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Commons Chamber

Volume 600: debated on Tuesday 13 October 2015

House of Commons

Tuesday 13 October 2015

The House met at half-past Eleven o’clock


[Mr Speaker in the Chair]

Oral Answers to Questions


The Secretary of State was asked—

General Practice/Primary Care

It is a pleasure to be back, Mr Speaker. By 2020, we will increase the primary and community care workforce by at least 10,000, including an estimated 5,000 doctors working in general practice, as well as more practice nurses, district nurses and pharmacists.

Fareham community hospital is an example of Labour’s expensive PFI gone wrong. At a cost of £28 million, it remains underused, half-built and subject to complex governance structures. What will my right hon. Friend do to enable better use of this facility to allow provision for minor injuries, a GP practice and more primary care?

My hon. Friend is right, regrettably, that the PFI projects under the previous Labour Government created a lot of unsustainable debt. I know her local clinical commissioning group is meeting GP practices and working with community health partnerships to see if they can progress the idea she is campaigning for. I hope to visit her in the near future to discuss it myself.

Will my right hon. Friend join me in welcoming the £2.7 million in vanguard funding given to Dudley to provide primary care services out in the community? This will not only improve the level of clinical and social services provided to people in Dudley South, but relieve pressures on Russells Hall hospital.

I welcome my hon. Friend to his post. I am not sure I have had a question from him before. I know quite a bit about the Dudley vanguard programme, because I shared a taxi to Manchester station with the entire Dudley team. They told me, at close quarters, about their exciting plans. What really struck me was how they are talking to different bits of the health and social care system in a way that has never happened before. It is really exciting and I think it really will be in the vanguard of what can happen in the NHS.

Many people in my constituency are struggling to see a GP from Monday to Friday. Warrington has fewer GPs than it had in 2010, despite a rise in population. The number of unfilled GP vacancies quadrupled under the previous Government. How does the Secretary of State expect to produce a seven-day service when he cannot properly staff the service from Monday to Friday?

I shall tell the hon. Lady how I expect to do it. We are, in fact, making very good progress. By March next year, a third of the country will be able to access routine GP appointments at evenings and weekends. We do need more GPs. I agree with her that it takes too long to get a GP appointment, but we are doing something about it. That is why we have announced plans to recruit an estimated 5,000 more GPs. That will be a 15% increase in the number of GPs, the biggest increase in the history of the NHS.

It is widely known that there is a serious lack of doctors who want to go into general practice. At the same time, the Secretary of State is guilty of an abject failure to engage with the British Medical Association in negotiations on junior doctors’ practices. On that basis, how the hell can he promise to increase general practice?

Just look at our track record in the previous Parliament: we increased the number of GPs by 1,700—a 5% increase. We are, on the back of a strong economy, putting in funding that will make it possible to increase that number even more. The hon. Gentleman talks about the BMA. I simply say that the people refusing to negotiate are not the Government, but the BMA.

Order. May I just gently advise the hon. Member for Croydon South (Chris Philp) that he should not stand at this point? He has Question 3. It will be very easily reached, so he should not stand before then. There is no merit in doing that at all.

Unfortunately, every time I open a page of my local newspaper these days I am met with the beaming face of yet another general practitioner in his mid-50s who has decided to throw in his hand after many, many years of serving his community. These doctors are best placed to manage patients in primary care and ensure that they do not have to go to secondary care or A&E. What analysis has my right hon. Friend made of the reasons these experienced professionals are leaving the profession prematurely, and what will his reforms do to stem the tide?

My hon. Friend makes a very important point. We have done extensive analysis, because of our commitment to transform the role of general practice, of the issues. They include too much bureaucracy and form-filling, which means that doctors do not spend enough time with patients, and a sense that successive Governments have not invested in general practice and primary care. That is exactly what we seek to turn around with the “Five Year Forward View”.

What discussions have taken place with the devolved Administrations regarding the introduction of the new GP contract, particularly the junior doctor contract, given the exodus of junior doctors to Australia?

We also have Australian paramedics working in the UK, particularly London, so that traffic goes both ways, but, as the hon. Lady will know, health is a devolved matter, and people follow their own paths. For England, we are determined to eliminate the weekend effect. Every year, there are 11,000 excess deaths as a result of inadequate cover at weekends, and we do not want that to continue.

Mental Health Services (Children and Young People)

2. How much additional investment there will be in children and young people’s mental health services in 2015-16. (901457)

5. How much additional investment there will be in children and young people’s mental health services in 2015-16. (901461)

7. How much additional investment there will be in children and young people’s mental health services in 2015-16. (901463)

We are investing an additional £173 million this year, which includes £30 million specifically for eating disorders. We are taking a targeted and phased approach to the additional investment to develop capacity and capability across health, education and children’s services, from prevention and resilience building to supporting the most vulnerable.

The Government explicitly promised £250 million for children’s mental health in 2015-16, yet the Department of Health has admitted it will be spending only £143 million by next April. Is this £170 million shortfall not further evidence that while Ministers might talk a good talk on mental health, we should judge them by their actions?

No. I take the hon. Lady’s point, but we are committed to spending £1.25 billion over the Parliament. We will not be able to spend the £250 million this year, but it will be included in future years. The reason is that we have to make sure it is effectively and properly spent and it is a phased programme. She will be delighted to know that in her constituency there will be an extra £536,000 for children’s mental health services.

The organisation YoungMinds found that one in five mental health trusts had had to freeze or cut budgets every year in the last Parliament, and at the moment 40,000 young people are being refused mental health treatment. What guarantees can the Minister give that the money promised by the Chancellor recently will actually be made available and that trusts will not continue to cut mental health budgets?

The hon. Lady makes a fair point. While we invest money nationally in services, people complain that locally clinical commissioning groups have not been funnelling the money down. Two things should help: first, for the first time the national access and working time targets, which the Government have introduced, will provide a means of monitoring what CCGs are doing; and, secondly, the new scorecard for CCGs will look explicitly to ensure that a proportion of the increase to a CCG goes into mental health services. The hon. Lady will also be pleased to know that in her own CCG area there will be an extra £521,000 for children’s mental health services.

Some 23% of the adult prison population were in care as children and many of them have poor mental health. Will the Minister ensure that mental health services are in place for children in care to make the greatest contribution possible to improving their life chances, and not least to ensure we reduce the numbers ending up in prison?

Yes, the hon. Gentleman makes a point made by successive Governments: care outcomes are terrible and the earlier the intervention the better. We are encouraging the engagement of early prevention therapies, including for those in care, and for the first time the Government have appointed a dedicated mental health Minister, in the Department for Education, further to promote resilience and work more closely with young children, including those in care.

Infection control in the community is a great way to reduce preventable illness. In November, I will launch a handwashing campaign in Parliament that I hope will have cross-party support. Will the Minister inform the House what his Department is doing to promote infection control outside the hospital setting?

Order. I listened carefully because I wished to hear the development of the question, but it did not appear to relate to mental health services.

Never mind. These things can always be recycled on subsequent occasions. I have been there and I have done it, and the hon. Lady should fear not.

The Minister referred to the additional money for eating disorders in the autumn statement last year, the purpose of which was to introduce a maximum waiting times standard from next April. We all know that early intervention is critical. It is a condition that kills too many people. Will he confirm that he remains committed to introducing a maximum waiting times standard for eating disorders from next April?

I believe we are. I will check to be certain, as I know the right hon. Gentleman knows a great deal about this, but I believe we are. We have £150 million for eating disorders, and £30 million is being spent this year, with additional beds allocated. I will check that the waiting target times remain because they have made a significant difference. The right hon. Gentleman’s work has been of powerful import in what we do.

Yesterday, the National Society for the Prevention of Cruelty to Children revealed that one in five children in need of mental health treatment are being turned away. Is it not appalling that young people are being denied help, only for them to become more seriously ill later on, and that the number of children turning up at A&E because of mental illness has doubled in recent years? Does the Minister accept that children’s mental health needs more money now—this year, as he promised? I can point to many different organisations across the country that would gladly receive that support now. How is he going to put his broken promise right?

May I welcome the hon. Lady to her position, not least her Cabinet position—he said carefully—and welcome the prominence that mental health now has among all parties? Let me say rather gently in response to the tirade that I have just received that under this Government we have for the first time introduced parity of esteem for mental health on waiting times and national access targets. We are spending more money—£1.25 billion over the next five years. We have the highest number of beds for young people in emergency situations; we have the first dedicated education Minister for young people’s health; we have £75 million for perinatal health; and in her own constituency, the hon. Lady will be pleased to welcome from her shadow Cabinet position an extra £1.1 million going to Liverpool for mental health treatment for children and young people. I think that is a significant response.

I do not know who writes a lot of this screed, but sometimes a blue pencil needs to be taken to it. The Minister is immensely capable and experienced, but a distillation or an abridged version rather than a “War and Peace” version would be appreciated.

Seven-day NHS Services

Eighteen million patients will benefit from seven-day GP appointments by March next year, and seven-day hospital services will reach a quarter of the country by then.

