House of Commons
Thursday 23 October 2014
The House met at half-past Nine o’clock
[Mr Speaker in the Chair]
Oral Answers to Questions
The Secretary of State was asked—
The Government have an ambitious strategy for tackling congestion and improving performance on our roads, as I think the whole House would acknowledge. This autumn we will set out our plans for a road investment strategy, with £24 billion to be spent on strategic roads up to 2021. For local roads, £7.4 billion will be spent in the next Parliament, and £1.5 billion funding from the local growth fund will bring forward vital schemes.
My right hon. Friend may well have an ambitious strategy, but it does not go as far as Mid Sussex. Is he aware that particularly in the towns of Haywards Heath and East Grinstead there have been frankly intolerable delays owing to works by the utilities? I want him to take a much, much tougher line with the utilities on how they handle traffic management so that they cease destroying the trading opportunities of towns that are trying to make much better of themselves.
As my right hon. Friend knows, I was in Sussex only last week looking at these very matters. There is no end to my strategic ambitions— geographically or in any other way. He is absolutely right that we need to take a tough line in ensuring that schemes do not have undesirable or unintended consequences. I will certainly look very closely at the circumstances he describes, and he can be absolutely certain of my toughness.
The pinch point fund is an excellent and cost-effective way of assisting with schemes such as the Blackheath lane roundabout in my constituency, and I urge my right hon. Friend to continue with it. However, there are even cheaper ways of reducing congestion, such as traffic light re-phasing and, as my right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) said, proper co-ordination of road works. Will the Minister also consider requiring local highway authorities to publish weekly information on delays caused by congestion in their areas in order to give them an incentive to do something about it and to give drivers the information they need to plan their journeys?
My hon. Friend will know that Staffordshire has been provided with local pinch point funding of £4.8 million to support three schemes: the Beacon business park growth point in Stafford, which was completed on 20 June 2014; the A50 to Alton growth corridor, which is due to be completed in March 2016; and the Gungate north-south link road in Tamworth, which is due for completion in March 2015. His idea of weekly reports is innovative and interesting, and I am more than happy to take it back to the Department. Once again, he has shown that he brings to this House fresh thinking that is most welcome.
Last week we had an excellent debate in the House on cycling. It was so good, in fact, that the right hon. Member for Mid Sussex (Sir Nicholas Soames) said he was going to take up cycling, which we look forward to seeing. One of the benefits of cycling is that for every driver who moves on to a cycle, less road space is taken up. How much of the £100 million that the Minister has announced for new roads will benefit cycling?
It is a hallmark of this Government that we have taken cycling as seriously as we have, and that is in no small measure due to the work of the Under-Secretary, my hon. Friend the Member for Scarborough and Whitby (Mr Goodwill). All new road schemes must take account of cycling provision, and, although I am never unnecessarily partisan in this Chamber, as you know, Mr Speaker, I am not sure that previous Governments could have claimed that.
I welcome the Minister to his role. Congestion is, as we have heard, all too often made worse by the poor state of local roads. The Local Government Association has warned of a road maintenance “time bomb”. The Minister may think that everything is going swimmingly well, with funding competitions, which pre-date him, that rob Peter to pay Paul, but when the Public Accounts Committee says that it is
“very frustrating that the Department for Transport still has not got a grip on how it funds road maintenance”,
one might think that he would listen, so why will he not?
I always take that kind of analysis and scrutiny seriously. This Government are going to resurface 80% of roads, because we acknowledge the hon. Gentleman’s point about the effect of road condition on congestion. This Government are taking a more strategic approach, putting their money where their mouth is and listening to the kinds of arguments the hon. Gentleman has amplified.
Provisional Licences: Motorbikes/Scooters
No formal assessment has been made of the merits of granting provisional driving licences for small motorbikes and scooters. The minimum age at which a motorist can apply for a provisional licence to ride mopeds is 16. From the age of 17, motorists can apply for a provisional licence to ride small motorcycles with an engine size of up to 125 cc.
I tabled that question because I nearly killed a young motorcyclist two weeks ago. He was a Domino’s Pizza delivery boy and it was obvious that he was totally inexperienced and should not have been employed delivering around London. Motorcycle and scooter users account for 20% of fatalities on our roads, yet they represent only 1% of the traffic in our country. Something significant is happening. Can we do something about it?
May I commend the hon. Gentleman for his long-standing commitment to road safety? It started many years ago and he has done an amazing job. He will be as pleased as I am that, overall, road deaths this year are at their lowest level since 1926. Since the regime of testing and compulsory basic training was introduced in 1990, deaths and fatalities among users of small and medium-sized motorbikes have fallen by up to 60%, so the regime is fit for purpose and we are always looking to make our roads even safer.
The Department keeps in close contact with UK carriers about the whole range of threats to aviation, including the risks of flying over conflict zones. The Secretary of State recently met the secretary general of the International Civil Aviation Organisation and discussed this very issue.
Our thoughts remain very strongly with the families and friends of those who died in the terrible disaster that affected flight MH17. Since then, conditions have become even more dangerous, particularly in relation to the middle east. What are the Government doing, through the ICAO, to ensure that information about international flights is shared between domestic countries?
May I extend the Government’s condolences to the families of the 283 passengers and 15 crew, including 10 British citizens, who were killed? Indeed, at the European Council in Luxembourg, we had the opportunity to express condolences to my Dutch counterpart; a very large number of the casualties came from his country. The ICAO has set up a taskforce to look at the provision of over-flights in conflict zones, and the UK is participating actively in that work.
May I associate myself with the Minister’s condolences to the families, not least our own UK citizens? After MH17 was shot down, I wrote to the Minister in August to ask how the Government would ensure that all airlines had equal access to recommendations based on authoritative intelligence about safety over specific conflict zones. I also asked him to reconsider his reserved powers so that passengers, pilots and airline staff in the UK could have confidence in the process. His reply was that he was looking into it. After eight weeks in which conflicts in Iraq and Syria have intensified those concerns, what changes has he made?
I have already explained that work is being undertaken at an international level. Indeed, the Secretary of State has power to direct airlines not to fly over particular locations and the independent Civil Aviation Authority can issue a notice to airmen—a NOTAM—instructing pilots not to fly over those areas. Ultimately, it is up to the airline and the captain to take the decision, based on the best available information they have.
Rail Passenger Journeys
I am proud that rail in this country is doing extremely well. Privatisation has seen passenger numbers more than double to over 1.6 billion last year. Innovation in the private sector has led to more seats, faster journey times and brighter station environments, which is why there have been an extra 233 million journeys between 2011 and 2014, despite economic conditions.
The growth in the number of passengers on the railways is encouraging, particularly at Gloucester station, where figures have risen considerably higher than the national average. Does my right hon. Friend agree that the train companies have to play their part in providing extra capacity and that the 2006 decision by Arriva cross-country services to halve the number of trains stopping at Gloucester station has not helped us to grow the number of railway passengers in a sustainable way? Does he agree that that should change when the renegotiations happen?
I am always pleased to listen to the representations made by my hon. Friend to get more and better services for his constituency and the people who live in and around Gloucester. I understand the points he makes, but we have seen a massive increase in rail use. The great difference from when I was in the Department 25 years ago is that rail was seen then as yesterday’s industry. Everywhere I go now, people are lobbying for extra services, which I think privatisation has brought about.
It is good to see such expansion in the use of rail, but what action will the Secretary of State take to relieve the severe overcrowding on some routes caused by the lack of both electric and diesel trains? Is he concerned about the safety threat posed by the continuation of the Pacer trains?
As Secretary of State for Transport I have seen franchises being told to convert first class carriages to standard class carriages so that more people can travel. I think I am the first Secretary of State to do that. It was not done by any previous Labour Secretary of State, so I am very pleased about that. On Pacers, I entirely agree with the hon. Lady. We must look for better services for those people who are currently served by Pacers, possibly by improving and redesigning the Pacers, which some of the companies are looking at. It is certainly something that I am interested in.
