer time. In addition to new technology that will enable us better to monitor offenders, this can be a very effective means of keeping track of those who have committed offences.
Does the Lord Chancellor recall that in the reign of Henry VIII it was made high treason to take an appeal outside this kingdom? Has not the time come for this Parliament once more to legislate to prohibit appeals to foreign courts and to prohibit the judgments of foreign courts leading our judiciary?
I know that my hon. Friend has strong views on these matters. While I may not agree with every word he says, he will know that I have some sympathy with his frustration about international courts and the rulings that they make. That is why I am very clear that, in relation to the European Court of Human Rights, further reform is necessary.
My constituent Jermaine Sheerin and his family are suffering a cycle of despair since he was convicted and received an indeterminate public protection sentence in 2007. He remains in prison, and sometimes in hospital, at risk of suicide. The Government have said that IPP sentences are wrong, so why are people who are currently serving them left in limbo?
It is difficult for me to comment on the individual case, because that is a matter for the probation authorities. We have put in place a package of longer sentences for more serious offenders. In relation to those who are still in prison on an indeterminate sentence, they will of course have to submit to the procedures that were law at the time. It is particularly important for us to know that they are safe to be released before they are released.
Stafford prison was built in 1794 and is one of the cheapest prisons in the country to run. Will my hon. Friend visit Stafford with builders of new prisons to see how it is done?
I am sure that those responsible for the building of prisons will always understand that they have more to learn. We all want to learn whatever lessons we can from the excellent construction of Victorian prisons, in particular, as I have discovered in my time touring the estate.
In London, a third of people sent to prison for criminal offences are foreign nationals, yet we have the scandalous position whereby they can apply for British citizenship, while no attempt is made for them to serve their sentences in their countries of origin. What is my hon. Friend doing to remedy this, particularly given that many of those who are finally freed after their prison sentences are then free to come and go?
I do not think it is fair to say that nothing is being done about ensuring that foreign national offenders leave the country. As my right hon. Friend the Secretary of State said earlier, we are making considerable efforts to negotiate compulsory prison transfer agreements so that these prisoners do not have the choice of staying in this country. We are also working as closely as we can with the Home Office to ensure that people who have completed sentences leave this country as soon as possible.
NHS Commissioning Board (Mandate)
With permission, Mr Speaker, I would like to make a statement regarding the publication of the Government’s first mandate to the NHS Commissioning Board.
The NHS is the country’s most precious creation. We are all immensely proud of the NHS and the people who make it what it is—a service that last year delivered half a million more outpatient appointments, nearly 1 million more A and E attendances and 1.5 million more diagnostic tests than the year this Government came into office; and it is doing so while meeting waiting time targets, reducing hospital-acquired infections and virtually eliminating mixed-sex wards. The essence of the NHS is its values: universal and comprehensive health care that is free and based on need and not the ability to pay.
Today I am proud to publish the first ever mandate to the NHS Commissioning Board. From now on, Ministers will set the priorities for the NHS, but for the first time, local doctors and clinical staff will have the operational freedom to implement those priorities using their own judgment as to the best way to improve health outcomes for the people they look after. That independence comes with a responsibility to work with colleagues in local authorities and beyond, to engage with local communities to create a genuinely integrated system across health and social care that is built around the needs of individual people.
The mandate makes clear my responsibility, as Secretary of State for Health, to uphold and defend the enduring values that make the NHS part of what it is to be British. It also sets out my priorities for the NHS Commissioning Board over the next two years and beyond, linked closely to the NHS outcomes framework, the latest version of which I am also publishing today.
The priorities set out in the mandate closely reflect the four key priorities I have identified to Parliament as my own. Let me take each of them in turn. My first priority is to reduce avoidable mortality rates for the major killer diseases, where despite increases in life expectancy our survival rates are still below the European average in too many areas. If our mortality rates were level with the best in Europe, we could save as many as 20,000 lives every year—20,000 personal tragedies that could be avoided, but are not. It cannot be right that we are below average for cancer survival rates, that for respiratory diseases we are the worst in the EU 15, or that our performance on liver disease is getting worse, not better. Today I call on the NHS Commissioning Board, working with Public Health England, local government, clinical commissioning groups and others, to begin a concerted effort to bring down avoidable mortality rates in this country.
