House of Commons
Wednesday 5 February 2014
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
Scottish Business Leaders: Independence Debate
I speak to businesses from across Scotland regularly and frequently. In those meetings we highlight the importance of the decision the Scottish people will make on 18 September, and encourage them to get involved in this important debate.
Has my right hon. Friend seen the recent intervention of Bob Dudley, the chief executive of British Petroleum—which, after all, has a major stake in Scotland—whose views should be taken seriously? Does he agree that other business leaders with a big interest in Scotland’s future should follow that example, and set out clearly the implications and consequences of independence for their employees, suppliers, and shareholders?
I have seen and studied the intervention from Bob Dudley yesterday. The terms of that intervention do not surprise me at all as they very much reflect the concerns expressed to me when I speak to businessmen and women across Scotland who represent businesses of all sizes. They all tell me the same: they see independence as being bad for their business. It brings uncertainties, uncertainty means risk, and that is bad for their business future.
I recently met Sir Tom Hunter at a business breakfast organised by the Prime Minister in No. 10 Downing street. The hon. Gentleman will have seen the recent initiative by Sir Tom, which is interesting and valuable, and sits well with the efforts of Her Majesty’s Government to ensure a solid base of information to inform the electorate about the decision they are being asked to take.
14. Will the Secretary of State assure the House that he is aware of the fears and concerns of businesses about the uncertainty posed by an independent Scotland, not only the currency but the fact that interest rates and borrowing costs could be set from outside Scotland? (902352)
Indeed, the hon. Lady makes a point that was made eloquently—and, I thought, in a very measured way—by the Governor of the Bank of England in his speech last week in Edinburgh. He made the point that a currency union such as that proposed inevitably involves ceding some degree of national sovereignty—the very opposite of what independence is supposed to be about. One wonders why any nationalist would, in all sincerity, genuinely want one.
This week the Financial Times reported that an independent Scotland should have healthier state finances than the rest of the UK. So far, more than 1,200 business owners and directors have declared their support for a yes vote by joining the pro-independence business group, Business for Scotland. Does the Secretary of State recognise their role in the Scottish economy and welcome their contribution to the referendum debate?
I will, of course, speak to businessmen and women of all views at any time in Scotland. The difficulty for the hon. Gentleman is that the most recent polling exercise undertaken in the business community showed that roughly three quarters of business people in Scotland intend to vote no. They know that independence would be bad for their business.
All the evidence from polling in recent weeks shows a substantial swing to the yes campaign, and the polls also show that by a majority of 4:1, the public wish to see a debate between the Prime Minister and First Minister Alex Salmond. How long can the Prime Minister continue supporting everybody else becoming part of the debate, but run away from one himself?
Make no mistake, Mr Speaker, we know exactly why the nationalists want that debate between the Prime Minister and Alex Salmond: they are trying to set the decision up as a contest between Scotland and England, which it absolutely is not. This is about Scotland’s best-placed constitutional future, and it is to be decided by Scots in Scotland.
My right hon. Friend will be aware that the First Minister dismissed Mr Dudley’s remarks as purely a personal opinion. In the light of that, may we take it that all those in the business sector who have apparently subscribed to independence can have their opinions dismissed in the same way?
I would dismiss nobody’s opinion and I would engage with people of all shades of opinion across this debate, but the fact is that Bob Dudley is not a lone voice. He is part of a growing chorus from the business community in Scotland who highlight the dangers that would come from independence. They all say the same—it would be a risk to their business because of the uncertainty of the future position of the currency and membership of the European Union. On those two key issues, the nationalists have no comfort for business.
As the Secretary of State has said, it is welcome that the chief executive of BP and the outgoing chief executive of Sainsbury’s have both spelled out substantial concerns about independence. Does the Secretary of State agree that all businesses, trade unions and voluntary organisations have a right to be heard without insult, intimidation or fear of the consequences, regardless of which side of the debate they are on?
I do, absolutely, and in that regard I commend the efforts of the Scottish Daily Mail, which in recent weeks has sought to highlight the poison coming into the debate from some of the cyber-interventions. Other hon. Members have also raised this issue. Whatever the outcome on 18 September we will all have to work together in Scotland for its best future, and that will not be possible if we allow the well to be poisoned in the way the cyber-Nats in particular seem determined to do.
I thank the Secretary of State for that response, but may I press him a little further? Business leaders have told me of intimidatory tactics being used in an attempt to stop them intervening in the independence debate. One leader of a FTSE company told Robert Peston of the BBC that the Scottish Government “became very aggressive” when he tried to raise concerns about independence. Just yesterday, Bob Dudley of BP was dismissed by the yes campaign as “a British nationalist”. Will the Secretary of State join me in condemning the pattern of behaviour that we are beginning to see in Scotland and say, in the strongest possible terms, that it has no place for us Scots as we debate our future?
I agree with the hon. Lady on that point in the very strongest terms. She knows as well as I do that the incidents she highlights are by no means isolated—we hear them anecdotally all the time. I encourage anyone who is bullied or intimidated in that way to follow the example of Chris Whatley, an academic from Dundee university who appeared at a Better Together event before Christmas, following which a Scottish Government Minister was on the phone to his employers saying he should be silenced. That is deplorable and no way in which to conduct the debate on Scotland’s future.
In recent months, I have met every local authority in Scotland, and most of them twice, as part of an ongoing dialogue with local authorities and other stakeholders in Scotland on what the impact of welfare reforms and the challenges of implementation have been for them, their services and their tenants.
The Minister will therefore know that 80% of the households in Scotland affected by the bedroom tax are the home of someone with a disability. He knows that there is a mismatch between the available housing stock and the needs of tenants, and he knows that Scottish MPs, including Government Back Benchers, voted overwhelmingly against this policy. Will the Government now lift the legal restrictions on discretionary housing payments to allow the Scottish Government to mitigate the impact of this nonsense of a policy?
What I do know is that the hon. Lady has a brass neck. She is a member of the Scottish Affairs Committee, but fails to take up her place. This issue was debated in detail yesterday and if she had been present she would know that the Scottish Government already have the powers to take measures if they genuinely believe there are concerns with welfare policies.
I am pleased that the Government listened when I pointed out the problems that withdrawal of the spare room subsidy, also known as the bedroom tax, would cause for tenants on islands and in remote parts of the mainland. I am delighted that the Government have given more than £400,000 to Argyll and Bute council to help affected tenants, and I hope that that generous allocation will continue in future years.
Ministers in the UK Government and Scottish Government are in regular dialogue on issues relating to funding public bodies in Scotland. This Government believe that pension reform is essential because people are living longer and we all need to save for retirement.
Scottish councils are struggling to protect local services, because the Scottish National party Government are not fully funding the council tax freeze. Will the Minister, unlike the SNP, stand up for Scottish councils and make representations to relevant ministries to protect Scottish councils from this budgetary time bomb?
It would be useful if the Minister, in his discussions with COSLA, pushed for a statutory override that would help companies in Scotland to manage the move to single-tier pensions, because that will have an effect when they are not able to opt out of the state earnings-related pension scheme.
Household Energy Bills
Rising energy bills are a serious concern for consumers in Scotland and across the rest of the UK. We are sustaining vital financial support for the most vulnerable consumers. Our reforms are opening up the market to competition and we are working to ensure that suppliers put customers on the cheapest tariff possible.
As the Minister knows, energy prices have risen dramatically since the coalition came to power. In rural and island communities people pay an even greater proportion of their income on fuel. Citizens Advice Scotland says that there was a sevenfold increase last year in people approaching it for advice on mis-selling in the energy sector. Does he not agree that it is now time for a radical reform of the energy sector, and for a price freeze until we put that reform in place?
I say gently to the hon. Lady, who I know has taken a long-term interest in and has a notable record on this issue, that the phenomenon of energy price increases did not just start in 2010. It was a feature of the years of the Labour Government too, as a consequence of the reduction in the number of companies operating in the market. That problem would be recreated if we were to undertake her policy of a price freeze. We have already seen the number of energy companies operating rise from six to 14. A price freeze would be a real threat to that.
It is now clear that we have two Governments who are choosing to side with the big energy companies rather than people struggling with the cost of living crisis. Is it not now clear that the only way for families across the UK to see some relief in their cost of living, with a freezing of their bills and breaking up the monopoly of the big six energy companies, is to vote no in the referendum and return a Labour Government in 2015?
I certainly agree with the first part of the hon. Gentleman’s prescription that a no vote in September is very important, but I have to remind him that in one year alone under Labour there was a 20% increase in energy prices, and there was no suggestion of a price freeze then. When Labour Members were in government, they knew the reality: a price freeze would see prices going up before the price freeze and prices going up again afterwards. We are delivering help to vulnerable people in the here and now.
Whatever the headline average price increase, the fact is that that hides a multitude of sins. A constituent who approached me this week is a low electricity user and is facing a 50% increase in his unit cost. Others are finding that they are being hammered by high standing charges. Is it not time for the Government to take action and stop these practices?
These are all reasons why it is important to improve transparency in the market and the range of tariffs available. That has been the result of the action this Government have been taking. Under the previous Government there were at one point no fewer than 400 different tariffs available, so it was no surprise that people were confused. Simplicity is the way ahead and the Government are working on that, along with the regulator.
We know that energy bills have rocketed under the Secretary of State’s Government and that Labour will freeze energy prices. As my right hon. Friend the Member for Don Valley (Caroline Flint) said this morning, one third of British investment in renewables comes to Scotland, but Scots contribute less than one tenth. That means that the rest of the UK supports Scottish renewable generation through their bills. Does the Secretary of State agree that the best future for renewables in Scotland, and the best way to keep costs down for Scotland, is for Scotland to stay part of the United Kingdom?
That is absolutely the case. Scotland has a tremendous opportunity to contribute to the growth of renewable energy as part of the United Kingdom, but that will take subsidies that come from consumers’ bills, the cost of which is spread across the whole nation, not simply the households of an independent Scotland. It would be madness for the renewable energy industry to support Scottish independence.
While there have been no prosecutions or naming and shaming of businesses for non-payment of the minimum wage in Scotland since at least 2007, a revised scheme came into effect on 1 October 2013 making it simpler to name and shame such employers. I urge anyone with information about such an employer to use that scheme.
