I beg to move,
That this House welcomes the Government’s guidance that hospital car parking charges should be fair and proportionate; notes that some hospitals are still charging patients and their visitors excessive fees of up to £500 per week; further notes that the charity Bliss has said that parents with premature babies are having to pay on average £32 per week; further notes that for many patients it is essential that they travel to hospital by car; believes that such charges affect vulnerable patients at a very difficult time; and urges the Government to consider ways in which hospital car parking fees can be reduced.
I am extremely pleased to be able to open the debate and I am grateful to the Backbench Business Committee for making time to discuss this important issue, which has been impacting on so many constituents up and down the country. Before I go into my arguments, I must pay tribute to the work of my hon. Friend the Member for Harlow (Robert Halfon), who has done so much to highlight this issue and many others that directly impact on ordinary hard-working people. It is incumbent on all of us in the House, when people’s loved ones are ill or they themselves require hospital treatment, to ensure that the national health service makes the conditions appropriate for them to access the treatment that they need, and car parking charges get very much in the way of that. I reiterate that I thank my hon. Friend for his efforts to push this matter up the political agenda.
Hospital car parking charges have largely been abolished in Scotland and Wales, but that is not the case in England where 79% of hospitals continue to charge, often at punitive rates. For so many of our constituents driving to hospital is not a choice; it is essential. Many of them are undergoing treatment which means that travel by public transport is simply not an option, particularly when they have to be accompanied by members of their family. Members of their family will also wish to visit them if they have a prolonged stay, and they, too, should not be faced with punitive car parking charges. To put it simply, hospital car parking charges are a tax on NHS treatment.
I congratulate my hon. Friend on procuring this debate, and I congratulate my hon. Friend the Member for Harlow (Robert Halfon) on his leadership of the campaign. Does my hon. Friend the Member for Thurrock (Jackie Doyle-Price) agree that at the root of this—I come from Hereford, where hospital parking charges are reportedly some of the highest in the country—is a private finance initiative contract in many cases, which it is often almost impossible for the hospital in question to control? Therefore, there must be wider action to control PFI costs alongside hospitals to support the people whom we are trying to help.
My hon. Friend is quite right. He has done much to highlight some of the PFI contracts, the long-term consequences of which we are now having to deal with, where the contractors may have been rather more savvy in negotiating a deal that suits them rather than the patients. We must remember that the NHS should serve the interests of patients, not the providers of any contracts or services within it. I wholeheartedly agree with my hon. Friend and I hope that the Minister will consider what more can be done to challenge some of the contracts.
I congratulate the hon. Lady and the hon. Member for Harlow (Robert Halfon) on securing the debate. I think that my hon. Friend the Member for Coventry South (Mr Cunningham) was also involved in that.
The hon. Member for Hereford and South Herefordshire (Jesse Norman) touched on the heart of the problem. I was an ex-Paymaster General when the Coventry bid was pushed through as a PFI project. We have a magnificent new hospital, but people’s impression of it is not how good the facility is, but how high the car parking charges are, necessitated, unfortunately, by the PFI contract. Does the hon. Lady agree that the key point to put to the Treasury is that these PFI contracts are often too onerous to be sustained by the normal income that the NHS can expect a hospital to generate, and, in particular, the car parking fees built into that are too high?
Order. I remind Members that about 37 Back Benchers want to speak in three debates that must finish at 10 o’clock, and we must also take the Front-Bench speakers and the proposers. We need interventions to be short, pithy and to the point, and Members must be disciplined if everybody who wishes to speak is to be able to do so. Time is of the essence.
The hon. Gentleman reiterates the point made by my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman). We have all learned a lot of lessons from poorly negotiated PFI contracts. It is worth noting that in Scotland and Wales, the movement to get rid of NHS car parking charges has not been limited by those contracts, and there are ways to see those contracts through.
My friend and neighbour, the hon. Member for Hereford and South Herefordshire (Jesse Norman), has already touched on the shocking situation that we have in Herefordshire, but it is made worse by the county council putting double yellow lines almost everywhere in the city. Ambulances do have to get through, but could not more be done by local authorities to ease the burden on patients?
Absolutely. It is always a good idea for public bodies to be more co-ordinated in how they approach such matters. No hospital acts in isolation, and car parking charges are often a function of how expensive local car parking is.
I welcome the recent announcement by the Department of Health to strengthen the guidelines given to NHS trusts on the implementation of car parking charges. They include the important provision that relatives of people who are seriously ill or in hospital for a long period should also be entitled to discounted or free parking. The guidelines are clear and welcome, but they do not go far enough. It is important that the House sends a clear message to the management of NHS trusts throughout the country that punitive car parking charges are wrong and will not be tolerated.
I congratulate the hon. Member for Harlow (Robert Halfon) on securing the debate; I assisted—if that is the right word—him in that. Does the hon. Lady agree that although car parking charges are far too high for a number of groups of people—my hon. Friend the Member for Coventry North West (Mr Robinson) and I have been campaigning for years in Coventry to get them reduced—it would take the muscle of the Secretary of State to help here, because not all car parking charges are based on PFI. There are hospitals that do not have a PFI, but those charges are built into their budgets.
The hon. Gentleman makes a good point. It is crucial for the Secretary of State to give clear and robust messages about what he expects from NHS trusts. This Secretary of State has probably done more in his period of office to put the patients at the heart of the NHS. We are talking about a rebalancing of the relationship between the patient and the provider. It is simply not appropriate for NHS trusts to decide their car parking charges without considering the impact that those will have on the welfare of patients.
This debate has been part of a campaign initiated by the Opposition on rip-off Britain, and I congratulate the hon. Lady and the hon. Member for Harlow (Robert Halfon) on getting a debate on one aspect of that. I totally welcome the Secretary of State’s guidance on this matter, but we know from our local areas that some hospital trusts will gently put two fingers up to what the Secretary of State says. I very much hope that when the Minister replies he will say what plan B is for those hospitals that continue to charge excessively those who need to continue to visit their relatives in hospital.
I humbly suggest to the right hon. Gentleman, who is not backward in coming forward in expressing his views, that it is up to us in this House to challenge the leadership of our trusts where we think they are being unfair with their car parking charges. Quite frankly, we should be prepared to make lots of noise about that when it occurs.
Several hon. Members
I would like to make a little more progress.
The guidance confirms that it is up to local trusts to decide how much and whether they charge for parking but that charges should be proportionate and concessions available. I think we have all seen many examples where charging policy could in no way be described as fair or proportionate. I make particular reference to London hospitals. The Royal Free hospital charges a staggering £72 a day. My constituency is just outside London, but when some of my constituents need to access specialist treatment they are sent to London hospitals. They travel some distance and the fact that they then have to pay punitive charges to access treatment is simply not acceptable.
On the ability of trusts to make their own concessions, I want to shed a glimmer of light on an example in my own Heart of England NHS Foundation Trust. It is possible for relatives to buy 20 visit passes for £10, no matter how long they stay. All they need to do is obtain a signature from the ward sister. There are compassionate ways of treating families who need to make regular and sometimes long visits to hospital.
My hon. Friend highlights exactly the kind of initiative that we in this House would expect the local management of trusts to undertake. On having a fair charging policy, we should not have simple flat fees and expect all patients and visitors to pay them. We should be thinking about the best possible opportunities to enable patients to get better when they are being visited by their families and to access treatment without being worried about parking charges.