I congratulate my right hon. Friend on the record that he set out to our hon. Friend the Member for Gloucester (Richard Graham). If he looks at the restarted franchise, which sees more passengers being put right at the heart of the process, more towns likely to come on to the network, and more seats available, does he agree that far from being yesterday’s industry, this is likely to be the industry of tomorrow and these trains are likely to accelerate?
I start by thanking my hon. Friend for all the work he did in improving and getting franchises back on the road after the difficulty that we inherited when we first entered the Department two years ago. He made a great contribution to that. I completely agree with him. As I said, all the meetings I have with various local authority leaders now are about increasing capacity and providing more and better services. The train operating companies and the rolling stock leasing companies all have roles to play in doing that.
Does my right hon. Friend agree that there could be a further boost to rail passengers if we had faster journeys on the west Anglia main line? Will he assure me that improvements to that line will not slip down the priority list?
As my hon. Friends have already said, the north has some of the most overcrowded trains in the country, and Ministers have hit passengers with stealth fare rises of up to 162%. The Department said that this will
“help reduce crowding on evening services.”
Will the Secretary of State confirm that it is his official policy to price people off the railways?
I will take no lectures from Labour about pricing people off the railways. This Government last year capped fares at inflation and have done so this year. We are the first Government to do so—the previous Government never did. The hon. Lady talks about the problem of serving northern cities and we fully accept that there are a number of problems. That is why the Chancellor has led on the question of how we improve connections between northern cities. We have to catch up after 13 years of neglect.
Road Improvements (Nettleton Bottom and Crickley Hill)
The Highways Agency is preparing a route strategy for the midlands to Wales and Gloucestershire. This includes the A417 at Nettleton Bottom and Crickley Hill, which is part of the section of the road identified as a key challenge on the route. Current options are being assessed, including major improvements, to produce an indicative business case as the basis on which to prioritise investment from 2015. I will press the Highways Agency to provide its assessments so that I can make decisions on this as soon as possible.
I thank the Minister for that response. He will be aware that the Secretary of State recently visited the area called “the missing link” and saw for himself the difficulties and dangers of that road. I know that my right hon. Friend is a very caring and a very competent Minister, and he will be very saddened indeed by the news of yet another death on that road less than two weeks ago. Will he therefore do everything in his power to bring about a solution for this congested and very dangerous stretch of road?
Yes, I had indeed heard about that fatality, and I obviously offer my commiserations and condolences to all concerned. My hon. Friend has been consistent in this campaign. In July, he asked the Under-Secretary, my hon. Friend the Member for Scarborough and Whitby (Mr Goodwill), a very similar question. I know that he has prioritised improvements to the road. I will look closely at the matter again, and we will do our very best for him.
Nettleton Bottom happens to be in the constituency of my hon. Friend the Member for Tewkesbury (Mr Robertson) and in mine. May I therefore reinforce what my hon. Friend has so adroitly put to the Minister? The recent fatality—I send my sympathy to the family—is the eighth since this time last year. This road is in desperate need of refurbishment.
I do understand that the death toll on this road is continuing to rise, and I also understand the delays that travellers are enduring as a result of congestion. I know that my hon. Friend has previously made this case, as has my hon. Friend the Member for Tewkesbury (Mr Robertson). The Department is conscious of that and of the need to do more across a whole range of roads, but he can be assured that the powerful case they have both made will not fall on deaf ears.
Inter-city East Coast Franchise
Three bidding companies are taking part in the competition for the inter-city east coast franchise, one of which is partly foreign-owned.
When I last asked the Transport Secretary about this issue on 8 May, he said that the reason Directly Operated Railways would be at a disadvantage and therefore could not take part in the competition was that it was funded through the taxpayer, yet both parts of Keolis-Eurostar are currently majority-owned by the French and UK Governments. What is it about that state-owned company that gives it an edge over our own state-owned company?
I just remember and call to mind the words of the last Transport Secretary under the previous Labour Government, who said that he did
“not believe that it would be in the public interest for us to have a nationalised train operating company indefinitely.”—[Official Report, House of Lords, 1 July 2009; Vol. 712, c. 232.]
I agree with those words, which he used when he was last in this office and had responsibility for this issue.
The tram-train pilot project, which introduces new services from Rotherham Parkgate to Sheffield city centre, is progressing. The seven new tram-train sets are being built, and modifications to the existing super-tram network and depot are well under way. Network Rail is developing its programme to modify the heavy rail network on which to run the tram-trains, including electrification from Meadowhall to Rotherham Parkgate and the construction of new platforms at Rotherham Central station. The service is due to start in 2016.
I thank the Minister for that reply because, as she is aware, that is precisely the timetable. The trams are supposed to start running early in 2016. As I understand it, Network Rail’s timetable is now slipping substantially, and there are concerns that it might slip by as much as a year. In response to those concerns, Baroness Kramer has simply promised extra scrutiny and that officials would impress the importance of the project on Network Rail. Will the Minister now get a grip of Network Rail so that it gets a grip of this project and gives an absolute assurance that the trams will start to run early in 2016, as planned?
The enthusiasm of the hon. Gentleman and the South Yorkshire passenger transport executive shows how vital that project is. He will know that it is an important pilot project. If this fantastic service works, it will liberate many transport systems in other cities. It will also future-proof the lines for the long-awaited electrification process, which we want to see on other parts of the railways. The Network Rail route director, my officials and I have made personal commitments to deliver this vital project.
Next week, the new Metrolink line to Manchester airport will open. At 14.5 km, it has been one of the biggest civil engineering projects in the country. Will the Minister join me in thanking the M-Pact Thales consortium, which has delivered the project a year ahead of schedule, as well as Transport for Greater Manchester and the good people of Wythenshawe, who have endured the disruption with good grace?
I certainly will. I also commend the hon. Gentleman and other hon. Members who came to the fabulous presentation by the Greater Manchester transport team earlier this week, where we heard about all the exciting plans for the area. It requires a large network of private and public sector innovation and effort to deliver these vital services, which are so long overdue.
Rail Electrification Programme
The electrification programme announced in the 2012 rail investment strategy is under way. The Manchester to Scotland route transferred to full electric operation in early 2014, following the electrification between Manchester and Wigan. The plan is for the Liverpool to Manchester, St Helens, Wigan and Warrington routes to move to electric operation in early 2015.
Following cost overruns on other electrification projects, Network Rail has said that it is reconsidering all electrification projects. Commuters in Chesterfield will be very concerned that that will mean delays or reductions to the midland main line project. Will the Secretary of State therefore confirm that the only review the Government are undertaking is about ensuring that they are on time and on budget next time, and not about cutting or delaying that important project?
I do not like to be party political, but considering that the last Government managed to electrify no more than 10 miles of railway in 13 years, Labour Members should not be giving any lectures to a Government who have announced plans to electrify more than 800 miles of railway. I am very proud of what we are doing. Of course there are challenges with electrification. If the hon. Gentleman pays a little more attention when he travels by train from London to Chesterfield, he will see that the work is already being undertaken.
When he looks at the electrification of the midland main line, will the Secretary of State consider extending electrification to the line through Langley Mill and Alfreton in my seat, which has been missed out of the plan? That would improve the services for those stations and the resilience of the line.
Electrification in the rest of the north-west is adding to the worry that the Furness line might lose its direct service to Manchester and Manchester airport, which is vital. Has the Secretary of State read the report by the Railway Consultancy, which was funded by businesses in my constituency through Cumbria Better Connected, and will he pay attention to the irrefutable case to keep and improve that service?
I thank the Secretary of State for a productive and useful meeting with representatives of the Peninsula rail group and West Devon local government, who are pressing hard for the reopening of the line through Okehampton to Tavistock and Plymouth, which would preferably be electrified. On his visit next week, will he examine closely the compelling case for the reopening of the line via Okehampton on the grounds of cost and resilience and of the economic benefits that it would bring to a wide swathe of economic areas?