I note that the Minister did not tell us how many instances of non-payment had been detected. At a time of economic difficulty, it is a scandal that people are being exploited by being paid less than the national minimum wage. The policing of the Act ought to be much strengthened, then there ought to be vigorous prosecutions and harsh punishments, and there certainly ought to be naming and shaming. Will the Government agree to co-operate with any investigation that the Scottish Affairs Committee—with its full complement of members, I hope—conducts into this matter?
I recognise that the Committee has done much valuable work in this area, and of course we will continue to work with it. In Scotland, prosecutions are a matter for the Lord Advocate, but I am sure he will have heard the hon. Gentleman’s contribution this morning.
13. What representations has the Scottish Office made to the Chancellor of the Exchequer about increasing the national minimum wage to £7 an hour, and what effect does the Minister think such an increase would have on living standards in Scotland? (902351)
It is very encouraging news that employment has increased to near-record highs of more than 2.5 million and that unemployment has fallen to 6.4%, which is the lowest rate in more than four and a half years. Those figures reflect how well Scotland is doing as part of the UK and demonstrate that the Government’s long-term economic plan is working.
I thank my right hon. Friend for that positive response, which shows how well Scotland is doing as part of the Union. Does he agree that the biggest threat to Scottish jobs is the fantasy-land promise of the SNP and its attempt to remove Scotland from the Union and the UK labour market?
That is indeed the case. When we talk about business people having concerns, we are talking about a threat not just to business, but to jobs. The UK is now the fastest-growing economy in the G7, and unemployment in Scotland is at 6.4%, which is significantly lower than the average across the UK, which is 7.1%. We have achieved that because we are part of the UK, not despite it. It is a result of Scotland, with her own Parliament, being represented here and having the best of both worlds.
There remains a great deal to do. I suspect I share many of the hon. Lady’s concerns about the continuing high level of youth unemployment and the number of people who have been unemployed for a longer period. I see encouraging signs of progress in these areas, but they are by no means to be taken for granted. There are tremendous opportunities for the two Governments in Scotland, along with councils in Edinburgh, Glasgow, Aberdeen and elsewhere, to work together to get the best possible arrangements for the unemployed.
When the Secretary of State visits the highlands and addresses a Burns supper in Inverness on Friday night, I am sure he will hear a lot from those present about one of the most exciting job prospects for the highlands and for Scotland as a whole, which is the potential of the Kishorn site in my constituency for offshore wind development. May I encourage him and his colleagues to continue to work with Edinburgh to promote the interests of this exciting project? I wanted to get my plug in now because, due to a previous long-standing engagement, I will not be there on Friday night myself.
I shall, in fact, be carrying out other engagements, although I understand that tickets for that Burns supper are still available and are very reasonably priced. In relation to Kishorn, my right hon. Friend raises an important local concern for his constituents, as he has a long and proud record of doing. I certainly look forward to hearing the detail about that. We are seeing such developments growing across the United Kingdom, particularly in Scotland, and it is because our plan has worked.
The Secretary of State may think that everything is rosy, but is it not a fact that we are seeing the most sustained fall in real wages since records began 50 years ago? Is it not also a fact that the jobs market is not working for ordinary Scots and that both Governments are failing the people we represent?
I wish the hon. Lady and her colleagues could find it within themselves to recognise the substantial progress we are making with the improving employment situation in Scotland. There is significant progress, which makes a real difference for her constituents and mine. Wage levels will doubtless need some improvement to catch up; that is an inevitable consequence of the steps we had to take to clear up the mess that she made.
The Scottish Government’s White Paper shows that the case for independence is unravelling. They promised answers, but failed to address key referendum issues such as currency, costings and EU membership.
In that regard, the most pertinent intervention came from the Institute of Chartered Accountants of Scotland—not a political party or a body that has an axe to grind, but people who know what they are talking about. They told us what we already know: there are substantial questions on pensions and other areas, and the Scottish Government have still failed to answer them.
Surely one of the great weaknesses of the White Paper is on the future of the pound in Scotland. Surely the simplest way in which the people of Scotland can guarantee to keep the pound is to vote no in the referendum.
That is indeed the case and I am confident that they will do so, because the people of Scotland value having the pound sterling as their currency. They value having the Bank of England as a lender of last resort and they value the fact that, as a result, risks and opportunities are spread across the whole United Kingdom.
The White Paper has caused ripples. The polls are tightening and the Tories, with their Labour friends, are worried, but still the Prime Minister is afraid to debate with Alex Salmond, the First Minister of Scotland. This week the Financial Times tells us that an independent Scotland could expect to start with healthier state finances than the rest of the UK. Our GDP per head is higher than France’s and Italy’s. Will the Secretary of State use his position to ensure that people know these facts and stay away from scares and fears designed to stop them making the best decision for Scotland?
Indeed I will, because these are all things that we have achieved as part of the United Kingdom. It all demonstrates what is possible for Scotland as part of the United Kingdom. As for any question of debate, we have dealt with that already, but is it not remarkable that when Scottish National party Members could be answering questions, all they want to do is have a debate about the debate?
8. What discussions he has had with Ministers in the Scottish Government on the funding of pensions in Scotland after 2014. (902346)
Despite having published a paper specifically about pensions in September and the much vaunted White Paper in November, the Scottish Government have left many questions about pensions unanswered.
The hon. Gentleman will be aware that the UK and Scottish Governments have agreed that there will be no negotiation on any issues, including pensions, before the independence referendum in September.
The Institute of Chartered Accountants of Scotland published its first report on pensions in an independent Scotland before the publication of the White Paper, and we were told by the Scottish National party that the answers to our questions about pensions would be in the White Paper. This week the institute issued its response: the White Paper does not contain the answers that would give Scots certainty about their pensions. Is the Secretary of State aware of any intention on the part of the Scottish National party to answer the crucial questions about Scots’ pensions?
I am pretty certain that any answers that would come from the nationalists would not find favour with the people of Scotland, so I am also pretty certain that we will not be hearing much by way of answers in the future. The people will have heard what the Institute of Chartered Accountants of Scotland had to say, and they will now want to hear from the Scottish Government what their answer is, but I am not expecting to hear much.
The Prime Minister was asked—
London is a 24/7 global city, and the commercial centre of the western world. Given that the economy is growing and unemployment is falling, does the Prime Minister agree that the efforts of the RMT to bring London to a halt by means of a tube strike is nothing short of economic vandalism?
I entirely agree with my right hon. Friend. There is absolutely no justification for a strike. We need a modernised tube line working for the millions of Londoners who use it every day. The fact is that only 3% of transactions now involve ticket offices, so it makes sense to have fewer people in those offices, but more people on the platforms and in the stations.
I unreservedly condemn this strike. When the shadow Secretary of State for Defence, the hon. Member for Gedling (Vernon Coaker), was asked to do so today, he said that it was a matter for the union, so I hope that the Leader of the Opposition will stand up and condemn it unreservedly now.
The ongoing floods and storms have caused families to be driven out of their homes, and are affecting significant parts of the country. As the Prime Minister knows, many of those who have been affected feel that the Government’s response has been slow, and that more could have been done sooner. Will he tell the House what action is now being taken to ensure that the affected areas are given all the support that they need?
Let me update the House on this very serious situation. I do not accept that the Government have been slow—we have been having Cobra meetings on a daily basis, and we have taken action right across the board—but let me give the latest figures.
Currently, 328 properties are flooded, 122,000 were protected last night because of the flood prevention measures that are in place, and 1.2 million have been protected since December. There are still seven severe flood warnings in place across the coast of Cornwall, Devon and Dorset. There are 69 flood warnings in place, which means that more flooding is expected, and that immediate action is required. The Environment Agency also has 219 flood alerts in place. There has been a serious situation in Dorset, with many people losing their electricity. More than 60,000 homes have been reconnected overnight, but, as of this morning, there are still 8,000 homes without power.
Whatever is required—whether it is dredging on the Rivers Tone and Parrett, support for our emergency services, fresh money for flood defences, or action across the board—the Government will help those families, and will get this issue sorted.
Notwithstanding the Prime Minister’s response, he will know that many people in the affected areas feel that the response has been too slow, and that they have been left on their own and isolated. Does he agree that the events that we have seen demand a comprehensive look at the Government’s investment in flood protection, and the speed of their response?
The Prime Minister promised that the Government would report to the House on these issues by the end of January. Can he tell us when that report will be available?
The Secretary of State for the Environment has given repeated statements in this House, but I can tell the House that he will make a comprehensive statement tomorrow.
Let me answer very directly the issue about flooding. This Government have spent £2.4 billion over this four-year period, which is more than the £2.2 billion spent under the previous Government, but let me announce today that a further £100 million will be made available to fund essential flood repairs and maintenance over the next year. This will cover £75 million for repairs, £10 million for urgent work in Somerset to deliver the action plan being prepared by the local agencies and £15 million for extra maintenance. I make the point that we are only able to make these decisions because we have looked after the nation’s finances carefully. I can confirm that that is new money that will protect more houses and help our country more with floods, and we will continue to do what is right.
I have to say to the Prime Minister that the figures actually show that investment by the Government has fallen not risen over the period, but the reality is that the scale of the challenge we face from climate change and floods demands that we have that comprehensive look at the investment that is required. I am glad that the Prime Minister has said the Environment Secretary will come to the House tomorrow.
I want to turn to another subject. The Prime Minister said that in 2014 he was going to lead the way on women’s equality. Can he tell us how that is going in the Conservative party?
I am glad that, with Falkirk going on, the right hon. Gentleman is asking me about constituency selection, but let me briefly return to the issue of floods, because I want to clarify this point about the funding. In the period 2010 to 2014, when this Government were in office, the funding was £2.4 billion—more than when Labour was in office. Secondly, let me say—this will be of interest to a number of constituency MPs—that when it comes to funding, the Bellwin scheme also matters because it is the way in which the Government support local authorities. So let me tell the House—[Interruption.] Let me tell the House—[Interruption.]
I know that many hon. Members with flooded homes in their constituencies will want to hear about the Bellwin scheme, because it is the way in which central Government help local government, so let me say we will be paying local authorities 100% of eligible costs above the Bellwin grant threshold, we will be extending the eligible—[Interruption.]
Labour Members claim to be concerned, but then will not listen to the answers. We are extending the eligible spending period for Bellwin claims until the end of March 2014, recognising that the bad weather is continuing, and I can say to colleagues in Cornwall that we will make sure they do not suffer from having a unitary authority, which I know they believe is very important.
