House of Commons
Tuesday 12 November 2013
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Business before Questions
London Local Authorities and Transport for London (No. 2) Bill [Lords]
Third Reading opposed and deferred until Tuesday 19 November (Standing Order No. 20).
Hertfordshire County Council (Filming on Highways) Bill [Lords]
Second Reading opposed and deferred until Tuesday 19 November (Standing Order No. 20).
Oral Answers to Questions
The Secretary of State was asked—
The Government should manage the prison estate in the most efficient and effective manner. As my hon. Friend is well aware, Wellingborough prison closed in December last year. Since then, we have looked carefully at whether the site should form part of our long-term capacity plans, and we have concluded that it should not. It is therefore in the taxpayer’s interest to avoid unnecessary holding costs and to dispose of the site.
I thank the Minister for his response, but he is completely and utterly wrong. Wellingborough prison is on a brownfield site, and there is massive room for expansion. People want an expanded prison there, and millions of pounds have been invested in the prison. Will the Minister meet me to look at this again to stop him making a disastrous mistake?
The answer to the last question is yes and, indeed, I am scheduled to do so on Monday next week. I look forward to discussing this with my hon. Friend in more detail. I am afraid that I do not accept that this was the wrong decision—we will discuss it in more detail on Monday—but the original decision to close the prison, as he knows, was based on the fact that substantial financial investment would be needed to bring it up to the required standard. The decision not to retain the site was, as I say, made after careful consideration. Looking at the estate as a whole we concluded that the prison simply did not fit our strategic needs, but I am happy to discuss it with him in more detail on Monday.
On the subject of the Ministry of Justice selling sites, I have raised many times the issue of Fenton town hall, for which the Ministry of Justice and its predecessors have never paid a penny to rent or to purchase. Will the Minister now have a change of heart and give that building back to the community of Stoke-on-Trent?
The hon. Gentleman has stretched the elastic beyond snapping point. The question was broadened by the content of the Minister’s answer, but not broadened beyond the prison estate—that is the subject matter with which we are dealing. The hon. Gentleman is very visible courtesy of his moustache so he can try his luck later.
In commending my hon. Friend the Member for Wellingborough (Mr Bone) on his energetic campaign to save Wellingborough prison, may I gently suggest to the Minister that Government papers must have become muddled on this prison, because it is extremely cost-effective? It has one of the lowest costs per prisoner across the prison estate. The Minister says that lots of money is needed to improve the site but, having gone round it myself, I simply do not think that that is the case. May I urge him to take my hon. Friend’s advice and look again at this wrong decision?
First, I agree entirely with my hon. Friend that our hon. Friend the Member for Wellingborough (Mr Bone) has done a first-class job in advocating for his constituents, as he always does. That is his job, but my job is to look at the prison estate across the country. I am afraid that my hon. Friend the Member for Kettering (Mr Hollobone) is not correct about the costs of running a prison, which are made up of several components, and a significant one is the cost of maintenance and the cost of maintaining accommodation standards. On our estimates, it would cost £50 million to bring that up to standard, which is why we concluded that it was right to close the prison. There is a separate consideration about whether it is right to retain the site, but for reasons that I have explained we have decided that it not the right thing to do.
I can reassure the right hon. Gentleman that we are nowhere near requiring the provisions of Operation Safeguard. I have to remind him that his Government needed to use Operation Safeguard which, for those who do not know, is about using police cells because we have run out of prison cells. Not only did the previous Government need to do that but they had to let people out early because they so mismanaged the prison population. It takes some cheek for him to ask whether we are properly prepared.
I can reassure my hon. Friend that it is important that when we look at the disposal of these sites, we work together with the local authority and other key stakeholders to make sure that that is done properly. As he will appreciate, what happens to the site now is predominantly a matter for the local planning authority, not for us, but we will co-operate in any way we can.
Extending statutory supervision and rehabilitation to every offender released from custody, introducing an unprecedented nationwide through-the-gate prison service, and bringing in innovation of a diverse range of providers will help to reduce stubbornly high and rising reoffending rates.
The Secretary of State will know that South Yorkshire probation trust is a high-performing organisation that has delivered five years of significant reductions in reoffending against predicted rates. Its performance is described as excellent by his Department. He also knows that his Department’s internal risk register warns that there is a more than 80% chance that his proposals to privatise the probation service will lead to an unacceptable drop in operational performance. Will he recognise the risk, face the facts, put public safety first and think again?
The real risk would be not to accept the fact that reoffending is rising in this country, and that each year thousands of people are victims of crime committed by people who leave prison unsupervised and unguided. That is what this Government intend to change.
Will the Minister look carefully at the evidence session that the Justice Committee held this morning and some of the practical difficulties that were raised there for achieving the objectives of his programme? Will he look with similar care at any recommendations that the Committee eventually makes, as the Department has clearly done in respect of our report on older prisoners, to which he responded today?
I can happily give my right hon. Friend that assurance. The reason that we have built into our plans a dry run-in period in the public sector of more than six months after the initial structural changes have taken place is precisely because we recognise the need to ensure that the transition is smooth and extended and that we iron out any wrinkles. I will look carefully at the evidence session and I look forward to giving evidence to his Committee and discussing these matters in greater depth.
I am a little hurt, Mr Speaker, that you have not seen fit to mention my moustache, although it has been there a while.
On a very serious point, the much-heralded Peterborough pilot has delivered a 6% cut in reoffending, whereas the integrated offender management project in Surrey and Sussex probation trust has achieved a 55% cut in reoffending. Does such evidence have no relevance to the right hon. Gentleman?
The right hon. Gentleman will have to extend his moustache somewhat sideways if we are to give him credit in Movember.
If the right hon. Gentleman looks at what has been achieved at Peterborough, he will see that the most recent figures published two weeks ago showed a 20% reduction in the number of crimes committed by that cohort, by comparison with a comparable cohort elsewhere, that the Peterborough pilot is making genuine progress, and that the integrated offender management schemes around the country are also making good progress. It is not an either/or. Our plans do not exclude—indeed, will actively encourage—the continuation of such schemes, but the reality is that reoffending is still rising.
Does the Secretary of State agree that the current probation system is not perfect, which is the picture being painted by the Opposition? In that light, will he release the internal inquiry report by the probation service into the case of Stephen Ayre who, after leaving prison, abducted and raped a 10-year-old boy in my constituency as a result of some appalling failures both in the parole system and in the probation system?
In normal circumstances in a serious further offence the family will see the report that is carried out. I will happily meet my hon. Friend to discuss the issue. He rightly highlights the very real challenge we face with reoffending in this country, because when it does take place, families are the victims of what happens and sometimes go through terrible circumstances. Some 3,000 very serious crimes committed by offenders who get no supervision is something that we all need to stop.
The best way to reduce pressure on the criminal justice system is to reduce reoffending and we seek to achieve this in prisons and in the community. For example, under our transforming rehabilitation reforms every offender released from custody, including those sentenced to less than 12 months, will receive statutory supervision and rehabilitation in the community. This is a step towards reducing high reoffending rates which is widely welcomed, including by the Labour party, though I note that Labour Members voted against it last night.