In my borough of Croydon, the clinical commissioning group is currently consulting on the possibility of having three seven-day-a-week, 12-hour-a-day combined minor injury and GP centres, with one at Purley hospital in my constituency. Can the Secretary of State confirm whether any additional funding is available from central Government to facilitate this seven-day-a-week service?

Yes, I can. I should have said that seven-day hospital services will be available to a quarter of the country by March 2017. We are putting an extra £10 billion into the NHS in the course of this Parliament, which will help in the roll-out of seven-day services—I hope in Croydon, as well. I commend my hon. Friend for his efforts in that respect.

I met a large group of junior doctors in my constituency on Friday, and we talked a lot about seven-day working. They asked me to put two things straight with the Health Secretary: first, the vast majority of junior doctors are already working seven days a week; and, secondly, on their contract, it was not terms and conditions that they were worried about, as I thought they were, but safety. In respect of those new contracts for junior doctors, what assessment has the Secretary of State’s Government made about patient safety?

I am very happy to do that, and to correct some of the misleading impressions given by the BMA about what the changes are. The changes are about patient safety. They are about the fact that someone is 15% more likely to die if admitted on a Sunday than on a Wednesday because we do not have as many doctors in our hospitals at the weekends as we have mid-week. I want to give better support to the doctors who work weekends by making sure that they have more of their colleagues and more consultants there, as well as proper safeguards, which I do not believe we have at the moment. I will be getting that message out, and I hope that the hon. Lady will, too, when she next meets her junior doctors.

I urge my right hon. Friend to continue on his drive to improve patient safety and to reduce avoidable harm in our NHS because that is crucial for patients and the professions.

I thank my right hon. Friend for his question, and for the interest that he showed in these issues when he was a Minister.

The reality is that about we have about 200 avoidable deaths every week in our hospitals. It is the same in other countries—this is not just an NHS issue—but it is a global scandal in healthcare, and I want England and our NHS to be the first to put it right. I think that that is consistent with NHS values, and consistent with what doctors and nurses all want.

It is good of the Secretary of State to join us today. If he had been here yesterday to discuss the small issue of the £2 billion NHS deficit, he would have heard me say that I hoped we could have a mature and constructive relationship.

As has already been said, junior doctors are key to the delivery of a seven-day NHS. The Secretary of State said recently:

“I don’t want to see any junior doctor have their pay cut.”

Can he now guarantee that no junior doctor will be paid less as a result of his proposed new contract? Yes or no?

I welcome the hon. Lady to her post. I hope that, just occasionally, we might agree on some things, although I suspect that today may not be one of those occasions.

Let me be absolutely clear about the commitment that we have made to junior doctors. We will not cut the junior doctor pay bill, but what we do need to change are the excessive overtime rates that are paid at weekends. They give hospitals a disincentive to roster as many doctors as they need at weekends, and that leads to those 11,000 excessive deaths. Let me gently say that that was a change to the doctors’ contracts made in 2003, so for members of the Labour party to say that this is nothing to do with them is not accurate, and they should help us to sort out the problem.

I think it is fair to say that junior doctors will make up their own minds about that response.

Last week I received an e-mail about a seriously ill woman who had needed to be admitted to hospital over the weekend, but had stayed at home for two days because of recent interviews given by the Department of Health that had made her think

“that the NHS was not staffed at weekends.”

Her doctor went on to say:

“This delayed her operation, put her life in danger and ultimately will have cost the NHS more”.

Does the Secretary of State feel any responsibility for that?

Let me give the hon. Lady the facts. According to an independent study conducted by The BMJ, there are 11,000 excess deaths because we do not staff our hospitals properly at weekends. I think it is my job, and the Government’s job, to deal with that, and to stand up for patients.

The hon. Lady talked about being constructive. There is something constructive that she can do, which is to join the Royal College of Surgeons, the Royal College of Physicians and the Royal College of Nursing, and urge members of the British Medical Association not to strike but to negotiate, which is the sensible, constructive thing to do. Will the hon. Lady tell them to do that?

The question is about the seven-day NHS, but there is no point in our having a seven-day NHS if it is not an NHS across the country. I have a constituent with advanced prostate cancer who, as his oncologist says, needs docetaxel chemotherapy. In fact, all east midlands oncologists say that it is needed, but it is not provided by the NHS in my constituency, although it is provided in Birmingham. If we are to have a seven-day NHS, we need treatment across the board. Will the Secretary of State step in and do something about this?

I will look into the individual case that my hon. Friend has raised, but I think patients recognise that sometimes they need to travel further for the most specialist care, and can receive better care if they do so. However, the way in which what we are doing will help my hon. Friend’s constituents, and other people with cancer, is not just about consultants and junior doctors working at the weekends; it is about seven-day diagnostic tests, which will enable us to get the answers back much more quickly and catch cancers earlier.

Care Costs

We have introduced primary legislation and consulted on draft regulations to introduce the care cap. Following the decision to delay implementation until April 2020, we will use the additional time to improve the policy in the light of feedback from stakeholders.

Let me first declare an interest as a vice-president of the Local Government Association.

May I ask what assistance the Department is offering local authorities which are currently cash-strapped so that they can implement new minimum wage regulation, which is very welcome, in order to provide first-class social care?

It is not possible for me to talk about what may emerge from the spending round and settlement, but I can say to the hon. Lady that local authorities were given extra finance to implement the Care Act 2014. Some £5.3 billion is available to local authorities to work through the new integrated social care and NHS budget. So we are very conscious of the pressures on local authorities, which need the resources to provide the social care we all expect.

The coalition Government agreed a policy of a cap on care costs, and the Conservative manifesto in May said that no one would have to sell their homes to pay for care. Some £100 million has been wasted on this delay, which has betrayed our older people and has simply ducked one of the biggest crises facing this country. Will the Minister and the Department now apologise?

There was a consultation on the coalition proposals, which began at the beginning of this year and ran through the election period. The consultation included a very strong representation from the Local Government Association, which said that it did not want to implement the care cap now and wanted extra time. Therefore, the decision has been taken not to cancel, but to delay. It is of course a change from the position we set out. I fully accept that, but we listened to stakeholders and we are now going to use the extra time, at the request of the LGA and others, to find a way through to implement the policy and to use the time for extra financial products.

Derriford Hospital

8. What assessment his Department has made of progress in implementing the success regime at Derriford hospital in Plymouth. (901464)

I am pleased to refer my hon. Friend to the recent appointments of Ruth Carnall to the role of programme chair and Judith Dean to the role of programme director for the success regime in Northern, Eastern and Western Devon. Together, they will lead an intensive diagnostic exercise within the local health economy, which will develop options for change to be implemented in the new year.

Given the news last week that the Northern, Eastern and Western Devon clinical commissioning group that covers my constituency has appointed a special team to ensure the projected £430 million funding shortfall does not become a reality, what can my hon. Friend do to assure my constituents that an already challenged constituency can retain confidence in its health care provision?

My hon. Friend rightly points out that there are specific challenges in Northern, Eastern and Western Devon and that is precisely why NHS England has instituted the success regime and why it has moved quickly to appoint a programme director and team. I hope that with the engagement that I know he will lead with his colleagues they will come to a resolution that will ensure that the challenges cease.

NHS: Winter Pressures

9. What additional financial support he is making available to the NHS to help it deal with winter pressures. (901465)

17. What additional financial support he is making available to the NHS to help it deal with winter pressures. (901473)

Some £400 million in resilience money has been invested in the NHS for this winter. Learning from previous years, we have put this money into the NHS baseline for 2015-16 so that the NHS can plan effectively at an earlier stage.

I thank the Secretary of State for his response. In my constituency we have an excellent and much-used facility—a walk-in centre in Middleton town centre—which is now threatened with closure. Will he support our campaign to keep it open? Does he agree that its closure would create more A&E attendances and increase winter pressures on our acute services?

I welcome the question and understand the hon. Lady’s concerns about the changes. She will understand that we do not direct these changes centrally and they are decided locally. One of the things we have to try to do is deal with the confusion a lot of people have at a local level as to what they should do when they have, for instance, a child with fever at the weekends and whether they require a GP, an urgent care centre or an A&E department. I would ask all CCGs to be very careful to make sure they sort out that confusion so NHS patients know exactly what they should do.

The Royal Free hospital in my constituency is at the cutting edge of medical research and is currently treating Ebola patient Pauline Cafferkey. I am sure the Secretary of State will join me in wishing her a speedy recovery, yet the hospital faced considerable winter pressures last year. Will the Secretary of State work with the fantastic nurses and doctors at the Royal Free to ensure these winter pressures do not happen again this year?

I thank the hon. Lady for her excellent question. I know that the whole House is thinking of Pauline Cafferkey and her family and that it is proud that, under Dr Mike Jacobs and his team, she is getting the most outstanding care that it is possible to get anywhere in the world. We all wish her a speedy recovery. With respect to winter pressures, I know that the Royal Free had a difficult winter but I also know that it has a very good management team and made heroic efforts. I know that the whole team of doctors and nurses will do an excellent job, and we will want to support them in any way we can.