The mandate asks the board to make measurable progress to improve early diagnosis, giving more people quicker access to the right drugs and treatment where they need it; to reduce the wide and unacceptable variation between different parts of the country, both in terms of inequality of health outcomes and variability of performance by NHS trusts; and to support a renewed focus on prevention, working with local authority partners to help people quit smoking, drink less, eat better and exercise more.
My second priority is to build a health and care system where the quality of a person’s care is valued as highly as the quality of their treatment. When we place ourselves in the hands of others, we should be confident that we will be treated well, our dignity respected and that that will be the case regardless of our age or mental state, or whether we are in a hospital, a care home or our own home. For most people, most of the time, that is already the case, but too often it is not. The appalling revelations from places such as Mid Staffs and Winterbourne View bring home the desperate need for change. We must go beyond the enforcement of minimum standards. We must raise our game so that the NHS is recognised globally for its commitment to the highest standards of care for all, just as it is recognised for its commitment to the highest standards of treatment for all.
The mandate asks the NHS Commissioning Board to ensure that GP-led commissioning groups work with others so that vulnerable people, particularly those with dementia, learning disabilities and autism, receive safe, appropriate, high-quality care. It also asks the board to improve standards of care during pregnancy and in the early years of children’s lives. This will include offering women the greatest possible choice over how they give birth, giving every woman a named midwife who will be responsible for them both before and after the birth, to reduce the incidence and impact of post-natal depression through early diagnosis and better intervention and support.
The mandate asks the board to measure and understand how people really feel about their care through the new friends and family test, asking patients whether they would recommend the care they receive to their friends or family. The test will cover hospital and maternity services in 2013, with other parts of the NHS following soon after. The mandate also asks the board to drive up standards of care by championing a transparency revolution within the NHS. This will make us the first country in the world to publish comparative information on performance throughout the health-care system, including on clinical commissioning groups, local councils, providers of care and consultant-led teams. Mental health, long the poor relation, must have parity with physical health. The mandate asks the board to make clear progress in rectifying that, particularly by looking at waiting times and rolling out the programme of improved access to psychological therapies.
My third priority is to improve dramatically care for the third of people in England who live with a long-term condition such as asthma, diabetes or epilepsy. As a group, they account for more than half of GP appointments and nearly three quarters of hospital admissions. That has a huge impact on the individuals concerned—an impact that can be compounded by the way in which they are dealt with by the NHS. We need to do better.
The mandate therefore asks the board to help those who rely heavily on the NHS by harnessing the power of the technology revolution. Labour’s NHS IT projects failed, wasting billions, but we must not allow that failure to blind us to how technology can transform treatment and care throughout the system. I am today asking the board to ensure, by 2015, that all NHS patients in England can access their GP records online; that, in at least parts of the country, those records are integrated with other medical records across the health and social care system, so that a single record can follow a patient seamlessly from ambulance to hospital, to GP clinic and to their own home; and that everyone can book GP appointments and order repeat prescriptions online, as well as contact their GP by e-mail. I am also asking that significant progress be made towards ensuring that 3 million people with long-term conditions benefit from telehealth and telecare by 2017.
With respect to people with long-term conditions, the mandate also asks the board to ensure, by 2015, that more people have the knowledge and skills to control their own care, and that carers have the information and advice that they need about the support that is available to them, including respite care.
My final priority is care for older people, specifically those with dementia. Already, one in three people over the age of 65 lives with dementia. Shockingly, even though the right medicines can make a huge difference to people’s quality of life and that of their families, we diagnose fewer than half of those with the condition. I want the diagnosis, treatment and care for people with dementia to be world-leading. The mandate therefore asks the NHS Commissioning Board to make significant progress in improving dementia diagnosis rates and to ensure that the best treatment and care is available to everyone, wherever they live. We also want hospitals, and indeed all NHS organisations, to make significant progress in becoming dementia-aware and dementia-friendly environments.
The mandate covers other important areas of NHS performance, including research, partnership working, the armed forces covenant and better health services for those in prison, especially at the point when they are integrated back into the community. The mandate also sets the NHS Commissioning Board’s annual revenue budget, which for 2013-14 will be £95.6 billion, with a capital budget of £200 million. An important objective for the board is therefore to ensure good financial management, as well as unprecedented and sustainable improvements in value for money across the NHS.