My hon. Friend is entirely right to say that work plays a crucial part in the task of reducing reoffending. He will be reassured to know that we are having considerable success in raising the number of prisoners who are working and the number of hours that they are working too. We have already achieved a 25% increase in the hours worked in prison since we came to power.
A reduction in reoffending rates is a key ambition across the House, and it is crucial to engage all potential partners. What assessment has my hon. Friend made of how the third sector groups can engage with expertise in new probation contracts?
Again, I entirely agree with my hon. Friend. The third sector—voluntary organisations—has a huge amount to offer us in this context, and already does to a large extent. Our proposals to transform rehabilitation will bring more of those organisations into the job of providing rehabilitation. We think that they have a first-class offering in many cases, and are likely to be a large part of what we go forward and do.
21. Surely the Minister has read the Ofsted reports on the quality of what happens to prisoners in prison. It is appalling that so many prisons fail to do the job of working, educating and training people for release. That is the problem—complacency on the Government Front Bench. (901050)
I can assure the hon. Gentleman that there is no complacency whatsoever. It is exceptionally important that prisoners learn literacy and numeracy skills, which many of them lack. It is also important that they develop vocational qualifications, because we know that gaining those qualifications leads on to higher chances of employment, and maintaining a job is the best way we know of keeping someone away from crime. That is hugely important.
The hon. Gentleman will also be reassured to know that we are looking carefully at how we can improve education within the youth estate. As a former Chairman of the Education Committee he will recognise the importance of our duty to educate those young people properly, and when the contracts come up for renewal next year, we will expect better.
How does the Minister reconcile the competing demands of tier 1 providers in reducing reoffending and disseminating good information with the retention of data on intellectual property? How will he reconcile those two competing issues?
There will be a number of contractual requirements on tier 1 providers, as indeed on other providers. But the key point that the hon. Gentleman must recognise is that we will reward tier 1 providers for succeeding in reducing reoffending, and the way in which they will do that is to look holistically at all the many factors that affect the likelihood of reoffending. Education is one, training is another, and there are many others.
19. Will the Minister meet me and representatives of the Amber Foundation, which achieves a reoffending rate of 26% compared with the average of 70% for the age group that they deal with? It is essential that Ministers understand the variety of experiences of smaller charities that have a lot to contribute in this area. (901048)
In principle, of course I am happy to meet my hon. Friend and the Amber Foundation. He will recognise that as we proceed with our reforms and with the competition process, there are restrictions on whom I can and cannot meet. Certainly I agree with him that such organisations have a huge amount to contribute to what we do, and even those that are not specifically criminal justice charities also have a part to play.
I am frankly not reassured by the Minister’s earlier answer to my hon. Friend the Member for Huddersfield (Mr Sheerman). Surely he is aware that not a single prison was rated as outstanding by Ofsted, and 65% were rated as not good enough. Is that not a shocking indictment of his rehabilitation revolution?
Something tells me that the hon. Gentleman was planning not to be reassured. None the less, let me try again. There is no complacency here. As I said to his hon. Friend the Member for Huddersfield (Mr Sheerman), there is a huge amount more to do on the education and training of prisoners, but he must recognise that this is something that we inherited from the Labour party. The situation was not perfect in 2010, and both sides of the House have more to do to understand the importance of this and to provide more of it.
Courts (Vulnerable Witnesses)
The Government are committed to putting victims first at every stage of the criminal justice system. We are implementing a wide range of reforms to make sure that victims and witnesses get the support they deserve and to ensure that their voice is heard. This includes work to improve awareness of, and access to, support services and special measures in court, and the piloting of recorded pre-trial cross-examination of vulnerable and intimidated witnesses.
Despite what the Secretary of State says, vulnerable witnesses, who are also often victims, still find themselves meeting perpetrators of the crime in court, are still accused by barristers of being predatory and still see people accused of serious offences released on bail near their home. Why does he not agree with Victim Support, victims themselves and his own former Victims’ Commissioner that a victims Bill is needed to enshrine their rights in law?
I am slightly surprised that the hon. Lady adopts a partisan tone in this regard. As I have just said, we have introduced pre-trial examination as a possibility for giving evidence for vulnerable witnesses. That measure was introduced in a Bill in 1999, but the Government she supported did nothing about it for 11 years. This Government have introduced it and it will come into force next month. It is a practical measure to help vulnerable witnesses, which her Government legislated for and put out the press release but then did nothing about, as was typical.
The Secretary of State will know that some of the most vulnerable witnesses are those involved in cases of stalking and harassment. Will he welcome the establishment of the all-party group on stalking and harassment, chaired by the right hon. Member for Dwyfor Meirionnydd (Mr Llwyd), and agree to meet him and me—I am the vice-chairman—to discuss the issues facing witnesses in such trials?
Motor Insurance Fraud
On 23 October the Government announced a package of reforms to ensure the availability of good-quality medical evidence in whiplash cases. Our reforms will create a robust system that deters speculative and fraudulent claims. They will lead to reduced costs for insurers and lower premiums for honest motorists.
I can assure my hon. Friend that our reforms will see experts commissioned jointly by both the claimant and the defendant and paid regardless of the outcome of the claim. The measures will help ensure independence, and the new examination and reporting scheme will result in fewer speculative and fraudulent claims.
A constituent of mine was involved in an accident in which the car in front of her made an emergency stop. She swerved to avoid it and the two vehicles made contact without significant impact, yet her insurers agreed to pay out a £4,000 claim for whiplash, which could not possibly have resulted from the accident, without informing her, let alone consulting her. Will my hon. Friend look into the case to see whether there are wider lessons to be learnt?
My hon. Friend will appreciate that I am unable to comment on individual cases and am not aware of any plans by the insurance industry to make information of that sort available. However, I can say that I very much hope that the reforms we are putting in place will ensure that fraudulent and speculative claims of the sort she refers to are weeded out in the first instance.
Has the Minister made any assessment of the different levels of fraudulent claims in the regions of the United Kingdom? Has he discussed the issue with the Northern Ireland Executive, particularly given that many of the insurance firms are based in the rest of the United Kingdom, rather than Northern Ireland, where it is a major issue?
I am aware of certain figures showing that some areas have a higher propensity for claims than others. We are in the process of consulting a broad spectrum of stakeholders. If there are any we have missed, I am more than happy for the right hon. Gentleman to contact me so that we can include them.
Did the Minister read the e-mail sent to us both yesterday by the victim of a whiplash sting? His insurer, without consulting him or any medical evidence, paid out £2,700, £1,600 of which went to a claims management company, and then more than doubled his premium. Rather than blaming genuine victims for the cost of motor insurance, why has the Minister not tackled the claims management companies and insurers whose actions encourage fraud? Is it because of the millions they give the Tory party every year?
The hon. Gentleman is clearly out of date. If he did his research properly, he would be aware that since January this year 800 CMCs have closed. This is an issue where we are trying to do good and where all stakeholders are working together for the greater good of the public. It is regrettable that he is resorting to type and cannot recognise that he should be working to do good rather than being his usual destructive self.
Victims (Criminal Justice System)
This Government are committed to putting victims first and we will give them a voice at every stage of the criminal justice system. The new victims code published on 29 October will provide extra support for victims and witnesses by offering them greater protection throughout the criminal justice process, a louder voice, and better redress. Victims will now be able to say whether they would like to read out their victim personal statement in court to explain how the crime has affected them.