As part of my right hon. Friend’s plans for dealing with winter pressures, will he look at making greater use of the 63,000 practitioners on the Professional Standards Authority’s 17 accredited registers covering 25 occupations? Has he found time yet to read the authority’s report, “Accredited Registers—Ensuring that health and care practitioners are competent and safe”?

I must confess that I have not yet read that report, but my hon. Friend has reminded me of how important it is that I should do so. I will read it carefully while thinking about whether it could help us to get through the winter pressures this year.

Kettering general hospital, the local clinical commissioning group and the Government are all agreed that the best way to help the NHS in north Northamptonshire to cope with pressures all year round, including in the winter, would be to develop a £30 million urgent care hub at Kettering general hospital. That project is with Monitor. What can the Secretary of State do to encourage Monitor to speed up its deliberations?

Once again, I thank my hon. Friend for his persistent campaigning on behalf of Kettering general hospital. It is a very busy hospital under a great deal of pressure, and I know that people work very hard there. The Under-Secretary of State for Health, my hon. Friend the Member for Ipswich (Ben Gummer), who has responsibility for hospitals, met campaigners from Kettering recently to discuss this issue, and I will bring the matter up with Monitor as well.

The Department of Health’s own figures show a dramatic change, from a £500 million surplus to a £100 million deficit in 2013, following the introduction of the Health and Social Care Act 2012. That deficit moved to £800 million last year and we have heard in the past week that it stood at more than £900 million from the first quarter of this year. Does the Secretary of State recognise that this situation has been exacerbated by the outsourcing and fragmentation of the NHS, which involves spending money on shareholder profits and tendering bureaucracy, rather than on patients?

I do not. That Act meant that we reduced the number of managers and administrators in the NHS in England by 19,000, saving the NHS £1.5 billion a year. The reason for the deficits that the hon. Lady talks about is that, around the same time, we had the Francis report on Mid Staffs, and hospitals in England were absolutely determined to end the scandal of short-staffing. However, agency staffing is not a sustainable way of doing that, which is why we are taking measures today to change that.

The Francis report recognised the problems of nursing levels. As hospitals will not be able to use agency staff or immigrant staff, how does the Secretary of State suggest they tackle the nursing ratios in hospitals?

If the hon. Lady looks at what has happened with permanent full-time nursing staff, she will see that the numbers have gone up in our hospitals by 8,000 over the past two years, so there are alternatives. We need to do more to help the NHS in this respect, and I will be announcing something about that shortly.

Medical Exemption Certificates

Medical exemption certificates excluding patients with long-term conditions have been in place since the 1960s. The requirement to renew the certificate every five years has been in place since at least 2002 and we have no plans to review it.

The Minister will be aware that, over the summer, there has been media coverage of patients with ongoing and exempt conditions being penalised for not having an up-to-date exemption certificate. Because the renewal period is five years long, the NHS Business Services Authority’s address database gets out of date very quickly and many people have been penalised for inadvertently not renewing their certificate because the database held an out-of-date address for them. What more can be done to assist the authority and the patients, perhaps by introducing a shorter renewal period, and to ensure that this stops occurring?

I pay tribute to my hon. Friend, who has first-hand experience of this matter. It is true that people who are responsible for ensuring that they hold a certificate when claiming the exemption could be subject to genuine mistakes. That is why we responded to the feedback this summer and put measures in place so that if someone submits a valid medical exemption certificate within 60 days of a penalty charge notice, the penalty charge will be cancelled. It is also worth remembering that all patients on benefits or on the NHS low income scheme are exempt anyway, and that patients who require frequent prescriptions can enrol for a pre-payment certificate, which costs no more than £100 a year.

There are 3.3 million diabetics in this country, including myself, who are entitled to these certificates. This is not special pleading, but the issue is that when they come to renew they do need help. As the hon. Member for Blackpool North and Cleveleys (Paul Maynard) has said, it is difficult for them to fill in some of these forms. Will the Minister ensure that local GP practices are able to help people if they need assistance in filling in these forms?

I will happily look into that specific issue, discuss it with the right hon. Gentleman and see whether there is anything we need to do.

Carers: Support

I am not quite sure what the situation is in Wales, but in England I do not think that carers’ invaluable contribution to society has ever been better recognised. We are working very hard to see the implementation of the improved rights for carers enshrined in the Care Act 2014. I am also responsible for developing a new national carers strategy to see what more we can do to support existing and new carers in England.

There are more than 6.5 million unpaid carers in the UK, with nearly 11,000 in my constituency. In total, they save the state more than £119 billion each year, which is more than this Government spend on the NHS . Research by Carers UK has found that nearly 50% of carers are struggling to make ends meet, and that is seriously affecting their health. What plans does the Minister have to work with the Department for Work and Pensions and the Treasury, and across government, to ensure that the improvement of carers’ finances will be a key part of the Government’s care strategy?

The work I am doing on developing the new strategy involves other Departments, and it will look at not only the economics, but what is happening internationally and where we can take the whole concept of caring for a different society in the future. The economics is certainly important; we could not do without the contribution that carers make, but it would be impossible to replace it with total Government finance.

Yesterday, the Public Accounts Committee heard from officials at the Department of Health about the implementation of the Care Act, which is a bold piece of legislation. They admitted that they were very concerned about the unidentified carers, who need to be found in order to be supported. What is the Minister planning to do to make sure that they are identified and supported?

In a way, the self-definition states its own problem: these are unidentified carers. I hope that the new responsibilities in the Care Act will encourage more people to come forward and that the greater work of carer support organisations, such as the one I preside over in Bedfordshire, Carers in Bedfordshire, will be able to identify more carers. We want more young people to come forward because, as the hon. Lady says, people are caring and they do not realise they are. We need a concerted effort all round to try to reveal them, so that more can be done.

I am surprised that the Minister believes he is supporting carers in any way acceptably well. The recent personal social services survey found that 38% of adult carers now care for more than 100 hours a week but only one in five of those carers is getting support to take a break from caring. Government cuts have caused a funding gap in social care, which, it is estimated, will be £4 billion by 2020, piling additional pressure on those family carers, and the better care fund and integration will not, in themselves, fix that gap. When will Health Ministers admit that they have got this wrong and argue for more funding for social care, so that carers can get the support and respite breaks they should get?

Between 2010 and 2015, £400 million extra was found in order to provide respite for those who are caring for others. Any support that goes into local government, or indeed the NHS, is predicated on a decent economy and decent economic principles in order to fund it—I believe from what happened last night that that has been abandoned by the Labour party. We have to have the resources in the first place. That is what we are seeking to ensure and that is what the work is being done for.

A&E Services (Worcester)

Last month, the Department approved a £4 million capital improvement loan for the expansion of the A&E department at Worcestershire Royal hospital and the development of a dedicated discharge lounge. Worcestershire Acute Hospitals NHS Trust and the local health system will also receive practical support via the emergency care improvement programme to help the trust to address the challenges it has faced in meeting the four-hour A&E waiting time standard.

I thank the Minister for his reply. I warmly welcome his recent decision to approve the £4 million interim investment in A&E capacity and a new discharge suite at the Worcestershire Royal. As he knows, demand remains very high, and the number of patients being admitted to hospital is close to record levels. May I urge him and his colleagues to look very carefully and urgently at plans for further upgrades, which could deliver much-needed capacity over the coming years?

I assure my hon. Friend that we will do so, but he will be conscious that capital plans are the responsibility of individual trusts. I urge his trust to take part fully in the Worcestershire acute review and in other reviews of the west midlands health service. There are challenges, and we will fix the problems only if there are locally sourced solutions, which we will then seek to support.

Nurse Training Places

The number of available nurse training places in England in 2015-16 is consistent with those filled in 2010-11. There are 20,033 nurse training places available in England in 2015-16, compared with 20,092 in 2010-11.

Simon Stevens, the head of the NHS in England, has already highlighted the devastating impact that new immigration earnings thresholds will have on nursing numbers—it is estimated that up to 29,755 nurses will be affected, and that the recruitment cost will be more than £178.5 million by 2020. What representations will the Minister be making to the Home Secretary to put a stop to this irresponsible and illogical change in policy that defines ballet dancers but not nurses as a shortage occupation?

The hon. Gentleman will be reassured to know that there are continuing and cordial relations between the Department of Health and the Home Office. Trusts have had three years to prepare for this moment. There is a bigger issue at play here, which is that there are five applicants for every nursing place in the United Kingdom; that is the position for people wishing to train as a nurse. Our first responsibility is to ensure that we are getting as many people who want to be nurses in this country into a nurse training place.

The Mid Yorkshire Hospitals NHS Trust, which covers the Wakefield constituency, has been forced to recruit nurses from both Spain and India. Following on from the previous question, what representations has the Minister made to the Home Office, because these changes could affect nurses who have come to Britain, bought mortgages here and plan to make their lives here? Will they be affected?

The hon. Lady knows that the Immigration Advisory Committee is independent and it makes its recommendations on that basis. There are trusts—I have visited some myself—that had previously relied on agency and migrant labour that have now managed to change the way they are hiring staff so that they can better source sustainable staffing from the domestic staffing pool.