On the important issue of getting more women into public life—[Interruption.] Yes, this is fantastically important for our country, because we will not represent or govern our country properly unless we have more women at every level in our public life and in our politics. I am proud of the fact that while I have been leader of the party the number of women Conservative MPs has gone from 17 to 48, but we need to do much more. I want this to go further. We have also seen more women in work than ever before and a tax cut for 11 million women; we have stopped pensions discriminating against women; and we are putting women at the front of our international aid programmes. Those are the actions we are taking. There is more to do, but we have a good record of helping women in our economy.
A picture tells a thousand words. Look at the all-male Front Bench ranged before us. The Prime Minister says that he wants to represent the whole country. I guess they did not let women into the Bullingdon club either, so there we go. He said that a third of his Ministers would be women; he is nowhere near meeting that target. Half the women he appointed as Ministers after the election have resigned or been sacked. And in his Cabinet—get this, Mr Speaker—there are as many men who went to Eton or Westminster as there are women. That is the picture. Does he think it is his fault that the Conservative party has a problem with women?
The right hon. Gentleman is interested in the figures; let me give him the figures. Of the full members of the Cabinet who are Conservatives, 24%—a quarter of them—are women. That is not enough; I want to see that grow. Of the Front-Bench Conservative Ministers, around 20% are women. That is below the 33% that I want to achieve. We are making progress, and we will make more progress. Let me make this point: this party is proud of the fact that we had a woman Prime Minister—[Interruption.]
The right hon. Gentleman mentioned Lady Thatcher. Unlike him, she was a Tory leader who won general elections. I notice that the hon. Member for Harwich and North Essex (Mr Jenkin) is in his place. He wrote an interesting article recently, in which he said:
“We men are all guilty of such unconscious slights to women”.
The Prime Minister recently greeted a leading high-profile businesswoman at a reception by asking, “Where’s your husband?” That says it all. The reason that representation matters is that it shapes the policies that a Government introduce and how they impact on women in this country. He is failing women. Can he say why, for the first time in five years, the gap between men’s and women’s pay has increased?
The fact is that there are more women in work in our country than ever before in our history. We have seen a tax cut for 12 million women, a pension increase that is benefiting women, tax-free child care that will help women who want to go out to work and more support on child care. The right hon. Gentleman talks about MPs and candidates; he might enjoy this one. The Labour candidate for Wythenshawe has made an endorsement today. He has endorsed Miliband—David Miliband.
If I were the right hon. Gentleman, I would not be talking about candidates, this week of all weeks. What is the Tory party doing? It is removing one of its most senior women and seeking to replace her with an Old Etonian. That says it all about the Conservative party. He did not answer my question, so I will tell him why the gender pay gap is increasing. It is because the minimum wage has been losing value, there is a growth in zero-hours contracts and women have a problem accessing child care. He promised to modernise his party, but he is going backwards. He runs his Government like the old boys’ network. That is why he is failing women across his party and across the country.
Is it not interesting that with six questions and an invitation to condemn the strike today, we heard not a word from the right hon. Gentleman? Is this not the truth: he raises constituency selections in a week when he has completely rolled over to the trade unions? Let us be clear about what is happening: they keep their block vote, they get more power over their discretionary funding and they get 90% of the votes for Labour’s leader. He told us that he was going to get rid of the red flag—all he has done is run up the white flag.
Q2. With 40 firms in west Norfolk, led by Bespak and Gilchrist Confectionery, expanding, which has led to unemployment falling by 20% since March last year, is the Prime Minister aware that another 440 hard-working families have been receiving a pay packet and facing a brighter future under our long-term economic plan? (902399)
My hon. Friend is absolutely right: two weeks ago, we saw the biggest increase in employment in one set of quarterly figures since records began in the 1970s; we are seeing unemployment come down and more people in work; most of those new jobs—the overwhelming majority—are full-time jobs; and nine out of 10 of those jobs over the past year have been in better-paid professions, rather than low-paid jobs. So we are seeing economic success, and every one of those jobs is not just a statistic; it is someone with a pay packet who can help take care of their family, and have the dignity and security that work brings. Is it not surprising that we heard not a word about the economy today from Labour Members? As they know, that is because it is growing and all their forecasts were wrong.
In evidence to the Select Committee on Welsh Affairs, the leader of the Welsh Conservative Assembly group said that the lockstep on income tax in the draft Wales Bill was not
“a sensible course of action”.
Subsequently that day, the Secretary of State for Wales said that the Assembly group leader was expressing
“very much a personal view of his own.”
Later, the Secretary of State received a letter from the Welsh Conservative Assembly group saying that it was very much its opinion. Who speaks for Wales? Is it the Secretary of State for Wales or the leader of that Assembly group?
The Secretary of State is doing a superb job standing up for Wales. Only yesterday, he and I were discussing how we are going to make sure that the NATO conference coming to Wales will be a success for the whole of the Welsh economy. On the future of devolution, we are in favour of taking these further steps, and we will be bringing forward legislation. We will be taking steps and making sure that people in Wales have a real say. I want the Conservatives in Wales to stand up as the low-tax party in Wales, and under our devolution plan that is exactly what they will do.
Q3. A couple of weeks ago, the Daventry university technical college opened the doors to its new campus, where, under the stewardship of its excellent principal, David Edmondson, its first 96 students will be learning the vocational skills that young people need to compete in the future. Does my right hon. Friend agree that university technical colleges such as Daventry’s will ensure that young people across our country have a brighter and more secure future, and are able to reap the benefits of our long-term economic plan? (902400)
My hon. Friend is absolutely right; making sure we have the best skills and the best schools is an absolutely key part of our long-term economic plan, and I support very much the university technical college movement. The number of pupils taught in underperforming schools under this Government has fallen by 250,000 in four years. Again, that is not just a statistic; it is tens of thousands of young people who are going to have the chance of a good education, a good future, and the chance to get a job and get involved in our modern economy. UTCs are well placed to help thousands of students in that way.
When, on 22 February 2012, I asked the Prime Minister about fraud at A4e, a company working with jobseekers, he told me that he was waiting for the truth before he would act. This week’s guilty pleas by A4e staff reveal a culture of fraud in that company. Is not the list of taxpayer-funded fraudsters—Serco, G4S, A4e—getting too long? When is it going to stop?
The hon. Lady makes an important point. The answer I would give is that instead of bandying around names of companies, where many people in them will be working hard to do a good job, what we should do is investigate wrongdoing properly and make sure that cases are properly taken to court, as this case clearly was.
Q4. Does the Prime Minister share my outrage at the false choice presented by the chairman of the Environment Agency between protecting urban areas and protecting rural areas from flood? Does my right hon. Friend recognise that my constituents in Holderness, and people in the Somerset levels and elsewhere, expect decent maintenance and dredging, and not abandonment? (902401)
My hon. Friend is absolutely right; there should not be a false choice between protecting the town or protecting people who live in the countryside. What we are now seeing, quite rightly, is a shift in the debate. From the late 1990s, for far too long, the Environment Agency believed that it was wrong to dredge. Those of us with rural constituencies that have been affected by flooding have seen the effectiveness of some dredging that has taken place. If it is good for some places, we need to make the argument that it would be good for many more places. I have said that we will see dredging on the Tone and the Parrett in the Somerset levels, because that will make a difference, but it is time for Natural England, the Environment Agency and the Departments to sit around a table and work out a new approach that will ensure that something that worked for decades and centuries is reintroduced again.
Queen Victoria was on the throne when the Dunlop factory in Erdington first produced world-class tyres for the motorsport industry. Jaguar Land Rover now needs the land for the welcome expansion of the Jaguar plant. The Business Secretary and Birmingham city council have identified three sites and a financial package so that Goodyear Dunlop can relocate. Will the Prime Minister join the Business Secretary and me in urging it to look at those alternatives and not walk away from 125 years of manufacturing history?
I was being briefed on that issue just before coming to the Chamber. I am happy to look carefully at it and see what can be done. The recovery of the automotive sector, particularly in the west midlands, has been hugely welcome for our country. Dunlop is an historic name and an historic brand, and I will do everything that I can to work with the Business Secretary and the hon. Gentleman to get a good outcome.
Q6. South Essex is proof that our long-term economic plan is working. However, the current options under consideration for an additional Lower Thames Crossing are limited in their ambition and do not maximise the economic potential of the Thames Gateway. Will my right hon. Friend agree to meet me and other interested colleagues so that he can hear why option A and certainly option C are not the right answers? (902403)
Where Essex goes so often the rest of the country follows, as my hon. Friend says. This is an important issue. We must consider all the potential bottlenecks that can hold back our economy. I am happy to meet him and colleagues. The Thames Gateway is an absolutely vital development for our country, and I want to see economic development spread throughout our country, so I am happy to hold that meeting.
Q7. Royal Mail shares are currently trading at 587 pence, almost 80% higher than when the Government sold off their share. Does the Prime Minister still honestly believe that his Government properly valued Royal Mail and that the price was set to secure the best deal for the taxpayer? (902404)
The Government did a good job to get private sector capital into Royal Mail. Frankly, that is something that has evaded Governments of all colours and all persuasions for decades. I well remember sitting on the Opposition Benches and hearing about the appalling losses in Royal Mail—tens and hundreds of millions of pounds. The fact that it is now well managed, well run and, with private sector capital in, it is a great development for our country.
Q8. In Erewash, we have a proud and strong history of supporting apprenticeships across a range of sectors. With national apprenticeship week taking place next month, does my right hon. Friend agree that the emphasis and drive of this Government on increasing apprenticeships—for men and women—is exactly what is needed to support people getting back into work and training? (902405)
My hon. Friend is absolutely right. The Government have invested record amounts in apprenticeships. More than 1.5 million people have started apprenticeships, many of whom come from the east midlands, including those whom I met with her in her constituency. Again, those are not just statistics. Each and every one of those apprentices is someone who is getting a chance, a skill, a job and an opportunity to build a life for themselves and to build that stability, peace of mind and security that should be the birthright of every single person in our country.
The loss of the railway line at Dawlish in the overnight storms is a devastating blow to the economies of Devon and Cornwall. It comes just a year after we lost our railway service for a whole month because of flooding. Does the Prime Minister accept that we, as a country, will have to spend a great deal more investing in the resilience of our transport infrastructure and that we need a Government who are united in their acceptance of, and their determination to do something about, climate change?