The Justice Secretary has been to Hanley Swan post office and met my constituents, Alan and Ros Davies, whose lives were devastated by a cruel attack from a prisoner on early release. Can he assure them, and other victims, that their voices and support needs will always be considered ahead of those of violent criminals?
I am aware of the terrible consequences of what was a very serious crime. It is precisely for such victims of crime that we are now providing a voice in court. If they so wish, they can read a personal statement to the offender, looking the offender in the eye, and many victims have said that that would have made a very big difference to them in the past.
I was pleased to hear that the new victims code will automatically inform victims of their right to make a statement in court. Does my right hon. Friend agree that it is important that services for victims of crime are not only commissioned locally but that we maintain our existing courts structure? As a justice of the peace, I specifically include magistrates courts, which help to safeguard a local perspective.
I agree that it is important for victims to be able to inform the court directly, through the personal statement, about how a crime has affected them. I also agree about the great importance of magistrates for local justice; indeed, that is precisely why I am leading work to broaden and strengthen their role in delivering justice.
Given that the Minister has broken up the funding for victim support and devolved it down to police and crime commissioners, and refused to make it mandatory in the Crime and Courts Act 2013, what guarantees can he give that some new scheme in future will provide uniform victim support services across the United Kingdom?
Some services will continue to be provided nationally, as I am sure the right hon. Gentleman is aware. The bulk of the funding is indeed being devolved to police and crime commissioners, who are all enthusiastic, across party boundaries, to maintain and improve victim services. Those who are closer to the specific problems of a local area are likely to be more sensitive to the needs of that area than the old top-down, centralist system that the right hon. Gentleman still clearly hankers after.
I welcome the hon. Gentleman to his post and regret that his first question attacks the Victims’ Commissioner, who is doing an extremely good job. She is helping us with the victims code, and she has made a significant difference. She has reviewed the operation of the probation service’s victim contact scheme. She will, I think, show that the terrible experience she has had herself will contribute to her role as Victims’ Commissioner. I hope that across the Floor of this House we can get behind the Victims’ Commissioner.
Illegal Drug Use (Prisons)
We are making good progress. As a result of effective prison security measures and working closely with health services to reshape drug treatment in prisons, the proportion of prisoners testing positive for drug misuse is the lowest it has been since 1996.
Many of my constituents remain baffled about why we cannot make prisons drug-free zones; successive Governments have not been able to do so. None the less, I welcome the recent through-the-gate reforms that my hon. Friend has introduced. Will he explain how they will help offenders to come off and stay off drugs?
I am grateful to my hon. Friend. On his first point, he will recognise that one of the emerging challenges is the misuse of drugs that are not in and of themselves illegal. In that regard, I commend to him the private Member’s Bill promoted by my hon. Friend the Member for Stourbridge (Margot James), which I think answers that problem very effectively and I hope the House will pass it.
On the through-the-gate reforms, again my hon. Friend the Member for South West Devon (Mr Streeter) is right that it is important that we undertake to all those providing drug treatment in prisons that what they begin will be properly completed; otherwise, they will not begin what may be long-term drug treatment programmes. That is why through-the-gate matters, and why our rehabilitation reforms will support people not only in custody but in their transition into the community and for some considerable time thereafter.
May I commend to the Minister as his recess reading an excellent book, “Doing Time: Prisons in the 21st Century”, by the hon. Member for Hexham (Guy Opperman)? In chapter 2 he talks about 50% of those in prisons having a drug problem. As the Minister knows, the Home Affairs Committee has recommended mandatory testing on arrival and exit. Are we any nearer to that?
As the right hon. Gentleman knows, I do not agree with him that the right way to deal with drug testing is to have a mandatory point at entry and exit. He also knows that the main reason I disagree with him is that everyone knows where the points are and can see them coming. What I think is much more effective is mandatory random testing, which is what we do now, but, as I explained in answer to my hon. Friend the Member for South West Devon (Mr Streeter), we must all recognise that the problem that is emerging is less about illegal drugs, dangerous though they are, and more about legal drugs that are being misused in our prisons. I hope the right hon. Gentleman will support the private Member’s Bill promoted by my hon. Friend the Member for Stourbridge.
9. What steps he is taking to facilitate mutual ownership of probation trusts; and if he will make a statement. (901036)
The transforming rehabilitation competition process has been designed to allow a range of entities to bid to deliver rehabilitation services. This could include alternative delivery vehicles and mutuals designed by individuals within existing probation trusts.
The Cabinet Office’s mutuals support programme has made some of its £10 million funding available to support mutuals interested in participating in the competition. This has included access to coaching and capability-building from experienced commercial mentors and leaders in the field.
I thank the Secretary of State for that reply. Will he reassure me that, while we have examples of good practice in local probation trusts and individuals who want to transfer to a mutual status, those moves will not be opposed by the Ministry of Justice but, rather, facilitated?
I can absolutely give my hon. Friend that assurance. Indeed, we held in this House a week ago, while we were all waiting for the Europe votes, a forum with potential bidders. It was gratifying to see among those in attendance a large contingent from the potential mutual bidders. I am very keen to see them make good progress in this process.
Will the Justice Secretary look again at the geographical boundaries affecting Cheshire, because there seems to be inconsistency with regard to how he, the Home Office and the police are thinking, and that is causing confusion among potential bidders?
Law Society (Handling of Complaints)
The Law Society is one of 10 approved regulators for which the Legal Services Board has oversight responsibility. It is independent of the Government. The Solicitors Regulation Authority is responsible for investigating alleged breaches of its conduct principles.
I raise this question because my constituent Paul Cowdrey now risks losing his home because the Law Society advised him that if he raised his complaint he would not be liable for costs. He has now been ordered to pay more than £100,000 to the solicitor whom he complained about. The Solicitors Regulation Authority condemned the solicitor’s actions as morally reprehensible, but claimed it was unable to take action. Does the Minister agree that a regulator that is unable to prevent solicitors from abusing their position is not fit for purpose, and will he investigate this case on behalf of my constituent?
I am well aware that this is an ongoing case about which the hon. Gentleman corresponded with my predecessor. However, the legal regulators and the legal ombudsman are independent of the Government and neither the Justice Secretary nor any of his Ministers have the power to intervene and it would be inappropriate for us to do so in any individual case. The hon. Gentleman’s constituent, Mr Cowdrey, needs to take independent legal advice.
We are creating a new national probation service that will work alongside 21 new community rehabilitation companies to manage offenders in the community. The national probation service will be tasked with advising the courts and protecting the public from the most dangerous offenders. It will be responsible for risk assessing all offenders who are supervised in the community.
Local service providers have expressed concerns to me about how a fragmented service will manage changes in offenders’ risk levels. Given that risk levels change in about a quarter of all cases, it will be common for offenders to transfer between providers. How will the Secretary of State ensure that the continuity of offender management does not suffer as a result?
The most important part of the way the new system will work will be the co-location of individuals in the national probation service who are responsible for risk management and the new community rehabilitation companies, to ensure that where risk does change there is a swift transition from one to the other.