Does my hon. Friend agree that NHS managers could learn from private providers, which in my constituency of Redditch provide two hours’ parking for £1.20, whereas my local hospital trust charges £3?
My hon. Friend has put a very important point on the record. It illustrates again that when management thinks about patients rather than managing the accounts, it can come up with solutions that are good for the patient.
We have all had many representations from individual patients about the costs they have incurred personally. We have also heard from pressure groups. In particular, Macmillan has highlighted that cancer sufferers have found parking charges to be a very costly element of their treatment, adding significantly to the financial strain for people who are going through prolonged periods of treatment. As I have said, some of them are losing considerable amounts of earnings during that process. We need to be making it easier for them to get better and overcome their debilitating illness.
I congratulate my hon. Friends the Members for Thurrock (Jackie Doyle-Price) and for Harlow (Robert Halfon) on securing this debate. Of course, it is patients and their families who are the main people affected by this particular issue, but does my hon. Friend the Member for Thurrock agree that surely it is wrong that NHS staff, who do such an amazing job in all our hospitals, are in many cases, particularly in my area, required to pay for the parking in the area where they work, thereby reducing their own salary?
My hon. Friend raises a very important point. One objection to our campaign on parking charges is that somehow the money would be taken away from health care, but I do not believe that is the case at all. He mentions staff. In order to get the best conditions for care, we need to make it easier for people to go out and work, and access to cheap parking is very much a part of that.
I would like to make a little more progress.
These charges are a tax on the sick. They hit patients and their families when they are at their most vulnerable. It is incumbent on hospital trusts and us in this House to make sure that we create the conditions for patients to have the support to aid their recovery. Simply levying high parking charges will not aid their recovery. We all know that receiving visitors will help. We should be making it easier for them to visit their loved ones.
Will the hon. Lady give way?
I will—persistence pays!
I appreciate the hon. Lady’s giving way in this very interesting and extremely worthwhile debate. Does she share my concern that, in seeking to get profits from car parks, the issue raised by the hon. Member for Hexham (Guy Opperman) about staff being sidelined or being asked to pay more is a problem? We certainly have that problem in Derriford, where staff are now finding it very difficult to park anywhere, if at all.
Absolutely. This comes back to the issue of challenging trusts as to whether the car parking charges are fair. We have had push-back from a number of trust managers who say that it costs money to operate and maintain the car parks, partly because of some of the PFI contracts that have been mentioned. It is simply not good enough, however, for hospital trusts to pass on costs to staff and vulnerable patients when they need to be more challenging about how they manage their finances and not simply take from the patients. Nor is it enough for trusts to argue that charges are reasonable for their area. That is like writing an open cheque and allowing London hospitals to levy extremely high charges. It simply is not good enough. There is, in effect, a parking lottery in the NHS, with some patients able to access health care without any charge for parking their car, while others pay extremely handsomely for the privilege. I find that scenario completely incompatible with an NHS that should be free at the point of use.
I was shocked to discover that 74% of hospitals make more than £500,000 a year from their car parks, and even more shocked that more than 40% raise more than £1 million. I recognise that there are many reservations about the removal of car parking charges because of the amount of revenue received, but I do not buy it: I think there is lots more that hospital trusts can do to replenish any gaps that might occur in their revenue as a result of removing car parking charges.
I want to refer to my own local trust of Basildon in that regard. Some will know that Basildon has a very troubled history. It was one of the hospitals that went into special measures following the inquiry into Mid Staffordshire and it has had very high death rates. In the past year, however, since a change of leadership in the hospital trust, it has made massive advances, and it was the first to come out of special measures.
One of the things that the new chief executive has done is to recruit 200 new nurses, and in doing so she has managed to cut the pay bill because she is no longer relying on agency staff. We can all find other ways of replenishing the money that might be lost as a result of reducing car parking charges—not least, I might add, through some patients getting better quicker because they will get more visits from their families. That makes perfect sense to me.
I thank my hon. Friend for giving way and for facilitating this very important debate. One area she has not yet touched on is the impact on built-up areas such as the one surrounding Eastbourne district general hospital. The car parking charges at the DGH are really quite high, so instead of using the car park people are parking around and about, which is making it very difficult for residents. If it is done badly, it is bad for residents—
Order. Short means not many words. A large number of Members are waiting to speak. The hon. Member for Thurrock (Jackie Doyle-Price) has now been on her feet for 17 minutes. This is going to be a severely curtailed debate and Members will get only a minute or two unless we can start making some progress. Remember that interventions must be short if there are to be any more. I wonder whether the hon. Lady would consider, in respect to her colleagues who wish to speak, drawing her remarks to a close.
Thank you, Madam Deputy Speaker—I certainly will. My hon. Friend the Member for Eastbourne (Stephen Lloyd) makes a very good point. I would also add that money could still be made by reducing car parking charges but enforcing action against those who should not be using the car park.
In deference to you, Madam Deputy Speaker, I shall make my comments briefer and move to a close so that other Members can speak, but I just want to reiterate this final point. The NHS is supposed to be free at the point of use, but it is not when patients who have to drive are paying through the nose. Hospital car parking charges are a tax on the sick. We should send a strong message to the managers of all hospitals that we expect them to take steps to reduce this financial penalty on the most vulnerable in our society.
Several hon. Members
Order. I will start with a time limit of five minutes. Because we need to get through two other debates, the five-minute limit will apply to all the debates and it may be necessary to reduce it further in fairness to Members who are still waiting to participate in the remaining debates. From now on, you have five minutes maximum on the clock for speeches in this debate.
I congratulate the hon. Member for Thurrock (Jackie Doyle-Price) on securing this debate. I start with the point on which she finished, which is that the NHS is supposed to be free at the point of use. When we set sometimes exorbitant charges at different hospitals, we are effectively taxing the ill and their families.
Members have talked about the families of patients in hospital for the long term, with all the costs involved for relatives who visit them. This is honestly not a party political point, but in 2009, when my right hon. Friend the Member for Kirkcaldy and Cowdenbeath (Mr Brown) was Prime Minister, the Labour party suggested that those who had family members in hospital for a long time should get special permits to enable them to visit without having to pay each time, but that was scrapped in 2010 when the current Government came in. I ask them to reconsider that proposal. One way in which they could act very positively would be to have a similar provision such that the family of those in hospital for the long term can get and use special permits. That would certainly deal with the problem of the long-term ill.
There is another group of people whom we have not mentioned. We now have an elderly population and most older people have not just one health issue, but several health complications, so they often end up having to go to hospital to see consultants and doctors for six, eight or nine different illnesses or health issues. Each time they go, they or the person accompanying them has to pay hospital parking charges.
I give the example of my mother, who is 82 years of age. She has several different health issues, and every time I take her to my local hospital—I am her carer—it costs £3, just for five or 10 minutes. I am in the privileged position of being able to afford that, but there are many people in my constituency, who have caring responsibilities for adult and often elderly family members, who may only be on the minimum wage.
Does my hon. Friend agree that for the many elderly people who do not drive, public transport is a really important issue, just like parking charges? Is she aware that Queen’s medical centre in Nottingham is soon to have the first dedicated hospital tram stop, which will improve access for older and disabled people in particular?
I did not know about the Nottingham tram, but I am pleased that people there will have a tram stop to deal with the problem. Something like that would be brilliant in my constituency. There is a bus that goes to my hospital, the Royal Bolton, but because of its location the service is not frequent, so getting there is quite difficult. Such public transport solutions can help people as well. My hon. Friend is absolutely right that many older people cannot drive, so they also have that challenge.