I am grateful to my hon. and learned Friend for leading that delegation to my office yesterday. As I informed him yesterday, I am looking forward to my visit to his constituency next week and to seeing what is behind the points that he made to me. As we all saw last winter, resilience for the south-west is incredibly important, and I am determined to look at all the available options.
In May when I asked the Secretary of State about problems with the electrification of the Great Western main line, he said that
“there will always be problems”.—[Official Report, 8 May 2014; Vol. 580, c. 264.]
Will he confirm that the Great Western £1.1 billion electrification project is now a £1.6 billion electrification project, and will he say which electrification projects will be delayed or cancelled when his Department has concluded its panic review of his flagship projects?
A “panic” review of a project that is more ambitious than anything the last Government ever dreamed of? I would have thought there would be a consensus across the House for the huge investment that we are putting into the railways through Network Rail. I am working with Network Rail and it is working with me to ensure that we get the electrification programme delivered, and within an overall budget.
Rail Services (East Midlands)
The east midlands will share in the Government’s massive investment in the railways, which is so unlike what was delivered by the Labour party. Last week we announced major service enhancements on the Nottingham to Lincoln line, which will provide 24 additional weekday trains from next May. The east midlands has already benefited from investment of approximately £70 million to improve line speeds on the midland main line up to 125 miles per hour, and it will see further investment with electrification extended to Corby in 2017 and Sheffield in 2020.
Of course this wonderful Minister can do no wrong, and it must therefore have been due to an oversight of her wrongheaded advisers that in the invitation to bid for the east coast main line there was no requirement to include the through train to Cleethorpes and Grimsby via Market Rasen. Will she put pressure on the bidders to ensure that the through train that we used to have, and which is vital to our Lincolnshire economy, is included?
My hon. Friend will know that I stood on Cleethorpes seafront only last week. I rode that line myself, and I was made fully aware of the strength of the feeling about it. Bids are currently being assessed, and I am looking forward to publishing further information in December. It is clear that we need investment in those areas of the north. The previous Government let those franchises on a zero-growth and zero-investment basis, and they should be ashamed of themselves.
I thank the Minister for recently visiting Sherwood and looking at the case for extending the Robin Hood line to Ollerton and Edwinstowe. Will she continue to support that project and give us advice on how to further it in the near future?
I enjoyed my meeting with the Ollerton economic forum. The advice and support of such bodies—as well as of local authorities—help us to pull together a business case to look further at such investment. I commend my hon. Friend and his constituents for their hard work on this line.
Quality Contract Board
11. What recent discussions he has had with his Department's quality contract board. (905613)
It is for the senior traffic commissioner to make arrangements for the constitution of a quality contract scheme board. No discussions have taken place between the Department and a quality contract scheme board, but I understand that the North East combined authority considered it on 21 October, and has decided to refer its draft quality contract scheme to the QCS board.
I am grateful to the Minister for his answer; as he indicates, discussions now need to take place. In Tyne and Wear this week we took a major step forward when the North East combined authority unanimously agreed to press ahead with plans for a quality contract scheme in the north-east. Will the Minister now respect the will of the people and ensure that the quality contract board has all the resources it needs to arrive at a speedy conclusion?
The Government are committed to localism and to local people making decisions about their local services. Whether to adopt a London-style quality contract scheme is a matter for individual local authorities to determine. This is an independent process, with the scheme examined by the QCS board and chaired by a traffic commissioner. It would be inappropriate for the Government to comment or intervene, but if there are issues to do with resources for that board, we would be keen to consider them.
Large infrastructure transport projects such as HS2 and Crossrail are all very well, and quality bus contracts may help in areas such as Tyne and Wear, but when will the Government do something—anything—for rural areas that have no buses at all, or no buses at weekends and at night?
Representing a rural area, I am well aware of the problems of pensioners with concessionary travel passes but no buses to use them on when, in some cases, evening or weekend services have been withdrawn. The Government are contributing more than 40% of the farebox through subsidies to buses in various ways, and we are committed to improving local bus services wherever we can, working in conjunction with local authorities.
HGV Speed Limits
The Department for Transport commissioned the Transport Research Laboratory specifically to assess the possible effects of raising the national speed limit for heavy goods vehicles and bringing them in line with those set for other large vehicles, such as coaches and cars towing caravans. In addition, the Department conducted analysis related to the national speed limit changes using its internal well established and peer-reviewed national transport model and also considered a substantial body of existing research into the various effects of speed changes on road safety.
I am grateful to the Minister for her response, but many of us are very concerned about this proposal. The plan is to raise HGV speed limits on single carriageways when the Minister’s own impact assessment makes it clear that that is likely to increase deaths and serious injuries on our roads. I know that the Minister sometimes comes up with very good ideas, but this is daft and dangerous. I urge her to reconsider in the light of the new evidence.
No decision is taken by me—I speak as a keen cyclist and someone with young children who are out on the roads—and my Department without careful consideration of the impact on road safety. Those speed limits have been in operation since 1960, since when technology in our road traffic and HGV fleet has advanced dramatically, and deaths and injuries caused by HGVs have declined substantially. We have assessed the deaths that might occur from the change, but we have also assessed the impact of not needing to overtake platooning lorries driving far below speed limits that already apply to other large vehicles such as coaches and caravans. I suggest that the hon. Lady speaks to hauliers in her constituency, such as Williams Haulage, which deliver vital services for the country. They are investing in safe-truck technology and they really welcome the changes.
The country faces a national shortage of 40,000 qualified HGV drivers, which is acting as a brake on national economic growth. Will my hon. Friend agree to meet me and Knights of Old, a distinguished lorry operator in my constituency, and the Road Haulage Association, to see how the Government might fund a package of vocational driver training and recruitment?
I am always reluctant to make funding commitments for the Government, but it would be a pleasure to meet my hon. Friend and his constituents. This is a vital industry for Britain and a core part of economic growth, so it would be a pleasure to listen to representation about how we might improve the skills of drivers.
Taxis/Private Hire Vehicles
The Government’s principal role in relation to taxis and private hire vehicles is to ensure that the legislative framework and the guidance to licensing authorities are fit for purpose. Our best practice guidance for licensing authorities stresses the importance of adequate safety checks and enforcement to ensure that these services are safe.
All the taxis will have been licensed, albeit by a neighbouring authority. I cannot see the difference between getting into a minicab in York to go to Scarborough, so I am being driven around Scarborough in a York minicab, and a firm in Scarborough ordering a York cab for me because it is so busy owing to the success of our resort.
I urge the Government to look one more time at the provisions in the Deregulation Bill, which is currently before the Lords. In northern towns such as Skipton, taxis have been a key part of the problem of child sexual exploitation.
Last month I was pleased to announce that from December this year Shrewsbury and Blackpool will benefit from direct rail services to and from London. More generally on franchising, our programme remains on track and most recently the Department announced its intention to negotiate a three and a half year direct award on the Great Western route. On roads, we started work over the summer on a major scheme to increase capacity on the A1 western bypass around Gateshead. I can also inform the House that after its first six months of operation the HGV levy has brought in £23.4 million in revenue from foreign hauliers, substantially above the forecast.
North-east manufacturers in the port of Tyne are warning that from January the EU sulphur directive will increase shipping costs by more than 15%. These effects could be mitigated by abatement technology, but that will take time to fit. In the meantime our local businesses are suffering. Will the Government live up to their commitment to support manufacturing and offer transitional support while new technology is implemented?