In the Secretary of State’s target operating model for probation there is welcome mention of restorative justice. Can he say anything more to ensure that awareness of restorative justice across the system is so embedded that it becomes an option to be considered on all occasions, particularly to deliver much-improved victim support as well as the rehabilitative effect it has already demonstrated?
We very much recognise the importance of restorative justice. We are providing funding to police and crime commissioners to enable them to source restorative justice services locally, and give them the option of working closely with providers who will look after offenders in the future. We are keen to see that partnership work well at a local level, and for that resource to be used to good effect in mitigating the impact of crime on victims in the way restorative justice can do so well.
Last night, when the Justice Secretary was not here, the prisons Minister assured the House that
“if Serco and G4S do not come out satisfactorily from the audit processes…they will not receive any contracts”—[Official Report, 11 November 2013; Vol. 570, c. 744.]
for probation. The Minister is well regarded across the House, and I am sure he will want to be clear about that. Does he mean the conclusion of the Cabinet Office investigation or the investigation by the Serious Fraud Office? It will be of great concern to Members of the House if the Serious Fraud Office investigation is not concluded before contracts are awarded.
We must treat that issue carefully because a potentially criminal investigation is taking place at the moment. I will make an appropriate statement to the House in due course about the way forward, but in the meantime, because of the nature of the investigation, I do not think it right for us to enter into discussion about it.
Offender Behaviour Programmes
Our priority is to provide accredited offending behaviour programmes, which evidence suggests are most likely to reduce reoffending and protect the public. The National Offender Management Service has begun the process of negotiating programme provision for 2014-15, and intends to maintain at least the current level of investment.
The hon. Gentleman is right that we want people to have such programmes as quickly as we can get them. He will recognise that the statistics we might collect—statistics on this issue are collected locally—will mask the fact that some offenders need such programmes urgently while some can perhaps wait a little longer. I understand the point he is making, and we will always try to supply as much information as we can. In answer to the hon. Gentleman’s written question on this matter, I pointed out that such information is not collected centrally, which makes it hard for me to give him a figure.
Victims Services (London)
More money than ever before is being made available for services to support victims of crime, with a potential total budget of up to £100 million—double the Ministry of Justice’s current spending of around £50 million. That means that more will be spent on victims of crime in London, with the Mayor of London making decisions on how the majority of the money will be spent.
It is simply not the case that there will be cuts in funding to London. As I have said, nationally, we are increasing funding considerably. Our current estimate is that, under the current indicative budget, London will receive more funding than is estimated to be spent under current Ministry of Justice funding arrangements. We are determined to continue to provide quality services to victims of crime both in London and in the rest of the country.
It is accepted that there will be more money overall but, from all the figures, it looks as if Greater London, which has more than one in four of all victims of crime and more than one in five of all crime referrals to victim support, will receive a much smaller percentage. Is the Minister willing to accept an all-party group of London MPs to put the case for victims to be funded properly?
I am always very happy to meet my right hon. Friend and London colleagues from both sides of the House. Indeed, I met the Deputy Mayor for Policing and Crime to discuss the subject yesterday, so I am well aware of the situation. I repeat that there will be more money for London than there is under the current arrangements.
Nevertheless, my right hon. Friend will be aware that victims of crime in North Yorkshire will receive £166 per head, but that victims of crime in London will receive only £24 per head. The fact is that £3 million extra is required to change that anomaly. Will he agree to an uplift for the capital, rather than victimising the victims?
I reject the thought that victims are being victimised. I can only repeat that, in London, as in the rest of the country, victims of crime will have more spent on the services available to them under our new system than under the current one. I would have hoped that London Members welcomed that increase.
Knives on our streets are a social scourge, and that is why we introduced new mandatory minimum sentences for threatening with a knife. Few offenders have been sentenced so far, but the majority have received custodial sentences. We are keeping this whole area under close scrutiny and I have raised how the offence is being sentenced with the senior judiciary and the Sentencing Council.
I am grateful for the Secretary of State’s reply, but does he agree that Parliament has spoken, that the offence should carry mandatory sentences, and that sentencers should bear in mind the will of Parliament? Will he use the opportunity to press the case for introducing mandatory sentencing for possession as well?
I pay tribute to my hon. Friend for his work in this area. I also pay tribute to the work done by members of his community in Enfield, whom I have met and spoken to. I fully understand the nature of the impact of knife crime on their community and on communities around the country. I assure him strongly that we will keep the issue under review. The clear will of Parliament is that such offences should be dealt with with great severity. I hope that those presiding over our courts recognise the will of Parliament. I also assure him that I continue to look at this area extremely carefully.
Human Rights Claims
As my hon. Friend knows, we continue to implement the work completed in the Brighton declaration, but he is aware that, as a party, the Conservatives are considering further measures that we would introduce as a majority Government to reduce the scope of the Court in Strasbourg to impose unwelcome judgments upon us.
After Qatada and prisoner voting, the latest ruling from Strasbourg demands that all lifers have the chance to be released. Does he agree that that latest shifting of the human rights goalposts offends the rule of law, erodes democratic accountability and only strengthens the case for that overhaul of our relationship with the Strasbourg Court?
I very much agree with my hon. Friend. The decision on whole-life tariffs was entirely regrettable and should not have been taken, and certainly not at the level of an international court. I assure him and all colleagues that the decision simply redoubles my determination to deliver a strategy, which I will do next year, for our party to go into the next general election with a clear plan for change.
On 4 November in the Chamber, the Home Secretary said that we should consider replacing the Human Rights Act 1998 with a British Bill of Rights. Given that the relevant commission reported to the Secretary of State last December, when can we expect draft legislation to abolish the Act in this Parliament?
I can give my hon. Friend an assurance that we will publish proposals for change in the new year, and they will include a replacement to Labour’s Human Rights Act 1998. I can also assure him that we, as a party, will publish a draft Bill later next year. Whether the coalition and this Parliament will choose to accept such a Bill, or whether it needs to wait for a majority Conservative Government, is something I suspect we will discover then.
On 23 October, the Government announced a package of reforms to ensure the availability of good-quality medical evidence in whiplash cases. Our reforms will create a robust and independent system of accredited experts to help the genuinely injured, and deter dishonest claimants from making claims.
The purpose of the measures is to try to ensure a reduction in the number of whiplash claims. At the moment, we have the highest whiplash claims in Europe. Given the quality of driving in some other countries—I will not name them—we have to accept that the number of whiplash claims is seriously flawed. That is what we are trying to address, and that is why we are introducing these measures.
As I mentioned earlier, we believe that the best way to reduce pressure on the criminal courts is to reduce reoffending, and we seek to do that both inside prisons and out in the community.
My hon. Friend is right that new generation GPS tags have huge potential. They will help us to enforce more effectively various provisions of community orders and conditions of licence. We have only to imagine the potential of GPS tags to enforce both curfews and exclusion zones to see what they might be able to do. We seek to take full advantage of that new technology.