We are the first country in the world to set out our ambitions for our health service in a short, concise document that is centred around patients. Its clarity and brevity will help bring accountability, transparency and stability to the NHS. The last Government sent endless instructions to strategic health authorities and primary care trusts, constantly bombarding them with new targets, new directions and new priorities, and drowning the NHS in red tape and bureaucracy. In stark contrast, the mandate is just 28 pages long. It signals the end of top-down political micro-management of the NHS—an approach that failed to get the best treatment for patients and the best value for taxpayers. The mandate demands much closer integration between secondary and primary care, and between the NHS and social care. It requires a new style of leadership from the NHS, with local doctors and nurses free to innovate in the way that they commission care. I look to the board to develop their leadership skills so that they can do that. The mandate will make it easier for Ministers to hold the health and care system to account, and easier for Parliament to hold Ministers to account for their stewardship of the system. It is a historic step for the NHS, and I commend the statement to the House.
The Secretary of State has just reeled off an impressive wish list, but people across the NHS will be asking a simple question: how on earth can he ask the NHS to do more, when we learn today that 61,000 jobs have been lost or are at risk in the NHS? His statements are dangerously at odds with the reality on the ground and risk raising unrealistic expectations. Across England, services are under severe pressure with ambulances queuing outside A and E, patients left on trolleys in corridors for hours on end, and increasing numbers of A and E and ward closures. No wonder nurses’ leaders today warn that the NHS is “sleepwalking into a crisis.” To listen to the Secretary of State, however, it is as if none of that is happening.
A toxic mix of reorganisation and real-terms cuts risks plunging the NHS into a tailspin. Today, people will have been hoping for a mandate for common sense to restore sanity to an NHS that is in danger of losing the plot, and for instructions to protect the front line. Well, they will have been disappointed.
The Secretary of State glosses over finance, but let me give the House the facts. He and his predecessor promised to reinvest all efficiency savings in the NHS front line—[Interruption.] Yes, they say, yet we learn that £3 billion of NHS money has been swiped back by the Treasury. When will the Secretary of State stand up to the Treasury and keep promises that the Government have made to the NHS? While the NHS front line takes a battering, the Government keep throwing money at a back-office reorganisation that nobody wanted. A full £1 billion has been spent on redundancy packages for managers, more than 1,000 of whom have received six-figure payouts while 6,000 nurses get P45s. That is the scandalous reality of the coalition Government NHS.
Will the Secretary of State confirm that a single payoff of £324,000 was made to the former chief executive of NHS Bolton? How would he care to justify that to NHS staff in Bolton who are losing their jobs? There could be no clearer illustration of a Government whose priorities are completely wrong.
Let me turn to some of the specific points set out by the Secretary of State. First, he makes welcome commitments on care for older people. If that is his priority, however, why are there no instructions in this mandate to stop commissioners from imposing restrictions on essential operations for older people? Last year, there were 12,000 fewer cataract operations than in 2009-10. Older people were told that they could have an operation in one eye but not in two. The Government boast about shorter waiting lists, but that is because people cannot get on those lists in the first place. A postcode lottery is running riot and there is nothing in this mandate to stop it.
The Secretary of State’s promises on dementia will be nothing more than hollow words until he faces up to the crisis in council budgets for adult social care. Across England, older people and carers are facing a desperate struggle as council services such as home helps are cut to the bone. Millions of people are facing ever higher care charges—cruel coalition dementia taxes—as councils are forced to put up the cost of meals on wheels and other services. If the Secretary of State really wants to help people with dementia, when will he act to stop this scandal?
Let me turn to mortality rates. Over the past decade, the deaths from heart attacks fell by 50% in men and 53% in women, and the NHS achieved the biggest drop in cancer deaths among the 10 most developed nations. It is widely accepted that the clinical networks established by the previous Government played a significant role in that success. Indeed, the NHS medical director, Professor Sir Bruce Keogh, called them “an NHS success story”. Why, then, is the Secretary of State proceeding with brutal cuts to cancer, heart and stroke networks? Surely the best way to meet the ambitions he has set out is to build on that track record of success, not destroy it.