Perhaps we do not think enough about the number of appointments most older patients have, as do those who are generally ill and have to go in and out of hospital for appointments numerous times. The way forward may be to abolish car park charging full stop, so that a scheme can be applied nationally. The minute we have a discretionary system and leave each hospital trust to decide for itself, some—perhaps because where they are located means they have a large parking space—can charge a small amount, such as 50p, while other hospitals that lack space because of where they are must charge a bit more. Leaving things to discretion means having, as everyone says, a postcode lottery. A better solution might be to make special dispensation, across the whole country, for those going to hospital appointments or those who are in hospital for some days.
Although I have a legal background, I am not normally an advocate for a lot more law, because it is not always a good idea to have loads of legislation. In this case, however, it is worth thinking about having legislation or a directive with the even more novel approach of abolishing such charges altogether. At the end of the day, nobody goes to hospital for pleasure; they go out of necessity and because they are unwell. Therefore, a hospital that raises £500,000 or £1 million, with all the budget it has—
To pick up the last point made by the hon. Member for Bolton South East (Yasmin Qureshi) about perhaps abolishing such charges outright, later this week the King’s Fund will publish the conclusions of the Barker commission. It is looking at several questions about the future of our health and social care system, and I am sure that it will say things about charging issues and how we pay for parking. It seems to me that such questions must be looked at in the round, and in the context of the overall resources available to the NHS, by asking how to make the best use of those resources to deliver the best possible outcome for patients.
I congratulate the hon. Member for Thurrock (Jackie Doyle-Price) on bringing this matter to the House, as she is absolutely right to do. Hard-working families face difficulties because of the inconsistent way in which different NHS trusts go about applying their policies, and it is right to highlight those that chose to see car parking as another cash cow at the expense of their patients. Hon. Members have spoken about the issue of the PFI and how it further complicates the picture—indeed, it ties the hands of NHS trusts—which is an incredibly important point. The Government need to do more to deal with the mess around PFI so that these things can be sorted out.
My right hon. Friend will know that hospital parking in Wales is free, but many of my constituents go to Hereford county hospital, which is a PFI hospital. A radiotherapy facility has just been opened there, but that fact is dampened by my constituents having to pay large parking fees.
Other Members have already quite rightly intervened to point out how exceptionally high and punitive car parking charges are in that area. If this debate does nothing else, I hope that it make that trust understand that it needs to look to its laurels, review its parking policies and perhaps introduce fairer charging for the future.
That matter relates to why I wanted to talk about what has been going on in my own patch. Back in 2010, the consumer organisation Which? published a study highlighting my local trust as a particularly bad one, including as one that was quite willing to use clamping regularly as a way to enforce its charging policies. I am pleased to tell the House—this is a model of what others could and should be doing—that the work by Which? spurred my Epsom and St Helier University Hospitals NHS Trust into action: it undertook a review, which involved its patients and carers, and its policy now reflects much of the good practice that we have already heard about in this debate. There is a discounted rate of £5 a week for out-patients who visit three or more times a week, those who are going in for dialysis, cancer patients who visit two or more times a week, cardiac rehabilitation patients and immediate family members of patients receiving intensive care or high dependency coronary or neonatal care. In other words, there is an effective policy that makes it affordable for people to visit their loved ones or to get the treatment that they need. More parking for disabled people also came out of the process. There is also a recognition that some people do not want to stay for long, but want to drop someone off or pick someone up. The trust has therefore introduced more short-stay dropping-off places. If the trust delivers an appointment an hour or more late, the parking fee is refunded. Those are the sorts of policies that other trusts could copy.
It is clear from the work published by Macmillan and others that too many trusts are not even following the guidance, let alone striving to be leaders in the field or to follow best practice. As the Care Quality Commission rolls out and refines its inspection regime for hospitals, it could do more in this area. Perhaps the Minister could ask the chief inspector of hospitals to ensure that car park charging policies are examined. For hospitals that are striving not just to pass muster in inspections, but to be leaders in their field, this is another area in which they could do so.
Finally, concessions and discounts are only part of the solution. They are only as good as the publicity about them and the public awareness of their existence. It is difficult for people to access something that they do not know exists. It is therefore important to ensure that there is information at the point of use so that people do not wind up paying more than they need to. Will the Minister look at the idea that I and others have put forward recently of a carer’s passport? Some hospital trusts already have it. It is about actively identifying more carers so that they and their families can benefit from concession and discount rates, as well as other facilities to support and ease the burden on family carers.
The hon. Member for Thurrock and her colleagues who secured this debate are absolutely right that punitive car parking charges and car parking being seen as a cash cow within the NHS cannot be acceptable, as Members on both sides of the House—judging by what has been said so far—are clearly indicating. I hope that in responding to the debate, the Minister will ensure that the NHS gets that message and changes in the ways that hon. Members are suggesting.
I rise to make a brief contribution to the debate. I congratulate the hon. Members who secured the debate. Already, we can see the value of it, not least from the way in which the last speaker drew attention to the sort of best practice that should be considered by trusts up and down the land.
In my patch, I have been very concerned about the rise in car park charges at Scunthorpe general hospital. I presented a petition to the House on behalf of local residents and patients in September 2013, which argued that the rises in car parking charges should not go ahead. At the time, the Secretary of State advised me that every trust has the autonomy to make decisions locally and that the provision of car parking for patients, visitors and staff should reflect the local situation. I am pleased that he has now gone further in the guidance that he has issued, which I hope will help people such as my constituents, who are taxed for being ill or for visiting the hospital. As the hon. Member for Eastbourne (Stephen Lloyd) pointed out, the impact on parking in the local area is also a problem for local residents. For those two strong reasons, it is important that the movement on this issue is welcomed and that it goes even further.
I believe that hospital parking charges should be abolished. The car parks in Telford and Shrewsbury could easily be managed without charges. Some people have expressed the concern that people will overflow-park in hospital parking areas. Tickets could still be issued to ensure that parking spaces are controlled, but it could be made free. The House should push the Government and the Opposition to make a commitment to abolish parking charges at hospitals in the medium to long term.
I very much agree with my hon. Friend’s point. That has been the thrust of the contributions to the debate. I hope the Minister and the shadow Minister are listening to the voice of the House, which reflects the voice of our constituents as patients and residents who live close to hospitals. Hospital car parking charges should be got rid of in the interests of better, more open and fairer access to health care. The hon. Member for Thurrock (Jackie Doyle-Price) made the point well that increasing the number of visitors increases the speed of recovery. It should therefore be welcomed and facilitated as part of the healing process.
As the hon. Gentleman knows, we share the same hospital trust. Patients are prepared to accept that more services are being shared between our two hospitals at Scunthorpe and Grimsby, but does he agree that patients face the double whammy of increased travelling costs and car parking charges at the other end?
The hon. Gentleman and I work well together on local issues such as health care. He makes the sound point that as we rationalise the way in which hospitals perform to maximise health outcomes, there will be more travelling by patients. Why should there be an added barrier to that travelling and to access? People should not have to focus on things like that, rather than on better health care, when there have to be discussions about where services will be delivered, as there have to be in north Lincolnshire. That is a sound and positive point that supports the point that was made by my hon. Friends the Members for Bolton South East (Yasmin Qureshi) and for Telford (David Wright), which is that the best way forward would be to have free car parking at every hospital as standard.