In 2015 we will mark the 800th anniversary of the Magna Carta. To mark that defining moment in the development of modern legal systems, the lord mayor of London and I are shaping a major programme of events and seminars to celebrate our justice system, and to promote the UK as a centre of legal services. The sector contributes £20 billion a year to the UK economy, and the global law summit will bring together leading practitioners from around the world to show what our legal system can offer, share expertise and open up opportunities for collaboration in new business. My Department has brought together the City of London, the Law Society and the Bar Council to plan the event under the stewardship of the former lord mayor Sir David Wootton and my hon. Friend the Member for North West Norfolk (Mr Bellingham). I hope and believe the summit will be a great moment to celebrate our proud legal traditions in the Magna Carta and to look to the future to promote our legal services, secure growth and win the global race.
I welcome the celebration of the great Magna Carta. In 2008, my constituent Carrie-Ann Wheatley was brutally attacked by three men who should not have been in this country. Her family are concerned that article 8 of the European convention on human rights might be used to stop their deportation on their release from prison. I seek reassurance that the Government will properly reform article 8.
I can give my hon. Friend the absolute assurance that both the Home Secretary and I are looking at ways of tightening the rules. There are provisions relating to article 8 in the Immigration Bill, and I am hopeful that our proposed reforms to human rights laws will strengthen the position of victims of crime in the terrible situation that his constituents have found themselves in. We will make sure that the offenders do not get away with it.
As a number of Conservative and Liberal Democrat Members have commented, the Justice Secretary is cutting and changing the funding for innocent victims of crime. For example, spending in Surrey and Hertfordshire will be £21.14 per victim, while the average in England and Wales will be £15 per victim. Why, under his plans, will spending per victim in London, at just £10.11 per victim, be 41% less than the national average?
It is nice to see the right hon. Gentleman launching his London mayoral campaign. I follow his Twitter feed, and for every tweet about justice, there are six about London. I will tell him simply and straightforwardly that under this Government the funding available for victims of crime in London has increased significantly, as it has across the whole country.
It is funny that the Justice Secretary says that, because I used the Mayor of London’s figures for that question. According to the Mayor, the reason for the cut in London is that the Justice Secretary has decided to use a formula based solely on population, while failing to take into account crime levels and the number of victims in police force areas. That means that London loses more than £3 million a year, according to the Mayor of London. As the Justice Secretary said, our justice system relies on the confidence of victims and witnesses, so he should be aware that the Metropolitan police have the lowest victim satisfaction rate of any police force in the country. What impact does he think his decision will have on that?
I wish the right hon. Gentleman well with his campaign, but I know that the right hon. Member for Tottenham (Mr Lammy) is the frontrunner at the moment, so he has a bit of catching up to do.
Only in the world of Labour party mathematics and economics could an increased budget be described as a cut.
My hon. Friend will know that the Home Secretary will shortly be publishing a modern slavery Bill that will deal with many of the issues that he rightly raises. Since July 2011, every trafficking victim has received Government funding, via the Salvation Army. The figures last year were about £3 million, with about 928 victims having received this vital support over the past year.
T2. The Secretary of State will know that 12 years ago five children and three adults were murdered by a gang of wicked men. Recently, the Parole Board, against the advice of probation and forensic psychologists, released one of those men before his minimum sentence had been served. What is going on in the Parole Board that it is releasing such men into the community? (901019)
As the hon. Gentleman knows, the Parole Board and its decisions are independent, but I hope that one benefit of the establishment of the national probation service, with expertise in dealing with the highest-risk offenders, will be a greater degree of expertise sitting alongside the Parole Board to advise it on when it is appropriate to release someone and when it is not. I share his concern about ensuring it is safe to release people on to our streets and that they do not continue to pose a threat to society.
T4. My right hon. Friend will be aware that there has previously been considerable disquiet within the country over the effectiveness of community penalties, in both marking the gravity of offences and ensuring the effective rehabilitation of offenders. I know that he is alive to those concerns, but I would be grateful if he told the House what steps he is taking to ensure they are met. (901022)
I entirely share my hon. and learned Friend’s concerns about public confidence in community sentencing, which is precisely why we have changed the system so that in the future every community order must contain a punitive element. Indeed, the Offender Rehabilitation Bill creates a new flexible rehabilitation activity requirement to aid the rehabilitation of offenders while they are doing some community activity.
T7. Companies such as G4S and Serco have lucrative, multi-million-pound contracts to provide public services. When will the Secretary of State adopt Labour’s plan to extend the Freedom of Information Act to these companies, so that the public have an equal right to know? (901026)
T5. Does the Secretary of State agree that we have a most excellent prisons Minister who has many superb qualities? One of the best of his qualities is that when he has made a decision and new facts are put to him, he has the courage to reconsider and change his decision. (901024)
The Under-Secretary of State for Justice, my hon. Friend the Member for Kenilworth and Southam (Jeremy Wright) certainly has those qualities, and he will undoubtedly look at all the issues carefully. Another quality he has is that, when he needs to take a difficult decision in the interests of the country, he will do so.
The right hon. Gentleman will know, because the matter came up during last night’s debate, that the national probation service will carry out a risk assessment for all short-sentence prisoners. It will then decide whether to retain them because they are high-risk offenders or to pass them to community rehabilitation companies. So I cannot give him a figure, because each case will involve a judgment for the national probation service.
First and foremost, those reforms are about ensuring that the justice system in this country is there for those who need it, and not used for purposes other than genuine redress. My view is that judicial review is being used at the moment as a delaying tactic and as a PR exercise. It does indeed undermine the will of Parliament and the will of the Executive, and it costs the taxpayer money. It should be used only when it is appropriate to do so, and not for trivialities.
We will continue to review the court estate on an ongoing basis, but at this time I have no plans for substantial court closures. There might be occasional changes in the system, such as those we have seen recently in Liverpool, but I am not planning major changes to the court estate at this time.
My hon. Friend is right to draw attention to the excellent work that is being done with female offenders by various organisations in the voluntary sector. Those organisations make a huge contribution in this regard. We are seeking to ensure that we recognise the particular characteristics of female offenders, that we address the significant problems caused by distance from home, which can have knock-on effects for family life, and that female offenders have an opportunity to work outside prison and to re-engage with lawful society. That is the basis for our reforms.
A previous Justice Minister announced in a Westminster Hall debate that I secured just over a year ago that the Office of the Public Guardian had launched a fundamental review of the supervision of court-appointed deputies. Will the Minister tell us what changes will be made as a result of that review?
This is an ongoing matter, and we are looking into it. I am happy to take on any comments that the hon. Gentleman might have, and I will look into it.
South Yorkshire probation trust has reduced its reoffending rate by 13.4% over its target, and it attributes that in part to its use of impact teams. However, privatisation is likely to blow apart that collaborative working. Why are the Government pushing ahead with that plan?
The hon. Lady might be referring to the local adult reoffending rate. The difficulty with that measurement is that it measures reoffending only over a three-month period. It is much more reliable to measure it over a longer period. She has heard me say many times that I recognise that much good work is already being done within the probation service, but that does not mean that there is no case for change. The case for change is that we still have very high reoffending rates, and we think it is necessary to do something about that. Our proposals will do so.
One of the really bad ideas from the previous Labour Government was the so-called Titan prisons. The Attorney-General, the right hon. and learned Member for Beaconsfield (Mr Grieve) said so, as did the Justice Select Committee, and I might even have said so myself. So will the Secretary of State tell my why that really bad idea might now be considered a good idea?