The Secretary of State promises to implement the Labour amendment to the Health and Social Care Act 2012 to ensure “parity of esteem” between physical and mental health. However, the opposite is happening as the NHS reverts to its default position and places mental health services first in line for cuts. Will he confirm that mental health spending was cut in real terms last year, and what will he do to reverse that? He says he wants a transparency revolution, but across the country local people are being shut out of crucial decisions affecting local NHS services. If he believes in “No decision about me without me,” will he today commit to consult Greater Manchester patients with long-term conditions on whether they want ambulance services to be run by a bus company? Will he act to stop details of contracts under his “any qualified provider” regime from being kept secret from local people under “commercial confidentiality”? The truth is that patients are being shut out as his friends in the private sector fill their boots.
In the weekend’s papers, this mandate was called the first contract with the NHS—the new language of the coalition NHS, in which competition and contracts replace care and compassion. Yes, the Secretary of State has today published a new mandate, but we needed a change of direction. The Government have put the NHS on a fast track to fragmentation. Today, they have unfairly and unrealistically raised expectations on a battered NHS, thinking they have cleverly contracted out responsibility to the national Commissioning Board. I have news for them. The chaos in the NHS starts and ends with the guilty men and women on the Government Benches. We will hound them and hold them to account for the damage they are doing.
This is an incredibly important document for the NHS, and I think that we were all expecting a bit more than the same old hollow rhetoric from the right hon. Gentleman.
There could be no greater commitment to the NHS than to protect its budget at a time of unprecedented austerity. This Government have protected the NHS budget; the right hon. Gentleman said that that would be irresponsible. The Government take action; he uses words. The picture he paints of the NHS in crisis is not the picture recognised by thousands of doctors and nurses up and down the country. Of course, with an ageing population, the NHS is doing more than ever before. Nearly 1 million more people every year are in A and E than when he was Health Secretary, but it is meeting all its waiting times targets and has virtually eliminated mixed-sex wards, and hospital-acquired infections are going down. This NHS is performing exceptionally well.
Let me address some of the points that the right hon. Gentleman made. On finance, in the figures he gave, I think he was alluding to the fact that, in the first year the coalition was in power, it worked to Labour’s NHS budgets. There was an underspend in that year, as there was in each of the last four years that Labour was in control. In three of those four years, the underspend was higher than it was when my right hon. Friend the Leader of the House was Health Secretary. Let us talk about redundancy payments. The reforms introduced by my right hon. Friend will save the NHS—[Interruption.]
Order. I appreciate that there are very strong feelings on these matters, but Opposition Front Benchers must not shout at the Secretary of State as he is responding to questions. He must be heard. Everybody will have a chance—Members can rely upon me to ensure that—but the Secretary of State must be heard.
The redundancies in management and administration will save the NHS £1.5 billion every year—£1.5 billion that can be spent on the front line. We should compare that with the £1.6 billion the NHS must spend every year to deal with the right hon. Gentleman’s disastrous private finance initiative policies that left the NHS with £73 billion of debt overhang.
Let us talk about clinical networks, which are extremely important. We have four clinical networks—for cardio, cancer, maternity and mental health—and they will continue. The budget that the networks are using is increasing and not decreasing under the Commissioning Board.
The right hon. Gentleman said that ambulance services in Manchester would be run by a private bus company. I am sure the House will be interested to know who the Health Minister was when the guidelines that allow private bus companies to bid to run ambulance services were drawn up. It was the right hon. Gentleman. He was in post when that happened.
The right hon. Gentleman describes the mandate as a wish list. He should tell that to the 570,000 people who have dementia, for whom Government Members want to do a better job. He should tell it to people who suffer from cancer. They have below-average European survival rates, but we want them to have the best survival rates in Europe. He should tell it to the families and carers of people who are worried about the level of care they receive in certain parts of the system.
Government Members are determined to aim high for our NHS, because we believe in it. We believe it is doing incredibly well in difficult circumstances, but it can do even better. The right hon. Gentleman should also want an ambitious NHS. Just because he did not have those ambitions when he was Health Secretary does not mean that the Government should not aim high to make our NHS the best in the world.
I apologise to you, Mr Speaker, and to the House for my inability to control modern technology.
Does my right hon. Friend think it striking that, when he presents the first mandate of the NHS Commissioning Board to the House of Commons, we hear a lot of synthetic rhetoric from the Opposition Front Bench, but not a single disagreement with any one of his propositions from the Dispatch Box or in the mandate? Does that not demonstrate—this has always been the Conservative case—that there is a shared commitment to the ideals of the NHS, and that the difference is our ability to deliver it effectively?