My hon. Friend makes a sound point about rural areas, but it is often difficult for people in urban areas to use public transport as well. Sometimes, people have to change buses several times to get to a hospital. If people in Telford want to go to Shrewsbury, they have to change buses multiple times.
My hon. Friend makes a sound point. The hon. Member for Cleethorpes (Martin Vickers) and I represent rural areas as well, so the point is well made and well received.
Everybody in the House wants free car parking at hospitals now, but what does my hon. Friend think we can do in the interim to ensure that hospitals stop private car parking companies targeting the disabled and those who arrive in emergency situations? None of that will stop now without proper enforcement.
I very much agree with my hon. Friend. I am sure that the Minister and the shadow Minister will take that point on board and listen to the other points that have been made in the debate. That will put pressure on hospital trusts to respond positively to the point that she has made.
I congratulate my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who has worked with me from the beginning on this debate on hospital car parking, and the many other Members who have been involved, including Opposition Members.
We face three problems on hospital car parking. First, it has become a stealth tax on the most vulnerable. It has hit parents who cannot afford to visit their premature baby in hospital. The charity Bliss states that about 30% of parents of premature babies are unable to visit their baby because they cannot afford the hospital car parking charges. Those who can afford it pay an average of £32 a week to visit their sick child. I do not want to live in a country where parents cannot afford to visit their sick children. It was never envisaged that people with cars would subsidise the national health service.
My hon. Friend the Member for Thurrock set out some hospital car parking charges. The most shocking are those at the Royal Free hospital in London, which I know because, sadly, both my grandparents passed away in that hospital. It costs £500 a week to park a car at that hospital. If there was ever an example of how hospital bosses have used car parking charges as a stealth tax, the Royal Free hospital provides it.
People say that we have to have these charges, but why is there such a wide range of charges across the country? Why do 25% of hospitals not charge at all? I am ashamed to say that my own county of Essex is one of the most expensive areas outside London for hospital parking charges. Why do so many hospitals in the north of England not charge at all?
My hon. Friend has done a fantastic job of leading this campaign. On the subject of neonatal intensive care, there is an added problem. Because of the shortage of facilities, parents often have to travel long distances and pay for accommodation in order to stay near their children overnight. It adds insult to injury that they have to pay hospital parking charges as well. This is a treble whammy, and the charges are particularly unjustified in such cases.
My hon. Friend highlights the problem exactly. It applies not only to the parents of premature babies but to people with cancer. Indeed, 10% of hospitals do not give people with cancer any kind of concession at all.
There is also a problem of transparency. No one knows why such huge increases in charges are taking place, and no one knows exactly what the money is being spent on. Southend hospital, in Essex, charges £2.50 for the first hour’s parking. It was highlighted on BBC Essex recently that the hospital had spent more than £7 million on a new multi-storey car park. Even Harrods and Selfridges would not spend £7 million on a car park. The hospital increased its charges in 2011 and raked in nearly £1.4 million in parking fees alone. It was never envisaged that hospital parking should become a cash cow or a tax on the vulnerable and the sick.
We should also remember that it is not only the patients, the vulnerable and those who are visiting them in hospital who face this stealth tax. It is also a tax on nurses, who are paying an average of £200 a month just to park their cars so that they can do their job. If we had to pay that amount to park our cars here at the House of Commons, I am sure that the practice would be stopped immediately. I also want to mention the concessions for people with disabilities. We often need a PhD to understand all the different rules and regulations involved. We need clear guidelines, and I welcome what the Government have said about this over the past week.
I want to set in context what my hon. Friend has just said about the scale of these charges. I have just checked the cost of parking at Chiltern Railways’ new multi-storey car park in Wycombe, and it is only £7.50 a day. I say “only” because that seems quite good value given that some people are paying £500 a week for hospital parking. Does he share my amazement that hospitals manage to provide so little parking for so much expense?
My hon. Friend hits the nail on the head. As I have said, this has become an easy way for hospital bosses to raise money, and there has been no dialogue with the public about it.
People say that the money could be spent elsewhere, but I believe that hospital parking is as much a front-line service as anything else. It is as important as how many nurses and doctors there are. I am glad that the Government have spent an extra £12.5 billion and that there are 3,000 extra nurses since the coalition came to power, but hospital parking is as much a front-line issue as those things and it should be put into the general pot of NHS spending. It should be taken into account in the same way as spending on nurses and doctors and on machinery. That is often forgotten.
The hon. Member for Bolton South East (Yasmin Qureshi) said that no one goes to hospital out of choice; people go because they have to, or because they have to visit relatives or friends. They should not suffer in the way that they do. They should not have to face the stress involved. Many of my constituents have contacted me to tell me of the stress they face when, having paid at the car park machine, they have to wait for a doctor’s appointment that should have been at, say, 11 but does not take place until 1 o’clock. Through no fault of their own, they have to pay extra car parking charges as a result. How can that be right? Again, I welcome what the Government have said about that.
We need to look at this as part of the front-line spending on the NHS. Estimates suggest that it would cost between £200 million and £250 million to scrap hospital parking charges. I believe that the Government should set up a special fund, possibly paid for by using more generic drugs, and I urge the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) to look at that proposal. I welcome the fact that he has listened, and that the Government have published some really tough guidelines for hospitals. I recognise that they are not the ten commandments; they are not written down on tablets of stone, and we cannot force hospitals to comply with them. They are the next best thing, however.
I put it to my hon. Friend the Minister that if hospitals do not comply with the guidelines, and that if they continue to fail to offer proper concessions to people with disabilities, to use hospital parking as a stealth tax on the vulnerable, to charge their staff for parking and to perpetuate the lack of transparency which means that no one can understand what the revenue is being spent on, we should scrap hospital parking charges completely, as Opposition Members have suggested. I hope that we are already moving in that direction.
It is an honour to follow my hon. Friend the Member for Harlow (Robert Halfon), who has been at the forefront of this campaign. I trust that, now that he has the ear of the Chancellor, he will use that power to persuade our right hon. Friend of what needs to be done. Earlier this year, I went to see the Chancellor with a delegation led by my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski), and we put it to him that hospital parking charges should be scrapped altogether. I note that it is now estimated that the cost of doing so would be £200 million. At the time, it was £90 million.
We should look at this matter strategically and say that anyone who is going to hospital for treatment or to visit people who are suffering in hospital and who need to be there for an extended period of time should be exempt from all charges. It is difficult to introduce such a policy across the country for the simple reason that hospitals are in different locations. Some are co-located with stations, for example, and have decent public transport links. Others do not, however. We need a policy whose presumption is that anyone using the hospital car park because they are using the hospital services as I have described should be able to do so free of charge.
Such a policy could be implemented by requiring people to pay on exit. They could obtain a ticket on entry and have it stamped by a ward sister or a similarly appropriate medical person in order to exempt them from paying the charge. That would prevent commuters and others from abusing free hospital parking places.
I trust that we can look at this matter as a sensible investment. We clearly cannot expect the Department of Health to find the money itself. We expect it to provide the funding for treating people who are sick. We should look to the Treasury to provide the health service with the necessary funds to enable this initiative to take place.
I completely agree with my hon. Friend that hospital parking charges should be scrapped. In the meantime, however, does he agree that when a hospital is at fault for delaying or cancelling an appointment, the patient should not have to pay more for their parking as a result?
I thank my hon. Friend for that intervention.