I agree wholeheartedly with the right hon. Gentleman on a number of points. First, we need to ensure that urgent action is taken to restore the transport links and that is why I will chair Cobra this afternoon, bringing together the problems of the power reductions, the floods and the effect on transport. Secondly, we must ensure that we go on investing in rail schemes and this Government are putting record amounts into such rail schemes. The third point, on which I totally agree with him, is that we need to continue the analysis of the resilience of our infrastructure that is now carried out by the Cabinet Office. Where extra investment and protections are needed, they must be put in place.
Q9. The Prime Minister recently visited Vent-Axia in my constituency, a company that has brought manufacturing jobs back to this country from China. What are the Government doing to encourage more reshoring of jobs to the UK as part of our long-term economic plan? (902406)
It was a huge pleasure to go to Crawley with my hon. Friend and see that company, which makes ventilation equipment, bringing jobs from China back to the UK. That is a small trend at the moment, as 1,500 jobs in manufacturing have been reshored since 2011. If we manage to ensure that our energy market is competitive, if we keep our labour markets flexible and competitive and if we make this a friendly country for business with low tax rates, including low corporate tax rates, there is no reason why we should not see more companies coming back to Britain. We will not get that with an anti-enterprise, anti-business, anti-growth Labour party.
Q10. Last week, the Care Quality Commission issued an appalling and damning report on Liverpool community health. Will the Prime Minister undertake to have the historic HR practices, the disciplinary actions and the subsequent pay-offs that were used as a mechanism to bully staff forensically examined and to ensure that the executive team and the board are held to account, making the huge statement that bullying is not acceptable in the NHS? (902407)
The hon. Lady is absolutely right to raise both the specific case and the general lessons it brings. Of course, we still have more to do, but I think the CQC is a hugely improved organisation. We now have a chief inspector of hospitals. It is all much more transparent than it was in the past, but I am very happy to look at the hon. Lady’s specific concerns about bullying and to ensure that the CQC deals with that. This week is the anniversary of the dreadful report into Stafford hospital and my right hon. Friend the Secretary of State for Health is absolutely committed to ensuring that there is a change of culture in the NHS so that we do not put up with poor practice, so that when there are problems we are not afraid or ashamed to surface them, and so that we do not just talk about those problems but deal with them.
Q11. In my constituency, business confidence is growing and unemployment has fallen by more than a quarter in the past 12 months. Does my right hon. Friend agree with me that we should take no lectures from the shadow Chancellor, particularly given the green budget report by the Institute for Fiscal Studies, which said:“The largest challenge for the Chancellor remains having to contend with the consequences of the Great Recession”—a recession caused by the Labour party? (902408)
My hon. Friend makes an important point and the IFS report, out this morning, states that the change in economic outlook from a year ago is “really quite remarkable”, and:
“The UK recovery is getting ever closer to achieving ‘escape velocity’”.
[Interruption.] We keep being told by the shadow Chancellor that it is about time, but if we had listened to him, there would have been more borrowing, more spending, more taxing and more debt. His view is very clear: if we gave him back the keys to the car, he would drive it just as fast into the same wall and wreck the economy all over again.
I agree with my right hon. and learned Friend that after a very promising start, with chemicals not only being discovered and removed but destroyed, there seem to be indications that the programme is now slowing and that not all the necessary information is forthcoming. I discussed the issue in a telephone call with President Putin some 48 hours ago. Britain will continue to put pressure on all parties to ensure that chemical weapons are produced and destroyed.
Q13. Overseas students who are offered places at top British universities get extra coaching in English and maths, but hard-working Hackney students from poor backgrounds with top A-level predictions are not even offered a place if they have a grade C in maths. That is not fair and does not help social mobility. What is the Prime Minister going to do to support hard-working Hackney students? (902410)
First, we must continue with what has been happening in Hackney, which is the introduction of new academy schools, such as the Mossbourne academy, which is one of the most impressive schools I have ever visited anywhere in the world. We must also continue with my right hon. Friend the Chancellor’s plan to uncap student numbers at our universities so that anyone who can get the grades is able to have a place there. On the hon. Lady’s specific point about GCSE grades, we have to be clear that, in the end, it is universities that set the criteria, rather than the Government, but I am very happy to look at the specific issue. I also believe that, as the Education Secretary has said, if people do not get the right grades at GCSE, particularly in English and maths, we ought to encourage retakes and more work. The reason for that is that there is not a job in the world that does not require good English and maths. That is a very important message to go out.
No doubt the Prime Minister saw the scenes of destruction resulting from storm damage in Dawlish in my constituency. Our railway line is out of action, 25 families have been evacuated and one house is about to fall into the sea. Devon and Cornwall feel cut off. Can he confirm that he is taking all the action possible to get transport systems back in action and families back into their homes and, crucially, that he will look at fast-tracking a review of the funding for a breakwater to protect the railway line and residents, which currently cannot be implemented until 2019 because of lack of funding?
I am very happy to look at all the suggestions my hon. Friend makes. That is why we are holding the meeting of Cobra this afternoon. Members right across the House will know that that railway line is not only a vital artery for the south-west, but one of the most scenic and beautiful lines anywhere in our country, so what has happened is hugely upsetting and disturbing. We will look at all the options, and we will do so with great urgency.
Q14. The Prime Minister will be aware of the investigation into the systematic beating, abuse and rape of young men and boys at the former Medomsley detention centre in my constituency. The victim toll has now topped 300. It is the biggest investigation ever undertaken by Durham constabulary, which is a relatively small police force. Will he give a commitment that, if it proves necessary, his Home Secretary will meet the police and crime commissioner, the chief constable and myself to ensure that that highly successful team have the resources they need to see the investigation to its conclusion? The victims deserve no less. (902411)
I am very happy to give the hon. Lady that assurance. I do not support the police merger ideas of the past and think that some of our smaller police forces are hugely capable, but when they are doing such large and complex investigations, they occasionally need help and support, so we should ensure that it is available. I am very pleased with the work the National Crime Agency is doing. It is now fully established, up and running and able to deal with some of the more serious crimes—people smuggling, sexual abuse and the like—and I think that we will hear more from it about the great work it is doing.
While I congratulate my right hon. Friend on the European Union (Referendum) Bill, and the whole House of Commons on passing it, will he tell us whether the dead parrot is merely resting? Does he have a Baldrick-like plan to use the Parliament Act so that we can get it squawking again?
I hope that particular parrot, which obviously has beautiful plumage, can be resuscitated if one of my colleagues is fortunate enough to win the private Member’s Bill ballot. We on this side of the House know that the British public deserve a say, and I am sure that one of my colleagues would be delighted to bring the Bill back in front of the House. Let us be clear—because the Opposition have all gone a bit quiet over there—about why the Bill was killed in the House of Lords: the Labour party and, I am afraid to say, the Liberal Democrats do not want to give the British people a say. This House should feel affronted, frankly, because we supported and voted for the Bill, so I hope that it will come together as one and insist on the Bill.
Q15. In the Chancellor’s Budget of 2105, he made a very welcome announcement about tax breaks for the computer games industry. That was passed on to the European Commission last April, but since then we have heard nothing. The games body, TIGA, is saying that this is having a very detrimental effect on the industry. Will the Prime Minister and, indeed, the Chancellor do something to address this delay? (902412)
I absolutely share the hon. Gentleman’s frustration. I think it is perfectly within a Government’s rights to set out a way of helping and supporting vital industries such as this which are so important for the future of our country. We are discussing it with the European Commission and we are hopeful of good news to come shortly.
Following the questions from the right hon. Member for Exeter (Mr Bradshaw) and the hon. Member for Newton Abbot (Anne Marie Morris), it is absolutely true that following the most recent storms, residents in Cornwall have been concerned that England will be completely cut off. In view of that, while MPs from Cornwall and the south-west have been content to support the billions of pounds necessary for HS2 and other transport projects to the north, does the Prime Minister accept that relatively small amounts are now needed to ensure the resilience of the rail line between Penzance and Paddington?
I know from personal experience how vital the Penzance to Paddington link is and how many people rely on it, so I am happy to look at this very urgently. Let me repeat something I was trying to say at the beginning of questions about the Bellwin scheme. I know that Cornish Members of Parliament are concerned that now they have a unitary authority, they would need a very big claim before triggering Bellwin. We are sorting that out so that the money and the assistance will be there. On the transport links, it is an urgent requirement to get this right.
Point of Order
On a point of order, Mr Speaker. This is a genuine request for information. On Monday, the Secretary of State for Work and Pensions appeared in front of our Select Committee. Our questioning was, in the main, about the slowness of the roll-out of universal credit and what seems to be gross misspending of public money. In response to my highly respected colleague, the Chair of our Select Committee, the Secretary of State replied, in the first instance:
“With respect, I do not have to tell the Committee everything that is happening in the Department”.
Later, he said:
“With respect, Chairman, I do not think this Committee can run the Department.”
Both replies—no surprises there, Mr Speaker—were, in my opinion, as ill-mannered as they were ill-informed, because it is my understanding that the duty laid on a Select Committee by the House of Commons is to scrutinise the working of the relevant Department. I would therefore be grateful for your advice on to whom I should go or whether there is a relevant committee to whose attention I should draw my concerns, to clarify the situation and, I hope, impose on the Secretary of State the reality of his responsibilities.
I am extremely grateful to the hon. Lady for that point of order. I accept that it is very much a request for information or clarification. I would make two points in response. First, her understanding of the function of a Select Committee is precisely correct—it is to scrutinise the work of the Department; not to run the Department but to hold to account those who do. That is certainly true. Secondly, however, I must say to the hon. Lady that the matter currently rests with the Committee, and it would not fall to me to say, still less to do, anything further beyond what I am saying to her now, unless the Committee were to report to the House a stated dissatisfaction. For now, however, she has lodged her point very clearly on the record, and I thank her for doing so.
Criminal Justice and Courts Bill
Presentation and First Reading (Standing Order No. 57)
Mr. Secretary Grayling, supported by the Prime Minister, the Deputy Prime Minister, Mr Chancellor of the Exchequer, Secretary Theresa May, Secretary Eric Pickles, the Attorney-General and Simon Hughes, presented a Bill to make provision about how offenders are dealt with before and after conviction; to amend the offence of possession of extreme pornographic images; to make provision about the proceedings and powers of courts and tribunals; to make provision about judicial review; and for connected purposes.
Bill read the First time; to be read a Second time tomorrow, and to be printed (Bill 169) with explanatory notes (Bill 169-EN).