In December 2009, Lord Lansley, as the then shadow Health Secretary, described the amount spent by the NHS on agency staff as “unforgiveable”. Since he made that statement, agency spending has spiralled out of control, rising by 83% in the past three years. Ministers are in denial about the root causes of that increase. The cuts to nursing training places have created a shortage of nurses and forced hospitals to spend vast amounts on expensive agency staff. Will the Minister now come clean and admit that it was the Government’s mismanagement that caused this financial crisis?

The hon. Gentleman should know that the unforgiveable thing was the dereliction of care by a Department of Health under a previous regime. It contributed to short staffing—a significant part of the scandal at Mid Staffs—that we needed to put right in short order. That required an emergency response and agency labour to be employed. We are now putting staffing on a sustainable basis; we were left with short staffing in 2010.

NHS: Consistency in Services and Treatment

14. What steps he is taking to ensure consistency in services and treatment throughout the NHS. (901470)

The mandate for NHS England sets out our national ambitions for the health service across England. NHS England and the clinical commissioning groups are responsible for working with local providers. To ensure quality and consistency, the Care Quality Commission has developed a set of fundamental standards. The National Institute for Health and Care Excellence also provides a range of guidance and quality standards, and the Department of Health has established the MyNHS website to highlight regional variations and use transparency to drive improvement across the system.

I thank the Minister for that answer, but earlier this year figures published by Public Health England showed that more people under the age of 75 die from cancer in Corby than anywhere else in England. What steps are Ministers taking to help to improve those rates? They are stubbornly high, and we need to stop the higher prevalence of cancer in our area.

My hon. Friend makes an important point. The Government are absolutely committed to world-class cancer care, which is why we put £1 billion into the cancer drugs fund. We have seen a huge 71% increase in cancer referrals, with 40,000 more patients treated, and a new cancer strategy has just been set out. It is true that the incidence of cancer in my hon. Friend’s constituency is regrettably high, and Corby CCG has significantly worse cancer outcomes. That has been recognised and the 2015-16 commissioning plan puts in place a series of measures on cancer, including improving earlier diagnosis, providing treatment within 62-day referral targets and implementing the national cancer survivorship programme.

Creswell in my constituency of Bolsover has been trying to get a health service centre, but that small ex-pit village has been unable to get it because NHS Property Services has been arguing with the CCG and others within the national health service. Despite efforts and letters to Ministers, the village is still waiting for the health service that it has been trying to get ever since this Secretary of State got his job under the coalition. If Ministers want some consistency throughout the land, they should give that deprived ex-pit village a new health service: knock some heads together and get it done.

It is a pleasure to take my first question from the hon. Gentleman. I thought I needed my ears cleaning, but I clearly do not. I will happily talk to him about the issue in his constituency, but the truth is that local CCGs are responsible for commissioning local services. I will happily, as a Health Minister, talk to him about what needs to be done.

I think the thrust of the hon. Gentleman’s view is very clear, and he has expressed it with unmistakable force.

Organ Donation

Organ donation rates have increased by about 60% since 2008. The Government give about £60 million a year to NHS Blood and Transplant to support organ donation. NHSBT has a strategy, which it launched in 2013, to take us up to 2020 and increase that figure even further.

Does the Minister agree that one of the most effective ways of increasing organ donation is to ensure that the next of kin of every potential donor is offered a meeting with a specialist nurse in organ donation, irrespective of whether the potential donor carries a card?

My hon. Friend is absolutely right to highlight one of the principal difficulties we face, which is people not having a conversation about donation. Even if people are on the organ donor register, their wishes are sometimes overtaken by those of their families at that very difficult moment. He is right to highlight the brilliant work done by SNODs, as well as initiatives such as the one that will happen this Saturday, when the Daily Mail, together with the organ donor register, will produce a publication that will, we hope, stimulate thousands of conversations across the land. Having a conversation about consent is one of the ways we will crack this problem.

NHS: Transparency

Last year I launched My NHS, where patients can see how safe their local hospital is and many other things. From next May, there will be overall information on the quality of mental health and cancer care.

Does the Secretary of State share my view that driving up standards in the NHS is better achieved through a culture whereby providers can learn from their peers? For example the excellent maternity department at my local Cossham hospital recently received an outstanding rating from the Care Quality Commission. That is better than the old ways of doing things through targets driven by Whitehall.

I agree, and I congratulate the doctors and nurses working in the Cossham maternity unit. Southmead hospital in Bristol has some of the best maternity survival rates in Europe, so there is a lot of very good practice. The way to get the word out is through transparency of outcomes, not endless new targets, so my hon. Friend is absolutely right.

Topical Questions

I would like to make a statement on measures the Government are taking to help NHS organisations tackle the deficits by reducing the cost of agency staff. Building on previously announced controls, from the end of November we will introduce maximum shift rates for all clinical staff employed through agencies, which will gradually decrease over time as the measures take effect and demand for agency staff reduces. In addition, we will work with each trust to limit or reduce the overall agency spend. Exceptional breaches of the limits will require advance agreement. Taken together, these measures are expected to improve patient care and reduce NHS agency staff spend by £1 billion over three years. The chief inspector of hospitals has confirmed that he believes this is the right thing to do.

Like many Members across this House, I have been inundated with letters and emails from junior doctors who feel completely undervalued and undermined by the actions of this Government, so much so that thousands of them are leaving the UK. This weekend over 2,000 medics and students wrote to the Secretary of State, condemning him for his proposed unfair and unsafe changes to the junior doctors contract. What further evidence does he need to see that he has lost the confidence of the future leaders of the NHS, and does he think he can win it back?

Yes, I do. Let us be clear: this is about patient safety, about which every single doctor and nurse in the NHS is passionate. The problem is that the doctors whom the hon. Lady has met have been misled by their own union. This is not about cutting the pay bill for junior doctors, as the BMA has suggested. This is about safer care at weekends, reducing unsafe hours and doing the right thing for patients, and that is the right thing for doctors as well.

T4. It emerged earlier this month that North East Lincolnshire CCG was operating a primary care incentive scheme intended to reduce outpatient referrals. Understandably, this has met with a hostile reception from my constituents, who fear it may affect decisions on their care. Will Ministers look into this scheme and either offer some reassurance or instruct the CCG to reconsider? (901549)

The north Lincolnshire scheme is designed to try to encourage doctors to make sure that there are no inappropriate referrals to secondary care; it is not designed to prevent appropriate ones. Over the past five years we have seen an increase of 600,000 in urgent referrals for cancer care, for example. We want to see that continue. It will not be helped if there are inappropriate referrals, and that is what the scheme is about.

Last week senior officials at Monitor reported being leaned on by the Department of Health to suppress the publication of financial figures ahead of the Conservative party conference. This week the Health Secretary has been accused of vetoing the release of impartial independent reports on measures that could reduce our consumption of sugar. Does he not understand that leadership on transparency must come from the very top? Will he now commit to practising what he preaches on NHS transparency and release this report immediately?

I will take no lessons on transparency from the Opposition. Professor Sir Brian Jarman said that the Department of Health under Labour was a “denial machine” when it came to the problems of Mid Staffs. We have made the NHS more transparent than ever before, and we will continue to practise transparency.

T6. What progress has been made towards the implementation of the Keogh review of urgent and emergency care? (901551)

We are making good progress and we expect to make a substantive announcement on that before the end of the year. That will be about improving the standard and the quality of care in A and E departments, which I know my hon. Friend has a great interest in, and removing the confusion that people feel about what precisely the NHS offer is in their area. It is looking good and I hope to have something to announce to the House before too long.

T3. A recent whistleblower revealed that the 111 helpline is in meltdown and at least two babies have died after staff failed to recommend treatment that may have saved them. Two weeks ago my own three-week-old premature granddaughter was very ill. Her parents called 111 and were promised that the duty doctor would call. He did not. They waited the whole long night and the next morning took her to A and E, and she was diagnosed with meningitis. What exactly is the Minister doing to fix the crisis in the 111 service? (901548)

This is a very serious issue and I will happily look into it personally to make sure that a full investigation is taking place into the incident the hon. Lady mentions, which clearly should not have happened. The 111 service has been an improvement on what we had before. It has taken nearly three times as many calls as the service it replaced, and around a quarter of those are referred to a clinician, but it is clearly not perfect, given the hon. Lady’s story, so I will look into the case that she raised.

T9. Patients in England wait 18 weeks for an operation, but in Wales, where Labour has run the NHS for the past 16 years, they wait 26 weeks. Does that not prove that only the Conservative party can be trusted to run the national health service? (901554)

My hon. Friend is right. A further cause of distress for the people of Wales is the fact they do not have the funding that the NHS requires in their country, just as England would not had a Labour Government been elected in 2015, because we would not have the funding that this Conservative Government have promised to ensure top care for patients.