I hope my right hon. Friend is right that there is agreement on the goals in the mandate, because they have been drawn up after extensive consultation with the people of this country and are important priorities, particularly as we grapple with an ageing society. I agree with him that it does not the help the NHS to descend to the rhetoric we heard from the right hon. Member for Leigh (Andy Burnham). There is a very important and legitimate debate about the right way to achieve shared goals. Government Members do not believe the right way is through performance management from the Department of Health and trying to echo out every part of the system. We believe the right way is to empower local GP-led groups to make changes on the ground. That is at the heart of the reforms.
I can understand the Secretary of State’s desire to give operational freedom to people in each locality, and his desire, as he says in his document, to reduce the inequalities of treatment between one area and another, but how does he intend to reconcile those two objectives?
The approach the reforms take is this: when there are inequalities in treatment, and when one hospital is particularly good at certain operations and another hospital is not as good, the best way to drive up performance is to make that information available in a way that has never happened before. More than anything, peer review drives the NHS. A very important part of the programme will be to roll out plans similar to those we have rolled out for cardiothoracic surgery, for which a performance comparison by consultant team, not just by hospital, has led to a dramatic improvement in survival rates from heart operations. We need to roll that out across many other disciplines. We also need to be able to compare local GP-led group with local GP-led group, and local authority with local authority. That will be a far more effective way of driving change than the old top-down way. That was tried under different Governments many times and in many ways, but it was never as successful as it was meant to be.
I welcome the statement, and particularly the actions that are being taken to deliver parity of esteem between physical and mental health, and to drive improvements on dementia. Those two things are linked by the common frustration of family carers, who feel that their voices are not always heard or understood within the NHS, and that there is too much variation in this country when it comes to identifying carers and ensuring that they get access to the breaks they so often need. Can the Secretary of State assure us that the mandate will ensure that people who need breaks get them before they have a breakdown?
I thank my right hon. Friend for the work he did at the Department, which is widely recognised on both sides of the House. He is right to talk about the critical role of carers. We have spoken a lot today about dementia. Dementia puts huge pressure on partners of the people affected. Very often, because we do not give the support we need to give at an early stage, people with dementia end up having to go to residential homes, whereas with that support, they would be able to stay at home happily for much longer. It is a critical issue. I hope he will be pleased to see in the section on long-term conditions explicit mention of the role of carers. We will follow the matter closely as the NHS Board implements at a local level the support he mentions.
My constituent Michael Wade was wrongly refused surgery for a life-threatening condition. What in the mandate improves patients’ rights, or will they have to continue to have to rely on MPs and campaigning local newspapers?
Any such examples are totally unacceptable. The rights that people have to the treatment they need clinically are enshrined in the NHS constitution. There will always be a need for MPs and other campaigners to highlight problems in the system, but we hope to make it much easier by exposing unacceptably low levels of clinical care much earlier than happens currently. As a result of the changes in the next two years we will see the NHS becoming the most transparent health care system of any in the world, which we hope will enable us to identify failures before they lead to the kind of tragedy the right hon. Gentleman mentions.
I understand that the Government are adding the one and five-year indicators for all cancers to existing indicators in the NHS outcomes framework. That is very welcome. It will particularly help those with rarer cancers, and the all-party group on cancer has long lobbied for it. Will the Government work towards ensuring that the commissioning outcomes framework, which measures clinical commissioning groups, mirrors those one and five-year indicators, which are terribly important in encouraging earlier diagnosis so that we have coherent policies at the national and local level?
May I thank my hon. Friend for his work campaigning on cancer? He is absolutely right. We want to make sure that we pick up rarer cancers, so we are moving towards a composite indicator for cancers with the one and five-year measures. He is absolutely right that, properly to drive improvement, we need to compare not just hospital and consultant-led teams, but local GP-led commissioning groups, so that where there are successful outcomes everyone knows that. To get that comparison to work, we have to ensure that we compare the demographics. Part of the work we are doing is to understand how we can meaningfully compare CCGs, so that the public can truly understand who is doing best and who needs to do better.
The Secretary of State talks about operational independence on the ground for doctors and CCGs. He did not mention anything in his statement about sexual health care. One issue that we have been struggling with for some time in Walthamstow is the limitations of doctors who have decided to deny women even the most basic contraceptive services. We are still struggling with how the new mandate and new services will deliver them. Will the Secretary of State meet me and women from Walthamstow to discuss the issue, so that we can be confident that the changes will not lead to a further deterioration in sexual health care services across the country?