Investment Management (Fiduciary Duties)
Motion for leave to bring in a Bill (Standing Order No. 23)
I beg to move,
That leave be given to bring in a Bill to place a fiduciary duty on those involved in managing an investment to act in the best interest of investors, including pension savers, in a transparent and accountable way; and for connected purposes.
I want to start with a simple observation: successful economies cannot exist if suppliers take advantage of their customers and do not act in their best interest. Competition helps to ensure that suppliers do the right thing, but when a service or product is complex, and when the customer cannot know whether he or she is receiving a good service or buying the right product, the onus has to be on the supplier to act in good faith. It comes down to trust. We trust that the service we require will be delivered to the best of the ability of the person or company providing it. We also trust that the product we purchase works and can do the job. If not, we demand some kind of redress and do not expect to pick up the repair bill. Those who act in a professional manner will guard against bad practice.
One place where trust and professionalism are vital is in the financial and investment services industry, but here is the problem: the agent of the agent of the saver can lose sight of the ultimate customer’s best interest. Nowhere is that clearer than in the investments of our pension industry, which is worth more than £2 trillion, or 135% of the size of the UK economy. With those statistics in mind, and with auto-enrolment bringing an additional 11 million savers into the system—many of them low-paid—the industry has a great responsibility to get it right.
Today, millions of pension savers from all over the world own shares in global companies. For the most part, these people are not wealthy investors; they work in shops and factories, small businesses and local government. Are all these companies run on their behalf to make a decent profit to pay a pension, and in a socially responsible way? Does our investment industry encourage them, on our behalf, to do so and bring them to book when they do not? Does the investment industry encourage the long-term profitable investment that its pensioner clients need? In most cases the answer is yes, but in some cases the system fails.
I believe that those whose task it is to look after the money of millions of pension savers should be under a fiduciary duty. We insist on it for pension trustees, but that obligation should not be lost if the management of the fund is delegated to someone else.
Over the decades, the Labour movement has championed workers rights. Now we must champion the rights of working people as capital holders and investors in the stock market. They are the new capitalists and they are our people, too. We must call on those who manage our funds to do so by putting our interests ahead of their own. At the core of every decision they take should be the savers’ interests, because it is our money, not theirs, for which they have responsibility. That is the essence of fiduciary duty. Financial institutions need to reflect such duties in the way in which they practise their craft. That is why fiduciary duties, transparency and accountability are important, and that is why I wish to bring in this Bill.
For pensioners, sustainable financial performance is what counts. This Bill is intended to emphasise the importance of the long-term result, which is the one that counts for millions of hard-working pension savers in our economy. I agree with ShareAction that, just as section 172 of the Companies Act 2006 requires company directors to have regard for the consequences of any decision in the long term, we should require investors in charge of our pension savings to be similarly enlightened. Those investors should also have regard to the impact of decisions on the financial system and the real economy, and take stock of social and environmental considerations as well as the implications of any investment activities on the beneficiary.
All of this is important because in 2010 only 11.5% of UK shares were owned by individuals. In the 1960s the figure was more than 50%. Today, the major investment decisions that affect companies are taken by asset managers controlling trillions of pounds. That money is our money. We want to know where it is invested and why. This Bill would make it a requirement for pension funds to detail where they invest. Votes taken by asset managers on the remuneration of corporate executives should also be in the public domain. Those votes represent our interest and should not be secret.
The Bill would also ensure that fees paid to pension managers and other intermediaries should be transparent, including an explanation of how much they are and why they are necessary. The Office of Fair Trading has discovered 18 different charges levied on pension funds, many of which we are not even told about. All of this matters because it is unacceptable for fees to eat up as much as 40% of a pension pot.
Lord Lawson has raised concerns about such fees. In the Financial Times on 22 January, he said:
“The costs are massive in this area. Some costs are not revealed at all; some are. Even with the costs that are revealed, there is such a lack of consistency.”
The article quoted the kind of fees charged, including bid-offer spreads to foreign exchange counterparties, payments to custodian banks and fees to pooled funds. These fees sound opaque because they are opaque. It is a language that is meant to be opaque, and behind which £2 trillion is traded. Are such fees necessary? How much do they cost the saver? Full disclosure of such fees would be a start.
The job of pension fund managers seems complex and opaque, so we need to be able to trust them. According to the “Concise Oxford English Dictionary”, trust is defined as a
“firm belief in someone or something. Acceptance of the truth of a statement without evidence or investigation”,
and to trust someone is defined as to
“have the confidence to allow someone to have, use or look after.”
We trust in the industry to look after our savings.
We trust in others all the time, especially when we require them to do something we ourselves cannot do. If we are ill and require surgery, we put our trust in the surgeon to look after our best interests. The General Medical Council lists among the duties of a doctor: to be
“honest and open and act with integrity”,
and never to
“abuse your patients’ trust in you or the public’s trust in the profession.”
If we want a solicitor to act on our behalf, the solicitors’ code of conduct states that solicitors must
“act in the best interests of each client”,
“behave in a way that maintains the trust the public places in you and in the provision of legal services.”
Even the gasman who comes to fix our boiler has a legal requirement to be signed up to the gas safety register, and needs to retrain every five years.
All those examples are of people in whom we must from time to time place our trust, and they are all governed by legal requirements. They cannot practise if they are not suitably qualified, and they can all be struck off if they are found negligent. If that applies to a doctor, a solicitor and a gas fitter, it should apply to financial agents and fund managers. When it comes to our pension investments, we may place our trust in fund managers for 40 years, not just from time to time, and there is no such transparency and accountability.
Fund managers have a moral duty to be transparent in their actions and be accountable for them. Savers have a right to know what fees they will be charged and where their savings will be invested. Every practitioner must be able to put their hand on their heart and say that they acted in the best interest of those whose funds they invest. Where market forces encourage them to do otherwise, they must report it.
Ever more regulation is not the answer. What is needed is a new compact, a new understanding of duty and a rediscovery of fiduciary duties. That is why I believe that, like a doctor who swears under the Hippocratic oath to prevent disease because prevention is better than cure, our fund managers should act responsibly and, like a doctor, swear:
“I will remember that I remain a member of society, with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.”
I am saying not that those in the industry should swear an oath, but that the sentiment of those words should be the foundations on which the industry is built. If there is a breach of that duty, there should be consequences. For example, if there is a mis-selling scandal, a fine levied by the authorities on financial institutions might also be levied on the individual perpetrators of the mis-selling. Perhaps, in that knowledge, mis-selling scandals would be less likely to happen.
We say that we live in a civil society, in which we have accountable Government, informed electors, a free press, an independent judiciary and freedom within the law—a society that attempts to be there for us all. I do not believe that we can achieve a civil society without a civil economy, in which institutional managers of capital are accountable to their savers and push corporations towards sustainability through responsible management. A civil society and a civil economy are two sides of the same coin. We will achieve neither until we realise that simple truth.
Question put and agreed to.
That Phil Wilson, Nic Dakin, Mr George Howarth, Ian Mearns, Derek Twigg, Sheila Gilmore, Julie Hilling, Mr William Bain, Bridget Phillipson and Debbie Abrahams present the Bill.
Phil Wilson accordingly presented the Bill.
Bill read the First time; to be read a Second time on Friday 28 February, and to be printed (Bill 170).
On a point of order, Mr Speaker. Just last April, the Deputy Prime Minister said, on the subject of international human rights, that
“stepping back simply for commercial expediency would be walking away from our beliefs.”
Today, he has returned from a commercial delegation to Colombia, which for the 18th year has had a United Nations Commission on Human Rights presence due to continued human rights violations. Has he indicated to you, Mr Speaker, that he intends to make a statement to the House explaining that he is now prepared to walk away from his belief in human rights for commercial expediency?
No, I have had no such notification from the Deputy Prime Minister. On the back of what the hon. Gentleman has said, I have a keen expectation that he will be in his place for the next session of questions to the Deputy Prime Minister. If he bobs up and down with his usual determination, he may just be lucky in catching my eye.
I beg to move,
That this House is concerned about recent pressure in Accident and Emergency departments and the increase in the number of people attending hospital A&Es since 2009-10; notes a recent report by the Care Quality Commission which found that more than half a million people aged 65 and over were admitted as an emergency to hospital with potentially avoidable conditions in the last year; believes that better integration to improve care in the home or community can relieve pressure on A&E; notes comments made by the Chief Executive of NHS England in oral evidence to the Health Select Committee on 5 November 2013, that the NHS is getting bogged down in a morass of competition law, that this is causing significant cost and that to make integration happen there may need to be legislative change; is further concerned that the competition aspects of the Health and Social Care Act 2012 are causing increased costs in the NHS at a time when there is a shortage of A&E doctors; and calls on the Government to reverse its changes to NHS competition policy that are holding back the integration needed to help solve the A&E crisis and diverting resources which should be better spent on improving patient care.
Our purpose in calling this debate is twofold. First, we want to help the House to develop a more sophisticated understanding of the underlying reasons for the sustained pressure in accident and emergency departments throughout England. Secondly, we want to remove what we see as the major barrier to a lasting solution in A and E.
What has been happening in A and E over recent years? Between 2007 and 2010, attendances at A and E were fairly stable, although they rose slightly. Over those three years, attendances at hospital A and E departments increased by 16,000. Between 2010 and 2013, something changed. In the first three years of this Government, attendances at A and E increased by a staggering 633,000.
What is going on? It is all too easy to reach for simplistic answers. In truth, the picture is complex and a range of factors has contributed to the rise. However, it is possible to point to underlying causes. One of those is clearly the general economic climate. People have been living under greater pressure and are struggling with the cost of living. A and E has become the last resort for people who are not able to cope for a range of reasons. If Members speak to A and E staff, they will be told that there has been a rise in people arriving at A and E who have a range of problems linked to their living circumstances, from people who have severe dental pain because they cannot afford to see the dentist, to people who are suffering a breakdown or who are in crisis, to people who cannot afford to keep warm and are suffering a range of cold-related conditions.
The right hon. Gentleman is explaining why there is increased pressure on A and E. Does he not accept that A and E performance has improved since the general election? The average waiting time is down from 77 minutes under the last Government to 30 minutes.