We are not building Titan prisons. The proposed new prison in Wrexham, for example, will be a campus prison with a number of separate small units for 250 to 300 prisoners. It will benefit from the economies of scale achieved by shared facilities, but we will not create a single monolithic institution in which people are detained.
In 2004, 16-year-old Robert Levy was murdered in Hackney Town Hall square. His parents, Pat and Ian, gave evidence to the murderer’s parole board this summer. Just recently, they received an insensitive and bureaucratic letter from Victim Support, requiring them to go through several hoops and to provide a lot of paperwork in order to claim the train fare. Let me quote Mr Levy:
“We are tired of jumping through hoops whilst on the face of things it appears the perpetrator has it all done for them without much trouble to them.”
We have a code and a commissioner, so when are we going to see an approach that will make it easier for victims?
Last week, a devastating report entitled “The Payment of Tribunal Awards” was published. It found that less than 50% of people received full payment of an award following a successful employment tribunal. Does the Minister agree that more needs to be done to enforce these claims? Will he meet me, my colleagues on the all-party parliamentary group on citizens advice and representatives from Citizens Advice to find ways to resolve this shocking injustice?
I am, of course, happy to meet my hon. Friend and his constituents. I would say, however, that in the context of the tribunal, there are two individual parties and none of the damages is owed to the state, so we have to be careful. We can provide advice and, where possible, assistance, but at the end of the day, enforcement has to be dealt with by the two parties concerned. As I say, I would be happy to see my hon. Friend.
A constituent had her name touted around Plymouth by a woman taking part in a custody case who, because of the cuts, had no legal aid and no support. This woman did not know that what she was doing was a contempt of court. What steps is the Justice Secretary taking to review the impact of his cuts and the potential rise in contempt cases as a result?
We will, of course, continue to review the impact of the changes we have made to legal aid, which were necessary because of the huge financial challenge we inherited in 2010. If the hon. Lady wants to write to us about the specific case, we will of course look at it.
I am ready for this one this time! The answer is 10,833, and my hon. Friend and I are in agreement that that is far too many. As we have discussed before, the answer is that we need to make more use of compulsory prisoner transfer agreements. I can tell him that, as he knows, we have a compulsory prisoner transfer agreement with Albania, and 77 Albanian nationals have been referred to the Home Office for immigration enforcement and deportation. He knows, too, that we are part of the European Union prisoner transfer agreement—another compulsory PTA—under which 277 EU nationals have been referred to the Home Office. We are making progress, although it is not as quick as either of us would like.
Can the Justice Secretary explain why the Mesothelioma Bill is cited in the Ministry of Justice review of the mesothelioma exemption as one of the recommended criteria for bringing into force sections 44 and 46 of the Legal Aid, Sentencing and Punishment of Offenders Act 2012? Those sections have nothing to do with the Mesothelioma Bill.
Does the Secretary of State agree with me that the comments by Frances Crook of the Howard League for Penal Reform—that magistrates should not be able to send people to prison at all—are typically idiotic? Does he further agree that the only Howard worth listening to on criminal justice matters is Michael Howard and not the Howard League for Penal Reform?
My moustache and I are most grateful, Mr Speaker. More seriously, I remain optimistic that the Secretary of State will have a change of heart over Fenton town hall, which was used by the magistrates, and give it back to the people of Stoke-on-Trent. If he does not, what assurances can he give that the buyer that we think is waiting in the wings and subsequent purchasers will protect the first world war memorial that is located in that building? Many thousands of people are concerned about its future.
I commend the hon. Gentleman for his patience. I can assure him that, in the event of any transfers of the building, there will be a covenant to ensure that the new owner preserves that very important and historic monument, which is a tribute to all who paid the ultimate price in the first world war.
In May, the now Under-Secretary of State for Culture, Media and Sport, the hon. Member for Maidstone and The Weald (Mrs Grant), announced a new pilot in which tribunal judges would give detailed explanations to the Department for Work and Pensions of their reasons for allowing employment and support allowance appeals. When can we expect an evaluation of that pilot?
Urgent and Emergency Care Review
In January this year, the board of NHS England launched a review of urgent and emergency care in England. Urgent and emergency care covers a range of areas, including accident and emergency departments, NHS 111 centres and other emergency telephone services, ambulances, minor injury units, and urgent care centres. The review is being led by Professor Sir Bruce Keogh, NHS England’s medical director. A report on phase 1 of the review is being published tomorrow, and it is embargoed until then. [Interruption.] This is an NHS England report, and NHS England is an independent body, accountable to me through the mandate. The report that will be published tomorrow is a preliminary one, setting out initial thinking. [Interruption.]
I should underline the fact that this morning’s briefing was under embargo, an embargo which, to my knowledge, has been respected. The final version will be published in the new year.
Sir Bruce has said that he will outline initial proposals and recommendations for the future of urgent and emergency care services in England, which have been informed by an engagement exercise that took place between June and August this year. There will be further consultation on the proposals through a number of channels, including commissioning guidance and demonstrator sites. Another progress report will be produced in the spring of 2014.
Decisions on changing services are made at a local level by commissioners and providers, in consultation with all interested parties. That is exactly as it should be, as only then can the system be responsive to local needs. It is vital to ensure that both urgent and emergency care and the wider health and care system remain sustainable and readily understandable to patients. A and E performance levels have largely been maintained, thanks to the expertise and dedication of NHS staff. A and E departments see 95% of patients within four hours, and the figure has not dropped below the 95% target since the end of April. However, urgent and emergency care is falling behind the public’s needs and expectations.
The number of people going to A and E departments has risen historically, not least because of an ageing population. A million more people are coming through the doors than in 2010. Winter inevitably challenges the system further, which is why we are supporting the most under-pressure A and Es with an additional £250 million. Planning has started earlier than ever this year, and the NHS has been extremely focused on preparing for additional pressure.
We will look at Sir Bruce’s report extremely carefully. Reform of the urgent and emergency care system may take years to complete, but that does not mean that it is not achievable. We are exceptionally fortunate in this country to have in the NHS one of the world’s great institutions. NHS staff are working tirelessly to ensure that the care that people need will continue to be available to them, wherever and whenever they need it.
Rarely has this House been treated to a more disrespectful and complacent reply. There are new reports today of 12,000 patients spending 12 hours or more on trolleys in A and E. A and E is in crisis according to the College of Emergency Medicine, and this is before the winter has even started. People are increasingly asking, “Where are the Government and what are they doing about it?” So far all they have heard is, “Crisis? What crisis?” But behind the scenes it is a different story. Such is the panic in Whitehall, the Prime Minister has apparently taken personal charge and this morning the media were given a private briefing on a major review of emergency care. What is going on and why is the Secretary of State running scared, blaming NHS England and trying to keep this House in the dark? It should not be for us to drag the Secretary of State here to give Members information already passed to journalists.
Let me remind the House what the Secretary of State said at Health questions in July. He said that Bruce Keogh’s review
“will report this autumn, precisely so that we can make sure we learn any lessons we need to learn for this winter”.—[Official Report, 13 July 2013; Vol. 566, c. 902.]