I was just coming on to the specifics of my area. My constituency and others now have centres of medical excellence, which means that people have to travel long distances for the treatment that they need. Many of them have to use their cars, because public transport is not an option. Over the past 18 months, I have witnessed people suffering when their appointment was delayed and they had to rush out to the car park to pay more at the pay and display machine. Such an encumbrance is unfair on people who need to receive important medical treatment, and it should without doubt be scrapped.
The guidelines should also stress strict adherence to a policy of paying on exit for the appropriate length of time spent in the car park, as opposed to using pay and display arrangements that involve people guessing how long they are going to spend in the hospital. I have witnessed at first hand people having to guess in that way and then finding that they do not need all the time they have paid for.
In my own area there is Northwick Park hospital, which is the centre at which many people from north-west London are treated, and Central Middlesex hospital, which is in the middle of an industrial estate and almost inaccessible by public transport, so anyone going there has to drive. There is no pay-on-exit facility available. In fact, the trust took away that facility and insisted that the parking area that was built for it be replaced with pay-and-display parking. It was a nonsensical decision, and I trust that the trust will review it and revise it accordingly. We also have Ealing hospital, which has a similar problem of not being anywhere near any public transport facilities. The tube lines run into the centre of London rather than radiating around the outside, so people travelling locally have to drive and use the car parking facilities.
I wish to touch on a specific case that I came across recently: Mr Francis Bacon, a registered disabled driver suffered a serious puncture while driving to a hospital appointment. He was unable to move his car, which some good samaritans pushed on to the pavement while he went to get help to change his tyre. He got his tyre changed by some good people who came and helped him and put him on his way. Sadly, a parking operative from Ealing council had come along and put a penalty notice sticker on the car, because Mr Bacon had had the temerity to park on the pavement. He could not move his car—his car was disabled, and he was disabled—yet he still got a parking ticket. Despite protestations from everyone concerned, Ealing council refused to cancel the ticket, which is typical of the wrong attitude of both local government and hospital trusts themselves. We need them to work in harmony to promote parking arrangements that suit and protect everyone. I trust that we can use this opportunity to encourage the Chancellor to provide extra funds so that we can do away with car parking charges once and for all.
I join in the congratulations to my hon. Friends the Members for Thurrock (Jackie Doyle-Price) and for Harlow (Robert Halfon). This is precisely the type of issue for which the Backbench Business Committee was established, so that we can try to alleviate the problems of people who feel their voice is rarely heard when set against a big bureaucracy.
Parking charges are an important issue because there are both philosophical and practical problems with them. Philosophically, it was never the intention that patients should be forced into a back-door stealth tax by virtue of the fact that they drive a car and need to park at a hospital. Health care has always been funded through general taxation, not patient charges, and that principle has been established by all parties. Also, surplus income has been ring-fenced for NHS activities. We run the risk of undermining the philosophical underpinning of the NHS. I accept that this is a cross-party matter, because Labour also sought to deal with it when it was in government.
In practical terms, parking charges cause real hardship for the simple reason that they are a regressive type of taxation that hits the elderly, the poorest and the sickest at the most vulnerable times in their lives. We have heard about various cases today. There are bigger issues involved in the debate, too, including our friends the West Lothian question and the Barnett formula. There is a question of fairness and equity, because people in Wales and Scotland do not suffer a similar encumbrance. Effectively, my constituents in England make a capital payment for free parking at health care facilities in Wales and Scotland, which cannot be right.
As my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) said, there is a bigger strategic financial issue to consider—the impact of the private finance initiative, particularly schemes such as that in my local trust, the Peterborough and Stamford Hospitals NHS Foundation Trust, which incidentally has a structural annual deficit of £40 million and so finds it difficult to deal with such matters. Both the Treasury and the Department of Health should consider the irreducibility and intractability of the debt encumbrance on such trusts, which forces them to seek finance in that way. I hope that Ministers will think in such wider strategic terms.
I agree with pretty much everything that the hon. Gentleman has said. One big problem is that many hospital trusts have gone into fairly long-term contractual arrangements with private sector car parking providers. Alongside the broader points that he makes about hospital funding and PFI, the Government should examine the structure of the parking contracts that hospital trusts have put in place. One of the few ways in which they can help in that regard is through national guidance. The Government should take a lead and say to hospital trusts, “You must review this.”
The hon. Gentleman is absolutely right, and he touches obliquely on another issue—that of transparency, which some of my hon. Friends have mentioned. It should not just be through freedom of information requests by my hon. Friend the Member for Harlow that we get the relevant data before us. Incidentally, my local trust substantially increased its parking revenue from £1.56 million to £1.71 million in one fiscal year. Transparency throws up some perverse practices, such as the fact that at Stamford hospital, in the constituency of my hon. Friend the Member for Grantham and Stamford (Nick Boles), a small community hospital, there is no requirement to pay for parking, but people have to pay at Peterborough hospital, which serves virtually all my constituents. I do not think that is right.
I believe that there is a direct correlation between a wider lack of NHS transparency and high car parking charges. I cannot prove that, but it is my instinct. I say that having found out only a few weeks ago that the interim chief executive of the Peterborough trust was paid more than £400,000 a year for a four-day week. He did a good job, but at some cost to the taxpayer. Parking charges fall within that narrative, because patients should be allowed to know the costs of parking and the income received from it. As my hon. Friends have said, people parking at hospitals are vulnerable, stressed and upset, and things outside their control—bureaucracy, delay, getting the wrong treatment or whatever—can mean that they have to stay at a health care facility, such as a big acute district hospital, for longer than they would otherwise have to.
My hon. Friend the Member for Harrow East (Bob Blackman) made a good point about centres of excellence. In my area, the eastern region, people have to travel 30 or 40 miles. Someone with a child who has a poorly heart might have to travel from south Lincolnshire to Addenbrooke’s hospital or other places, which is difficult.
It would be churlish not to mention the Government’s guidelines. I welcome them, but we need to be tougher and we need a fiscal incentive for trusts to do the right thing—hopefully, abolishing parking charges. We need to punish trusts if they arbitrarily disregard the Government’s guidelines. Hopefully my hon. Friend the Member for Harlow, with his legendary powers of persuasion that we have seen in the past four years, will ask the Chancellor to take the appropriate action. Ultimately, we should work to abolish parking charges completely, because they are an insidious, pernicious tax on the most vulnerable people in our society.
Some of my colleagues have talked about parking arrangements needing to change so that instead of getting a ticket at the beginning of their stay, people pay at the end. South Derbyshire has free car parking for everything, but it does not have a hospital, so my constituents have to travel to Burton, to Glenfield in Leicester or to the Queen’s medical centre in Nottingham, and they have to pay. Burton hospital has changed its arrangements, along with a company called ParkingEye, and there has been a huge outcry. Part of the arrangement is that people have to remember when they came in, and when they go out they pay according to when they came in. They do not get a card that tells them when they came in. They might be rushing to take a child into A and E, or they might be a bit elderly and have eyesight that is not so good—I am coming and going with my glasses these days, so I feel their pain. A number of constituents have come to me in absolute outrage, because when they get it wrong they get a £70 fine. I am delighted that on every occasion I have been able to appeal to the chief executive and get that fine removed, but what an incredible waste of her time and mine, let alone the angst and anger of constituents.