No, I do not accept that. This has been the worst year in a decade in A and E departments. Almost 1 million people have waited more than four hours to be seen. In my year as Secretary of State for Health, the figure was 350,000. There has been a big increase in the number of people who are waiting a long time. I was going to come on to the average waiting time, but since the hon. Gentleman mentions it, let me make the situation clear now. The figure that he is talking about and which appears in the Government amendment relates to the waiting time until an initial assessment, not the total waiting time in A and E. [Interruption.] The Secretary of State is nodding because, as ever with him, it is all about the spin. That figure does not mean anything to the public. They want to know how long they will spend waiting in A and E in total. We need to have a bit of truth in this debate.
My right hon. Friend was making a point about the wider economic pressures that are leading to greater pressure within A and E. Was he as shocked as I was to read in the Manchester Evening News last year that people in our area are presenting at A and E as a result of malnutrition? Is it not an appalling indictment of the Government that they have allowed that to happen in the 21st century? It is putting huge pressure on A and E departments across the north-west, including those at Wythenshawe hospital and Manchester Royal infirmary.
That is an indictment of the Government. They have made it harder for people to afford a good basic diet. We have seen a rise in hypothermia, rickets and scurvy. Sadly, we have also seen the rise of food banks under this Government. That is why I am beginning my speech by saying that there is a range of reasons for the sustained pressure on A and E.
I will make a little progress and then I will give way.
There have been record levels of hypothermia this year and thousands of over-75s have been treated in hospital for respiratory or circulatory diseases. That brings me to the second underlying cause of the increase in attendances at A and E. The ageing society is not a distant prospect on the horizon. Demographic change is happening now and it is applying increasing pressure on the front line of the NHS.
We all need to face up to the uncomfortable fact that our hospitals are increasingly full of extremely frail elderly people. Too many older people are in hospital who ought not to have ended up there or who are trapped there because they cannot get the right support to go home. That situation is unacceptable and it has to be addressed.
Does the right hon. Gentleman not accept that the emergence of older people visiting A and E in far greater numbers has been coming on for a long time? I know that he does not like to be reminded of the 2004 GP contract, but surely he agrees that it is a factor, because older people have not been able to get the necessary support over a long period. The Government are putting that right by integrating health and social care far better.
The hon. Lady wants me to answer that question, but I direct her to her right hon. Friend, the Chairman of the Health Committee, who has dismissed the self-serving spin from the Government that says that these problem are all to do with a contract that was signed 10 years ago. I began my speech by citing figures that show an exponential rise in the number of people attending A and E since 2010. Many of those people are very frail older people. That is the issue before the House, so it does not help the debate for the hon. Lady to stand up and make a spurious political point.
Is not one of the reasons why more elderly and frail people are going to hospital that there has been a £1.8 billion cut in adult social services and support? Those people are ending up in hospital because they are not receiving the care that they need at home.
My hon. Friend is absolutely right. I will come on to say that the single most important underlying cause of the A and E crisis is the severe cuts that we have seen to adult social care. That has created a situation in which older people are trapped on the ward and cannot go home because there is not adequate support at home. That means that A and E cannot admit to the ward because the beds are full. Hospitals are operating way beyond safe occupancy levels. Because of that, the whole hospital begins to jam up and the pressure backs up through A and E. When A and E cannot admit to the ward it becomes full, so ambulances queue up outside because they cannot hand people over to A and E.
That is exactly what is happening in our NHS at the moment. A and E is the barometer of the whole health and care system. If there is a problem anywhere in the system, it will be seen eventually as pressure in A and E. That is what is happening. The simplistic spin from the Conservative party, which says that it is all to do with a GP contract from 10 years ago, is discounted by expert after expert.
My right hon. Friend rightly said that back-ups in A and E cause problems elsewhere. May I draw his attention to the fact that over the past 18 months, more than 1,600 people have waited more than 20 minutes in ambulances outside Warrington hospital before they could even get to A and E and the clock starts ticking? North West Ambulance service says that it cannot be accurate about the waiting time for hundreds of incidents. Does that show that waiting times may be even worse than first thought?
I fear my hon. Friend is absolutely right. I know Warrington hospital well and the pressures that have been on it, and I agree that ambulance response times have increased across the country because so many ambulances have been held in queues outside A and E, unable to hand over patients to A and E staff because it is full. That has left large swathes of the country—particularly in rural areas—without adequate ambulance cover, and very serious incidents have taken place across the country, not least in the Minister’s area of Norfolk where people have not received ambulances on time. That is the consequence of the pressure on A and E not being addressed, and it is threatening to drag down the rest of the NHS.
My right hon. Friend is making an incredibly powerful speech that goes to the very heart of our NHS and the staff who work in it. North East Ambulance Service is one of the highest performing services in the country and reaches 80% of most seriously ill or injured patients within eight minutes. Last week, however, it had to hold an emergency summit because staff morale is at an all-time low. Assaults on staff are increasing dramatically, and the stress and pressure of waiting outside A and E to admit patients is having a deeply damaging impact on the wider NHS. Does my right hon. Friend agree that that is not what the Prime Minister meant when he said that the NHS was safe in his hands?
My hon. Friend’s point was also made powerfully by ambulance staff at an A and E summit held by the shadow Front-Bench team in Parliament before Christmas when a paramedic spoke of the phenomenon she has just described. He mentioned an occasion when staff were at the door of A and E waiting to hand over a patient to A and E staff, when the patient had a heart attack. The staff did not know what to do and had to go back to the ambulance to try to stabilise the patient. Those sorts of joining points or disconnects in the system are leading to real pressure on staff who do not know what to do in those difficult circumstances. The system is in danger of being overwhelmed, and the pressure on staff must be addressed urgently.
I share the right hon. Gentleman’s view that delays in handover at A and E are not acceptable, and I remember well that last decade, under the previous Government, ambulances were stacking up outside the A and E at the Norfolk and Norwich hospital. Does he welcome the fact that this winter, delays of longer than 30 minutes are down by more than 30% compared with last year?
Yes, there has always been pressure on the ambulance service at this time of year, but if the Minister wants me to join in with his complacency, I am afraid I will not. The past 12 months have been the worst in A and E in a decade, and there are reports of ambulances across the country held in queues. Is the Minister satisfied with the performance of the ambulance service in his region of east England? Was he satisfied with the way the case I mentioned was handled? I do not believe he was or that his complacency at the Dispatch Box will be appreciated by his constituents.
As a Norfolk MP I assure the right hon. Gentleman that we are on the case regarding ambulances, and the Minister is leading the charge. I am interested in the facts. Is not the truth that we are treating 2,000 more patients every day in under four hours in A and E, and that we have 350 more A and E consultants? In Norfolk and Norwich hospital, people tell us that it was under Labour, with the IT issues, integration, GP contracts and working time directive that A and E became chaotic. The right hon. Gentleman’s attack is unfair, ill-judged and overly partisan.
I acknowledged that there is always pressure in A and E, but the fact is that it performed better in every month when I was Health Secretary than it has under the current Health Secretary. The hon. Gentleman mentions Norfolk again. We have been looking at the Minister’s website, which makes us wonder whether he considers himself a Minister or an observer of events in the NHS. Under the headline “Norman Lamb’s North Norfolk Ambulance Survey” he states:
“I have been campaigning over the last year to improve unacceptable ambulance response times in rural Norfolk.”
My God, this is the Minister! He is campaigning against his own Government.
I wonder whether the Minister will write to the Minister about that problem. The spin from those on the Government Front Bench may kid some of their Back Benchers, and it has certainly kidded some Liberal Democrats who I have been speaking to across the Chamber, but it will not kid patients who go to A and E and see people on trolleys, camp beds or blocked in ambulances.
My hon. Friend is absolutely right, and I would love the Government to explain that everything is fine and that there is no problem at all to more than 100,000 people who have waited more than four hours on a trolley this year, or almost 1 million people who have waited more than four hours in A and E. The complacency is not justified, and if those people were to read the Government’s motion, I am afraid, quite frankly, they would be astonished.
Perhaps I may help my right hon. Friend by saying that the campaign in North Norfolk began on the Minister’s website after the excellent campaign run by the Labour prospective parliamentary candidate, Denise Burke, who pointed out how deficient local services were—[Interruption.]
Will my right hon. Friend join me in condemning the Government for still classing A and Es as such when, like the one at Charing Cross, they are in practice closing and turning into GP-run clinics? The Government are still calling them A and Es, and people are misled. That will lead them to go to the GP-run centres when they should be going to properly staffed A and Es, and we will get tragedies such as the one at Chase Farm.
I am afraid that under the coalition, NHS treatment for “Gove-itis” is being rationed, like everything else, unfortunately. As my hon. Friend said, the Government claim they are keeping A and Es and call them “local” A and Es, but they are actually downgrading A and E units all over the country. How can it make sense to close and downgrade A and Es in the midst of an A and E crisis? In west London, as my hon. Friend knows, incredible changes are being introduced without proper regard for the evidence I am presenting to the House today of a change in A and E and of sustained pressure on A and E units. The Government must go back and consider their plans for my hon. Friend’s constituency and the rest of London.
I totally agree with the right hon. Gentleman that the last thing the health service requires is complacency, but synthetic rage does not help either. He must remember that when he was Health Secretary, and indeed a Health Minister, up to seven ambulances were queuing outside Treliske hospital in Cornwall. That problem happens from time to time and it would be better for parties to co-operate and to come together to try to find a solution, rather than simply trying to score political points and ignoring the past.
I will put forward a solution that the hon. Gentleman might support. I think he supported the campaign to oppose the Government’s Health and Social Care Bill, and I pay credit to him for that as we worked across party lines on that issue. It is my job to hold the Government to account where there are problems in the national health service, and if the Minister is saying to me that there are no problems in the health service right now, I am afraid I do not agree with him. Emergency services are under intense pressure. If he looks back to our time in government, as he invited me to do, he will see that the winter crisis was a regular feature at the turn of the millennium and the early years of the last decade, although it got progressively better and better and we did not see the annual winter crisis. Now it is back with a vengeance, although it is different. The winter/spring crisis has become a summer/autumn crisis too. The pressure is relentless and it needs a proper, lasting solution.
Would the right hon. Gentleman care to reflect on the fact that we now have 350 more A and E consultants in the NHS? Given his commitment to cut the NHS at the last election, if he is going to offer a sensible improvement, where will the money come from? How will he pay for it? That is what the people out there want to understand.