T2. The Secretary of State will recall a joint letter from me and nine other of his hon. Friends urging him to restore a direct Oxford to Bristol service through Chippenham in the new Great Western franchise. Our campaign is now backed by Business West and the Swindon and Wiltshire and the West of England local enterprise partnerships. Will he meet us to consider how this could be achieved in his direct award negotiations with First Great Western? (905619)
T8. What are the Minister’s proposals for the future structures of trust ports? (905625)
The right hon. Gentleman will know that trust ports are an important part of our ports sector. They have no shareholders and plough their profits back into the port for the benefit of stakeholders. Since the modernisation of trust port guidance was published in 2009 a lot of work has been done, but I think it is time to re-evaluate the current effectiveness of trust ports and to update our guidance. A trust port study is therefore being undertaken to look at these matters. Officials are working closely with trust ports to that effect.
T3. The local growth deal recently announced a much needed new bridge over the River Mersey in Warrington. I thank the Minister for his support on that but ask that he continue to support the need for a second bridge over both the Mersey and the ship canal, which is a strategic priority for the local enterprise partnership. This will make a much needed difference to the town. (905620)
Local growth deals across the country have been a great success in supporting local priorities. A second crossing in Warrington falls firmly into the category of a local priority, and the purpose of the local growth fund is to reflect those strongly.
T10. Only a third of the infrastructure projects trumpeted by the Government will have actually started by 2015, and the A14 fiasco probably sums up the Government’s record on roads. When will the Government end the delays and re-announcements and start to deliver the infrastructure our country needs? (905627)
I would put the infrastructure record of this Government alongside the infrastructure investment of the previous Government any day. It would be shown to be far more substantial than anything ever planned by the previous Government. I have had the solid support of both the Prime Minister and the Chancellor of the Exchequer in making sure we have available funds for infrastructure.
I thank the hon. Gentleman for that question. This is a matter for local authorities, and of course they are keen to reduce the carbon footprint resulting from having needless lights on. The experience around the country is mixed. In fact, some local authorities have shown that turning off lights does not detract from road safety.
A large gauge rail freight network capable of carrying lorries and lorry trailers on trains is being developed across the continent of Europe. In Britain, such traffic can only reach as far as Barking from the channel tunnel, so Britain is being left behind on these developments. Will the Secretary of State look seriously at proposals to develop such a rail freight network in Britain?
The hon. Gentleman speaks with passion on this subject and has led the campaign for some time, but I have to say he has not succeeded in persuading me, just as he did not succeed in persuading the last Government, on this matter. However, I am pleased that over the last 10 years we have seen a 60% increase in freight on our railways, and I will do everything possible to encourage the freight industry to transfer more of its freight to rail, because it is in the long-term interests of this country. HS2 will also allow us to concentrate on that.
T5. I thank the ports Minister for visiting the trust port of Dover last week. It was great to have a people’s Minister come to see the rise of a people’s port at Dover. Does he agree that community directors should be appointed by the community to deliver for the community? (905622)
It is generous of my hon. Friend to describe me as the people’s champion. I have never sought acclamation, but it would be negligent not to step up to the mark. I was delighted to visit Dover last week, to see once again the white cliffs and to be reminded of this
“precious stone set in the silver sea”.
He is right that the link between the port and the community is vital, and community directors are critical to that. I share his view about the importance of investment in linking the port to the town, particularly in the western dock, and about the significance of community directors. He has my full support, as does the port.
Ministers will know that the growth in rail usage in recent years is unevenly distributed across the regions. London has seen the highest growth and the most journeys, which has a knock-on impact in the form of overcrowded trains. What percentage of national investment in rolling stock and infrastructure will go into London commuter services over the next decade?
I do not have those numbers directly to hand, but I am sure the hon. Lady will be reassured to know that under this Government the overall transport infrastructure spend outside London is higher than it was under the last Labour Government. I shall instruct my officials to see whether we can get the data on rolling stock, but I am sure that she, like me, will welcome the fact that the £40 billion we are spending across the country is benefiting all parts of the country. If I could just—
T6. The roads Minister, my right hon. Friend the Member for South Holland and The Deepings (Mr Hayes), from whom I anticipate an excellent answer and whom it is always a pleasure to welcome to my constituency, will be aware that the M55 link road received £2 million of Government money as part of the regional growth fund announcement. Will he meet me to ensure that the work on this vital road begins in 2015, as planned? (905623)
A few days before her appointment, the rail Minister wrote to her predecessor about proposals that direct services to London from Bedwyn and Pewsey would cease as a result of electrification proposals that she described as “mad”. Will she tell the House whether she has now received a reply from herself, whether she has had an opportunity to read it and whether she agrees with herself?
The hon. Gentleman has rightly pointed out that one of my important local campaigning priorities is the maintenance of those vital direct links, but as he will know, as a former Minister, owing to ministerial propriety I can no longer directly comment on or investigate those links. I am delighted to say, however, that electrification and investment on that network is an important priority for this Government.
T7. I am grateful for the private reassurances given to me by the Minister, but he will know that Lincolnshire county council has wrongly decided to close Hawthorn road over the new eastern bypass around Lincoln. Under pressure, it is now opening a footbridge, which I am glad to say one can bring a horse across, but unfortunately not many of my constituents have stables at the back of their gardens to access Lincoln on a horse. Will he please put pressure on the county council to put a proper bridge over the bypass so that we can have access? (905624)
Few are greater champions of rural roads than my hon. Friend, and he knows that I share his passion in that respect, particularly in Lincolnshire. I will happily organise a meeting between the county council, him and myself to take up the very matters he describes.
Leader of the House
The Leader of the House was asked—
Preventing Sexual Violence in Conflict
We have now started the work on delivering commitments from the June global summit to end sexual violence in conflict. Members of the UK team of experts have been deployed to Mali and to the Syrian borders, and shortly we will also deploy an expert to Iraq.
I welcome my right hon. Friend’s answer and all the work he is doing in this most important area. In the International Development Committee report of June last year, we recommended that the UK Government make the prevention of violence against women and girls a priority in the response to humanitarian emergencies and that UN peacekeepers should be trained in preventing and responding to such violence. Will he kindly update us on progress?
It is a very important priority of the work we do on this to encourage other Governments and international organisations to incorporate the prevention of sexual violence into military doctrine and training. I think we are making progress on that—in the EU, for example, by ensuring that the prevention of sexual violence is included in all common security and defence policy missions. We are also supporting the efforts of the African Union and the United Nations to ensure that there is zero tolerance of sexual exploitation and abuse committed by UN and African Union personnel in peacekeeping missions. We will keep up this work.
May I pay tribute to the extraordinary personal commitment of my right hon. Friend to this agenda and say how much I think it is appreciated across the House? Will he tell us what specific action he has taken to address reports—horrific reports—of violence being perpetrated against women and girls in ISIS-controlled areas of Iraq and Syria?
This is the latest appalling demonstration of the importance of this issue. Crimes against humanity are being committed by ISIL in Iraq and in Syria. The UK is providing £23 million in humanitarian aid, including aid that meets the specific needs of displaced women and girls. We are sending an expert to Iraq to look at what we can do to work with the Iraqi Government to help prevent sexual violence in conflict, to punish those responsible in the future and to provide more assistance for those affected.
While the status of oral questions is, of course, kept under review, there are no current plans to change the policy so that topical questions may be asked of the Secretary of State for Northern Ireland.
I thank the Minister for his response. He will be aware that there are occasions, particularly in Northern Ireland, when urgent matters need to be discussed and that that has sometimes proved problematic. I ask him to reconsider the possibility of perhaps allowing 10 minutes to be given over to topical questions in each session.
I guess that one of the issues with topical questions for Northern Ireland is that matters are often more complex because of devolution. Mr Speaker has rightly been generous in allowing urgent questions, which provide another route for consideration of urgent matters in Northern Ireland.
I very much support the proposition put forward by the Chairman of the Select Committee on Northern Ireland Affairs. The Democratic Unionists very much support the introduction of topical questions and urgent questions for Northern Ireland matters. I do not accept the argument about complexity: every Department has complex issues to deal with and Northern Ireland issues are no more complex. I thus urge the House authorities and the Government to consider this very carefully.