T5. The all- party spinal cord injury group, which I chair, recently reported that very vulnerable patients are being prejudiced by delayed discharges, taking up lots of public money in hospital expenses that should be used to treat more patients. Will the Secretary of State carry out an urgent service review to address this real problem in England, Wales, Scotland and Northern Ireland? (901550)

Delayed discharge has been a problem across the system for many years. An awful lot of work is going on to ensure that more preventive work is done so that people do not go into hospital, and to ensure that if they do go in they leave quickly. I visited Salford Royal only a couple of months ago and saw the process it has for dealing with discharges more effectively. Learning is going on throughout the system, and more money is in the system for winter in order to cover the problem.

To continue on the same theme—hopefully I am coming in at the right time, Mr Speaker—I chair the all-party group on patient safety, in collaboration with the Patients Association. We are about to look into hospital infections, and in Parliament in November I will launch a hand washing campaign. What is the Department of Health doing to promote infection control outside hospital settings?

I thank my hon. Friend for her great interest in this issue and for the campaigning she did before entering Parliament, which I know stemmed from personal tragedy. This is an incredibly important issue. We face a crisis in global healthcare as a result of anti-microbial resistance, which means the current generation of antibiotics is no longer as effective as it needs to be. Proper hygiene in hospitals is therefore vital, and we have a lot of plans that I will be happy to share with her.

T7. What measures is the Secretary of State putting in place to recruit and retain GPs? Given that he has indicated recruiting 5,000, where does he plan to find them? (901552)

As part of the proposal to see an increase of 5,000 in the number of doctors working in general practice by 2020, work is being done not only to recruit more, but to retain them and to bring back those who have left general practice but want to return. Health Education England is working with the Department on all these plans and proposals. The hon. Gentleman is right to identify that as a key source of those who will come into the service in future.

Delayed publication of evidence is as damaging as non-publication, which is why we rightly expect clinicians, researchers and managers to publish their evidence and data in a timely and transparent manner. It is a matter of great regret to the Health Committee that we started our inquiry today without access to the detailed and impartial review of the evidence that we need to make a contribution to this inquiry. Will the Secretary of State please set out when he will publish it?

I agree with my hon. Friend about the importance of transparency and publishing in a timely manner. I will look again at the planned publication date for the report she wants to see, which will be published so that Parliament can debate it properly. The normal practice is for advice to Ministers to be published at the same time as policy decisions are made, as happened with the Chantler review and the Francis report.

T8. The Royal College of Nursing reports that it is becoming clear that for the first time since the early 2000s there is a critical shortage of registered nurses in the UK. Both the UK and global nursing labour markets are changing, and our increasing reliance on alternative sources is not sustainable. In 2014, 37,645 students across the UK were turned away from nursing courses. Is it not time the Minister admitted that the situation is not good enough and that the Government need drastically to scale up those places to reduce dependency on overseas nursing staff? (901553)

The thrust of the right hon. Lady’s question is correct. That is why we have near-record numbers of nurses in training and a record number of nurses in practice, and we will continue to see growth over the next five years.

Last year the NHS paid £300 million to claimants’ lawyers. Indeed, for small and medium claims, the lawyers made two to three times as much as the claimants themselves. Is there more we can do to stop this abusive behaviour?

There certainly is. We spend £1.3 billion every year on litigation claims—money that could be used to look after patients on the front line. The way to avoid spending that money is to have safer care, and that is why it is so important that we have a seven-day service.

T10. As the Secretary of State will know, the Scottish Government are once again in the vanguard in introducing crucial legislation—the Smoking Prohibition (Children in Motor Vehicles) (Scotland) Bill, which will eradicate more than 60,000 journeys per week where children are exposed to dangerous second-hand smoke. Will he advise on what plans are in place for the rest of the UK to follow Scotland’s example? (901555)

I have to tell the hon. Lady that the law for England and Wales changed on 1 October, so in fact we are in the vanguard, not Scotland.

Given this Government’s continued excellent commitment to investing in our NHS and reducing preventable mortality, does the Minister agree that keeping healthcare provision as local as possible is very important for Moorgreen hospital in my constituency?

The core purpose of the Vanguard programme is to ensure that we get local solutions to local healthcare problems. Only by making sure that we release the potential of local healthcare staff and providers, doctors and nurses, do we get the solutions we require rather than things being determined from Whitehall, as was the wont of previous Administrations that we will not follow.

I can think of few things more frightening than being in labour and being turned away from a maternity unit that someone has visited, become familiar with, and got to know the staff. Over a third of units closed their doors to women in labour last year. What is the Minister going to do about this, and why does he think it has been happening?

The hon. Lady is absolutely right; we need more midwives. We recruited more midwives in the previous Parliament, and we do need to expand maternity provision as we have a growing birth rate. I am happy to look at the problems in her area. However, we also have a maternity review coming up early next year, led by Baroness Cumberlege, that will help us to address this problem sustainably.

What health problems are caused by first-cousin marriages, and how much does dealing with those problems cost the NHS each year?

I cannot give my hon. Friend a specific answer, but I would be very happy to get back to him because I know there has been some local discussion about this in the city that he represents. I know of the issues to which he refers.

Order. As in the health service under any Government, demand on these occasions always tends to outstrip supply. I apologise to colleagues who did not get in, but we must now move on.

Redcar Coke Ovens

(Urgent Question:) To ask the Secretary of State for a statement on the closure announced yesterday of Redcar coke ovens, leading to the direct loss of 2,200 jobs and many thousands more in the supply chain in the local community.

Let me begin by saying that the significance of yesterday’s announcement is not lost on me or any member of this Government, because we know and understand the profound implications it will have for Teesside. The hon. Member for Redcar (Anna Turley) and I will not agree on this matter, but I pay tribute to her for fighting for her constituents, as every good MP should do. I also pay tribute to the hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop), who I suspect will also fall out with me today, for the work that he has done on behalf of his constituents.

I say that the significance was not lost on me because it was an honour to go up to Redcar the other week to meet a number of people. We knew that SSI was in huge difficulty. To put the situation in context, it never made a profit, notwithstanding the undoubtedly outstanding workforce and a lot of good will, and the coke ovens were losing, on average, £2 million a month.

The official receiver was accordingly brought in that Friday, and in his capacity as liquidator of SSI he announced, following discussions with potential buyers, that he had received no viable offers for the coke ovens or the blast furnace and that he would therefore begin closing those facilities. The terminology is that this is a “hard closure”—it is a tough closure as well. This is not mothballing, so we have to be realistic about the implications.

This is hugely regrettable news for SSI workers, their families and the local economy more broadly. Only this morning I spoke to the chief executive of the local council, Amanda Skelton, who informed me that at least 50% of the people employed at the ovens and blast furnace live in Redcar, so we are under no illusions as to the significance of the situation for the town.

The Government remain absolutely focused on supporting those people who find themselves out of work as a result of SSI’s liquidation. Through a package of up to £80 million, we will continue to invest in them and the future of the Tees valley economy.

Safety, as Members might imagine, is a top priority. We will continue to ensure that the official receiver has all the funding and support necessary to deliver a safe and orderly closure of these assets, working with the Health and Safety Executive and Environment Agency. I thank the official receiver for what he has done. He was able, with Government assistance, to keep the coke ovens going until yesterday’s announcement, which is no mean achievement.

By way of example of the seriousness of the situation, when I was last in Redcar we discussed the possible sale of coke that might just have raised £800,000 that Friday morning and that might just have bought some sulphuric acid to keep the power plant going. That was the reality of the hand-to-mouth existence of SSI. That is a reflection not of the local management, which struggled under the most difficult of conditions, but, unfortunately, of the Thai owners, notwithstanding the welcome they properly received when they bought the plant and the great hope invested in them by the local community.

I place on record my thanks to everybody—including the Community trade union, which I had the great pleasure to meet, representatives from the local authorities, local Members of Parliament and other stakeholders—who has helped to operate SSI’s facilities safely during this particularly difficult period. They have done so much to try to ensure that there is a future for steel making in Redcar, but unfortunately all that good work has come to nothing.

This Government have overseen a tragedy for the people of my constituency and the region. This is an act of industrial vandalism for British manufacturing. We are talking about potentially as many as 6,000 jobs in the local area, but this is about more than jobs and livelihoods: this is about people’s identity, their pride, their dignity and their respect in work, and it is about the heritage and the history of our local community, where people have been involved in steel making for generations. That has been torn away.

This is about more than our past: it is about our future. Fifty apprentices were due to start with SSI on the day it paused production. Steel underpins the entirety of the Teesside economy. The Government have turned their back on my constituents and on steel making in Teesside, and they have dealt a hammer blow to the UK industry.

Why did the Government refuse to intervene on environmental grounds to secure the site? Why have they hidden behind state aid rules when other countries in Europe have stepped in to protect national assets? Why are they claiming that money would go to the Thai banks when the official receiver works on behalf of the Crown and has a responsibility to maximise the value of an asset, not to close it down? How can the Government say, in just a few days, that there were no viable options or buyers, when I understand that there were at least 11 interested parties? Why did they pull the plug before they had properly explored the options for developing foundry coke for emerging markets in western Europe? Why have they included—this is absolutely disgraceful—statutory redundancy payments in the £80 million support package? The payments could be as much as £20 million to £30 million of that sum. They are misleading people and cheating them of the support promised to them. Finally, why have they allowed 170 years of great British steel making, which built the world from Sydney harbour bridge to Canary Wharf, just to fade away without so much as a whimper from this Government?