First, I would be grateful if the hon. Gentleman did not continue to misrepresent what I said on the NHS. I have never said, “Cut the NHS”. I stood at the last election on a commitment to protect the NHS budget in real terms. He stood on a manifesto promising real-terms increases for the NHS. I said that if there were to be increases for the NHS, they should be given to social care instead, and that would have relieved some of the pressures on A and E. Let us have the facts straight.
Secondly, the hon. Gentleman boasts about having enough A and E doctors. Perhaps he should speak to people from the College of Emergency Medicine and hear what they have to say on that subject. They talk of warning the Government of a recruitment crisis in A and E about two or three years ago. They said that they could not get through to Ministers who were obsessed with structural reorganisation. They were left feeling like John the Baptist crying in the wilderness—their words. Perhaps before the hon. Gentleman shouts the odds in the House, he should speak to the people who know about these things and who warned his Government —who failed to act.
One of the major problems with the pressure on A and E is the number of older people trapped in hospital. This is a product of demographic pressure and the ageing society. Nursing staff talk of how, when they first qualified, it was rare to see someone in their 90s on the ward. Now they are there in great numbers and that makes the task of meeting their needs much more complex. When people reach an advanced age it is simply not possible to separate out their physical, social and mental needs. Need becomes a blur of all three. Our hospitals are not geared up to provide the additional mental and social support that very frail elderly people often need.
I have given way to the hon. Lady once: I want to make some progress.
Some, but not all, of the needs of older people are met in an acute hospital environment, which explains why their condition often drops like a stone. It is a phenomenon that was accurately identified by Robert Francis QC in his report, published a year ago this week. He called for an overhaul of the way in which older people are cared for in acute hospitals. He was right to do so, and while I applaud some of the steps the Secretary of State has taken in that regard, such as the move towards a named consultant, I do not believe it will tackle the root cause of the problem, which is the arrival of far too many older people in hospital in the first place. Only when that is tackled will we begin to address the underlying causes of the A and E crisis.
I am grateful to the former Secretary of State for giving way, because I am concerned—especially as we are talking about not distorting the facts—by his initial analysis. He attributed part of the pressure on A and E to an outbreak of scurvy and rickets cases. I do not want anybody in my constituency or elsewhere to be unduly alarmed, so can he please put on the record what proportion of people reporting to A and E, including those who are not seen within four hours, are doing so because they have scurvy? He can give the numbers in absolute figures or percentages, but it is important that the House not be misled and that we are given the unvarnished truth.
The hon. Gentleman should climb off his high horse for a moment. In answer to an important point made by my hon. Friend the Member for Stretford and Urmston (Kate Green), I pointed to the increase in cases of scurvy, rickets and malnutrition. If he wants—[Interruption.] If he wants to deny that that is the case, that is up to him—[Interruption.] If he speaks to A and E staff, he will hear that people who are not eating properly are turning up in ever greater numbers—[Interruption.] I have answered his point and I will now make some progress.
It is the case that too many older people are arriving at hospital in the first place. A recent Care Quality Commission report found avoidable emergency admissions for pensioners topping 500,000 for the first time—[Interruption.]
Order. The exchange between the hon. Member for Liverpool, Walton (Steve Rotheram) and the hon. Member for Taunton Deane is most unseemly. I remind the latter that he is a distinguished former member of Her Majesty’s Government and he should comport himself with appropriate dignity. That is what we look for in an hon. Member who aspires to be a statesman.
The beard is certainly helping. I suggest that the hon. Member for Taunton Deane (Mr Browne) visit Liverpool Walton, because he will see more food banks there than anywhere else in the country. He will meet families who cannot afford to put enough food on the table to give their kids a decent diet. He will see the direct effects of some of his Government’s policies on some of the most deprived communities in the country.
I agree, and the last time we had a debate on this issue I quoted a well-known GP who said that she has taken to asking her patients whether they are eating properly, because many are presenting with unexplained symptoms that she cannot identify. People on several prescription medicines who are not eating properly are putting themselves at risk—
I am grateful to the right hon. Gentleman for giving way. I do not dispute that there are people who live on a small amount of money or that some of those who go to see doctors are not eating adequately. But he attributed the pressures on A and E in part—he raised the issue, not me—to an increase in the number of people who are reporting to A and E with scurvy and rickets. He made that point with all the authority of a former Secretary of State, so he should tell the House how much of the extra pressure on A and E is attributable to people who have scurvy or rickets. If he does not know, why did he raise the issue in the first place?
I began by saying that the reasons for the rise in A and E attendances were complex. I did not say—if the hon. Gentleman was listening—that there were any simplistic reasons. I did say that there had been a rise in malnutrition and diseases linked to it. If hon. Members on the other side of the House want to dispute that fact, I will have that debate any time they wish. They seek to suggest that malnutrition is not a problem, but they are confirming how out of touch they are.
As I was saying, the number of emergency admissions of pensioners has topped 500,000 for the first time. It is rising faster than the increase in the ageing population. There were 65,000 more emergency admissions in the last 12 months compared to the previous 12 months, a clear sign of more frail, elderly people ending up in A and E. Hospitals are operating way beyond safe recommended bed occupancy levels, with increasing numbers of frail, elderly people on the wards. That means that A and E finds it increasingly difficult to admit people, and pressure backs up through A and E.
The Government’s amendment seems to have been written in a parallel universe. Let us get this clear: the last 12 months have been the worst in A and E for a decade. Hospital A and Es have missed the Government’s target in 44 out of the last 52 weeks. How can that equate to A and E performing strongly, as the amendment suggests? It serves only to confirm an impression that has been building about this Secretary of State since he took office: that he seems to spend more time paying attention to spin doctors than he does to real doctors.
One problem my food bank has reported to me is that people are reducing the number of drugs they are taking because they cannot afford to buy them. There is a queue in A and E departments to register. Not only are people waiting in ambulances outside, but there are queues of people, as happened in a hospital very close to this place, waiting to be registered.
My hon. Friend is absolutely right. She knows the pressure people are under in our area. What we have heard from the Government is denial that this is the reality in many parts of the country. [Interruption.] We can hear them shouting now, claiming that it is a myth that people are using food banks and not eating properly, and that they cannot afford to heat their homes because of the rise in fuel bills under this Government. All of that is placing extra pressure on A and E, and people are waiting longer and longer to be seen.
I thank the right hon. Gentleman for giving way; he is being very generous. As he is widening the debate out to the wider economy, does he not accept that, although there are many reasons for increased A and E consultations and some of the issues relating to nutrition are valid, the point made by the hon. Member for Bolton West (Julie Hilling) about people not being able to afford prescriptions must be fallacious? They will receive free prescriptions if they have a very low income and are attending food banks. There are many more reasons than the right hon. Gentleman is giving credit for.
Not for the first time, Government Members are showing how out of touch they are with what is happening. The hon. Lady says that she is not aware that any family is unable to afford a prescription item. Let me put her straight: that is what many families are facing at the moment, particularly those who are in work, who do not get free prescriptions. They are facing difficult choices about whether they can afford to buy their prescriptions. If she is saying she does not recognise that problem, then I am afraid she really needs to get out of this place a bit more.
I did not intend to intervene, but I should say to the House and to the hon. Member for Stourbridge (Margot James) that I met recently representatives from community pharmacy associations and others who said to me, explicitly and clearly, that people from what one would assume to be relatively well-off families—middle class and relatively affluent—who are prescribed multiple prescriptions are now choosing not to pay for them because of the cost of living and the squeeze on their finances. They are choosing to go without, and that is apparent at pharmacy counters.
My hon. Friend puts his finger on it. There are families who are choosing between eating, heating or other essentials, such as prescriptions. That is the reality for many families and it is having an impact on their health. For those on the Government Benches not to recognise that that is the reality of life for many people, I fear for the state that we are in. They have been shouting at me for the past few minutes about scurvy. I can tell the hon. Member for Taunton Deane (Mr Browne) that the number of admissions has doubled. There are a relatively small number of cases, but they are on the rise. He really should not sit there barracking and dismissing the whole problem. He would do well to look at the facts.
Today, the Secretary of State says that the NHS got better in the past year. He should say that to the 131,000 people left waiting on trolleys for more than four hours. He should say that to the people finding it harder to get a GP appointment under his Government, left ringing the surgery at 9 am to be told that nothing is available. He should tell that to the families of children who have suffered a mental health crisis, but are told that there are no beds available anywhere in the country and end up being held in police cells. The truth is that the Government have failed to get the A and E crisis under control and it is threatening to drag down the rest of the NHS. In the past 12 months trolley waits are up, waiting times are up, emergency admissions are up, cancelled operations are up and delayed discharges are up, too. That is the reality of what is happening in the NHS.
One of the main reasons for the intense pressure on A and E is the collapse of social care in England. In December, a report from the Personal Social Services Research Unit found that, due to local government cuts, social care support in the home has been withdrawn from about 500,000 older and vulnerable people. These are people who were receiving support in the home, but are no longer getting any help. Even for those people still receiving some support, we continue to hear stories of corners being cut: slapdash 15-minute visits where staff have to choose between helping people wash or helping people eat. If we carry on like this, our hospitals will become more and more full of older people. A and E will be overwhelmed by the pressure and that really is no answer to the ageing society. That brings me to the second part of our debate today: the solution.
What is clear to most people is that there will not be a solution to the sustained pressure on A and E without better integration of hospital services with social care, primary care and more collaboration between the two. What is also clear is that there is now great frustration among people working in the NHS that they are being prevented from developing solutions to the A and E crisis by a large barrier standing in their way: the Health and Social Care Act 2012. This Government like to talk about integration, but the fact is that they have legislated for fragmentation. Under this Government, market madness has run riot throughout the NHS and is now holding back solutions to the care that older people need.
Will the right hon. Gentleman welcome the exact example that he so urgently seeks: Haltwhistle hospital in Northumberland? It is currently being built and I have been around it. It is integrated, with the local authority on the top floor and the NHS on the bottom floor. That is surely the model and the way forward.
I agree with the hon. Gentleman. There are examples of good practice out there, but I suggest that he speaks to chief executives of clinical commissioning groups and trusts. They are telling me that the competition regime introduced by his Government is a barrier to that kind of sensible collaboration. The chief executive of a large NHS trust near here says that he tried to create a partnership with GP practices and social care, but was told by his lawyers that he could not because it was anti-competitive. Does the hon. Gentleman support that? Is that what he thought he was legislating for when he voted for the Health and Social Care Act? People are being held back from doing the right thing for fear of breaking this Government’s competition rules.