I am afraid that I am not in a position to change my earlier response. Urgent questions provide a route to raise urgent matters. The complexities of devolution are a fact, which makes it more difficult for Members to ensure that their question is pertinent to topical questions and is one to which Ministers can respond.
I support calls for topical questions for Northern Ireland but also a review of topical questions in general and, in particular—despite the great skills of Mr Speaker—the almost impossibility of fitting in all the topical questions to the Deputy Prime Minister.
My hon. Friend will be aware that the time set aside for topical questions to the Deputy Prime Minister was extended owing to demand. The issue is that we have a limited amount of time in this House available for questions and extending questions in one area inevitably means cutting them in another.
The House performs its functions effectively in September just as it does in other months of the year.
Before anyone gets too excited, may I just make it clear that I am not suggesting that we have fewer sitting days? September sittings were introduced early in the 2000s but ignore the facts of the party conference season, which was originally at the end of September and into October because of the availability of cheap rooms in seaside resorts. That is no longer an issue for parties. Have there been any discussions about bringing party conferences forward in September so that we can avoid this very expensive two-week period when the House is brought back to life?
The Deputy Leader of the House is responsible for a limited number of things and party conferences is certainly not one of them. Members would agree that the September sittings that we have just had were essential. We debated some essential matters and there might well have had to be a recall of Parliament had we not had those sittings. I was pleased to note that on Friday 5 September there was the largest turnout of Labour MPs ever—subject to my being corrected by the Labour Whips—on a private Member’s Bill. I was pleased to note that the hon. Gentleman’s name followed mine in the list in Hansard of those who voted.
Has the institution of September sittings made any difference at all to the total number of days per year on which the House sits? What does my right hon. Friend calculate the cost to be in terms of the interruption of maintenance works and the inconvenience to all people on the Parliamentary Estate when certain facilities are not available at that time?
The number of days has not changed as a result of September sittings. Were we to abolish them, if that is something for which Members are pressing, we would simply have to make that time available elsewhere. The additional costs are marginal; I understand them to be of the order of £200,000 for that period.
Whatever the arrangements are for possibly changing the times of conferences, is the Deputy Leader of the House aware that it would be totally unacceptable to return to a situation where the House did not meet for nine or 10 consecutive weeks? In the past many of us urged that that should be discontinued and I am pleased that it has been.
I do not think the hon. Gentleman and I often see eye to eye on matters in this House but on that point I am in total agreement with him. The public and indeed Members of Parliament would consider it strange that for a very extended period during the summer we are not sitting and there were not opportunities to raise important matters in this place.
Is not the real problem that the two Houses are now completely out of sync with each other, with the House of Lords sitting until the end of July and not now coming back until mid-October? Will the Leader and Deputy Leader of the House speak to their counterparts about trying to realign the two Houses, thus not only saving money but improving parliamentary scrutiny?
That is a valid point and I am certainly happy to follow it up. Often the Houses are not synchronised in terms of the progress of Bills in any case, but the hon. Gentleman has raised an important point. It is certainly worth seeing whether the timetables could be synchronised if that had a significant impact in reducing the costs of running Parliament.
House of Commons Commission
The hon. Member for Caithness, Sutherland and Easter Ross, representing the House of Commons Commission, was asked—
May I begin my answer by reiterating, on behalf of Members on all sides of the House, the gratitude for the excellent work of all those who serve us at every level in the House service? More specifically, as part of the current three-year pay agreement for the main pay groups, there is a commitment to review the existing performance management arrangements and to introduce a new system that can reward staff based on their overall contribution, including service to Members. In addition there are also a number of non-financial ways in which staff who provide excellent service can be recognised and rewarded. One particular example is through the regular “thank you” events that are now held by the acting Clerk.
That all sounds fine and good, but should we in this House not be trying to be a model employer, and a model employer would not employ lots of people on short-term contracts to substitute full-time employees with agency staff? Also, surely we should be an employer that can boast that our staff have the highest morale and highest commitment. They do have the commitment, but the morale is going down week after week, and early retirements of good, valued members of staff is the result.
On morale, the most recent staff survey shows that 84% of the staff spoken to would recommend the House of Commons and PICT as a good place to work, and that is up on last year’s 76%, so I think that actually morale has been improving, particularly since we have come to a settlement on pay and other matters. With regard to contracts, I would point out that the House, in its endeavours to become a model employer, has got rid of zero-hours contracts and some of the people who were on zero-hours are now on contracts that are appropriate to the work they do. The House always looks to produce the best contract for employees and to retain its staff. We do not always succeed as best we can, but we certainly always endeavour to do it and will continue to do so.
That suggestion has been made from time to time, most recently and specifically by the hon. Lady, who suggested a rescue cat or two from Battersea Dogs and Cats Home in our exchanges on 6 February. The idea has a clear appeal and has therefore been given full and proper consideration by the House authorities. However, that consideration showed that there are very clear practical and technical difficulties, and therefore this has led to a decision not to accept the generous offer.
I am grateful for the full reply and the fact that the Battersea Dogs and Cats Home has offered a rescue cat. It is a matter of fact that the mouse population is spiralling out of control, particularly in areas where food is being prepared, which poses a clear health hazard. Will the right hon. Gentleman review his decision and, using the same model adopted by Nos. 10 and 11, consider having a rescue cat that can be released in the evenings to keep the mouse population under control? If mice can be close to the source of food and pose a health hazard, one would think it would be perfectly sensible to introduce a cat to keep the mouse population down.
The hon. Lady has made reference to the significant rodent problem in this place, and measures are being taken to combat that through pest control. On the possibility of having a cat, given the scale and size of the estate, it would be necessary to have a great number of cats to make any real impact, and having a herd of cats on the Parliamentary Estate would present a number of difficulties. I am also advised by my own Chief Whip that herding cats is quite difficult.
Leader of the House
The Leader of the House was asked—
Following a resolution of the House on 8 May, my office has been working with the Procedure Committee on a collaborative e-petition system. Details of what the new system will look like and how it will operate are still being discussed and developed. However, I can assure Members that before the end of this Parliament a set of proposals for a new e-petition system will be brought before the House for debate and decision.
I thank my right hon. Friend for that answer. My constituent John Clough has sponsored a petition on the change.org website calling for a stalkers register that so far has attracted over 120,000 signatures. Could well-supported online petitions such as Mr Clough’s hosted on sites other than the official e-petition website play a role in influencing the debates here in Parliament?
Clearly the petition of the hon. Gentleman’s constituent John Clough can indeed play a role in influencing Parliament, in that the hon. Gentleman has a number of opportunities to raise it, such as through Adjournment debates, and the Backbench Business Committee remains an option to raise petitions not just on the e-petition site, but any other site.
The Government intend to set up a petitions committee, whose purpose will be to allow a greater airing of petitions and to give advice to people seeking to table petitions. The committee will be able to consider petitions of any size, so the threshold will be completely flexible.
Five Year Forward View
NHS England, along with other NHS organisations, has today published its independent “Five Year Forward View”, which sets out its view of how the health service needs to change over the coming years. It is a report that recognises the real challenges facing the NHS, but it is essentially positive and optimistic. It says that continuing with a comprehensive tax-funded NHS is intrinsically do-able, and that there are
“viable options for sustaining and improving the NHS over the next five years.”
The report says that the challenges of an ageing population can be met by a combination of increased real-terms funding, efficiencies and changing the models of care delivered. It also says that
“decisions on these options will need to be taken in the context of how the UK economy overall is performing.”
In other words, a strong NHS needs a strong economy.
The report proposes detailed new models of care, putting out-of-hospital services front and centre of the solution, delivered through greater integration between primary, community and specialised tertiary sectors alongside national urgent and emergency networks. These can help to reduce demand significantly for hospital services and give older people in particular the personal care that we would all want for our own parents and grandparents.