To hear him now, it was all about the long term. Let me ask him: what are those lessons, and what immediate action is he now taking ahead of winter?
Weekend briefings suggested Sir Bruce emphasises alternatives to A and E, such as walk-in centres and 111, but Monitor reported yesterday that one in four walk-in centres have been closed and others are today under threat of closure. We need a clear answer. Will the Secretary of State stop further closures of walk-in centres? Does he now accept that his 111 helpline is flawed, and will he put nurses back on the end of the phone, rather than call handlers? And what of the recruitment crisis in A and E? There is a shortage of senior A and E doctors and, according to the Royal College of Nursing, 20,000 too few nurses. Will the Secretary of State give a clear commitment to bring all A and Es back up to safe staffing levels?
Last week, a complacent Prime Minister stood there, told us everything was fine, and even claimed that the average waiting time in A and E had gone down to 50 minutes, but that is not true. I have here a written reply from the public health Minister telling us it has gone up to over two and half hours. When are the Government going to show this House and the country some respect, cut the spin, and give us the real picture about a crisis that is happening right now?
Mr Speaker, I will tell the right hon. Gentleman what complacency is: it is refusing to have a public inquiry into Mid Staffs, where staff in A and E departments were bullied and harassed when they tried to speak out. He did not think it was worth having a public inquiry into the poor care that his Government swept under the carpet and which we are doing something about. There is one figure that he refused to mention: the A and E performance figures published last week of 96.4%—hitting the target, higher than the previous week, higher than this time last year. That sums it up: in a good week he wants to run down the performance of hard-working staff whereas this Government are backing them.
Why are we having an A and E review? It is to clear up the mess and confusion caused by 13 years of Labour mismanagement of our emergency services. The right hon. Gentleman talks about walk-in centres. Why were they introduced? Because of the disastrous mistake over the GP contract. The brave thing for his Government to have done would have been to admit they got that wrong and reverse it, but they did not. They introduced a whole new raft of services, which confused the public: A and E, walk-in centres, GP surgeries, telephone helplines. Tomorrow we will sort out those problems. Yes there are difficult decisions, but they are decisions his Government ducked and left the public exposed as a result.
Before the right hon. Gentleman runs down our A and E services, let me just gently remind him that he talked about a recruitment crisis, but we have 300 more A and E consultants than when he was Health Secretary, we have nearly 2,000 more people—[Interruption.] I am sorry that this is difficult for those on the Opposition Front Bench to listen to. We have nearly 2,000 more people being seen within four hours every single day than when the right hon. Gentleman was Health Secretary —that is some 700,000 more people every year. We have more hospital doctors, more hospital nurses, more treatments and fewer long waits than when he was Health Secretary, and he should celebrate that improvement in our NHS’s performance, instead of trying to run down the people on the front line.
I will tell the right hon. Gentleman something else we are doing. We are tackling the long-term causes of pressure in A and E that his Government absolutely failed to do: not just the GP contract but also the integration of the health and social care system, the lack of which means that hospitals are not able to discharge people from their beds on time, causing huge pressure. Today, the shadow Health Secretary has shown his true colours. The man whose Government made so many wrong decisions about A and E is exposed as trying to make political capital while this Government sort out his mess.
My hon. Friend is absolutely right. The changes we announced in north-west London will save hundreds of lives, by using principles that we will hear more of from Sir Bruce tomorrow. In particular, we are putting 800 extra people into out-of-hospital care, which will help the frail elderly, many of whom should never go to A and E—it is the most confusing place that someone with advanced dementia can go. If we can treat them at home, it is better for them and for our hard-working A and E departments.
May I assure the Secretary of State that the people of Exeter are not confused about their walk-in centres, but appreciate them and have been using them in ever-increasing numbers? These centres are now under threat, so will he at least admit that closing NHS walk-in centres and scrapping Labour’s GP access targets has been a dreadful mistake?
Perhaps the right hon. Gentleman might like to hear what the British Medical Association said yesterday about walk-in centres. The BMA is not known for its support of Government policies, but it said that urgent care centres
“were often opened in places with little patient demand…The result has been a lot of money being spent on these facilities with some now closing because commissioners have found there is not sufficient demand”.
That is the problem we are sorting out.
One long-term cause of pressures in our A and E departments is the lack of parity of esteem between physical and mental health. Does the Secretary of State agree that it is unacceptable that two thirds of people experiencing a mental health crisis do not get access within four hours to a psychiatric assessment? Was it not a failure of the previous Government not to set access standards for people with mental health problems? Is it not time, as the mandate does today, to deliver just that?
My right hon. Friend is absolutely right about that. We do need parity of esteem between mental and physical health. The situation puts particular pressure on A and E departments, including the one closest to this House, at St Thomas’s hospital, where people said that the biggest single worry they have and the biggest single thing that makes it difficult for them to meet their targets is the lack of quick access to psychiatric services. We are looking at this matter and he is right to highlight it.
The Minister said that changes taking place in urgent and emergency care are done locally for local need. What does he think of the following statement made by Sir David Nicholson last week before the Select Committee on Health? He said:
“We are bogged down in a morass of competition law…we have competition lawyers all over the place telling us what to do, which is causing enormous difficulty.”
Does the Secretary of State not agree that the Government were warned about that when they brought in the Health and Social Care Act 2012? They were told that competition law was going to create chaos in the NHS, and it is doing exactly that.
Is the Secretary of State aware that hospitals in Norfolk have recently made it clear to MPs that one of the key drivers of a big increase in people going to A and E is the fact that many people are not going to their doctor? Does he agree that it is essential that the GP contract of 2004 is rewritten so that doctors provide that 24/7 cover? When will he be able to sit down with the BMA and make real progress to right a serious mistake that the Opposition made?
My hon. Friend speaks wisely. The most senior A and E doctor in the country, Professor Keith Willett, said that he thought that between 15% and 30% of the people attending A and E could be looked after in the community. This is a root cause of pressure. I am afraid that the Labour party needs to show some humility before it starts whipping up public concern about problems that it had a very big part in making. I am in the process of discussions with the BMA, and I hope my hon. Friend will not have to wait too long for some good news.
Will the Keogh review genuinely examine the lack of parity in respect of those who are physically ill and those who are mentally ill? We are already suffering from a crisis in emergency mental health beds in London and we are seeing an increasing use of A and E departments for those who are mentally ill. Surely we should be looking at an increase in walk-in centres for the mentally ill, which have proven to be remarkably effective in helping those on the brink of a serious fall.
The hon. Lady is absolutely right that the urgent emergency care we offer to people with mental health problems is not up to scratch and needs to be a great deal better. Different solutions will be appropriate in different parts of the country, but often going to a normal A and E is not the right approach. We need to consider whether, when people have such conditions, there can be better access to people who know them, their medical history and their condition and who are in a position to advise them in a way that means they do not end up doing what I have seen happening time and again in A and Es, where people end up as frequent fliers, going again and again to an A and E just because there is nowhere else to go. That is one thing that we are trying to sort out tomorrow.
This Government have been in power for three and a half years. They could have chosen to remedy some of the continuing problems in the health service, but what did they do? They decided to reorganise it from top to bottom. Is there any wonder there is a crisis this winter? Instead of closing A and Es and walk-in centres, why does the Secretary of State not walk away? It would give him more time to count his money.