We love our local hospitals. Burton hospital has been going through tough times, but it is our hospital. This system has been imposed on my constituents, and I am not happy about it. Fortunately, I have a good working relationship with Helen Ashley, the chief executive, and she is trying her best for our local hospital. She has reviewed the arrangements for ParkingEye and got it to make the press button keyboards and wording on the signs bigger, and to put more signs all the way round, but still the principle applies—what a daft system! I cannot believe the hospital has ended up going down that route and think that national guidelines would be excellent. Like everybody else, I congratulate my hon. Friends on securing this debate and the Minister on setting out guidelines over the past few days. That is a major step forward, but I implore hospitals, which are there to serve the public—just as we are in this Chamber—for goodness’ sake to put the patient first.
I congratulate my hon. Friend the Member for Thurrock (Jackie Doyle-Price) on introducing the debate, and my hon. Friend the Member for Harlow (Robert Halfon) on his excellent speech and championing of this cause.
This is a huge issue in Worcester and has been for the eight years I have been banging on doors in the area. It came up regularly over the summer recess, so I apologise to the House if I am a little parochial in my arguments. As my hon. Friend the Member for Hereford and South Herefordshire (Jesse Norman) pointed out, the private finance initiative is a big part of this. In Worcester it is a big part of the problem with capacity rather than just cost, and a lot of the land that was originally intended for parking was sold off because of the appallingly bad negotiations over PFI by the previous Labour Government.
Parking is not just a problem for patients, as the motion states, but for family visiting and—as my hon. Friend the Member for Hexham (Guy Opperman) pointed out—for staff. On top of that, it is a massive problem for people who live in the local area around the hospital when staff are effectively encouraged to park for free in residential streets. I have had complaints over the years from residents of Leopard rise, Aconbury close, Darwin avenue and Linksview crescent, which are all close to Worcestershire Royal hospital, about people not being able to park outside their homes.
Charges at Worcestershire Royal hospital are not quite as high as those mentioned in the motion, but as my hon. Friend the Member for Redditch (Karen Lumley) pointed out, they still start at £3 for two hours, which is more than people are charged for parking in Worcester city centre. For many people, costs can swiftly mount up. Someone visiting for one hour each day for a week could end up paying at least £21, and information about concessions, which is badly needed, does not always reach those who need it most. The hospital trust currently makes more than £400,000 profit on its parking overall, and by contrast with the new guidelines there is no difference in charges for the disabled and other users of parking spaces. There are some reserved bays, but 52 bays out of 1,543 does not seem enough to me or most of my constituents.
As I said, parking capacity is a massive problem for staff, and it is about to become much worse because the park and ride used by many staff was, until recently, subsidised by the county council. It has had to reduce that subsidy, and the hospital trust has agreed to take it over, but only temporarily. This is an urgent time for the Worcestershire Acute Hospitals NHS Trust to review its approach to charging staff and the public.
May I reinforce the hon. Gentleman’s point about staff? Enabling nurses in particular to park near where they work means that hospitals can recruit nurses. In my constituency, if nurses live within 5 miles of the hospital, they are not able to get a parking space and have to pay high charges. In practice, most of them get on the train to St Mary’s in Paddington and work there rather than in Slough. That means that my constituents get a less good quality of care.
The hon. Lady makes an excellent point, and I welcome the fact that the Government’s new guidelines suggest a concession for staff who may not be able to get to work by public transport. That is important, but it would be so much better if the charges were not there in the first place.
Concessions for patients at Worcestershire Acute Hospitals NHS Trust are largely good. There are £1 tickets for a day, including for terminally ill patients, people undergoing coronary care and those in an intensive therapy unit or in oncology and paediatrics, but not for those who may have suffered a premature birth, for example, or have complexities during maternity leave—my hon. Friend the Member for Harlow was right to raise those issues. The concessions are also for relatives attending the bereavement office but not for other relatives. An £8 weekly ticket is available for next of kin, which most people do not know about, and there are £1 weekly tickets for renal patients and people undergoing radiotherapy, but they still have to be applied for on the wards, and only after people have paid £3 for parking in the hospital in the first place. That is one of the absurdities of the current system of charging on entry, rather than on exit as the Government suggest.
I would like much better advertising of concessions, and I think a simpler system would be good as it would be easier for people to understand. As many colleagues have said, getting rid of parking charges altogether would put us in a better place. My only worry about that would be if it disincentivised hospitals to invest in capacity, because in hospitals such as mine there is a clear need for new capacity. Lack of parking capacity at Worcester has been made worse by temporary disruption from the construction of a new radiotherapy unit—something I strongly support. Other hospitals, however, such as that in the constituency of my hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones), have delivered multi-storey car parks in time for such upgrades to their hospital, and I wish that Worcestershire Royal hospital had been able to do that. I welcome the fact that the planned breast unit at the hospital will come with its own parking, which I hope will contribute to addressing overall demand. I have raised the concerns of my constituents about hospital parking time and again, but it is right to show leadership in the House and for the Government to address the matter properly.
My final point is about accessibility and ease of payment. Asking people to pay in cash up front is unacceptable in this day and age. Worcester city centre has schemes where people can pay for parking by card or with their phone. People use those schemes; they are popular, and I urge Worcestershire Acute Hospitals NHS Trust to consider how it can implement such a scheme to make it easier for people who do not have ready cash to hand. If I take one thing from this debate it is that I hope my trust acts like that of the right hon. Member for Sutton and Cheam (Paul Burstow), and reviews its policies on these issues immediately, taking a lead from the guidance the Government have set and the arguments made in the House.
Like my hon. Friend the Member for Worcester (Mr Walker), I would like my trust to review its approach to parking charges at Hexham hospital and in the region.
I will start my short speech by pointing out that I have probably spent more time in hospitals as an acute patient than virtually any other Member of the House, and I have certainly had my life saved on two separate occasions. More particularly, I have seen on the many occasions that I was visited by family and friends the degree of worry in the wards that I was in, whether with a brain tumour or as an injured jockey. The last thing people need at such times is to worry about parking and similar matters. That is not the right approach, and it is wonderful that the House is debating the issue today—as always, full praise is due to my hon. Friends the Members for Harlow (Robert Halfon) and for Thurrock (Jackie Doyle-Price).
The direction of travel is clearly good, with the Secretary of State’s announcements over the summer, today’s discussion, and the sharing of innovative ideas. The hon. Member for Solihull (Lorely Burt) made a fair point about the alternative ways that such issues can be approached, and we all agree that at times our trusts seem not to talk to each other to develop an alternative way forward.
Northumbria NHS Trust is an outstanding trust with exemplary staff and quality service, and Hexham hospital charges are well below those of many trusts. There is free disabled parking and concessions for some patients and visitors. It has got rid of the dreaded ParkingEye that so many people complained about, but problems still remain and there are complaints not only from individual constituents but from the staff who are effectively required to use the hospital car park if they wish to get to their job. That cannot be right. I endorse all the comments about how we need to review that and change the system.
In Northumberland, we have managed to remove local authority parking charges, so a visitor to Hexham is entitled to free parking. As a consequence, the one argument the town centre hospital had for charging has disappeared. We therefore have the bizarre situation where it is free to park in the town, but expensive to park at the hospital. The Network Rail station, Marks & Spencer and the hospital are the only three organisations charging for parking in the local area, whereas in the town it is now free.
Sadly, the trust is not prepared to reduce or cancel the parking charges. We can all understand why parking charges should be imposed where a hospital is in a town centre and where, sadly, members of the public would use free parking to avoid a Northumberland county council car park or alternative private cark park—there is ample evidence for that—but we need to balance the two arguments to ensure a flexible approach. Then we can have an individual policy for the town.