The report talks about continued opportunities for efficiency savings driven by innovation and new technology, and suggests that they could be increased above the long-term run rate of efficiency savings in the NHS. It talks about reducing variation in the quality of care, in the wake of the tragedy in Mid Staffs, and about how the new Care Quality Commission inspection regime is designed to drive up standards across the system. It says that to do this we will need to move to much greater transparency in outcomes across the health and social care system. Finally, the report makes important points about better integrating the public health agenda into broader NHS activity, with a particular focus on continued reductions in smoking and obesity rates.
The Government warmly welcome the report as a blueprint for the direction of travel needed for the NHS. We will be responding to its contents in detail in due course, but we think it is an important contribution to the debate. We are proud of how the NHS has coped with the pressures of financial constraint and an ageing population in the last four years, but we also know that to sustain the levels of service that people want, the NHS needs to face up to change—not structural change, but a change in the culture of the way we care for people.
Given that the report has been welcomed on both sides of the House, I also hope that this can be the start of a more measured debate about the future of the NHS in which those from all parties in the House recognise our shared commitment to its future and focus on the best way to achieve the strong and successful NHS that the whole country desires.
A five-year forward view for the NHS, involving more than £550 billion of public spending, briefed to the media but not to Parliament—what clearer illustration could there be of the serious loss of public accountability arising from the Government’s reorganisation? The Secretary of State is in his place today only because he was dragged here by us. I do not know who runs the NHS these days, but I do know that it is certainly not him. We know why he wants to distance himself from this report: because it endorses key planks of Labour’s plan and leaves him with big questions to answer.
First, on GP services, does the Secretary of State agree with the report that primary care has been under-resourced and that people are struggling to get appointments? Will he accept its recommendation to stop his cuts to the GP budget, stabilise funding and match Labour’s plans to recruit 8,000 more GPs?
Secondly, on cancer, the report makes it clear that “faster diagnosis” is needed—we agree. So why did the Prime Minister yesterday dismiss Labour’s proposals for one-week cancer tests?
On integration, the report endorses Labour’s vision for new models of care, including hospitals evolving into integrated care organisations with more salaried GPs. Can the Secretary of State tell the House why he has spent the last few weeks attacking that plan, and is he now prepared to drop his opposition? On public health, is the report not right that the time has come for radical action on obesity, and will he now concede that his voluntary responsibility deal is simply not working?
It will not have escaped people’s notice that the report does not give one mention to competition—that is because it creates fragmentation, when the future demands integration. So will the Secretary of State commit to reviewing his competition rules and vote with Labour in four weeks’ time to repeal them?
Finally, on funding, the report could not be clearer: simply protecting the NHS budget in the next Parliament, as the Conservatives propose, will not prevent it from tipping into a full-blown crisis. As the hon. Member for Totnes (Dr Wollaston), the Chair of the Health Committee, has said, current Tory funding plans raise the spectre of rationing, longer waits and charges. Will he now drop them and match Labour’s plans for more money for the NHS? Labour has set out its plan, and today the NHS endorses that plan. The big question people are asking is: where on earth is his?
I talked about having a more measured debate, but I think I was speaking a trifle too soon, judging by what we have just heard. The right hon. Gentleman obviously was not listening to what I actually said, so let me just repeat to him that the Government warmly welcome this report. I talked about it as a “blueprint” for the future. He did not agree with setting up NHS England, and I do not think he agreed with the appointment of Simon Stevens as the chief executive, but we did that so that we would have a body that would think strategically about the long-term future of the NHS at arm’s length from the Government. That is what it has done, and the report is excellent.
The right hon. Gentleman and I have a sometimes slightly fractious relationship, but I would like to congratulate him this morning on his Houdini-like spin in the way he is approaching this report. He has been constantly telling this House that the NHS is on the point of collapse, but the chief executive of NHS England says that the NHS has been “remarkably successful” in weathering the pressures of recent years. The right hon. Gentleman has told this House constantly that the biggest threat to the NHS is privatisation and competition. This report, a five-year forward view, by bodies at arm’s length from the Government, contains not one mention of competition and privatisation as a threat, yet he says this report endorses Labour’s plans.
The right hon. Gentleman says, as has his leader, that the first thing he would do in government is repeal the Health and Social Care Act 2012 and strip clinical commissioning groups of their powers. He really should read the report carefully on that. He now says he welcomes the report, but it begs him not to carry out further big structural changes; it does not call for the repeal of the 2012 Act, and this is the report which he warmly welcomes today.
Then we need to consider money. The right hon. Gentleman told this House repeatedly that it was irresponsible to increase spending on the NHS, but now we have a report that says that the NHS needs real-terms increases, along the lines that this Government have been delivering in this Parliament. What does he say? He says, “It is great to have our plans endorsed by NHS England.” This report does not endorse Labour’s narrative; it exposes it for the shallow party politicking that we have had from him.
Let me say to the right hon. Gentleman that the really important message of this report is something we can agree on, and he should be talking about that. We both agree about the integration of health and social care, which is now happening. We both agree about improving investment in primary care. We both agree that we need more GPs. We both agree that we need more care closer to home. I think the public would say that we would have a more measured, intelligent and sensible debate—the kind of debate they want to hear—if we started talking about the things we agree on a bit more instead of constantly pretending there are vast disagreements.
My right hon. Friend has welcomed this report, which says, among other things, that there have to be new ways of working and breaking down barriers. The Royal London Hospital for Integrated Medicine—part of the University College London Hospitals NHS Trust—which is about a mile away from here, is Europe’s largest public sector provider of integrated medicine. Will he go there and see its 13 care pathways, which use qualified complementary and mainstream practitioners, because then it will be clear to him how we can reduce costs in the health service and take the pressure off practitioners? Will he make that part of his package?
I congratulate my hon. Friend on finding every opportunity to promote integrated care. What the report says is that we need much more person-centred care. It welcomes the kind of models that we see in Tower Hamlets, where the new clinical commissioning groups, led by inspiring leaders such as Sam Everington, are carrying out social prescribing. GPs are actually prescribing social solutions to problems as well as medical ones. This report is a big stepping stone towards that type of integrated care.
I welcome the hon. Lady to her place. This report says something with which this Government very strongly agree, which is that we need to reverse the shift that there has been over many decades of investment away from community care towards hospital care. It is really important that we focus on the role of GPs. We do not want to force all GPs to become employees of hospitals, but we would like to back them, so we have brought back personal responsibility for GPs for every single NHS patient as an important first step in that direction.
This is an important report, which must not turn into another political football. We should focus on what it says and make that the basis for a real debate about our NHS. There are 23 references in this report to mental health. Parity of esteem is an established idea, but it has not yet been incorporated into NHS practice, so we still have further to go. Does the Secretary of State agree that another area in which we need to go further is perinatal mental health, where the cost to society, to mothers and to generations runs into billions? If the NHS could do a bit more in that regard, it would make a big difference.
My right hon. Friend is absolutely right. We know that perinatal mental health problems have a big impact on the child as well as on the mother. This report says that we must stop looking at conditions such as mental health as separate to physical health conditions. We need to look at people’s whole condition in the round. If we start to do that, we will make the NHS sustainable by making the kind of investments that will bring down the overall cost of treatments. Putting mental health centre-stage in that approach will be an important part of our strategy.
The NHS has been a political football ever since the 1947 Government decided to take it under public control. The Tories fought against it then, and they have fought against it ever since. The important thing to remember is that this report does not commend the Government for carrying out their reconstruction of the health service, which has cost billions. What we did when we were in power for 13 years was increase the amount of money for the health service from £33 billion to £100 billion—a threefold increase in real terms. Had we continued with that approach over the past five years, people would not be dying of cancer because they had not been tested early enough. The Tories talk about all-party agreement, but it is high time that they understood that since 1947 the Secretary of State and his posh people on millionaires’ row have opposed the very essence of the health service, which is why it will be the biggest political issue at the next election. It will also help us to win and get this lousy mob out.