Let me tell the hon. Gentleman that thanks to the reorganisation that he is so bitterly against, we have 5,500 more doctors on the front line and 8,000 fewer managers. We would not be managing to hit our A and E target today if we had not taken the difficult decisions that the Leader of the House took when he was doing my job.
Geography dictates that my Montgomeryshire constituents depend on A and E services in hospitals in England. Will my right hon. Friend reassure us that devolution will not be allowed to create a health care iron curtain between England and Wales, and will he ensure that decisions on A and E services in Shropshire take account of the interests of my constituents?
We will absolutely ensure that there is no iron curtain, but I must say that the increasing number of people coming from Labour-run Wales to seek treatment in England is an indication that people are voting with their feet because they know where the NHS is being better run.
On repeated occasions in this place, the Health Secretary has claimed to be saving A and Es when his proposals would remove intensive care units in many hospitals and allow blue-light ambulances to go sailing past their doors. Will the Health Secretary tell me what his definition of an A and E is?
Thank you, Mr Speaker.
The hon. Member for Lewisham East (Heidi Alexander) will know that her constituents have some of the best stroke survival rates in England because we reduced the number of hospitals in London offering stroke services from 32 to eight. I am not going to stand in the way of those changes if they save lives.
I very much look forward to the review, which is urgent. Given that accident and emergency departments do not operate in isolation, will the Secretary of State assure me that the review will consider the whole system, including support services, critical care units and the availability of specialist consultants—particularly those in paediatrics—who need to be available for an A and E to function effectively?
No one has campaigned more assiduously than my hon. Friend for his local hospital, despite the incredible tragedies and difficulties that it has been through and the pressures that has created for the people of Stafford. He is absolutely right: if we are going to solve the problem, we must consider the system holistically and consider how different A and E departments can specialise services. We need much more of a hub-and-spoke system, rather than one where every A and E has to offer exactly the same menu of services. If we do that, we will save more lives and that has to be the right thing to do.
Following Monitor’s report yesterday on the closure of walk-in centres, is it not the case that at the heart of the Government’s NHS reforms is a massive shift in power from the consumers—the patients—to the producers of services? When the Government’s slogan is, in effect, “All power to the producers”, it is not surprising that services have been reorganised in a way that does not benefit patients. May I suggest that instead of sticking up for the BMA, the Secretary of State starts to stick up for patients?
After what happened at Mid Staffs, we will not take any lessons on sticking up for patients—none whatsoever. We are taking the power out of the hands of the managers in PCTs and SHAs and putting it into the hands of doctors on the front line who are seeing patients every day. That is the best thing we can possibly do.
That is the tragedy of what happened in 2004, when the personal link between doctor and patient was broken because the previous Government abolished named GPs for every patient. My hon. Friend speaks very wisely, as that is exactly what most members of the public want—they want to be able to get in and see their own GP quickly and easily. That is at the heart of the problem that tomorrow’s review of A and E will seek to address.
Notwithstanding the brilliant local work of nurses and doctors, hospitals like those in the Brighton and Sussex University Hospitals NHS Trust face real challenges, including bed shortages and people having to wait for many hours for tests such as X-rays and so on. Sometimes, people wait in A and E for 12 hours for a bed. Does that not demonstrate how reckless and dangerous it is for the Secretary of State’s Department to impose cuts of £30 million on that hospital trust this year and next year, and will he reconsider?
Let me gently remind the hon. Lady that we have protected the NHS budget—we took a very difficult decision—but how the NHS budget is spent in local areas is a matter for local discretion. It is challenging for all hospitals, because if we are to address the long-term stability of the NHS we need to spend more money out of hospitals, which means finding efficiency savings in hospitals. We do not want to duck those challenges, which is why we are having the review that will be published tomorrow.
My right hon. Friend will be aware that there are concerns about whether blue-light ambulance services will continue to define what an A and E is. Does he agree that for some years now victims of stroke, trauma and other serious problems have not necessarily gone to their local A and E but to specialist hospitals, and that that has been the reason behind the excellent improvement in outcomes?
My hon. Friend speaks extremely wisely. We have talked about stroke, so let me give another example, which is trauma. We have cut mortality rates by 20% as the result of a strategy to specialise trauma care. Those are the difficult decisions that the Government believe that we should not duck and that we need to face up to. If I may say so, when the Opposition were in power, they took a slightly wiser approach to the issue than the party political posturing we are getting today.
The Secretary of State earlier quoted the suggestion that GP walk-in centres were in the wrong places, where there was little demand. Last year, 33,000 people used the under-threat Accrington Victoria hospital walk-in centre, and now there is deep anger with the Conservative party. Will he explain how 36,000 people going to overstretched Royal Blackburn hospital A and E will help the situation there?
The hon. Gentleman makes my point for me extremely eloquently. Under the previous Government, we had a top-down, ham-fisted policy of opening walk-in centres everywhere as a sticking plaster solution to the disasters with their GP contract. Sometimes they were valuable services, sometimes they were not. We are clearing up the mess, but sometimes, when those centres are useful and important for the public, we will keep them.
The origins of the recruitment crisis in A and E obviously predate this Government. Will Sir Bruce Keogh’s review highlight the local trusts, like that in Gloucestershire, which appear to have significantly worse recruitment and retention records than neighbouring trusts and have used it as a rationale for downgrading services—such as, in this case, those at Cheltenham general hospital?
I hope that it will. I hope that it will give clarity about the long-term future for A and E departments, which has been a difficult issue for this Government and for the previous Government. What people want is stability, and they want to know that there is a Government who are prepared to face up to difficult decisions. They want to know that they have a future, and I hope that tomorrow’s review is the first step towards providing that security.
The number of people waiting more than a year for an operation has gone down from 18,000, when the hon. Gentleman’s Government were in power, to fewer than 1,000 now. We have reduced long waits at a time of great pressure on the NHS, so I do not recognise the hon. Gentleman’s figures at all, I am afraid.
My right hon. Friend will have seen the disastrous reports that have come in about Barking, Havering and Redbridge University Hospitals NHS Trust, with some of the most alarming things including a report of a baby being put in a stationery cupboard. I am sure that, as he said in a recent debate, he will conduct a full review of King George hospital. Can that be done urgently, as we are now in a very serious situation?
I pay tribute to my hon. Friend for raising both publicly and privately his concerns about the hospital provision that his constituents face. We shall of course make sure that there is a proper review before any service changes are made. I hope that he will be reassured by the big change that happened this year with the introduction of an independent chief inspector of hospitals, who is going round the country rooting out poor care, not sweeping it under the carpet, as happened so often under the Labour Government.
The three Members for north Northamptonshire— the hon. Member for Corby (Andy Sawford), my hon. Friend the Member for Wellingborough (Mr Bone) and I—have come together on a cross-party basis, and are working with local clinical commissioning groups and Kettering general hospital to try to attract more investment to our local A and E because of the increase in the local population. May I share with the Secretary of State the fact that all agree that up to a third of attendees at A and E could be better treated closer to home, particularly in excellent urgent care centres such as that in Corby?