In rural Northumberland, well over 90% of journeys to the hospital are made by car. Mr Deputy Speaker, you have kindly granted me a debate on rural transport in Northumberland, so you know that I shall be raising the absence of bus, train and alternative provision to Northumberland town centres this Wednesday evening at 7.15 pm. Currently, however, the harsh fact is that those journeys have to be made by car. As I have indicated, we have received many complaints from members of staff and constituents, and I endorse the favourable comments about the Macmillan report on the treatment of cancer patients and the findings of the charity Bliss which my hon. Friend the Member for Harlow outlined so eloquently.
There is a cost to this process, but if we all stopped using hospital car parks, hospitals would not benefit from the charges, so, bizarrely, unless the trusts act, all of us will attempt to boycott them and use alternative means, in which case they will be the ones facing the costs. Trusts need to review this policy in the light of their individual circumstances—town centre parking and other parking facilities in their areas—and ultimately change it, because this policy is wrong.
It is a pleasure to follow the hon. Member for Hexham (Guy Opperman). I also thank the hon. Member for Thurrock (Jackie Doyle-Price) for opening the debate in a very thorough and meaningful way. There has been a large degree of consensus across the Chamber on this important issue.
The Opposition welcome any move that could help to ease the financial burden on those suffering from illness. As said, when people go to hospital, the last thing they want to worry about is keeping the car parking ticket up to date. For some patients and their families, the costs can really rack up, and we have seen big increases in charges in recent years, adding to the cost of living crisis facing people up and down the country. In the past four years, more than a quarter of hospital trusts have increased their charges, some of them substantially, as we have heard today, and it cannot be right either if some people do not get visitors because they cannot afford the parking fees. We know that having friends and families around helps patients to get better quicker, which can save the public purse—the NHS—money down the line, as several hon. Members have pointed out.
As we have also heard, the problem extends to staff, too. In my role as a shadow Minister, I get to visit hospitals around the country. A nurse working in Liverpool told me fairly recently how unfair it was that she had to pay for parking, even when her shift ended past 10 pm. She said she often felt vulnerable when using public transport at night, yet she had to pay extra for the privilege of using her own method of transport. Even when public transport is still running, it is not unreasonable to expect better treatment when working late hours.
It is right that we debate this issue today, and I pay tribute to the Members who secured this debate and to the Backbench Business Committee for finding the time to have it in the main Chamber. I also pay tribute to Members on both sides of the House, particularly the hon. Member for Harlow (Robert Halfon), who has pushed this subject on to the Minister’s desk. Despite the consensual nature of Backbench Business Committee debates, it would be wrong of me not to point out that this issue was on Ministers’ desks back in May 2010, when the previous Labour Government left fully costed plans to phase out charges for in-patients—to be fair, the hon. Member for Peterborough (Mr Jackson) mentioned that. Our plans would have seen patients given a permit to cover the length of their stay that visitors could also use to park for free.
The hon. Gentleman also touched on the important issue of information. I do not wish to enter into a game of hospital top trumps with the hon. Member for Hexham, but in 2010 I also spent an awful lot of time in my local hospital through illness. Three weeks into an eight-week stay—my first of two long stays in hospital—my wife was told that she could apply for a parking permit. It was not advertised; somebody mentioned it in passing when she was visiting me in the high-dependency unit. Frankly, that is not on. If there are permit schemes, it should be advertised to all patients and their visitors.
We were also consulting on extending free parking to out-patients, and I want briefly to pay tribute to Macmillan Cancer Support for its campaign on this, but for whatever reasons, Health Ministers shelved our plans soon after the election. At the time, they said there were better uses of public money. I am pleased that there has been an apparent change of heart. Members can imagine my delight in the summer recess when, reading the news, I learned that Ministers had changed their minds. “Victory over parking cowboys” and “End of the hospital parking rip off”, the headlines read. I think we know it is probably not quite as simple as that. Perhaps the Minister will admit that, despite their good intentions, the Government have no power to force hospitals to follow these laudable principles and that trusts are under no such obligation. Is it not the case that all the Secretary of State has done is effectively to amend existing guidelines to suggest that some people should not have to pay to park?
One of the few changes to the guidelines is the addition of pay-on-exit schemes, which is something that we have discussed tonight and which I fully support. As we have heard, appointments often take longer than planned. However, these schemes come with their own additional costs, which was why I was interested in the suggestion from the hon. Member for Harlow of a special fund. Is the Department of Health considering that and will it be contributing towards the purchase and installation of the new equipment and software, not to mention the lost revenue from people paying less across the board?
More broadly, will the Minister confirm that there is no new money attached to the implementation of any of these guidelines? When money is tight, is there not a huge danger that some trusts will be left with the choice of either implementing the principles, which we all support, or threatening to cut back on services? That point started to come out in the arguments put by Members. Indeed, that is exactly what one hospital has already warned about. A governor at Dorset county hospital said:
“When the government makes announcements like this, it has an effect right the way along the line. The money has to come from somewhere.”
That was why I was interested in the special fund idea suggested by the hon. Member for Harlow. It needs proper consideration by the Treasury and the Government.
Is there anything to prevent trusts from no longer offering parking as part of their hospital provision and selling off any car parks they might have developed—particularly multi-storey car parks—with capital costs to a private operator? If we are not careful, that could be one of these unforeseen consequences. Forgive my scepticism, Mr Deputy Speaker, but the problem is that the Government are trying to use the carrot-and-stick approach without either a carrot or a stick. It reminds me of when a public health Minister told a crowd that the Health and Social Care Act 2012 had pretty much given away the Government’s control of the NHS. That is the real reason why I fear those headlines possibly will not match the reality, because the Government have given away so much day-to-day control that I fear they are powerless to do anything about ever-increasing car parking charges, particularly if no funding follows that. The former Health Secretary would be more than entitled to ask the current Health Secretary, “Whatever happened to operational independence?” The guidelines are not mandatory on hospitals, so what confidence can we have that trusts will pay even a blind bit of notice to the new regulations?
Members are right to raise this issue and to push the Government further on it. The aims are laudable, and anything that helps people with the squeeze on living standards, especially at a time of need, when somebody is in hospital, has to be welcome. The challenge for the Government now is actually making it happen.
I would like to begin by congratulating my hon. Friend the Member for Harlow (Robert Halfon) on securing this debate and my hon. Friend the Member for Thurrock (Jackie Doyle-Price) on her opening speech, which outlined a number of the key issues, about which we are all concerned and to which a number of Members have referred. I understand and have listened to the concerns expressed, both in this House and by the public more generally, about car parking in our NHS, especially where the cost is high and can be considered a rip-off for patients, their families and, sometimes, NHS staff. That is why we published the new NHS patient, visitor and staff car parking principles last month, which will lead to new guidelines at the beginning of next year.
Before I address those principles and respond in more detail to some of the points raised, it is important to pick up on the key issue that has been outlined—my hon. Friend the Member for Thurrock raised it in her opening remarks—which is that, for a patient, driving to hospital is not a choice; it is essential in order to receive important and, often, life-saving treatment. It is also important for relatives and those wishing to support and look after friends and others who may be admitted to hospital through no fault of their own. It is right to say, as my hon. Friend did, that Basildon was a challenged trust, but addressing the challenges of that trust, both financial and in terms of patient care, should not come at the expense of short-changing patients. There are many other measures that trusts need to look to—such as improving their procurement practices, better managing the NHS estate and, in the long term, lowering costs by reducing their dependence on temporary staffing—to balance their books and ensure that as much money as possible is directed to front-line patient care.