I think that is the kind of rhetoric that does the whole country a massive disservice. If the Government had the kind of views about the NHS that the hon. Gentleman talks about, we would not have protected its budget during the most difficult recession we have had since the second world war. We actually increased the NHS budget over that period, because we believe in the NHS. With regard to what he says about the report, the chief executive of NHS England, a former Labour special adviser, said this, and it is a fact: “Over the past five years, despite growing pressure, the NHS has been remarkably successful.” That is what Labour people are saying.
I very much welcome the plans for urgent and emergency care set out on page 4, in paragraph 10, which ought to produce a solution that could be welcomed in Wycombe hospital and more than 20 similar hospitals across the country. When the proposals are taken forward, will my right hon. Friend ensure that they are explained to people in such a way that they can have real peace of mind that urgent and emergency care will be there for them?
My hon. Friend, as ever, makes an important point. I do not think that we have been as good as we should have been in the NHS about explaining changes to urgent and emergency care, and people are understandably worried if they think that there is any risk that they will not be able to see a doctor in an emergency, which is what the NHS is there to do. I think that we now have a better blueprint for urgent and emergency care, but the report also recognises that it is not sustainable to say that all urgent and emergency care will always be dealt with in A and E departments. We have to find a way to improve the capacity of primary care and make it easier for people to see their GP so that we can reduce the pressure on hard-pressed A and Es.
Will the Secretary of State take on board the fact —I invite him to visit Calderdale and Huddersfield NHS Foundation Trust to have a look—that the reforms that his Government introduced have fragmented the health service? It is very difficult to find in the health service one common purpose or one common voice. The fact of the matter is that whether it is A and E closures or NICE—National Institute for Health and Care Excellence—prescriptions being handed down by GPs, everywhere I try to find an answer, instead of one voice, one team and one leadership, I find fragmentation and no real positive movement.
Let me try to reassure the hon. Gentleman. The reality is that those reforms, by getting rid of the huge bureaucracies of the primary care trusts and strategic health authorities—19,000 administrators—have allowed us to hire an extra 10,000 doctors and nurses. We are doing nearly 1 million more operations every year. I will write to him with the details, and I think that he will find that there are more nurses and doctors employed in his constituency now than there were before the reforms.
May I thank my right hon. Friend for appointing me to be the Government’s pharmacy champion? What role does he perceive pharmacies playing in this, because I think that they are an important part of the whole NHS?
I had a very enjoyable evening at the pharmacy business awards last night. Pharmacies have an important role to play, because they could save a significant number of A and E and GP visits. The single most important change—my hon. Friend and I have talked about this—is to make it possible, if a patient gives permission, for pharmacists to access their GP record so that they can see their medication history and ensure that they give them exactly the right drugs.
In the light of this report, is it still the Government’s case that the emerging English hospital trusts’ deficits can be dealt with by efficiency savings alone?
The Government believe that the NHS has to live within its means, as do individual hospitals. We recognise that that is challenging, and one of the reasons it is challenging is that in the past it has been too easy for hospitals trying to balance their books to cut corners, for example on nursing numbers in elderly care and dementia wards. We have a new inspection regime that has made it much harder to do that, which I think is a good thing, because it means that older people are getting the care they need. It also means a harder road to getting those deficits under control, however.
Page 26 of the document refers to
“an equal response to mental and physical health”.
Despite my right hon. Friend’s good leadership on this topic, I suspect that the document’s authors do not operate an equal funding formula for mental and physical health. Can my right hon. Friend give me any guidance on that?
We are looking at the issue very closely, and I think that we have made very good progress. We have introduced maximum waiting time targets for some mental health conditions, which has never been done before, and we have made a clear commitment to applying those targets to all mental health treatment during the next Parliament. However, my hon. Friend is right: ultimately, we need to look at funding differently. We need to look at it holistically. We need to understand that it is a false economy not to invest in proper mental health care, because it will only make the overall costs to the system greater in the long run.
The Health Secretary will know that one of the biggest challenges facing the NHS is our ageing population. Thousands of lonely people are living in unsuitable accommodation and are not receiving the care that they need. What proportion of the NHS land that will be sold off over the next five years will be used to create more suitable accommodation for older people, and to create communities of care where they can be given the service and attention that they need?
The hon. Lady has made an important point. We would like more NHS land to be sold off for precisely those purposes.
There is a broader point to be made about housing, which is also important, and which I thought the hon. Lady was going to make. If we are to think about care in a more integrated way, we shall need to reform the NHS so that we look at people’s problems holistically, and that will include looking at their housing, which has a direct impact on their health. I think the structures that feature in the five-year plan begin to make such an approach possible for the first time, and I find that very exciting.
Does the Secretary of State agree that the key aim of our reforms is to support hospitals which have not been fully supported before? Medway Maritime hospital, which is in my constituency, had one of the highest mortality rates in 2005-06, but nothing was being done. I thank the Secretary of State for putting the hospital into special measures, so that it can secure the support that it needs to turn things around and my constituents can have an excellent hospital that delivers for them. I also thank him for visiting the hospital recently and meeting its excellent front-line staff, who do a great job.
I thank my hon. Friend for what he has done for Medway Maritime. That was a very good visit: I met both management and staff, and gained a better idea of the challenges faced by the hospital.
The report makes it clear that we must become much better at tackling variations in care. Never again must we have a system in which hospitals are struggling and delivering poor care, and that poor care is swept under the carpet and nothing is done about it. The Government have put 18 hospitals into special measures—more than 10% of all the hospitals in the NHS—and that has been very challenging. We have been accused by Opposition Front Benchers of running down the NHS when we have done it, but do you know what has happened? Six of those hospitals have now come out of special measures, and nearly all the others have improved dramatically. It is time that the Labour party got behind what is a really good inspection programme, based on openness, honesty and transparency about problems.
Bolton clinical commissioning group is putting mental health services out to tender, which seems to involve a cut of between a half and a third on the basis of current spending. Are such cuts in mental health services what the Secretary of State means by his vision?
No, and that is why the Government legislated for parity of esteem between mental and physical health. As I said earlier, we have introduced maximum waiting times for some mental health conditions, and we have focused on improving access to psychological therapies—IAPT—and on dementia. Anxiety and depression and dementia are two of the most common mental health conditions in respect of which we can make a real difference, and we are doing more all the time.
May I remind the Opposition that the primary care trusts that the clinical commissioning groups replaced sat above primary care, and were remote from it? Let me give an example of how much more integrated the system is now. Our clinical commissioning group has joined our hospital to fund the opening of an urgent care centre, which will relieve pressure on accident and emergency departments and give more patients a chance to gain access to the hospital from primary care. Does my right hon. Friend agree that that is an example of integration, not fragmentation?
Exactly—that is precisely the point. This report has example after example of how the new structures—clinical commissioning groups—are integrating care. That is why it makes it so clear that it would be wrong to do what Labour wants to do, which is to repeal the Health and Social Care Act 2012 and to strip CCGs of their powers when they are providing precisely the integrated care that we all think is important.
Northern Lincolnshire and Goole Hospitals NHS Trust has made significant progress over the past two years, but it remains financially very challenged and in significant deficit. What, if anything, in these plans will help to remedy that challenging situation?
Two things. I have had a very interesting visit to Goole hospital. It was very impressive to see how it has responded to the special measures programme and how, as a result of the new inspection regime, which Labour Front Benchers tried to vote down, it has made real improvements in care on the front line for the hon. Gentleman’s constituents. Those at the hospital will be pleased to see that this report endorses the new transparent approach to dealing with variations in care. It also says that we need to continue with increases in real-terms funding for the NHS, which we only get with a strong economy.
The theme of integration is re-emphasised in this plan, but how can commissioners ensure that they achieve that integration if they are forced against their will to outsource many services and also fear that their commissioning decisions will be challenged for being anti-competitive?