We will publish a sexual health strategy at the end of this year that will look at variation in services across the country and at the kind of problems the hon. Lady raises. It will be led by the public health Minister, my hon. Friend the Member for Broxtowe (Anna Soubry), who will be happy to meet the hon. Lady to discuss the issue further.
My right hon. Friend’s statement will be widely welcomed, especially his emphasis on an integrated system based on the needs of people. Does he not agree, however, that there is far too little use of complementary medicine outside private health care, and that greater use of herbal medicine, acupuncture and the much under-utilised resource in this country of homeopathic medicine, homeopathic doctors and the Society of Homeopaths, would be a good thing? Seventy per cent. of pregnant women in France use homeopathic medicine.
There are parts of the country where acupuncture is available on the NHS. This will be clinically led. It needs to be driven by the science, but where there is evidence, and where local doctors think that it would be the best clinical outcome for their patients, that is what they are able to do.
As a customer of the national health service, I was lucky enough to have cancer treatment and a heart bypass in those days—halcyon days, almost, by comparison—when 80,000 nurses and 20,000 doctors were recruited, and the money increased from £33 billion to well over £100 billion. Does the Secretary of State know that the optimistic outlook that existed in those days has now been replaced by a climate of fear? That is what I find at the sharp end in hospitals when I go to see the same people I met at the end of the last century. What I say to you is that the figures might sound grand and all the rest of it, but when you start sacking 60,000 people in the national health service, set against a background of elderly people living longer—people like me who need the treatment—the net result will be a catastrophe and not those halcyon days of yesteryear.
Let me say to the hon. Gentleman that we have 17,000 fewer managers than when his party was in power. We also have 3,500 more doctors and there are more clinical staff in the NHS today than when his party left office, so I think the record speaks for itself. There is not a climate of fear—I reject that. There is an understanding that the NHS is under a lot of pressure, with an ageing population and more people using and needing its services every year. That is why today’s package is so important to support the NHS in delivering what the public need.
At long last, the NHS will be operationally independent, and genuinely clinically led. I welcome the mandate: it is an excellent and ambitious target for the NHS. Will the Secretary of State reassure the House that, in these challenging times, efficiencies made in the NHS will be genuinely reinvested in patient services?
My hon. Friend, as a GP, will recognise from the mandate that a lot of the improvements that we need in the NHS are in primary care. The budget for the NHS is protected, but demand for services is going up, so we need to make these changes. I will give her one example where I think that this is particularly important. The number of hours it will save GPs if the majority of prescriptions are ordered online, which does not happen at the moment, could transform life for more than 8,000 GP surgeries up and down the country.
One of the great problems the NHS has is the millstone of private finance initiative costs that are so damaging to so many hospitals. The other millstone is the huge profit made by the private sector on contracted out and privatised services. Is it not time for the Government to give a clear directive to the NHS to employ its staff to deliver its services and borrow money in the traditional way to build new facilities, so that public money goes into a public service and the public are not lining the pockets of the banks and private health providers instead?
I hope we can move beyond the debate about public good, private bad and private good, public bad that has dogged the NHS for many years. I believe there is a role for the independent sector and the voluntary sector. Of course, the primary role will be for the traditional NHS. However, when the private and voluntary sectors are used will not be a matter not for politicians or parties; but for local doctors on the ground. I think that in the vast majority of cases, they will want to use and contract with traditional NHS services, but it is important that they have the choice to do what is in the interests of the patients for whom they are responsible.
For too many years in my Crawley constituency health decisions were made by people who were nowhere near that location. I am delighted that under this Government decisions are being returned to local clinicians and local people. We have seen results already—the local CCG has started a dementia pilot with money from the Department of Health. Will my right hon. Friend join me in congratulating that kind of vision, both in Crawley and elsewhere?
I am more than happy to do that, because when it comes to conditions such as dementia there is no one right solution, and doctors’ surgeries and hospitals will have different approaches in different parts of the country. We want everyone to take ownership of the problem. I hope that what is happening in Crawley will be noticed by other parts of the country, so that we can spread best practice everywhere. That is the point—we want to allow innovation to happen in a way that has never happened before.