As I said, the hon. Lady and I are bound to fall out on these things. Let me just make this absolutely clear: this is not a decision that the Government have taken; this is a decision that the official receiver has taken. The official receiver is independent. It is his decision and, as I said, he has made it after more than a week of trying to forge an agreement with potential buyers, notably of the coke ovens. I do not believe that anybody has come forward to buy the blast furnace.

We know the reality. The reality is that there is an over-production of steel across the world and an under-consumption. We have not even got back to pre-crisis levels; in fact, we are 25% short. The price of slab made in Redcar has almost halved in 12 months. That is why the site has never turned a profit. That is why, unfortunately, it has made losses year on year. As I said, the coke ovens were making a loss of some £2 million a month. We have done everything we can.

In relation to the environment, we disagree. We are working with the Health and Safety Executive and the Environment Agency. The truth is that those discussions had been happening for some considerable time before the company went into liquidation, because such an outcome was always the fear, faced with the harsh reality of where we are with our steel industry not only in this country but across the whole world.

Nobody is hiding behind the state aid rules. Many stories are told about what other countries do, but when we dig deep into such stories, we find that they are actually the stuff of myth. Italy is a particular example of that. [Interruption.] I think somebody is shouting, “Outrageous!” I am more than happy to share with—

Oh, I don’t have a problem with being brave. I can tell the right hon. Lady that if we look at the action that Italy has taken, even in the peculiar and exceptional circumstances of a group of directors facing allegations that they were poisoning the land and causing cancer, the Commission is now investigating the situation because it is concerned that there has been a breach of the state aid rules. Such is the nature of the rules, which are very onerous.

Finally, on the £80 million package we have put in, the hon. Member for Redcar makes the point that about £20 million—I think it is nearer £30 million—of that is by way of redundancy payments. Let me make it clear that that was always my understanding, and I thought that we had made that clear when we were up in Redcar. In any event, let me also make it very clear that I am not closing the door on the £80 million, because one of the things of which we are very aware is the implications for the many thousands of other people through the supply chain. Many of them have not been paid for some considerable time, such was the contractors’ and subcontractors’ loyalty to SSI, so the effects through the supply chain will be considerable. I certainly want to be in a position to be able to help everybody, not just the 2,100 people who have unfortunately been affected by the announcement.

Our steel industry pays the most expensive electricity prices in the EU and, indeed, in the world, and it is impossible to compete at the margin with such costs. Does the Minister agree that whenever we discuss the balance between environmental taxes and lower energy costs, the Labour party always wants to go further, faster and more unilaterally, and that has had an effect in Redcar?

My hon. Friend makes a very good point. We have to get the balance right. We all want to live in a cleaner, greener world, but there is a cost associated with that. I just want to say one thing. I had to go to Berlin yesterday, and one of the things I did was to take the opportunity to talk about the actual reality of the situation in Germany. It is right that its energy prices for industry are lower, but those for ordinary consumers are considerably higher. Such is the Commission’s concern that it is now looking at and investigating whether such a balance is a breach of state aid rules. There is a lot of strength in what my hon. Friend says, but we again have some mythology. Sorting it out and getting to the facts is one reason why we are having a steel summit on Friday.

If someone were to build a steelworks today, they would build it at Redcar because of the port, the quality of the steel, its location in relation to the European market, the skills of the people and the fact that the largest blast furnace in Britain is located there. Coke will still be pushed till Wednesday, and possibly even Saturday. I could ask many questions of the Minister, but the main one that I want answered now is why, when the Insolvency Service is under the jurisdiction of the Secretary of State, allowing him to steer and guide it, did it recommend closure of the entire site yesterday, prior to the steel summit on Friday? We thought that we would be talking about Redcar and Britain’s largest blast furnace. If Britain’s largest blast furnace is not part of a steel summit and a steel strategy for Britain, what is the point of the summit?

There are many points to discuss at the summit, one of which is the reality of the steel industry across the world. Let me make it absolutely clear that the official receiver is independent and free of interference from Government, and rightly so. That should never change. I would have hoped that the hon. Gentleman understood that. We have to be absolutely clear on this. The coking ovens were losing £2 million a month. It is a tribute to—[Interruption.] Honestly, I would take another question, but heckling will not help the hon. Gentleman.

It is, I know. That was the pot calling the kettle black, but this is a serious matter.

As the hon. Member for Middlesbrough South and East Cleveland (Tom Blenkinsop) knows, the official receiver ensured that there was enough coal to put into the coking ovens. That went over and above what we all thought would happen on that Friday, when there was not even enough money to buy the sulphur to keep the power station going, as the hon. Gentleman knows. Notwithstanding his efforts, those of the hon. Member for Redcar and the meeting that I had with the group of people based locally who had expressed an interest, the harsh reality is that nobody has come forward with an offer to buy the coke ovens. Are Members honestly surprised when they were losing £2 million a month?

Order. The Minister’s self-knowledge is a blessed thing and I genuinely thank her for it, but there is a balance to be struck. She is trying to respond comprehensively, which is to be respected. Equally, I want to get everybody in if possible. We will try to strike the right balance.

My hon. Friend the Member for Warrington South (David Mowat) is right about the irony of the Labour party complaining about steel plants closing when it imposed the Climate Change Act 2008 on the UK, which unilaterally put huge costs on energy that other countries did not face. Will the Minister confirm that the Government have learned the lesson and will not unilaterally impose huge energy costs and carbon emission targets on British businesses? If the Government do not make that commitment, many other manufacturing jobs will follow. We are merely exporting jobs to other countries around the world.

My hon. Friend makes a good point. However, even if we had the sort of energy prices that I would like, it would not solve the problem for our steel making industry, which is that the price of steel has almost halved because of over-production and under-consumption.

I note that the Minister said that she and her colleagues understand the significance of this situation. That statement would have had more resonance with the House had the Secretary of State come along today.

I pay tribute to my hon. Friend the Member for Redcar (Anna Turley) and all my hon. Friends from Teesside, who have worked tirelessly on behalf of their constituents. In contrast, we now see the practical consequences of having a Conservative Business Secretary who is so ideologically opposed to the notion of Governments acting to protect our strategic economic assets in difficult times that he will not even use the words “economic strategy”, preferring the phrase “industrial approach”. I am afraid that “industrial indifference” would be a more accurate description of what we are seeing.

This is not just about the 2,100 jobs that will be directly affected at Redcar, although each one represents a tragedy for those families; this is about a long-term strategic vision for Britain’s economic and industrial future. I am afraid that for all the rhetoric about northern powerhouses and the march of the makers, at the first big test of whether this Government have any long-term strategic economic vision, the march of the makers has come to a stuttering halt.

Why have the Government been so passive about working to save the steel industry in this country when it is so strategically important? What options did they explore for mothballing to save the assets? Why do they believe it acceptable that the £80 million support package also contains statutory entitlements to redundancy pay? I was interested to hear that the Minister might not stop at £80 million, so perhaps she will tell the House a little more about how much she has in mind. Will she confirm how much it will cost the taxpayer to clean up the site safely?

What assessment has the Minister made of the economic impact of the closure on the local community and the supply chain? Did she raise the issue of Chinese dumping during her recent visit to China, or does the UK’s relationship with China now simply consist of kowtowing to the Chinese Government in a way that will mean that they have more financial interest in Britain’s strategic assets than our own British Government?

It does nobody any good—especially those who have been made redundant—when people engage in scoring cheap political points, and I think it is absolutely pathetic. The Secretary of State and I have worked together tirelessly to consider every single option for how we could assist. That consumed the time of both of us, and we did that work together. One example of that is the fact that, apparently, during all the goings on in the past about saving Redcar, no Minister ever went there. We were the first—it got both of us—and that reflected our dedication and was our attempt to ensure that we did everything we could. That is what we have done, but we must be realistic. The price of slab has almost halved due to over-production and under-consumption. Yes, I did talk about Chinese dumping and many other things related to the steel industry when I went to China, and unfortunately the account that one gets back is not good. This is a worldwide problem, and it will not be solved overnight. This is a tough time—possibly the toughest time ever—for steel industries across the world.

Does the Minister agree that if Labour Members want more freedom for the UK Government to determine Government subsidy for important businesses such as the steel industry, they should vote to support the “leave” campaign?

My view is that we should stay within a reformed Europe, but those are exactly the sorts of conversations we need to have. We must speak to countries such as Germany and get the facts out there. The idea that only the British steel industry is suffering is not true. This problem affects all steel industries, not just in Europe but in Turkey, Brazil, and around the world. This is a real crisis throughout the world.