They are not forced against their will to outsource. They make the decisions as to where they want to purchase services from, and they do so on the basis of what is best for patients. Just like the primary care trusts that they succeeded, they have to follow European law in the way that they do that.
The growing funding gap over the next five years is a real cause for concern. Can the Secretary of State tell me whether, after five years of changing plans, scrutiny and prevarication, we will finally get approval from his Department and the Treasury for the new North Tees and Hartlepool hospital, or will I have to wait for my right hon. Friend the Member for Leigh (Andy Burnham) to approve it after the election?
The Commonwealth Fund’s recent study of 11 national health systems, including those of Sweden, France, Germany and the United States, found that the NHS in England was ranked top for a safe, effective, co-ordinated, efficient, patient-centred care system. Against that background, is it not rather unedifying for Labour Members constantly to try to pretend that the NHS in England is in some form of crisis, particularly given the deplorable performance of the NHS in Wales, which is run by Labour? Would not the shadow Secretary of State do rather better to remember the words,
“Or how wilt thou say to thy brother, Let me pull out the mote out of thine eye; and, behold, a beam is in thine own eye”?
I welcome the King James Bible reference. The independent Commonwealth Fund report that my right hon. Friend mentions contained one very startling fact, which Labour Members would do well to remember when they go on about the NHS—when they left office, we were seventh out of 11 countries on patient-centred care, whereas this year, now that we are in office, we came top. That is a huge improvement in patient-centred care. Under the new Care Quality Commission regime, his own hospital, John Radcliffe, got a “good” rating, which is an extremely impressive result.
The ambulance trust in the north-east has quadrupled the use of private ambulances, increasing its costs, and South Tees Hospitals NHS Foundation Trust is in deficit. In my constituency, two urgent care wards and a minor injuries unit are to be closed. A medical centre in Skelton has been closed, a medical centre in Park End has been closed, and a medical centre in Hemlington is to be closed. Does the Secretary of State take any responsibility for any of these health services in my constituency or across England? Every single response we get from him, every single time, is that somebody else is to blame.
Not at all—I take full responsibility for the NHS. Given the pressures created by having nearly 1 million more over-65s than we had four years ago, and the fact that the Government have had to cope with the deepest recession since the second world war, I believe that the NHS is doing remarkably well, and this document gives it a blueprint for the future that we can all welcome.
Under this Government, the number of young people taking up smoking has fallen dramatically to some 3% and the number of people giving up smoking has increased. I welcome that very good news. We can now aspire to a smoke-free Britain over the next five years. Personally, I would like to see the tobacco companies taxed out of existence, but is it not irresponsible to base future spending plans on the basis of a tax on companies that will cease to exist?
That is a very good point and I agree with my hon. Friend that we should aspire to a smoke-free Britain. We are making remarkable progress. The point the report makes—this goes alongside what my hon. Friend has said—is that we need to integrate our thinking about public health with our thinking about the services the NHS delivers. The better care fund has shown how it is possible to get excellent collaboration between local authorities and the local NHS for the delivery of social care. Transformational things are happening up and down the country right now. I would like to see the same thing for public health as well.
Alcohol abuse costs the NHS in Nottinghamshire more than £55 million a year and cuts in social services are making the pressures worse, especially for emergency departments. Dr Stephen Ryder, consultant hepatologist at Nottingham University Hospitals NHS Trust, wrote to me recently to express his deep concern that the Government are not taking forward the introduction of minimum unit pricing. Why are this Government ignoring advice and clinicians and ducking the issue of dealing with cheap alcohol?
We are doing a number of things to tackle alcoholism. Alcoholism rates have continued to fall under this Government, so we are making good progress. The approach to alcohol is different from that to cigarettes, because responsible drinking is perfectly okay for a person’s health; it may even be good for their health, depending on which doctor they speak to. We want to be careful that our alcohol policies do not penalise responsible drinkers who may not have large salaries and worry very much about the pennies their shopping basket costs.
Women chief executives now lead every one of the three hospitals serving my constituency. We have to thank all members of the NHS for this report, but will the Health Secretary comment in particular on the role of women in delivering NHS change and development?
I am absolutely delighted to do that. The new hospital inspection regime we have introduced has shone a light on some outstanding leadership. One of the best examples is Basildon hospital, which had terrible problems, including blood-stained floors, blood on the carpets and syringes left lying around in wards. That failing hospital has been turned around by an inspiring chief executive, Clare Panniker, and in the space of just 18 months it has now officially been rated as a “good” hospital by the CQC. We welcome the brilliant leadership of a growing number of female chief executives.
GP commissioners in Morecambe bay are doing exactly the kinds of things mentioned in the report by shifting their focus from primary care to prevention. They know, however, that all the things they could do will not come close to closing the £25 million deficit. The Government say that they have to close it, but doing so would decimate hospital services. Will the Health Secretary listen to our case about the special funding needs of the area?
I am very happy to look into that. I recognise that all clinical commissioning groups face very real financial challenges to balance their books. That is why the report is so important, because it says that we cannot go on like this for ever and we have to look at changing the model decisively. It addresses the three things that could give hope to the hon. Gentleman’s CCG: increased real-terms funding based on a strong economy; more imagination in looking for efficiencies; and innovation and technology. We are absolutely committed to doing those things.
In my constituency Deal hospital was left under threat of closure. It has now been safeguarded. Our acute hospitals had a Care Quality Commission inspection to identify problems, which have been dealt with; they were not covered up. Dover hospital, which was wrecked, is now being rebuilt. Will my right hon. Friend take a forward view of his diary and consider reopening that hospital at the opening ceremony in the spring?
If I possibly can, I will be delighted to do so. This is the pattern in many parts of the NHS that we do not hear from the Opposition Benches—where there have been problems in care year after year, they are finally being addressed. In my hon. Friend’s constituency and the hospitals that serve it he will be seeing more nurses and more doctors being employed and giving a higher standard of care, particularly to vulnerable older people. That is the kind of NHS that we should all welcome wholeheartedly.
The Secretary of State talks about holistic care and a range of issues that affect people, but active participation in sport, recreation and cardiovascular activity is declining. In constituencies such as mine, that is a real problem. What will he do to integrate CCGs with district councils? He seems to be saying nothing about this.
In my earlier comments I spoke a bit about childhood obesity, which is a very important issue. I was the Secretary of State responsible for the Olympics, and as part of the Olympic legacy we set up the school games movement, which now has about two thirds of schools in the country doing Olympic-style games every year, and we have put an extra investment into school sport. We need to work closely with the Department for Education on this, and I agree that it is very important that we do so.
May I invite my right hon. Friend to come to my local hospital and to my constituency to see what good works have been done in my area? A £25 million health centre has opened, we have a new walk-in centre that was opened by the Under-Secretary of State for Health, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). May I ask my right hon. Friend’s views on the talk about top-down reorganisation? [Interruption.] We walked into a shambles of an NHS after 13 years of Labour government and a debacle of a CQC policy that we had to reconfigure. What are his thoughts—[Interruption.]
Of course I would be delighted to visit my hon. Friend’s constituency. Morecambe Bay hospital is one of the hospitals whose problems we are looking at in a way that should have happened before but did not. We are turning round that hospital. We are determined to do it and we want his constituents to have absolute confidence in the quality of hospital care they receive.
That is why we continue to take the tough and difficult decisions—[Interruption] that keep this country on the right economic path and which are opposed at every turn by Labour. They told us that our economic plans would lead to a million jobs being lost—[Interruption.]
Perhaps the simplest thing is to say to the hon. Member for Edinburgh East (Sheila Gilmore) that we inherited one of the poorest performing economies in Europe. We now have the fastest growing major economy in Europe and that is the best possible future for the NHS.
The report makes it clear that with an increasing population and increasing proportion of elderly patients, the role of GPs will become even more important, yet the demographics of the GP profession mean that we will lose thousands of GPs to retirement in the next few years. What can be done to address this very important problem?