This is a hugely significant occasion. It is the one opportunity that Parliament will have to call the Secretary of State to account for the priorities that he sets for the NHS Commissioning Board, so may I refer him to his pledge to improve cancer outcomes? Given that he made a pledge to the House on 23 October to make available to anybody who required it innovative radiotherapy, how does that square with giving back to the Treasury £3,000 million that could otherwise be used to buy advanced and innovative radiotherapy equipment?
Let me remind the hon. Gentleman, as I reminded the right hon. Member for Leigh, that for the four years that preceded this Government, there were underspends, including when the right hon. Gentleman was Health Secretary, and in three of those four years the underspend was higher than it was in our first year in office. But we do want innovative cancer treatments to be available. That is why we introduced, among other things, the cancer drugs fund, which was not introduced by his Government and which has transformed the lives of thousands of cancer sufferers.
I welcome the statement, particularly the use of IT and online resources, but how will we avoid the previous errors of Connecting for Health and its huge costs?
That is a very important question. We are going to avoid that because I will not be signing any big national IT contracts. The initiative will be locally led and locally driven. Guidelines will be laid down to make sure that all the systems developed in different parts of the country are inter-operable. That is very important, but we will not have any grand plans nor will there be a big single database, so we can thereby avoid some of the problems. We must none the less be prepared to grasp what technology changes can mean for the NHS, just as they do for the rest of society.
On 23 October I raised with the Secretary of State unacceptable delays of two and a half hours for the transfer of patients from ambulances to James Cook University hospital accident and emergency in Middlesbrough on 27 September. Last Thursday night for one hour and last Friday morning for one hour, owing to bed pressures, patients in ambulances were diverted from James Cook to North Tees hospital, and 14 planned operations were cancelled the same Friday and the following Saturday. Is not the mandate completely dependent on whether the Secretary of State is in control of the remit of his Department?
The mandate makes it clear that waiting times targets must be met. That is a very important part of the mandate. I continue to be extremely concerned by what the hon. Gentleman tells me about what is happening in his constituency, and I look to his local NHS to come up with a sustainable, rapid solution.
As the Secretary of State saw for himself when he visited Kettering general hospital recently, the NHS is very good at treating people but perhaps is not quite as good at preventing people from getting ill. Given that prevention is better than cure and often less expensive, what is there in this mandate that will encourage up-front health care before patients are admitted to hospital?
There is something critically important in the mandate that will do that, which is that by making the NHS operationally independent we are giving commissioning responsibilities to local GP-led groups for the first time, and GPs understand the importance not just of primary care but of prevention. So I think we will see much more innovation, along with the co-operation that the NHS has with local authorities and the new health and wellbeing boards, to make sure that there is a much bigger focus on prevention than there has been in the past.
Will the Secretary of State confirm that if there is an underspend in the NHS Commissioning Board financial allocation, that will stay in the NHS and not go back to the Treasury?
As the hon. Lady knows, we manage our finances extremely carefully but we do have underspends. We try to minimise them and there has been a real-terms growth in spending—actual money spent in the NHS, compared with Labour’s plans. In the first year of the review there was a real-terms increase and we will continue to manage NHS finances with a commitment to protecting the budget, which did not ever happen when the right hon. Member for Leigh was in post.
I welcome the Secretary of State’s priority to reduce the disparity in health outcomes, not just across the country but across local areas. Will he reassure me that the mandate, delivered in partnership with local health and wellbeing boards and local GPs, will end the scandal—Labour’s legacy—that from the west of the borough of Enfield to the east, the age mortality rates decrease by more than 10 years?
My hon. Friend is right. That is why, at the heart of the mandate, is an information revolution so that the public can understand exactly how well different parts of the system work, and so that we create the right pressures on the system to improve where performance is poor. I agree that the central, top-down structures that we had before did not allow that to happen. If we had cut the budget, as the Opposition wanted, it would have been even more difficult now.
Tomorrow, as the Secretary of State knows, is world diabetes day. I discovered that I had diabetes only because of a chance visit to my local GP. I welcome what the right hon. Gentleman said about including diabetes in his mandate, but will he mandate the local health authority to test all its patients? Today marks the start of the Hindu new year—Diwali. In this new year statement that he is making today, will he ensure that everyone is tested for diabetes in their local practice?