My right hon. Friend the Member for Sutton and Cheam (Paul Burstow) made a number of important points, including the key one that car parking should not be a cash cow and needs to be seen in the context of the wider sustainability challenge of the NHS, and that many trusts are still paying the price for poor PFI deals that they signed up to under the previous Government. He also asked what role the CQC could play in addressing the issue if parking charges were prohibitive. Of course there is a role for the CQC. If concerns were raised about patients being prevented from accessing the NHS care they needed as a result of prohibitive car parking charges, the CQC could of course make recommendations and raise that with the trust as part of its inspection regime. The power for the CQC to do that exists at the moment, and I am sure the chief inspector of hospitals will be mindful of that as part of the inspection regime.
We had many other good and important contributions, including from my hon. Friends the Members for Harrow East (Bob Blackman) and for Harlow, who spoke very eloquently and outlined clearly the reasons for calling this debate. We also heard from my hon. Friends the Members for Peterborough (Mr Jackson), for South Derbyshire (Heather Wheeler), for Worcester (Mr Walker) and for Hexham (Guy Opperman), all of whom spoke eloquently. In the time available to me, I will do my best to pick up on some of their points in my broader remarks.
We talk about the fact that there are many examples of unacceptable practice in hospital car parking, but it is important to highlight the fact that 40% of hospitals that provide car parking do not charge and of those that do, 88% provide concessions to patients. However, I am aware that there are 40 hospital sites—which is 3.6% of hospitals in acute and mental health trusts—that have charges and do not allow concessions to patients who need to access services. As a Government, we want to see greater clarity and consistency for patients and their friends and relatives about which groups of patients and members of staff should receive concessions and get a fairer deal when it comes to car parking. It is exactly for those reasons that we published the principles that will underpin the guidance that will be published in February or March next year about how we deliver fairer car parking charges, of which all trusts will be expected to be mindful.
I want briefly to outline some of the key points in that guidance. We want to see concessions, including free or reduced charges or caps for the following groups: disabled people, frequent out-patient attenders, visitors with relatives who are gravely ill, visitors to relatives who have an extended stay in hospital, and staff working shifts that mean that public transport cannot be used. Other concessions—for example, for volunteers or staff who car share—should be considered locally. The list I have given is not exhaustive—we will return to it as part of the guidance we produce early next year—but it is important that we have much greater consistency and clarity from all hospitals about which groups should receive parking concessions and free parking when that is appropriate.
It is quite clear that the Government have a model in mind of the minimum standards that hospitals should subscribe to, which is welcome. Will the next round of consultations that the Government undertake with hospital trusts outline what will happen to those that pay scant regard to what the Government are suggesting?
It is exactly because a small minority of hospital sites have no concessions at the moment, which is unacceptable and not fair to patients—I outlined 40 such sites that I am aware of in acute and mental health trusts—that we brought forward the principles and are refreshing the guidance. We need to see hospitals respond to that guidance. Powers are already available to the CQC and the chief inspector of hospitals for the CQC to take action, if appropriate, if there is behaviour in a hospital that makes it prohibitive for patients to receive treatment. However, we also need to look at what other measures we can introduce against trusts that still show disregard for the guidelines, to make it clear that doing so is no longer acceptable. For example, mechanisms are available to us when we give finance to trusts to ensure greater conditionality on that finance in future.
That is something we would certainly look at seriously as a mechanism for enforcing better behaviour, but I am hopeful, thanks to the fact that we will have refreshed guidance and that many patient groups are championing this issue at the local level. My right hon. Friend the Member for Sutton and Cheam made the point articulately that patient action locally meant that St Helier hospital, which was one of the worst offenders for car parking charges and disregarding the rights of patients and staff, has reformed its ways. Patient action has led to improvements. A number of mechanisms are already in place and, with the guidelines, I am sure we will get to a much better place across all trusts. However, if necessary, we have other measures, when we are giving finance to trusts, to put levers in place.
Does the inspector have powers to instruct the groups that will probably pay scant attention to the guidelines to make the changes that the whole House wants?
If concerns are raised as part of a care quality inspection that patients are receiving substandard care or not receiving the quality of care that they should be as a result of being unable to access services, there would of course be a role for the chief inspector of hospitals and the CQC to raise that as part of their inspection report. I am sure the chief inspector will bear that in mind for the 40 hospital sites that at the moment do not have concessions for those who are very unwell or who are disabled. I am sure that those trusts, which will be listening keenly to this debate, will bear that in mind and will want to take action, hopefully before the refreshed guidance is produced.
I know that time is pressing and I do not wish to detain the House much further, but I want quickly to outline a few of the other measures that are in place as part of the principles that will underpin the guidance, which hopefully will reassure right hon. and hon. Members that the Government have taken appropriate steps to address these issues.
Staff parking is an important issue. I probably speak as the only Member—currently, at least—who, as a practising hospital doctor, has genuine, first-hand experience of this issue. It is important to look after our front-line staff. Car parking in hospitals should not be allocated according to staff seniority or because someone happens to be a senior manager; it should be allocated according to the needs of staff and the type of care and shift patterns they provide. That is made very clear in the principles underpinning the guidance to be published.
On payments for hospital parking, our principles say that trusts should consider pay-on-exit or similar schemes, whereby drivers pay only for the time they have used, and fines should be imposed only where they are reasonable and should be waived when overstaying is beyond the driver’s control. Details of charges, concessions and penalties should be well publicised, including at car park entrances, wherever payment is made, including inside the hospital. The issue has been raised of the sharp practice sometimes carried out by the management of car parks in hospitals, and we have made it clear in the principles underpinning the guidance that those practices are unacceptable.
Finally, on contracted-out car parking—another issue raised in the debate—NHS organisations remain responsible for the actions of private contractors who run car parks on their behalf. NHS organisations are expected to act against rogue contractors in line with the relevant codes of practice, where applicable. Contracts should not be let out on any basis that incentivises fines—for example, income from penalties only. This Government expect hospitals to take action against contractors who behave irresponsibly, short-change people and behave badly towards patients, their relatives and staff.
I hope that I have reassured the House, particularly those who brought this debate before us today, that this Government take the issue very seriously and believe that unacceptable behaviour by hospitals and unacceptable hospital car parking charges will become things of the past.
I thank all Members who have participated in this debate, which, in displaying zero tolerance for punitive car parking charges, has been a rare show of unanimity. When the House reaches a consensus on such issues, it is all the more powerful.
I would like the Minister to take away the message that some examples of very bad practice have been highlighted, as well as some examples of good practice. That must be disseminated, to show exactly what we will not tolerate. Perhaps we should look more at naming and shaming trusts that are not stepping up to the plate and not doing the best for their patients. At its heart, this issue is about the relationship between patients and providers, and whether the latter are doing everything they can to put the interests of patients first. We must continue to apply pressure to ensure that they do exactly that.
Question put and agreed to.
That this House welcomes the Government’s guidance that hospital car parking charges should be fair and proportionate; notes that some hospitals are still charging patients and their visitors excessive fees of up to £500 per week; further notes that the charity Bliss has said that parents with premature babies are having to pay on average £32 per week; further notes that for many patients it is essential that they travel to hospital by car; believes that such charges affect vulnerable patients at a very difficult time; and urges the Government to consider ways in which hospital car parking fees can be reduced.