I make no apology for repeating in my short contribution some of what has already been said. My constituents know only too well the terrible cost of plant closures. That has happened twice in Redcar, and my heartfelt sympathies go to each and every person involved. I know how hard the hon. Member for Redcar (Anna Turley) and other Members from Teesside have worked.

Industrial vandalism does not even begin to describe what has happened, and is happening, to steel plants in this country. Ravenscraig—I have said the name, but it now means very little. They are still cleaning up in Ravenscraig. They have tried to contain all the terrible heavy metals and industrial material. Most of it has gone, but people are finding it hard to redevelop that site simply because of what was there before. Will the Minister please pledge in Rotherham on Friday to give positive help to the UK steel industry? We must have positive help to survive the recession for all the reasons that have already been mentioned, such as high electricity costs, high rates and so on.

We have had many talks—I know the Minister wants to help; she has been commended for her positivity and her help—but we have come to the end of the line. No more talking; we need action and more than £80 million to try, somehow, to replace all those well-paid jobs. My constituents know how that feels. Many people, including a previous Member for my constituency, went to university on the back of a training course that they received at that time. He was lucky because not everyone was able to do that, but that still did not produce the type of well-paid jobs that there used to be in that area. That is what will happen in Redcar—we all know that.

We talk about state aid, and other countries in Europe seem able to provide that. Conservative Members seem to use Europe as a battering ram. It is one thing for one side, and something else for another, and they change their minds all the time. State aid is possible; it has been done by other countries. Please consider it.

I am more than happy to meet the hon. Lady to explain to her the state aid rules and to bust some myths. She must be assured that the problem is one of over-consumption across the world. These are harsh economic realities, and although I wish I had a magic wand, no Government can set the price of steel. The price of slab has almost halved in 12 months. Hardly anybody is making a profit, and no Government can solve that. She can be assured that the Government are doing everything they can to support the steel industry in this country. Where we cannot support it—as we have unfortunately found in Redcar—we support those workers into new jobs.

The Minister referred several times to the global steel market, and we know that the dumping of certain Chinese steel products has played a part in the situation at Redcar and set a worrying precedent for all other manufacturing industries, including high-tech. Will she confirm that the Government will look to use anti-dumping measures in other situations, just as they have supported their use in this instance?

It was, I think, a first when a clear ministerial direction was given that we should vote in favour of anti-dumping measures in the European Commission, and we did that. Last week we abstained from another vote, and I am more than happy to explain to my hon. Friend in more detail why we did that—Mr Speaker, quite rightly, wants me to keep my remarks short. There was a good reason for that abstention, because by doing so we were actually voting in favour of supporting the British steel industry.

More than 20% of the people affected by this issue are from Middlesbrough, as they know only too well. Like me, they heard the Secretary of State say that he does not like industrial strategy. They know exactly what those words mean—[Interruption.] It is no good the Minister whingeing, because that is what the Secretary of State said, and this is how it impacts on people. The Minister hides behind state aid rules, but she or the Secretary of State could intervene if they were minded to. There is regional and environmental aid. Italy, France and Germany have stepped up, but this Government have completely lifted the white flag and surrendered. The people of Teesside will never forgive them for that and for having to spend £1.1 billion to clean the place up. It is an absolute utter disaster, and the Government should be ashamed of themselves.

The hon. Gentleman was at the meeting—he wanted to come to it and I said he was more than welcome to attend—and he knows that nobody put up a white flag. He is not stupid, and he knows the reality—[Interruption.] I am not patronising; I am reminding the hon. Gentleman, because he is intelligent and he knows, that the price of steel has almost halved. We are not hiding behind state aid rules. I challenge him to tell me what we could do that is within the state aid rules, and I will have a look at that. We have explored everything.

I recognise that the closure will have a real impact on the community. Redcar is a great part of the world and has a really skilled workforce, and the Government have taken pragmatic steps to try to assist in a difficult situation. Does my right hon. Friend agree that there are benefits to undertaking more proactive reviews of large sites in industries that are going through transformational change—including diversification initiatives, and considering alternative uses for sites—just as the Minister for Life Sciences is initiating in the pharmaceutical sector?

I am very grateful to my hon. Friend for his comments and for his question. I very much agree with him. We have to take an honest and realistic approach to all these matters, looking at conditions and at events we actually have no control over. There are, however, many things we can do. To say that we do not have a strategy is just ludicrous, because we absolutely do have one.

With regard to the £80 million in support funding, apart from the disgraceful issue of statutory redundancies being paid out of it, when will people actually get some real money in their hands? People have not been paid for up to eight weeks now. Apart from retraining, what they need is money to buy food and pay bills before this tragedy turns into an utter disaster for those families.

Unfortunately, the hon. Lady is right when she talks about the people in the supply chain who have not been paid because of their absolute determination to try to support SSI. One of the things we absolutely looked at was whether there was anything we could do to help them. At the moment, we cannot find any way to help people along the supply chain who have not been, but who should have been, paid. It was known that the redundancies were part of the package of £80 million, but we will have to agree to disagree on that. [Interruption.] Well, I certainly said it in the media, so perhaps they did not listen to the local television. In any event and most importantly, we are determined to make sure that it is not just the workforce at SSI Redcar who benefit from the package, but that it goes through the supply chain. We know there are many thousands more who suffer because of this liquidation.

Like all Members in this House, I feel exceptionally sorry for the people of Redcar. I know the Corby steelworkers send their very best wishes. Has the Minister received representations from any other sites that perhaps find themselves in a similarly perilous position? Will she promise to continue to engage with the industry and do everything she can to help?

It is not a secret that we have a really serious crisis in the British steel industry. We identified that when we had our very good Back-Bench debate a few weeks ago. We are holding the steel summit precisely for the reasons my hon. Friend has given. We are very keen to talk to everybody, to explore all options and to do everything we can. As the Prime Minister said, steel is a vital industry. We are determined to continue to do everything we can to support it.

The SSI closure is a tragedy for Redcar, but yesterday’s announcement has repercussions far beyond the boundaries of that town. The snuffing out of the blast furnace and coke works puts a pillow over and suffocates the entire UK steel industry and a large part of the manufacturing supply chain. It will no doubt contribute to that sector’s death. What is the Minister doing not just to retrain staff but to maintain and preserve this efficient industrial asset, maintaining and preserving that capability and knowledge to ensure that competitiveness throughout our manufacturing and supply chain sector is not lost forever?

I absolutely agree with the hon. Gentleman. I absolutely know and recognise the importance of the manufacturing sector. I have already used the words the Prime Minister used in recognition of the vital part that steel plays in our manufacturing, and indeed in the country’s, whole industrial base. We absolutely want to support it. That is one of the reasons why we are having the summit on Friday. It is absolutely understood and accepted that it would be wrong to lose steel—the manufacturing, rolling, pressing and everything else of steel in this country—but we are where we are. At the moment, we have gross overcapacity. That is the tragedy, as prices continue to fall.

Clearly, what has happened in Redcar is a terrible blow to its local economy. In northern Lincolnshire, our economy is very dependent on the future of the Scunthorpe works. It is clearly important that we maintain steel manufacturing capacity in the country. Will the Minister give an assurance that the Government will redouble their efforts to ensure that the Scunthorpe works continues?

Let me make it clear: I will continue to do everything we can to keep the steel industry going in this country. I am looking forward to meeting my hon. Friend later and I am going to Rotherham on Monday to meet people there. I will continue to meet, go around and visit. That is part of our determination to do everything we can to support this vital industry.

High carbon taxes and energy costs played a major role in SSI failing. Many other industries across our country are facing the self-same issues. Hundreds of my constituents lost their jobs on Teesside last week. How many more jobs have to be lost before the Government change their policy and start to address these issues?

I think we fall out when we say it is “our” policy. We have all been agreed that we want a cleaner, greener world, but it comes at a price. As I said before, electricity prices and the cost of energy were not the reason. They did not help, but this is about the worldwide problem of over-production, under-consumption and a fall in the price of steel by up to a half of what it was 12 months ago.

This is deeply regrettable and will have profound implications for the whole economy. I welcome the announcement of a steel summit to discuss the broader impacts on industry. Will the Minister say more about the organisations that will be involved?

Off the top of my head, those attending will be—as you might imagine, Mr Speaker—steel owners, manufacturers, the steel trade industry itself, trade unions, local Members of Parliament and Ministers from relevant Departments. I cannot remember now, but I think we have a couple of other people coming along to provide an independent assessment of the future of the steel industry. I do not want the summit to be too big; otherwise it will just turn into a grand talking shop. That is the one thing we do not want. I hope we will have all the key people there.

My words could never convey to the Minister the sense of abandonment that is felt in communities throughout the Tees Valley. She stands there as if she has had no choices to make. Why can we not mothball this site? It would cost £30 million. Last time Redcar was in this position it took three years to find a solution. This Government are giving it only days. Why?

Because the official receiver has come to the conclusion—[Interruption.] No, we cannot hide behind the fact that the official receiver is in charge. The official receiver has said he cannot find a buyer. The hon. Lady says it is a mere £30 million. I am sorry, but is that for six months, 12 months or 18 months? How would she justify that to her constituents? It is not Government money, but her constituents’ money. Let me make it very clear: if we do it for Redcar, then do we not do it for every other industry or business in our country that, unfortunately, cannot find a buyer for its products?