As the right hon. Gentleman will know, we are losing 24,000 people unnecessarily every year by not properly recognising the symptoms of diabetes. That is incredibly important. We have made it clear that reducing mortality rates—preventing avoidable mortality—is a major priority of this Government, so I expect this to be a key priority for GP practices and for local authorities throughout the country.
I welcome my right hon. Friend’s statement today and the mandate, and note that it is based on the NHS constitution, which states that it is founded on a common set of principles and values. So in a week when GPs have become millionaires by selling off their interests in parts of the NHS, may I suggest a further test, beyond the friends and family test—a patients before profit test? Will that be introduced?
The outcome that we want is for more patients to live longer and more healthily than ever before. The right thing for me to specify in the mandate is that we want the NHS to deliver improved patient outcomes. Sometimes that will involve using the independent sector and the voluntary sector, but in the vast majority of cases it will mean working within the traditional NHS. If we deliver those improved outcomes, we will be doing the right thing by patients throughout the country.
Minister, may I thank you for your statement on the mandate and in particular your reference to the armed forces covenant? Mental health has been the poor relation for too long. The statement says that mental health will be elevated to parity with physical health. Can the Minister explain how those who have fought in the wars in Iraq and Afghanistan in particular and who have seen the awfulness and the brutality of war will be helped through the mandate?
Order. I always listen extremely carefully to the hon. Gentleman, who has asked a very serious question. I hope he will take it in the right spirit if I say that my medium-term ambition is to persuade him to cease to use the word “you” in asking questions in the House. But his question has been heard and it will now be answered.
The hon. Member for Strangford (Jim Shannon) may know that there is a mental health helpline specifically for veterans because we recognise the importance of this decision. He will also have seen from the mandate that mental health is mentioned in virtually every part of it, whether in the context of avoiding mortality from extreme mental illness or helping people with long-term conditions, which would also cover post-traumatic stress disorder.
The Secretary of State rightly places survival rates at the top of his agenda and identifies the importance of early diagnosis. When it comes to breast screening, the switch to digital is critical in spotting cancer early. Does he agree that the NHS must move faster in making that switch to digital?
I absolutely agree. That can be hugely transformational in terms of patient outcomes. Many patients would be astonished to know that a full medical record is not available to consultants in hospitals before they operate on them. We need to put that right because it could transform the decisions that surgeons take in extreme cases. So my hon. Friend is right, and we must press on with this very fast.
The Secretary of State and the whole Government are keen to deliver public services using the internet and online. He mentioned in particular people with long-term conditions being able to communicate with their doctors online. The Department for Work and Pensions has found that 6.5 million people who will be entitled to universal credit have never used a computer. Has he any knowledge at all of how many of those with long-term conditions are computer literate?
Some will be, some won’t be, but the hon. Lady should not underestimate the computer literacy of people who are adopting the internet at breakneck speed, including the 40% of pensioners who now do their banking online.
I welcome my right hon. Friend’s objectives, particularly on the quality of care and—I would add—patient safety, which is so important. With an ageing population—a 50% increase in the number of over-60s by 2045 has been predicted—equality of access will require most clinical services to be close at hand. How does he expect to hold the board to account over its duty to reduce inequalities of access?
The waiting time targets are among the board’s responsibilities under the mandate. Having care close to home is a key priority for many patients, often because they think that the quality of care will be better, if it is at a local hospital or—even better—in their own home. One major change resulting from the increased role for GPs under the mandate will be much better support for domiciliary care, which will enable people to live at home for longer.
The tension between the postcode lottery and local commissioning has been discussed, but of paramount importance is how the budgets filter down to the various groups. The Secretary of State just said that funding to the cancer, stroke and heart networks will increase, yet a paper from the NHS Commissioning Board talks about funding cuts from £18 million to £10 million. I am afraid that the veracity of his figures is often challenged. Would he like to put the record straight on the figures?
I will happily look into the matter the hon. Lady raises, but my information is clear that the budget through which the clinical networks are funded is increasing.
In priority 4—dementia—the Secretary of State states that the NHS Commissioning Board is mandated to ensure that the best treatment and care are available to everyone, wherever they live. Can he guarantee that there will be no postcode lottery, and that people with dementia in Liverpool will get the same treatment as the best in the rest of the country?
There is an element of postcode lottery now—there is a huge and unacceptable variation in treatment throughout the country—but the structures we are putting in place have a much better chance of reducing that variation than what went before, which failed to reduce it.<