Recently, we heard of two CCGs in Blackpool that have been referred to Monitor for failing to send enough patients to a private hospital. The CCG says that there is a good reason for that: patients can be treated better in the community, avoiding costly unnecessary hospital visits. That is not good enough for the new NHS, however, so the CCG has had to hire an administrator to collect thousands of documents, tracking every referral from GPs and spending valuable resources that could have been spent on the front line.
My hon. Friend is right. For the very first time in the history of the NHS, competition intervenes to block sensible collaboration between two hospitals seeking to improve care and make savings. Since when have we allowed competition lawyers to call the shots instead of clinicians? The Government said that they were going to put GPs in charge. Instead, they have put the market in charge of these decisions and that is completely unjustifiable. The chief executive of Poole hospital said that it cost it more than £6 million in lawyers and paperwork and that without the merger the trust will now have an £8 million deficit. That is what has happened. That is not just what I say; listen to what the chief executive of NHS England told the Health Committee about the market madness that we now have in the NHS:
“I think we’ve got a problem, we may need legislative change…What is happening at the moment…we are getting bogged down in a morass of competition law…causing significant cost and frustration for people in the service in making change happen. If that is the case, to make integration happen we will need to change it”—
that is, the law. That is from the chief executive of NHS England.
That was Labour’s law.
No, it was your law, your Government’s law, the Health and Social Care Act 2012—the same law against which his own care Minister, the hon. Member for North Norfolk (Norman Lamb), has recently been speaking out. He recently told the King’s Fund:
“I have a problem with the OFT being involved in all of these procurement issues… I think that’s got to change… In my view I think it should be scrapped in the future… That might happen at some future date… we’ve got to look at the barriers and address them and sort them out.”
Is that just his view, or the view of the whole Government? [Interruption.] He voted to let the OFT into the NHS. Why is he now changing his tune?
The former care Minister, the right hon. Member for Sutton and Cheam (Paul Burstow), said the same:
“The one area I have my concerns about is the way”—
the 2012 Act—
“opened up the role of the OFT.”
Yes, but did we not tell him that two years ago when he voted for the Act and when his hon. Friend the Member for St Ives (Andrew George), who is sitting next to him, joined us in the Lobby to oppose it? This is exactly what we warned them about. We warned them that it would let the market run riot through the NHS, but they would not listen, and that is why we are where we are today.
It is not just Ministers who are saying it; the comments by the chair of the Care Quality Commission at the weekend show the utter confusion in Government policy on competition in the NHS:
“We need more competition…more entrants into the market from private-sector companies”.
Will the Secretary of State clarify? Is that a statement of official Government policy? Is it his policy to get more private sector companies and more competition into the NHS? Is that what he wants? If that happens, it will mean more enforced competition leading to the fragmentation of care, and it will load extra costs on to the NHS at the worst possible time.
We are seeing this across the NHS. We have also seen contracts going to companies whose shareholders are Tory party donors. The closeness of the links between the Tory party and private health care is worrying.
Since April, when their Act came in, seven out of the 10 contracts let have gone outside the NHS. That is the clearest of all wake-up calls about what is happening to the NHS under this Government: it is being broken up and sold off. Under section 75 of the Act, clinicians have to put services out to tender, regardless of whether they are performing well, and that is the big difference between this Government and the last one. They are enforcing competition and marketisation in the NHS, but nobody voted for it.
Why, when the right hon. Gentleman was Secretary of State, were the previous Government prepared to pay private sector providers 11% more than NHS providers?
Let me explain the difference to the Minister. When we were in government we used the private sector in a supporting role to help bring down NHS waiting times; he is using the private sector to replace the public NHS. There is a very big difference. He might remember that as Secretary of State I introduced the NHS preferred provider policy. At the time, his party complained—it said it was wrong—but I did it because I believed in the public NHS. I believe in what it stands for, unlike him and his party.
I remind the right hon. Gentleman that, unlike him, I have worked for the NHS and understand what it is like to work on its front line. Will he confirm that the previous Government introduced private sector provision into the NHS and paid 11% more to private sector providers than to NHS providers? This Government will not allow that.
The Minister looks pleased with himself, but I am afraid he has got his facts wrong. We did not introduce the private sector into the NHS; it has always worked with the private sector to relieve pressure on waiting lists. As a doctor, he should know that. He might also know that waiting lists and times came right down under the last Government, because the private sector supported the NHS, and I am proud of how we brought waiting lists down, but he is using the private sector to replace the public NHS. He is saying that any qualified provider can provide NHS contracts. I had a policy of designating the NHS as the preferred provider. So let us get the facts straight. There is a major difference between the two positions.
I think the hon. Gentleman is referring to Hinchingbrooke, the contract for which, he will recall, was signed under his Government. If he comes to the House, he should at least have the decency to get his facts straight. A procurement exercise began under the NHS preferred provider policy that I introduced, but he will find that his Government changed that to any qualified provider, and then appointed Circle health, whose shareholders also happen to be major donors to the Conservative party, to run the hospital.
The Government are spending millions of pounds on competition advice under the regime introduced by the 2012 Act. Since last April, CCGs, have spent £5 million on external competition legal advice. How can that be justifiable at a time when we have a shortage of A and E doctors? Around the world, we see that competition not only costs more, not less, than a planned system such as the NHS, but results in more fragmentation. It will never be an answer to the pressures in A and E. We need an approach where clinicians can collaborate and develop integrated solutions to relieve pressure. How can we possibly achieve integrated care when there are several different providers, each providing a different part of the same patient pathway?
The A and E crisis will be permanent, unless the Government accept its root causes and remove the barriers to its solution. The answer is in the motion before the House. The House can vote to reverse the competition policy introduced by the Government in the 2012 Act and to remove the market madness now holding back the NHS, and it could all be done because it would be consistent with the coalition agreement. The simple fact is that nobody voted for the NHS to be broken up in this way. Who gave this Prime Minister and Government permission to put the NHS up for sale? Nobody. They said there would be no top-down reorganisation. In the fullness of time, “No top-down reorganisation of the NHS” will be to this Prime Minister what, “No rise in tuition fees” is to the Deputy Prime Minister.
The choice on the NHS in 2015 is becoming clear: it can stay on the fast track to fragmentation or it can return to its values of putting integration over fragmentation, collaboration over competition, and people before profits. That is what the Opposition believe in. Let us have that debate so that we can save our NHS for future generations.
On a point of order, Madam Deputy Speaker. In response to yesterday’s sensitive statement on Sri Harmandir Sahib, the shadow Foreign Secretary, the right hon. Member for Paisley and Renfrewshire South (Mr Alexander), made a point about documents pertaining to Lady Thatcher not being released. In fact, they were released back in January. I would appreciate your guidance, Madam Deputy Speaker, as this is a very sensitive matter, and I would hate to see it politicised.
I am grateful to the hon. Gentleman for notice of his point of order, but this is a matter for the right hon. Member for Paisley and Renfrewshire South (Mr Alexander), whom I understand he notified of his intention to raise it in the Chamber. It is not a point of order for the Chair, but he has got his concerns on the record, and I think he will have to leave it at that for today.
I beg to move an amendment, to leave out from “House” to the end of the Question and add:
“notes the strong performance of NHS accident and emergency departments this winter; further notes that the average waiting time to be seen in A&E has more than halved since 2010; commends the hard work of NHS staff who are seeing more people and carrying out more operations every year since May 2010; notes that this has been supported by the Government’s decision to protect the NHS budget and to shift resources to frontline patient care, delivering 12,000 more clinical staff and 23,000 fewer administrators; welcomes changes to the GP contract which restore the personal link between doctors and their most vulnerable patients; welcomes the announcement of the Better Care Fund which designates £3.8 billion to join up health and care provision and the Integration Pioneers to provide better care closer to home; believes that clinicians are in the best position to make judgements about the most appropriate care for their patients; notes that rules on tendering are no different to the rules that applied to primary care trusts; and, a year on from the publication of the Francis Report, notes that the NHS is placing an increased emphasis on compassionate care, integration, transparency, safe staffing and patient safety.”.
The right hon. Member for Leigh (Andy Burnham) today made some strong accusations. He talked about the worst winter in A and E for a decade. For months now, he has been predicting a winter crisis in A and E, but as ever, when we look at the facts, they simply do not stack up. Let us look at the last week available for A and E statistics, which is the week ending 26 January. Over 96% of patients were seen within four hours. At this stage in the winter, we have missed the target four times; at the same stage when he was Health Secretary, he had missed it 12 times. That is three times more. [Interruption.] He says the target is different. It is true: on the basis of advice from clinicians, the target was reduced from 98% to 95%, so let us strip out the targets altogether and just ask a simple question. How many people every day are being treated within four hours? Under him, it was fewer than 52,000; under this Government it is nearly 55,000. That is 3,000 more people every day.
The right hon. Gentleman did not just say that; he also said that people were waiting longer and longer to be seen, but that is simply not true. When he was Health Secretary, shockingly, people had to wait on average over an hour to be seen in emergency departments. With 350 more A and E consultants—as my hon. Friend the Member for Mid Norfolk (George Freeman) rightly mentioned—under this Government we have cut that to just 30 minutes. The right hon. Gentleman has the gall to stand up and criticise a record that is better than his.
In relation to those targets, the Secretary of State ignores the number of people who have not registered because they are in ambulances or because there is a huge queue to be registered. I wonder how that is factored into his claim that people are always seen within half an hour, when patently they are not.
With great respect to the hon. Lady, it was under her Government that we had the horrific tragedy of ambulances circling round hospitals because hospitals did not want to admit them in case they missed their four-hour A and E target. There is a lot of pressure in the system, but the fact is that 3,000 more people every day are being seen within four hours than when her Government were in power. That is something that A and E departments up and down the country can be rightly proud of.
I have had reason to visit my accident and emergency four times with my young son, who is 10 years old and an enthusiastic rugby and football player. On those four occasions—for a broken nose, a damaged knee, damaged ankles and damaged elbows—we were seen within minutes for pain relief and were out of A and E within two hours.
That is exactly what is happening in so much of the country. Despite a lot of pressure, our A and E departments are holding up extremely well. I wonder how the staff in that hospital would feel about the constant running down of the NHS that we get from the Opposition.
Let us look at the figures that the right hon. Member for Leigh quoted in more detail. How does he get the number he quoted for the worst winter for a decade?