May I, on behalf of the Scunthorpe steel community, express solidarity and support for the Teesside steel community at this very difficult time? When Jaguar Land Rover was in significant difficulty and very challenged, the then Labour Government stepped in and intervened. Jaguar Land Rover is now a byword for success. When will the Conservative Government step in and intervene so that steel can be the byword for success in the future that it has been in the past?

The hon. Gentleman knows we have done everything we can. He also knows that the state aid rules on steel are the toughest. I am more than happy to go through them with the hon. Gentleman to see whether he can find me a way of doing what he says he wants us to do.

We have to be frank today that the Redcar tragedy casts a dark pall over the steel summit on Friday. Will the Minister say to the stakeholders, and to others in the industry who will be attending and who are struggling with very difficult times, what she will come up with that is new so that it will not be just a talking shop? Does she, crucially, have the backing of the Chancellor, the Prime Minister and her own Secretary of State to take the actions that matter?

Let me deal with the last point first. I repeat what the Prime Minister said: this is a vital industry that we will continue to support. So yes is the short answer to that question. The hon. Gentleman knows that the state aid rules are the state aid rules. This idea or myth that other countries are doing magic things in breach of the state aid rules without any comeback is just that—an absolute myth.

The hon. Gentleman also forgets—I have to repeat it—that the price of slab has almost halved in the last 12 months. We have over-production and under-consumption across the world, and we are 25% short of where we were before 2009. If we had a magic wand, we perhaps would all want to do these things, but in the harsh reality of the world we are in, we cannot give £1 billion of taxpayers’ money a year, which is what we estimated it would cost, to keep the steel industry where it is today. He cannot justify that to his constituents. That is the reality.

May I place on the record the sympathy of the people of south Yorkshire for the people of Redcar? Of course, people in south Yorkshire know what it is like to see thousands of jobs go at a stroke.

The UK steel industry faces volatile times. The Minister has said today she understands that manufacturing as a whole will be damaged if the UK steel industry goes under, and it is under serious threat. At the steel summit on Friday—in Rotherham, by the way, not Sheffield—will she please bring forward firm proposals for UK Government support for the steel industry? Otherwise it will just be a talking shop. She needs to take responsibility and bring forward firm proposals that we can all talk seriously about on Friday.

I am grateful for the hon. Lady’s comments, but I can assure her that I take full responsibility for the importance of this sector and will do everything I can to make sure we support it.

Is the Minister aware that here we are, on 13 October, about three months since the general election, and we are now beginning to witness the true face of Toryism in practice? We heard for several weeks the story about looking after the working man. We heard the story about the living wage. Now that they have been tested, the Government have decided to hand over the Redcar steelworks lock, stock and barrel, just as the previous Tory Government did at Consett, Corby and many other places. We are witnessing today the true face of Toryism. It has only taken them three months to appear as they really are. This was the day when Osborne’s northern powerhouse strategy died its death.

And the question is? There was no question. Just standing up and making speeches that do not offer a solution—

So have I. [Interruption.] You know what, that is so out of order. [Interruption.] Well, I do. I find it offensive and sexist, and the hon. Gentleman should know better. I know he has a bigger majority than me, but in Broxtowe more people voted for me than for him in Bolsover. He needs to understand that there is under-consumption of steel in the world. The price of steel has almost halved. Fine words are not enough. Realism and action are required. We have to live in the real world, not the fantasy world of the ’60s.

It has been suggested that improper words were used. I say to the Minister and the House that I can respond only to what I hear, and I did not hear anything. A Minister on the Treasury Bench suggested that something improper was said, but I have to deal with the here and now. The Minister has had her say, and we will now continue with questions.

The Back-Bench debate secured by my hon. Friend the Member for Redcar (Anna Turley) was held shortly before the trip to China, which took place amid much fanfare. The Minister pledged to go to China and lobby strongly against the massive dumping of Chinese steel in our market. May we have a detailed response about what was secured as a result of those discussions?

I had a number of discussions, and I raised with the Chinese the fact that there is now a growing demand for protectionism, especially in the EU, because of these various allegations—not just on steel—of Chinese dumping. I also had discussions about the future of the Chinese economy, including its steel economy, and whether any change in their policy was expected. We were informed that things would not change, which I am sure the hon. Gentleman will agree was unfortunate, and that they would continue to produce steel in this way. That economy, although growing, is not growing as much as it could, so I am afraid that there is not much hope there. However, we continue to make the case.

I echo Members across the Chamber in saying that my heart dropped when I heard what had happened in Redcar and Teesside during the recess. The hon. Member for Redcar (Anna Turley) has dealt with the matter very well, against all the odds. Having listened to the mealy-mouthed excuses from the Government Front Bench, I would like to remind the Minister that while her Government should have been acting to protect British industry, Mr Chancellor was off wooing the Chinese. What representations did her Government make to Chinese steel over the upcoming HS2 contracts?

These things are all in the future. I can assure the hon. Lady that everybody in the Government wants to make sure that, when the day comes and we look to buy the rails, it is British steel that is bought. I also remind her, following our debate on this, that it would be helpful if the Scottish Government made sure that in their projects they bought Scottish steel.

My father and many others in my family are proud Teessiders, so I know exactly the devastation that this will cause to local jobs, the local economy and the UK steel industry. I also want to pay tribute to the former MP for Redcar, Ian Swales, who did a wonderful job in the last Parliament. The Liberal Democrats fully support the cross-party campaign. Will the Minister listen to the Liberal Democrat leader and immediately commission a cross-departmental ministerial committee to talk about this matter? This must happen straightaway, before these flames die out and the plant is killed forever, which must not happen. Over the next few days, she must do everything she can and look at all the possible options to save this plant.

Yes, that committee, which has already been formed, will meet this afternoon. Everybody seems to have forgotten, however, that Redcar unfortunately was mothballed under the last Labour Government and that the furnaces were restarted under the coalition Government. [Interruption.]

Order. The hon. Member for Blyth Valley (Mr Campbell) must calm himself. I am sure he wishes to hear his colleague, Mr Wes Streeting.

The fate of the Redcar steel industry and the effect on communities on Teesside demonstrate the consequences of a hands-off economic policy and the lack of an industrial strategy. May I press the Minister on the consequences for people on Teesside? She has been asked again and again by colleagues about the statutory redundancy payments they will receive. The hand-to-mouth existence of the plant she describes is nothing next to the hands-to-mouth existence that those people now face. Will she give an assurance that she will consider what more the Government can do to make sure that people receive more than the statutory redundancy package?

Saudi Penal System

(Urgent Question): To ask the Secretary of State if he will withdraw from the contract for training needs analysis with the Saudi penal system in the light of recent concerns, particularly the cases of Mohammed al-Nimr, Raif Badawi and Karl Andree?

I thank the hon. Gentleman for his question. It is important that the resources of the Ministry of Justice are targeted at our programme of domestic public service reform, so, as has previously been announced, we have wound up the work that Just Solutions International, the commercial arm of the National Offender Management Service, has been engaged in. This is in line with our ambition to ensure that the Department’s resources are firmly focused on our domestic priorities. On the commercial work that Just Solutions International had been engaged in with Saudi Arabia, as the House is aware, the final bid was submitted this April, but discussions have been going on since then. We have now reviewed the issue further and decided to withdraw our bid.

The power of the urgent question. What a pity, though, that once again a Secretary of State has to be dragged before the House and that what he said was not volunteered by way of ministerial statement. The Secretary of State is trying to establish a reputation as a prison reformer, and now perhaps as a champion of human rights as well. That would be highly commendable and would be better if our prisons were not in a downward spiral of violence, idleness and despair and if the right hon. Gentleman were not intent on repealing the Human Rights Act.

On 25 September, the Leader of the Opposition wrote to the Prime Minister, raising the case of Mohammed al-Nimr. The Secretary of State will be aware that Mr al-Nimr was 17 when he was arrested for peaceful protest and sentenced to death by beheading and then crucifixion. Three weeks later, the Leader of the Opposition is yet to receive a response. That letter also asked for the ending of the contract, so perhaps that response could now be forthcoming. More importantly, Mr al-Nimr remains in solitary confinement, awaiting execution.

The case of Raif Badawi—a blogger sentenced to 1,000 lashes and 10 years in prison for criticising the Saudi regime—is similarly shocking, and today we add to the list the case of Mr Karl Andree. Mr Andree is a 74-year-old British citizen from south London who has been sentenced to 350 lashes by the Saudi Government after spending more than a year in custody. I do not know whether the Secretary of State heard the interview on the “Today” programme this morning with Mr Andree’s youngest son, Simon, which was all the more powerful for being rational and understated. He said there was no doubt in the family’s mind that 350 lashes would kill his father, who needs medical care for his cancer, which he has had three times, and his asthma. Simon said:

“I think my father is at the bottom of the list and the bottom of the pecking order”,

when it comes to the Government. He continued: